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Objective:To investigate the efficacy and safety of cold snare polypectomy (CSP) and hot snare polypectomy (HSP) for the removal of colorectal polyps of 10-15 mm.Methods:A total of 173 polyps of 154 patients with at least one polyp of 10-15 mm were resected under colonoscopy from December 2019 to December 2020. Based on Paris classification, the polyps were divided into Ⅰsp, Ⅰs and Ⅱa. According to random number table, the polyps were randomly divided into CSP group ( n=85) and HSP group ( n=88). The polyp size, location, morphology, histological classification, complete resection rate, incidence of complications, resection time and the number of prophylactic clips were compared between the two groups. Results:There were no significant differences in age, sex, indication of colonoscopy or the success rate of intubation at the end of ileum between the two groups. The polyps of the two groups were comparable in size, position, morphology and histological classification. There were no significant differences in the complete resection rate of polyps, rates of intraoperative bleeding and postoperative bleeding or perforation between the CSP group and the HSP group. The operation time in CSP group was significantly shorter than that in HSP group (63.5 ±23.6 s VS 184.3 ±62.4 s, P<0.05). The number of prophylactic clips used in CSP group was significantly less than that in HSP group (0.8±0.5 VS 1.4±0.7, P<0.05). Conclusion:CSP shows similar complete resection rate and complication incidence, and requires shorter operation time and fewer prophylactic clips, compared with HSP, in the resection of colorectal sessile polyps of 10-15 mm.
RESUMO
Objective To evaluate surgical approach,safety and efficacy of endoscopic submucosal excavation (ESE) for the treatment of gastric submucosal tumors originated from the muscularis propria layer.Methods Fifty-three patients with submucosal tumors of the stomach diagnosed by gastroscope,were examined using endoscopic ultrasonography (EUS) from February 2012 to April 2013.The patients were completed ESE at general anesthesia.Results The diameter of the tumor was from 5 to 35 mm (median 13.2 mm).The tumors of 48 patients were complete resection,the complete resection rate was 90.6％(48/53).The operation time was from 30 to 150 min (median 45 min).Three patients (5.7％,3/53) had impulsivity hemorrhage during ESE,no patients had unmanageable hemorrhea under the gastroscope.Perforation occurred in 6 patients during ESE,perforation rate was 11.3％ (6/53),the perforation was closed by endoclip in 5 patients.Five patients with inability resection and 1 patient with perforation inability closed were treated with surgical operation.None was developed perforation postoperative and hemorrhea.Conclusion ESE is a safety and efficacy method for treating gastric submucosal tumors originating from the muscularis propria layer.