Abstract：Objective: To explore the effect and prognosis of endoscopic submucosal dissection (ESD) in the treatment of early gastric carcinoma (GC) with different infiltration depths. Methods: A total of 141 patients with early GC admitted to the hospital were enrolled between January 2018 and December 2020. According to different infiltration depths, they were divided into group mucosa (M, 112 cases) and group submucosa (SM, 29 cases). All patients underwent ESD. The intraoperative blood loss, operation time, gastrointestinal ventilation time, hospitalization time, complete resection rate, curative resection rate, incidence of postoperative complications and tumor recurrence during 12-month follow-up were compared between the two groups. The general data such as age, gender and tumor infiltration depth were compared between non-recurrence and recurrence patients. The influencing factors of recurrence in early GC patients after ESD were analyzed by binary Logistic regression analysis. Results: The blood loss during ESD, diameter of resection lesions and operation time in group M were significantly lower than those in group SM, and curative resection rate was significantly higher than that in group SM (P<0.05). There was no significant difference in incidence of complications during ESD between groups M and SM (P>0.05). Of the 141 patients, there were 22 cases with recurrence after ESD. At 3-12 months after ESD, recurrence rate in group M was significantly lower than that in group SM (P<0.05). The postoperative recurrence was related to age, diabetes mellitus, tumor infiltration depth, tumor diameter, tumor differentiation, operation time and diameter of resection lesions (P<0.05). Logistic regression analysis showed that diabetes mellitus, SM infiltration and low differentiation or non-differentiation were independent risk factors of recurrence in patients with early GC after ESD (P<0.05). Conclusion: Curative effect of ESD is more significant on patients with early GC of M infiltration, with lower recurrence rate. Diabetes mellitus, SM infiltration and low differentiation or non-differentiation are independent risk factors of postoperative recurrence.
璩辉, 丁云, 夏超. 内镜黏膜下剥离术治疗不同浸润深度早期胃癌的疗效及预后的影响[J]. 河北医学, 2022, 28(6): 918-923.
QU Hui, DING Yun, XIA Chao. Effect and Prognosis of Endoscopic Submucosal Dissection in the Treatment of Early Gastric Carcinoma with Different Infiltration Depths. HeBei Med, 2022, 28(6): 918-923.
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2022, Vol. 28 
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