Comparison of effects of endoscopic mucosal dissection and endoscopic mucosal resection on gastrointestinal function in patients with early gastric cancer

doi:10.11958/20241202

Abstract

Abstract:

Objective To compare the effects of endoscopic mucosal dissection (ESD) and endoscopic mucosal resection (EMR) on gastrointestinal function in patients with early gastric cancer. Methods According to different treatment methods, 86 patients with early gastric cancer were divided into the ESD group and the EMR group, with 43 cases in each group. The operation duration, postoperative exhaust time and hospital stay of the two groups were observed and compared. Inflammatory factors including interleukin (IL-6) and IL-8 before surgery and 1 month after surgery were compared between the two groups of patients. Gastrointestinal hormone indexes including motilin (MTL), gastrin (GAS), apoptosis-related factors including anti-apoptotic factor (Livin) and epidermal growth factor (EGF), European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Scale (QLQ-C30) score before surgery, 3 months after surgery and 6 months after surgery were compared between the two groups of patients. An adverse reaction was also compared between the two groups of patients. Results The operation time, postoperative exhaust time and hospital stay were shorter in the ESD group than those of the EMR group (P<0.05), and the intraoperative blood loss was significantly less than that of the EMR group (P<0.05). Compared with the pre-operation, serological indexes such as IL-6, IL-8, MTL, GAS and Livin were decreased after surgery in the two groups (P<0.05). One month after surgery, IL-6, IL-8 and Livin were decreased, and MTL and GAS were increased in the ESD group compared with those of the EMR group (P<0.05). QLQ-C30 scores were higher at 3 months and 6 months after operation than those before operation in both groups, and the QLQ-C30 scores of the two groups were significantly higher at 6 months after operation (P<0.05). The scale scores of the ESD group were significantly higher than those of the EMR group at 3 months and 6 months after operation (P<0.05). The overall incidence rates of adverse reactions were (4.65%) in the ESD group and (20.93%) in the EMR group (P<0.05). Conclusion Compared with EMR, ESD can more effectively improve the gastrointestinal function, improve the quality of life and reduce the levels of inflammation and apoptosis-related factors in patients with early gastric cancer.

Key words: stomach neoplasms, endoscopic mucosal resection, quality of life, Livin, gastrointestinal function

CLC Number:

R735.2，R61

Figures/Tables 4

References 19

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组别		性别（男/女）	年龄/岁		病灶直径/cm
EMR组		24/19	48.86±7.21		2.14±0.55
ESD组		26/17	48.21±7.48		2.02±0.64
t或χ²		0.191	0.410		0.932
组别	内镜下分型				病变位置
组别	表浅凹陷型	表浅隆起型	息肉样隆起型	平坦型	胃窦	贲门	胃体
EMR组	15	16	5	7	23	10	10
ESD组	19	12	8	4	21	14	8
χ²	2.553				0.980

组别		性别（男/女）	年龄/岁		病灶直径/cm
EMR组		24/19	48.86±7.21		2.14±0.55
ESD组		26/17	48.21±7.48		2.02±0.64
t或χ²		0.191	0.410		0.932
组别	内镜下分型				病变位置
组别	表浅凹陷型	表浅隆起型	息肉样隆起型	平坦型	胃窦	贲门	胃体
EMR组	15	16	5	7	23	10	10
ESD组	19	12	8	4	21	14	8
χ²	2.553				0.980

组别	手术时长/min	术中出血量/mL	术后排气时间/h	住院时间/d
EMR组	84.12±6.96	82.75±6.33	5.11±1.46	10.08±3.06
ESD组	75.42±7.68	69.64±5.34	4.09±0.83	7.14±2.28
t	5.501^＊＊	10.383^＊＊	3.983^＊＊	5.034^＊＊

组别	手术时长/min	术中出血量/mL	术后排气时间/h	住院时间/d
EMR组	84.12±6.96	82.75±6.33	5.11±1.46	10.08±3.06
ESD组	75.42±7.68	69.64±5.34	4.09±0.83	7.14±2.28
t	5.501^＊＊	10.383^＊＊	3.983^＊＊	5.034^＊＊

组别	术前	术后3个月	术后6个月
EMR组	50.12±5.22	61.27±6.67	68.43±6.88
ESD组	48.87±5.46	66.43±6.82	76.24±7.75
t	1.085	3.547^＊＊	4.942^＊＊