Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences.
Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences.
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内窥镜粘膜切除术带有圆周肿瘤的圆周粘膜切口：与内窥镜粘膜下截面的比较以及两位具有不同经验的内镜医生之间的比较。
DOI：
10.5946/ce.2016.058
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发表时间：
2017-07
影响因子：
2.5
通讯作者：
Friedland S
中科院分区：
文献类型：
--
作者：
Yang DH;Kwak MS;Park SH;Ye BD;Byeon JS;Myung SJ;Yang SK;Kim HG;Friedland S
环形粘膜切口内镜粘膜切除术（CMI-EMR）的受益与内镜粘膜下剥离术（ESD）相当，但技术熟练程度低于ESD。我们回顾性比较了CMI-EMR（n=34）和大小匹配的ESD（n=102）的结果，这是由韩国内镜医生进行的结直肠上皮病变的20-35毫米。美国ESD新手（n=30）进行的CMI-EMR的程序参数进行了比较，由韩国内镜医生进行。CMI-EMR组和尺寸匹配ESD组的病变尺寸分别为22.3±3.9 mm和22.9±2.4 mm（p=0.730）。CMI-EMR组的切除时间为12.7±7.0分钟，ESD组为45.6±30.1分钟（p<0.001）。CMI-EMR组的整体切除率为94.1%，ESD组为100%（p=0.061）。韩国和美国内镜医师在CMI-EMR的整块切除和并发症发生率方面没有差异。对于中等大小的结直肠病变的治疗，CMI-EMR显示出整体切除率较低的趋势，但需要的手术时间比ESD短。当由韩国ESD专家和美国ESD新手进行CMI-EMR时，结果相似。
Endoscopic mucosal resection with circumferential mucosal incision (CMI-EMR) may offer benefits comparable to those of endoscopic submucosal dissection (ESD), while requiring less technical proficiency than ESD. We retrospectively compared the outcomes of CMI-EMR (n=34) and size-matched ESD (n=102), which were performed by a Korean endoscopist for colorectal epithelial lesions of 20–35 mm. Procedural parameters of CMI-EMRs performed by an American ESD novice (n=30) were compared with those performed by the Korean endoscopist. The lesion size was 22.3±3.9 mm and 22.9±2.4 mm in the CMI-EMR and size-matched ESD groups, respectively (p=0.730). The resection time was 12.7±7.0 minutes in the CMI-EMR group and 45.6±30.1 minutes in the ESD group (p<0.001). The en bloc resection rate was 94.1% in the CMI-EMR group and 100% in the ESD group (p=0.061). There were no differences in the en bloc resection and complication rates of CMI-EMRs between a Korean and an American endoscopist. For the treatment of moderate-size colorectal lesions, CMI-EMR showed a trend toward lower en bloc resection rate, but required shorter procedure time than ESD. CMI-EMR outcomes were similar when performed by a Korean ESD expert and an American ESD novice.