Shang Hui-Hui, Tian Xiu-Mei, Li Yan, Zhang Rong, Wang Yu, Song Wen-Xian
Department of Health Medicine, The 991st Hospital of the Joint Logistics Support Force of the People's Liberation Army, Xiangyang, Hubei, China.
Department of Gastroenterology, The 991st Hospital of the Joint Logistics Support Force of the People's Liberation Army, Xiangyang, Hubei, China.
Medicine (Baltimore). 2025 Jun 20;104(25):e42863. doi: 10.1097/MD.0000000000042863.
This study evaluates the safety and efficacy of cold snare polypectomy (CSP) and hot snare polypectomy endoscopic mucosal resection (HSP-EMR) for small sessile colorectal polyps in the elderly population.
Patients with small sessile colorectal polyps were randomized to either CSP or HSP-EMR, including 80 patients in the observation group (CSP) and 125 patients in the control group (HSP-EMR). General data, titanium clip utilization rates, complete resection rates, immediate bleeding rates, specimen recovery rates, incidence of delayed bleeding, perforation rates, and incidence of abdominal discomfort were compared between the 2 groups.
There were no significant differences in the distribution of general data (age, gender, location, morphology, and pathological type) or underlying diseases (hypertension and diabetes) between the 2 groups (P > .05). There were no significant differences in the complete resection rate, specimen recovery rate, or delayed bleeding rate between the 2 groups (P > .05). The utilization rate of titanium clips and the incidence of abdominal discomfort in the observation group were significantly lower than those in the control group. The immediate bleeding rate was higher in the observation group than that in the control group. The difference between the 2 groups was statistically significant (P < .05). No perforation occurred in either of the groups. Group discussion was conducted according to whether postoperative complications occurred. Univariate and binary logistic regression analysis was used to analyze the risk factors of postoperative complications. The average polyp diameter, body mass index and surgical method were independent risk factors for postoperative complications (P < .05).
CSP and HSP-EMR are safe and efficacy in the treatment of small sessile colorectal polyps in elderly people. For overweight and obese people with large polyps, HSP-EMR patients should be closely observed for postoperative complications.
本研究评估冷圈套息肉切除术（CSP）和热圈套息肉切除术内镜黏膜切除术（HSP-EMR）用于老年人群小的无蒂结直肠息肉的安全性和有效性。
将患有小的无蒂结直肠息肉的患者随机分为CSP组或HSP-EMR组，观察组（CSP）80例患者，对照组（HSP-EMR）125例患者。比较两组患者的一般资料、钛夹使用率、完整切除率、即时出血率、标本回收率、延迟出血发生率、穿孔率和腹部不适发生率。
两组患者在一般资料（年龄、性别、部位、形态和病理类型）或基础疾病（高血压和糖尿病）分布方面无显著差异（P>0.05）。两组患者在完整切除率、标本回收率或延迟出血率方面无显著差异（P>0.05）。观察组钛夹使用率和腹部不适发生率显著低于对照组。观察组即时出血率高于对照组。两组间差异有统计学意义（P<0.05）。两组均未发生穿孔。根据术后是否发生并发症进行组内讨论。采用单因素和二元逻辑回归分析术后并发症的危险因素。息肉平均直径、体重指数和手术方式是术后并发症的独立危险因素（P<0.05）。
CSP和HSP-EMR治疗老年患者小的无蒂结直肠息肉安全有效。对于息肉较大的超重和肥胖患者，HSP-EMR术后应密切观察并发症。
