目的 探讨冷圈套息肉切除术(cold snare polypectomy,CSP)治疗结直肠10～15 mm息肉的疗效及安全性.方法 研究设计为前瞻性观察性研究.研究对象为2018年1月至2020年1月从中国人民解放军总医院第七医学中心接受结肠镜检查发现的10～15 mm结直肠息肉并采用CSP切除的患者.主要观察指标是CSP的完全切除率,次要指标为CSP相关不良事件发生率.结果 研究共纳入119枚10～15 mm结直肠息肉,直径为(11.1±1.6)mm.CSP的完全性切除率为95.0％.术中即时出血发生率为8.4％(10/119),均通过内镜下钛夹夹闭成功止血,未发现其他CSP相关不良事件的发生.结论 CSP切除结直肠较大息肉的安全性好.但对于10 mm直径以上息肉进行冷切除,最好对病变进行充分的病理学评估.

Clinical data of 210 patients with early colorectal cancer and precancerous lesion treated by endoscopic submucosal dissection (ESD) in the Digestive Endoscopy Center of the Seventh Medical Center of Chinese PLA General Hospital from January 2015 to March 2018 were collected and analyzed retrospectively. Patients were divided into two groups according to the age: the elderly group (≥65 years old, 100 cases) and the non-elderly group (<65 years old, 110 cases). The en bloc resection rate, complete resection rate,and curative resection rate of the elderly group were 92.0% (92/100), 91.0% (91/100) and 89.0% (89/100), respectively. The above indicators of the non-elderly group were 90.9% (100/110) ( P=0.972), 90.0% (99/110) ( P=0.991) and 88.2% (97/110) ( P=1.000), respectively. The incidence of intraoperative perforation in the elderly group was 4.0% (4/100) and in the non-elderly group was 6.4% (7/110) ( P=0.543). Delayed postoperative bleeding rate was 2.0% (2/100) in the elderly group, and 0 (0/110) in the non-elderly group ( P=0.226). ESD is effective and safe in treating early colorectal cancer and precancerous lesion in elderly patients.