冷内镜黏膜切除术与常规内镜黏膜切除术治疗5~10 mm结直肠无蒂腺瘤的疗效对比

Comparison of Cold Endoscopic Mucosal Resection and Conventional En⁃doscopic Mucosal Resection in the Treatment of 5-10 mm Adductal Colorectal Adenomas

目的对比分析冷内镜黏膜切除术与常规内镜黏膜切除术治疗5~10 mm结直肠无蒂腺瘤的临床疗效。方法方便选择2017年12月—2021年12月期间在南京鼓楼医院集团仪征医院行手术治疗的5~10 mm结直肠无蒂腺瘤患者83例,按照随机抽签法分为对照组(n=41)与研究组(n=42)。对照组患者行常规内镜黏膜切除术治疗,研究组患者行冷内镜黏膜切除术治疗,统计比较两组患者临床疗效、手术相关指标、疼痛程度、并发症发生率、生存质量。结果两组总有效率对比,差异无统计学意义(P>0.05)。两组手术时间、术中出血量、术后肛门排气时间、下床活动时间、住院时间对比,差异无统计学意义(P>0.05)。两组术后2、8、12 h疼痛评分对比,差异无统计学意义(P>0.05)。研究组并发症发生率(7.14%)低于对照组(24.39%),差异有统计学意义(χ^(2)=4.672,P<0.05)。两组手术前后各项生存质量指标对比,差异无统计学意义(P>0.05)。结论在5~10 mm结直肠无蒂腺瘤治疗中,冷内镜黏膜切除术与常规内镜黏膜切除术治疗效果相当,且安全性更高,值得临床借鉴与推广。

Objective To compare the clinical efficacy of cold endoscopic mucosal resection with conventional endo⁃scopic mucosal resection in the treatment of 5-10 mm adductal colorectal adenomas.Methods 83 patients with 5-10 mm colorectal sessile adenoma who underwent surgical treatment at Yizheng Hospital of Nanjing Gulou Hospital Group from December 2017 to December 2021 were conveniently selected and randomly divided into a control group(n=41)and a study group(n=42).The control group patients underwent conventional endoscopic mucosal resection,while the study group patients underwent cold endoscopic mucosal resection.The clinical efficacy,surgical related in⁃dicators,pain level,incidence of complications,and quality of life of the two groups of patients were statistically com⁃pared.Results There was no statistically significant difference in total effective rate between the two groups(P>0.05).There was no statistically significant difference between the two groups in terms of surgical time,intraoperative bleed⁃ing volume,postoperative anal exhaust time,time to get out of bed activity,and hospital stay(P>0.05).There was no statistically significant difference in pain scores between the two groups at 2 h,8 h,and 12 h after surgery(P>0.05).The incidence of complications in the study group(7.14%)was lower than that in the control group(24.39%),and the difference was statistically significant(χ2=4.672,P<0.05).There was no statistically significant difference in various quality of life indicators between the two groups before and after surgery(P>0.05).Conclusion In the treatment of 5-10 mm adductal colorectal adenoma,cold endoscopic mucosal resection has the same therapeutic effect as conven⁃tional endoscopic mucosal resection,with higher safety,which is worthy of clinical reference and promotion.