【摘要】 目的：系统评估内镜下黏膜切除术（endoscopic mucosal resection,EMR）治疗大肠扁平及亚蒂息肉的疗效及安全性，探索技术改良的临床价值。方法：纳入2022年1月-2022年12月收治的300例患者，随机分为透明帽法组（n=150）、水下EMR组（n=100）和传统EMR组（n=50），对比整块切除率、并发症发生率及复发率。结果：总体整块切除率94.0%(282/300)，术中出血率3.3%(10/300)，无穿孔病例；透明帽法手术时间最短（12.3±2.1）min，直肠部位出血风险最高（5.4%）；术后3个月复发率1.7%，与息肉直径呈正相关（P<0.05）。结论：EMR是大肠扁平及亚蒂息肉的安全有效术式，改良术式治疗效果更理想，可有效提升患者生活质量，减少疾病复发率，可在临床推广运用。更多还原

【Abstract】 Objective:To systematically evaluate the efficacy and safety of endoscopic mucosal resection(EMR) in treating colorectal flat and sessile polyps, and to explore the clinical value of technical modifications. Methods:A total of 300 patients admitted from January 2022 to December 2022 were enrolled and randomly assigned to three groups:transparent cap-assisted EMR(n=150), underwater EMR(n=100), and conventional EMR(n=50). Comparative analysis of en bloc resection rates, complication rates, and recurrence rates was performed. Results:The overall en bloc resection rate was 94.0%(282/300), with an intraoperative bleeding rate of 3.3%(10/300) and no perforation cases. The transparent cap-assisted group demonstrated the shortest operative time(12.3±2.1) min. Bleeding risk was highest in rectal lesions(5.4%). The 3-month postoperative recurrence rate was 1.7%, positively correlated with polyp diameter(P<0.05). Conclusion:EMR is a safe and effective approach for colorectal flat and sessile polyps. Modified techniques yield superior therapeutic outcomes, significantly improving patients ’ quality of life, reducing recurrence rates, and warranting broader clinical adoption.更多还原