结直肠小息肉圈套器冷切除术与内镜下黏膜切除术治疗效果对比分析

Comparative Analysis of the Therapeutic Effects of Cold Snare Polypectomy and Endoscopic Mucosal Resection with Small Colorectal Polyp

目的比较圈套器冷切除术(cold snare polypectomy,CSP)与内镜下黏膜切除术(endoscopic mucosal resection,EMR)治疗结直肠小息肉的效果。方法选取2021年6月—2022年6月济南市第七人民医院消化内科收治的190例结直肠无蒂小息肉(直径5~9 mm)患者为研究对象,根据不同的手术方式分为观察组(采用CSP治疗)、对照组(采用EMR治疗),各95例。比较两组息肉切除情况、并发症、复发(息肉复发、息肉新生)情况。结果观察组息肉切除时间短于对照组,差异有统计学意义(P<0.05)。观察组术后迟发性出血发生率为1.05%(1/95),低于对照组的7.37%(7/95),差异有统计学意义(χ^(2)=4.698,P=0.030)。两组患者息肉完整切除率、标本回收率比较,差异无统计学意义(P均>0.05)。两组患者均无穿孔、术后感染。两组术中出血、术后1年息肉复发率及息肉新生发生率比较,差异无统计学意义(P均>0.05)。结论采用CSP、EMR治疗结直肠小息肉,并发症少、息肉完整切除率高和复发率低。CSP可缩短手术时间、减少术后迟发性出血、操作更简单。

Objective To compare the effect of cold snare polypectomy(CSP)and endoscopic mucosal resection(EMR)in the treatment of small colorectal polyps.Methods A total of 190 patients with colorectal sessile small polyps(diameter 5-9 mm)admitted to Department of Gastroenterology of Jinan Seventh People's Hospital from June 2021 to June 2022 were selected as the research objects.According to different surgical methods,they were divided into observation group(treated with CSP)and control group(treated with EMR),with 95 cases in each group.The polyp resection,complications and recurrence(polyp recurrence,polyp regeneration)were compared between the two groups.Results The polyp resection time in the observation group was shorter than that in the control group,the difference was statistically significant(P<0.05).The incidence of postoperative delayed bleeding in the observation group was 1.05%(1/95),which was lower than that 7.37%(7/95)in the control group,and the difference was statistically significant(χ^(2)=4.698,P=0.030).There was no significant difference in complete polyp removal rate and specimen recovery rate between two groups(both P>0.05).There was no perforation or postoperative infection in both groups.There was no significant difference in the incidence of intraoperative bleeding,polyp recurrence and polyp regeneration of 1 year after operation between the two groups(all P>0.05).Conclusion CSP and EMR treatment with small colorectal polyps,with fewer complications,high complete resection rate of polyps and low recurrence rate.CSP can significantly shorten the operation time,reduce postoperative delayed bleeding,and make the operation simpler.