ABSTRACT
Objective?To investigate the efficacy and safety of dental floss traction assisted technique in endoscopic submucosal dissection (ESD) of early rectal cancer and precancerous lesions.?Methods?57 patients recived ESD for early colorectal cancer and precancerous lesions from September 2014 to June 2017 were randomly divided into dental floss traction group (n = 28) and routine group (n = 29). To compare the average operation time, the amount of supplementary submucosal injection, and frequency of supplementary submucosal injection, complete resection rate, R0 resection rate, complications and follow-up results of the two groups.?Results?All 57 cases were treated with ESD successfully. The average operation time, the amount of supplementary submucosal injection and the frequency of injection were significantly less in the dental floss traction group than in the conventional group [(55.11 ± 10.44) vs (74.72 ± 14.47) min; (5.80 ± 1.80) vs (10.00 ± 5.70) ml; frequency (1.10 ± 0.90) vs (1.70 ± 0.90)]. The average operation time (P = 0.000), the amount of supplementary submucosal injection (P = 0.001) and the frequency of supplementary submucosal injection (P = 0.022) were significantly different between the two groups. The complete resection rate and R0 resection rate were 100.0% in both groups. There was no bleeding or perforation in the dental floss traction group, and 1 cases (3.4%) in the conventional group had delayed bleeding after operation, and 2 cases (6.9%) perforation occurred during the operation, and there was no significant difference between the two groups (P > 0.05). No recurrence was found in the two groups during follow-up period.?Conclusions?Dental floss traction assisted technique can significantly shorten the operation time of ESD, reduce the amount and frequency of supplementary submucosal injection and ensure good therapeutic effect for early colorectal cancer and precancerous lesions.
ABSTRACT
Objective To analyze risk factors for delayed postpolypectomy bleeding (DPPB) of colorectal polyps. Methods We reviewed 1 098 patients (2 169 polyps) who accepted endoscopic polypectomy from July 2014 to July 2017. Evaluate the risk factors for DPPB. Results DPPB occurred in 18 (1.6%) cases. Univariate analysis revealed that history of hypertension (P = 0.007), polyp size ≥10 mm (P = 0.009), right hemicolon location (P = 0.015) and adenomatous polyp (P = 0.045) were risk factors for DPPB. Multivariate logistic regression analysis revealed that history of hypertension (P = 0.002, O(R) = 4.654, 95%CI: 1.755 ~ 12.343), polyp size ≥10 mm (P = 0.009, O(R) = 3.637, 95%CI: 1.390 ~ 9.517), location in the right hemicolon (P = 0.016, O(R) = 3.656, 95%CI:1.273 ~ 10.504) were independent risk factors for DPPB. Conclusion Patients with history of hypertension, polyp size ≥10 mm, polyp location in the right hemicolon are prone to DPPB. We should take effective measure to prevent DPPB.