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强化肠道准备对结肠镜下息肉切除术后并发症及预后的影响。

Impact of enhanced bowel preparation on complications and prognosis following colonoscopic polypectomy.

作者信息

Ma Yan-Ping, Zheng Xue-Yong, Shen Xin-Feng, Ling Yi-Ting, Qian Mei-Ping, Ni Min-Jun

机构信息

Endoscopy Center, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China.

Department of General Surgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China.

出版信息

World J Gastrointest Surg. 2025 Jun 27;17(6):106264. doi: 10.4240/wjgs.v17.i6.106264.

Abstract

BACKGROUND

Colonoscopic polypectomy is a crucial procedure for the prevention and treatment of colorectal cancer, with its success and safety largely dependent on the quality of bowel preparation. Currently, polyethylene glycol electrolyte solution remains the standard method for bowel preparation, but its use may cause patient discomfort and incomplete cleansing.

AIM

To evaluate impact of enhanced and conventional bowel preparation protocols on the outcomes of colonoscopic polypectomy.

METHODS

This retrospective cohort study collected data from 130 patients who underwent colonoscopic polypectomy between March 2023 and June 2024. Patients were divided into the conventional bowel preparation group ( = 65) and enhanced bowel preparation group ( = 65). Primary outcome measures included Boston Bowel Preparation Scale (BBPS) scores, procedure-related parameters, complication rates, and prognosis. Statistical analysis was performed using SPSS version 25.0, with < 0.05 indicating statistical significance.

RESULTS

The enhanced group demonstrated significant advantages over the conventional group, with higher BBPS total scores (4.2 ± 0.7 3.1 ± 0.8, < 0.001), higher one-time complete resection rates (95.4% 83.1%, = 0.01), shorter operative times (23.1 ± 4.8 25.4 ± 5.2 min, = 0.03), and lesser intraoperative blood loss (18.2 ± 4.5 20.3 ± 5.1 mL, = 0.04). Total complication rates were significantly lower (5.9% 16.9%, = 0.05), particularly for bleeding (1.5% 16.9%, = 0.01) and infection (1.5% 7.7%, = 0.04). The enhanced group also showed lower 6-month recurrence rates (3.1% 10.8%, = 0.05) and higher patient satisfaction (87.7% 76.9%, = 0.04) than did the conventional group.

CONCLUSION

The enhanced bowel preparation protocol demonstrates significant advantages, particularly in improving surgical outcomes, reducing complications, and increasing patient satisfaction, underscoring its importance of its application during colonoscopic polypectomy.

摘要

背景

结肠镜息肉切除术是预防和治疗结直肠癌的关键手术,其成功与安全在很大程度上取决于肠道准备的质量。目前,聚乙二醇电解质溶液仍然是肠道准备的标准方法,但其使用可能会导致患者不适和清洁不彻底。

目的

评估强化肠道准备方案与传统肠道准备方案对结肠镜息肉切除术结果的影响。

方法

这项回顾性队列研究收集了2023年3月至2024年6月期间接受结肠镜息肉切除术的130例患者的数据。患者被分为传统肠道准备组(n = 65)和强化肠道准备组(n = 65)。主要观察指标包括波士顿肠道准备量表(BBPS)评分、手术相关参数、并发症发生率和预后。使用SPSS 25.0版进行统计分析,P < 0.05表示具有统计学意义。

结果

强化组在各方面均显示出比传统组更显著的优势,其BBPS总分更高(4.2 ± 0.7 vs 3.1 ± 0.8,P < 0.001),一次性完全切除率更高(95.4% vs 83.1%,P = 0.01),手术时间更短(23.1 ± 4.8 vs 25.4 ± 5.2分钟,P = 0.03),术中出血量更少(18.2 ± 4.5 vs 20.3 ± 5.1 mL,P = 0.04)。总并发症发生率显著更低(5.9% vs 16.9%,P = 0.05),尤其是出血(1.5% vs 16.9%,P = 0.01)和感染(1.5% vs 7.7%,P = 0.04)。强化组的6个月复发率也低于传统组(3.1% vs 10.8%,P = 0.05),患者满意度更高(87.7% vs 76.9%,P = 0.04)。

结论

强化肠道准备方案显示出显著优势,特别是在改善手术结果、减少并发症和提高患者满意度方面,凸显了其在结肠镜息肉切除术中应用的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a355/12188597/dc3af90d4c34/wjgs-17-6-106264-g001.jpg

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