2024 年第 12 期 第 0 卷

体内牙线牵引技术在辅助结直肠病变内镜黏膜下剥离术教学中的作用

The role of internal dental floss traction in assisting the teaching of endoscopic submucosal dissection for colorectal lesions

作者：孙亚梅张杰

英文作者：Sun Yamei Zhang Jie

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：结直肠病变；牙线牵引；内镜黏膜下剥离术；教学

英文关键词：Colorectallesions;Flosstraction;Endoscopicsubmucosaldissection；Teaching

• 摘要：

• 目的 探讨体内牙线牵引技术在辅助结直肠病变内镜黏膜下剥离术（ESD）教学中的作用。方法 选择2024年4月1日至7月31日于首都医科大学附属北京安贞医院消化内科因结直肠病变行ESD治疗的27例患者。本期共有4名初级ESD内镜医师参与ESD操作的教学培训，所有ESD操作由熟练ESD内镜操作的医师指导、初级内镜医师操作，并收集患者的临床资料和病理结果。结果入选的27例进行结直肠病变ESD治疗的患者中男16例、女11例，年龄（61±9）岁。病变部位包括回盲部病变1例、升结肠病变3例、横结肠病变3例、降结肠病变4例、乙状结肠病变5例、直肠病变11例。病理类型包括低级别管状腺瘤13例、低级别绒毛管状腺瘤5例、锯齿状腺瘤3例、神经内分泌肿瘤3例、高级别上皮内瘤变3例。所有患者均未出现出血、穿孔、感染等并发症，整块切除率和完整切除率均为100%。4名初级ESD内镜医师均迅速地掌握了ESD操作技术，安全有效。结论 对于初级内镜医师，应用体内牙线牵引技术辅助结直肠病变ESD操作，有助于其迅速掌握ESD，安全有效。

• Objective To investigate the role of internal dental floss traction in assisting the teaching of endoscopic submucosal dissection (ESD) for colorectal lesions. Methods A total of 27 patients who underwent ESD treatment for colorectal lesions in the Department of Gastroenterology, Beijing Anzhen Hospital, Capital Medical University from April 1 to July 31, 2024 were selected. A total of 4 primary ESD endoscopists participated in ESD teaching training, all ESD operations were guided by skilled ESD endoscopists and operated by primary endoscopists, and clinical data and pathological results of patients were collected. Results A total of 27 patients who underwent ESD for colorectal lesions were enrolled, including 16 males and 11 females, with an average age of (61±9) years. The lesion sites consisted of 1 case in the ileocecal region, 3 cases in the ascending colon, 3 cases in the transverse colon, 4 cases in the descending colon, 5 cases in the sigmoid colon, and 11 cases in the rectum. The pathological types comprised 13 cases of low-grade tubular adenoma, 5 cases of low-grade villous tubular adenoma, 3 cases of serrated adenoma, 3 cases of neuroendocrine tumor, and 3 cases of high-grade intraepithelial neoplasia. All patients had no complications such as bleeding, perforation, infection, and so on. The whole resection rate and complete resection rate were 100%. All the four primary ESD endoscotists quickly mastered the ESD operation technique, which was safe and effective. Conclusion For primary endoscopists, the application of internal dental floss traction to assist colorectal ESD operation can help them quickly master ESD, which is safe and effective.