引与陷的比较作为挑战性结直肠内镜亚粘膜剖析的救援方法:倾向性得分匹配的研究
Keitaro Takahashi1, Takuya Iwama2, Kazuyuki Tanaka3
1Division of Gastroenterology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Japan.
Endoscopy international open
|March 20, 2025
概括
与救援陷切除相比,在困难的结肠直肠病例中,救援引辅助内镜下膜切除 (ESD) 提供了较高的块状和R0切除率. 早期启动引可能会缩短手术时间.
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
- 在瘤学瘤学.
背景情况:
- 难以进行结肠直肠内镜下层剖析 (ESD) 带来了挑战.
- 救援陷切除 (rSnare) 是一种常见但效率较低的救援方法.
- 引力辅助ESD是一种潜在的替代救援技术.
研究的目的:
- 为了比较救援陷切除 (rSnare) 和救援引辅助ESD (rTraction) 的有效性.
- 为了评估两种救援方法的块切除,R0切除和手术时间.
主要方法:
- 追溯分析了162个结直肠ESD病例,需要在八个机构进行救援干预.
- 倾向性得分匹配,以比较88个用rSnare或rTraction治疗的病变.
- 对切除率和手术时间的分析.
主要成果:
- 救援引辅助的ESD (rTraction) 实现了比rSnare (45.5%和38.6%) 的 en bloc (93.2%) 和R0切除率 (77.3%) 显著更高.
- 与rSnare (92.2分钟) 相比,rTraction组的手术时间更长 (122.3分钟).
- 在75分钟内开始引,在rTraction组中预测了更短的程序持续时间.
结论:
- 拉力辅助ESD是困难的结直肠ESD的优质救援技术,产生更好的切除结果.
- 早期采用引 (在75分钟内) 可以优化程序时间.
- 这项研究提供了rSnare和rTraction在结直肠ESD中的第一次直接比较.
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