对大小为10-14毫米的结直肠息肉进行低功率纯切割热陷多角切除术:一个多中心的回顾性研究
Hidenori Kimura1, Kazunori Takada2, Kenichiro Imai2
1Division of Digestive Endoscopy, Department of Medicine, Shiga University of Medical Science, Otsu, Japan.
Journal of gastroenterology and hepatology
|May 13, 2024
概括
低功率纯切割电流热陷多角切除术 (LPPC HSP) 是对内镜粘膜切除 (EMR) 的安全有效替代方案,用于切除10-14毫米大肠直肠多,具有相似的疗效,并且没有增加不良事件.
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
- 结肠直肠癌 预防 预防
背景情况:
- 大型结直肠多 (>10毫米) 的热陷切除是常见的,但具有深度热损伤的风险.
- 10-14毫米的结肠直肠多很少存在侵入性癌症,这表明需要使用不那么侵入性的治疗方法.
- 一种新的技术,用低功率纯切断电流 (LPPC HSP) 进行热陷多角切除术,是为了最大限度地减少热损伤而开发的.
研究的目的:
- 评估LPPC HSP对10-14毫米大肠直肠多的疗效和安全性.
- 为了将LPPC HSP与传统的内镜粘膜切除 (EMR) 进行比较,对于这个多重体大小范围.
主要方法:
- 一项多中心,回顾性,观察性研究比较了EMR和LPPC HSP在10-14毫米的非形结直肠多瘤中.
- 倾向性得分匹配用于确保EMR和LPPC HSP组之间的可比基线特征.
- 分析了临床结果,包括封锁和R0切除率,以及不良事件 (延迟出血,穿孔).
主要成果:
- 在倾向分数匹配 (120对) 后,EMR和LPPC HSP之间,块切除率 (95.8%与97.5%) 和R0切除率 (90.0%与91.7%) 类似.
- 两组之间没有观察到延迟出血或穿孔率的显著差异.
- 该研究最初包括203例EMR病例和208例LPPC HSP病例.
结论:
- 对于10-14毫米的非形结直肠多,LPPC HSP的切除能力与常规EMR相提并论.
- 与EMR相比,LPPC HSP并没有导致不良事件发生率增加.
- LPPC HSP是一种安全有效的治疗选择,用于治疗10-14毫米的非形结肠直肠多.
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