改良内镜黏膜切除术治疗结直肠息肉的效果及安全性分析

Effect and Safety of Modified-endoscopic Mucosal Resection in the Treatment of Colorectal Polyps

目的:探究改良内镜黏膜切除术(modified-endoscopic mucosal resection,M-EMR)治疗结直肠息肉的效果及安全性。方法:回顾性分析武汉市第八医院与武汉市汉口医院2019年12月-2020年12月收治的152例结直肠息肉患者的临床资料,依据不同的手术方式分为改良组(82例,101枚息肉)与电切组(70例,89枚息肉),改良组患者行M-EMR治疗,电切组行内镜下高频电凝电切术治疗,对比两组患者手术指标(手术时间、胃肠道功能恢复时间、肛门直肠恢复时间)、息肉切除情况、标本回收率、不良反应及息肉复发率。结果:改良组手术时间(5.80±2.06)min、胃肠道功能恢复时间(25.61±2.77)h、肛门直肠恢复时间(2.51±0.36)个月,均短于电切组的(20.18±1.95)min、(35.41±3.58)h、(3.18±0.50)个月(P<0.05);改良组息肉完全切除率为98.02%(99/101),显著高于电切组的91.01%(81/89),改良组标本回收率为99.01%(100/101),高于电切组的92.13%(82/89)(P<0.05);改良组不良反应发生率为2.44%(2/82),显著低于电切组的21.43%(15/70),改良组息肉复发率为3.66%(3/82),低于电切组的15.71%(11/70)(P<0.05)。结论:M-EMR治疗结直肠息肉效果显著,能够有效促进患者机体恢复,降低不良反应发生率、减少息肉复发,是一种高效且安全的手术方式。

Objective:To explore the effect and safety of modified-endoscopic mucosal resection (M-EMR) in the treatment of colorectal polyps.Method:Clinical data of 152 patients with colorectal polyps admitted to the Eighth Hospital of Wuhan and Hankou Hospital of Wuhan from December 2019 to December 2020 were retrospectively analyzed.According to different surgical methods,they were divided into modified group (82 cases,101 polyps) and electrosurgical group (70 cases,89 polyps).Patients in the modified group received M-EMR treatment,while patients in the electrosurgical group received endoscopic high frequency electrocoagulation electrosurgical resection treatment.The surgical indicators (operation time,gastrointestinal function recovery time,anorectal recovery time),polyp removal situation,specimen recovery rate,adverse reactions and polyp recurrence rate were compared between the two groups.Result:The operation time (5.80±2.06) min,gastrointestinal function recovery time (25.61±2.77) h,and anorectal recovery time (2.51±0.36) months of patients in the modified group,which were shorter than (20.18±1.95) min,(35.41±3.58) h,(3.18±0.50) months in the electrosurgical group (P<0.05);the complete polyp removal rate of modified group was 98.02% (99/101),which was significantly higher than 91.01% (81/89) of electrosurgical group,and the specimen recovery rate of modified group was 99.01% (100/101),which was higher than 92.13% (82/89) of electrosurgical group (P<0.05).The incidence of adverse reactions in the modified group was 2.44% (2/82),which was significantly lower than 21.43% (15/70) in the electrosurgical group,and the polyps recurrence rate in the modified group was 3.66% (3/82),which was lower than 15.71% (11/70) in the electrosurgical group (P<0.05).Conclusion:M-EMR has a significant effect on the treatment of colorectal polyps,can effectively promote the recovery of patients,reduce the incidence of adverse reactions,and reduce the recurrence of polyps.It is an efficient and safe surgical method.