Comparative analysis of the efficacy of cold snare polypectomy and endoscopic mucosal resection in treatment of colonic adenoma in proximity to the orifice of appendix
- VernacularTitle:圈套器冷切除术和内镜黏膜切除术治疗阑尾口结肠腺瘤的疗效对比分析
- Author:
Bin LIU
1
;
Qinqin QI
1
;
Xinglin CHEN
1
;
Ke WEI
1
;
Yuanyuan CAI
1
;
Zhemin WANG
1
;
Liuyong CHEN
1
Author Information
- Publication Type:Journal Article
- Keywords: cold snare polypectomy(CSP); endoscopic mucosal resection(EMR); the orifice of appendix; colonic adenoma; complication
- From: China Journal of Endoscopy 2025;31(2):63-69
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the feasibility,efficacy and safety of cold snare polypectomy(CSP)and endoscopic mucosal resection(EMR)in treatment of colonic adenoma in proximity to the orifice of appendix.Methods Clinical data of 41 cases of colonic adenoma in the orifice of appendix treated with CSP(CSP group)and 15 cases treated with EMR(EMR group)from January 2018 to January 2023 were collected.The clinicopathological features and outcomes were analyzed.The main outcome was postoperative complications,including bleeding,perforation and postoperative appendicitis,while the secondary outcome was the total resection rate,block resection rate and local recurrence rate.Results The operation time and treatment cost of CSP group were shorter than EMR group,and the differences were statistically significant(P<0.05).The diameter of applicable lesions in CSP group was smaller than that in EMR group,and the proportion of lesions with tubular adenoma was significantly higher than that in EMR group.There were no significant differences in the time of admission,intestinal preparation score,length of stay,lesion morphology and lesion type between the two groups(P>0.05).Perforation and postoperative appendicitis were not observed in both groups,and delayed postoperative hemorrhage occurred in 1 case in the CSP group,but it could heal itself after surgery without endoscopic intervention.The complete resection rate was 100.0%in both groups.The total removal rate of CSP group was 100.0%,which was significantly higher than that of EMR group(86.7%),and the difference was statistically significant(P<0.05).The local recurrence rate was 2.4%(1/41)in CSP group,and no local recurrence was observed in EMR group(0/15),with no statistical significance(P>0.05).Conclusion CSP and EMR are safe and effective in the treatment of colonic adenoma in proximity to the orifice of appendix,and they are trustworthy.Compared with EMR,CSP is more applied to small diameter tubular adenomas,which has the characteristics of economy and time saving,but at the same time there is the risk of recurrence.EMR obviously has a wider application range,but there is a disadvantage in price and time,and individual cases need to be segmented resection.
