内镜胃黏膜下剥离术对早期胃癌患者复发及并发症的影响

Effect on recurrence and complications of patients with early gastric cancer underwent endoscopic gastric submucosal dissection and surgical operation

目的:探究内镜胃黏膜下剥离术对于早期胃癌患者的治疗效果和并发症及复发率的影响。方法:选取74例早期胃癌患者作为研究对象,按照手术方式不同分为观察组(n=32)和对照组(n=42)。观察组采用内镜胃黏膜下剥离术治疗,对照组采用外科胃癌根治术治疗。对比两组的术后恢复、并发症的发生率和患者的生存情况。结果:观察组的术中出血量和手术时间低于对照组(P<0.001);治疗后,观察组的住院时间、肛门排气时间、疼痛程度均低于对照组(P<0.001),且术后并发出血、感染、流出道梗阻的情况也明显低于对照组(P<0.05);3年生存率及术后复发率情况比较,差异无统计学意义(P>0.05)。结论:内镜胃黏膜下剥离术可降低早期胃癌患者术中出血量和手术时间,减少并发症的发生,缓解术后疼痛,促进患者康复,远期疗效与外科胃癌根治术相当。

Objective:To explore the effect on recurrence and complications of patients with early gastric cancer underwent endoscopic gastric submucosal dissection and surgical operation.Methods:74 patients with early gastric cancer were selected.According to the surgery,they were divided into the observation group and control group.In the observation group,32 cases were treated by endoscopic gastric submucosal dissection,while in the control group,42 cases were treated by surgical radical gastrectomy.The post-operative recovery,the incidence of complications and the survival of patients were compared between the two groups.Results:The bleeding volume and operation time in the observation group were lower than those in the control group(P<0.001).The hospitalization time,anal exhaust time and pain degree in the observation group were lower than those in the control group(P<0.001),and the occurrence rates of bleeding,infection,or outflow tract obstruction after operation were also lower than those in the control group(P<0.05).There were no significant differences in 3-year survival and recurrence rates(P>0.05).Conclusion:The long-term curative effect of endoscopic gastric submucosal dissection for early gastric cancer is comparable to that of surgical gastric cancer radical surgery,but the amount of intraoperative bleeding is less,the operation time is short and the incidence of postoperative complications is low,which can also relieve postoperative pain and promote the recovery of patients.