内镜下黏膜剥离术与黏膜切除术治疗早期胃癌的临床对照研究

The clinical controlled study of endoscopic submucosal dissection and mucosal resection in treatment of early gastric cancer the clinical research of treatment EGC by ESD

目的探讨内镜下黏膜剥离术(ESD)与内镜下黏膜切除术(EMR)治疗早期胃癌的临床效果是否存在差异。方法分析2016年4月~2018年4月我院收治的60例早期胃癌患者临床资料,依据手术方式不同进行分组,内镜下黏膜切除术(EMR)组30例和内镜下黏膜剥离术(ESD)组30例。观察两组患者创面直径、手术时间、胃肠道恢复时间、住院时间、病变整块切除率、完整切除率、出血、穿孔、复发率、残留率情况。结果ESD组患者创面直径、手术时间高于EMR组,胃肠道恢复时间、住院时间均低于EMR组,ESD组患者病变整块切除率、完整切除率均高于EMR组,差异有统计学意义(P<0.05)。两组患者出血、穿孔发生率比较,差异无统计学意义(P>0.05),ESD组患者复发率、残留率低于EMR组,差异有统计学意义(P<0.05)。结论ESD治疗早期胃癌患者,病灶切除彻底,预后良好,值得临床推广应用。

Objective To explore whether there are differences in the clinical curative effects of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)in the treatment of early gastric cancer.Methods Clinical data of 60 patients who were admitted and treated in The Third Affiliated Hospital of Sun Yat-Sen university Yuedong hospital from April 2016 to April 2018 were analyzed.According to different surgical methods,they were divided into the endoscopic mucosal resection(EMR)group and the endoscopic submucosal dissection(ESD)group,with 30 cases in each group.The wound diameter,operation time,recovery time of gastrointestinal tract,hospital stay,the resection rate of whole lesions,complete removal rate,bleeding,perforation,recurrence rate and residual rate of patients in two groups were observed.Results The wound diameter and operation time of patients in ESD group were higher than those of EMR group,and recovery time of gastrointestinal tract and hospital stay were shorter than those of EMR group.The resection rate of whole lesions and complete removal rate patients in ESD group were higher than those of EMR group.The differences were statistically significant(P<0.05).There was no significant difference in the incidence of bleeding and perforation between the two groups(P>0.05).The recurrence rate and residual rate of the SD group were lower than those of the EMR group,and the difference was statistically significant(P<0.05).Conclusion In the treatment of patients with early gastric cancer by ESD,lesions are completely resected and the prognosis is good.It is worthy of clinical promotion and application.