A127 ENDOSCOPIC MUCOSAL RESECTION WITH HYBRID-ARGON PLASMA ABLATION TO PREVENT RECURRENCE OF 20 MM NON-PEDUNCULATED COLORECTAL POLYPS: A MULTI-CENTER PROSPECTIVE CLINICAL STUDY
Notice bibliographique
Résumé
Abstract Background Endoscopic mucosal resection (EMR) is the mainstay of therapy for non-pedunculated colorectal polyps 20 mm or larger. Post EMR recurrence rates are about 15% if no margin ablation technique is used. Aims Study aim was to evaluate recurrence rates if hybrid Argon Plasma Coagulation ablation (h-APC) is routinely used after the EMR to ablate the margins, base and vessels. Methods A prospective multi-center study including adult patients (18-89 years) undergoing EMR of non-pedunculated colorectal polyps 20 mm or larger was conducted. h-APC was used to ablate all post EMR margins and to ablate the post EMR resection surface and visible submucosal vessels. The primary outcome was the biopsy proven recurrence rate at the first follow-up colonoscopy (4-6 months after EMR). All the resection sites were visually inspected, and biopsies were obtained from the EMR scar. Secondary outcomes included technical success and complication rates. Results A total of 220 EMRs were performed during the study for h-APC ablation of non-pedunculated colorectal polyps, with a size of ≥20 mm. The average size of the polyps included in the study was 35.7 mm (ranging from 20 mm to 100 mm). Among all resected polyps, 16.8% were sessile serrated lesions (SSL), while 66.3% were adenomas. Additionally, 4 cases of cancer were in the study. The application of hot snare EMR with h-APC ablation was technically successful and completed for all cases. The mean duration of the EMR procedure was 19.6 minutes, ranging from 2.3 to 103 minutes, while the mean duration of h-APC ablation was 6.4 minutes, ranging from 1 to 65 minutes. A total of 147 EMRs with follow up examination (57 EMR involving lesions 40mm or larger) are available currently. The overall recurrence rate was 1.3% (2 out of 147 cases). For cases where complete base ablation was achieved, there was a 0% recurrence rate, including lesions 40mm or larger. For lesions measuring 40mm or larger, the recurrence rate was 1.8% (1 out of 54 cases). Out of the 220 total EMRs conducted, perforations were observed in 0.9% (2 cases, managed conservatively with antibiotics only), and clinically significant bleeding occurred in 2.3% (5 cases). In particular, clinically significant bleeding was noted in 2.3% (4 out of 167 cases) of lesions without clipping and in 4.0% (4 out of 99 cases) for right-sided lesions without clipping. Conclusions In this multicenter study EMR in combination with h-APC demonstrated a high technical success rate with low complication rates and showed very low post EMR recurrence in the preliminary data analysis. Funding Agencies Erbe
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».