Objective: To explore the value of high-frequency electrocoagulation (APC) and endoscopic mucosal resection (EMR) in the treatment of colorectal polyps, and to provide guidance for the surgical treatment of such patie...Objective: To explore the value of high-frequency electrocoagulation (APC) and endoscopic mucosal resection (EMR) in the treatment of colorectal polyps, and to provide guidance for the surgical treatment of such patients. Methods: Cases were included in the period from December 2020 to December 2021. Patients with rectal polyps who underwent surgery in hospitals during this period were selected as the main subjects, and they were divided into groups by even and odd method. Among them, 75 patients underwent EMR as the experimental group, and the remaining 75 patients underwent APC as the control group. After the operation, the treatment effect, inflammatory factor level, related indicators, operation situation, complications and recurrence were compared among the groups. Results: (1) The therapeutic effect of the experimental group was significantly higher than that of the control group, and the difference was valuable (P 0.05);(2) After treatment, the levels of inflammatory factors in the experimental group were significantly lower than those in the control group, and the difference was significant (P 0.05). (3) The levels of E and Cor in the experimental group were significantly lower than those in the control group, and the average levels of AQP4 and AQP3 were significantly higher than those in the control group, and the difference was significant (P 0.05). (4) The recovery time of gastrointestinal function and anorectal function in the experimental group was significantly earlier than that in the control group, and the hospitalization time and operation time were significantly shorter than those in the control group, with significant difference (P 0.05). (5) The complications and recurrence rate of the experimental group were lower than those of the control group, and the difference was significant (P 0.05). Conclusion: EMR has a significant effect in the treatment of colorectal polyps, which can significantly reduce the level of inflammatory factors and stress indicators. It has the advantages of short operation time, quick postoperative recovery, few complications and low recurrence rate. The curative effect is significantly better than APC, and it can be applied and popularized in such diseases.展开更多
BACKGROUND Ultrasound-guided prostate biopsy is a reliable diagnostic procedure for prostate cancer diagnosis with minimal procedure-related trauma.However,complications,such as massive rectal bleeding may occur after...BACKGROUND Ultrasound-guided prostate biopsy is a reliable diagnostic procedure for prostate cancer diagnosis with minimal procedure-related trauma.However,complications,such as massive rectal bleeding may occur after the puncture.We hypothesized that using a transrectal resectoscope could help treat massive rectal bleeding after transrectal prostate punctures.AIM To identify a simple and effective treatment for massive rectal bleeding after transrectal prostate punctures.METHODS Patients requiring treatment for massive rectal bleeding after transrectal prostate punctures were included.A SIMAI resectoscope was inserted through the anus.Direct electrocoagulation was performed for superficial bleeding points.Part of the rectal mucosa or surface muscle layer was removed to expose deep bleeding points,followed by electrocoagulation.An electric cutting ring was used to compress and stop the bleeding for jet-like points before electrocoagulation.The fluid color in the drainage tube was monitored postoperatively for continuous bleeding.RESULTS Eight patients were included from 2012 to 2022.None of the patients with massive rectal bleeding after the transrectal prostate punctures improved with conventional conservative and blood transfusion treatments.Two patients had an inferior artery embolism,and digital subtraction angiography was ineffective.All patients received emergency transanal prostate resection,which immediately stopped the bleeding.Four days after the procedure,the patients had recovered and were discharged.CONCLUSION Using a transanal prostate resection instrument is a simple,safe,and effective method for treating massive rectal bleeding after transrectal prostate punctures.展开更多
BACKGROUND Colorectal polypectomy is fundamental to the prevention of colorectal cancer,utilizing several endoscopic techniques.Robust comparative data regarding the efficacy and safety of these modalities in clinical...BACKGROUND Colorectal polypectomy is fundamental to the prevention of colorectal cancer,utilizing several endoscopic techniques.Robust comparative data regarding the efficacy and safety of these modalities in clinical practice are limited.AIM To evaluate and compare the efficacy and safety of three endoscopic polypectomy techniques,namely,high-frequency electroresection(HFE),cold snare polypectomy(CSP),and endoscopic mucosal resection(EMR),for the treatment of colonic polyps.METHODS This single-center retrospective cohort study included adults who underwent endoscopic resection of pathologically confirmed colorectal polyps at Central Hospital Affiliated to Shandong First Medical University between January 2015 and December 2023.Patients were grouped by technique:HFE(n=107),CSP(n=106),and EMR(n=108).Standardized preoperative,intraoperative,and postoperative protocols were applied.Outcome measures included resection status(en bloc,R0,R1,and Rx),adverse events(immediate/delayed bleeding,perforation,and post-polypectomy coagulation syndrome),postoperative pain(visual analog scale at 1,3,and 5 hours),and 12-month recurrence rate.RESULTS Baseline demographics and polyp characteristics,except for polyp diameter,were comparable among groups.CSP achieved the highest en bloc resection rate,whereas HFE had a higher R0 resection rate.Polyp diameter was largest in the EMR group.Procedure duration was shortest with HFE.Adverse reactions were more frequent with HFE,particularly post-polypectomy bleeding and delayed perforation,whereas CSP demonstrated a superior safety profile and the lowest incidence of complications.Postoperative pain diminished in all groups over time but was consistently low for CSP and EMR.Recurrence rates were significantly higher in the EMR group vs CSP group,with HFE showing intermediate recurrence.CONCLUSION CSP offers the best safety profile and lowest recurrence rate among patients undergoing endoscopic resection of colorectal polyps,whereas HFE confers a high R0 resection rate but increased risk of adverse events.EMR remains essential for large polyps despite elevated recurrence.Technique selection should be tailored according to polyp characteristics and patient risk factors to optimize outcomes.展开更多
文摘Objective: To explore the value of high-frequency electrocoagulation (APC) and endoscopic mucosal resection (EMR) in the treatment of colorectal polyps, and to provide guidance for the surgical treatment of such patients. Methods: Cases were included in the period from December 2020 to December 2021. Patients with rectal polyps who underwent surgery in hospitals during this period were selected as the main subjects, and they were divided into groups by even and odd method. Among them, 75 patients underwent EMR as the experimental group, and the remaining 75 patients underwent APC as the control group. After the operation, the treatment effect, inflammatory factor level, related indicators, operation situation, complications and recurrence were compared among the groups. Results: (1) The therapeutic effect of the experimental group was significantly higher than that of the control group, and the difference was valuable (P 0.05);(2) After treatment, the levels of inflammatory factors in the experimental group were significantly lower than those in the control group, and the difference was significant (P 0.05). (3) The levels of E and Cor in the experimental group were significantly lower than those in the control group, and the average levels of AQP4 and AQP3 were significantly higher than those in the control group, and the difference was significant (P 0.05). (4) The recovery time of gastrointestinal function and anorectal function in the experimental group was significantly earlier than that in the control group, and the hospitalization time and operation time were significantly shorter than those in the control group, with significant difference (P 0.05). (5) The complications and recurrence rate of the experimental group were lower than those of the control group, and the difference was significant (P 0.05). Conclusion: EMR has a significant effect in the treatment of colorectal polyps, which can significantly reduce the level of inflammatory factors and stress indicators. It has the advantages of short operation time, quick postoperative recovery, few complications and low recurrence rate. The curative effect is significantly better than APC, and it can be applied and popularized in such diseases.
基金Supported by President Fund Innovation Team Project of Hexi University,No.CXTD2022012Gansu Province Education Technology Innovation Project,No.2023B-163.
文摘BACKGROUND Ultrasound-guided prostate biopsy is a reliable diagnostic procedure for prostate cancer diagnosis with minimal procedure-related trauma.However,complications,such as massive rectal bleeding may occur after the puncture.We hypothesized that using a transrectal resectoscope could help treat massive rectal bleeding after transrectal prostate punctures.AIM To identify a simple and effective treatment for massive rectal bleeding after transrectal prostate punctures.METHODS Patients requiring treatment for massive rectal bleeding after transrectal prostate punctures were included.A SIMAI resectoscope was inserted through the anus.Direct electrocoagulation was performed for superficial bleeding points.Part of the rectal mucosa or surface muscle layer was removed to expose deep bleeding points,followed by electrocoagulation.An electric cutting ring was used to compress and stop the bleeding for jet-like points before electrocoagulation.The fluid color in the drainage tube was monitored postoperatively for continuous bleeding.RESULTS Eight patients were included from 2012 to 2022.None of the patients with massive rectal bleeding after the transrectal prostate punctures improved with conventional conservative and blood transfusion treatments.Two patients had an inferior artery embolism,and digital subtraction angiography was ineffective.All patients received emergency transanal prostate resection,which immediately stopped the bleeding.Four days after the procedure,the patients had recovered and were discharged.CONCLUSION Using a transanal prostate resection instrument is a simple,safe,and effective method for treating massive rectal bleeding after transrectal prostate punctures.
文摘BACKGROUND Colorectal polypectomy is fundamental to the prevention of colorectal cancer,utilizing several endoscopic techniques.Robust comparative data regarding the efficacy and safety of these modalities in clinical practice are limited.AIM To evaluate and compare the efficacy and safety of three endoscopic polypectomy techniques,namely,high-frequency electroresection(HFE),cold snare polypectomy(CSP),and endoscopic mucosal resection(EMR),for the treatment of colonic polyps.METHODS This single-center retrospective cohort study included adults who underwent endoscopic resection of pathologically confirmed colorectal polyps at Central Hospital Affiliated to Shandong First Medical University between January 2015 and December 2023.Patients were grouped by technique:HFE(n=107),CSP(n=106),and EMR(n=108).Standardized preoperative,intraoperative,and postoperative protocols were applied.Outcome measures included resection status(en bloc,R0,R1,and Rx),adverse events(immediate/delayed bleeding,perforation,and post-polypectomy coagulation syndrome),postoperative pain(visual analog scale at 1,3,and 5 hours),and 12-month recurrence rate.RESULTS Baseline demographics and polyp characteristics,except for polyp diameter,were comparable among groups.CSP achieved the highest en bloc resection rate,whereas HFE had a higher R0 resection rate.Polyp diameter was largest in the EMR group.Procedure duration was shortest with HFE.Adverse reactions were more frequent with HFE,particularly post-polypectomy bleeding and delayed perforation,whereas CSP demonstrated a superior safety profile and the lowest incidence of complications.Postoperative pain diminished in all groups over time but was consistently low for CSP and EMR.Recurrence rates were significantly higher in the EMR group vs CSP group,with HFE showing intermediate recurrence.CONCLUSION CSP offers the best safety profile and lowest recurrence rate among patients undergoing endoscopic resection of colorectal polyps,whereas HFE confers a high R0 resection rate but increased risk of adverse events.EMR remains essential for large polyps despite elevated recurrence.Technique selection should be tailored according to polyp characteristics and patient risk factors to optimize outcomes.
