Li Hongxia, Hong Yiping, Yao Linhua, Ji Xia, Chen Dan, Tao Maogen, Yan Huihui, Chen Jiamin, Wang Lingling, Xu Liyi, Wang Leilei, Luo Erfei, Cai Jianting, Wei Wei
Department of Gastroenterology, The Second Affiliated Hospital, College of Medicine Zhejiang University Hangzhou China.
Department of Gastroenterology, The Affiliated Jinhua Hospital Zhejiang University School of Medicine Jinhua China.
JGH Open. 2024 Dec 5;8(12):e70066. doi: 10.1002/jgh3.70066. eCollection 2024 Dec.
Endoscopic submucosal dissection (ESD) is an established treatment for laterally spreading tumors (LSTs). Hybrid ESD, a novel technique, is gaining popularity for colorectal neoplasms. This study aimed to compare hybrid ESD with conventional ESD for treating LSTs.
Data from patients with colorectal LSTs ≥ 10 mm who underwent ESD at six centers from May 2020 to April 2023 were analyzed retrospectively. The study assessed baseline characteristics, hospitalization costs, and outcomes (operative time, R0 resection rate, complications).
890 patients were included: 490 underwent conventional ESD and 400 hybrid ESD. Hybrid ESD showed significantly shorter procedure times and lower hospitalization costs compared to conventional ESD. However, the R0 resection rate and lifting sign positivity were lower with hybrid ESD. Subgroup analysis indicated potential cost savings and shorter operative times for lesions 10-30 mm with hybrid ESD, without compromising R0 resection rates. For lesions ≥ 30 mm, hybrid ESD had lower R0 resection rates despite cost savings.
Hybrid ESD offers a viable alternative to conventional ESD for LSTs sized 10-30 mm, reducing procedure duration and costs while ensuring R0 resection.
内镜黏膜下剥离术（ESD）是治疗侧向发育型肿瘤（LST）的成熟方法。混合ESD作为一种新技术，在结直肠肿瘤治疗中越来越受欢迎。本研究旨在比较混合ESD与传统ESD治疗LST的效果。
回顾性分析2020年5月至2023年4月在六个中心接受ESD治疗的结直肠LST患者（肿瘤直径≥10mm）的数据。研究评估了基线特征、住院费用和手术结果（手术时间、R0切除率、并发症）。
共纳入890例患者，其中490例行传统ESD，400例行混合ESD。与传统ESD相比，混合ESD的手术时间明显缩短，住院费用更低。然而，混合ESD的R0切除率和抬举征阳性率较低。亚组分析表明，对于10 - 30mm的病变，混合ESD可能节省成本且手术时间更短，同时不影响R0切除率。对于≥30mm的病变，混合ESD尽管节省了成本，但R0切除率较低。
对于直径为10 - 30mm的LST，混合ESD是传统ESD的可行替代方案，可缩短手术时间并降低成本，同时确保R0切除。
