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Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences

机译:内镜粘膜切除与结肠直肠肿瘤的周向粘膜切口:与内窥镜粘膜粘膜解剖和两位内窥镜员进行比较

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摘要

Background/Aims Endoscopic mucosal resection with circumferential mucosal incision (CMI-EMR) may offer benefits comparable to those of endoscopic submucosal dissection (ESD), while requiring less technical proficiency than ESD. Methods We retrospectively compared the outcomes of CMI-EMR (n=34) and size-matched ESD (n=102), which were performed by a Korean endoscopist for colorectal epithelial lesions of 20–35 mm. Procedural parameters of CMI-EMRs performed by an American ESD novice (n=30) were compared with those performed by the Korean endoscopist. Results The lesion size was 22.3±3.9 mm and 22.9±2.4 mm in the CMI-EMR and size-matched ESD groups, respectively (p=0.730). The resection time was 12.7±7.0 minutes in the CMI-EMR group and 45.6±30.1 minutes in the ESD group (p<0.001). The en bloc resection rate was 94.1% in the CMI-EMR group and 100% in the ESD group (p=0.061). There were no differences in the en bloc resection and complication rates of CMI-EMRs between a Korean and an American endoscopist. Conclusions For the treatment of moderate-size colorectal lesions, CMI-EMR showed a trend toward lower en bloc resection rate, but required shorter procedure time than ESD. CMI-EMR outcomes were similar when performed by a Korean ESD expert and an American ESD novice.
机译:背景/旨在具有周向粘膜切口(CMI-EMR)的内窥镜粘膜切除,可以提供与内窥镜粘膜粘膜粘膜释放(ESD)相当的益处,同时需要较少的技术熟练程度而非ESD。方法回顾性地比较了CMI-EMR(n = 34)和尺寸匹配的ESD(n = 102)的结果,其由韩国内窥镜病变为20-35mm的结直肠上皮病变进行。将美国ESD新手(N = 30)执行的CMI-EMRS的程序参数与韩国内窥镜师执行的人进行比较。结果分别在CMI-EMR和尺寸匹配的ESD组中分别为22.3±3.9mm和22.9±2.4mm(p = 0.730)。在CMI-EMR组中切除时间为12.7±7.0分钟,在ESD组中为45.6±30.1分钟(P <0.001)。 CMI-EMR组的EN集团切除率为94.1%,在ESD组中100%(P = 0.061)。韩国和美国内窥镜师之间的CMI-EMRS的en Bloc切除和并发症率没有差异。结论用于治疗中等大小结肠直肠病变,CMI-EMR显示出较低的EN集团切除率的趋势,但需要比ESD更短的程序时间。韩国ESD专家和美国ESD新手执行时,CMI-EMR结果类似。

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