RESUMO
Background: There are no data comparing a regular diet with a restricted diet after endoscopic polypectomy in patients with colorectal polyps. The current guidelines also did not provide the detailed information of dietary patterns after polypectomy. In this study, we aimed to evaluate the safety and efficacy of different diets on post-polypectomy outcomes. Methods: A total of 302 patients with colorectal polyps who underwent polypectomy were prospectively enrolled between March 2019 and December 2019 in Nanfang Hospital (Guangzhou, China). Enrolled patients were then randomly assigned to a regular diet group or a restricted diet group after polypectomy. The study is a non-inferior design and the primary end point was the post-operative adverse events (AE) rate. Secondary end points included length of stay (LOS) and hospitalization cost. Results: Among all the included patients, 148 patients received a restricted diet and 154 patients received a regular diet after polypectomy. A total of 376 polyps were removed, with 183 polyps in the restricted diet group and 193 polyps in the regular diet group. Shorter LOS (4.0 ± 1.4 vs 4.8 ± 1.7, P < 0.001) and lower hospitalization costs (7,701.63 ± 2,579.07 vs 8,656.05 ± 3,138.53, P = 0.001) were observed in the regular diet group. In particular, there was no significant difference in 3-day AE rates between the restricted diet and the regular diet group (1.35% [2/148] vs 2.60% [4/154], P = 0.685). Subgroup analysis looking at the number of polyps removed in each patient and different treatment modalities also showed similar findings. Conclusion: Regular diet should be recommended after polypectomy for polyps <20 mm as it can shorten LOS and save hospitalization costs.
RESUMO
BACKGROUND AND AIM: There is a lack of literature comparing linear endoscopic ultrasound (EUS) and radial EUS for the prediction of the depth of invasion in early gastric cancer (EGC). The aim of this study is to evaluate the accuracy of linear EUS for the diagnosis of submucosal (SM) invasion and compare linear EUS with radial EUS in suspected EGC patients. METHODS: Seventy-two consecutive patients with suspected EGC who underwent a preoperative assessment using linear EUS or radial EUS were prospectively enrolled. The depth of invasion was categorized into mucosal to SM (< T1b) and SM or deeper (≥ T1b), and the EUS-determined diagnosis was compared with postoperative histopathological findings. RESULTS: Thirty-nine patients underwent radial EUS, and 33 patients underwent linear EUS examination. The baseline characteristics between the groups were well balanced. The diagnostic accuracy was much higher for patients who underwent linear EUS compared with radial EUS (90.9% vs 69.2%, P = 0.024). The sensitivity was 92.3% (95% confidence interval [CI] 66.7-98.6%) for linear EUS and 90.9% (95% CI 62.3-98.4%) for radial EUS. The specificity was 90.0% (95% CI 69.9-97.2%) in the linear EUS group, while the specificity was 60.7% (95% CI 42.4-76.4%) in the radial EUS group. Univariate analysis showed that EUS type (odds ratio 0.225, 95% CI 0.057-0.884, P = 0.033) was an associated risk factor of incorrect T1b staging in EGC patients. The area under the receiver operating curve was 0.912 and 0.758 for linear and radial EUS, respectively. CONCLUSION: Linear EUS was more accurate for determining SM invasion and therapeutic strategy in suspected EGC patients compared with radial EUS.