| Objective:To analyze the clinical effects and complications of endoscopic submucosal dissection(ESD)and endoscopic mucosal resection with transparent cap(EMR-C)for early esophageal cancer that the length of lesion is more than 5cm and to summarize the better endoscopic treatment for long lesion’s early esophageal cancer.Methods:Retrospective analysis of 64 patients with early esophageal cancer that the length of lesion is more than 5cm in Fujian Esophageal Cancer Alliancefrom January 2013 to May 2016.It was divided into ESD group and EMR-C group by different operation ways,to compare clinical effects and complications for early esophageal cancer.Result:34 patients were accepted by ESD,while 30 patients were accepted by EMR-C.In the ESD group the average length of lesions was 5.91 cm,the rate ofen-bloc resection was 97.1%,the rate of whole complete resection was 82.4,the operation time was 64.20±15.10 min,postoperative fasting time was 4.26±1.19 day,hospital-stay time was 14.94±2.55 day,postoperative antibiotic needed time 4.62±2.07day;In the EMR-C group the average length of lesions was 5.93 cm,the rate ofen-bloc resection was 0,the rate of whole complete resection was 90.0%,the operation time was 30.67±7.28 min,postoperative fasting time was 3.73±0.98 day,hospital-stay time was 8.77±2.30 day,postoperative antibiotic needed time 2.22±2.22day;The rate ofen-bloc resection in ESD group is apparently higher than EMR-C group,and the differences between them have statistical significant(P<0.05).There was nosignificantdifference in the rate of whole complete resection.The operation time in ESD group higher than EMR-C group,but postoperative fasting time、hospital-stay time and postoperative antibiotic needed time roughly similar(P>0.05).There were 1 case of high blood pressure、2 case of airway hyperresponsiveness、2 case of intraoperative bleeding、no case of low blood pressure、low blood oxygen、atrial fibrillation and mediastinal emphysema in the operation,2 cases of fever,8 cases of chest pain,2 cases of retrosternal pain、2 cases of stenosis、8 case of postoperative bleeding、3 case of recurrence and distal metastasis after surgery in ESD group;while in EMR-C group,there were 1 case of atrial fibrillation、no case of high blood pressure、low blood pressure 、 low blood oxygen 、 airway hyperresponsiveness 、 mediastinal emphysema and intraoperative bleeding in the operation,no cases of fever,3 cases of chest pain,1 cases of retrosternal pain、1 cases of stenosis、1 case of postoperative bleeding 、 1 case of recurrence and distal metastasis after surgery.There was no significant difference in the rate of intraoperative complication(P>0.05).The rate of postoperative stenosis in the ESD group higher than EMR-C group,and the differences between them have statistical significant(P<0.05).There was nosignificantdifference in the rate of postoperative chest pain 、 fever 、 retrosternal pain、postoperative bleeding、recurrence and distal metastasis between two groups(P>0.05).Conclusion:ESD and EMR-C have equivalent efficacy in the treatment of early esophageal cancer that the length of lesion is more than 5cm,but EMR-C have superior security.Moreover EMR-C is easily to master and suitable for primary health care units to use. |
