目的:分析结肠10 mm以下息肉采用内镜下结肠息肉冷切除术的治疗效果与安全性。方法:选取2019年1月—2020年12月遵义市红花岗区人民医院收治的80例结肠10 m m以下息肉患者,采用数字抽签法将其分为实验组与参照组各40例。实验组采用内镜...目的:分析结肠10 mm以下息肉采用内镜下结肠息肉冷切除术的治疗效果与安全性。方法:选取2019年1月—2020年12月遵义市红花岗区人民医院收治的80例结肠10 m m以下息肉患者,采用数字抽签法将其分为实验组与参照组各40例。实验组采用内镜下结肠息肉冷切除术治疗,参照组采用内镜下高频电切手术治疗。比较分析两组患者手术相关指标(手术时间、住院时间、胃肠功能恢复时间、术中出血量)、并发症发生率(术中出血、术后出血)、手术前后血清C反应蛋白、肿瘤坏死因子-α水平变化。结果:实验组患者的手术时间、住院时间、胃肠功能恢复时间均短于参照组,差异有统计学意义(P<0.05);实验组患者的术中出血量少于参照组,差异有统计学意义(P<0.05)。实验组患者的并发症发生率(2.50%)低于参照组(17.50%),差异有统计学意义(P<0.05)。手术前,两组患者的C反应蛋白、肿瘤坏死因子-α指标对比,差异无统计学意义(P>0.05);手术后,实验组患者低于参照组,差异有统计学意义(P<0.05)。结论:在结肠10 m m以下息肉患者的临床治疗中采用内镜下结肠息肉冷切除术的效果显著,可缩短患者术后恢复时间,减少术后并发症发生率,值得临床应用。展开更多
AIM: To examine the efficacy and complications of colonoscopic resection of colorectal polypoid lesions. METHODS: We retrospectively reviewed 1354 polypectomies performed on 1038 patients over a ten- year period. One ...AIM: To examine the efficacy and complications of colonoscopic resection of colorectal polypoid lesions. METHODS: We retrospectively reviewed 1354 polypectomies performed on 1038 patients over a ten- year period. One hundred and sixty of these were performed for large polyps, those measuring ≥ 20 mm. Size, shape, location, histology, the technique of polypectomy used, complications, drugs assumption and associated intestinal or extra intestinal diseases were analyzed. For statistical analysis, the Pearson χ2 test, NPC test and a Binary Logistic Regression were used. RESULTS: The mean patient age was 65.9 ± 12.4 years, with 671 men and 367 women. The mean size of polyps removed was 9.45 ± 9.56 mm while the size of large polyps was 31.5 ± 10.8 mm. There were 388 pedunculated and 966 sessile polyps and the most common location was the sigmoid colon (41.3%). The most frequent histology was tubular adenoma (55.9%) while for the large polyps was villous (92/160 -57.5%). Coexistent malignancy was observed in 28 polyps (2.1%) and of these, 20 were large polyps. There were 17 procedural bleeding (1.3%) and one perforation. The statistical analysis showed that cancer is correlated to polyp size (P < 0.0001); sessile shape (P < 0.0001) and bleeding are correlated to cardiac disease (P = 0.034), tubular adenoma (P = 0.016) and polyp size.CONCLUSION: The endoscopic resection is a simple and safe procedure for removing colon rectal neoplastic lesions and should be considered the treatment of choice for large colorectal polyps. The polyp size is an important risk factor for malignancy and for bleeding.展开更多
Colonic perforation during endoscopic diagnostic or therapeutic procedures,represents an uncommon occurrence even if,together with haemorrhage,it is still the most common complication of colonoscopy,with an incidence ...Colonic perforation during endoscopic diagnostic or therapeutic procedures,represents an uncommon occurrence even if,together with haemorrhage,it is still the most common complication of colonoscopy,with an incidence ranging between 0.1% and 2% of all colonoscopic procedures. The ideal treatment in these cases remains elusive as the endoscopist and the surgeon have to make a choice case by case,depending on many factors such as how promptly the rupture is identified,the condition of the patient,the degree of contamination and the evidence of peritoneal irritation. Surgical interventions both laparotomic and laparoscopic,and other medical non-operative solutions are described in the literature. Only three cases have been reported in the literature in which the endoscopic apposition of endoclips was used to repair a colonic perforation during colonoscopy. Ours is the first case that the perforation itself was caused by the improper functioning of a therapeutic device.展开更多
A case of inflammatory myoglandular polyp (IMGP) causing hematochezia is reported. The patient was a 33-year-old man who visited our hospital for further evaluation of hematochezia. Colonoscopy revealed a red, hard, s...A case of inflammatory myoglandular polyp (IMGP) causing hematochezia is reported. The patient was a 33-year-old man who visited our hospital for further evaluation of hematochezia. Colonoscopy revealed a red, hard, spherical peduncular polyp with erosion and mucous exudation, about 20 mm in diameter, in the descending colon. Excluding the polyp, there was no lesion in the colorectum. Endoscopic polypectomy was performed. Histological examination of the specimen revealed inflammatory granulation tissue in the lamina propria, proliferation of smooth muscle, and hyperplastic glands with variable cystic changes. This polyp was diagnosed as an IMGP. The symptom of hematochezia was resolved after endoscopic resection. Our case shows that treatment is necessary for IMGP if intestinal bleeding occurs and endoscopists should be aware of the endoscopic characteristics of IMGP.展开更多
文摘目的:分析结肠10 mm以下息肉采用内镜下结肠息肉冷切除术的治疗效果与安全性。方法:选取2019年1月—2020年12月遵义市红花岗区人民医院收治的80例结肠10 m m以下息肉患者,采用数字抽签法将其分为实验组与参照组各40例。实验组采用内镜下结肠息肉冷切除术治疗,参照组采用内镜下高频电切手术治疗。比较分析两组患者手术相关指标(手术时间、住院时间、胃肠功能恢复时间、术中出血量)、并发症发生率(术中出血、术后出血)、手术前后血清C反应蛋白、肿瘤坏死因子-α水平变化。结果:实验组患者的手术时间、住院时间、胃肠功能恢复时间均短于参照组,差异有统计学意义(P<0.05);实验组患者的术中出血量少于参照组,差异有统计学意义(P<0.05)。实验组患者的并发症发生率(2.50%)低于参照组(17.50%),差异有统计学意义(P<0.05)。手术前,两组患者的C反应蛋白、肿瘤坏死因子-α指标对比,差异无统计学意义(P>0.05);手术后,实验组患者低于参照组,差异有统计学意义(P<0.05)。结论:在结肠10 m m以下息肉患者的临床治疗中采用内镜下结肠息肉冷切除术的效果显著,可缩短患者术后恢复时间,减少术后并发症发生率,值得临床应用。
文摘AIM: To examine the efficacy and complications of colonoscopic resection of colorectal polypoid lesions. METHODS: We retrospectively reviewed 1354 polypectomies performed on 1038 patients over a ten- year period. One hundred and sixty of these were performed for large polyps, those measuring ≥ 20 mm. Size, shape, location, histology, the technique of polypectomy used, complications, drugs assumption and associated intestinal or extra intestinal diseases were analyzed. For statistical analysis, the Pearson χ2 test, NPC test and a Binary Logistic Regression were used. RESULTS: The mean patient age was 65.9 ± 12.4 years, with 671 men and 367 women. The mean size of polyps removed was 9.45 ± 9.56 mm while the size of large polyps was 31.5 ± 10.8 mm. There were 388 pedunculated and 966 sessile polyps and the most common location was the sigmoid colon (41.3%). The most frequent histology was tubular adenoma (55.9%) while for the large polyps was villous (92/160 -57.5%). Coexistent malignancy was observed in 28 polyps (2.1%) and of these, 20 were large polyps. There were 17 procedural bleeding (1.3%) and one perforation. The statistical analysis showed that cancer is correlated to polyp size (P < 0.0001); sessile shape (P < 0.0001) and bleeding are correlated to cardiac disease (P = 0.034), tubular adenoma (P = 0.016) and polyp size.CONCLUSION: The endoscopic resection is a simple and safe procedure for removing colon rectal neoplastic lesions and should be considered the treatment of choice for large colorectal polyps. The polyp size is an important risk factor for malignancy and for bleeding.
文摘Colonic perforation during endoscopic diagnostic or therapeutic procedures,represents an uncommon occurrence even if,together with haemorrhage,it is still the most common complication of colonoscopy,with an incidence ranging between 0.1% and 2% of all colonoscopic procedures. The ideal treatment in these cases remains elusive as the endoscopist and the surgeon have to make a choice case by case,depending on many factors such as how promptly the rupture is identified,the condition of the patient,the degree of contamination and the evidence of peritoneal irritation. Surgical interventions both laparotomic and laparoscopic,and other medical non-operative solutions are described in the literature. Only three cases have been reported in the literature in which the endoscopic apposition of endoclips was used to repair a colonic perforation during colonoscopy. Ours is the first case that the perforation itself was caused by the improper functioning of a therapeutic device.
文摘A case of inflammatory myoglandular polyp (IMGP) causing hematochezia is reported. The patient was a 33-year-old man who visited our hospital for further evaluation of hematochezia. Colonoscopy revealed a red, hard, spherical peduncular polyp with erosion and mucous exudation, about 20 mm in diameter, in the descending colon. Excluding the polyp, there was no lesion in the colorectum. Endoscopic polypectomy was performed. Histological examination of the specimen revealed inflammatory granulation tissue in the lamina propria, proliferation of smooth muscle, and hyperplastic glands with variable cystic changes. This polyp was diagnosed as an IMGP. The symptom of hematochezia was resolved after endoscopic resection. Our case shows that treatment is necessary for IMGP if intestinal bleeding occurs and endoscopists should be aware of the endoscopic characteristics of IMGP.
