黏膜下注射显影联合U-EMR治疗边界模糊无蒂锯齿状腺瘤的临床价值OA

Objective To evaluate the clinical efficacy and safety of submucosal dye injection combined with underwater endoscopic mucosal resection(U-EMR)for sessile serrated adenomas(SSAs)with ill-defined borders.Methods A total of 100 patients with ill-defined SSAs admitted to Longyan People's Hospital from March 2024 to September 2025 were enrolled and were divided into the conventional group(treated with submucosal dye injection plus conventional EMR)and the combined group(treated with submucosal dye injection plus U-EMR)according to the surgical approach,with 50 cases in each group.The operative quality indicators(operation duration,border visualization score,first-attempt snaring success rate,en bloc resection rate,pathological complete resection rate),safety indicators and 6-month postoperative follow-up outcomes were compared between the two groups.Multivariate Logistic regression analysis was conducted to identify independent influencing factors of composite adverse outcomes.Results Compared with the conventional group,the combined group achieved higher border visualization score,higher first-attempt snaring success rate,higher en bloc resection rate and higher pathological complete resection rate,with shorter operation duration and lower 6-month residual/recurrence rate(P<0.05).There were no statistically significant differences in the incidence of immediate bleeding,delayed bleeding,perforation and electrocoagulation syndrome between the two groups(P>0.05).Multivariate Logistic regression analysis showed that conventional EMR procedure,lesion diameter≥10 mm and low border visualization score<3 points were independent risk factors for composite adverse outcomes in patients with SSAs(P<0.05).Conclusions Submucosal dye injection combined with U-EMR can significantly improve border delineation of ill-defined SSAs,elevate resection quality and reduce the risk of short-term residual/recurrence,without significantly increasing the incidence of complications.