内镜黏膜切除术与内镜黏膜下剥离术治疗早期胃癌的效果比较

Comparative analysis on effects of endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of early gastric cancer

目的对比分析内镜下黏膜切除术(EMR)与内镜黏膜下剥离术(ESD)治疗早期胃癌患者的临床效果。方法随机选取2015年1月至2017年12月于侯马市人民医院治疗的68例早期胃癌患者为研究对象,采用随机数字表法将患者分为两组。EMR组34例患者采用EMR治疗,ESD组34例患者采用ESD治疗。比较两组手术切除效果、手术时间、并发症发生情况及复发情况。结果ESD组患者的治愈性切除率、完全切除率、大块切除率均高于EMR组(P均<0.05),手术时间长于EMR组(P<0.05),局部复发率低于EMR组(P<0.05)。两组患者出血、穿孔发生率比较差异未见统计学意义(P>0.05)。结果ESD治疗早期胃癌的效果更佳,局部复发率更低,不会增加穿孔、出血风险,但手术时间较长,应熟练手术操作,尽量缩短手术时间。

Objective To compare the clinical effects of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) on patients with early gastric cancer. Methods Sixty-eight patients with early gastric cancer who were treated in Houma People’s Hospital from January 2015 to December 2017 were randomly collected as research objects, and they were divided into two groups by random number table method. Thirty-four patients in EMR group were treated by EMR and 34 patients in ESD group were treated by ESD. The resection result, operation time, complications and recurrence of gastric cancer were compared between the two groups. Results The curative resection rate, complete resection rate, and large resection rate were significantly higher in ESD group than those in EMR group (P<0.05). The ESD group had significantly longer operative time than the EMR group (P<0.05). The local recurrence rate of ESD group was significantly lower than that of EMR group (P<0.05). There was no significant difference in the incidence of bleeding or perforation between the two groups (P>0.05). Conclusions ESD is more effective and has lower local recurrence rate in the treatment of early gastric cancer, by which the risk of perforation and bleeding will not be increased. However, the operation time is longer, so surgeons should master the operation to shorten the operation time.