水下冷圈套器切除结直肠小息肉的临床研究

Clinical study of endoscopic underwater cold snare polypectomy treating small colorectal polyps

摘要:

目的 探讨水下冷圈套器息肉切除术（CSP）治疗结直肠小息肉的临床效果。方法 选取2021年7月－2022年6月该院收治的结直肠小息肉（5～10 mm）患者186例，随机分为水下CSP组（n = 93）和传统CSP组（n = 93）。比较两组患者手术时间、息肉完全切除率、标本回收率、止血夹使用量、术中术后出血和复发情况。结果 水下CSP组息肉共156枚，传统CSP组息肉共140枚。水下CSP组完全切除率明显高于传统CSP组（95.51%和89.29%），差异有统计学意义（P < 0.05）；水下CSP组术中出血发生率明显低于传统CSP组（13.46%和23.57%），差异有统计学意义（P < 0.05）；水下CSP组标本回收率明显高于传统CSP组（99.36%和95.71%），差异有统计学意义（P < 0.05）；水下CSP组单个息肉手术时间明显短于传统CSP组［（86.23±33.66）和（111.77±40.06）s］，差异有统计学意义（P < 0.01）。两组患者止血夹使用量、术后出血发生率和息肉复发率比较，差异均无统计学意义（P > 0.05）。两组患者均无穿孔发生。结论 水下CSP治疗结直肠小息肉，完全切除率高，术中出血发生率低，手术时间短，是一种安全、有效的治疗方式。

Abstract:

Objective To explore the clinical effect of underwater cold snare polypectomy (CSP) for the treatment of small colorectal polyps.Method A total of 186 patients with small colorectal polyps (5~10 mm) admitted to the hospital from July 2021 to June 2022 were selected for the study. They were randomly divided into underwater CSP group (n = 93) and traditional CSP group (n = 93). To compare the polyp surgery time, polyp complete resection rate, specimen retrieved rate, consumed clips, intraoperative and postoperative bleeding complications, and recurrence between the two groups.Results There were 156 polyps in underwater CSP group and 140 polyps in traditional CSP group. The complete resection rate in underwater CSP group was significantly higher than that in traditional CSP group (95.51% and 89.29%), the difference was statistically significant (P < 0.05); The incidence of intraoperative bleeding in underwater CSP group was significantly lower than that in traditional CSP group (13.46% and 23.57%), the difference was statistically significant (P < 0.05); The specimen retrieval rate in underwater CSP group was significantly higher than that in traditional CSP group (99.36% and 95.71%), the difference was statistically significant (P < 0.05); The surgical time of single polyp in underwater CSP group was significantly shorter than that in traditional CSP group [(86.23 ± 33.66) and (111.77 ± 40.06) s], the difference was statistically significant (P < 0.01). There were no significant differences in terms of consumed clips, postoperative bleeding incidence, and polyp recurrence rate between the two groups (P > 0.05). There were no cases of perforation in either group.Conclusion Underwater CSP is a safe and effective treatment for small colorectal polyps, with a higher complete resection rate, lower intraoperative bleeding rate, and shorter surgical time.