冷圈套器切除4~9mm结直肠息肉的临床研究

叶 睿, 刘 东亚, 刘 佳瑶, 许 亚聪, 杨 文义
河南大学第一附属医院

摘要


目的 探讨冷圈套器内镜下黏膜切除术（cold snare endoscopic mucosal resection， CS-EMR）与圈套器冷切除术（cold snare polypectomy，CSP）对直径4～9mm结直肠息肉患者的息肉完整切除率、并发症影响。方法 本研究为单中心回顾性研究，选取2022年1月至2024年1月在河南大学第一附属医院消化内科行结直肠息肉切除的284例患者作为研究对象，共切除498枚息肉，根据息肉切除术式不同分为CS-EMR组（140例，246枚息肉）和CSP组（144例，252枚息肉）。结果 纳入研究的284例患者，CS-EMR组息肉共246枚，CSP组息肉共252枚。CS-EMR组息肉总体切除率显著高于CSP组（95.1% vs 86.9%，P<0.05）；CS-EMR组6～7mm、8～9mm息肉切除率高于CSP组（95.4％和87.7％，92.2％和76.5％），差异均有统计学意义（P＜0.05）；近端结肠息肉切除率CS-EMR组更高（94.5% vs 83.3%，P<0.05），远端结肠无差异；无蒂或平坦息肉CS-EMR组切除率更优（97.9% vs 89%，P<0.05），亚蒂息肉无差异；CS-EMR组腺瘤和非腺瘤性息肉切除率均高于CSP组（83.8％和92.2％，90.2％和98.3％），差异均有统计学意义（P＜0.05）。CS-EMR组术中即时出血发生率低于CSP组（5.7％和12.3％），差异有统计学意义（P＜0.05）。两组患者均无术中即时穿孔及术后迟发性穿孔发生。结论 CS-EMR与CSP同样为治疗直径4～9mm结直肠息肉安全、有效的治疗方式，但CS-EMR息肉完全切除率更高，术中并发症发生率更低。

关键词


结直肠癌；圈套器冷切除术；冷圈套器内镜下黏膜切除术；结直肠息肉

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参考


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