Department of Gastroenterology and Hepatology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
Sci Rep. 2022 Jul 1;12(1):11142. doi: 10.1038/s41598-022-15410-4.
Endoscopic submucosal dissection (ESD) is a minimally invasive treatment option for superficial esophageal cancer (SEC) with high rates of complete resection. However, limited research exists on the efficacy of ESD for SEC in gastrectomized patients. This study aimed to evaluate the efficacy of ESD for SEC in gastrectomized patients. We included 318 patients of SEC treated at our institution between April 2005 and October 2021. To minimize bias between the gastrectomized and non-gastrectomized groups, we conducted a propensity-score matched analysis and compared the ESD outcomes for SEC of the two groups. Of the 318 patients included in the study, 48 and 270 patients were in the gastrectomized and non-gastrectomized groups, respectively. After 1:2 propensity-score matching, we matched 44 patients in the gastrectomized group to 88 patients in the non-gastrectomized group, and found no significant differences in the baseline clinicopathological characteristics. Regarding the ESD outcomes, there were no significant differences in the complete resection rate, procedure time, hospitalized period, and recurrence rates between the two groups. Multivariate analysis also cofirmed that the history of gastrectomy was not a risk factor of the difficult case of esophageal ESD. In conclusion, history of gastrectomy might not negatively affect the ESD outcomes of SECs.
内镜黏膜下剥离术(ESD)是治疗早期食管癌(SEC)的一种微创治疗选择,其完全切除率较高。然而,关于胃切除术后患者行 ESD 治疗 SEC 的疗效的研究有限。本研究旨在评估 ESD 治疗胃切除术后 SEC 的疗效。我们纳入了 2005 年 4 月至 2021 年 10 月在我院接受治疗的 318 例 SEC 患者。为了最大程度地减少胃切除组和非胃切除组之间的偏倚,我们进行了倾向评分匹配分析,并比较了两组 SEC 的 ESD 治疗结果。在这项研究中,318 例患者中,胃切除组和非胃切除组分别为 48 例和 270 例。经过 1:2 的倾向评分匹配,我们将胃切除组的 44 例患者与非胃切除组的 88 例患者相匹配,发现两组患者的基线临床病理特征无显著差异。在 ESD 治疗结果方面,两组患者的完全切除率、手术时间、住院时间和复发率均无显著差异。多因素分析也证实,胃切除术史不是食管 ESD 困难病例的危险因素。总之,胃切除术史可能不会对 SEC 的 ESD 治疗结果产生负面影响。