两种术前活检方案用于早期胃癌患者行内镜黏膜下剥离术的临床价值比较

Clinical value comparison of two kinds of preoperative biopsy protocols on patients with gastric cancer for early stage underwent ESD

摘要:

探讨术前活检方案差异对行内镜黏膜下剥离术（ESD）的早期胃癌患者取材量及手术用时的影响。方法 研究对象选取该院2013年6月-2016年6月行ESD术治疗早期胃癌患者共60例，根据活检方案不同分为A组（30例）和B组（30例），分别在术前行多次多点活检术和靶向活检术，比较两组患者活检次数、取材总标本数、术后病理符合率及ESD手术过程用时。结果 B组患者活检次数和取材总标本数均明显少于A组（P <0.05）；B组患者术后病理符合率明显高于A组（P <0.05）；两组患者确定切除范围时间、标记时间、黏膜下注射时间及切除标本处理时间比较差异无统计学意义（P >0.05）；B组患者黏膜剥离时间、止血时间及创面处理时间均明显短于A组（P <0.05）。结论 术前靶向活检术用于行ESD手术患者可有效减少取材创伤，提高活检准确率，并有助于缩短手术用时，价值优于多次多点活检术。

Abstract:

Abstract: Objective To investigate the influence of preoperative biopsy protocols difference on the material amount and operation time of patients with gastric cancer for early stage underwent ESD. Methods 60 patients with gastric cancer for early stage underwent ESD were chosen from June 2013 to June 2016 and randomly divided into A group (30 patients) with multiple times and points biopsies and B group (30 patients) with targeted biopsy before surgery; the biopsy number, the total number of specimens, the postoperative pathological coincidence rate and the ESD operation time of the two groups were compared. Results The biopsy number and the total number of specimens of B group were significant shorter than that in A group (P < 0.05). The postoperative pathological coincidence rate of B group were significant higher than that in A group (P < 0.05). There was no significant difference in the time of resection range determined, labeling, submucosal injection and specimen resection handling between the two groups (P > 0.05). The time of mucous membrane dissection, hemostasis and wound handling of B group were significant shorter than that in A group (P < 0.05). Conclusion Compared with multiple times and points biopsies, targeted biopsy before surgery on patients with gastric cancer for early stage underwent ESD can efficiently reduce the trauma degree, improve the biopsy accuracy and be helpful to shorten the operation time.