Clinical Efficacy And Safety Of Endoscopic Mucosal Dissection In The Treatment Of Early Gastric Cancer

Research Background:Gastric cancer is one of the most common clinical malignancies,with over 1 million new cases annually worldwide,ranking the fourth in morbidity and the second in mortality after lung cancer worldwide,among which east Asia,eastern Europe and South America are the regions with high incidence.China is a high incidence area of gastric cancer,with about 400,000 new cases and 350,000 deaths every year.The prevention and treatment situation is very serious.Early gastric cancer refers to an early malignant lesion in which the infiltration of cancer cells is limited to the mucosa layer and submucosa layer.The traditional treatment is mainly gastrectomy and lymph node dissection.Although the lesion can be effectively removed,the wound is large and there are many complications,which seriously affect the quality of survival and prognosis.Developing fast in recent years,endoscopic diagnosis and treatment technology,the curative effect of endoscopic treatment of early gastric cancer has attracted widespread attention,also from endoscopic mucosal resection treatment technology to a new,better overall curative effect of endoscopic submucosal layer stripping,but by the surgical treatment of early gastric cancer clinical efficacy and safety remains to be further defined.Objective:To explore the clinical efficacy and safety of endoscopic submucosal dissection(ESD)in the treatment of early gastric cancer(EGC),and to provide a reference for the clinical treatment of EGC.Methods:Collected 35 patients with early gastric cancer diagnosed by gastroscopy admitted to our hospital from January 2013 to December 2015,all of whom received endoscopic mucosal dissection(ESD),and set them as the observation group.A total of 25 patients with early gastric cancer diagnosed in our hospital during the same period and receiving surgical treatment were selected as the control group.The Hospital Anxiety and Depression Scale(HADS)was used to evaluate the Anxiety and Depression of patients before treatment and 6 months after surgery,and the European organization for research and treatment of cancer(EORTC)qlq-c30 Scale was used to evaluate the quality of life of patients 6 months after surgery.All patients were followed up for more than 3 years.Patients in the two groups were counted for lesion resection(complete resection rate,curative resection rate),tumor recurrence rate,operation time,intraoperative blood loss,hospitalization time,hospitalization cost,incidence of surgical complications and long-term survival rate.Results:There was no significant difference in hospital anxiety and depression score(HADS)between the two groups before treatment(P>0.05),and the anxiety and depression seore of the ESD group 6 months after surgery was lower than that of the surgery group(P<0.05).The overall quality of life scale of ESD group was significantly higher than that of operation group(P<0.05).After treatment,the complete resection rate and curative resection rate in the ESD group were lower than those in the surgery group,but the difference was not statistically significant(P>0.05).The local recurrence rate of ESD group was lower than that of operation group,but the difference was not statistically significant(P>0.05).The operation time,intraoperative blood loss,hospitalization time,hospitalization cost and fasting time of the ESD group were all better than those of the operation group(P<0.05).The incidence of early postoperative complications in the ESD group was lower than that in the surgery group,and the difference was statistically significant(P<0.05).The follow-up rate was 94.74%(54/57),and the overall 5-year survival rate was 97.4%in the ESD group and 96.3%in the surgery group.There was no significant difference between the two groups(P>0.05).Conclusions:Endoscopic mucosal dissection for the treatment of early gastric cancer has the advantages of complete resection of the lesion,short operation and hospitalization time,less complications,low local recurrence rate,etc.,and the patient has a good quality of life after surgery,which is a safe and effective surgical treatment.