SMSA评分在结直肠息肉内镜下黏膜切除术中的应用价值

Application value of SMSA score in endoscopic mucosal resection of colorectal polyp

目的探讨大小、形态、部位和可及性(size,morphology,site,access,SMSA)评分在结直肠息肉内镜切除治疗中的应用。方法选取2021年1月至2021年12月在黑龙江省医院行结直肠息肉内镜切除治疗的284例患者进行回顾性研究,收集患者息肉大小、形态、部位及肠镜检查治疗可及性等指标,计算息肉SMSA评分,分析SMSA评分与息肉一次性完整切除率和术后并发症的关系。结果不同大小、部位、形态及可及性的息肉SMSA评分水平比较,差异均有统计学意义(P<0.05)。SMSA1、SMSA2、SMSA3及SMSA4的息肉一次性完整切除率分别为100%、92.5%、80.0%及33.3%,并发症发生率分别为2.6%、5.8%、20.0%及33.3%。一次性完整切除率与息肉SMSA评分水平呈显著负相关(r=-0.331,P<0.05);术后并发症的发生率与息肉SMSA评分水平呈显著正相关(r=0.175,P<0.05)。结论SMSA评分可作为评价结直肠息肉内镜治疗困难程度及判断术后并发症的依据。

Objective To explore the application of size,morphology,site,access(SMSA)score in endoscopic resection of colorectal polyps.Methods A total of 284 patients who underwent endoscopic resection of colorectal polyps at Heilongjiang Provincial Hospital from January 2021 to December 2021 were selected for a retrospective study.The indicators of size,morphology,site and accessibility of polyps during colonoscopy treatment were collected,and the SMSA score of polyps was calculated to analyze the relationship between the SMSA score and the rate of one-time complete removal of polyps and postoperative complications.Results Compared with the SMSA score levels for polyps of different size,morphology,site,and accessibility,the differences were statistically significant(P<0.05).100%,92.5%,80.0%and 33.3%of polyps were excised in one visit for SMSA1,SMSA2,SMSA3 and SMSA4 respectively.The postoperative complication rates for SMSA1,SMSA2,SMSA3 and SMSA4 were 2.6%,5.8%,20.0%and 33.3%respectively.There was a significant negative correlation between the one-time complete excision rate and the level of SMSA score for polyps(r=-0.331,P<0.05).The incidence of postoperative complications was significantly and positively correlated with the level of SMSA score for polyps(r=0.175,P<0.05).Conclusion SMSA score can be used to evaluate the difficulty of endoscopic treatment of colorectal polyps and predict the incidence of postoperative complications.