冷圈套器息肉切除术治疗直径10~15 mm结直肠息肉的有效性与安全性

EFFICACY AND SAFETY OF COLD SNARE POLYPECTOMY IN TREATMENT OF COLORECTAL POLYPS WITH A DIAMETER OF 10-15 mm

目的评估冷圈套器息肉切除术(CSP)与热圈套器息肉切除术(HSP)治疗直径10~15 mm结直肠息肉的有效性和安全性。方法收集2022年6月—2023年2月于青岛大学附属医院崂山院区消化内科行结肠镜检查并拟行息肉切除(至少有1枚结直肠息肉的最大直径为10~15 mm)的患者138例,随机分为CSP组76例,HSP组62例,对两组患者息肉切除的有效性指标(息肉完全切除比例、整块切除比例)及安全性指标(术中出血、迟发出血、术中穿孔、迟发穿孔、术后反应性结肠浆膜炎发生比例)进行比较。结果HSP组息肉完全切除比例为98.4%,整块切除比例为96.8%;CSP组息肉完全切除比例为97.3%,整块切除比例为98.7%,两组患者的上述有效性指标比较差异均无显著性(P>0.05)。CSP组中2例患者发生术中出血,无迟发出血、术中和迟发穿孔和反应性结肠浆膜炎发生,有71例患者使用钛夹,共使用82枚;HSP组中1例患者发生术中出血,2例患者发生迟发出血,无术中和迟发穿孔发生,4例患者发生反应性结肠浆膜炎,有61例患者使用钛夹,共使用72枚,两组患者的上述安全性指标比较差异均无显著性(P>0.05)。结论CSP用于切除直径10~15 mm结直肠息肉安全、有效,推荐临床选择应用。

Objective To investigate the safety and efficacy of cold snare polypectomy(CSP)versus hot snare polypectomy(HSP)in the treatment of colorectal polyps with a diameter of 10-15 mm.Methods A total of 138 patients who underwent colonoscopy and planned to undergo polypectomy(at least one colorectal polyp with a maximum diameter of 10-15 mm)in Department of Gastroenterology,Laoshan Branch of The Affiliated Hospital of Qingdao University,from June 2022 to February 2023 were randomly divided into CSP group with 76 patients and HSP group with 62 patients.The two groups were compared in terms of the efficacy of polypectomy(complete resection rate and en bloc resection rate)and safety indicators(proportion of patients with intraoperative bleeding,delayed bleeding,intraoperative perforation,delayed perforation,and postoperative reactive serocolitis).Results The HSP had a complete resection rate of 98.4% and an en bloc resection rate of 96.8%,while the CSP group had a complete resection rate of 97.3% and an en bloc resection rate of 98.7%;there were no significant differences in the above efficacy indicators between the two groups(P>0.05).In the CSP group,2 patients experienced intraoperative bleeding,while there were no patients with delayed bleeding,intraoperative and delayed perforation,or reactive serocolitis,and a total of 82 titanium clips were used in 71 patients;in the HSP group,1 patient experienced intraoperative bleeding,2 patients experienced delayed bleeding,and 4 patients developed reactive serocolitis,while there were no patients with intraoperative and delayed perforation,and a total of 72 titanium clips were used in 61 patients.There were no significant differences in the above safety indicators between the two groups(P>0.05).Conclusion CSP is safe and effective in removing colorectal polyps with a diameter of 10-15 mm and is thus re-commended for clinical application.