不同黏膜切口方式在内镜黏膜下剥离术治疗胃黏膜下肿物中的临床疗效比较

Comparison of clinical efficacy of different mucosal incision methods in endoscopic submucosal dissection for the treatment of gastric submucosal tumors

摘要:

目的 探讨不同黏膜切口方式在内镜黏膜下剥离术（ESD）治疗胃黏膜下肿物中的临床疗效。方法 回顾性分析2022年7月－2024年3月该院30例因胃黏膜下肿物行ESD治疗的患者的临床资料，根据黏膜切口方式不同，将患者分为环形组（n = 15）和纵行组（n = 15）。比较两组患者病理资料、临床疗效、手术情况和并发症。结果 两组患者住院时间、治疗费用、病灶直径、病灶部位和病变性质比较，差异均无统计学意义（P > 0.05）；纵行组手术时间明显短于环形组，差异有统计学意义（P < 0.05）；纵行组术中并发症总发生率与环形组比较，差异无统计学意义（P > 0.05）；纵行组完全切除率低于环形组，但差异无统计学意义（P > 0.05）。结论 ESD治疗胃黏膜下肿物安全有效，纵行切口较环形切口可缩短手术时间，两种方法均具有并发症发生率低和完全切除率高等特点，值得应用于临床。

Abstract:

Objective To explore the clinical efficacy of different mucosal incision methods in endoscopic submucosal dissection (ESD) for the treatment of gastric submucosal tumors.Methods A retrospective analysis was conducted on the clinical data of 30 patients with gastric submucosal tumors treated with ESD from July 2022 to March 2024. They were divided into a circular group (n = 15) and a longitudinal group (n = 15) based on different mucosal incision methods. Then compare the pathological data, clinical efficacy, surgical outcomes, and complications between the two groups.Results There were no statistically significant differences between the two groups in length of hospital stay, hospitalization costs, lesion diameter, lesion location and lesion nature (P > 0.05). The surgical time of the longitudinal group was significantly shorter than that of the circular group, and the difference was statistically significant (P < 0.05); There was no statistical significant in the incidence of intraoperative complications in the longitudinal group and the circular group (P > 0.05); The complete resection rate of the longitudinal group was lower than that of the circular group, but the difference was not statistically significant (P > 0.05).Conclusion ESD treatment for gastric submucosal tumors is safe and effective, and the longitudinal incision can shorten the surgical time compared to the circular incision. Both methods have the characteristics of low incidence of complications and high complete resection rate, and are worthy of clinical application.