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Clinical Analysis of Endoscopic Treatment of 382 Cases with Colonic Polyps

Author: ZhangMiChun
Tutor: GongAiXia
School: Dalian Medical University
Course: Internal Medicine
Keywords: Colon polyps Endoscopic treatment High frequency electrosurgical excision procedure Pretreatment
CLC: R735.34
Type: Master's thesis
Year: 2010
Downloads: 93
Quote: 0
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Abstract


Objective: To analyze the patient's gender, age, polyp morphology, size, location, histological type, rate of cancer, endoscopic treatment effective removal rate and complications after resection of the incidence and clinical features of colon polyps, explore the colon the safety and efficacy of the polyp endoscopic therapy, as well as pre-treatment in large polyps huge polypectomy role. Methods: Retrospective analysis of Dalian Medical University First Affiliated Hospital of hospitalized between January 2005 - December 2009 line of endoscopic colon polypectomy patients, a total of 382 cases were found polyps 1097, by size into three group: a small polyp group (less than 1.0cm), polyp (1.Ocm-2.Ocm) and huge polyp (greater than 2.Ocm,). Total removal of polyps 1093. Resection in two ways, namely A method and B method. A method is a simple line Electrosurgical resection, B method Electrosurgical removal of polyps before preprocessing, including ① submucosal injection 0.5:10000 norepinephrine, ② metal clip clipping operation ③ submucosal injection of 0.5 : 10000 norepinephrine joint metal clip clipping operation. Depending on the resection method, large polyps with huge polyp is divided into non-pretreated group (application A resection) and pretreatment group (application the B method resection). Small polyps 838 take A method resection, 53 applications A method of large polyp excision, cut out 161 application method B; huge polyp group 4 application A method resection, resection of 37 applications B method. Relatively small polyp and large polyp, polyp huge position of the patient's age, gender, polyps among the three groups, morphology, pathological type, rate of cancer, endoscopic resection effective removal rate and the incidence of complications difference , and A and B are the two methods that is removed before the preprocessing and without pretreatment complications incidence of any differences. Results: 1, three groups of small polyps, large polyps group, huge polyp on the gender and age of the patients, the difference was not statistically significance (P gt; 0.05) were men slightly more than women; shape, location distribution pathological type pairwise comparisons, the differences were statistically significant (P lt; 0.05). Small polyp sessile huge polyp pedunculated; huge polyps in the left colon highest incidence and adenoma-up. No one case of cancer of the small polyp; polyps cancer was 2.45% (4/163), huge polyp cancer was 11.36% (5/44), a large polyp huge polyp between the rate of cancer statistics significance (P lt; 0.05), huge polyps cancerous higher than the group of large polyps. The small polyp total removal and effective resection rate was 100%; with large polyp effective cut rate of 99.53% (214/215); huge polyp effective resection rate was 93.18% (41/44). The effective removal rate in the a large polyp huge polyp was statistically significant (P lt; 0.05), the large polyp effective resection higher than huge polyp. 3, a total of 1093 removal of polyps, 18 polyps bleeding (1.65%), 16 of which occurred early bleeding (1.46%), the two late bleeding (0.18%). No major bleeding occurred in 1 patient (0%) (0%), intestinal perforation. Small polyp bleeding incidence was 0.36% (3/838), large polyp bleeding rate was 5.14% (11/214), huge polyp bleeding incidence was 9.76% (4/41). Pairwise comparisons among the three groups, the incidence of bleeding in the small polyp and large polyp, with huge polyp was statistically significant (P lt; 0.01), the incidence of bleeding between the a large polyp huge polyp no statistically significant (P gt; 0.05). Large polyp and huge polyp group of 57 A resection, bleeding rate was 12.28% (7/57), 198 B resection, bleeding rate was 4.04% (8/198 ), A and B are two methods, the incidence of bleeding was statistically significant (P lt; 0.05) the pretreatment group PPB incidence lower than non-pretreated group. Conclusion: 1, regardless of the size of colon polyps in patients with gender, age of onset; 2, the higher the greater the rate of cancer of the colon polyps; endoscopic treatment of colon polyps is safe, effective and is the preferred method for the treatment of colon polyps ; 4, the size of colon polyps is not whether to endoscopic resection determinants, as long as the proper way, the huge polyp endoscopic resection, anterior pretreatment can effectively reduce the incidence of postoperative complications.

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CLC: > Medicine, health > Oncology > Gastrointestinal Cancer > Intestinal neoplasms > Colorectal tumors
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