结直肠癌内镜治疗的2种手术方法比较

Comparison of two endoscopic surgeries in the treatment of colorectal cancer

目的比较内镜下黏膜切除术(EMR)和内镜下黏膜剥离术(ESD)治疗结直肠癌的效果。方法选取结直肠癌患者164例为研究对象,按照随机数字表法分为对照组和研究组。对照组接受EMR治疗,研究组接受ESD治疗。比较2组手术时间、术中出血量及不同直径病灶切除情况。检测2组治疗前后血清癌抗原125(CA125)、CA199、癌胚抗原(CEA)等肿瘤标志物指标水平,并比较术后并发症发生率。结果研究组手术时间长于对照组,且术中出血量大于对照组(P<0.05);对照组和研究组直径<2 cm的病灶完全切除率分别为80.00%、86.11%,但差异无统计学意义(P>0.05);研究组直径≥2 cm的病灶完全切除率为91.30%,高于对照组的61.70%,差异有统计学意义(P<0.05);2组治疗前CA125、CA199、CEA等肿瘤标志物指标水平比较无显著差异(P>0.05);治疗后,研究组CA125、CA199、CEA指标水平低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为18.29%,高于对照组的7.32%,差异有统计学意义(P<0.05)。结论EMR、ESD治疗结直肠癌各具优势,临床可结合患者实际情况合理选用相应术式。

Objective To investigate the effect of endoscopic endoscopic submucosal dissection(EMR)and endoscopic submucosal dissection(ESD)in the treatment of colorectal cancer.Methods A total of 164 patients with colorectal cancer were selected and divided into control group and research group according to the random number table method.The control group received EMR,while the research group received ESD.The operation time,intraoperative blood loss and excision of lesions with different diameters of the two groups were compared.The levels of tumor markers such as cancer antigen 125(CA125),CA199 and carcinoembryonic antigen(CEA)in the two groups before and after treatment were detected and analyzed,and the incidence of postoperative complications was compared.Results The operative time of the study group was longer,and the intraoperative blood loss was more than that of the control group(P<0.05).The rates of complete resection of lesions with diameter<2 cm in the control group and the research group were 80.00% and 86.11%,respectively,but there were no significant differences(P>0.05).The rate of complete resection of lesions with diameter≥2 cm in the research group was 91.30%,which was significantly higher than 61.70% of the control group(P<0.05).There were no significant differences in the levels of CA125,CA199 and CEA between the two groups before treatment(P>0.05).After treatment,the levels of CA125,CA199 and CEA in the research group were lower than those in the control group(P<0.05).The incidence of complications in the study group was 18.29%,which was significantly higher than 7.32% in the control group(P<0.05).Conclusion EMR and ESD both have advantages in the treatment of colorectal cancer,and the corresponding surgical methods can be selected reasonably according to the actual situations of patients.