活检钳钳除法治疗上消化道小息肉样病变56例

Biopsy forceps polypectomy for diminutive polypoid lesions of the upper gastrointestinal tract: an analysis of 56 cases

目的:探讨活检钳钳除法治疗上消化道小息肉样病变的疗效和安全性.方法:回顾性分析北京大学深圳医院2000-2009年电子胃镜检查发现上消化道小息肉样病变(直径≤0.5cm)并行活检钳钳除病例治疗和随访资料,并与同期高频电切除病例资料(病变直径≤2.0cm)对比,比较两种治疗方法的并发症和病变复发情况.结果:入选病例共91例.活检钳钳除组56例,单发息肉样病变48例,多发8例,共计68枚病变.高频电切除组35例,单发息肉样病变23例,多发12例,共计54枚病变.所有研究病例内镜治疗后均无上消化道出血、穿孔等并发症,两组并发症发生率均为0.0%,无显著性差异.半年以后的随访和胃镜复查中两组均各有1例复发,两组复发率分别为1.5%、1.9%,无显著性差异.结论:活检钳钳除法治疗上消化道小息肉样病变的疗效和并发症与高频电切除法相比无显著性差异.活检钳钳除法可彻底摘除上消化道小息肉样病变,临床疗效肯定,安全实用,是治疗上消化道小息肉样病变的有效手段.

AIM： To evaluate the efficacy and safety of biopsy forceps polypectomy in the management of diminutive polypoid lesions of the upper gastrointestinal tract. METHODS： The gastroscopic data for 91 cases of upper gastrointestinal polypoid lesions which were removed by biopsy forceps polypectomy （diameter ≤ 0.5 cm） or by high frequency electric resection （diameter ≤ 2.0 cm） at our hospital from 2000 to 2009 were retrospectively reviewed to compare the rates of complications and recurrence between the two groups of patients. RESULTS： Of 56 patients undergoing biopsy forceps polypectomy, 48 had single polypoid lesion and 8 had multiple lesions. Of 35 patients undergoing high frequency electric resection, 23 had single polypoid lesion and 12 had multiple lesions. No upper gastrointestinal bleeding, perforation or other complications occurred in all cases. At six-month follow-up, a case of relapse occurred in the site of previous lesion in each group, and there was no significant difference in the recurrence rate between the two groups （1.5% vs 1.9%, P 0.05）. CONCLUSION： There were no significant differences in therapy effectiveness and complications between biopsy forceps polypectomy and high frequency electric resection in the removal of diminutive polypoid lesions of the upper gastrointestinal tract.