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内镜下分片冷切除术治疗最大径≥20 mm结直肠侧向发育型肿瘤的安全性和有效性 |
徐威1, 诸炎2,3, 付佩尧2,3, 徐佳昕2,3, 周静洁1, 钟晓锋1, 沈明1, 汤瑜1, 花海兵1, 胡学军1, 姚平1, 陈巍峰2,3, 胡健卫2,3, 周平红2,3, 李全林2,3
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1.江苏省江阴市中医院消化内科, 江阴 214400;2.复旦大学附属中山医院内镜中心, 上海 200032;3.上海市内镜微创协同创新中心, 上海 200032
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摘要: |
目的 评价内镜下分片冷切除术治疗最大径≥20 mm结直肠侧向发育型肿瘤(LST)的安全性和有效性。方法 前瞻性纳入2021年11月至2022年6月接受诊治的最大径≥20 mm的结直肠LST患者。病变黏膜下注射染色剂后,采用圈套器进行内镜下分片冷切除。主要研究终点指标为内镜切除术后6个月病变复发率;次要研究终点指标为不良事件(如出血、穿孔)发生率等。结果 共13例患者纳入研究,病灶平均最大径为2.3(2~3.3) cm。13例肿瘤均成功完成内镜下分片冷切除,平均分片4.2(2~7)片,手术平均时间为16.1(7~31)min。术中出血1例,经金属夹夹闭成功止血;未出现深层损伤、迟发性出血和迟发性穿孔。所有患者均于术后第6个月接受监测性结肠镜检查,均未发现局部复发及远处转移。结论 内镜下分片冷切除术治疗最大径≥20 mm结直肠LST安全、有效。 |
关键词: 内镜下分片冷切除术 结直肠侧向发育型病变 复发 |
DOI:10.12025/j.issn.1008-6358.2023.20230067 |
分类号:R735.3 |
基金项目:2021年上海市“医苑新星杰出青年人才”和上海市卫健委临床研究卓越项目(20224Z0005),江阴市科技局项目(JY0603A021014210026PB). |
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Safety and efficacy of piecemeal cold snare polypectomy for ≥ 20 mm colorectal laterally spreading tumor |
XU Wei1, ZHU Yan2,3, FU Pei-yao2,3, XU Jia-xin2,3, ZHOU Jing-jie1, ZHONG Xiao-feng1, SHEN Ming1, TANG Yu1, HUA Hai-bing1, HU Xue-jun1, YAO Ping1, CHEN Wei-feng2,3, HU Jian-wei2,3, ZHOU Ping-hong2,3, LI Quan-lin2,3
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1.Department of Gastroenterology, Jiangyin Hospital of Chinese Medicine, Jiangyin 2014400, Jiangsu, China;2.Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China;3.Shanghai Collaborative Innovation Center of Endoscopy, Shanghai 200032, China
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Abstract: |
Objective To investigate the safety and efficacy of piecemeal cold snare polypectomy (p-CSP) for ≥ 20 mm large colorectal laterally spreading tumor (LST). Methods Eligible patients with colorectal LST with large diameter ≥ 20 mm were prospectively included between November 2021 and June 2022. After submucosal injection of staining agent in the lesion, the snare was used to perform endoscopic p-CSP. The primary outcome was the lesion recurrence within 6 months after p-CSP. The secondary outcome was adverse events (such as bleeding, perforation) happening, etc.. Results A total of 13 patients were included, and the average diameter of the lesions was 2.3 (2-3.3) cm. All tumors were successfully removed by p-CSP with 16.1 (7-31) minutes of average operation time, and the average number of slices was 4.2 (2-7). One case of intraoperative bleeding was successfully managed by metal clips. There was no intraoperative deep injury, delayed bleeding or delayed perforation. All patients received surveillance colonoscopy inspection 6 months after operation, and there was no local recurrence or distant metastasis. Conclusion p-CSP might be safe and effective for colorectal LST ≥ 20 mm. |
Key words: piecemeal cold snare polypectomy colorectal laterally spreading tumer recurrence |