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冷内镜黏膜切除术对最大径<20mm结直肠侧向发育型肿瘤的临床疗效
Clinical efficacy of cold snare endoscopic mucosal resection for <20 mm colorectal laterally spreading tumor
收稿日期:  
DOI:10.3969/j.issn.1673-9701.2024.19.005
关键词:  结直肠侧向发育型肿瘤  内镜黏膜切除术  冷内镜黏膜切除术  临床疗效
Key Words:
基金项目:浙江省湖州市科学技术局资助项目(2023GYB20)
作者单位
何彤云 湖州市第一人民医院麻醉科浙江湖州 313000 
陆会飞 湖州市第一人民医院消化内科浙江湖州 313000 
胡丕伟 湖州市第一人民医院病理科浙江湖州 313000 
王新强 湖州市第一人民医院麻醉科浙江湖州 313000 
邱雷 湖州市第一人民医院消化内科浙江湖州 313000 
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摘要:目的 比较冷内镜黏膜切除术(cold snare endoscopic mucosal resection,CS-EMR)与常规内镜黏膜切除术(endoscopic mucosal resection,EMR)治疗最大径<20mm结直肠侧向发育型肿瘤(colorectal laterally spreading tumor,CLST)的临床疗效。方法 选取2020年1月至2022年6月湖州市第一人民医院收治的行内镜下切除治疗CLST患者248例,根据随机数字表法将其分为EMR组和CS-EMR组,每组各124例。统计比较两组患者的一般资料、病灶特征、手术相关指标、并发症发生率。结果 两组患者的病灶整块切除率、完全切除率及术后复发率比较差异均无统计学意义(P>0.05)。CS-EMR组患者的手术操作时间、住院时间均显著短于EMR组,钛夹数量、住院费用均显著少于EMR组,术中出血、迟发性出血及迟发性穿孔的发生率均显著低于EMR组(P<0.05)。结论 在最大径<20mm CLST治疗中,CS-EMR既保留手术相关并发症少的优点,又具有与EMR相似的治疗效果,且减轻患者的费用负担,值得临床借鉴与推广。
Abstract:Objective To compare the clinical efficacy of cold snare endoscopic mucosal resection (CS-EMR) with conventional endoscopic mucosal resection (EMR) in the treatment of <20 mm colorectal laterally spreading tumor (CLST). Methods A total of 248 CLST patients undergoing endoscopic resection treated in the First People’s Hospital of Huzhou from January 2020 to June 2022 were selected and divided into EMR group and CS-EMR group according to random number table method, with 124 cases in each group. The general data, focal features, surgical indicators and complication rate of two groups were statistically compared. Results There were no significant differences in en bloc resection rate, complete resection rate and postoperative recurrence rate between two groups (P>0.05). The operation time and hospital stay in CS-EMR group were significantly shorter than those in EMR group, the number of titanium clips and hospitalization costs were significantly lower than those in EMR group, and the incidence of intraoperative bleeding, delayed bleeding and delayed perforation were significantly lower than those in EMR group (P<0.05). Conclusion In treatment of CLST with a maximum diameter of <20mm, CS-EMR not only retains the advantages of fewer surgery-related complications, but also has similar therapeutic effect as EMR, and reduces the cost burden of patients, which is worthy of clinical reference and promotion.
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