热活检钳联合圈套器辅助牵引在内镜黏膜下剥离术治疗胃肿瘤中的应用

Application value of thermal biopsy forceps combined with snare-assisted traction in endoscopic submucosal dissection treating stomach tumors

目的:研究热活检钳联合圈套器辅助牵引在胃肿瘤内镜黏膜下剥离术(ESD)治疗中的临床价值。方法:选取ESD治疗的120例胃肿瘤病人临床资料,随机分为观察组和对照组,各60例。观察组病人术中均使用了热活检钳联合圈套器圈套辅助牵引技术,对照组病人术中未使用任何辅助牵引技术;比较2组肿瘤一次性完整切除率、手术时间、术中出血及穿孔等并发症的发生率以及术后随访情况,评价其临床效果及安全性。结果:观察组肿瘤一次性完整切除率明显高于对照组(P<0.05),术中出血量、手术时间及并发症发生率均明显低于对照组(P<0.01);2组病人ESD术后病理结果差异无统计学意义(P>0.05)。结论:热活检钳联合圈套器体外牵引技术具有操作方便、组织损伤少、牵引效果好等优点,能够有效保证ESD手术视野的清晰性,缩短手术时间,降低术中出血、穿孔、病变残留、瘤体误入胸腹腔等并发症的发生率。

Objective:To study the clinical value of thermal biopsy forceps combined with snare-assisted traction in endoscopic submucosal dissection(ESD)treating stomach tumors.Methods:The clinical data of 120 stomach tumor patients treated with ESD were analyzed,and the patients were randomly divided into the observation group and control group(60 cases in each group).The observation group was treated with hot biopsy forceps combined with snare-assisted traction technique,and the control group was not treated with any assisted traction technique.The rate of one-time complete removing tumor,operation time,incidence rates of intraoperative bleeding and perforation,and postoperative following-up were compared between two groups.The clinical efficacy and safety in two groups were evaluated.Results:The rate of one-time complete removing tumor in observation group was significantly higher than that in control group(P<0.05).The operation time,intraoperative bleeding and incidence rate of complication in observation group were significantly lower than those in control group(P<0.01).The difference of the postoperative pathology results between two groups was not statistically significant(P>0.05).Conclusions:The thermal biopsy forceps combined with snare-assisted traction has the advantages of convenient operation,less tissue damage and good traction effects,etc.,which can effectively ensure the clear vision field of ESD operation,shorten the operation time,and reduce the incidence rates of intraoperative complications such as bleeding,perforation,lesion residue and tumor strapping into the chest and abdominal cavity.