| 摘要: |
| 目的:基于倾向性得分匹配分析（Propensity Score-Matched，PSM）探究水下内镜下黏膜切除术（Underwater endoscopic mucosal resection，UEMR）与常规内镜下黏膜切除术（Conventional endoscopic mucosal resection，CEMR）治疗老年患者6-9 mm无蒂结直肠息肉的疗效以及安全性。方法:本研究为多中心回顾性研究，纳入2022年1月至2024年12月期间接受内镜下治疗的老年患者，其中CEMR组257例，UEMR组124例。采用PSM以1:1比例匹配两组基线资料，最终各110例纳入分析。比较两组的手术时间、完整切除率、并发症（出血、腹痛）及6个月复发率。结果:匹配后，UEMR组在完整切除率（91.82%vs.81.82%,P<0.05）均显著高于CEMR组，且手术时间更短（147.72±84.94svs.170.08±83.79s,P<0.05）。两组在术中出血、迟发性出血及术后腹痛方面无显著差异（P>0.05）。UEMR组6个月复发率显著低于CEMR组（14.55%vs.21.82%,P<0.05）。结论:对于老年患者6–9 mm无蒂结直肠息肉，UEMR相较于CEMR具有更高的切除完整性和更低的短期复发率，同时不增加手术风险，是一种更优的治疗选择。 |
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Department of Gastroenterology, Jingmen Central Hospital, Jingmen Central Hospital Affiliated to Jingchu University of Technology
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| Abstract: |
| Objective: This study aimed to compare the efficacy and safety of underwater endoscopic mucosal resection (UEMR) with conventional endoscopic mucosal resection (CEMR) for removing 6-9 mm non-pedunculated rectal polyps in elderly patients.
Methods: We conducted a multicenter, retrospective study of elderly patients who underwent endoscopic resection between January 2022 and December 2024. To ensure a balanced comparison, propensity score matching was used to pair 110 UEMR patients with 110 CEMR patients based on baseline characteristics. Key outcomes included procedure duration, rate of complete resection, peri- and post-procedural complications (bleeding, abdominal pain), and recurrence at 6 months.
Results: The UEMR group demonstrated a significantly higher rate of complete resection (91.82% vs. 81.82%, P<0.05) than the CEMR group. UEMR procedures were also shorter on average (147.72 ± 84.94 s vs. 170.08 ± 83.79 s, P<0.05). The incidence of complications-including intraprocedural bleeding, delayed bleeding, and abdominal pain-was comparable between groups (P>0.05). At the 6-month follow-up, the recurrence rate was significantly lower in the UEMR group (14.55% vs. 21.82%, P<0.05).
Conclusion: For the removal of 6–9 mm non-pedunculated rectal polyps in elderly patients, UEMR offers a more effective approach than CEMR, yielding superior resection completeness and lower short-term recurrence, without increasing procedural risk. |
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