腹腔镜辅助胃癌根治术与内镜黏膜下剥离术治疗早期胃癌的回顾性对比分析

Retrospective comparative analysis of laparoscopic-assisted radical gastrectomy and endoscopic submucosal dissection for early gastric cancer

目的比较腹腔镜辅助胃癌根治术与内镜黏膜下剥离术(ESD)治疗早期胃癌(EGC)的效果。方法回顾性纳入2019年8月至2021年10月河南科技大学第一附属医院收治的104例EGC患者,根据治疗方法分为对照组与观察组,每组52例。对照组行腹腔镜辅助胃癌根治术,观察组行ESD。比较两组手术指标、血清肿瘤因子、负面情绪评分及并发症发生率。结果观察组手术时间、术后肠鸣音恢复时间、住院时间短于对照组,手术出血量少于对照组,差异有统计学意义(P均<0.05)。两组术前糖类抗原125、糖类抗原724、表皮生长因子水平比较差异未见统计学意义(P>0.05);术后1周,观察组糖类抗原125、糖类抗原724、表皮生长因子水平低于对照组,差异有统计学意义(P<0.05)。两组术前焦虑、抑郁评分比较差异未见统计学意义(P>0.05);术后1周,观察组焦虑、抑郁评分低于对照组(P<0.05)。观察组并发症率(11.54%,6/52)低于对照组(28.85%,15/52),P<0.05。结论EGC应用腹腔镜辅助胃癌根治术与ESD均有一定效果,但ESD手术时间短,术后恢复快,并发症少,安全性更高,且能改善血清肿瘤因子与负面情绪。

Objective To compare the effects of laparoscopic-assisted radical gastrectomy and endoscopic submucosal dissection(ESD)in the treatment of early gastric cancer(EGC).Methods A total of 104 EGC patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from August 2019 to October 2021 were retrospectively included,and they were divided into control group and observation group according to treatment methods,with 52 cases in each group.The control group underwent laparoscopic-assisted radical gastrectomy,and the observation group underwent ESD.The operation indicators,serum tumor factors,negative emotion scores and incidence of complications were compared between the two groups.Results The operation time,postoperative bowel sound recovery time,and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss volume was less than that in the control group(all P<0.05).There was no significant difference in the level of carbohydrate antigen 125,carbohydrate antigen 724,and epidermal growth factor between the two groups before treatment(P>0.05);and the levels of carbohydrate antigen 125,carbohydrate antigen 724,and epidermal growth factor in the observation group were lower than those of the control group 1 week after treatment(P<0.05).There was no significant difference in anxiety score and depression scores between the two groups before operation(P>0.05);and the anxiety score and depression score in the observation group were lower than those in the control group 1 week after treatment(P<0.05).The incidence of complications in the observation group(11.54%,6/52)was lower than that in the control group(28.85%,15/52),P<0.05.Conclusions Laparoscopic-assisted radical gastrectomy and ESD,in the treatment of EGC,have certain effects,but ESD has shorter operation time,faster postoperative recovery,fewer complications,higher safety,and can improve serum tumor factors and negative emotions.