一种内镜手术用辅助带在结直肠侧向发育型肿瘤内镜黏膜下剥离术中的应用价值

Clinical application value of an endoscopic surgical auxiliary belt in endoscopic submucosal dissection of colorectal laterally spreading tumor

摘要:

目的 探讨简易手工橡胶牵引装置在结直肠侧向发育型肿瘤（LST）内镜黏膜下剥离术（ESD）中的应用价值。方法 回顾性分析2022年6月1日－2023年6月9日66例在该院因结直肠LST行ESD治疗的患者的临床资料，根据术中是否使用简易手工橡胶牵引装置，分为结直肠牵引ESD组（tESD组，n = 22）和结直肠传统ESD组（cESD组，n = 44），比较两组患者术中止血次数、钛夹使用个数、ESD成功率、术后并发症发生率、住院时间和治疗费用等的差异。结果 tESD组手术时间较cESD组长，住院时间较cESD组短，但差异均无统计学意义（P > 0.05）；两组患者钛夹使用个数、术后并发症发生率和住院费用比较，差异均无统计学意义（P > 0.05）。结论 简易手工橡胶装置用于ESD，可作为在传统ESD难以进行时的补救方案，且借助牵引后，并不会增加患者住院成本，两者术后并发症相当。值得临床推广应用。

Abstract:

Objective To explore the application value of simple manual rubber traction device in endoscopic submucosal dissection (ESD) of colorectal laterally spreading tumor (LST).Methods A retrospective cohort study was used to collect patients who underwent ESD for colorectal LST from June 1, 2022 to June 9, 2023. According to the use of the manual rubber traction device, patients were divided into colorectal traction ESD group (tESD group, n = 22) and colorectal conventional ESD group (cESD group, n = 44), the differences were compared between the two groups in the number of intraoperative hemostasis, the number of titanium clips used, the success rate of ESD, incidence of postoperative complications, hospital stay time, and treatment costs.Results The tESD group had relatively longer operation time and shorter hospitalization days than those of cESD group, but the difference was not statistically significant (P > 0.05); There were no statistically significant differences in the number of titanium clips used, postoperative complication rates, and hospitalization costs between the two groups (P > 0.05).Conclusion Colorectal traction ESD can be used as a remedial plan when traditional ESD is difficult to perform, and the use of traction does not increase the hospitalization cost of patients, and the postoperative complications of the two methods are similar. It is worthy of clinical application.