Comparison of postoperative bleeding between two endoscopic resection methods for colorectal polyps with coarse pedicle
10.3760/cma.j.cn321463-20231122-00270
- VernacularTitle:内镜下切除结直肠粗蒂息肉两种术式的术后出血比较
- Author:
Wenjie LIU
1
;
Min WANG
;
Yulin GU
;
Li LIU
Author Information
1. 江苏省人民医院（南京医科大学第一附属医院）消化内镜科，南京 210029
- Keywords:
Postoperative hemorrhage;
Colorectal polyps;
Coarse pedicle;
Endoscopic submucosal dissection;
Nylon cord
- From:
Chinese Journal of Digestive Endoscopy
2024;41(9):729-733
- CountryChina
- Language:Chinese
-
Abstract:
To compare the effect of endoscopic submucosal dissection (ESD) and endoscopic pedicle ligation with nylon rope or metal clip followed by electrical resection on postoperative hemorrhage for thick colorectal pedicle polyps, clinical data of patients undergoing endoscopic polypectomy in Jiangsu Province Hospital (The First Affiliated Hospital with Nanjing Medical University) from January 2018 to November 2022 were retrospectively collected, and the patients were divided into ESD group and pre-ligation group according to different treatment methods. Postoperative bleeding data of the two groups were compared and analyzed. A total of 265 patients were included, including 124 in ESD group and 141 in pre-ligation group. There were no significant differences in gender, age, polyp sites, polyp diameter or pedicle diameter between the two groups ( P>0.05). The postoperative bleeding rate in the ESD group was significantly lower than that in the pre-ligation group [4.0% (5/124) VS 10.6% (15/141), χ2=4.126, P=0.042]. Compared with ESD group, more bleeding occurred in the left colon in the pre-ligation group, with statistically significant difference [40.0% (2/5) VS 93.3% (14/15), P=0.032]. The hospital stay was longer in the ESD group than that in the pre-ligation group (4.6±1.9 days VS 3.4±1.5 days, t=5.641, P<0.001). ESD is more effective than pre-ligation in reducing postoperative hemorrhage for coarse pedicle colorectal polyps, especially for those on distal colon.
