A retrospective clinical study of non-injection mucosal resection for Paris type 0-Ⅰ colonic polyps less than 2 cm
10.3760/cma.j.cn321463-20230103-00136
- VernacularTitle:非注射黏膜切除术治疗长径小于2 cm 巴黎分型0-Ⅰ型结肠息肉的回顾性临床研究
- Author:
Xiaotan DOU
1
;
Jing WANG
;
Ting ZHOU
;
Ying XIE
;
Tingsheng LING
;
Xiaoqi ZHANG
;
Lei WANG
;
Min CHEN
Author Information
1. 南京大学医学院附属鼓楼医院消化科，南京 210008
- Keywords:
Colonic polyps;
Injections;
Endoscopic mucosal resection
- From:
Chinese Journal of Digestive Endoscopy
2023;40(9):729-733
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the value of non-injection mucosal resection for Paris type 0-Ⅰ colon polyps with a long diameter less than 2 cm.Methods:At the Department of Gastroenterology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, patients with type 0-Ⅰcolonic polyps of a long diameter less than 2 cm who underwent non-submucosal injection resection from January 2019 to December 2019 were enrolled as the non-injection group, and those who received endoscopic mucosal resection (EMR) in the same period were enrolled as the control (EMR group). The differences in complete resection rate, operation time, complication incidence and 1-year follow-up polyp detection rate between the two groups were compared.Results:A total of 373 patients were treated with non-injection mucosal resection and 743 patients with conventional EMR. There was no significant difference in gender [68.6% (256/373) VS 64.6% (480/743) for male, χ2=1.796], age (56.2±11.8 years VS 57.4±11.2 years, t=-1.984), number of polyps (1.5±0.9 VS 1.4±0.8, t=1.776), polyp distribution [48.0% (269/561) VS 34.6% (362/1 045) in right colon, χ2=3.364], lesion diameter less than 1 cm [80.0% (449/561) VS 76.9% (804/1 045), χ2=2.043] between the two groups ( P>0.05). The operation time in the non-injection group was 2.82±1.70 min, which was shorter than that in the EMR group (4.94±2.54 min) with significant difference ( t=-16.489, P<0.001). The number of metal clips used in the non-injection group was 0.90±0.68, which was less than that in the EMR group (1.30±0.73, t=-8.971, P<0.001). The en bloc resection rates of lesions in non-injection group and EMR group were both 100.0%. The complete resection rate of non-injection group was 97.3% (546/561), which was not significantly different from that of EMR group [98.1% (1 025/1 045), χ2=0.749, P=0.387]. There was no significant difference in the incidences of delayed bleeding in the two groups [0.0% (0/373) VS 0.8% (6/743), P=0.187]. No intraoperative or delayed perforation in either group occurred. There was no significant difference in the incidence of electrocoagulation syndrome between the two groups [0.8% (3/373) VS 0.7% (5/743), P=0.534]. A total of 63 patients in the non-injection group underwent colonoscopy review within the set period, and the polyp detection rate was 41.2% (26/63). A total of 178 patients in the EMR group also underwent colonoscopy review, and the polyp detection rate was 53.9% (96/178). There was no significant difference in the polyp detection rate between the two groups ( χ2=2.985, P>0.05). Conclusion:Non-submucosal injection resection is safe and effective for Paris type 0-Ⅰ colon polyps with a long diameter less than 2 cm, which can significantly shorten the operation time and is worth of clinical promotion.
