内镜下不同术式治疗早期结直肠癌的临床效果比较
Comparison of clinical effects of endoscopic mucosal dissection and endoscopic mucosal resection in the treatment of early colorectal cancer
史池红 1陆德文 1景慧芬1
作者信息
- 1. 315040 宁波,宁波大学附属人民医院
- 折叠
摘要
目的 比较内镜下黏膜剥离术(ESD)与内镜下黏膜切除术(EMR)治疗早期结直肠癌的临床效果.方法 回顾性分析本院2019 年 3 月至 2022 年 3 月收治的 92 例早期结直肠癌患者的临床资料,按照手术方式不同分为ESD组、EMR组,各 46例.比较两组患者围术期情况、不同肿瘤直径患者手术切除效果,比较手术前后血清超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平及术后并发症发生率、术后 1 年复发率.结果 ESD组手术时间、住院时间、住院费用均长于/多于EMR组,有统计学意义(P＜0.05);ESD组肿瘤直径≥2 cm的患者整块切除、完全切除率均高于EMR组,有统计学意义(P＜0.05);ESD组术后 1d血清hs-CRP、TNF-α、IL-6水平,术后并发症发生率均比EMR组高,差异有统计学意义(P＜0.05);随访 1 年显示,ESD组复发率明显低于 EMR组,差异有统计学意义(P＜0.05).结论 ESD、EMR治疗早期结直肠癌患者各有优势,可根据不同患者进行个体化选择,对于肿瘤直径＜2 cm的患者可选择 EMR,可减少手术时间、住院时间,降低住院费用、炎症反应及并发症发生率,对于肿瘤直径≥2 cm的患者可选择ESD,提高肿瘤切除率,且ESD的短期复发率更低.
Abstract
Objective To compare the clinical efficacy of endoscopic mucosal dissection(ESD)and endoscopic mucosal resection(EMR)in the treatment of early colorectal cancer.Methods The clinical data of 92 patients with early stage colorectal cancer admitted to our hospital from March 2019 to March 2022 were retrospectively analyzed,and they were divided into ESD group and EMR group according to different surgical methods,with 46 cases each.The perioperative situation,surgical resection effect of patients with different tumor diameters were compared between the two groups,and the serum hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels before and after surgery,the incidence of postoperative complications and 1-year postoperative recurrence rate were compared.Results The operation time,hospital stay,hospitalization cost in the ESD group were longer than those in the EMR group,with statistical significance(P＜0.05).The total resection and complete resection rates of patients with tumor diameter≥2 cm in ESD group were higher than those in the EMR group,with statistical significance(P＜0.05).The serum hs-CRP,TNF-α and IL-6 levels at after operation 1d,total incidence of complications in ESD group were higher than those in the EMR group,with statistical significance(P＜0.05).The 1-year follow-up showed that the recurrence rate in the ESD group was significantly lower than that in the EMR group,with statistical significance(P＜0.05).Conclusion ESD and EMR have their respective advantages in the treatment of early stage patients with colorectal cancer,and can be selected individually according to different patients.EMR can be selected for patients with tumor diameter＜2 cm,which can reduce surgical time,hospital stay,hospitalization costs,inflammatory reactions,and the incidence of complications.ESD can be se-lected for patients with tumor diameter≥2cm,which can improve the tumor resection rate,and the recurrence rate of ESD is lower.
关键词
结直肠癌/内镜下黏膜剥离术/内镜下黏膜切除术/炎症因子/并发症Key words
Colorectal cancer/Endoscopic mucosal dissection/Endoscopic mucosal resection/Inflammatory factors/Complication引用本文复制引用
出版年
2024
NETL
NSTL
维普
万方数据