Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Cheonan Hospital, 23-20 Bongmyung-Dong, Cheonan, Choongnam, 330-721, Republic of Korea.
Department of Pathology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea.
Dig Dis Sci. 2018 Mar;63(3):775-780. doi: 10.1007/s10620-018-4918-6. Epub 2018 Jan 30.
BACKGROUND/AIMS: Submucosal injection with indigo carmine mixed solution can improve the delineation of colorectal neoplasia during endoscopic mucosal resection (EMR). Thus, the aim of this study was to evaluate the efficacy of submucosal injection with indigo carmine mixed solution during EMR of colorectal neoplasia.
This was a prospective, randomized, controlled study of a total of 212 neoplastic colon polyps (5-20 mm) subjected to EMR in a single tertiary university hospital. The patients were randomized into two groups according to whether or not indigo carmine mixed solution was used, and the complete resection rate (CRR) after EMR was evaluated.
A total of 212 neoplastic polyps (normal saline group, 115; indigo carmine group, 97) were successfully removed by EMR. There was no significant difference in the CRR (92.8 vs. 89.6%, p = 0.414) or macroscopic delineation (86.0 vs. 93.8%, p = 0.118) between the two groups. In a separate analysis of sessile serrated adenomas/polyps (SSAs/Ps), macroscopic delineation was better in the indigo carmine group than the normal saline group (87.5 vs. 53.8%), albeit not significantly (p = 0.103). In univariate analyses, the CRR was significantly related to polyp location, polyp morphology, macroscopic delineation, and pathologic findings. In a multiple logistic regression analysis, macroscopic delineation (odds ratio (OR), 7.616, p = 0.001) and polyp pathology (OR, 8.621; p < 0.001) were significantly associated with the CRR.
Submucosal injection with indigo carmine mixed solution did not improve the CRR or macroscopic delineation of EMR of colorectal neoplasias.
背景/目的：靛胭脂混合溶液黏膜下注射可提高内镜黏膜切除术（EMR）中结直肠肿瘤的边界描绘效果。因此，本研究旨在评估靛胭脂混合溶液黏膜下注射在结直肠肿瘤 EMR 中的疗效。
这是一项在一家三级大学医院进行的前瞻性、随机、对照研究，共纳入 212 例直径为 5-20mm 的结直肠息肉。根据是否使用靛胭脂混合溶液，将患者随机分为两组，并评估 EMR 后的完全切除率（CRR）。
共 212 例肿瘤性息肉（生理盐水组 115 例，靛胭脂组 97 例）成功行 EMR 切除。两组的 CRR（92.8% vs. 89.6%，p=0.414）或大体描绘（86.0% vs. 93.8%，p=0.118）无显著差异。在一项对无蒂锯齿状腺瘤/息肉（SSA/Ps）的单独分析中，靛胭脂组的大体描绘效果优于生理盐水组（87.5% vs. 53.8%），但无统计学意义（p=0.103）。单因素分析显示，CRR 与息肉位置、息肉形态、大体描绘和病理发现显著相关。多因素逻辑回归分析显示，大体描绘（比值比（OR），7.616，p=0.001）和息肉病理（OR，8.621；p<0.001）与 CRR 显著相关。
靛胭脂混合溶液黏膜下注射并不能提高结直肠肿瘤 EMR 的 CRR 或大体描绘效果。
