内镜黏膜下剥离术治疗早期胃癌及癌前病变的临床效果

Clinical effect of endoscopic submucosal dissection in the treatment of early gastric cancer and precancerous lesions

目的探讨内镜黏膜下剥离术(ESD)治疗早期胃癌及癌前病变的临床效果。方法选取2015年1月~2018年10月我院收治的60例早期胃癌及癌前病变患者作为研究对象进行回顾性分析,根据治疗方法的不同将其分为对照组与实验组,每组各30例。对照组患者采用常规外科手术治疗,实验组患者采用ESD治疗。比较两组患者的组织学完整治愈率、并发症发生率、治疗费用、复发率及狭窄发生率等指标。结果两组患者的组织学完整治愈率比较,差异无统计学意义(P>0.05)。实验组患者的并发症总发生率为3.33%,低于对照组的33.33%,差异有统计学意义(P<0.05)。实验组患者的治疗费用为(1.1±0.2)万元,低于对照组的(4.2±0.5)万元,差异有统计学意义(P<0.05)。两组患者的复发率与狭窄发生率比较,差异无统计学意义(P>0.05)。结论相较于常规外科手术治疗,ESD用于治疗早期胃癌及癌前病变患者的效果显著,且能够降低患者的治疗费用及术后并发症发生率,同时具备较低的术后复发率及狭窄发生率,值得临床应用及推广。

Objective To investigate the clinical effect of endoscopic submucosal dissection(ESD) in the treatment of early gastric cancer and precancerous lesions. Methods Sixty patients with early gastric cancer and precancerous lesions admitted to our hospital from January 2015 to October 2018 were selected as the research objects for retrospective analysis. They were divided into control group and experimental group according to different treatment methods,with 30 cases in each group. Patients in the control group were treated with conventional surgery, while patients in the experimental group were treated with ESD. The histological complete cure rate, complication rate, treatment cost, recurrence rate and stenosis rate of the two groups were compared. Results There was no significant difference in histological complete cure rate between the two groups(P>0.05). The total incidence of complications in the experimental group was 3.33%, lower than 33.33% in the control group, and the difference was statistically significant(P<0.05). The treatment cost of the patients in the experimental group was(1.1 ±0.2) million yuan, lower than that of the control group([4.2±0.5] million yuan), the difference was statistically significant(P<0.05). There were no significant difference between recurrence rate and stenosis rate between the two groups(P>0.05). Conclusion Compared with conventional surgical treatment, ESD has a significant therapeutic effect in treating patients with early gastric cancer and precancerous lesions, and can reduce the treatment cost and incidence rate of postoperative complications of patients, and has a lower postoperative recurrence rate and stenosis incidence rate, which is worthy of clinical application and promotion.