内镜黏膜下剥离术治疗早期胃癌的可行性研究

Feasibility Study of Endoscopic Submucosal Dissection for Early Gastric Cancer

目的探讨内镜黏膜下剥离术(ESD)治疗早期胃癌的可行性。方法选取142例早期胃癌患者作为研究对象,观察ESD与EMR(内镜黏膜切除术)治疗早期胃癌的临床疗效。结果 ESD组一次性完全切除率、治愈性切除率均显著高于EMR组(P<0.05);ESD组可能治愈性切除率、非治愈性切除率显著低于EMR组(P<0.05);ESD组肿瘤复发率显著低于EMR组(P<0.05);ESD组术中出血率和穿孔率分别为3.53%和2.35%,均显著低于EMR组的19.30%和8.77%(P<0.05);ESD组3年生存率显著高于EMR组(P<0.05)。结论 ESD治疗早期胃癌具有病灶切除彻底、复发率低、并发症少等优点,具有较好的应用前景。

Objective To study feasibility of endoscopic submucosal dissection( ESD) for early gastric cancer. Methods142 early gastric cancer patients were selected as the subjects,and the clinical efficacy of ESD and endoscopic mucosal resection( EMR) for early gastric cancer were observed. Results The one-time complete resection rate and the curative resection rate of the ESD group were visibly higher than those of the EMR group( P < 0. 05); the potentially curative resection rate and the noncurative resection rate of the ESD group were visibly lower than those of the EMR group( P < 0. 05); the tumor recurrence rate of the ESD group were visibly lower than that of the EMR group( P < 0. 05); the bleeding rate during the surgery and the perforation rate of the ESD group were 3. 53% and 2. 35%,respectively,which were visibly lower than 19. 30% and 8. 77% of the EMR group( P < 0. 05); 3-year survival rate of the ESD group was visibly higher than that of the EMR group( P < 0. 05). Conclusion The ESD approach to early gastric cancer can remove the lesion completely,reduce the recurrence rate and complications. It has a bright prospect.