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Endocuff视觉辅助切除困难结肠病变——一项多中心、前瞻性随机试点研究的初步结果

Endocuff Vision-Assisted Resection for Difficult Colonic Lesions-Preliminary Results of a Multicenter, Prospective Randomized Pilot Study.

作者信息

Palma Rossella, Andrisani Gianluca, Fanello Gianfranco, Lauro Augusto, Panetta Cristina, Eberspacher Chiara, Di Matteo Francesco Maria, Vaccari Samuele, Zorzetti Noemi, D'Andrea Vito, Pontone Stefano

机构信息

Department of Surgery, "Sapienza" University of Rome, 00161 Rome, Italy.

Digestive Endoscopy Unit, Campus Bio-Medico, University of Rome, 00185 Rome, Italy.

出版信息

J Clin Med. 2023 Jul 28;12(15):4980. doi: 10.3390/jcm12154980.

Abstract

Background-Screening programs for colorectal cancer are implemented due to their ability to reduce mortality. The Endocuff Vision is a new endoscopic device that significantly improves the adenoma detection rate. The primary outcome was to assess the efficacy of ECV in improving stability and reducing operation time during difficult colon polypectomies in a multicenter randomized prospective study. Methods-In a randomized multicenter pilot study, two groups of patients who underwent difficult polypectomies with and without the assistance of Endocuff Vision were compared. Demographics and clinical characteristics of patients were obtained, and polyps' size, morphology, site, and access (SMSA); polypectomy time; and endoscope stability were evaluated. Results-From October 2016 to April 2020, 32 patients were enrolled. In total, 12 patients underwent Endocuff Vision polypectomy, and 20 patients underwent standard polypectomy by using a computer-generated random number table. No statistical differences were found in clinical characteristics, SMSA, and polypectomy time. The most interesting findings were the positive correlations between shaking and SMSA (r = 0.55, = 0.005) and shaking and polypectomy time (r = 0.745, < 0.0001). Conclusion-Endocuff Vision seems to be adequately stable during difficult endoscopic resection procedures. The new parameter proposed that shaking is strongly correlated to the stability of the endoscope, the difficulty of the resection (SMSA), and the polypectomy time.

摘要

背景——由于结直肠癌筛查项目具有降低死亡率的能力,因此得以实施。Endocuff Vision是一种新型内镜设备,可显著提高腺瘤检出率。在一项多中心随机前瞻性研究中,主要结局是评估Endocuff Vision在困难结肠息肉切除术中提高稳定性和缩短手术时间的疗效。方法——在一项随机多中心试点研究中,比较了两组在有无Endocuff Vision辅助下进行困难息肉切除术的患者。获取患者的人口统计学和临床特征,并评估息肉的大小、形态、部位和入路(SMSA);息肉切除时间;以及内镜稳定性。结果——2016年10月至2020年4月,共纳入32例患者。总共12例患者接受了Endocuff Vision息肉切除术,20例患者通过计算机生成随机数字表接受了标准息肉切除术。在临床特征、SMSA和息肉切除时间方面未发现统计学差异。最有趣的发现是晃动与SMSA之间呈正相关(r = 0.55,P = 0.005)以及晃动与息肉切除时间之间呈正相关(r = 0.745,P < 0.0001)。结论——在困难的内镜切除手术过程中,Endocuff Vision似乎具有足够的稳定性。新提出的参数表明,晃动与内镜稳定性、切除难度(SMSA)以及息肉切除时间密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e81/10420096/aeb5058f118e/jcm-12-04980-g001.jpg

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