不同的内镜治疗方法对形结直肠息肉中的出血并发症的影响
1Department of Gastroenterology, Xuyi People's Hospital, Clinical Medical College of Yangzhou University.
Surgical laparoscopy, endoscopy & percutaneous techniques
|March 10, 2025
概括
内镜下粘膜切割 (ESD) 和预防性剪贴显著减少了与形结直肠多瘤内镜粘膜切除相比的多瘤切割后出血. 对于较大的息肉来说,ESD特别有效.
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:
- 内镜断层切除提供了好处,但带有出血的风险,特别是在形结直肠多体.
- 目前的方法缺乏最佳的方法来去除脚的息肉,这导致需要进行比较研究.
- 术后出血是内镜结直肠多片切除后的一个严重并发症.
研究的目的:
- 为了比较三种技术的切割后出血结果,以去除形结肠直肠多.
- 评估内镜粘膜切除,内镜粘膜下切割 (ESD) 和预防性剪贴在控制出血风险方面的有效性.
- 确定最优的内镜技术,以最大限度地减少在形多切除过程中的出血并发症.
主要方法:
- 经过三种切除技术后,对出血并发症的回顾性分析:内镜粘膜切除,内镜亚粘膜解剖 (ESD) 和预防性剪贴.
- 收集关于切割后出血率 (延迟和手术内) 和血静需要的数据.
- 在三个干预组中对出血结果的统计比较.
主要成果:
- 内镜粘膜切除具有最高的延迟出血率 (18.9%).
- 内镜下粘膜切割 (ESD) 和预防性剪贴显示出明显较低的延迟出血率 (分别为4.3%和5.9%).
- ESD导致了最高的手术内出血率 (6.5%),但血液静止的需要在不同组中没有显著差异.
结论:
- 内镜下粘膜切割 (ESD) 和预防性切割多茎有效降低了多切割术后出血的风险.
- 对于切除较大的脚型息肉来说,ESD是有利的,它解决了茎和头.
- 这些技术为脚踏式结直肠多片切除提供了更好的安全性.
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