在大平面和状结直肠多体的内镜下粘膜剖析后预防性剪贴关闭:多中心随机对照试验 (EPOC试验)
Akihiro Miyakawa1, Yuzuru Tamaru2, Takeshi Mizumoto2
1Department of Gastroenterology, Asahi General Hospital, Asahi, Japan a292miyaka2007@yahoo.co.jp kuwai@hiroshima-u.ac.jp.
Gut
|June 3, 2025
概括
预防性剪贴关闭显著减少大聚合体的结直肠内镜亚粘膜解剖 (ESD) 后延迟出血. 这种有效的技术,达到~90%的关闭率,降低严重出血事件,提高患者的安全.
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:
- 在结肠直肠内镜下粘膜切割 (ESD) 后,延迟出血是一种风险.
- 预防性剪贴关闭在结直肠ESD中的有效性的证据有限.
- 之前的研究表明,对大病变进行内镜粘膜切除有好处.
研究的目的:
- 为了比较剪贴关闭和没有关闭组之间的延迟出血率.
- 评估预防性剪贴关闭在结肠直肠ESD的疗效.
- 为了评估ESD后平坦和状结直肠多 (20-50毫米) 中的严重延迟出血.
主要方法:
- 在四个日本机构进行多中心随机对照试验.
- 患者随机分配到预防性剪贴关闭或没有关闭的组.
- 血液分类为轻度或重度 (需要干预).
主要成果:
- 剪片关闭显著减少了整体延迟出血 (6.7%与20.1%) 和严重延迟出血 (1.3%与8.7%).
- 在~90%的案例中,成功关闭片.
- 预防性剪贴关闭是延迟出血的独立预防因素.
结论:
- 预防性剪贴关闭是有效的减少在结肠直肠ESD后延迟出血20-50毫米的息肉.
- 该技术是安全的,没有观察到穿孔和类似的ESD后凝血综合征率.
- 通过ESD进行大结直肠聚切除时,应考虑将剪贴关闭.
关键词:
这是一种出血.殖民地多聚体 (colony polyps) 是一种这是内镜多重切割术.内镜检查程序 内镜检查程序内镜下粘膜解剖的方法末镜检查 (endoscopy) 是一种检查.预防性剪贴关闭更多相关视频
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