不同剥离辅助牵引技术辅助ESD治疗食道早癌的临床效果研究

Study on the clinical effect of different stripping and traction assisted ESD in the treatment of early esophageal cancer

目的研究不同剥离辅助牵引技术辅助内镜黏膜下剥离术(ESD)治疗食道早癌的临床效果。方法选取2017年1月至2018年12月诊治的食管早癌和癌前病变患者共60例,根据术中不同辅助牵引法分为两组,各30例。A组患者行ESD时使用牙线辅助牵引,B组使用橡皮圈辅助牵引。采用统计学软件SPSS 24.0进行数据分析,手术相关指标等计量资料采用(±s)表示,独立样本t检验;术后并发症等计数资料采用χ^2检验。P<0.05为差异有统计学意义。结果两组手术时间、牵引装置时间、完整剥离时间、一次性完整切除率、平均住院时间差异无统计学意义(P>0.05).A组止血夹脱落次数为8次(26.7%),明显高于脱落次数为2次(6.7%)的B组(P<0.05)。A组患者并发症发生率为13.3%,B组为10.0%,差异无统计学意义(P>0.05)。术后随访共12个月,两组患者均未见肿瘤复发和死亡病例。结论两种牵引技术均能有效辅助ESD操作,为其提供一个良好的术野,各有特点,临床可根据临床实际需要选择。

Objective To study the clinical effect of different stripping and traction assisted ESD in the treatment of early esophageal cancer.Methods From January 2017 to December 2018,60 patients with esophageal early cancer and precancerous lesions were selected and divided into two groups,30 in each group.The patients in group A were treated with floss assisted traction while those in group B were treated with rubber band assisted traction.The measurement data of operation time,traction device time and complete stripping time of the two groups were expressed as,and independent sample t test was used.[n(%)]was used to count the postoperative complications,andχ^2 test was used.P<0.05 was considered statistically significant.Results There was no significant difference between group A and group B in terms of operation time,traction device time,complete stripping time and average hospitalization time(P>0.05).Group A had 8 times of bleeding clip shedding(26.7%),which was significantly higher than group B with 2 times(6.7%),and the difference was statistically significant(P<0.05).The incidence of complications was 13.3%in group A and 10.0%in group B,with no significant difference between the two groups(P>0.05).The postoperative hospital stay was(10.2±3.4)d in group A and(9.7±3.1)d in group B,with no significant difference between the two groups(P>0.05).The patients were followed up for 12 months.There was no recurrence or death in the two groups.Conclusion Both kinds of traction technology can effectively assist ESD operation and provide a good surgical field for it.Each has its own characteristics,which can be selected according to clinical needs.