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首页> 外文期刊>Surgical Endoscopy >Factors associated with conversion to snare resection during gastric endoscopic submucosal dissection
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Factors associated with conversion to snare resection during gastric endoscopic submucosal dissection

机译：胃内镜粘膜清除术治疗肠道切除术相关的因素

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Background and aims Although gastric endoscopic submucosal dissection (ESD) achieves a higher en-bloc resection rate compared to that with endoscopic mucosal resection (EMR) for gastric epithelial tumors, the higher complication rate and the longer procedure time are obstacles for its widespread use. Rescue EMR may be a valuable treatment option during difficult ESD procedures. We have aimed to identify the clinical outcomes and associated factors of rescue EMR during ESD. Patients and methods The medical records of patients who underwent ESD between January 2009 and February 2016 were reviewed. The clinical outcomes of rescue EMR during ESD and associated factors with rescue EMR were evaluated. Results A total of 1778 gastric epithelial lesions were enrolled. ESD without using a snare and rescue EMR were performed in 94.5% and 5.5% of patients, respectively. Lesion locations of mid-third [odd ratio (OR 4.470)], upper-third (OR 1.997), and submucosal fibrosis (OR 1.906) were the significant associated factors with rescue EMR. The en-bloc resection rate and complete resection rate of rescue EMR were lower than that of ESD (98.4% vs. 93.8% and 96.2% vs. 83.5%, respectively). Local recurrence rate was higher after rescue EMR than that after ESD (4.1% vs. 1.2%). Procedure-related complications and procedure time were not significantly different between the two groups. Conclusions In a difficult ESD procedure, rescue EMR may be an alternative treatment option, especially for lesions located at the mid-to-upper third of the stomach, without increasing either the procedure time or the rate of complications.
机译：背景和目的虽然胃内镜下粘膜粘膜解剖（ESD）达到较高的肠道切除率，而具有内镜粘膜切除（EMR）的胃上皮肿瘤，并发症率越高，程序时间越长，其广泛使用的障碍。在困难的ESD程序期间，救援EMR可能是一个有价值的治疗选择。我们旨在确定ESD期间救援EMR的临床结果和相关因素。患者和方法审查了2009年1月至2016年2月至2016年2月至2016年2月患者的患者的病程。评估ESD期间救援EMR的临床结果和救援EMR的相关因素。结果共注入1778例胃上皮病变。不使用陷阱的ESD和救援EMR分别以94.5％和5.5％的患者进行。中期三分之二的病变位置[奇数比（或4.470）]，上三分之一（或1.997）和粘膜纤维化（或1.906）是救援EMR的重要相关因素。 en-Bloc切除率和救援EMR的完全切除率低于ESD（98.4％，分别为93.8％，分别为96.2％，与83.5％）。救助EMR后局部复发率高于ESD之后（4.1％vs.1.2％）。与手术相关的并发症和手术时间在两组之间没有显着差异。在困难的ESD程序中结论，救援EMR可以是替代治疗选择，特别是对于位于胃中半三分之一的病变，而不增加程序时间或并发症率。

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