胃食管早癌及癌前病变中EMR与ESD的应用分析  

Application of EMR and ESD in Early Gastroesophageal Cancer and Precancerous Lesions

作　　者：李翔[1] 崔建华[1] 徐康[1] LI Xiang;CUI Jianhua;XU Kang(Department of Gastroenterology,Dongtai People's Hospital,Dongtai Jiangsu 224200,China)

机构地区：[1]东台市人民医院消化科,江苏东台224200

出　　处：《中国卫生标准管理》2023年第2期126-130,共5页China Health Standard Management

摘　　要：目的探讨在胃食管早癌及癌前病变中应用内镜下黏膜切除术(endoscopic mucosal resection,EMR)及内镜下黏膜剥离术(endoscopic submucosal dissection,ESD)治疗的效果差异。方法选取东台市人民医院2019年3月—2021年7月收治的胃食管早癌及癌前病变患者共90例作为研究对象,所有患者统一编号,奇数号码的45例患者为对照组,开展EMR治疗,偶数号码的45例患者为观察组,开展ESD治疗,就不同组别患者的围手术期指标、病灶切除效果、术后并发症发生率及病灶复发率等指标进行比较分析。结果与对照组相比,观察组手术时间、术中出血量更少,差异有统计学意义(P<0.05),但两组住院时间则比较,差异无统计学意义(P>0.05);与对照组相比,观察组侧切缘阴性、基底缘阴性、病灶治愈性切除及整块切除率等病灶切除效果更佳,差异有统计学意义(P<0.05);与对照组相比,观察组患者术后并发症发生率及病灶复发率均更低,差异有统计学意义(P<0.05)。结论ESD对胃食管早癌及癌前病变的治疗有效性和安全性相比EMR更理想,因此值得进行推广应用。Objective To investigate the difference between endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)in the treatment of early gastroesophageal cancer and precancerous lesions.Methods A total of 90 patients with early gastroesophageal cancer and precancerous lesions admitted to our hospital from March 2019 to July 2021 were randomly selected as the research objects.All patients were uniformly numbered.45 patients with odd numbers were selected as the control group and carried out EMR treatment,while 45 patients with even numbers were selected as the observation group and carried out ESD treatment.The perioperative indicators,the effect of lesion resection,the incidence of postoperative complications and the recurrence rate of lesions were compared and analyzed in different groups.Results Compared with the control group,the observation group had less operation time and less intraoperative bleeding,with statistically significant differences(P<0.05),but the two groups had no statistically significant difference in hospital stay(P>0.05).Compared with the control group,the observation group had a higher resection effect,such as negative lateral margin,negative basal margin,curative resection rate of the lesion and whole resection rate,with statistically significant differences(P<0.05).Compared with the control group,the incidence of postoperative complications and the recurrence rate of lesions in the observation group were lower,with statistically significant differences(P<0.05).Conclusion ESD has better efficacy and safety than EMR in the treatment of early gastroesophageal cancer and precancerous lesions,so it is worthy of promotion and application.

关 键 词：胃食管早癌 癌前病变 EMR ESD 并发症 消化系统肿瘤 病灶切除 

分 类 号：R735[医药卫生—肿瘤]