METHODS: We retrospectively analyzed patients received ESD combined with CSM-PLT or conventional ESD from June 2018 to December 2021 in Shenzhen People\'s hospital. The primary outcome was resection speed.
RESULTS: Forty-two patients were enrolled in ESD combined with CSM-PLT group and sixty-five patients in conventional ESD group respectively. Baseline characteristics were comparable among two groups (P>0.05). There were no significant differences in terms of R0 resection rate, en bloc resection rate (97.6% vs. 98.5%, P = 1.000 and 97.6% vs. 96.9%, P = 1.000, respectively), operation costs (933.7 (644.1-1102.4) dollars vs. 814.7 (614.6-988.3) dollars, P = 0.107), and hospital stays (8.0 ± 3.1 days vs. 7.3 ± 3.2 days, P = 0.236). In addition, no significant difference was observed with respect to complications (P>0.05). However, the resection speed of ESD combined with CSM-PLT was faster than that of conventional ESD (11.3 (9.4-14.9) mm2/min vs. 8.0 (5.8-10.9) mm2/min, P < 0.001), particularly lesions located in anterior wall and lesser curvature. In addition, the association between ESD combined with CSM-PLT and resection speed was still supported after propensity matching scores (PMS).
CONCLUSIONS: CSM-PLT can help to improve ESD efficiency without reducing the en bloc resection rate or increasing the incidence of complications.
方法:回顾性分析深圳市人民医院2018年6月至2021年12月接受ESD联合CSM-PLT或常规ESD的患者。主要结果是切除速度。
结果:ESD联合CSM-PLT组42例,常规ESD组65例。两组基线特征具有可比性(P>0.05)。R0切除率无显著差异,整体切除率(97.6%vs.98.5%,P=1.000和97.6%vs.96.9%,分别为P=1.000),运营成本(933.7(644.1-1102.4)美元与814.7(614.6-988.3)美元,P=0.107),和住院时间(8.0±3.1天vs.7.3±3.2天,P=0.236)。此外,在并发症方面没有观察到显着差异(P>0.05)。然而,ESD联合CSM-PLT的切除速度比常规ESD快(11.3(9.4-14.9)mm2/minvs.8.0(5.8-10.9)mm2/min,P<0.001),特别是位于前壁和较小曲率的病变。此外,在倾向匹配评分(PMS)后,ESD联合CSM-PLT与切除速度之间的相关性仍得到支持.
结论:CSM-PLT有助于提高ESD效率,而不降低整块切除率或增加并发症的发生率。