摘要
目的比较内镜下黏膜切除术(EMR)和内镜黏膜下剥离术(ESD)对消化道肿瘤的临床治疗效果以及应用价值。方法选取60例消化道肿瘤患者作为观察对象,其中接受内镜下黏膜切除术治疗的30例患者纳入EMR组,同期接受内镜黏膜下剥离术治疗,且一般资料与EMR组均衡的30例患者纳入ESD组。对比两组患者的肿瘤整块切除率、完全切除率、手术时间、术中出血量、住院时间、并发症情况以及术后1个月病灶残留情况。结果EMR组肿瘤整块切除率以及完全切除率均明显低于ESD组,手术时间短于ESD组,术中出血量大于ESD组,住院时间长于ESD组,术后并发症发生率低于ESD组(均P<0.05)。术后1个月EMR组的病灶残留率高于ESD组,但差异无统计学意义(P>0.05)。结论EMR和ESD在治疗消化道肿瘤中均有良好效果,其中在手术时间及并发症控制上,EMR优于ESD,但在术中出血量、肿瘤整块切除率、完整切除率、住院时间上,ESD明显优于EMR。临床上在选择手术方式时,需结合患者的实际情况。
Objective To compare the clinical therapeutic effect and application value of endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)in the treatment of digestive tract tumor.Methods A total of 60 patients with digestive tract tumor were selected,among which,30 patients received EMR were enrolled as EMR group,while the other 30 patients received ESD,whose general data were equilibrium to those of the EMR group,were enrolled as ESD group during the same study period.The total tumor resection rate,complete resection rate,operation duration,intraoperative bleeding volume,hospital stay,the prevalence of complications,and lesion residue conditions 1 month after operation were compared between the two groups.Results Compared to the ESD group,the EMR group yielded lower total tumor resection rate and complete resection rate,shorter operation duration,whereas greater intraoperative bleeding volume,longer hospital stays,and a lower postoperative incidence of complications(all P<0.05).The residual rate of lesions 1 month after operation in the EMR group was higher than that in the ESD group,but there was no statistically significant difference between the two groups(P>0.05).Conclusion Both EMR and ESD have a good effect in the treatment of digestive tract tumor,with EMR superior to ESD in operation duration and complications control,while ESD superior to EMR in intraoperative bleeding volume,total resection rate of tumor,complete resection rate,and hospital stay.Hence,it is necessary to consider with the practical condition of patients when selecting surgical method in clinical practice.
作者
程毅东
孔红梅
张焕乐
何慧
CHENG Yidong;KONG Hongmei;ZHANG Huanle;HE Hui(Department of Gastroenterology,Guangxi Hezhou People′s Hospital,Hezhou 542899,China)
出处
《微创医学》
2019年第6期706-708,共3页
Journal of Minimally Invasive Medicine
基金
广西科学研究与技术开发计划项目(编号:桂科攻1298003-6-4)
关键词
内镜下黏膜切除术
内镜黏膜下剥离术
消化道肿瘤
手术方式
疗效
Endoscopic mucosal resection
Endoscopic submucosal dissection
Digestive tract disease
Surgical method
Efficacy
