单金属夹牵引在内镜黏膜下剥离术治疗结直肠侧向发育型肿瘤中的应用  

Application of single metal clip traction in endoscopic submucosal dissection for the treatment of colorectal lateral developmental tumors

作　　者：郭玲玲 周嘉桦 魏绮丽 郭凡华 王云花[1] 杨柳静 陈金连 李抗抗[1] 蔡建群[1] 李爱民[2] 叶院宁 GUO Lingling;ZHOU Jiahua;WEI Qili;GUO Fanhua;WANG Yunhua;YANG Liujing;CHEN Jinlian;LI Kangkang;CAI Jianqun;LI Aimin;YE Yuanning(Department of Gastroenterology,Nanfang Hospital Zengcheng Campus,Southern Medical University,Guangzhou 511300,China;Department of Gastroenterology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院增城院区消化内科,511300 [2]南方医科大学南方医院消化内科,510515 [3]南方医科大学南方医院,510515

出　　处：《现代消化及介入诊疗》2025年第1期10-13,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：国家自然科学基金(82373165);南方医科大学南方医院院长基金(2024B039)。

摘　　要：目的探讨单金属夹牵引方法应用于内镜黏膜下剥离术(ESD)治疗结直肠侧向发育型肿瘤(LST)的安全性及有效性。方法回顾性分析2023年8月至2024年6月在南方医科大学南方医院增城院区行牵引辅助ESD治疗的98例结直肠LST患者的临床资料,根据术中牵引方式分为单金属夹牵引组(n=48例)和线夹辅助牵引组(n=50例),比较两组的手术时间、整块切除率、完全切除率、治愈性切除率、并发症发生情况。结果单金属夹牵引组手术时间为(43.26±21.75)min,显著短于线夹牵引组手术时间(60.43±30.94)min(P<0.001)。两组病变整块切除率和完全切除率(R0切除率)均为100%,组间差异无统计学意义(P>0.05)。单金属夹牵引组治愈性切除率93.8%,线夹牵引组治愈性切除率为92.0%,差异无统计学意义(P=0.737)。单金属夹牵引组术中出血率14.6%,线夹牵引组治愈性术中出血率为20.0%,差异无统计学意义(P=0.479)。两组患者术中均未出现穿孔,术后均未发生迟发性出血及穿孔。结论应用单金属夹牵引可显著缩短ESD治疗结直肠LST病灶的手术时间,降低操作难度,值得临床推广。Objective To investigate the safety and efficacy of single metal clip traction for endoscopic submucosal dissection(ESD)in the treatment of colorectal laterally spreading tumor(LST).Methods The clinical data of 98 patients with colorectal LST who underwent tractor-assisted ESD treatment in our hospital from August 2023 to June 2024 were retrospectively analyzed.According to the operative traction method,they were divided into single metal clip traction group(n=48)and wire clip assisted traction group(n=50).The operative time,en bloc resection rate,complete resection rate(R0 resection rate),curative resection rate and complications were compared between the two groups.Results All patients were successfully treated with ESD,and all lesions were completely resected at one time.The operative time of single metal clip traction group was(43.26±21.75)min,which was significantly shorter than that of wire clip traction group(60.43±30.94)min(P<0.001).The en bloc resection rate and complete lesion resection rate(R0 resection rate)were 100%in 2 groups,and there was no significant difference(P>0.05).The curative resection rate was 93.8%in the single metal clip group and 92.0%in the wire clip group,with no significant difference(P=0.737).The intraoperative bleeding rate was 14.6%in the single metal clip group and 20.0%in the wire clip group,with no statistical significance(P=0.479).No postoperative perforation occurred in both groups,and no postoperative delayed bleeding or perforation occurred.Conclusion The application of single metal clip traction can significantly shorten the operation time and reduce the operation difficulty of ESD treatment of colorectal LST lesions,it is worthy of clinical promotion.

关 键 词：单金属夹牵引 内镜黏膜下剥离术 结直肠侧向发育型肿瘤 

分 类 号：R574[医药卫生—消化系统]