Division of Gastroenterology, ASL NA5, Hospital A. Maresca, Torre del Greco, Italy.
Gastrointest Endosc. 2009 Nov;70(5):1018-22. doi: 10.1016/j.gie.2009.04.041. Epub 2009 Jul 15.
Endoscopic resection of colorectal nonpolypoid lesions requires adequate submucosal lifting of the lesion.
To evaluate a self-assembled hydro-jet system for tissue elevation to improve endoscopic resection of colorectal nonpolypoid lesions.
Prospective study.
Single-center teaching hospital.
Efficacy and safety of the hydro-jet system and rate of complete resection.
The system was clinically applied in 31 patients to remove a total of 34 lesions throughout the colon. An adequate submucosal fluid cushion was achieved in all but 1 case without any lifting-associated complications. Complete endoscopic resection was possible in all 33 lifted lesions by using a snare. The size of the resected lesions ranged from 7 to 60 mm. Major intraprocedure bleeding occurred in only 1 case. No perforation or late bleeding was recorded. Histological examination showed a selective accumulation of fluid in the submucosa with edema and dissociation of submucosal structures, with no damage to the muscularis mucosa and very limited "burn effect" hampering assessment of radial margins.
Lack of controls.
This inexpensive system allows safe and rapid submucosal lifting of colorectal nonpolypoid lesions to assist endoscopic resection.
内镜切除结直肠无蒂病变需要充分提升黏膜下层的病变。
评估一种自组装水喷射系统用于组织提升以改善结直肠无蒂病变的内镜切除。
前瞻性研究。
单中心教学医院。
水喷射系统的疗效和安全性以及完全切除率。
该系统在 31 例患者中进行了临床应用，总共切除了 34 个结肠病变。除了 1 例没有提升相关并发症外，所有病例均实现了充分的黏膜下液垫。通过圈套器，所有 33 个提升的病变均能实现完全内镜切除。切除病变的大小范围为 7 至 60mm。仅 1 例发生术中大出血。无穿孔或迟发性出血。组织学检查显示，在黏膜下层有选择性地积聚液体，伴有水肿和黏膜下层结构分离，而对黏膜肌层没有损伤，并且对评估径向边缘有非常有限的“烧伤效应”妨碍。
缺乏对照。
这种廉价的系统允许安全、快速地提升结直肠无蒂病变，以辅助内镜切除。
