多环套扎法作为一种加速结直肠内镜黏膜下剥离术的新型牵引方法。
Multiloop as a novel traction method in accelerating colorectal endoscopic submucosal dissection.
机构信息
Center for Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan.
Center for Translational Research, The Institute of Medical Science Hospital, The University of Tokyo, Tokyo, Japan.
出版信息
Gastrointest Endosc. 2020 Jan;91(1):185-190. doi: 10.1016/j.gie.2019.08.042. Epub 2019 Sep 12.
BACKGROUND AND AIMS
Traction methods have been reported to speed up endoscopic submucosal dissection (ESD). We used the multiloop (M-loop) method as a traction method for colorectal ESD and recorded the submucosal dissection time (SDT) and submucosal dissection speed (SDS).
METHODS
From January to August 2018, we used the M-loop method for colorectal ESD procedures and timed the duration and recorded the outcomes. Two experts and eight nonexperts performed the procedures, which were carried out at a tertiary endoscopic center in Japan.
RESULTS
A total of 50 patients were treated by colorectal ESD using the M-loop method. The mean SDT was 42.1 ± 4.16 minutes and the mean SDS was 28.0 ± 2.89 mm/minutes. The mean SDS was 38.9 ± 6.9 mm/minutes for experts and 25.3 ± 3.1 mm/minutes for nonexperts. En bloc resection was achieved in 100% of cases. There were 3 adverse events and unfavorable outcomes.
CONCLUSIONS
Traction by the M-loop method improved SDS in colorectal ESD. The method can be an effective tool to assist colorectal ESD. Further evaluation of the usefulness of the M-loop method is required in direct comparison with conventional ESD.
背景与目的
已有报道称牵引方法可加速内镜黏膜下剥离术（ESD）。我们使用多环（M 环）方法作为结直肠 ESD 的牵引方法，并记录黏膜下剥离时间（SDT）和黏膜下剥离速度（SDS）。
方法
2018 年 1 月至 8 月，我们在日本的一家三级内镜中心使用 M 环法进行结直肠 ESD 手术，并计时和记录结果。两位专家和八位非专家进行了这些手术。
结果
共 50 例患者接受 M 环法结直肠 ESD 治疗。平均 SDT 为 42.1 ± 4.16 分钟，平均 SDS 为 28.0 ± 2.89mm/min。专家的平均 SDS 为 38.9 ± 6.9mm/min，非专家为 25.3 ± 3.1mm/min。100%的病例均达到整块切除。有 3 例不良事件和不良结局。
结论
M 环法的牵引提高了结直肠 ESD 的 SDS。该方法可以成为辅助结直肠 ESD 的有效工具。需要与传统 ESD 进行直接比较，进一步评估 M 环法的有用性。
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