2024 年第 6 期 第 0 卷

体内牙线牵引法在内镜黏膜下剥离术治疗早期结直肠癌及癌前病变中的应用效果分析

Application effect of internal dental floss traction assisted technique in endoscopic submucosal dissection for early colorectal cancer and precancerous lesions

作者：郎海波张杰代静曹艳李奇鞠红岩

英文作者：Lang Haibo Zhang Jie Dai Jing Cao Yan Li Qi Ju Hongyan

单位：首都医科大学附属北京安贞医院消化内科，北京100029

英文单位：Department of Gastroenterology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：早期结直肠癌；体内牙线牵引法；内镜黏膜下剥离术

英文关键词：Earlycolorectalcancer;Internaldentalflosstraction;Endoscopicsubmucosaldissection

• 摘要：

• 目的 探讨体内牙线牵引法在内镜黏膜下剥离术（ESD）治疗早期结直肠癌及癌前病变中的应用效果。方法 回顾性分析2022年1月至2023年12月于首都医科大学附属北京安贞医院消化内科行ESD的98例早期结直肠癌和癌前病变患者的临床资料。根据内镜下治疗方法分为牙线组（51例）和对照组（47例），对照组则行标准ESD，牙线组在ESD术中加用体内牙线牵引辅助。比较2组患者ESD手术操作时间、术中出血发生率、病灶切除效果、术后并发症发生率、住院时间等临床资料。结果 牙线组手术时间、术中出血比例短于/低于对照组［25.0（17.3,30.0）min比45.0（32.0,64.0）min、39.2%（20/51）比53.2%（25/47）］（均P＜0.05）。2组整块切除率、完整切除率、术后并发症发生率和住院时间比较差异均无统计学意义（均P＞0.05）。2组术后均无迟发穿孔发生。结论 体内牙线牵引法在ESD治疗早期结直肠癌及癌前病变中可明显缩短手术操作时间，降低术中出血发生率，安全有效。

• Objective To explore the application effect of internal dental floss traction assisted technique in endoscopic submucosal dissection (ESD) for early colorectal cancer and precancerous lesions. Methods Clinical data of 98 patients with early colorectal cancer and precancerous lesions who underwent ESD in Department of Gastroenterology, Beijing Anzhen Hospital, Capital Medical University from January 2022 to December 2023 were selected to retrospective analysis, and they were divided into the dental floss group (51 cases) and the control group (47 cases) according to endoscopic treatment methods. The control group received standard ESD, while the dental floss group received additional internal dental floss traction during ESD. The ESD procedure time, incidence of intraoperative bleeding, lesion resection effect, incidence of postoperative complications, and length of hospital stay were compared between the two groups. Results Compared to the control group, ESD procedure time and the incidence of intraoperative bleeding in the dental floss group were shorter/lower ［25.0（17.3,30.0）min vs 45.0（32.0,64.0）min, 39.2%（20/51） vs 53.2%（25/47）］(both P<0.05). There were no significant differences in overall resection rate, complete resection rate, postoperative and length of hospital stay between the two groups (all P>0.05), and no delayed perforation occurred. Conclusion The application of internal floss traction in ESD for the treatment of early colorectal cancer and precancerous lesions can shorten the procedure time, reduce the incidence of intraoperative bleeding.