Suzuki Takuto, Kitagawa Yoshiyasu, Nankinzan Rino, Yamaguchi Taketo
Department of Endoscopy, Chiba Cancer Center, Chiba, Japan.
Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan.
Endosc Int Open. 2020 Jan;8(1):E87-E91. doi: 10.1055/a-1035-9411. Epub 2020 Jan 8.
Cold polypectomy is becoming popular for treatment of colon polyps due to its safety and convenience, but there is still the problem of tumor remnants. Because linked color imaging (LCI) improves polyp visibility, cold polypectomy under LCI is anticipated to reduce the tumor remnant rate. Therefore, we investigated the usefulness of this procedure. Fifty patients scheduled to undergo cold polypectomy for treatment of colon polyps < 10 mm and assumed to be adenomas were registered prospectively. After performing cold snare polypectomy (CSP) under LCI, biopsy was performed at two resection margin sites for each polyp to determine the tumor remnant rate. A total of 145 lesions were treated by CSP. Of the 139 lesions in which polyps were retrievable and diagnosed as adenomas pathologically, one lesion was recognized as a remnant adenoma on biopsy (remnant rate: 0.7 % [95 % CI: 0.0-4.4]). This remnant rate was extremely low. Treatment results were extremely promising given that en bloc resection, post-procedure bleeding, and perforation rates were 100 %, 0 %, and 0 %, respectively. Cold snare polypectomy under LCI may be an effective treatment method capable of reducing the tumor remnant rate. This trial was approved by our Institutional Ethics Committee and registered at the University Hospital Medical Information Network (UMIN 000033690).
由于其安全性和便利性，冷圈套息肉切除术在结肠息肉治疗中越来越受欢迎，但仍存在肿瘤残留问题。由于联动成像（LCI）可提高息肉的可视性，因此预计LCI下的冷圈套息肉切除术可降低肿瘤残留率。因此，我们研究了该手术的有效性。前瞻性登记了50例计划接受冷圈套息肉切除术治疗直径<10mm且疑似腺瘤的结肠息肉患者。在LCI下进行冷圈套息肉切除术（CSP）后，对每个息肉的两个切除边缘部位进行活检，以确定肿瘤残留率。总共145个病变接受了CSP治疗。在139个可取出息肉且病理诊断为腺瘤的病变中，有1个病变在活检时被识别为残留腺瘤（残留率：0.7%[95%CI：0.0-4.4]）。该残留率极低。鉴于整块切除率、术后出血率和穿孔率分别为100%、0%和0%，治疗结果非常令人满意。LCI下的冷圈套息肉切除术可能是一种能够降低肿瘤残留率的有效治疗方法。本试验经我院伦理委员会批准，并在大学医院医学信息网络注册（UMIN 000033690）。
