ESD与EMR治疗胃早癌的临床疗效观察

ESD and EMR in the treatment of early gastric cancer and its effect on clinical features

目的本研究探讨ESD与EMR治疗胃早癌的临床疗效,以期为胃早癌的临床治疗和提高检出率提供新的研究方向。方法根据纳入及排除标准选择我院就诊的63例胃早癌患者根据手术方式分为ESD组(n=30)和EMR组(n=33),采用多光子显微成像法测定ESD组和EMR组术后切缘/基底情况;采用疗效指标、手术临床指标、术后肿瘤学和并发症指标考查ESD和EMR的临床疗效。结果ESD组整块切除率、完全切除率和治愈性切除率均高于ENR组(均P<0.05),ESD组病变残留率低于ENR组(P<0.05)。ESD组手术时间高于EMR组(P<0.05),ESD组住院时间低于EMR组(P<0.05)。ESD组切缘阳性率、溃疡阳性率均低于EMR组(均P<0.05)。ESD组术后发热感染率低于EMR组(均P<0.05)。结论从疗效指标、临床手术指标、术后肿瘤学和术后并发症指标入手证实ESD对胃早癌的治疗效果相较EMR更优。

Objective To investigate the efficacy of ESD and EMR in the treatment of early gastric cancer and its clinical features,in order to provide a new research direction for the clinical treatment of gastric early cancer and improve the detection rate.Methods According to the inclusion and exclusion criteria,63 patients with early gastric cancer who were admitted to our hospital were divided into ESD group(n=30)and EMR group(n=33)according to the surgical procedure.Multi-photon microscopy imaging was used to determine the margin/basal condition of ESD group and EMR group.Surgical clinical indicators,postoperative oncology and complication indicators were used to examine the clinical efficacy of ESD and EMR.Results The whole resection rate,complete resection rate and curative resection rate in ESD group were higher than those in ENR group(all P<0.05),and the residual rate of lesions in ESD group was lower than that in ENR group(P<0.05).The operation time of ESD group was higher than that of EMR group(P<0.05),and the hospitalization time of ESD group was lower than that of EMR group(P<0.05).The positive rates of incision margin and ulcer in ESD group were lower than those in EMR group(all P<0.05).The postoperative fever infection rate in ESD group was lower than that in EMR group(all P<0.05).Conclusion From the efficacy index,clinical surgical index,postoperative oncology and postoperative complications,it is confirmed that the therapeutic effect of ESD on early gastric cancer is better than EMR.