内镜黏膜下挖除术与内镜下黏膜切除术治疗消化道神经内分泌肿瘤的效果及安全性

Efficacy and Safety of Endoscopic Submucosal Excavation and Endoscopic Mucosal Resection in the Treatment of Gastrointestinal Neuroendocrine Tumors

目的本研究旨在比较内镜黏膜下挖除术(ESE)和内镜下黏膜切除术(EMR)治疗消化道神经内分泌肿瘤(NET)的效果和安全性。方法选取2021年1月至2023年1月在南阳市中心医院接受治疗的95例NET患者,并将其随机分为ESE组(48例)和EMR组(47例)。对比分析两组患者的手术效果以及复发情况。结果ESE组一次性完整病灶切除成功率高于EMR组,ESE组手术时间、术后住院时间比EMR组短,差异均有统计学意义(P<0.05)。ESE组术中出血率、术中穿孔率、术后出血率较EMR组高,差异均有统计学意义(P<0.05)。术后并发症发生率、复发率均低于EMR组,差异均有统计学意义(P<0.05)。结论ESE较EMR治疗NET的效果更为显著,一次性完整病灶切除率高、术后并发症少且可降低复发风险,但术中术后出血率及术中穿孔率较高,临床应给予重视。

Objective This study aimed to compare the efficacy and safety of endoscopic submucosal excavation(ESE)and endoscopic mucosal resection(EMR)in the treatment of gastrointestinal neuroendocrine tumor(NET).Methods A total of 95 patients with NET who received treatment in Nanyang Central Hospital from January 2021 to January 2023 were selected and randomly divided into the ESE group(48 cases)and the EMR group(47 cases).The surgical outcomes and recurrence rates of the two groups of patients were compared and analyzed.Results The success rate of complete lesion removal in one operation was higher in the ESE group than that in the EMR group,the operation time and the postoperative hospital stay was shorter in the ESE group than those in the EMR group,and the differences were statistically significant(P<0.05).The intraoperative bleeding rate,intraoperative perforation rate,and postoperative bleeding rate were higher in the ESE group than those in the EMR group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications and recurrence rate were lower in the ESE group than those in the EMR group,and the differences were statistically significant(P<0.05).Conclusion ESE has better efficacy than EMR in the treatment of NET,with a higher success rate of complete lesion removal in one operation,fewer postoperative complications and reduced risk of recurrence.However,the intraoperative and postoperative bleeding rates and intraoperative perforation rate are higher,which should be given clinical attention.