摘要
目的分析内镜黏膜下剥离术(ESD)治疗早期食管癌的效果。方法抽取2019年6月至2022年6月新乡市中心医院收治的早期食管癌患者89例,按照手术方式分为内镜组(46例)和开放组(43例)。内镜组采用ESD治疗,开放组采用传统开放切除术治疗。比较两组围术期指标、血清肿瘤标志物[癌胚抗原(CEA)、鳞状细胞癌抗原(SSCA)、神经元特异性烯醇化酶(NSE)]水平、病灶切除效果、并发症发生率及复发率。结果内镜组手术时间、术后卧床时间、术后进食时间均短于开放组,术中出血量少于开放组(P<0.05)。术后7 d,内镜组CEA、SSCA、NSE水平低于开放组(P<0.05)。内镜组病灶整块切除率(93.48%,43/46)、完整切除率(89.13%,41/46)高于开放组(72.09%,31/43;65.12%,28/43),P<0.05。内镜组并发症发生率(2.17%,1/46)低于开放组(20.93%,9/43),P<0.05;术后随访6个月,内镜组复发率(2.17%,1/46)低于开放组(18.60%,8/43),P<0.05。结论ESD治疗早期食管癌可明显缩短手术时间和卧床时间,促进患者术后恢复,病灶切除率高,可降低机体肿瘤标志物水平及术后并发症发生率、复发率。
Objective To analyze the effect of endoscopic submucosal dissection(ESD)in the treatment of early esophageal cancer.Methods A total of 89 patients with early esophageal cancer treated in Xinxiang Central Hospital from June 2019 to June 2022 were selected,and they were divided into endoscopic group(46 case)and open group(43 case)according to the surgical method.The endoscopic group was treated by ESD,and the open group was treated by traditional open resection.The perioperative indicators,levels of serum tumor markers,including carcinoembryonic antigen(CEA),squamous-cell carcinoma antigen(SSCA)and neuron-specific enolase(NSE),lesion resection effect,complication rate and recurrence rate were compared between the two groups.Results Compared with the open group,the endoscopic group had shorter operation time,shorter postoperative bed rest,shorter postoperative eating time,and less intraoperative blood loss(P<0.05).Compared with the open group,the endoscopic group had lower levels of CEA,SSCA and NSE 7 days after operation(P<0.05).The overall resection rate(93.48%,43/46)and complete resection rate(89.13%,41/46)in the endoscopic group were higher than those in the open group(72.09%,31/43;65.12%,28/43),P<0.05.The incidence of complications in the endoscopic group(2.17%,1/46)was lower than that in the open group(20.93%,9/43),P<0.05.After 6 months of follow-up,the recurrence rate in the endoscopic group(2.17%,1/46)was lower than that in the open group(18.60%,8/43),P<0.05.Conclusions ESD in the treatment of early esophageal cancer can significantly shorten the operation time and bed rest time,promote postoperative recovery,and has a high tumor resection rate.It can significantly reduce the level of tumor markers in the body,and decrease the incidence of postoperative complications and recurrence.
作者
申飞飞
李小环
祁海莉
Shen Feifei;Li Xiaohuan;Qi Haili(Department of Endoscopy,Xinxiang Central Hospital,the Fourth Clinical College of Xinxiang Medical University,Xinxiang 453000,China)
出处
《中国实用医刊》
2023年第7期33-36,共4页
Chinese Journal of Practical Medicine
关键词
食管癌
内镜黏膜下剥离术
血清肿瘤标志物
Esophageal squamous cell carcinoma
Endoscopic submucosal dissection
Serum tumor markers
