用于老年早期胃癌患者的离合器切割器内镜黏膜下剥离术的临床疗效
Clinical outcomes of Clutch Cutter endoscopic submucosal dissection for older patients with early gastric cancer.
作者信息
Otsuka Yoshihiro, Akahoshi Kazuya, Yasunaga Kayoko, Kubokawa Masaru, Gibo Junya, Osada Shigeki, Tokumaru Kayo, Miyamoto Kazuaki, Sato Takao, Shiratsuchi Yuki, Oya Masafumi, Koga Hidenobu, Ihara Eikichi, Nakamura Kazuhiko
机构信息
Department of Gastroenterology, Aso Iizuka Hospital, Iizuka 820-8505, Japan.
Diagnosis Procedure Combination Coding Management Office, Aso Iizuka Hospital, Iizuka 820-8505, Japan.
出版信息
World J Gastrointest Oncol. 2017 Oct 15;9(10):416-422. doi: 10.4251/wjgo.v9.i10.416.
AIM
To evaluate the clinical outcome of endoscopic submucosal dissection using the Clutch Cutter (ESDCC) in older patients.
METHODS
We reviewed 232 consecutive patients with early gastric cancer who underwent ESDCC between June 2010 and February 2014 at Aso Iizuka Hospital. We divided patients into two groups according to age: Older patients (> 80 years, = 64) and non-older patients (≤ 80 years, = 168). We retrospectively compared the prevalence rates of pre-existing comorbidities, anticoagulant therapy, resection, mean duration of hospitalization, incidence of ESDCC-related complications, change in performance status (PS) before and after ESDCC, and financial cost of admission.
RESULTS
The older group comprised 64 patients with a mean age of 84.1 years, and the non-older group comprised 168 patients with a mean age of 69.5 years. Older patients had significantly more pre-existing comorbidities than did non-older patients, specifically heart disease ( < 0.05). The resection rate in non-older patients was significantly higher than that in older patients (100% 95.3%, = 0.02). There were no significant differences between the older and non-older groups in the incidence of ESDCC-related complications (., postoperative bleeding and perforation) and the post-ESDCC change in PS. There were also no significant differences between the older and non-older groups in the mean duration of hospitalization (11.4 and 10.7 d, respectively) and financial cost of admission (657040 JPY and 574890 JPY, respectively).
CONCLUSION
ESDCC has a good clinical outcome in older patients.
目的
评估在老年患者中使用圈套切割器进行内镜黏膜下剥离术（ESDCC）的临床疗效。
方法
我们回顾性分析了2010年6月至2014年2月期间在阿苏饭冢医院接受ESDCC的232例连续性早期胃癌患者。根据年龄将患者分为两组：老年患者（>80岁，n = 64）和非老年患者（≤80岁，n = 168）。我们回顾性比较了既往合并症的患病率、抗凝治疗情况、切除率、平均住院时间、ESDCC相关并发症的发生率、ESDCC前后体能状态（PS）的变化以及住院费用。
结果
老年组有64例患者，平均年龄84.1岁，非老年组有168例患者，平均年龄69.5岁。老年患者既往合并症明显多于非老年患者，尤其是心脏病（P<0.05）。非老年患者的切除率显著高于老年患者（100%对95.3%，P = 0.02）。老年组和非老年组在ESDCC相关并发症（如术后出血和穿孔）的发生率以及ESDCC后PS的变化方面无显著差异。老年组和非老年组在平均住院时间（分别为11.4天和10.7天）和住院费用（分别为657040日元和574890日元）方面也无显著差异。
结论
ESDCC在老年患者中具有良好的临床疗效。
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