套扎夹闭法联合预弯技术在结直肠内镜黏膜下剥离术中的应用效果。
Impact of the clip and snare method using the prelooping technique for colorectal endoscopic submucosal dissection.
机构信息
Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
出版信息
Endoscopy. 2016 Mar;48(3):281-5. doi: 10.1055/s-0034-1393241. Epub 2015 Oct 30.
BACKGROUND AND STUDY AIM
Endoscopic submucosal dissection (ESD) is more difficult to perform for colorectal tumors, but the use of traction to facilitate direct submucosal layer visualization is a promising method to reduce procedure times and complication rates. This study aimed to evaluate the efficacy and safety of the clip and snare method (CSM) with a prelooping technique (PLT) for colorectal tumors.
PATIENTS AND METHODS
A total of 140 colorectal tumors were treated: 17 using the CSM with PLT; 123, used as controls, by standard ESD without these techniques. Therapeutic efficacy and safety were retrospectively assessed.
RESULTS
All tumors were successfully resected en bloc using the CSM with PLT. Multisegment resection was found in four tumors in the control group. There was a significant difference in the procedure time between the patients in the CSM with PLT group and the control group (45.6 vs. 70.1 minutes; P = 0.047). There were no significant differences in the complication rates (5.9 % vs. 8.1 %; P = 1.00).
CONCLUSIONS
The CSM with PLT was effective and safe in this study.
背景与研究目的
内镜黏膜下剥离术（ESD）在结肠直肠肿瘤中更难进行，但使用牵引来促进直接黏膜下层可视化是一种有前途的方法，可以减少手术时间和并发症发生率。本研究旨在评估夹套和圈套方法（CSM）联合预环技术（PLT）在结肠直肠肿瘤中的疗效和安全性。
患者和方法
共治疗 140 例结肠直肠肿瘤：17 例采用 CSM 联合 PLT；123 例作为对照组，采用无这些技术的标准 ESD。回顾性评估治疗效果和安全性。
结果
所有肿瘤均采用 CSM 联合 PLT 整块切除。对照组中有 4 例肿瘤为多节段切除。CSM 联合 PLT 组和对照组的手术时间有显著差异（45.6 分钟比 70.1 分钟；P=0.047）。并发症发生率无显著差异（5.9%比 8.1%；P=1.00）。
结论
在本研究中，CSM 联合 PLT 是有效且安全的。
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