摘要
目的 探讨直径≤10 mm的无蒂结直肠息肉患者应用冷圈套切除术(cold snare polypectomy, CSP)与内镜下黏膜切除术(endoscopic mucosal resection, EMR)治疗的临床疗效。方法 选取2019年1月—2021年12月北京丰台右安门医院收治的120例无蒂结直肠息肉患者,根据手术方式将患者分为CSP组51例和EMR组69例。CSP组接受CSP手术治疗,EMR组接受EMR手术治疗。比较两组手术时间、术中出血量、住院时间和胃肠功能恢复时间;比较两组息肉组织学完整切除率、标本回收率、术中即刻出血率、术后延迟出血率;记录两组并发症发生情况;术后回访6个月,统计两组息肉复发情况。结果 CSP组手术时间、术中出血量、住院时间和胃肠功能恢复时间均明显短于EMR组(P<0.05);CSP组息肉组织学完整切除率、标本回收率分别为94.81%、91.11%,与EMR组的96.69%、95.04%无显著差异(P>0.05);CSP组术后即刻出血率为3.91%,与EMR组的5.88%无显著差异(P>0.05);CSP组术后延迟出血率为5.88%,显著低于EMR组的18.84%(P<0.05);CSP组并发症发生率和复发率为9.80%、3.92%,与EMR组的11.59%、4.35%无显著差异(P>0.05)。结论 与EMR术比,CSP治疗直径≤10 mm的无蒂结直肠息肉患者可缩短手术时间和住院时间,降低延迟性出血,息肉组织学完整切除率高,复发率低,安全性好。
Objective To explore the clinical curative effect of cold snare polypectomy(CSP) and endoscopic mucosal resection(EMR) on patients with sessile colorectal polyps with diameter of ≤10 mm. Methods A total of 120 patients with sessile colorectal polyps admitted to the hospital were enrolled between January 2019 and December 2021. According to different surgical methods, they were divided into CSP group(51 cases) and EMR group(69 cases). The operation time, intraoperative blood loss, hospitalization time, recovery time of gastrointestinal function, complete resection rate of polyp tissues, recycle rates of specimens, bleeding rate immediately after surgery and postoperative delayed bleeding rate were compared between the two groups. The occurrence of complications in both groups was recorded. All were followed up for 6 months to statistically analyze the recurrence of polyps. Results The operation time, intraoperative blood loss, hospitalization time and recovery time of gastrointestinal function in CSP group were significantly lower than those in EMR group(P<0.05). The complete resection rate of polyp tissues and recycle rate of specimens in CSP group were 94.81% and 91.11%, without significant difference compared with those in EMR group(96.69%, 95.04%)(P>0.05). There was no significant difference in bleeding rate immediately after surgery between CSP group and EMR group(3.91% vs 5.88%)(P>0.05). The postoperative delayed bleeding rate in CSP group was significantly lower than that in EMR group(5.88% vs 18.84%)(P<0.05). The incidence and recurrence rate of complications in CSP group were 9.80% and 3.92%, without significant difference compared with those in EMR group(11.59%, 4.35%)(P>0.05). Conclusion Compared with EMR, CSP can shorten operation time and hospitalization time, and reduce delayed bleeding in patients with sessile colorectal polyps with diameter of ≤10 mm, with high complete resection rate of polyp tissues, low recurrence rate and good safety.
作者
黄祎诺
李帅
杜娟
朱志元
HUANG Yi-nuo;LI Shuai;DU Juan;ZHU Zhi-yuan(Department of Gastroenterology,Beijing Fengtai You'anmen Hospital,Beijing 100069,China)
出处
《医药论坛杂志》
2022年第23期55-58,63,共5页
Journal of Medical Forum
