Therapeutic Effect Of Endoscopic Submucosal Dissection In The Treatment Of Gastric Stromal Tumors

Objective:To explore the safety and efficacy of endoscopic submucosal dissection(ESD)in the treatment of gastric stromal tumors.Methods:This study selected in June 2015 to January 2018 in the second affiliated hospital of kunming medical university during the surgery treatment of 36 cases of patients with gastric stromal tumor were retrospectively analyzed,according to different operation method,can be divided into ESD treatment group and the surgical treatment group,sum up clinical data and pathological characteristics of GIST,complete lesion resection rate,operation time,length of hospital stay,hospital expenses and risk classification,the cause of the complications and preventive measures.Results:There was no significant difference in age,gender of ESD group and surgical group.The mean diameter of the lesion in the 20 patients with ESD group was 2.8 ±0.33 cm,and the average length of hospital stay was 4.65 ± 1.70 d,and the operation time was 70.96 ± 17.84 min,hospitalization cost is 7163.17 ? 603.88 yuan,1 case of hemorrhage and 1 perforation occurred during the operation,and the complication rate was 10%.The mean diameter of surgical resection in 16 surgical patients was 6.6? 0.61 cm,and the average length of hospital stay was 10.91 ± 3.17 d,and the operation time was 117.6 ? 23.7 min,and the hospitalization cost was 13163.17 ±7333.72 yuan,intraoperative bleeding occurred in 2 cases,postoperative gastric emptying disorder and stenosis in 1 case,the incidence of complications was 25%.The maximum diameter of gastric stromal tumor in group ESD was 1.92 cm,with an average diameter of 1.38 ± 0.31 cm.The maximum diameter of the gastric stromal tumor in the surgical group was 4.87 cm,the average diameter was 3.86 ± 0.35 cm,and the diameter of the two groups was different(P<0.05).the surgical group and ESD in the removal of the tumors had diameter,operation time,length of hospital stay,hospital expenses P<0.05 difference was statistically significant.All tumors had complete resection operation process,the edge of the removal of the tumor and the base are not found that tumor cells infiltration,lymph nodes were found around violations,postoperative immunohistochemical display CD 117 positive rate were 91.17%,DOG-1 positive rate were 94.45%,CD34 positive rate 77.78%,Ki-67 positive rate ranged from 1%?15%.Dangerous grouping of ESD is extremely low risk in 15 cases(75%),the low risk group with 2 cases(10%),moderate group have 2 cases(10%),high risk groups in 1 case(5%),surgical extremely low risk group for 3 cases(18.75%),low-risk groups in 4 cases(25%),moderate group has 8cases(50%),high-risk groups in 1 case(6.25%).Conclusion:ESD in the treatment of gastric stromal tumor,and have the same the rapeutic effect with traditional surgery,and compared with traditional surgery with small trauma,shorter operation time,hospitalization days,hospitalization less low cost advantage,is a kind of safe and effective treatment.