黏膜下注射后内镜黏膜冷切除术治疗结直肠无蒂息肉效果

Effect of endoscopic mucosal cold resection after submucosal injection in the treatment of colorectal sessile polyps

目的研究分析黏膜下注射后内镜黏膜冷切除术治疗结直肠无蒂息肉效果。方法选择2019年11月—2021年2月于本院消化内科治疗的133例结直肠无蒂息肉患者作为研究对象,按照随机数表法分为实验组(67例)和对照组(66例)两组。两组均给予术前常规治疗及护理,对照组术中给予内镜黏膜热切除术,实验组术中给予内镜黏膜冷切除术。比较两组标本回收率、息肉切除情况、复发率、手术、住院情况及并发症发生率。结果实验组标本回收率(95.52%)高于对照组(83.33%)(t=5.245,P=0.022),息肉完全切除率(94.03%)与对照组(93.94%)未见明显差异(t=0.000,P=0.982),实验组息肉切除次数(1.65±0.08)少于对照组(t=16.169,P=0.000),实验组复发率(5.97%)与对照组(7.58%)未见明显差异(t=0.136,P=0.712)。实验组住院时间(5±0.3)天、手术时间(26.11±9.38)分及胃肠道功能恢复时间(22.17±7.82)小时,均短于对照组,住院费用(6217.60±96.15)元,少于对照组(t=4.984、8.838、3.798、28.106,P=0.000)。实验组治疗后并发症总发生2例,对照组发生10例,实验组总发生率(2.99%)低于对照组(15.15%)(t=5.996,P=0.014)。结论黏膜下注射后内镜黏膜冷切除术对结直肠无蒂息肉完全切除率及复发率无明显改善,但是可改善术中一般情况,提高标本回收率,减少住院费用,降低术后并发症发生情况。黏膜下注射后内镜黏膜冷切除术值得临床广泛推广应用。

Objective To study and analyze the effect of endoscopic mucosal cold resection after submucosal injection in the treatment of colorectal sessile polyps.Methods 133 patients suffered from colorectal sessile polyps who were treated in the hospital from November 2019 to February 2021 were selected as study subjects,and they were divided into two groups of experimental group(n=67)and control group(n=66)according to the random number table method.Both groups were given routine treatment and nursing before operation.The control group was given endoscopic mucosal hot resection during operation,and the experimental group was given endoscopic mucosal cold resection during operation.The sample recovery rate,polypectomy,recurrence rate,operation,hospitalization and complication rate of the two groups were compared.Results The sample recovery rate of the experimental group(95.52%)was higher than that of the control group(83.33%)(t=5.245,P=0.022).There was no significant difference in complete polypectomy rate between experimental group(94.03%)and the control group(93.94%)(t=0.000,P=0.982).The polypectomy frequency of the experimental group(1.65±0.08)was less than that of the control group(t=16.169,P=0.000).The recurrence rate of the test group was 5.97%,and there was no significant difference from that of the control group(7.58%)(t=0.136,P=0.712).The hospitalization time(5±0.3 days),operation time(26.11±9.38 minutes)and gastrointestinal function recovery time(22.17±7.82 hours)of the test group were shorter than those of the control group,and the hospitalization cost(6217.60±96.15 yuan)was less than that of the control group(t=4.984,8.838,3.798,28.106,all P=0.000).After treatment,there were 2 cases of complications in the test group and 10 cases in the control group.The total incidence of the test group was 2.99%,which was lower than that of the control group(15.15%)(t=5.996,P=0.014).Conclusions Endoscopic mucosal cold resection after submucosal injection has no significant improvement on the complete resection rate and recurrence rate of colorectal sessile polyps,but it could improve the general situation during operation,improve the recovery rate of specimens,reduce hospital expenses and reduce postoperative complications.Endoscopic cold mucosal resection after submucosal injection is worthy of extensive clinical application.