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一种策略,结合内镜手工接与剪贴,以关闭直肠缺陷后内镜下膜解剖或没有肌切除术 (带视频) 后的策略

Shibo Song¹, Lizhou Dou¹, Yong Liu¹

¹Department of Endoscopy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Gastrointestinal endoscopy

|November 22, 2023

概括

通过EHS-Clips方法,在内镜下粘膜解剖 (ESD) 和ESD与肌切除术 (ESD-ME) 后有效地关闭直肠缺陷,防止延迟出血. 幅≥5mm提高了持续关闭的可靠性.

科学领域:

胃肠病学胃肠病学
手术创新在外科创新.
内镜手术进行内镜手术

背景情况:

内镜手 (EHS) 在内镜后的粘膜下解剖 (ESD) 中显示出关闭缺陷的希望,但在技术上具有挑战性.
一种新的策略,EHS-Clips,将EHS与剪辑结合起来,以应对这些挑战.

研究的目的:

评估EHS-Clips策略在ESD或ESD与肌切除术 (ESD-ME) 后关闭直肠缺陷的有效性.
评估关闭率,延迟出血和持续关闭,并确定影响持续关闭的因素.

主要方法:

一项观察性研究审查了使用EHS-Clips关闭直肠缺陷的患者的数据.
EHS-Clips涉及使用EHS进行初始接,然后对未经修复的部分进行剪贴关闭.
主要终点包括完全关闭,延迟出血 (DB) 和持续的关闭率;后勤回归确定了风险因素.

主要成果:

在所有49个缺陷 (42个ESD,7个ESD-ME) 中,EHS-Clips实现了100%的完全关闭.
没有出现延迟出血 (DB).
在73.5%的缺陷中观察到持续关闭;≥5毫米的边缘是持续关闭的唯一独立因素 (HR 0.313).

结论:

该EHS-Clips策略是有效的关闭后ESD/ESD-ME直肠缺陷,并防止DB.
达到一个完整的接与 ≥5毫米的边缘提高了持续关闭的可靠性.

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