内镜下黏膜剥离与黏膜切除治疗早期消化道神经内分泌肿瘤的有效性及安全性

Effectiveness and safety of endoscopic mucosal dissection and mucosal resection in the treatment of early gastrointestinal neuroendocrine tumors

目的研究早期消化道神经内分泌肿瘤应用内镜下黏膜剥离与黏膜切除治疗的有效性和安全性。方法2019年9月至2021年9月收治的72例早期消化道神经内分泌肿瘤患者,采取随机数字表法将其分为研究组与对照组,每组36例,研究组应用内镜下黏膜剥离术治疗,对照组应用内镜下黏膜切除术治疗,比较2组患者手术指标、整块切除率、完全切除率、术后并发症发生率、术后1年内疾病复发率、生活质量改善情况、治疗满意度。结果研究组患者手术时间、住院时间短于对照组,切除病灶直径长于对照组,住院费用少于对照组,整块切除率和完全切除率高于对照组,术后并发症发生率、术后1年内疾病复发率低于对照组,出院时生活质量评分、治疗满意度高于对照组,差异均有统计学意义(P<0.05)。结论对早期消化道神经内分泌肿瘤患者应用内镜下黏膜剥离术治疗可取得很好的疗效,治疗安全性也较高,还有助于提升其生活质量,其应用价值高于内镜下黏膜切除术,患者认可度也更高。

Objective To investigate the effectiveness and safety of endoscopic mucosal dissection and mucosal resection in the treatment of early gastrointestinal neuroendocrine tumors.Methods A total of 72 patients with early gastrointestinal neuroendocrine tumors admitted from September 2019 to September 2021 were enrolled in this study and were randomly allocated to the study group(n=36)and the control group(n=36).The study group and the control group were treated with endoscopic mucosal dissection and endoscopic mucosal resection,respectively.The surgical indicators,overall resection rate,complete resection rate,postoperative complications,disease recurrence rate within 1 year after surgery,quality of life,and treatment satisfaction were compared between two groups.Results The operation time and hospital stay in the study group were significantly shorter than those in the control group(P<0.05).The diameter of the resected lesion in the study group was longer than that in the control group,and the hospitalization cost was lower than that in the control group(P<0.05).Meanwhile,the overall resection rate(88.89%vs 66.67%)and complete resection rate(77.78%vs 52.78%)in the study group were higher than in the control group(P<0.05).However,the incidence of postoperative complications(16.67%vs 38.89%)and disease recurrence rate within 1 year after surgery(0%vs 11.11%)in the study group were lower than the control group(P<0.05).The quality of life score and treatment satisfaction(94.44%vs 75.00%)of the study group were higher than those of the control group(P<0.05).Conclusion For patients with early gastrointestinal neuroendocrine tumors,the application of endoscopic mucosal dissection can achieve good therapeutic results,high treatment safety,and help to improve their quality of life.Overall,its application value is higher than endoscopic mucosal resection,with higher patient recognition.