Management of local recurrence after endoscopic resection of neoplastic colonic polyps

A proportion of neoplastic polyps are incompletely resected, resulting in local recurrence, especially after resection of large polyps or piecemeal resection. Local recurrences that develop after endoscopic resection of intramucosal neoplasms that lacked risk factors for lymph node metastasis or positive vertical margins are usually treated endoscopically. Endoscopic submucosal dissection(ESD) is indicated for local residual or recurrent early carcinomas after endoscopic resection. However, ESD for such recurrent lesions is technically difficult and is typically a lengthy procedure. Underwater endoscopic mucosal resection(UEMR), which was developed in 2012, is suitable for recurrent or residual lesions and reportedly achieves superior en bloc resection rates and endoscopic complete resection rates than conventional EMR. However, a large recurrent lesion is a negative independent predictor of successful en bloc resection and of complete endoscopic removal. We therefore perform UEMR for relatively small(≤ 10-15 mm) recurrent lesions and ESD for larger lesions.

Cold snare polypectomy:A closer look at the efficacy and limitations for polyps 10-20 mm in size

Current guidelines recommend cold snare polypectomy for polyps less than 10 mm in size.Conversely,endoscopic mucosal resection is still the preferred technique for larger polyps.Concerns regarding cold snare polypectomy for larger polyps revolve around the difficulty in conducting en-bloc resection(resulting in piecemeal removal),and the potential for local residual polyp tissue and a high rate of recurrence.On the other hand,cold snare technique has the advantages of shortening procedure time,reducing delayed bleeding risks and lowering cost of treatment.Numerous ongoing and recent studies are focused on evaluating the risks and benefits of this technique for polyps larger than 10 mm,with the goal of providing clear guidelines in the near future.The aim of this editorial is to provide our readers with an overview regarding this subject and the latest developments surrounding it.

Endoscopic submucosal dissection vs endoscopic mucosal resection for colorectal polyps:A meta-analysis and metaregression with single arm analysis

BACKGROUND Endoscopic submucosal dissection(ESD)has shown to be effective in management of colorectal neoplasm in the Asian countries,while its implementation in Western countries where endoscopic mucosal resection(EMR)is preferred is still debatable.AIM To compare the surgical,histological,and oncological outcomes between ESD and EMR in the treatment of colorectal polyps,with subgroup analysis comparing the efficacy of ESD and EMR between Japan and the rest of the world.METHODS Embase and Medline databases were searched from inception to October 2020 in accordance with PRISMA guidelines for studies comparing en bloc,complete resection,margin involvement,resection time,need for additional surgery,complications,and recurrence rate of ESD with EMR.RESULTS Of 281344 colorectal polyps from 21 studies were included.When compared to EMR,the pooled analysis revealed ESD was associated with higher en bloc and complete resection rate,and lower lateral margin involvement and recurrence.ESD led to increased procedural time,need for additional surgery,and perforation risk.No significant difference in bleeding risk was found between the two groups.Meta-regression analysis suggested only right colonic polyps correlated with an increased perforation risk in ESD.Confounders including polyp size and invasion depth did not significantly influence the en bloc and complete resection rate,bleeding risk and recurrence.In subgroup analysis,Japan performed better than the rest of the world in both ESD and EMR with perforation risk of 4%and 0.0002%,respectively,as compared to perforation risk of 8%and 1%,respectively,in reports coming from rest of the world.CONCLUSION ESD resulted in better resection outcomes and lower recurrence compared to EMR.With appropriate training,ESD is preferred over EMR as the first-line therapy for resection of colorectal polyps,without restricting to lesions greater than 20 mm and those with high suspicion of submucosal invasion.

What can be the criteria of outpatient-based endoscopic resection for colon polyp?

AIM: To investigate whether out-patient based endo-scopic mucosal resection(EMR) for colon polyps ≤ 10 mm is safe.METHODS: Between January 2004 and December 2012, a total of 3015 EMR cases conducted in 1320 patients were retrospectively reviewed. The factors contributing delayed hemorrhage were analyzed. We calculated the probability of delayed bleeding after stratifying conditions of specific risk factors.RESULTS: The size of the polyp(95%CI: 1.096-1.164, P < 0.001) and patients with chronic renal failure(95%CI: 1.856-45.106, P = 0.007) were identified as independent risk factors for delayed bleeding in multi-variate analysis. 95%CI for percent of delayed bleedingaccording to polyp size was determined for the fol-lowing conditions: size ≤ 10 mm, 0.05%-0.43%; 20 mm ≥ size > 10 mm, 0.54%-2.08%; size > 20 mm, 4.22%-11.41%. 95%CI was determined for the risk of serious immediate bleeding for a polyp ≤ 10 mm was 0.10%-0.56%. Finally, 95%CI for percent of incomplete resection was 0.07%-0.49% in polyps ≤ 10 mm. CONCLUSION: It seems acceptable to perform outpa-tient-based EMR for colon polyps ≤ 10 mm.

Extensively infarcted giant solitary hamartomatous polyp treated with endoscopic full-thickness resection:A case report

BACKGROUND Solitary hamartomatous polyps(SHPs)are rare lesions.Endoscopic full-thickness resection(EFTR)is a highly efficient and minimally invasive endoscopic procedure that benefits from complete lesion removal and high safety.CASE SUMMARY A 47-year-old man was admitted to our hospital after experiencing hypogastric pain and constipation for over fifteen days.Computed tomography and endoscopy revealed a giant pedunculated polyp(approximately 18 cm long)in the descending and sigmoid colon.This is the largest SHP reported to date.Having considered the condition of the patient and mass growth,the polyp was removed using EFTR.CONCLUSION On the basis of clinical and pathological evaluations,the mass was considered an SHP.

Endoscopic management of colorectal polyps: From benign to malignant polyps

Colorectal cancer(CRC)is the third most common cancer worldwide and the second leading cause of cancer related death in the world.The early detection and removal of CRC precursor lesions has been shown to reduce the incidence of CRC and cancer-related mortality.Endoscopic resection has become the first-line treatment for the removal of most precursor benign colorectal lesions and selected malignant polyps.Detailed lesion assessment is the first critical step in the evaluation and management of colorectal polyps.Polyp size,location and both macro-and micro-features provide important information regarding histological grade and endoscopic resectability.Benign polyps and even malignant polyps with superficial submucosal invasion and favorable histological features can be adequately removed endoscopically.When compared to surgery,endoscopic resection is associated with lower morbidity,mortality,and higher patient quality of life.Conversely,malignant polyps with deep submucosal invasion and/or high risk for lymph node metastasis will require surgery.From a practical standpoint,the most appropriate strategy for each patient will need to be individualized,based not only on polyp-and patient-related characteristics,but also on local resources and expertise availability.In this review,we provide a broad overview and present a potential decision tree algorithm for the evaluation and management of colorectal polyps that can be widely adopted into clinical practice.

Case of pediatric traditional serrated adenoma resected via endoscopic submucosal dissection

Traditional serrated adenoma(TSA)is a type of serrated polyp of the colorectum and is thought to be a precancerous lesion.There are three types of serrated polyps,namely,hyperplastic polyps,sessile serrated adenomas/polyps,and TSAs.TSA is the least common of the three types and accounts for about 5% of serrated polyps.Here we report a pediatric case of TSA that was successfully resected by endoscopic submucosal dissection(ESD).This rare case report describes a pediatric patient with no family history of colonic polyp who was admitted to our hospital with hematochezia.On colonoscopy,we found a polypoid lesion measuring 10 mm in diameter in the lower rectum.We selected ESD as a surgical option for en bloc resection,and histopathological examination revealed TSA.The findings in this case suggest that TSA with precancerous potential can occur in children,and that ESD is useful for treating this lesion.

Management of malignant colon polyps:Current status and controversies

Colon cancer remains a significant clinical problem worldwide and in the United States it is the third most common cancer diagnosed in men and women.It is generally accepted that most malignant neoplasms of the colon arise from precursor adenomatous polyps.This stepwise progression of normal epithelium to carcinoma,often with intervening dysplasia,occurs as a result of multiple sequential,genetic mutations-some are inherited while others are acquired.Malignant polyps are defined by the presence of cancer cells invading through the muscularis mucosa into the underlying submucosa(T1).They can appear benign endoscopically but the presence of malignant invasion histologically poses a difficult and often controversial clinical scenario.Emphasis should be initially focused on the endoscopic assessment of these lesions.Suitable polyps should be resected en-bloc,if possible,to facilitate thorough evaluation by pathology.In these cases,proper attention must be given to the risks of residual cancer in the bowel wall or in the surrounding lymph nodes.If resection is not feasible endoscopically,thenthese patients should be referred for surgical resection.This review will discuss the important prognostic features of malignant polyps that will most profoundly affect this risk profile.Additionally,we will discuss effective strategies for their overall management.

Efficacy and adverse events of cold vs hot polypectomy: A meta-analysis

AIM: To compare previously reported randomized controlled studies (RCTs) of cold and hot polypectomy, we systematically reviewed and clarify the utility of cold polypectomy over hot with respect to efficacy and adverse events.METHODS: A meta-analysis was conducted to evaluate the predominance of cold and hot polypectomy for removing colon polyps. Published articles and abstracts from worldwide conferences were searched using the keywords &#x0201c;cold polypectomy&#x0201d;. RCTs that compared either or both the effects or adverse events of cold polypectomy with those of hot polypectomy were collected. The patients&#x02019; demographics, endoscopic procedures, No. of examined lesions, lesion size, macroscopic and histologic findings, rates of incomplete resection, bleeding amount, perforation, and length of procedure were extracted from each study. A forest plot analysis was used to verify the relative strength of the effects and adverse events of each procedure. A funnel plot was generated to assess the possibility of publication bias.RESULTS: Ultimately, six RCTs were selected. No significant differences were noted in the average lesion size (less than 10 mm) between the cold and hot polypectomy groups in each study. Further, the rates of complete resection and adverse events, including delayed bleeding, did not differ markedly between cold and hot polypectomy. The average procedural time in the cold polypectomy group was significantly shorter than in the hot polypectomy group.CONCLUSION: Cold polypectomy is a time-saving procedure for removing small polyps with markedly similar curability and safety to hot polypectomy.

Traction-assisted endoscopic mucosal resection for polypectomy in the large intestine

AIM: To evaluate if traction-assisted endoscopic mucosal resection (TA-EMR) is feasible and if it enables en bloc resection of colorectal lesions. METHODS: Seven patients with a total of 12 colorectal adenomas were prospectively enrolled. All lesions were removed by TA-EMR: one hemostatic clip tied to a white silk suture was applied to the base of the lesion to allow traction through the working channel of the colonoscope. A conventional polypectomy snare was mounted over the suture and the lesion was pulled into the snare and resected in one piece. RESULTS: All 12 lesions (nine sessile) were resected en bloc with free lateral and vertical margins by using this novel technique, including five lesions (5/12, 41.6%) in less-accessible positions, where TA-EMR enabled complete visualization of the base before resection. Mean longest lesion and specimen sizes were 9 mm (range: 6-25 mm) and 11 mm in diameter (range: 7-17 mm),respectively. No serious procedure-related complications were observed. CONCLUSION: TA-EMR through the endoscope using a hemostatic clip and suture material is technically feasible. Visualization of colorectal lesions in less-accessible locations can be improved.

Meta-analysis comparing differing methods of endoscopic therapy for colorectal lesions

AIM： To compare the outcomes of endoscopic mucosal resection （EMR） and endoscopic submucosal dissection （ESD） of colorectal lesions.METHODS： An electronic systematic literature search of four computerized databases was performed in July 2014 identifying studies reporting the outcomes of colorectal ESD and EMR. The primary outcome measures were en-bloc resection rate, endoscopic clearance rate and lesion recurrence rate of the patients followed up. The secondary outcome was the complication rate （including bleeding, perforation and surgery post EMR or ESD rate）. Statistical pooling and random effects modelling of the studies calculating risk difference, heterogeneity and assessment of bias and quality were performed.RESULTS： Six observational studies reporting the outcomes of 1324 procedures were included. The en-bloc resection rate was 50% higher in the ESD group than in the EMR group （95%CI： 0.17-0.83, P 〈 0.0001, I2 = 99.7%）. Endoscopic clearance rates were also signifcantly higher in the ESD group （95%CI： -0.06-0.02, P 〈 0.0001, I2 = 92.5%）. The perforation rate was 7% higher in the ESD group than the EMR group （95%CI： 0.05-0.09, P 〉 0.05, I2 = 41.1%） and the rate of recurrence was 50% higher in the EMR group than in the ESD group （95%CI： 0.20-0.79, P 〈 0.001, I2 = 99.5%）. Heterogeneity remained consistent when subgroup analysis of high quality studies was performed （with the exception of piecemeal resection rate）, and overall effect sizes remained unchanged for all outcomes.CONCLUSION： ESD demonstrates higher en-bloc resection rates and lower recurrence rates compared to colorectal EMR. Differences in outcomes may beneft from increased assessment through well-designed comparative studies.

Analysis of the Pathological Examination Results of 100 Colon Polyps Cases after EMR or ESD Operation

Aim: To study the characteristics of EMR (endoscopic mucosal resection) or ESD (endoscopic submucosal dissection) postoperative pathological examination of colonic polyps in different age groups, and the difference of pathological examination after EMR or ESD operation. Methods: A retrospective analysis was made of the EMR or ESD postoperative pathological data of 100 cases of colonic polyps patients in the Jingzhou Central Hospital digestive internal medicine. The time is from March 2016 to March 2018. Results: In 100 cases of EMR or ESD operation, there are 65 cases of young and middle-aged group. Pathological examination results include: 34 cases of adenomatous polyp, 18 cases of inflammatory polyp, 11 cases of benign tumors, 1 case of malignant tumor, 1 case of hyperplastic polyp. There are 35 cases of elderly group. Pathological examination results include: 27 cases of adenomatous polyp, 2 cases of inflammatory polyp, 2 cases of benign tumors, 4 cases of malignant tumor. 71 cases of complete EMR operation include: 51 cases of adenomatous polyp, 17 cases of inflammatory polyp, 3 cases of benign tumors;29 cases of complete ESD operation include: 10 cases of adenomatous polyp, 3 cases of inflammatory polyp, 10 cases of benign tumors, 5 cases of malignant tumor, 1 case of hyperplastic polyp. Conclusion: For the pathological examination results after EMR or ESD operation, the proportion of inflammatory polyps in the young and middle-aged group was greater than that in the elderly group. The proportion of adenomatous polyps in the elderly group was larger than that in the young and middle-aged group. The proportion of adenomatous polyps in EMR was greater than that of ESD. The proportion of benign tumors and malignant tumors in ESD was greater than that of EMR. The difference has statistical significance.

不同方法治疗结肠多发腺瘤性小息肉的临床研究

目的比较热圈套息肉切除术(HSP)、冷圈套息肉切除术(CSP)、黏膜下注射冷圈套切除(CS-EMR)治疗结肠多发腺瘤性小息肉的临床价值。方法本研究为回顾性分析,选取2021年10月至2022年8月内蒙古医科大学附属医院消化内科行结肠息肉切除的450例结肠息肉患者为研究对象。根据手术方案的不同分为三组,选择采取热圈套息肉切除术治疗的患者150例为HSP组、选择采取冷圈套息肉切除术治疗的患者150例为CSP组、选择采取黏膜下注射冷圈套切除术治疗的患者150例为CS-EMR组。收集患者的基线资料,对比分析组间手术指标及息肉基本特征。结果三组患者的基线资料、息肉基本特征比较,差异均无统计学意义(P>0.05)。息肉切除时间比较,CSP组<CS-EMR组<HSP组,差异有统计学意义(P<0.05);止血夹使用数量比较,HSP组低于CSP组和CS-EMR组(P<0.05);息肉完整切除率,CSP组低于CS-EMR组和HSP组(P<0.05);术中出血率比较,HSP组、CS-EMR组低于CSP组(P<0.05);迟发性出血率比较,HSP组高于CSP组和CS-EMR组(P<0.05)。结论CSP、HSP、CS-EMR均是治疗结肠多发小息肉的有效方案,CSP术中出血率较高、息肉完整切除率较低,HSP迟发性出血率较高,CS-EMR息肉完整切除率较高、术中出血率和迟发性出血率均较低。

内镜下黏膜切除术与高频电凝电切术治疗结肠巨大息肉效果及安全性分析

目的:探究内镜下黏膜切除术(EMR)治疗结肠巨大息肉的效果。方法:选择2019年5月—2022年5月在大连市第三人民医院进行治疗的110例结肠巨大息肉患者,应用随机数字表法将其分为对照组(行高频电凝电切术)及研究组(行EMR),各55例。对比两组临床指标(手术时间、住院时间)、临床疗效、应激反应[肾上腺素(E)、去甲肾上腺素(NE)、皮质醇(Cor)]、炎症反应[白细胞介素-6(IL-6)、白细胞介素-12(IL-12)、白细胞介素-1β(IL-1β)]、并发症发生情况。结果:研究组手术时间、住院时间均短于对照组,差异均有统计学意义(P<0.05)。研究组临床疗效优于对照组,差异有统计学意义(P<0.05)。与术前比较,术后两组E、NE、Cor均升高,研究组上述指标均低于对照组,差异均有统计学意义(P<0.05)。与术前比较,术后两组IL-6、IL-12、IL-1β均升高,研究组上述指标均低于对照组,差异均有统计学意义(P<0.05)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:结肠巨大息肉患者行EMR治疗,可提高临床疗效,减轻炎症反应、应激反应,减少并发症发生,促进康复。

内镜下黏膜切除术治疗结肠息肉效果及复发相关因素分析

目的探讨内镜下黏膜切除术(EMR)治疗结肠息肉的效果,分析其复发相关因素。方法选取2020年10月—2023年12月收治的结肠息肉120例,根据手术方式不同将其分为EMR组(采用EMR,69例)和电切术组(采用内镜下高频电切术,51例)2组。比较2组手术相关指标、临床疗效、并发症和复发情况;采用单因素和多因素Logistic回归分析探讨影响EMR术后结肠息肉复发的相关因素。结果EMR组手术时间、胃肠功能恢复时间和住院时间均短于电切术组,术中出血量少于电切术组(P<0.01)。术后2个月,EMR组总有效率(67/69,97.10%)高于电切术组(44/51,86.27%)(P<0.05);EMR组并发症发生率(2/69,2.90%)低于电切术组(7/51,13.73%)(P<0.05)。术后6个月,2组复发率比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,体质量指数和息肉直径为影响EMR术后结肠息肉复发的独立危险因素(P<0.01)。结论EMR治疗结肠息肉效果良好,利于改善手术相关指标,减少术后并发症。体质量指数和息肉直径为影响EMR术后结肠息肉复发的独立危险因素。

结肠息肉内镜下切除术后迟发性出血的危险因素分析

目的:探讨结肠息肉内镜下切除术后迟发性出血的危险因素。方法:回顾性分析2019年1月1日~2020年12月31日在芜湖市中医医院内镜中心行结肠息肉切除的735例患者的临床资料,分析与结肠息肉术后迟发性出血相关的因素。结果:术后迟发性出血发生率为6.80%;单因素分析显示,术后迟发性出血与年龄(P=0.045)、性别(P=0.007)、术后进食时间(P<0.001)、息肉外观(P<0.001)、息肉直径(P=0.016)、切除息肉数量(P=0.017)、息肉有蒂(P<0.001)、息肉分叶(P<0.001)、钛夹夹闭方式(P<0.001)有关;多因素Logistics回归分析显示,高龄(OR=1.03,95%CI:1.005~1.055)、术后进食时间24~48 h(OR=3.909,95%CI:2.185~6.995)、术后进食时间>48 h(OR=7.244,95%CI:3.218~16.304)、息肉外观发红(OR=47.608,95%CI:23.117~98.042)、切除息肉数量≥5枚(OR=3.999,95%CI:1.728~9.255)、息肉有蒂(OR=2.904,95%CI:1.678~5.024)均是术后出血的独立危险因素(P<0.05)。结论:高龄、男性、息肉外观发红、息肉有蒂、切除息肉数量≥5枚、术后近期进食增加结肠息肉内镜下切除术后迟发性出血风险。

内镜下黏膜切除术与圈套器冷切除术治疗结肠息肉患者的效果对比

目的对比内镜下黏膜切除术(EMR)与圈套器冷切除术(CSP)治疗结肠息肉患者的效果。方法选择2022年1月至2023年6月我院收治的结肠息肉患者78例,随机分为两组各39例。对照组行EMR治疗,观察组行CSP治疗。比较两组息肉切除效果、手术相关指标及并发症发生情况。结果两组的息肉切除总有效率比较差异无统计学意义(P>0.05)。观察组息肉切除时间、住院时间短于对照组,VAS评分及并发症发生率低于对照组(P<0.05)。结论EMR、CSP治疗结肠息肉的效果相当,但CSP所需时间更短,术后疼痛轻、并发症少、恢复快,应用价值更高,值得临床推广应用。

Oakland评分系统联合凝血功能指标对结肠息肉内镜切除术后下消化道出血的预测价值

目的 分析Oakland评分系统联合凝血功能指标对结肠息肉内镜切除术后下消化道出血的预测价值。方法 选取2020年1月~2023年5月于成都郫都区人民医院接受结肠息肉内镜切除术的患者337例,依据术后72 h内是否发生下消化道出血将其分为未出血组(308例)、出血组(29例)。比较两组患者基本资料,纤维蛋白原(FIB)、血小板(PLT)、凝血酶原时间(PT)、D-二聚体(D-D)、Oakland评分,分析Oakland评分、凝血指标对息肉切除术后下消化道出血风险的预测价值。结果 与未出血组对比,出血组的Oakland评分、D-D水平上升[(5.29±1.42)分vs.(9.13±1.78)分、(0.33±0.11)mg/L vs.(0.38±0.12)mg/L],PT时间延长[(12.42±1.30)s vs. 13.29±2.15)s],FIB、PLT水平降低[(3.42±1.10)g/L vs.(2.39±0.70)g/L、(255.34±43.19)×10^(9)/L vs.(178.51±32.45)×10^(9)/L],差异均有统计学意义(t=13.601、4.945、9.329、2.141、2.159,P<0.05)。多因素logistic回归分析发现,高血压、息肉直径、息肉是否有蒂、医师技术、Oakland评分、FIB、PLT、PT、D-D为患者术后发生下消化道出血的风险因素(P<0.05)。Oakland评分、FIB、PLT、PT、D-D与术后下消化道出血相关,相关系数分别为0.690、-0.618、-0.682、0.461、0.357。Oakland评分、FIB、PLT、PT、D-D五项联合预测患者术后下消化道出血的ROC曲线下面积最大,为0.853。结论 凝血指标、Oakland评分与结肠息肉患者术后出血密切相关,Oakland评分联合PLT、FIB、PT、D-D对预测息肉切除术后下消化道出血具有一定价值,对高出血风险患者,可制定针对性干预措施改善预后。

内镜下黏膜切除术对结肠息肉患者炎症因子、预后恢复的影响

目的探讨内镜下黏膜切除术对结肠息肉患者炎症因子、预后恢复的影响。方法方便选取2022年3月—2023年3月烟台海港医院收治的102例结肠息肉患者为研究对象。按照不同的治疗方案分成对照组和观察组,采取高频电切术治疗的51例患者纳入对照组,采取内镜下黏膜切除术的51例患者纳入观察组。比较两组的治疗效果、围术期指标、炎症因子、并发症。结果观察组总有效率为98.04%,高于对照组的78.43%,差异有统计学意义(χ^(2)=9.444,P=0.002)。观察组手术时间、住院时间、术后胃肠功能恢复时间均比对照组短,差异有统计学意义(P均<0.05)。术前,两组白细胞介素-6、白细胞介素-8、白细胞介素-1β比较,差异无统计学意义(P均>0.05);与术前相比,术后1 d两组上述炎性因子水平均上升明显,且观察组术后1 d上述炎性因子水平均比对照组低,差异有统计学意义(P均<0.05)。观察组并发症发生率比对照组更低,差异有统计学意义(P<0.05)。结论采用内镜下黏膜切除术治疗结肠息肉患者,能够有效抑制炎症反应,疗效显著,安全性高,可促进患者预后恢复。

内镜下不同术式治疗结直肠小息肉的临床效果分析

目的:比较内镜下黏膜切除术(EMR)、水下内镜黏膜切除术(UEMR)及冷圈套息肉切除术(CSP)治疗结直肠小息肉(直径6~9 mm)的临床效果。方法:选取2020年3月—2022年12月东莞市大朗医院消化内科收治的288例结直肠小息肉患者作为研究对象,随机分为EMR组(采用EMR治疗)、UEMR组(采用UEMR治疗)和CSP组(采用CSP治疗),各96例。对比三组治疗效果。结果:CSP组手术时间、住院时间短于EMR组、UEMR组(P<0.05),UEMR组手术时间、住院时间短于EMR组(P<0.05);三组息肉完整切除率、息肉回收率比较,差异无统计学意义(P>0.05)。术前,三组C反应蛋白(CRP)水平比较,差异无统计学意义(P>0.05);术后24 h,三组CRP水平均升高,但CSP组<UEMR组<EMR组,差异有统计学意义(P<0.05)。三组并发症总发生率比较,差异无统计学意义(P>0.05)。结论:相较于EMR、UEMR,CSP治疗结直肠小息肉的效果更显著,其手术时间更短,可减轻机体炎性反应,且并发症发生率低,安全性高。