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首页> 外文期刊>Gastrointestinal Endoscopy >Endoscopic submucosal dissection with or without snaring for colorectal neoplasms.
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Endoscopic submucosal dissection with or without snaring for colorectal neoplasms.

机译：内窥镜黏膜下剥离术对大肠肿瘤有无声纳。

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BACKGROUND: Despite a high en bloc resection rate, its technical difficulty and risk of complications limit the widespread use of colorectal endoscopic submucosal dissection (ESD). OBJECTIVE: To analyze outcomes after colorectal ESD and ESD with snaring (ESD-S), a simplified modification of ESD. DESIGN: A retrospective observational study. SETTING: A single, tertiary-care, referral center. PATIENTS AND INTERVENTION: ESD was performed on 163 lesions in 162 patients and ESD-S on 74 lesions in 71 patients. All lesions were nonpedunculated colorectal neoplasms of 15 mm or larger. MAIN OUTCOME MEASUREMENTS: We analyzed procedure-related variables such as en bloc resection rate, procedure time, and complications. Histopathologic results were reviewed. Follow-up data were analyzed. RESULTS: The en bloc resection rate was higher for ESD than for ESD-S (87% vs 64%, P < .01). The histologically complete resection rate was also higher for ESD. However, both rates for resection of lesions of <20 mm were not different between ESD and ESD-S groups. The rates of perforation and bleeding were similar for both groups. Submucosal cancers were present in 21% and 31% of the ESD and ESD-S groups, respectively. One patient from each group developed a local adenoma recurrence. LIMITATIONS: Retrospective design. CONCLUSION: Both ESD and ESD-S were safe and effective for resection of colorectal neoplasms. The higher en bloc resection rate for ESD suggests that it should be the first option for resection of suspected superficial submucosal cancers in the colorectum. ESD-S can be a good alternative to ESD for en bloc resection of colorectal lesions of <20 mm.
机译：背景：尽管整体切除率很高，但其技术难度和并发症风险限制了结直肠内窥镜黏膜下剥离术（ESD）的广泛应用。目的：分析结直肠ESD和snaring（ESD-S）对ESD的简化修改后的结局。设计：一项回顾性观察研究。地点：单一的三级转诊中心。病人和干预措施：162例患者的163处病灶进行了ESD，71例患者的74处病灶进行了ESD-S。所有病变均为15 mm或更大的无蒂大肠肿瘤。主要观察指标：我们分析了与手术相关的变量，例如整块切除率，手术时间和并发症。回顾了组织病理学结果。随访数据进行了分析。结果：ESD的整体切除率高于ESD-S（87％vs 64％，P <.01）。 ESD的组织学完整切除率也更高。但是，在ESD和ESD-S组之间，两种<20 mm病变的切除率没有差异。两组的穿孔和出血率相似。黏膜下癌分别占ESD和ESD-S组的21％和31％。每组一名患者出现局部腺瘤复发。局限性：回顾性设计。结论ESD和ESD-S均能安全有效地切除大肠肿瘤。 ESD的整体切除率较高，表明它应该是切除可疑结直肠浅表黏膜下癌的首选方法。 ESD-S可以很好地替代ESD，用于整体切除小于20 mm的大肠病变。

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