Zhong J, Zhong J, San-To W, Lu J, Li W, Li H, Huang J, Han Z, Liu S
Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510405, China.
First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2023 Dec 20;43(12):2103-2110. doi: 10.12122/j.issn.1673-4254.2023.12.15.
To evaluate the clinical efficacy of endoscopic submucosal dissection (ESD) assisted by metal-clip pocketcreation traction for treatment of colorectal tumors.
We retrospectively analyzed the clinical data of 244 patients with colorectal tumors undergoing colorectal ESD treatment between January, 2019 and December, 2022, including 169 patients receiving ESD without metal-clip pocket-creation traction (N-ESD group) and 75 with traction-assisted ESD (M-ESD group). Propensity score matching was used to screen the patients using general clinical data as the covariates for matching. Operative time, surgical resection outcome indicators, incidence of adverse events, and histopathological diagnosis indicators were compared between the two groups of patients after matching.
The median operative time was significantly shorter in M-ESD group than in N-ESD group (20.0 [15.0, 30.0] 30 [20.0, 45.0] min, =0.008). No significant difference was found in the en bloc resection rate (100% 98.6%), complete resection rate (97.3% 96%) and radical resection rate (97.3% 96%) between the two groups (>0.05). The incidence of adverse events was low in both groups and showed no significant difference between them (>0.05).
In patients with colorectal tumors, the use of metal-clip pocket-creation traction can shorten the operative time of ESD although it does not significantly reduce the surgical resection rate or incidence of adverse events.
评估金属夹袋状造口牵引辅助内镜黏膜下剥离术(ESD)治疗结直肠肿瘤的临床疗效。
回顾性分析2019年1月至2022年12月期间接受结直肠ESD治疗的244例结直肠肿瘤患者的临床资料,其中169例患者接受无金属夹袋状造口牵引的ESD(N-ESD组),75例接受牵引辅助ESD(M-ESD组)。采用倾向评分匹配法,以一般临床资料作为协变量对患者进行匹配筛选。比较两组患者匹配后的手术时间、手术切除结果指标、不良事件发生率及组织病理学诊断指标。
M-ESD组的中位手术时间显著短于N-ESD组(20.0[15.0,30.0]对30[20.0,45.0]分钟,P=0.008)。两组间整块切除率(100%对98.6%)、完整切除率(97.3%对96%)和根治性切除率(97.3%对96%)差异均无统计学意义(P>0.05)。两组不良事件发生率均较低,且差异无统计学意义(P>0.05)。
对于结直肠肿瘤患者,使用金属夹袋状造口牵引可缩短ESD的手术时间,尽管其未显著降低手术切除率或不良事件发生率。