Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Asan Digestive Disease Research Institute, Songpa-gu, Seoul, Korea.
Gastrointest Endosc. 2011 Sep;74(3):485-93. doi: 10.1016/j.gie.2011.04.038. Epub 2011 Jul 13.
Current guidelines for endoscopic management such as EMR and endoscopic submucosal dissection (ESD) in early gastric cancer (EGC) are in evolution, with broader indication criteria.
To determine the clinical outcomes of endoscopic treatment, based on absolute indication and extended indication criteria and endoscopic methods.
Retrospective study.
Tertiary-care, academic medical center.
EMR or ESD was performed on 1627 cases of EGC in 1447 patients from July 1994 to January 2009.
EMR and ESD.
Clinical outcomes of EGC after EMR or ESD, based on the indication criteria.
Although the complete resection rate was higher (95.9% vs 88.4%; P < .001), and the complication rate was lower (6.8% vs 9.8%; P = .054) in the absolute than in the extended indication group, there was no between-group difference in the local recurrence rate (0.9% vs 1.1%; P = .783) at a median follow-up period of 32 months (interquartile range 22-48 months). In the extended indication group, ESD resulted in a significantly higher complete resection rate than EMR (83.0% vs 91.1%; P = .006).
Retrospective study.
ESD in the extended indication group showed acceptable clinical outcomes with a relatively high complete resection rate and a low local recurrence rate.
目前，内镜下黏膜切除术（EMR）和内镜黏膜下剥离术（ESD）等早期胃癌（EGC）内镜治疗指南正在不断发展，适应证标准也在放宽。
根据绝对适应证和扩展适应证标准以及内镜方法，确定内镜治疗的临床效果。
回顾性研究。
三级学术医疗中心。
1994 年 7 月至 2009 年 1 月，对 1447 例患者的 1627 例 EGC 行 EMR 或 ESD 治疗。
EMR 和 ESD。
根据适应证标准，评估 EGC 患者行 EMR 或 ESD 后的临床效果。
尽管绝对适应证组的完全切除率（95.9% vs 88.4%；P <.001）更高，且并发症发生率（6.8% vs 9.8%；P =.054）更低，但在中位随访 32 个月（22~48 个月）期间，两组间的局部复发率（0.9% vs 1.1%；P =.783）并无差异。在扩展适应证组中，ESD 的完全切除率明显高于 EMR（83.0% vs 91.1%；P =.006）。
回顾性研究。
扩展适应证组中 ESD 的临床效果可接受，完全切除率较高，局部复发率较低。
