消化内镜黏膜下剥离术治疗早期食管癌的疗效分析

目的分析消化内镜黏膜下剥离术(ESD)治疗早期食管癌的疗效及安全性。方法纳入早期食管癌患者99例,将其中以ESD为治疗方案的52例患者纳入ESD组,同期实施内镜下黏膜切除术(EMR)的47例患者纳入EMR组,分析患者手术情况、术后情况、病灶切除效果、并发症及复发情况。结果与EMR组比较,ESD组手术时间和术后禁食时间较长,最大病灶直径较大,组间比较差异均有统计学意义(P<0.05);2组患者术后抗生素使用时间和住院时间比较,差异无统计学意义(P>0.05)。ESD组病灶整块切除率及病灶完全切除率均高于EMR组,差异有统计学意义(P<0.05)。2组患者并发症发生率比较,差异无统计学意义(P>0.05)。ESD组患者术后12个月复发率低于EMR组,差异有统计学意义(P<0.05)。结论ESD治疗直径较大的早期食管癌具有剥离病灶彻底、复发率较低的优势。

Clinical analysis of digestive endoscopic submucosal dissection in treatment of early esophageal cancer

Objective To study the efficacy and safety of digestive endoscopic submucosal dissection(ESD)in the treatment of early esophageal cancer.Methods A total of 99 patients with early esophageal cancer were included.According to the operation methods,52 patients treated with ESD were included in the ESD group,and the other 47 patients who underwent endoscopic mucosal resection(EMR)during the same period were included in the EMR group.The surgical status,postoperative status,lesion resection effect,complications and recurrence of patients in the two groups were analyzed.Results Compared with the EMR group,the ESD group had longer operation time,longer postoperative fasting time and larger maximum lesion diameter,and the differences between the two groups were statistically significant(P<0.05).There was no significant difference in the duration of antibiotic use and hospital stay between the two groups(P>0.05).The en bloc resection rate and complete resection rate of lesions in the ESD group were higher than those in the EMR group,with statistical significance(P<0.05).There was no statistical significance in the incidence of complications between the two groups(P>0.05).The recurrence rate in the ESD group was lower than that in the EMR group 12 months after operation,and the difference was statistically significant(P<0.05).Conclusion ESD has the advantages of complete dissection of lesions and low long-term recurrence rate in the treatment of early esophageal cancer with large lesion diameter.