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This study will retrospectively include LST patients who were admitted to 6 medical centers (The Second Affiliated Hospital, College of Medicine, Zhejiang University; The Affiliated Jinhua Hospital, Zhejiang University School of Medicine; First Affiliated Hospital of Huzhou University; The Second Hospital of Jiaxing; Jinhua People's Hospital; Lanxi People's Hospital) from 2020.05.01 to 2023.04.30 with the purpose of comparing the efficacy and safety of hybrid ESD and ESD in the treatment of colorectal LST. The complete resection rate, operation time, operation cost, intraoperative and postoperative complications of hybrid ESD and ESD LST will be compared. To provide strong evidence for the selection of endoscopic treatment strategies for LST.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| conventional ESD | Submucosal injection of methylene blue solution at various sites was performed, followed by periphery incision using a dual knife. The submucosal injection was administered multiple times, followed by the utilization of an IT knife for submucosal separation and gradual excision of the lesion. In cases of significant bleeding at the wound site, electrocoagulation hemostatic forceps were employed for hemostasis. |
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| hybrid ESD | The submucosal injection and circumferential incision of the Hybrid ESD were performed as described above. Subsequently, snaring was conducted post submucosal dissection utilizing a polypectomy snare for complete lesion removal. Careful attention was paid during excision to avoid muscle layer penetration and to control cutting speed in order to mitigate the potential for hemorrhage and perforation. The subsequent steps of the procedure closely followed the conventional ESD methodology outlined previously. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conventional ESD | Procedure | Conventional ESD is the most suitable method for total resection, especially for large lesions. This method can complete the resection of early gastrointestinal cancer and precancerous lesions, while maintaining the integrity of digestive tract anatomy and physiological function.The operation difficulty of this technique is high, the equipment requirements are high, the operation time is long, and the complication rate is closely related to the technical level of the operator. |
| Measure | Description | Time Frame |
|---|---|---|
| complete resection rate | One-time complete excision | 2 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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This study involved a multicenter retrospective analysis of 890 consecutive patients with a colorectal LST > 10 millimeters who underwent endoscopic treatment at 6 medical centers (The Second Affiliated Hospital, College of Medicine, Zhejiang University; The Affiliated Jinhua Hospital, Zhejiang University School of Medicine; First Affiliated Hospital of Huzhou University; The Second Hospital of Jiaxing; Jinhua People's Hospital; Lanxi People's Hospital) between May 2020 and April 2023.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| 2nd Affiliated Hospital, School of Medicine, Zhejiang University, China | Hangzhou | Zhejiang | 310009 | China |
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| Hybrid ESD | Procedure | Hybrid ESD is a better choice, but only can remove the lesion in one piece, but also has a lower technical difficulty than conventional ESD |
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