内镜黏膜下剥离术与腹腔镜远端胃癌根治术在早期胃癌治疗中的疗效差异研究

Study on the Difference of Curative Effect Between Endoscopic Submucosal Dissection and Surgery in the Treatment of Early Gastric Cancer

目的:比较内镜黏膜下剥离术(ESD)与腹腔镜远端胃癌根治术在早期胃癌治疗中的临床疗效。方法:选取2016年1月~2019年12月本院住院治疗的40例早期胃癌患者,依随机数字表法分组,每组各20例,根治术组采纳腹腔镜远端胃癌根治术治疗,ESD组采纳ESD术治疗,比较两组治疗效果。结果:ESD组手术时间、首次肛门排气时间、住院时间均短于根治术组,ESD组术中出血量低于根治术组,ESD组完全切除率高于根治术组,ESD组术后3d血清TNF-α、IL-6、CRP因子均低于根治术组,ESD组并发症发生率、1年复发率均低于根治术组,P<0.05(差异均有统计学意义)。结论:ESD术可有效提高早期胃癌病灶完全切除率,优于腹腔镜远端胃癌根治术,患者术后恢复速度快、炎症反应较轻,并发症发生率、复发率均较低,效果显著。

Objective:To compare the clinical efficacy of ESD and laparoscopic distal gastric cancer radical resection in the treatment of early gastric cancer.Methods:Selected 40 patients with early gastric cancer who were hospitalized in our hospital from January 2016 to December 2019,and grouped 20 patients in each group according to the random number table method.The radical mastectomy group was treated with laparoscopic distal gastric cancer radical resection,and the ESD group ESD treatment was adopted,and the treatment effects of the two groups were compared.Results:The operation time,first anus exhaust time,and hospital stay in the ESD group were shorter than those in the radical operation group.The intraoperative blood loss in the ESD group was lower than that in the radical operation group.The complete resection rate in the ESD group was higher than that in the radical operation group.Serum TNF-α,IL-6 and CRP factors were lower than those in the radical operation group.The complication rate and one-year recurrence rate in the ESD group were lower than those in the radical operation group,P<0.05(the differences are statistically significant).Conclusion:ESD surgery can effectively improve the complete resection rate of early gastric cancer lesions,which is better than laparoscopic distal gastric cancer radical resection.The patient has a faster postoperative recovery,less inflammation,lower complication rate and recurrence rate,and the effect is significant.