内镜下注水法冷圈套器切除术在治疗5~10 mm无蒂型大肠息肉中的疗效分析

Analysis of the therapeutic effect of endoscopic underwater cold snare polypectomy in the treatment of 5-10 mm sessile colorectal polyps

目的研究注水法内镜下冷圈套器切除术在5~10 mm无蒂型大肠息肉中的临床疗效。方法纳入120例阳春市中医院收治的5~10 mm无蒂型大肠息肉患者,合计246枚息肉,根据结肠息肉切除方式不同分为内镜下注水法冷圈套器切除术(UCSP)与传统内镜下冷圈套器切除术(CCSP)两组,每组分别纳入60例患者。比较两组息肉部位、息肉大小、术后病理诊断、完整息肉切除率、术后病理深度、息肉回收率、手术时间、术中瞬时性出血率、迟发性穿孔率、迟发性出血率以及手术时间、Boston及视觉模拟评分法(VAS)评分。结果两组息肉部位、息肉大小、术后病理诊断、完整息肉切除率、息肉回收率、术中瞬时性出血率、迟发性穿孔率、迟发性出血率以及Boston评分比较差异均无统计学意义(P>0.05);UCSP组术后病理深度[(8.80.5)mm]大于CCSP组[(5.90.4)mm](P<0.01),CCSP组手术时间[(21.32.4)min],较UCSP组[(25.71.1)min]缩短(P<0.01),VAS评分UCSP组[(2.60.7)分]优于CCSP组[(2.90.3)分](P<0.001)。结论UCSP能有效、安全5~10 mm无蒂型大肠息肉,术后深度的病理组织学评估获得更高的肌层黏膜切除深度,虽然UCSP手术时间较长,但术后腹痛发生率较低。

Objective To study the clinical efficacy of endoscopic cold snare resection using water injection method in 5-10 mm pedunculated colorectal polyps.Methods A total of 120 patients with 5-10 mm sessile colorectal polyps admitted to Yangchun Traditional Chinese Medicine Hospital were selected as the research subjects.A total of 246 polyps were enrolled,and the patients were divided into two groups based on the different methods of endoscopic resection:underwater cold snare polypectomy(UCSP)and conventional cold snare polypectomy(CCSP),with 60 patients enrolled in each group.Compare the location,size,postoperative pathological diagnosis,complete polypectomy rate,postoperative pathological depth,polyp recovery rate,surgical time,instantaneous intraoperative bleeding rate,delayed perforation rate,delayed bleeding rate,surgical time,Boston and VAS scores between two groups.Results Two groups of polyp locations,polyp size,postoperative pathological diagnosis,complete polyp resection rate,polyp recovery rate,the instantaneous intraoperative bleeding rate,delayed perforation rate,delayed bleeding rate,and Boston score,all of above were not significant different(P>0.05);the postoperative pathological depth in the UCSP group[(8.8±0.5)mm]was significantly greater than that in the CCSP group[(5.9±0.4)mm](P<0.01),and the surgical time in the CCSP group[(21.3±2.4)min]was shorter than that in the UCSP group[(25.7±1.1)min](P<0.01).The VAS score in the UCSP group(2.6±0.7)was significantly better than that in the CCSP group(2.9±0.3)(P<0.001).Conclusions The underwater cold snare polypectomy can achieve good therapeutic results in patients with 5-10 mm sessile colorectal polyps.Further pathological evaluation of postoperative can obtain deeper of myomucosal resection.Although the UCSP group has a longer surgical time,the incidence of postoperative abdominal pain is lower.