摘要
目的探讨结直肠无蒂锯齿状病变的内镜下特点。方法回顾性分析我院2020年1月至2022年7月完成肠镜检查者,所有患者均在发现结肠息肉时立即予以切除治疗并送活检,分析无蒂锯齿状息肉(SSL)的临床及内镜特征,切除方式等。结果共完成筛查性结肠镜检查36904例,锯齿状息肉患者4876例,其中无蒂锯齿状病变284例,SSL检出率(SDR)0.77%,SSL占锯齿状息肉比例约5.8%,左半结肠SSL构成比为28.5%,右半结肠SSL构成比为71.5%,直径≤5 mm 29.6%,6~9 mm 45.5%,10~19 mm 18.4%,≥20 mm 6.5%。其中41.2%SSL合并腺瘤,高危腺瘤占13.4%,低危腺瘤占27.8%,33.5%同步多发SSL,6%SSL伴异型增生。SSL的切除方式选择,冷切除占60.2%,内镜下黏膜切除术(EMR)为29.9%,内镜下黏膜剥离术(ESD)为8.1%,外科切除为1.8%。结论锯齿状病变的检出率可能在筛查性结肠镜检查中被低估了,因此,我们需要结合更多的方式以提高锯齿状病变的检出率。
Objective To investigate the endoscopic characteristics of sessile serrated lesions.Methods From January 2020 to July 2022,retrospective analysis was performed on colonoscopy patients in our hospital.All polyps when found were immediately resected.Clinical and endoscopic characteristics and resection methods of SSL were analyzed.Results Total 36904 cases of colonoscopy were completed,of which 4876 cases were serrated polyps,among which 284 cases were sessile serrated lesions.The detection rate of SSL(SDR)was 0.77%,the proportion of SSL in serrated polyps was about 5.8%,the SSL componen rate of left colon was 28.5%,the SSL component rate of right colon was 71.5%,and the diameter less than 5mm was 30%.5-9mm was 45.5%,10-19mm was 17.6%,greater than 20mm was 6.5%.41.2%of SSL patients were associated with adenomas,13.4%with high-risk adenomas,27.8%with low-risk adenomas,33.5%with synchronous multiple SSL,and 6%with dysplasia.Cold resection accounted for 60.2%,EMR 29.9%,ESD 8.1%and surgical resection 1.8%.Conclusion The detection rate of sessile serrated lesions may be underestimated in screening colonoscopy.Therefore,we need more methods to improve the detection rate of sessile serrated lesions.
作者
杨梅
孙晓滨
周正奎
单晶
刘榴
刘莉
杨鹏
Yang Mei;Sun Xiaobin;Zhou Zhengkui(The Third People′s Hospital of Chengdu,Chengdu,Sichuan 610000,China.)
出处
《四川医学》
CAS
2023年第9期927-932,共6页
Sichuan Medical Journal
关键词
无蒂锯齿状病变
结直肠
内镜特点
切除方式
sessile serrated lesion
colorectal
endoscopic feature
resection method