Clinical effect of endoscopic submucosal dissection in the treatment of gastrointestinal submucosal tumors
10.3760/cma.j.cn431274-20240726-01154
- VernacularTitle:内镜黏膜下剥离术治疗胃肠道黏膜下肿瘤的临床效果
- Author:
Ning WU
1
;
Xufan CAI
;
Zaiyuan YE
Author Information
1. 浙江树人大学树兰国际医学院附属树兰（杭州）医院内镜中心，杭州 310022
- Keywords:
Gastrointestinal neoplasms;
Submucosal tumor;
Endoscopic submucosal dissection
- From:
Journal of Chinese Physician
2024;26(8):1129-1132
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical efficacy of endoscopic submucosal dissection (ESD) in the treatment of gastrointestinal submucosal tumors (SMT).Methods:A retrospective analysis was conducted on the clinical data of 114 SMT patients who underwent ESD treatment at the Endoscopy Center of the Shulan (Hangzhou) Hospital from January 1, 2023 to December 31, 2023. The use of mucosal incision during surgery, surgical related indicators, and postoperative recovery were observed.Results:The age of the patients in this group ranged from 22-84(61.0±12.0)years old, with 62 males and 52 females. Tumors were located in 5 cases of esophagus, 2 cases of cardia, 11 cases of gastric fundus, 7 cases of gastric body, 3 cases of gastric angle, 13 cases of gastric antrum, 38 cases of colon, 11 cases of sigmoid colon, and 24 cases of rectum. All tumors were located in the submucosal layer, with 55 cases of benign lesions, 44 cases of precancerous lesions, and 15 cases of malignant tumor lesions. All patients successfully completed the surgery without any serious complications or deaths. During the operation, 59 cases used Dual knives, the surgical cost was 5 082.44-12 515.51(8 657.34±1 471.23)yuan, the total hospitalization cost was 10 878.02-32 310.74(18 934.47±4 404.21)yuan; 55 cases used snare devices, the surgical cost was 3 159.87-9 970.71(5 597.37±1 587.78)yuan, the total hospitalization cost was 6 985.92-40 309.26(13 807.12±5 213.76)yuan, the surgical time was 18-204(63.07±35.48)minutes; there were 22 cases of intraoperative bleeding, 8 cases of intraoperative perforation, 36 cases of fasting for 48 hours after surgery, 78 cases of fasting for 72 hours after surgery, and the postoperative hospitalization time was 3-16(6.91±2.38)days. Postoperative complications such as abdominal pain, bloating, and fever occurred in 14 cases. After surgery, 5 patients underwent surgical salvage surgery due to pathological indications of malignant tumors with infiltration depth>500 μm (>1 000 μm in the colon).Conclusions:ESD treatment for SMT is safe and feasible. For different sizes of gastrointestinal SMT, each endoscopic center and surgeon should comprehensively consider factors such as tumor characteristics, treatment effectiveness, and cost-effectiveness balance when selecting the corresponding surgical type and consumables.
