Shuang Jiang1, Dahe Ge2, Kaijun Shou3. 1. Department of Emergency Medicine, The First People's Hospital of Shangqiu Shangqiu 476000, Henan Province, China. 2. Department of Gastroenterology, The First People's Hospital of Shangqiu Shangqiu 476000, Henan Province, China. 3. Department of Anorectal Surgery, Zhuji Affiliated Hospital of Shaoxing University Zhuji 311800, Zhejiang Province, China.
Abstract
OBJECTIVE: To investigate the prognosis of patients with early gastric carcinoma (EGC) treated by endoscopic submucosal dissection (ESD) and the risk factors for additional postoperative surgery. METHODS: A retrospective analysis was performed on 100 patients with EGC admitted to our hospital from January 2017 to May 2019. According to different surgical methods, patients were divided into the ESD (n=60) and endoscopic mucosal resection (EMR) groups (n=40). Clinical efficacy, perioperative indexes, incidence of complications and risk factors for additional postoperative surgery were compared. RESULTS: The ESD group had evidently prolonged operation time (P<0.01) but similar intraoperative blood loss (P>0.05) as compared with the EMR group. In comparison to the EMR group, the gastrointestinal recovery time and length of stay in the ESD group were notably shorter (P<0.01), the rates of en bloc resection and complete resection of lesions were markedly higher (P<0.05), and the postoperative fever/infection rate was noticeably lower (P<0.05). The two surgical methods had no significant difference on the overall survival rate of patients (P=0.302). It was identified that the infiltration depth and the positive surgical margin were independent risk factors for postoperative additional surgery (all P<0.05). ROC analysis revealed that positive surgical margin was quite valuable in judging the need for additional postoperative surgery. CONCLUSION: ESD can accelerate the postoperative recovery of patients with EGC, and positive surgical margin is independently tied to additional postoperative surgery in patients after ESD. AJTR
OBJECTIVE: To investigate the prognosis of patients with early gastric carcinoma (EGC) treated by endoscopic submucosal dissection (ESD) and the risk factors for additional postoperative surgery. METHODS: A retrospective analysis was performed on 100 patients with EGC admitted to our hospital from January 2017 to May 2019. According to different surgical methods, patients were divided into the ESD (n=60) and endoscopic mucosal resection (EMR) groups (n=40). Clinical efficacy, perioperative indexes, incidence of complications and risk factors for additional postoperative surgery were compared. RESULTS: The ESD group had evidently prolonged operation time (P<0.01) but similar intraoperative blood loss (P>0.05) as compared with the EMR group. In comparison to the EMR group, the gastrointestinal recovery time and length of stay in the ESD group were notably shorter (P<0.01), the rates of en bloc resection and complete resection of lesions were markedly higher (P<0.05), and the postoperative fever/infection rate was noticeably lower (P<0.05). The two surgical methods had no significant difference on the overall survival rate of patients (P=0.302). It was identified that the infiltration depth and the positive surgical margin were independent risk factors for postoperative additional surgery (all P<0.05). ROC analysis revealed that positive surgical margin was quite valuable in judging the need for additional postoperative surgery. CONCLUSION: ESD can accelerate the postoperative recovery of patients with EGC, and positive surgical margin is independently tied to additional postoperative surgery in patients after ESD. AJTR