GUT: 冷圈套和热圈套息肉切除术治疗4-9 mm结直肠息肉的效果比较

2018-10-20 MedSci MedSci原创

结直肠腺瘤性息肉的切除有两种切除方法--冷圈套息肉切除术(CSP)与热圈套息肉切除术(HSP)。本研究主要探讨冷圈套息肉切除术(CSP)与热圈套息肉切除术(HSP)在切除4-9 mm结直肠腺瘤性息肉中的成功率。

背景及目的
结直肠腺瘤性息肉的切除有两种切除方法--冷圈套息肉切除术(CSP)与热圈套息肉切除术(HSP)。本研究主要探讨冷圈套息肉切除术(CSP)与热圈套息肉切除术(HSP)在切除4-9 mm结直肠腺瘤性息肉中的成功率。

方法
研究人员在日本的12家内镜治疗中心进行了一项前瞻性,多中心,随机对照,平行,非劣效性试验。将内窥镜诊断的无柄腺瘤性息肉(4-9mm大小)随机分配至CSP或HSP组。主要观察终点是息肉完全切除率,其定义为在所有病理证实的腺瘤性息肉中活检标本中没有腺瘤组织的证据。

结果
2015年9月至2016年8月期间,共有912名符合资格患者,共检测到796例符合条件的息肉.CSP的完全切除率为98.2%,而HSP为97.4%。与HSP相比,CSP完全切除的非劣效性为0.8%(90%CI -1.0至2.7)完全切除率(非劣效性p <0.0001)。需要内镜再止血的术后出血仅发生在HSP组(0.5%)。

结论
CSP的完全切除率不低于HSP,且未发生术后再出血。CSP可以是4-9 mm结直肠息肉的标准技术之一。

原始出处:

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    2018-10-20 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0