老年单发早期胃癌内镜黏膜下剥离术的疗效  

Analysis of endoscopic curative effect in elderly patients with single early gastric cancer

作　　者：孟环[1] 孙智勇[2] 韩东[1] 高强 张倩 

机构地区：[1]山东省单县中心医院消化内科,山东单县274300 [2]山东省菏泽市立医院普外科,山东菏泽274031 [3]山东省烟台市中医医院内科,山东烟台264001 [4]新矿集团莱芜中心医院消化内科,山东莱芜271103

出　　处：《中国内镜杂志》2016年第10期74-77,共4页China Journal of Endoscopy

摘　　要：目的探讨老年单发早期胃癌(EGC)内镜黏膜下剥离术(ESD)的疗效。方法选取2010年1月-2015年2月山东省单县中心医院收治的126例单发EGC患者为研究对象,根据年龄分为老年组(≥65岁,n=50)和青中年组(<65岁,n=76)。比较两组患者的基线资料、手术时间、失血量、术后住院天数、整块切除率、治愈性切除率和并发症等围术期状况及随访结果。结果老年组的年龄、高血压史、冠心病史的发生率明显高于青中年组,差异有统计学意义(P<0.05)。两组患者的性别、糖尿病史、病灶形态、大小、病理结果和浸润深度等其余基线资料比较,差异无统计学意义(P>0.05)。所有患者均成功完成ESD术,两组患者的围手术期资料比较,差异无统计学意义(P>0.05)。全部患者均未出现肿瘤转移及死亡,共有3例出现复发,老年组与青中年组的复发率分别为2.0%与2.6%,两组比较差异无统计学意义(P>0.05)。结论对于老年单发EGC患者而言,ESD术是安全有效的微创治疗方法,临床疗效与安全性与青中年患者无明显差异。ObjectiveTo investigate the clinical effect of endoscopic submucosal dissection in elderly patients with single early gastric cancer （EGC）. Methods126 elderly patients with single EGC from January 2010 to February 2015 were divided into elderly group （≥65 years old, n = 50） and young and middle-aged group （〈65 years old, n = 76） according to age. Baseline data, operation time, volume of intraoperative blood loss, duration of postoperative hospital stay, rate of en bloc resection, curative resection; complications and result of follow-up were compared between two groups. ResultsAge, the incidence of hypertension and coronary heart disease in elderly group were significantly higher than young and middle-aged group （P 〈 0.05）. There were no significant differences in gender, history of diabetes, lesion morphology, size, pathological results and infiltration depth between two groups （P 〉 0.05）. All patients were successfully completed ESD, and there were no significant differences in all perioperative data between two groups （P 〉 0.05）. No tumor metastasis and death were occurred in all patients. Recurrence was occurred in a total of 3 cases. The recurrence rate of elderly group and young and middle-aged group were 2.0 % and 2.6% respectively, and there were no significant differences between the two groups （P 〉 0.05）. ConclusionFor elderly patients with single EGC, ESD is a safe and feasible minimally invasive treatment, and it is equivalent to clinical efficacy and safety in young and middle-aged patients.

关 键 词：内镜黏膜下剥离术 老年 早期胃癌 疗效 

分 类 号：R735.2[医药卫生—肿瘤]