Q法自牵引技术治疗早期食管癌的效果及对并发症发生率的影响

Effect of Q Self-Traction Method on Early Esophageal Cancer and Its Influence on the Complication Rate

目的:探究Q法自牵引技术治疗早期食管癌的效果及对并发症发生率的影响。方法:回顾性分析2019年6月至2022年6月我院收治的184例早期食管癌患者临床资料,按术式不同分为观察组(Q法自牵引技术)89例和对照组(标准内镜黏膜下剥离术)95例,比较两组围手术期指标、治疗效果、并发症发生情况以及术后6个月复发情况、生活质量综合评定问卷(GQOLI-74)评分。结果:观察组术中出血量、剥离时间、手术时间及住院时间均低于对照组(P<0.05);两组整块切除率和治愈性切除率差异均无统计学意义(P>0.05);两组各项并发症发生率差异无统计学意义(P>0.05),但观察组并发症总发生率低于对照组(P<0.05);术后6个月随访,观察组复发1例(1.12%),对照组复发3例(3.16%),差异无统计学意义(P>0.05);两组术前各项GQOLI-74评分均无统计学意义(P>0.05),术后6个月各项GQOLI-74评分均显著升高(P<0.05),观察组各项评分升高幅度均高于对照组(P<0.05)。结论:Q法自牵引技术能够优化早期食管癌ESD手术操作,其治疗效果与传统ESD术式相当,但并发症发生率较低,患者生活质量显著改善,值得推广应用。

Objective:To explore the effect of Q self-traction method in the treatment of early esophageal cancer and its influence on the incidence rates of complications.Methods:Retrospective analysis was performed on the clinical data of 184 patients with early esophageal cancer admitted to the hospital from June 2019 to June 2022.According to different surgical methods,the patients were divided into observation group(89 cases,Q self-traction method)and control group(95 cases,standard endoscopic submucosal dissection).Perioperative indicators,therapeutic effect,occurrence of complications,and recurrence and scores of Generic Quality of Life Inventory-74(GQOLI-74)at 6 months after surgery were compared between the two groups.Results:The intra-operative blood loss,dissection time,surgical time and hospital stay in observation group were shorter than those in control group(P<0.05).There were no statistically significant differences in the en bloc resection rate and curative resection rate between the two groups(P>0.05).There were no statistical differences in the incidence rates of various complications between the two groups(P>0.05),but the total incidence rate of complications in observation group was lower than that in control group(P<0.05).At 6 months of follow-up after surgery,there was 1 case of recurrence(1.12%)in observation group and 3 cases of recurrence(3.16%)in control group(P>0.05).The scores of items of GQOLI-74 showed no statistical differences between the two groups before surgery(P>0.05),and the GQOLI-74 scores at 6 months after surgery were significantly increased(P<0.05),and the increase of scores in observation group were higher compared with those in control group(P<0.05).Conclusion:Q self-traction method can optimize ESD operation for early esophageal cancer,and its therapeutic effect is comparable to that of traditional ESD,but the incidence rates of complications are low and the quality of life of patients is significantly improved.