Risk factors for incomplete polyp resection after cold snare polypectomy
Risk factors for incomplete polyp resection after cold snare polypectomy
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DOI：
10.1007/s00384-019-03347-6
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发表时间：
2019-09-01
影响因子：
2.8
通讯作者：
Nakajima, Atsushi
中科院分区：
文献类型：
--
作者：
Arimoto, Jun;Chiba, Hideyuki;Nakajima, Atsushi
背景息肉不完全切除（IPR）被认为是间隔期结直肠癌（ICC）的危险因素，因此是息肉切除术中的一个重要问题。冷圈套息肉切除术（CSP）是一种不涉及电烙术且无烧伤效应的手术。因此，有可能在接受CSP的病例中与IPR相关的ICC风险高于接受热息肉切除术的病例。然而，对CSP后IPR的危险因素知之甚少。目的准确识别影响CSP术后IPR发生的危险因素，预防CSP术后IPR的发生.因此，我们进行了这项观察性研究，以准确识别CSP后IPR的风险因素。方法回顾性分析2017年10月至2018年3月在大森红十字会医院切除的501例患者的1177个结直肠息肉的病历。对切除息肉的外侧和深边缘进行评估，以检查切除的完整性。结果1177例息肉切除术中，1163例进入分析。206例（17.7%）检出IPR。由受训者进行切除术（OR（95%CI）1.87（1.328-2.632）; P < 0.001）被确定为CSP患者IPR的独立危险因素。结论：实习生施行息肉切除术是CSP患者发生IPR的重要危险因素。未来有必要进行前瞻性随机研究，以制定预防/控制CSP后IPR的有效方法。
Background Incomplete polyp resection (IPR) is recognized as a risk factor for interval colorectal cancer (ICC), and is, therefore, an important issue in polypectomy. Cold snare polypectomy (CSP) is a procedure that does not involve electrocautery and has no burn effect. Therefore, there is the possibility that the risk of ICC associated with IPR is higher in cases undergoing CSP than in those undergoing hot polypectomy. However, little is known about the risk factors for IPR after CSP. Purpose Precise identification of the risk factors can lead to prevention of IPR after CSP. Therefore, we performed this observational study for accurate identification of the risk factors for IPR after CSP. Methods Medical records of a total of 501 patients with 1177 colorectal polyps that were resected at Omori Red Cross Hospital between October 2017 and March 2018 were retrospectively reviewed. The lateral and deep margins of the resected polyps were evaluated to check for the resection completeness. Results Among the 1177 polyp resections, 1163 were included in the final analysis. IPR was detected in 206 (17.7%) cases. Performance of the resection by a trainee (OR (95% CI) 1.87 (1.328-2.632); P < 0.001) was identified as an independent risk factor for IPR in patients undergoing CSP. Conclusions Performance of the polypectomy by a trainee was identified as a significant risk factor for IPR in patients undergoing CSP. Prospective, randomized studies are necessary in the future to develop effective methods for the prevention/control of IPR after CSP.