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首页> 外文期刊>Endoscopy International Open >The pocket-creation method may facilitate endoscopic submucosal dissection of large colorectal sessile tumors
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The pocket-creation method may facilitate endoscopic submucosal dissection of large colorectal sessile tumors

机译：口袋创造方法可以促进大型整理术肿瘤的内窥镜粘膜抑制

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Background and study aims Resecting large colorectal sessile tumors using endoscopic submucosal dissection (ESD) is challenging because of severe submucosal fibrosis. Previously, we reported that ESD strategy using the pocket-creation method (PCM) is useful for large colorectal sessile tumors, but there are no large studies reporting the effectiveness and safety of the PCM for resection of large colorectal sessile tumors. Patients and methods This was a retrospective review of 90 large colorectal sessile tumors in 89 patients who underwent ESD in our institution. Large colorectal sessile tumors were defined as polypoid lesions 20?mm or more in diameter. We divided them into PCM (n?=?40) and conventional method (CM) groups (n?=?50). The primary outcome measure was en bloc resection. The inverse-probability-treatment weighting (IPTW) approach was used to adjust for selection bias. Results Both PCM and CM achieved high en bloc resection (100?% vs. 94?%, non-adjusted P =?0.25, IPTW-adjusted P =?0.19) and R0 resection rates (88?% vs. 78?%, non-adjusted P =?0.28, IPTW-adjusted P =?0.27). When PCM was used, the rate of pathologically negative vertical margins was significantly greater than with the CM (IPTW-adjusted P =?0.045). The dissection time was significantly shorter (IPTW-adjusted P =?0.025) and dissection speed faster (IPTW-adjusted P =?0.013) using the PCM than when the CM was used. There was no significant difference in the incidence of adverse events (intraprocedural perforation and delayed bleeding, IPTW-adjusted P =?0.68). Conclusion Although en bloc resection and R0 resection rates were similar, PCM significantly increased the rate of negative vertical margins with rapid dissection for treatment of large colorectal sessile tumors.
机译：背景和研究旨在使用内窥镜粘膜粘膜释放（ESD）对大型结肠直肠牙齿肿瘤进行挑战是挑战性的，因为患有严重的粘膜纤维化。以前，我们报告说，使用口袋创作方法（PCM）的ESD策略对于大型结肠直肠牙齿肿瘤有用，但没有大的研究报告了PCM用于切除大结肠直肠术肿瘤的效果和安全性。患者和方法这是在我所在机构遭受ESD的89名患者中对90例大结肠直肠术肿瘤的回顾性审查。大结肠直肠术肿瘤的直径为膜状体肿瘤20μmmm≤mm或更大。我们将它们划分为PCM（n？= 40）和常规方法（cm）组（n？=Δ50）。主要结果措施是en Bloc切除。逆概率处理加权（IPTW）方法用于调整选择偏压。结果PCM和CM均达到高EN BLOC切除（100μl％vs.94≤0.25，IPTW调节的P =β0.19）和R0切除率（88Ω％与78？％，不调整的p =？0.28，IPTW调节的p = 0.27）。当使用PCM时，病理负垂直边缘的速率明显大于CM（IPTW调节的P = 0.045）。解剖时间明显缩短（IPTW调节的P =Δ025），并且使用PCM的解剖速度更快（IPTW调节的P =Δ013）而不是使用CM时。不良事件发生率没有显着差异（颅脑穿孔和延迟出血，IPTW调整的P = 0.68）。结论虽然EN集团切除和R0切除率相似，但PCM具有快速扫描率的负垂直边缘的速率显着增加，以治疗大结肠直肠牙垢肿瘤。

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