当前位置: X-MOL 学术Gastrointest. Endosc. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Impact of preoperative biopsy sampling on severe submucosal fibrosis on endoscopic submucosal dissection for colorectal laterally spreading tumors: a propensity score analysis
Gastrointestinal Endoscopy ( IF 7.7 ) Pub Date : 2018-09-08 , DOI: 10.1016/j.gie.2018.08.051
Shusei Fukunaga , Yasuaki Nagami , Masatsugu Shiba , Taishi Sakai , Hirotsugu Maruyama , Masaki Ominami , Koji Otani , Shuhei Hosomi , Fumio Tanaka , Koichi Taira , Tetsuya Tanigawa , Hirokazu Yamagami , Toshio Watanabe , Yasuhiro Fujiwara

Background and Aims

It is believed that preoperative biopsy sampling for superficial-type colorectal tumors should be avoided because submucosal fibrosis caused by biopsy sampling makes EMR impossible. However, few studies have reported the influence of biopsy sampling on colorectal endoscopic submucosal dissection (ESD). This study aimed to examine the effect of biopsy sampling on submucosal fibrosis and treatment outcomes of ESD for laterally spreading tumors (LSTs).

Methods

Between April 2005 and September 2015, 441 consecutive patients underwent colorectal ESD in Osaka City University Hospital. Using propensity score matching and inverse probability of treatment weighting (IPTW), we retrospectively evaluated risk factors for severe submucosal fibrosis and treatment outcomes for patients with LSTs, with or without preoperative biopsy sampling.

Results

A total of 428 LSTs resected using ESD were enrolled. After matching, there were 136 matched pairs of lesions that did or did not undergo biopsy sampling. Preoperative biopsy sampling increased severe fibrosis compared with that in the non–biopsy sampling group (20.6% vs 11.0%; P = .03) and was significantly associated with severe fibrosis after matching (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.07-4.10; P = .03). After adjustment with IPTW, biopsy sampling also increased the risk of severe fibrosis (OR, 2.33; 95% CI, 1.17-4.63; P = .02). However, no significant differences were observed between the 2 groups in treatment outcomes.

Conclusions

Preoperative biopsy sampling for colorectal LSTs might cause severe submucosal fibrosis but has no adverse influence on clinical outcomes of ESD.



中文翻译:

术前活检取样对严重粘膜下纤维化的影响对内镜黏膜下剥离对结直肠侧向扩散性肿瘤的影响:倾向评分分析

背景和目标

据认为,应避免对浅表型结直肠肿瘤进行术前活检取样,因为由活检取样引起的粘膜下纤维化使EMR无效。然而,很少有研究报道活检采样对结直肠内窥镜黏膜下剥离(ESD)的影响。这项研究旨在检查活检样本对粘膜下纤维化的影响以及ESD对横向扩散肿瘤(LSTs)的治疗效果。

方法

在2005年4月至2015年9月期间,大阪市立大学医院连续441例患者接受了大肠ESD治疗。使用倾向评分匹配和治疗加权比重(IPTW),我们回顾性评估了有或没有术前活检样本的LSTs患者严重粘膜下纤维化的危险因素和治疗结果。

结果

总共登记了使用ESD切除的428个LST。匹配后,有136对匹配的病灶已进行或未进行活检。与非活检样本组相比,术前活检样本增加了严重的纤维化(20.6%比11.0%;P  = .03),并且与匹配后的严重纤维化显着相关(比值比[OR]为2.09;置信区间为95%) [CI],1.07-4.10;P  = .03)。经IPTW调整后,活检样本也增加了严重纤维化的风险(OR为2.33; 95%CI为1.17-4.63;P  = .02)。但是,两组在治疗结局方面均未观察到显着差异。

结论

结直肠LSTs的术前活检取样可能会导致严重的粘膜下纤维化,但对ESD的临床结局没有不利影响。

更新日期:2018-09-08
down
wechat
bug