内镜黏膜下剥离术与腹腔镜手术治疗早期胃癌的临床疗效比较研究

The clinical efficacy comparison of the endoscopic submucosal dissection surgery comparing with the laparoscopic surgery in the treatment of early gastric cancer

[目的]研究比较内镜黏膜下剥离术(ESD)与腹腔镜手术治疗早期胃癌的临床疗效。[方法]将行ESD治疗的早期胃癌患者28例作为治疗组,同期行腹腔镜手术治疗的早期胃癌患者28例作为对照组,比较2组患者的临床疗效。[结果]治疗组患者手术时间、术中出血量、住院时间、住院费用、并发症发生率分别为(55.2±19.5)min、(68.6±l1.2)ml、(6.5±2.1)d、(1.2±0.2)万元、7.14%,对照组患者分别为(75.3±17.9)min、(100.3±12.5)ml、(10.8±1.0)d、(5.1±0.3)万元、25.00%,2组比较差异均有统计学意义(P<0.05)。治疗组患者术后随访过程中有2例复发,均发生在术后3个月左右;对照组有1例复发,发生在术后5个月;2组复发率比较差异无统计学意义(P>0.05)。[结论]ESD与腹腔镜手术治疗早期胃癌的临床疗效相比,具有手术时间短、出血量少、创伤小、住院时间短、术后并发症少等诸多优势,安全有效,值得临床推广应用。

[Objective]To compare the clinical curative effect of endoscopic submucosal dissection（ESD） and the laparoscopic surgery on the treatment of early gastric cancer. [Methods]Twenty-eight cases of early gastric cancer treated with ESD in our department from March 2011 to March 2015 were set as treatment group（group 1）. Twenty-eight cases of early gastric cancer treated with laparoscopic surgical treatment were set as control group（group 2）. The clinical efficacy of the two groups were compared. [Results]The operation time, intraoperative blood loss, hospital stay, hospital expenses, complication rates in group 1 were（55.2±19.5） min,（68.6± 11.2） ml,（6.5±2.1） d,（1.2±0.2） w and 7.14% respectively,which were significantly better than those in group 2（[75.3 ±17.9] min,[100.3± 12.5] ml,[10.8± 1.0] d, [5.1±0.3] w and 25.00% ,P〈0.05）. The difference of recurrence rate was not significant between the two groups（P〉0.05）. [Conclusion]ESD shows, shorter operation time, less blood loss, milder trauma, shorter hospitalization time,less postoperative complications, and many other advantages than laparoscopic surgery in the treatment of early gastric cancer. It is worthy of clinical application.