8字环辅助结直肠困难内镜下黏膜剥离术的临床效果评价

The effect assessment of 8-like ring assisted endoscopic submucosal dissection for colorectal lesions

目的本文旨在评价8字环辅助结直肠困难内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)的临床效果。方法本研究共纳入行8字环辅助ESD治疗的结直肠腺瘤或早癌患者42例。收集年龄、性别、病变形态及病变大小等基线数据。通过分析操作时间、整块切除率、完全切除率、并发症等情况评价其安全性和有效性。结果42例患者平均操作时间为(60.26±37.77)min,整块切除率为98%(41/42),完全切除率为93%(39/42),术后病理结果显示低级别上皮内瘤变11例,高级别上皮内瘤变23例,侵犯黏膜下层8例。并发症方面:术中出现穿孔3例,术后出血0例,均予结肠镜下治疗好转。随访期间未出现复发、肠腔狭窄及排便困难等并发症。结论应用8字环辅助ESD治疗结直肠病变安全、有效。

Objective To assess the clinical outcomes of 8-like ring-assisted endoscopic submucosal dissection(ESD)for challenging colorectal cases.Methods In this study,we conducted a retrospective data collection of 42 patients with colorectal adenomas or early-stage cancer who underwent 8-like ring-assisted ESD at Beijing Friendship Hospital from November 2018 to September 2021.The baseline data,including age,gender,lesion morphology,and lesion size,were collected.Safety and efficacy were evaluated by analyzing operative time,enbloc resection rate,complete resection rate,and complications.Results The mean procedure time of ESD was(60.26±37.77)min,en bloc resection rate was 98%(41/42)and complete resection rate was 93%(39/42).Histopathologic examinations showed that there were 11 low-grade intraepithelial neoplasia cases,23 high-grade intraepithelial neoplasia cases,and 8 submucosal(SM)adenocarcinoma cases.For the complication,perforation occurred in 3 cases and delayed bleeding occurred in 0 cases.All complications were successfully resolved under endoscopy management.No recurrences,anal stenosis and defecation difficulties events were observed during the follow-up period in all patients.Conclusion The 8-like ring assisted ESD is safe and feasible as a minimal invasive way for treatment.