{"title":"内镜下粘膜下夹层对结直肠病变的水下夹子闭合与常规夹子闭合:首次比较研究。","authors":"Hirotaka Oura, Daisuke Murakami, Harutoshi Sugiyama, Takayoshi Nishino, Makoto Arai","doi":"10.1159/000548463","DOIUrl":null,"url":null,"abstract":"<p><p>Introduction This single-center retrospective study compared underwater clip closure (UCC) with conventional clip closure (CCC) under routine gas insufflation for post-endoscopic submucosal dissection (ESD) ulcers of colorectal lesions measuring ≤5 cm. Methods Between May 2021 and June 2023, 89 patients were enrolled. Since March 2022, all cases underwent UCC. Patients were divided into the UCC group (n = 52) and the CCC group (n = 37). Primary outcomes were complete closure rate and incidence of post-ESD coagulation syndrome (PECS), delayed bleeding, and perforation. Secondary outcomes included closure time and number of clips used. Results Complete closure was achieved in all cases, with no PECS, delayed bleeding, or perforation in either group. Median closure time was significantly shorter in the UCC group (10 min [IQR, 7-14]) than in the CCC group (11 min [IQR, 8.5-19]; p = 0.044). The number of clips used was similar (median 10 in both groups; p = 0.290). Multiple regression analysis identified both resection area (p < 0.001) and closure method (p = 0.002) as independent factors affecting closure time. Conclusion UCC may decrease the time required for post-ESD closure of colorectal lesions measuring ≤5 cm, while using a comparable number of clips to CCC, with no serious complications.</p>","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-16"},"PeriodicalIF":3.6000,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Underwater Clip Closure versus Conventional Clip Closure following Endoscopic Submucosal Dissection in Colorectal Lesions: A First Comparative Study.\",\"authors\":\"Hirotaka Oura, Daisuke Murakami, Harutoshi Sugiyama, Takayoshi Nishino, Makoto Arai\",\"doi\":\"10.1159/000548463\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Introduction This single-center retrospective study compared underwater clip closure (UCC) with conventional clip closure (CCC) under routine gas insufflation for post-endoscopic submucosal dissection (ESD) ulcers of colorectal lesions measuring ≤5 cm. Methods Between May 2021 and June 2023, 89 patients were enrolled. Since March 2022, all cases underwent UCC. Patients were divided into the UCC group (n = 52) and the CCC group (n = 37). Primary outcomes were complete closure rate and incidence of post-ESD coagulation syndrome (PECS), delayed bleeding, and perforation. Secondary outcomes included closure time and number of clips used. Results Complete closure was achieved in all cases, with no PECS, delayed bleeding, or perforation in either group. Median closure time was significantly shorter in the UCC group (10 min [IQR, 7-14]) than in the CCC group (11 min [IQR, 8.5-19]; p = 0.044). The number of clips used was similar (median 10 in both groups; p = 0.290). Multiple regression analysis identified both resection area (p < 0.001) and closure method (p = 0.002) as independent factors affecting closure time. Conclusion UCC may decrease the time required for post-ESD closure of colorectal lesions measuring ≤5 cm, while using a comparable number of clips to CCC, with no serious complications.</p>\",\"PeriodicalId\":11315,\"journal\":{\"name\":\"Digestion\",\"volume\":\" \",\"pages\":\"1-16\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-09-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Digestion\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1159/000548463\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestion","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000548463","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
本研究是一项单中心回顾性研究,比较了内镜下粘膜下夹层(ESD)溃疡≤5 cm的结直肠病变,在常规充气条件下水下夹封术(UCC)与常规夹封术(CCC)的疗效。方法2021年5月至2023年6月,89例患者入组。自2022年3月起,所有病例均行UCC。患者分为UCC组(n = 52)和CCC组(n = 37)。主要结局是完全闭合率和esd后凝血综合征(PECS)发生率、延迟出血和穿孔。次要结果包括闭合时间和使用夹的数量。结果所有病例均获得完全闭合,两组均无PECS、延迟出血或穿孔。UCC组的中位闭合时间(10 min [IQR, 7-14])明显短于CCC组(11 min [IQR, 8.5-19]; p = 0.044)。使用的夹子数量相似(两组中位数为10个;p = 0.290)。多元回归分析发现,切除面积(p < 0.001)和闭合方法(p = 0.002)是影响闭合时间的独立因素。结论UCC可缩短esd对≤5cm结直肠病变的闭合时间,且使用的夹数与CCC相当,无严重并发症。
Underwater Clip Closure versus Conventional Clip Closure following Endoscopic Submucosal Dissection in Colorectal Lesions: A First Comparative Study.
Introduction This single-center retrospective study compared underwater clip closure (UCC) with conventional clip closure (CCC) under routine gas insufflation for post-endoscopic submucosal dissection (ESD) ulcers of colorectal lesions measuring ≤5 cm. Methods Between May 2021 and June 2023, 89 patients were enrolled. Since March 2022, all cases underwent UCC. Patients were divided into the UCC group (n = 52) and the CCC group (n = 37). Primary outcomes were complete closure rate and incidence of post-ESD coagulation syndrome (PECS), delayed bleeding, and perforation. Secondary outcomes included closure time and number of clips used. Results Complete closure was achieved in all cases, with no PECS, delayed bleeding, or perforation in either group. Median closure time was significantly shorter in the UCC group (10 min [IQR, 7-14]) than in the CCC group (11 min [IQR, 8.5-19]; p = 0.044). The number of clips used was similar (median 10 in both groups; p = 0.290). Multiple regression analysis identified both resection area (p < 0.001) and closure method (p = 0.002) as independent factors affecting closure time. Conclusion UCC may decrease the time required for post-ESD closure of colorectal lesions measuring ≤5 cm, while using a comparable number of clips to CCC, with no serious complications.
期刊介绍:
''Digestion'' concentrates on clinical research reports: in addition to editorials and reviews, the journal features sections on Stomach/Esophagus, Bowel, Neuro-Gastroenterology, Liver/Bile, Pancreas, Metabolism/Nutrition and Gastrointestinal Oncology. Papers cover physiology in humans, metabolic studies and clinical work on the etiology, diagnosis, and therapy of human diseases. It is thus especially cut out for gastroenterologists employed in hospitals and outpatient units. Moreover, the journal''s coverage of studies on the metabolism and effects of therapeutic drugs carries considerable value for clinicians and investigators beyond the immediate field of gastroenterology.