Iishi H, Tatsuta M, Narahara H, Iseki K, Sakai N
Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Gastrointest Endosc. 1996 Nov;44(5):594-7. doi: 10.1016/s0016-5107(96)70015-9.
Colonoscopic resection of pedunculated polyps with heads 1 cm or greater in diameter is difficult because of the risk of bleeding. To minimize this complication, we used a detachable snare that allowed endoscopic ligation of the stalk of a large pedunculated polyp and evaluated its safety and effectiveness in comparison with conventional endoscopic snare polypectomy.
Patients with pedunculated polyps with heads 1 cm or greater in diameter were randomly assigned to colonoscopic polypectomy with (N = 47) or without (N = 42) a detachable snare. Arterial pumping bleeding immediately after colonoscopic polypectomy or hematochezia resulting in a 10% or greater drop in hematocrit was defined as "bleeding."
No bleeding occurred during or after polypectomy with a detachable snare, but bleeding occurred significantly more frequently (five patients, 12%) without a snare. Moreover, the use of a detachable snare reduced the duration of hospitalization after polypectomy.
Colonoscopic polypectomy with a detachable snare may be safer than conventional polypectomy without a detachable snare for resection of large, pedunculated polyps.
由于存在出血风险，对直径1厘米或更大的有蒂息肉进行结肠镜切除很困难。为了将这种并发症降至最低，我们使用了一种可分离圈套器，该圈套器可对大型有蒂息肉的蒂进行内镜下结扎，并与传统内镜圈套息肉切除术相比，评估其安全性和有效性。
将直径1厘米或更大的有蒂息肉患者随机分为两组，一组（N = 47）采用可分离圈套器进行结肠镜息肉切除术，另一组（N = 42）不使用可分离圈套器进行结肠镜息肉切除术。结肠镜息肉切除术后立即出现的动脉搏动性出血或导致血细胞比容下降10%或更多的便血被定义为“出血”。
使用可分离圈套器进行息肉切除术期间及术后均未发生出血，但不使用圈套器时出血发生率显著更高（5例患者，12%）。此外，使用可分离圈套器缩短了息肉切除术后的住院时间。
对于大型有蒂息肉的切除，使用可分离圈套器进行结肠镜息肉切除术可能比不使用可分离圈套器的传统息肉切除术更安全。
