内镜下治疗结肠息肉的安全性及有效性

Efficacy of three different endoscopic methods in treatment of colorectal polyps

AIM

To evaluate the effectiveness and safety of argon plasma coagulation (APC), high-frequency electrocoagulation, and endoscopic mucosal resection (EMR) in the treatment of colorectal polyps.

METHODS

A total of 310 polyps were selected and randomly divided into three groups to undergo APC (n = 78), electrosurgical excision (n = 108), and EMR (n = 124), respectively. All of the patients were followed for 6 months. Postoperative complications and the wounds of the original resection were statistically analyzed in the three groups. The cure rates and complication rates among the three groups were also compared statistically.

RESULTS

There were 178 flat and superficially protruded polyps; the cure rates in groups A and C were 98.1% and 95.9%, respectively, which were significantly higher than that of group B (64.2%), but there was no significant difference between groups A and C (P > 0.05). There were 132 subpedunculated and pedunculated polyps; the cure rates in groups B and C were 89.1% and 97.3%, respectively, which were significantly higher than that in group A (69.2%), but there was no significant difference between groups B and C (P > 0.05). Bleeding and perforation were common complications. The incidence rates in the three groups were 1.28%, 1.85%, and 2.42%, and there was no significant difference among the three groups (P > 0.05).

CONCLUSION

APC is suitable for flat and superficial polyps, high-frequency electrocoagulation is suitable for subpedunculated and pedunculated polyps, and EMR is suitable for all types of polyps. All three methods are safe and effective. In clinical work, individualized treatment should be selected based on the morphology and pathological type of colorectal polyps.

Clinical and pathologic features of colorectal polyps: Analysis of 313 cases

AIM: To investigate the clinical and pathological features of colorectal polyps, and to provide reference for clinical diagnosis and treatment.

METHODS: The clinical records of 313 cases of colorectal polyps treated from September 2011 to September 2014 at Nanjing First Hospital were retrospectively analyzed. All patients received colonoscopy, and were confirmed to have colon polyps through endoscopic and histopathological examinations.

RESULTS: The incidence of adenomatous polyps was 72.8%. There was no significant difference in clinical characteristics between adenomatous and non-adenomatous polyps (P > 0.05). The occurrence of colorectal polyps was not correlated with sex, Yamada type, growth location and number of polyps (P > 0.05). The incidence of adenomatous polyps in different age groups and in polyps with different diameters was statistically significant (P < 0.05). The extent of the tumor was not associated with sex, age, location of growth or number of polyps, but there were significant differences in the degree of tumor variation when stratified by the Yamada type and the diameter of polyps (P < 0.05).

CONCLUSION: Colorectal polyps have no specific clinical manifestations. Most of colorectal polyps are located in the left colon. There is no significant difference in the incidence of adenomatous polyps between males and females, but the incidence rate is higher in patients with polyps whose diameter is > 1 cm. The number of polyps has no effect on the incidence of adenoma.