World journal of gastrointestinal surgery · 2025
Effects of endoscopic mucosal resection and argon plasma coagulation on postoperative recovery and complications in elderly colon polyp patients.
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Li Hong-Tao, Liu Feng, Mei Peng-Fei, Lei Xia, Liu Shen-Ying
Аннотация
BACKGROUND: Colon polyps represent a significant clinical challenge in elderly patients. While endoscopic mucosal resection (EMR) and argon plasma coagulation (APC) are widely used, their comparative effectiveness in elderly populations remains unclear, particularly regarding postoperative recovery and complication profiles.
AIM: To compare the postoperative recovery, complications and efficacy of EMR and APC in elderly patients with colonic polyps.
METHODS: We retrospectively analyzed clinical data from 224 elderly patients with colon polyps treated at our center between January 2021 and July 2024. All patients were divided into the EMR group and APC group according to the surgical method they received. By comparing the operation time, intraoperative bleeding situation, hospital stays, postoperative inflammatory response index, complication rate and recurrence status of the two groups, the effect of the two surgical methods was comprehensively evaluated.
RESULTS: The APC group exhibited superior outcomes in terms of operative time (10.63 minutes vs 13.27 minutes, P < 0.001), intraoperative bleeding situation (39.00% vs 52.42%, P = 0.031), and length of hospital stay (1.63 days vs 3.87 days, P < 0.001) compared to the EMR group. The one-time resection rate of the APC group (94.69%) was higher than that of the EMR group (89.14%) (P = 0.026). The overall effective rates of the two groups were 94.35% and 92.00%, respectively. Postoperative procalcitonin and C-reactive protein levels were lower in the APC group than in the EMR group (P < 0.001). The incidence of complications was comparable between the two groups (P = 0.159). The recurrence rate was lower in the APC group (2.00%) than in the EMR group (8.06%) (P = 0.045).
CONCLUSION: For elderly patients with colon polyps, APC showed certain advantages compared with EMR in promoting postoperative recovery, reducing the inflammatory response and the risk of complications. However, the study is limited by its single-center retrospective design and short follow-up period, and further multicenter prospective studies are needed to validate the findings.
AIM: To compare the postoperative recovery, complications and efficacy of EMR and APC in elderly patients with colonic polyps.
METHODS: We retrospectively analyzed clinical data from 224 elderly patients with colon polyps treated at our center between January 2021 and July 2024. All patients were divided into the EMR group and APC group according to the surgical method they received. By comparing the operation time, intraoperative bleeding situation, hospital stays, postoperative inflammatory response index, complication rate and recurrence status of the two groups, the effect of the two surgical methods was comprehensively evaluated.
RESULTS: The APC group exhibited superior outcomes in terms of operative time (10.63 minutes vs 13.27 minutes, P < 0.001), intraoperative bleeding situation (39.00% vs 52.42%, P = 0.031), and length of hospital stay (1.63 days vs 3.87 days, P < 0.001) compared to the EMR group. The one-time resection rate of the APC group (94.69%) was higher than that of the EMR group (89.14%) (P = 0.026). The overall effective rates of the two groups were 94.35% and 92.00%, respectively. Postoperative procalcitonin and C-reactive protein levels were lower in the APC group than in the EMR group (P < 0.001). The incidence of complications was comparable between the two groups (P = 0.159). The recurrence rate was lower in the APC group (2.00%) than in the EMR group (8.06%) (P = 0.045).
CONCLUSION: For elderly patients with colon polyps, APC showed certain advantages compared with EMR in promoting postoperative recovery, reducing the inflammatory response and the risk of complications. However, the study is limited by its single-center retrospective design and short follow-up period, and further multicenter prospective studies are needed to validate the findings.