使用牵引装置的造袋方法在内镜黏膜下剥离治疗残留或复发性结直肠病变中的疗效。
Efficacy of the pocket-creation method with a traction device in endoscopic submucosal dissection for residual or recurrent colorectal lesions.
作者信息
Ide Daisuke, Ohya Tomohiko Richard, Ishioka Mitsuaki, Enomoto Yuri, Nakao Eisuke, Mitsuyoshi Yuki, Tokura Junki, Suzuki Keigo, Yakabi Seiichi, Yasue Chihiro, Chino Akiko, Igarashi Masahiro, Nakashima Akio, Saruta Masayuki, Saito Shoichi, Fujisaki Junko
机构信息
Department of Gastroenterology, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan.
出版信息
Clin Endosc. 2022 Sep;55(5):655-664. doi: 10.5946/ce.2022.009. Epub 2022 May 31.
BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions.
METHODS
We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 lesions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events.
RESULTS
En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group.
CONCLUSION
PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.
背景/目的：由于严重纤维化，对不完全切除术后残留或复发性结直肠病变进行内镜黏膜下剥离术（ESD）具有挑战性。本研究旨在比较使用带牵引装置（TD）的造袋法（PCM）与传统ESD治疗残留或复发性结直肠病变的疗效。
方法
我们回顾性研究了72例使用ESD切除残留或复发性结直肠病变的患者。总体而言，分别使用带TD的PCM和传统ESD方法切除了31个和41个病变。我们分别比较了带TD的PCM组和传统ESD组的患者背景和治疗结果。主要终点是整块切除率和R0切除率。次要终点是剥离速度和不良事件发生率。
结果
所有使用带TD的PCM的病例均可行整块切除，但传统ESD的病例中有22%未能整块切除。带TD的PCM和传统ESD的R0切除率分别为97%和66%。带TD的PCM组的剥离明显更快（13.0对7.9平方毫米/分钟）。每组各有1例患者发生穿孔和术后出血。
结论
带TD的PCM是治疗不完全切除术后残留或复发性结直肠病变的有效方法。
Zotero 插件