冷陷内镜粘膜切除与标准热技术对大型平面非杆结肠病变:一个随机对照试验
Oscar Nogales1, Carlos Carbonell Blanco1, Sheyla Montori Pina2
1Department of Gastroenterology and Hepatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Endoscopy
|February 19, 2025
概括
对于大型平面非形结肠病变的冷陷内镜粘膜切除 (CS-EMR),与标准EMR相比,复发率更高. 虽然安全性概况相似,但CS-EMR在防止病变复发方面效果较差.
科学领域:
- 胃肠病学 胃肠病学
- 内镜手术是一种内镜手术.
- 大肠直肠癌查检查
背景情况:
- 大型平面非形结肠病变 (LFNPCLs) 需要有效的内镜切除.
- 冷陷内镜粘膜切除 (CS-EMR) 为标准EMR提供了一个潜在的更安全的替代方案.
- 对LFNPCL的CS-EMR与标准EMR的疗效进行比较的证据有限.
研究的目的:
- 为了比较CS-EMR和LFNPCL标准EMR之间的6个月复发率.
- 评估和比较两个内镜技术的安全性.
- 在随机对照试验中评估与程序相关的结果.
主要方法:
- 进行了一项多中心,开放标签,随机对照试验.
- 229名患有大 (≥20毫米) LFNPCL的患者随机分配到CS-EMR或标准EMR中.
- 这项研究是一项非劣势性试验,评估6个月后的复发情况.
主要成果:
- 复发率在CS-EMR组 (33.0%) 与EMR组 (16.2%) (P=0.004) 相比显著更高.
- 这种差异在30毫米以上的病变中更为明显.
- 两组之间没有观察到不良事件的显著差异.
结论:
- 与标准EMR相比,CS-EMR与LFNPCL复发率显著增加有关.
- 这两种技术都显示出可比的安全性.
- 标准EMR仍然是防止LFNPCL复发的更有效的选择.
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