Voudoukis Evangelos, Tribonias Georgios, Tavernaraki Aikaterini, Theodoropoulou Angeliki, Vardas Emmanouil, Paraskeva Konstantina, Chlouverakis Gregorios, Paspatis Gregorios A
Department of Gastroenterology, Benizelion General Hospital, Heraklion, Greece.
Department of Social Medicine, University of Crete, Heraklion, Greece.
Clin Endosc. 2015 Mar;48(2):136-41. doi: 10.5946/ce.2015.48.2.136. Epub 2015 Mar 27.
BACKGROUND/AIMS: Endoscopic mucosal resection (EMR) of large colorectal lesions is associated with increased procedural time. The objective of this study was to evaluate the effect of double-channel gastroscope (DCG) use on the procedural time of EMRs in the rectosigmoid area.
All EMRs for sessile or flat rectosigmoid lesions ≥2 cm performed between July 2011 and September 2012 were retrospectively analyzed.
There were 55 lesions ≥2 cm in the rectosigmoid area in 55 patients, of which 26 were removed by EMR using a DCG (DC group) and 29 by using an ordinary colonoscope or gastroscope (OS group). The mean size of the removed polyps, morphology, adverse effects, and other parameters were similar between the two groups. The mean procedural time was significantly lower in the DC group than in the OS group (24.4±18.3 minutes vs. 36.3±24.4 minutes, p=0.015). Moreover, in a subgroup of patients with polyps >40 mm, the statistical difference in the mean procedural time between the DC and OS groups was even more pronounced (33±21 minutes vs. 58.7±20.6 minutes, p=0.004).
Our data suggest that the use of a DCG in the resection of large nonpedunculated rectosigmoid lesions significantly reduces the procedural time.
背景/目的：大肠大病变的内镜黏膜切除术（EMR）与手术时间延长有关。本研究的目的是评估使用双通道胃镜（DCG）对直肠乙状结肠区域EMR手术时间的影响。
回顾性分析2011年7月至2012年9月期间对所有直径≥2 cm的直肠乙状结肠无蒂或扁平病变进行的EMR。
55例患者的直肠乙状结肠区域有55个直径≥2 cm的病变，其中26个通过使用DCG的EMR切除（DC组），29个通过使用普通结肠镜或胃镜切除（OS组）。两组切除息肉的平均大小、形态、不良反应及其他参数相似。DC组的平均手术时间显著低于OS组（24.4±18.3分钟对36.3±24.4分钟，p = 0.015）。此外，在息肉>40 mm的患者亚组中，DC组和OS组之间平均手术时间的统计学差异更为明显（33±21分钟对58.7±20.6分钟，p = 0.004）。
我们的数据表明，在切除直肠乙状结肠大的无蒂病变时使用DCG可显著缩短手术时间。
