冷圈套切除术与热圈套切除术治疗结直肠小息肉的对比研究

Comparative Study of Cold Snare Polypectomy and Hot Snare Polypectomy in Treatment of Small Colorectal Polyps

目的比较冷圈套切除术(CSP)与热圈套切除术(HSP)治疗结直肠小息肉的效果。方法选择2021年6月至2022年8月广州市花都区人民医院门诊收治的217例行CSP的结直肠小息肉(直径4~10 mm)患者纳入CSP组,另选取同期门诊收治的223例行HSP的结直肠小息肉(直径4~10 mm)患者纳入HSP组。比较两组患者的息肉参数(息肉大小、部位)、单个息肉切除所用时间、费用,治疗情况(术中出血率、术后迟发性出血率、钛夹使用率、标本回收失败率、息肉完全切除率、息肉整块切除率)及手术医师满意度评分。结果两组患者单个息肉切除时间比较差异无统计学意义(P>0.05),HSP组单个息肉切除费用明显低于CSP组[(1008±97)元比(1160±79)元](P<0.01)。两组患者术后迟发性出血率比较差异无统计学意义(P>0.05),HSP组术中出血率明显低于CSP组[0比9.22%(20/217)],钛夹使用率明显高于CSP组[49.33%(110/223)比34.10%(74/217)](P<0.01)。两组患者标本回收失败率及息肉完整切除率比较差异无统计学意义(P>0.05),HSP组息肉整块切除率明显高于CSP组[98.21%(219/223)比94.47%(205/217)](P<0.05)。HSP组手术医师满意度评分高于CSP组[(3.6±0.5)分比(3.1±0.5)分](P<0.01)。结论HSP用于治疗直径4~10 mm的结直肠小息肉,术中出血率及手术费用较低,医师手术满意度较高,相较于CSP,其安全性及经济学效益更高。

Objective To compare the effect of cold snare polypectomy(CSP)and hot snare polypectomy(HSP)in the treatment of small colorectal polyps.Methods A total of 217 patients with small colorectal polyps(4-10 mm)admitted to the outpatient department of Huadu District People′s Hospital of Guangzhou from Jun.2021 to Aug.2022 undergoing CSP treatment were included as a CSP group,and 223 patients with small colorectal polyps(4-10 mm)admitted to the outpatient department for HSP treatment during the same period were included as an HSP group.The polyp parameters(polyp size,location),time and cost of single polyp resection and treatment outcomes(intraoperative bleeding rate,delayed postoperative bleeding rate,use of titanium clips rate,failure rate of specimen retrieval,complete polyp resection rate,en bloc resection rate)and doctor′s satisfaction with surgery of the two groups were compared.Results There was no significant difference in the time of single polyp resection between the two groups(P>0.05),and the cost of single polyp resection in the HSP group was significantly lower than that in the CSP group[(1008±97)yuan vs(1160±79)yuan](P<0.01).The difference of postoperative delayed bleeding rate between the two groups was not statistically significant(P>0.05),the intraoperative bleeding rate of the HSP group was significantly lower than that of the CSP group[0 vs 9.22%(20/217)],and the utilization rate of titanium clips was significantly higher than that of the CSP group[49.33%(110/223)vs 34.10%(74/217)](P<0.01).There was no significant difference in the failure rate of specimen recovery and the rate of complete polyps between the two groups(P>0.05),and the en bloc resection rate of the HSP group was significantly higher than that of the CSP group[98.21%(219/223)vs 94.47%(205/217)](P<0.05).The surgical satisfaction score of surgeons in the HSP group was higher than that in the CSP group[(3.6±0.5)vs(3.1±0.5)](P<0.001).Conclusion In the treatment of small colorectal polyps with a diameter of 4-10 mm,HSP has lower intraoperative bleeding rate and cost,and higher doctor′s satisfaction,so compared with CSP,its safety and economic benefits are higher.