结肠直肠多胞体冷陷多角切除术不清晰差距的危险因素
Ryosuke Ikeda1, Hiroaki Kaneko, Hiroki Sato
1Department of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan.
European journal of gastroenterology & hepatology
|September 26, 2024
概括
冷陷多角切除术 (CSP) 具有较高的不清晰边缘率,特别是在折叠和曲等困难部位. 实习生的表现显著影响边缘清晰度,这表明经验改善了结直肠多片去除的结果.
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
背景情况:
- 冷陷多角切除术 (CSP) 是一种广泛使用的内镜技术,用于切除结直肠多.
- 对CSP的一个重大挑战是实现明确的切除幅度,这可能会影响长期结果.
- 识别导致不清晰差距的因素对于提高程序成功至关重要.
研究的目的:
- 分析结肠直肠多在冷陷多角切除术 (CSP) 后与不清晰的边缘相关的风险因素.
- 为了比较专家内镜师和实习生之间不清楚的边缘的发生率.
- 为了确定特定的解剖位置和程序因素,增加不完整的多切除的风险.
主要方法:
- 在2021年7月至2022年7月期间用CSP治疗的结直肠多的回顾性分析.
- 排除具有无法恢复的标本或非新生/超塑性病理的息肉,没有边际评估.
- 分析了不清楚边缘的临床病理特征和风险因素,重点关注专家与实习生使用倾向分数匹配执行的程序.
主要成果:
- 在分析的572个息肉中,41.4%有不清楚的边缘.
- 不清楚的边缘与位于跨越和点的息肉以及由实习生执行的程序有显著的关联 (P < 0.0001).
- 在与倾向分数匹配的分析中,与专家相比,实习生在跨越折叠 (P=0.0004) 和曲点 (P=0.005) 上显示出较高的不清楚边缘率.
结论:
- 跨越折叠,曲点和由实习生执行的程序是CSP不清楚边际的重要风险因素.
- 增加经验,特别是在具有挑战性的解剖学部位,被假定可以减少未明边缘在学员的速度.
- 在困难位置优化训练和技术可能会改善冷陷多角切除术的切除质量.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
57
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
57
Assessment of the Rectum and Anus
166
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
166
Endoscopic Procedures II: Colonoscopy
62
The colon, or large intestine, is the final segment of the digestive system. Its primary functions include absorbing water and vitamins produced by gut bacteria and transforming waste from liquid to solid to form stool. In adults, the large intestine is approximately 5 feet long and consists of four main sections:
62


