内镜黏膜下剥离术治疗早期胃癌或胃癌前病变临床效果及并发出血影响因素分析

目的 探讨内镜黏膜下剥离术治疗早期胃癌或胃癌前病变临床效果,并对其并发出血影响因素进行分析.方法 回顾性分析行内镜黏膜下剥离术治疗确诊30例早期胃癌及66例胃癌前病变的临床资料,收集所有患者一般资料,观察治疗后临床效果,记录并发症、复发及生存情况,并采用单因素及多因素Lo-gistic回归分析对内镜黏膜下剥离术治疗早期...

Clinical Efficacy of Endoscopic Submucosal Dissection in the Treatment of Early Gastric Cancer or Precancerous Lesions and Influencing Factors of Concurrent Intraoperative Bleeding

Objective To explore the clinical efficacy of endoscopic submucosal dissection(ESD)in the treatment of early gastric cancer or precancerous lesions,and to analyze the influencing factors of concurrent intraoperative bleeding.Methods The clinical data of 30 patients diagnosed with early gastric cancer and 66 patients with precancerous lesions who underwent ESD in our hospital were retrospectively analyzed.General data of all patients were collected,and the clinical effect was observed after treatment.Complications,recurrence and survival were recorded.Univariate and multivariate Logistic regression analyses were used to analyze the influencing factors of concurrent bleeding in patients with early gastric cancer or precancerous lesions treated by ESD.Results There were 96 cases(100%)with en bloc resection,93 cases(96.88%)with complete resection,and 90 cases(93.75%)with curative resection.There were 22 cases(22.92%)with concurrent bleeding and 3 cases(3.12%)with perforation.The 1-year recurrence rate was 2.08%,and the 1-year survival rate was 96.88%.Univariate analysis showed that patients with early gastric cancer or precancerous lesions aged≥65 years,with lesion located on the upper 2/3 of the stomach and lesion diameter≥1.5 cm in patients with early gastric cancer or precancerous lesions had higher bleeding rate than those aged<65 years,with lesion located on the lower 1/3 of the stomach,and lesion diameter<1.5 cm(P<0.05).Multivariate Logistic analysis found that the lesion located on the upper 2/3 of the stomach,and the lesion diameter≥1.5 cm were independent risk factors affecting concurrent bleeding of patients with early gastric cancer or precancerous lesions undergoing ESD(P<0.05).Conclusion The patients with early gastric cancer or precancerous lesions undergoing ESD have a high rate of en bloc resection.The lesion located on the upper 2/3 of the stomach and the diameter of the lesion≥1.5 cm are independent risk factors that affect concurrent intraoperative bleeding of patients with early gastric cancer or precancerous lesions treated with ESD.