内镜下治疗早期胃癌及癌前病变的安全性及有效性分析

Safety and Efficacy Analysis of Endoscopic Treatment of Early Gastric Cancer and Precancerous Lesions

摘要: 目的：探讨早期胃癌及癌前病变经内镜黏膜下剥离术(ESD)治疗后的安全性及有效性。方法：收集2016年1月至2020年5月于青岛市市立医院因早期胃癌及癌前病变而行内镜黏膜下剥离术治疗的187例手术病例，统计术后临床资料及病理资料，进一步分析病变特点、术后病理，完整切除率，术后复发情况。结果：1) 187例患者术后患者病灶整块切除率为100%，完整切除率97.3%，2) 发生术后出血9例，发生术后发热2例，发生术后穿孔例数为0。3) 中位随访时间20个月，187例患者1年内至少进行了至少一次的内镜下复查，术后2年复发率0.53% (1例)。结论：ESD在治疗早期胃癌患者中具有安全有效性，及时处理病变，能够更好地改善患者的预后。

Abstract: Objective: To investigate the safety and efficacy of endoscopic submucosal dissection (ESD) for early gastric cancer and precancerous lesions. Methods: 187 cases of endoscopic submucosal dissection were collected for early gastric cancer and precancerous lesions in Qingdao Municipal Hospital from January 2016 to May 2020. The postoperative clinical and pathological data were analyzed, and the pathological characteristics, postoperative pathology, complete resection rate and postoperative recurrence were further analyzed. Results: 1) In 187 patients, the total resection rate was 100% and the complete resection rate was 97.3%, 2) Postoperative bleeding occurred in 9 cases, postoperative fever occurred in 2 cases, postoperative perforation occurred in 0 cases. 3) The median follow-up time was 20 months, and 187 patients underwent at least one endoscopic review within 1 year, with a recurrence rate of 0.53% (1 case) 2 years after surgery. Conclusion: ESD is safe and effective in the treatment of early gastric cancer patients, timely deal with pathological change, can better improve the prognosis of patients.