摘要
目的明确预防性蒂部结扎法对大肠有蒂大息肉切除术中发生的出血及穿孔的预防作用。方法回顾分析91例术前病理证实为良性病变的大肠有蒂息肉(息肉直径≥1.0cm,蒂部直径0.5～1.0cm)进行息肉切除术,其中采用钛夹结扎息肉蒂部后进行高频电切除的30例(钛夹组),采用尼龙圈结扎息肉蒂部后进行高频电切除32例(尼龙圈组);只进行高频电切除29例(对照组),比较各组的操作成功率、早期出血发生率、迟发性出血发生率及穿孔率。结果钛夹组无早期出血,有1例出现了迟发性出血(3.3%),尼龙圈组有2例操作失败(6.25%),其中1例因尼龙圈将息肉蒂部横断而出现了早期出血(3.1%),尼龙圈组无迟发性出血,对照组有4例早期出血(13.8%)及5例迟发性出血(17.2%),各组均无穿孔发生。结论对于体积大的有蒂大肠息肉,进行预防性蒂部结扎能有效地预防息肉切除术后出血等并发症。
[ Objective ] To evaluate the prophylactic peduncle ligature polypectomy with endoclip or endoloop in the patients with large pedunculated colorectal polyps, in comparison with high-frequency electric snare polypectomy. [Methods] 91 colonoscopic polypectomies of large pedunculated polyps （head〉or=10 ram, stalk〉or=5 ram） were retrospectively studied in our endoscopy unit between March 2009 and June 2010. 30 patients in the clip group were treated with endoclip-assisted polypeetomy. 32 patients in the endoloop group were treated with endoloop-assisted polypectomy. For 29 patients in the control group underwent polypectomy with eleetroeoagulation and electrocision only. Operation success rate, early bleeding rate, laterly bleeding rate and perforation rate were compared among the groups. [Results] No early bleeding but 1 ease of delayed hemorrhage （3.3%） occurred in the clip group. Loop placement was impossible in 2 cases （6.25%）,including 1 case of early bleeding because the stalk was tran- seeted by the loop before polypectomy, and no delayed hemorrhage occurred in the endoloop group. There were 4 cases of early bleeding and 5 cases delayed hemorrhage in the control group. No perforation occurred in all groups. [ Conclusions ] Prophylactic peduncle ligature with endoclip or endoloop can prevent the bleeding effectively for the resection of large peduneulated colorectal polyps.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第5期490-493,共4页
China Journal of Endoscopy
关键词
大肠有蒂息肉
息肉切除术
尼龙圈
钛夹
large pedunculated colorectal polyp
polypectomy
nylon endoloop
titanium clips
