内镜下黏膜切除术与内镜黏膜下剥离术治疗早期胃癌的近期疗效及对远期生存质量的影响  

Short-term effect of endoscopic mucosal resection and endoscopic submucosal dissection in treatment of early gastric cancer and its influence on long-term quality of life

作　　者：吴红艳 尚学彬 刘婷利 WU Hong-yan;SHANG Xue-bin;LIU Ting-li(Department of Gastroenterology,Henan Provincial Worker's Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省职工医院消化内科,郑州450000

出　　处：《医药论坛杂志》2022年第22期23-25,30,共4页Journal of Medical Forum

摘　　要：目的探究内镜下黏膜切除术(EMR)及内镜黏膜下剥离术(ESD)治疗早期胃癌的近期疗效及对远期生存质量的影响。方法选取2017年7月—2018年7月河南省职工医院收治的52例早期胃癌患者为研究对象,根据手术方式分为切除组(n=26,EMR治疗)和剥离组(n=26,ESD治疗)。记录两组切除用时、出血量、手术时长,治愈性切除率、完整切除率,术后包括穿孔、皮下气肿、出血等并发症及远期随访复发率、生存率。结果剥离组出血量(68.38±4.09)mL、手术用时(54.01±16.24)min、住院时间(8.09±1.11)d小于切除组[(70.61±3.16)mL、(63.83±15.93)min、(9.14±1.03)d],治愈性切除率(88.46%)、完整切除率(96.15%)大于切除组[(65.38%)、(76.92%)],并发症总发生率(3.85%)小于切除组(26.92)(P<0.05);两组均随访1~3年,剥离组复发率(3.85%)低于切除组(23.08%)(P<0.05),两组生存率比较差异无统计学意义(P>0.05)。结论ESD可减少早期胃癌患者术中出血量、手术用时、住院时间,提高治愈性切除率、完整切除率,降低术后并发症发生率,且有较好远期生存质量。Objective To explore the short-term effect of endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)in the treatment of early gastric cancer and their impact on long-term quality of life.Methods Totally fifty-two patients with early gastric cancer admitted to our hospital from July 2017 to July 2018 were selected as the research objects.According to different surgical methods,they were divided into resection group(n=26,EMR treatment)and dissection group(n=26,ESD treatment).The resection time,blood loss,operation time,curative resection rate,complete resection rate,postoperative complications including perforation,subcutaneous emphysema,bleeding,and long-term follow-up recurrence rate and survival rate were recorded in the two groups.Results The bleeding volume(68.38±4.09)mL,operation time(54.01±16.24)min,and hospital stay(8.09±1.11)d in the dissection group were less than those in the resection group[(70.61±3.16)mL、(63.83±15.93)min、(9.14±1.03)d].The rate of curative resection(88.46%)and complete resection(96.15%)were higher than those of the resection group[(65.38%)、(76.92%)],and the total incidence of complications(3.85%)was lower than that of the resection group(26.92%)(P<0.05);both groups were followed up for 1 to 3 years.The recurrence rate of the dissection group(3.85%)was lower than that of the resection group(23.08%)(P<0.05),and there was no significant difference in the survival rate between the two groups(P>0.05).Conclusion ESD can reduce intraoperative blood loss,operation time,and length of stay in patients with early gastric cancer,increase the rate of curative resection and complete resection,reduce the rate of postoperative complications,and have a better long-term quality of life.

关 键 词：早期胃癌 内镜下黏膜切除术 内镜黏膜下剥离术 近期疗效 远期生存质量 

分 类 号：R735.2[医药卫生—肿瘤]