Clinical Analysis Of Endoscopic Submucosal Dissection In The Treatment Of Early Gastric Cancer And Precancerous Lesions

Objective:(1) Study for the treatment of endoscopic submucosal dissection the effectiveness of early gastric cancer and precancerous lesions.(2) Analysis the complications of the endoscopic submucosal dissection technique independent associated risk factors.(3) For further application of ESD treatment of gastrointestinal carcinoma and precancerous lesions in early development to provide the reference data.Methods: Collected in February 2012 to February 2015 in shan xi medical university institute of digestive endoscopy center of tai gang group applied for the treatment of endoscopic submucosal dissection of early gastric cancer and precancerous lesions in 49 cases, pathological characteristics(such as age, gender, lesion site, tumor size, lesion type, operative time, pathological diagnosis), relationship with related complications(such as bleeding, perforation or stenosis). Collected at the same time the provincial tumor hospital of 46 patients with surgical treatment of early gastric cancer, compared to observe the postoperative follow-up. observe and compare the postoperative follow-up analysis. Results: 49 cases of ESD patients in male 27 cases, female 22 cases. The average age of 58.1 ± 8 years(29-78 years). Surgical excision of the lesion with an average size of 1.5 ±0.6 cm. The average operation time was 65.3 ±16.5min. Pathological results 23 cases of cancer, high-grade intraepithelial neoplasia 26 cases. The whole resection rate was 97.9, the complete resection rate was 95.9%. The average follow-up period of 1.7±0.7 years, in situ recurrence rate was 2.04%. Operation of perforation occurred in 2 cases, respectively occurred in the bottom of the stomach and the stomach body. There were 10 patients with bleeding during the operation, and no delayed bleeding after operation. The first part of this paper, the possible influence factors of early gastric cancer and precancerous lesions complications(such as age, gender, tumor size, tumor location, etc.) for statistical analysis, single factor analysis that include age(P = 0.002), location of the tumor(P = 0.001), tumor size(P = 0.003) effects of early gastric cancer, ESD complications related factors. On the age, tumor location, gross morphology of multi factor analysis showed that tumor location(P=0.03) and morphological(P=0.036) related factors to affect gastric ESD complications. The second part of this paper, respectively, through the postoperative cure rate and the quality of life of the two aspects of the effectiveness of the ESD and the patient’s superiority to make an evaluation. The 49 cases after ESD group and 46 groups after surgery patients with early gastric cancer were regular follow-up, follow-up observations include gastrointestinal symptoms(such as decreased abdominal distension, abdominal pain, nausea, vomiting, loss of appetite, weight loss, etc.) and endoscopic performance two aspects. Results: the effect of surgical treatment on early gastric cancer was not better than that of endoscopic treatment, and there were differences in the long-term survival quality of the two patients.Conclusions: Endoscopic submucosal dissection is a safe and effective minimally invasive treatment for early gastric cancer and precancerous lesions. The therapeutic effect of ESD technique on early gastric cancer is similar to the surgical results. The long-term quality of life of patients after ESD was better than that of surgical patients.