寒冷的蛇口多角切除术和冷内镜粘膜切除术与中等大小的状纹病变的热内镜粘膜切除术:一个随机对照试验
Li-Chun Chang1,2, Andrew Y Wang3, Cheng-Hao Tseng4,5
1Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
United European gastroenterology journal
|March 10, 2026
概括
冷陷多角切除术 (CSP) 和冷内镜粘膜切除术 (EMR) 有效地去除中等大小的状状病变 (SSL),与热EMR疗效相匹配. 这些发现支持当前关于SSL删除的指南.
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:
- 目前的指导方针建议在中等大小 (10-20毫米) 状状病变 (SSL) 时进行冷陷多角切除术 (CSP).
- 支持CSP的现有数据主要来自单臂或回顾性研究.
- 需要随机对照试验来证实与其他方法相比,CSP的疗效.
研究的目的:
- 为了比较CSP和冷内镜粘膜切除 (EMR) 与热EMR的疗效.
- 使用这些技术,评估中等尺寸SSL的完整组织切除率.
主要方法:
- 一个多中心的,随机的,非劣势试验,涉及113名患者和159名SSL.
- 患者被随机分为三个组:CSP,冷EMR和热EMR.
- 主要结局:完全组织切除;次要结局:整体切除率,手术时间,并发症.
主要成果:
- 完整组织切除率:CSP (90.6%),冷EMR (88.5%),热EMR (87.0%),证明没有劣势.
- 与热EMR (88.9%) 相比,CSP的手术时间较短,但阻断切除率较低 (69.8%).
- 下注射改善了CSP的垂直切除深度和块切除速率.
结论:
- 在中型SSL中,CSP和冷EMR是热EMR的有效替代品.
- 这些发现提供了强有力的证据,支持当前的指导方针建议.
- 需要进一步的研究来评估这些程序后的长期残留率.
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