Abstract:Objective: To investigate the therapeutic effects of endoscopic submucosal dissection (ESD) in patients with early gastrointestinal cancer and precancerous lesions. Methods: 77 patients with early gastrointestinal cancer and precancerous lesions who underwent endoscopic mucosal resection (EMR) or ESD in the Department of Gastroenterology of the hospital from August 2015 to August 2017 were selected as subjects. The size and type of lesions in the two groups were recorded. The complete resection rate, en bloc resection rate, operation time, length of hospital stay, intraoperative and postoperative complications, and follow-up recurrence were recorded. Results: There were 32 patients (35 lesions) in ESD group and 45 patients (50 lesions) in EMR group. The lesion diameter in ESD group was significantly larger than that in EMR group (P<0.05). The complete resection rate of ESD group and EMR group was 97.14% and 68.89%, respectively, and the whole resection rate was 100.00% and 75.56%, respectively, with significant difference between the two groups (P<0.05). There was no significant difference in the complete resection rate and the whole resection rate of lesions ≤ 20 mm between the two groups (P>0.05). The complete resection rate and the total resection rate of lesions ≥ 20 mm in ESD group were significantly higher than those in EMR group (P<0.05). The operation time in ESD group was higher than that in EMR group (P<0.05). There was no significant difference in bleeding, perforation and postoperative recurrence between the two groups (P>0.05). Conclusion: The curative effect and safety of ESD are good in the treatment of early gastrointestinal cancer and precancerous lesions. Compared with EMR, the resection effect of ESD is better. However, the duration of ESD is longer and there's a high risk for the surgeon. Clinically, the patient's clinical data, condition of lesions and indications can be combined for choosing surgical method reasonably.
靳迎春, 赵金, 周津. 上消化道早期癌癌前病变患者应用内镜下黏膜剥离术治疗的效果观察[J]. 河北医学, 2020, 26(8): 1338-1342.
JIN Yingchun, ZHAO Jin, ZHOU Jin. Observation on Therapeutic Effects of Endoscopic Submucosal Dissection in Patients with Early Gastrointestinal Cancer and Precancerous Lesions. HeBei Med, 2020, 26(8): 1338-1342.
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