内镜下黏膜剥离术与常规外科肿瘤切除术对早期胃癌患者术中肿瘤切除率、术后复发率的影响

Effects of EMD and Conventional Surgical Tumor Resection on the Intraoperative Tumor Resection Rate and Postoperative Recurrence Rate in Patients with Early Gastric Cancer

目的 研究内镜下黏膜剥离术与常规外科肿瘤切除术对早期胃癌患者术中肿瘤切除率、术后复发率的影响。方法 回顾性分析122例早期胃癌患者的临床资料。根据不同的治疗方法进行分组,其中64例采用内镜下黏膜剥离术分为观察组,58例患者采用常规外科肿瘤切除术分为对照组。观察两组术后临床疗效,术中肿瘤切除情况,术前、术后24 h血清炎症因子水平,术后并发症及随访1年复发率,术前、术后生活质量评分。结果 观察组术后临床疗效比较总有效率为92.19%,高于对照组72.41%(P<0.05)。观察组术中出血量、手术时间低于对照组(P<0.05),病灶切除率高于对照组(P<0.05)。术后24 h,两组IL-6、IL-8、IL-12水平明显低于术前,且观察组低于对照组(P<0.05)。观察组患者并发症总发生率低于对照组(P<0.05),观察组1年复发率低于对照组(P<0.05)。术后两组生活质量评分明显高于术前,且观察组优于对照组(P<0.05)。结论 内镜下黏膜剥离术有效提高了肿瘤的切除率,降低了术后复发率。

Objective To study the effects of endoscopic mucosal dissection(EMD)and conventional surgical tumor resection on the intraoperative tumor resection rate and postoperative recurrence rate in patients with early gastric cancer.Methods A retrospective analysis was done on the clinical data of 122 patients with early gastric cancer.According to different treatment methods,64 patients were included in the observation group with endoscopic mucosal dissection,and 58 patients were included in the control group with conventional surgical tumor resection.The postoperative clinical efficacy,intraoperative tumor resection,24 h serum inflammatory factor levels before and after surgery,postoperative complications,recurrence rate of 1 year follow-up,and preoperative and postoperative quality of life scores were observed in the 2 groups.Results The total effective rate of postoperative clinical efficacy was higher in the observation group compared with the control group(92.19 vs.%72.41%,P<0.05).The intraoperative blood loss and operation time were lower than in the observation group versus the control group(P<0.05),and the lesion resection rate was higher than that of the control group(P<0.05).After 24 h operation,the levels of IL-6,IL-8,and IL-12 were significantly lower than those before the operation in the 2 groups,so were in the observation group versus the control group(P<0.05).The total incidence of complications was lower in the observation group than in the control group(P<0.05),and the 1-year recurrence rate was lower in the observation group compared with the control group(P<0.05).The postoperative quality of life scores of the 2 groups were significantly higher than the preoperative ones,so were in the observation group versus the control group(P<0.05).Conclusion Endoscopic mucosal dissection can effectively increase the tumor resection rate and reduce the postoperative recurrence rate.