橡皮圈辅助内牵引与口袋法内镜黏膜下剥离术治疗早期结肠癌及癌前病变的临床疗效对比

Comparison of clinical efficacy of rubber band traction assisted and pocket-creation method assisted endoscopic submucosal dissection for early colon cancer and precancerous lesions

摘要:

目的 对比橡皮圈辅助内牵引内镜黏膜下剥离术（ESD）与口袋法ESD治疗早期结肠癌（ECC）及癌前病变的临床疗效。方法 选取2023年1月－2024年7月该院收治的ECC及癌前病变患者118例，按照手术方式的不同，分为A组（64例）和B组（54例），A组行橡皮圈辅助内牵引ESD，B组行口袋法ESD。评估两组患者手术指标、病灶切除情况、并发症发生情况和术后随访情况。结果 A组剥离时间短于B组，剥离速度快于B组，整块切除率高于B组，差异均有统计学意义（P 0.05）；两组患者病理类型、浸润深度、组织治愈性切除率和术后并发症发生率比较，差异均无统计学意义（P 0.05）。结论 与口袋法ESD相比，橡皮圈辅助内牵引ESD可明显缩短剥离时间，提高剥离速度，提高病灶切除效果，术后恢复和复发情况与口袋法ESD相当。值得应用于临床。

Abstract:

Objective To compare the clinical efficacy of rubber band traction assisted endoscopic submucosal dissection (ESD) and pocket-creation method assisted ESD in treating early colon cancer (ECC) and precancerous lesions.Methods A total of 118 patients with ECC and precancerous lesions from January 2023 to July 2024 were selected and divided into group A (64 cases) and group B (54 cases) according to different surgical methods. Group A underwent endoscopic traction ESD assisted by rubber bands, and group B underwent the pocket method ESD. The surgical indicators, lesion resection, occurrence of complications and postoperative follow-up of the two groups of patients were evaluated.Results The dissection time of group A was shorter than that of group B, the peeling speed was faster than that of group B, and the total resection rate of group A was higher than that of group B. The differences were statistically significant (P 0.05). There were no statistically significant differences in the pathological types, the depth of infiltration, the rate of curative tissue resection and the incidence of postoperative complications between the two groups of patients (P 0.05).Conclusion Compared with pocket-method ESD, rubber band-assisted endoscopic traction ESD can significantly shorten the stripping time, increase the stripping speed, improve the resection effect of the lesion, and the postoperative recovery and recurrence are comparable to those of pocket-method ESD. It is worth applying in clinical practice.