内镜下钛夹和(或)尼龙圈套辅助电切术治疗大肠有蒂巨大息肉的临床应用

Clinical application of treatment of large colorectal polyps with wide peduncle by nylon loop and/or clamping with titanium clips in combination with colonoscopy-assisted high-frequency electric snare

目的评价内镜下钛夹、尼龙圈套辅助高频电切术治疗大肠有蒂巨大息肉的效果及安全性。方法对41例患者共43枚大肠有蒂巨大息肉分别采用内镜下钛夹和(或)尼龙圈套辅助电切术治疗的临床资料进行回顾性分析。结果 43枚巨大息肉中,结肠26枚,直肠17枚。其中14枚息肉采用尼龙圈套+高频电切术治疗,24枚息肉采用钛夹+高频电切术治疗,5枚息肉采用尼龙圈套+钛夹+高频电切术治疗,均未出现穿孔,术中出血1例;术后迟发性出血2例,急诊内镜下加用钛夹止血成功,无其它并发症发生。结论采用金属钛夹、尼龙圈套辅助高频电切术,能有效预防大肠有蒂巨大息肉切除术中和术后出血,是大肠有蒂巨大息肉内镜下治疗安全有效的联合治疗技术。

Objective The aim of this study was to assess the effect and safety of high - frequency electric snare used for removal of big colorectal polyp with peduncle under endoscopy with the assistance of titanium folder and nylon loop. Methods The clinical data of 41 patients with 43 colorectal polyps resected under endoscopy with the assistance of titanium folder and nylon loop were retrospectively analyzed. Results A- mong the distribution of these 43 polyps, 26 of them were located in colon and 17 in rectum. Fourteen colorectal polyps were cut by nylon loop and high - frequency electric snare, 24 colorectal polyps were removed by titanium folder and high - frequency electric snare, 5 colorectal polyps were cut by nylon loop and titanium folder as well as high - frequency electric snare. No case had tresis, but bleeding occurred during operation in 1 case ; and delayed hemorrhage after operation had been happened in 2 cases. The bleeding was successfully stopped by applying titanium folder un- der endoscopy for emergency treatment. There was no other complication occurred. Conclusion The application of high - frequency electric snare with the assistance of titanium folder and nylon loop can effectively prevent the bleeding during cutting colorectal polyps or after the operation. This combination therapy is safe and effective in removal of colorectal polyps under endoscopy.