使用超范围剪切 (OTSC) 系统在复杂的ESD和EMR大结肠息肉后进行预防性剪切
T Blasberg1, J Hochberger2, M Meiborg1
1Division of Gastroenterology, Gastrointestinal Oncology and Interventional Endoscopy, Sana Clinic Offenbach, Starkenburgring 66, 63069, Offenbach, Germany.
Surgical endoscopy
|July 7, 2023
概括
在通过内镜下粘膜解剖 (ESD) 或内镜粘膜解剖 (EMR) 进行大结肠聚切除后,预防性超范围剪贴 (OTSC) 的应用有效地减少了延迟出血和穿孔风险. 这一策略为复杂的内镜手术提供了更好的安全性.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 结肠直肠手术 结肠直肠手术
背景情况:
- 延迟出血是大结肠息肉的内镜切除后的一个常见并发症.
- 目前的预防方法包括透视镜剪贴 (TTSCs),但超视镜剪贴 (OTSCs) 可能提供优越的血液静止.
- 这项研究调查了OTSC在内镜手术后预防并发症的有效性.
研究的目的:
- 评估预防性超范围剪贴 (OTSC) 应用的安全性和有效性.
- 评估OTSC系统在减少大结直肠多体内膜切除 (ESD) 或内膜切除 (EMR) 后延迟出血和穿孔方面的作用.
主要方法:
- 从2009年至2021年在三个内镜中心前性收集数据的回顾性分析.
- 包括接受ESD或EMR的大型 (≥20毫米) 结肠多的患者.
- 在切除后对高风险的粘膜缺陷区域进行预防性OTSC应用,主要结果是延迟出血.
主要成果:
- 75名患者接受了ESD (67%) 或EMR (33%) 对于大型息肉 (平均直径57毫米).
- 预防性OTSC使用导致延迟出血率低 (1.4%),没有延迟穿孔.
- 术内出血和穿孔率得到了有效的管理,只有两个病例需要为穿孔进行手术转换.
结论:
- 大型ESD/EMR后粘膜缺陷的OTSC部分关闭是一种有效的预防策略.
- 在复杂的内镜切除后,OTSC的应用显著降低了延迟出血和穿孔的风险.
- 这种方法提高了对大结直肠多体的内镜手术的安全性.
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