| Objective To compare the efficacy and safety of EMR,HSP and CSP in the treatment of small colon polyps.Methods Retrospectively,240 patients with polyps found by colonoscopy in the outpatient department and wards of the Department of Gastroenterology,Hefei First People’s Hospital from January 2019 to December 2019 were selected as the study subjects.According to the treatment method adopted under endoscopy,a total of 420 polyps in the 240 patients were divided into HSP group.In CSP group and EMR group,the complete resection rate and postoperative complications of polyp treatment in the three groups were observed and compared.Results A total of 420 polyps were removed,among which 146 were removed in the HSP group,136 in the CSP group and 138 in the EMR group.There were no significant differences in the size,location and distribution of polyps among the three groups,as well as the length of postoperative hospital stay.Comparison of polypectomy time and hospitalization cost among the three groups showed that the treatment time and hospitalization cost in CSP group were significantly shorter than those in HSP group and EMR group,and the difference was statistically significant(P<0.05).In terms of complete excision rate,the complete excision rate of EMR group was 98.7%,and that of CSP group was 93.2%.The complete excision rate of EMR group was higher,and the difference between the three groups was not statistically significant(P>0.05).A total of24 cases of post-resection bleeding occurred in 420 resected polyps,including 23 cases of immediate bleeding and 1 case of delayed postoperative bleeding.There were 10 cases in the HSP group,8 cases in the CSP group,5 cases of immediate bleeding and 1case of delayed bleeding in the EMR group,and 1 case of intraoperative perforation in the EMR group.There was no significant difference in the total incidence of complications among the three groups(P>0.05).A total of 228 patients were followed up 6 months after surgery,of which 12 patients were lost to follow up.Polyp recurrence was found in 2 patients,both in the HSP treatment group.Twelve months after the operation,199 patients were followed up,and a total of 41 patients were lost to follow-up.One patient recurred in the CSP group,while no polyp recurred in the EMR group.The effective rates of the three groups were 95.8%,95.1% and 97.8%,respectively.There were no significant differences among the three groups in total resection rate,block resection rate,treatment effective rate and recurrence rate(P>0.05).Immediate postoperative bleeding in patients with risk factors for single factor analysis,including hypertension,polyp,polyp size,polyp,pathological type and anticoagulation and antiplatelet drugs associated with polyps resection after immediate bleeding(P<0.05),and age,gender,number of polyps,polyp morphology,diabetes history has no obvious correlation(P>0.05).Logistic regression analysis showed that history of hypertension and long-term oral anticoagulant and antiplatelet drugs before surgery were independent risk factors for immediate bleeding after polypectomy(P <0.05).Conclusion For polyps with a diameter less than 5mm,CSP can be used as the preferred treatment method.Shortening operation time and treatment cost is one of the advantages of CSP,which can improve the efficiency of endoscopists and reduce adverse events of patients.For polyps with a diameter of 6-9mm,EMR group has the highest complete polyp removal rate and treatment effective rate,and low recurrence rate,so it can be used as the first choice for treatment.Bleeding after polypectomy with hypertension and polyp,polyp size,polyp,pathological type and relevant anticoagulation and antiplatelet drugs(P < 0.05),and the history of high blood pressure,long-term oral anticoagulation and antiplatelet drugs are the independent risk factors of instant bleeding after polypectomy,need to focus on in this part of patients in clinical treatment. |
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