探讨结肠镜下使用止血夹辅助Hook刀或圈套器治疗结直肠巨大带蒂息肉的疗效及安全性。

选取2014年1月至2016年12月在上海市嘉定区安亭医院普外科治疗的40例结直肠巨大带蒂息肉患者。随机分为2组，每组患者20例，试验组采用止血夹辅助Hook刀治疗，对照组采用圈套器结合止血夹治疗，比较2组的手术时间、术中出血、标本完整度、取标本时间及术后随访。

2组患者的一般资料相似，差异无统计学意义（P>0.05）。2组患者均完成了预定手术，术中、术后无穿孔，术后随访12~36个月无复发。试验组在手术时间、标本完整度及取标本时间方面优于对照组，差异具有统计学意义（P<0.05）；而术中出血方面，对照组优于试验组，差异无统计学意义（P>0.05）。

结肠镜下使用止血夹辅助Hook刀或圈套器切除结直肠带蒂巨大息肉均安全、有效，Hook刀组具有手术时间短、取标本时间短、标本完整度好等优点，值得临床推广应用。

To evaluate the efficacy and safety of endoscopic hemoclip assisted hook knife or snare in the resection of large colorectal pedunculated polyps.

Forty patients with large colorectal pedunculated polyps were randomly divided into either an experimental group or a control group between January 2014 and December 2016, with 20 cases in each group. The experimental group underwent endoscopic hemoclip assisted hook knife treatment, and the control group was treated using snare combined with hemoclip. Operative time, intraoperative blood loss, the integrity of the specimen, and postoperative follow-up were compared between the two groups.

There were no significant differences in the demographics of patients between the two groups. The scheduled operations were all completed, no intraoperative or postoperative perforation occurred, and no recurrence happened during 12-36 months of follow-up. The experimental group was significantly superior to the control group in operative time, the integrity of the specimen, and the time of taking the specimen (P<0.05). Although intraoperative blood loss was less in the control group than in the experimental group, the difference was not statistically significant (P>0.05).

Both endoscopic hemoclip assisted hook knife and snare combined with hemoclip are safe and effective in removal of large colorectal pedunculated polyps. The hook knife group has the advantages of shorter operative time, shorter time of taking specimen, and better integrity of the specimen.