内镜黏膜下剥离术治疗早期胃印戒细胞癌的疗效和安全性

Efficacy and Safety of Endoscopic Submucosal Dissection for Early Signet-ring Cell Carcinoma of the Stomach

目的:探讨内镜黏膜下剥离术(ESD)在早期胃印戒细胞癌治疗中的疗效和安全性。方法:回顾性分析2016年7月至2016年12月于福建省立医院南院内镜诊断发现的21例早期胃印戒细胞癌患者的临床资料,其中10例接受ESD治疗(内镜治疗组),11例接受外科手术治疗(外科手术组),观察内镜治疗组患者并发症发生率、整块切除、完全切除等指标,同时比较两组患者在性别、年龄、肿瘤病灶大小、术后住院天数及病理浸润深度等方面的差异,总结ESD治疗早期胃印戒细胞癌的疗效和安全性。结果:内镜治疗组患者在治疗后均达到了完全切除,且无出血、穿孔等并发症发生。两组患者在性别构成、年龄、肿瘤病灶大小、术后病理浸润深度情况比较,差异均无统计学意义(P>0.05)。在术后住院天数上,内镜治疗组患者短于外科手术组,差异具有统计学意义(P<0.05)。结论:对于早期胃印戒细胞癌,ESD具有与外科手术相似的良好效果,ESD术后住院时间甚至更短,但是ESD术前需严格评估病灶的边界以及适应证。

Objective To investigate the efficacy and safety of endoscopic submucosal dissection(ESD)in the treatment of early signet-ring cell carcinoma of the stomach.Methods The clinical data of 21 patients with early signed-ring cell carcinoma of the stomach diagnosed by endoscopy in South Hospital of Fujian Provincial Hospital from July 2016 to December 2016 were retrospectively analyzed.Among them,10 patients received ESD treatment(endoscopic treatment group)and 11 patients received surgical treatment(surgical treatment group).The incidence of complications,en bloc resection and complete resection were observed in the endoscopic treatment group,and the differences in gender,age,tumor lesion size,postoperative hospital stay and depth of pathological invasion were compared between the two groups.The efficacy and safety of ESD in the treatment of early signet ring cell carcinoma of the stomach were summarized.Results All patients in the endoscopic treatment group achieved complete resection after treatment,and no complications such as bleeding or perforation occurred.There was no significant difference in gender composition,age,tumor lesion size,and depth of postoperative pathological invasion between the two groups(P>0.05).In terms of postoperative hospital stay,the endoscopic treatment group was shorter than that of the surgical group,and the difference was statistically significant(P<0.05).Conclusion For early signet ring cell carcinoma of the stomach,ESD has a good effect similar to surgery,and the length of hospital stay after ESD is even shorter.However,the boundary of lesions and indications should be strictly evaluated before ESD.