内镜黏膜下剥离术与传统手术治疗早期胃癌的对比研究

Comparison of endoscopic submucosal dissection and conventional surgery in treatment of early gastric cancer

目的比较内镜黏膜下剥离术(ESD)与传统手术治疗早期胃癌的疗效。方法选取早期胃癌患者773例,根据治疗方法不同分为两组,采用ESD治疗的423例为观察组,采用传统手术治疗的350例为对照组。比较两组患者术后并发症发生情况、随访情况和围术期指标。结果观察组胃部出血比例、术后狭窄比例、住院费用均低于对照组,手术时间和住院时间均少于对照组,差异均有统计学意义(均P<0.05);但两组患者2年生存率比较差异无统计学意义(P>0.05)。结论 ESD治疗早期胃癌效果显著,相比传统手术缩短了手术时间及住院时间,降低了并发症的发生率,值得推广应用。

Objective To compare the efficacy and safety of endoscopic submucosal dissection （ESD） with conventionalsurgery in treatment of early gastric cancer. Methods Total 773 patients with early gastric cancer treated in our hospital from Jan2010 to Jan 2015 were randomly assigned to treat with ESD （study group, n=423） or with conventional surgery （control group,n=350）. The pathological results, operation time, length of hospital stay and postoperative survival rate were analyzed andcompared between two groups. Results The rates of postoperative bleeding and perforation, the medical costs in study groupwere significantly lower than those in control group; the operation time, length of hospital stay in study group were shorter thanthose in control group （all P〈0.05）. There was no significant difference in 2-year survival rate between study group and controlgroup（P〉0.05）. Conclusion ESD is an effective surgical modality in treatment of early gastric cancer with shorter operation time,lower complication rate and shorter hospital stay.