Effect and safety of three kinds of endoscopic surgeries on colon polyps

doi:10.3877/cma.j.issn.1674-3946.2024.01.021

Abstract

Abstract:

Objective

To explore the effect and safety of endoscopic high-frequency electrical resection, endoscopic cold snare resection and endoscopic mucosal resection in the treatment of colon polyps.

Methods

Data of 95 patients with colon polyps who underwent endoscopic surgical resection from March 2021 to March 2022 were retrospectively analyzed, and the patients were divided into group A (29 cases, endoscopic high-frequency electrical resection), group B (31 cases, endoscopic cold snare resection) and group C (35 cases, endoscopic mucosal resection) according to different treatment methods. SPSS 24.0 software was used for statistical analysis. Perioperative indicators, levels of serum prostaglandin (PGE2), tumor necrosis factor α (TNF-α) and interleukin-6 (IL-6) before surgery and at 24 hours after surgery and other measurement data were performed by One-way ANOVA of variance. Polyp resection, complications, recurrence rate at 1 year after surgery and other enumeration data were compared by χ² test. P<0.05 was expressed as a statistical significance.

Results

There were no statistically significant differences in postoperative gastrointestinal function recovery time and hospital stay among the three groups (P>0.05), and the endoscopic operation time in group C was longer than that in groups A and B (P<0.05), and the intraoperative blood loss was less than that in groups A and B (P<0.05), and the intraoperative blood loss in group B was more than that in group A (P<0.05). At 24 hours after surgery, serum levels of PGE2, TNF-α and IL-6 in the three groups were higher than those before surgery (P<0.05), and the above levels in groups B and C were lower than those in group A (P<0.05). At 1 year after surgery, the difference in the recurrence rate was statistically significant among the three groups (P<0.05), and the recurrence rate was lower in group C than that in group A (P<0.05).

Conclusion

The clinical efficacy of the three surgical methods is comparable. Endoscopic mucosal resection is superior to high-frequency electrical resection in relieving postoperative inflammatory response and preventing recurrence, thus it is worthy of popularization and application.

Key words: Colonic Polyps, Endoscopic High-Frequency Electrical Resection, Endoscopic Cold Snare Resection, Endoscopic Mucosal Resection

Chengxue Yuan, Zongxia Zhang, Ting Xu, Slanglam. Effect and safety of three kinds of endoscopic surgeries on colon polyps[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(01): 78-81.

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References 14

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组别	例	年龄(岁)	性别	平均息肉直径(cm)	平均息肉数量(枚)	有蒂息肉(枚)
组别	例	年龄(岁)	男/女	平均息肉直径(cm)	平均息肉数量(枚)	有蒂息肉(枚)
A组	29	49.2±8.4	16/13	7.2±1.8	1.8±0.4	5
B组	31	50.0±8.9	19/12	7.6±2.0	1.6±0.4	9
C组	35	48.7±8.6	17/18	7.4±1.4	1.7±0.6	10
F/χ²值		0.197	1.077	0.424	0.988	1.424
P值		0.822	0.584	0.655	0.376	0.491
组别	例	息肉位置	息肉类型	合并疾病
组别	例	A/B /C	D/F	G/	H/	I
A组	29	7/13/9	12/17	6/	3/	3
B组	31	10/15/6	14/17	9/	5/	3
C组	35	11/12/12	17/18	11/	5/	6
F/χ²值		2.047	0.331	0.984
P值		0.079	0.847	0.611

组别	例	年龄(岁)	性别	平均息肉直径(cm)	平均息肉数量(枚)	有蒂息肉(枚)
组别	例	年龄(岁)	男/女	平均息肉直径(cm)	平均息肉数量(枚)	有蒂息肉(枚)
A组	29	49.2±8.4	16/13	7.2±1.8	1.8±0.4	5
B组	31	50.0±8.9	19/12	7.6±2.0	1.6±0.4	9
C组	35	48.7±8.6	17/18	7.4±1.4	1.7±0.6	10
F/χ²值		0.197	1.077	0.424	0.988	1.424
P值		0.822	0.584	0.655	0.376	0.491
组别	例	息肉位置	息肉类型	合并疾病
组别	例	A/B /C	D/F	G/	H/	I
A组	29	7/13/9	12/17	6/	3/	3
B组	31	10/15/6	14/17	9/	5/	3
C组	35	11/12/12	17/18	11/	5/	6
F/χ²值		2.047	0.331	0.984
P值		0.079	0.847	0.611

分组	例	内镜下操作时间(min)	术中出血量(ml)	术后胃肠功能恢复时间(h)	住院时间(d)
A组	29	11.4±1.6	1.6±0.2	30.2±4.4	5.2±1.4
B组	31	11.7±2.00	1.9±0.2^a	31.0±4.9	5.2±1.3
C组	35	12.8±1.2^ab	1.0±0.2^ab	30.8±3.8	5.5±1.3
F值		6.772	151.856	0.276	0.615
P值		0.002	<0.001	0.068	0.542

分组	例	内镜下操作时间(min)	术中出血量(ml)	术后胃肠功能恢复时间(h)	住院时间(d)
A组	29	11.4±1.6	1.6±0.2	30.2±4.4	5.2±1.4
B组	31	11.7±2.00	1.9±0.2^a	31.0±4.9	5.2±1.3
C组	35	12.8±1.2^ab	1.0±0.2^ab	30.8±3.8	5.5±1.3
F值		6.772	151.856	0.276	0.615
P值		0.002	<0.001	0.068	0.542

分组	例	息肉数量(枚)	整块切除	完整切除
A组	29	53	49(92.4)	48(90.6)
B组	31	51	48(94.1)	46(90.2)
C组	35	60	58(96.6)	58(96.6)
χ²值			0.986	2.219
P值			0.611	0.330

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