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圈套器冷切除术与热切除术在治疗结直肠小息肉安全性与有效性的回顾性对比研究
Cold versus hot snare polypectomy in treatment of small colorectal polyps: a retrospective study on safety and efficacy
- 陆军军医大学学报 2022年44卷第23期 页码：2429-2434
- 作者机构：
400038 重庆，陆军军医大学(第三军医大学)第一附属医院消化内科
- 作者简介：
[吉清, E-mail: 1013364419@qq.com JI Qing, E-mail: 1013364419@qq.com
- 基金信息：
DOI：10.16016/j.2097-0927.202206038
中图分类号： R181.32;R730.56;R735.35收稿：2022-06-07，
修回：2022-07-05，
纸质出版：2022-12-15
- 稿件说明：
移动端阅览
何金龙, 陈磊, 陈静, 等. 圈套器冷切除术与热切除术在治疗结直肠小息肉安全性与有效性的回顾性对比研究[J]. 陆军军医大学学报, 2022,44(23):2429-2434.
Jinlong HE, Lei CHEN, Jing CHEN, et al. Cold versus hot snare polypectomy in treatment of small colorectal polyps: a retrospective study on safety and efficacy[J]. Journal of Army Medical University, 2022, 44(23): 2429-2434.
何金龙, 陈磊, 陈静, 等. 圈套器冷切除术与热切除术在治疗结直肠小息肉安全性与有效性的回顾性对比研究[J]. 陆军军医大学学报, 2022,44(23):2429-2434. DOI： 10.16016/j.2097-0927.202206038.
Jinlong HE, Lei CHEN, Jing CHEN, et al. Cold versus hot snare polypectomy in treatment of small colorectal polyps: a retrospective study on safety and efficacy[J]. Journal of Army Medical University, 2022, 44(23): 2429-2434. DOI： 10.16016/j.2097-0927.202206038.
摘要
目的
2
评价内镜下圈套器冷切除术(cold snare polypectomy
CSP)与热切除术(hot snare polypectomy
HSP)治疗结直肠小息肉的安全性与有效性。
方法
2
收集2020年1月1日到2021年8月31日陆军军医大学第一附属医院收治的3 750例行结直肠小息肉内镜下治疗患者的临床资料，包括CSP组1 796例，HSP组1 954例。回顾性分析两组患者一般资料及钛夹使用数量、使用率、完整切除率、标本回收率、迟发性出血发生率、穿孔率、腹部不适发生率。
结果
2
两组患者一般资料(年龄、性别、BMI、息肉数量、大小、部位、形态、病理类型)和合并基础疾病(高血压、糖尿病)分布情况比较差异均无统计学意义(
P
>
0.05)，CSP组钛夹使用率及平均使用数量均显著低于HSP组[11.19%
vs
19.55%，
P
<
0.001；(0.16±0.49)
vs
(0.27±0.63)枚，
P
<
0.001
]
；CSP组完整切除率与HSP组差异无统计学意义(93.99%
vs
95.04%，
P
=0.158)；CSP组标本回收率优于HSP组(99.55%
vs
98.26%，
P
<
0.001)；CSP组迟发性出血发生率明显低于HSP组(0.06%
vs
0.46%，
P
=0.037)；CSP组未发生穿孔，HSP组发生1例(0.05%)，二者差异无统计学意义(
P
=0.521)；CSP组腹部不适发生率明显低于HSP组(4.18%
vs
9.31%，
P
<
0.001)。
结论
2
CSP在治疗结直肠小息肉中与HSP相比，钛夹使用率及平均使用数量更低，标本回收率更高，且并发症发生率更低，是一种安全有效的治疗方式，值得在临床中推广应用。
Abstract
Objective
2
To evaluate the safety and efficacy of cold snare polypectomy (CSP) and hot snare polypectomy (HSP) in the treatment of small colorectal polyps.
Methods
2
The clinical data of 3 750 patients who underwent endoscopic polypectomy for small colorectal polyps in our hospital from January 1
2020 to August 31
2021 were collected and analyzed retrospectively. There were 1 796 cases assigned into CSP group and 1 954 cases into HSP group. Their general data
number and utilization rate of titanium clips
complete resection rate
specimen recovery rate
incidence of delayed bleeding
perforation rate and incidence of abdominal discomfort were analyzed and compared between the 2 groups.
Results
2
There we
re no significant differences in the general data (age
gender
BMI
and number
size
location
morphology and pathological type of polyps) and in proportions of comorbidities (hypertension and diabetes) between the 2 groups (
P
>
0.05). The utilization rate and average number of clips used were significantly lower in the CSP group than the HSP group (11.19%
vs
19.55%
P
<
0.001; 0.16±0.49
vs
0.27±0.63
P
<
0.001). No statistical difference was found in the complete resection rate between the 2 groups (93.99%
vs
95.04%
P
=0.158). The CSP group had higher specimen recovery rate (99.55%
vs
98.26%
P
<
0.001)
lower incidence of delayed bleeding (0.06%
vs
0.46%
P
=0.037) and incidence of abdominal discomfort (4.18%
vs
9.31%
P
<
0.001) when compared with the HSP group. In terms of perforation
no occurrence was observed in the CSP group and 1 case (0.05%) in the HSP group
though no statistical difference (
P
=0.521).
Conclusion
2
When compared with HSP
CSP has advantages of lower utilization rate and less number of titanium clips
higher specimen recovery rate
and lower incidence of complications in the treatment of small colorectal polyps. It is a safe and effective treatment
and worthy of clinical application.
关键词
Keywords
references
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