Early gastric cancer(EGC) that has a better prognosis is superficial in the depth and low in the rate of lymph node metastasis.A standard treatment of gastrectomy and lymph node resection can radically removc EGC,however,it inflicts a greater trauma on patients,and has a greater impact on postoperative quality of life.Compared with surgery,endoscopic resection(ER) approaches a similar outcome and thus becomes a new research hotspot.However,accurate assessment of lymph node metastasis before procedure and indication of ER is crucial to the safety of treatment.This article will give an overview of current research status of indication of endoscopic treatment.

Objective:To analyze the negative effect of prolonged postoperative ileus on postoperative recovery in patients underwent open alimentary tract surgery.Methods:This study was a retrospective cohort study. The subjects of the study were patients who underwent open gastrointestinal surgery at the General Surgery Department of Beijing Friendship Hospital, Capital Medical University from October 2016 to November 2018. According to the PPOI diagnostic criteria proposed by the University of Auckland, the included patients were classified as PPOI Group ( n=14) and non-PPOI group ( n=112). The postoperative complications, postoperative hospital stay and medical expenses during hospitalization were selected as the study endpoint indicators. T-test or Fisher′s exact test were performed to compare the differences between the two groups, and linear regression analysis was used to explore the independent effects of PPOI on hospital stay and medical expenses. Results:The incidence of PPOI in this study cohort was 11.1%. The total postoperative complications occurred more frequent in PPOI group (64.29% vs 38.39%, P=0.08). The average postoperative hospital stay of patients in the PPOI group was longer than that in non-PPOI group [(21.21±14.83) d vs (13.98±14.21) d, P=0.070]. Adjusting for various possible confounding factors, the PPOI regression coefficient beta (95% CI) that affects the length of hospital stay was [-0.43 (-7.16, 6.3), P=0.90]. The average medical cost of patients in the PPOI group was more than that in non-PPOI group [(104 389.64±52 427.66)元比(79 111.41±50 832.29)元, P=0.070]. Adjusting for various possible confounding factors, the PPOI regression coefficient beta (95% CI) that affects medical expenditure was [-134.12 (-21656.85, 21388.62), P=0.99]. Conclusions:Prolonged postoperative ileus leads to delayed postoperative recovery, which is related to increased postoperative complications, hospital stay duration and medical cost. But it needs further confirmation from large sample data.