术前牵引与按需牵引辅助结直肠内镜黏膜下剥离术的比较。
Comparison Between Preincision Traction and On-Demand Traction in Assisting Colorectal Endoscopic Submucosal Dissection.
机构信息
Digestive Endoscopy Center, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Gastroenterology, Shanghai Tenth People's Hospital Chongming Branch, Shanghai, China.
出版信息
Clin Transl Gastroenterol. 2022 Dec 1;13(12):e00539. doi: 10.14309/ctg.0000000000000539.
INTRODUCTION
Adequate exposure of the dissection site is very important for colorectal endoscopic submucosal dissection (ESD). We aimed to investigate the safety and efficacy of the preincision traction (PIT) method using an internal clip-with-spring device in comparison with the conventional on-demand traction (ODT) method in assisting colorectal ESD.
METHODS
This was a prospective nested case-control study. A total of 26 patients for PIT-ESD and other 26 patients for ODT-ESD were involved. Data on clinical characteristics and therapeutic outcomes were collected and analyzed.
RESULTS
The en bloc resection rate (both 100%) and curative resection rate (92.3% vs 96.2%) showed no significant difference between the 2 groups. Compared with ODT-ESD, PIT-ESD significantly reduced the procedure time (29.8 ± 18.4 vs 57.4 ± 33.7 minutes, P = 0.001) and submucosal injection volume (49.6 ± 32.3 vs 70.8 ± 37.6 mL, P = 0.034), decreased the rate of intraoperative bleeding (26.9% vs 57.7%, P = 0.025) and muscular injury (7.7% vs 34.6%, P = 0.038), and shortened the postoperative hospital stay (1.8 ± 0.8 vs 2.5 ± 1.2, P = 0.015).
DISCUSSION
The PIT method could significantly improve the safety and efficacy of colorectal ESD.
简介
充分显露解剖部位对于结直肠内镜黏膜下剥离术（ESD）非常重要。我们旨在研究使用内置夹-弹簧装置的预切开牵引（PIT）方法与传统按需牵引（ODT）方法辅助结直肠 ESD 的安全性和有效性。
方法
这是一项前瞻性嵌套病例对照研究。共纳入 26 例接受 PIT-ESD 的患者和 26 例接受 ODT-ESD 的患者。收集和分析了临床特征和治疗结果数据。
结果
整块切除率（均为 100%）和治愈性切除率（92.3% vs 96.2%）在两组之间无显著差异。与 ODT-ESD 相比，PIT-ESD 显著缩短了手术时间（29.8 ± 18.4 分钟 vs 57.4 ± 33.7 分钟，P = 0.001）和黏膜下注射量（49.6 ± 32.3 毫升 vs 70.8 ± 37.6 毫升，P = 0.034），降低了术中出血率（26.9% vs 57.7%，P = 0.025）和肌肉损伤率（7.7% vs 34.6%，P = 0.038），并缩短了术后住院时间（1.8 ± 0.8 天 vs 2.5 ± 1.2 天，P = 0.015）。
讨论
PIT 方法可显著提高结直肠 ESD 的安全性和有效性。
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