简易橡皮圈内牵引辅助内镜黏膜下剥离术在结直肠早期病变中的应用  

Application of simple rubber ring traction assisted technique in endoscopic submucosal dissection for in Early colorectal lesions

作　　者：杨林[1] 舒磊[1] 刘嵩[1] 刘浩[1] 汪念 刘怡[1] YANG Lin;SHU Lei;LIU Song;LIU Hao;WANG Nian;LIU Yi(The first hospital in wuhan,Wuhan 430022,China)

机构地区：[1]武汉市第一医院消化科,430022

出　　处：《现代消化及介入诊疗》2022年第12期1505-1508,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：湖北省自然科学基金(2020CFB358),武汉市医学科研项目(WZ20C17)。

摘　　要：目的评价简易橡皮圈内牵引辅助内镜黏膜下剥离术(endoscopic submucosal dissection,ESD)治疗结直肠病变的有效性和安全性。方法收集2020年8月至2022年7月间在武汉市第一医院内镜中心接受内镜黏膜下剥离术治疗的76例结直肠病变患者,按随机数字表法分为简易橡皮圈牵引组(研究组)和常规治疗组(对照组),各38例,比较两组间病变手术时间、病变剥离速度、黏膜下注射液体量、术中出血量、术中较大出血次数、术后标本面积、病理类型、病变浸润深度、整块切除率、治愈性切除率、并发症发生率、住院天数及随访情况等指标。结果76例均成功施行ESD治疗。两组的性别、年龄、病变分布、病变形态、病变大小等临床资料差异无统计学意义(P>0.05)。研究组术中剥离速度快于对照组(P<0.05),术中手术时间、黏膜下注射液体量、术中出血量、术中较大出血次数、术后并发症及住院天数方面均少于对照组(P<0.05),研究组和对照组在术后标本面积、术后病理类型、病变浸润深度、整块切除率及治愈性切除率差异均无统计学意义(P>0.05)。两组病例随访期间均无复发。结论简易橡皮圈内牵引辅助技术治疗结直肠病变可提高手术效率,降低手术难度,减少并发症发生,其安全有效。Objective To investigate the efficacy and safety of rubber ring traction assisted technique in endoscopic submucosal dissection(ESD)of in early colorectal lesions.Methods A total of 76 patients with colonic lesions who underwent endoscopic treatment were enrolled between August 2020 and July 2022 at the endoscopic center of the first hospital in wuhan.Based on whether traction device was used during the operation,38 patients in each group were assigned to the conventional ESD group(control grop)and simple rubber ring traction assisted ESD group(research group).The average operation time,submucosal dissection speed,the amount of supplementary submucosal injection,intraoperative blood loss,number of large intraoperative blood loss,Postoperative specimen area,postoperative pathological type,depth of lesion infiltration,complete resection rate,surgical curative resection rate,complications,hospital stay and follow-up results of the of the two groups were analyzed.Results All 76 cases were treated with ESD successfully.There was no significant difference in gender,age,lesion distribution,lesion shape,lesion size and other clinical data between the two groups(P<0.05).The average operation time,submucosal dissection speed,the amount of supplementary submucosal injection,intraoperative blood loss,number of large intraoperative blood loss,complications,and hospital stay were significantly less in the research group than in the control group.The Postoperative specimen area,postoperative pathological type,depth of lesion infiltration complete resection rate and surgical curative resection rate were no significant difference between the two groups(P>0.05).No recurrence was found in the two groups during follow-up period.Conclusion Simple rubber ring traction assisted technique can improve the efficiency of operation,reduce the difficulty of operation,reduce the incidence of complications,and it is safe and effective.

关 键 词：内镜黏膜下剥离术 结直肠早期病变 牵引术 简易橡皮圈 

分 类 号：R574[医药卫生—消化系统]