Department of Gastroenterology, Shenzhen People's Hospital, Second Clinical Medical College, Jinan University, Guangzhou, China.
First Affiliated Hospital, Southern University of Science and Technology, Shenzhen 518020, Guangdong, China.
Can J Gastroenterol Hepatol. 2022 Aug 17;2022:7957877. doi: 10.1155/2022/7957877. eCollection 2022.
This study compared the efficacy and safety of endoscopic submucosal dissection (ESD) combined with clip-and-snare method and a prelooping technique (CSM-PLT) with ESD alone for the treatment of gastric submucosal tumors (gSMTs).
We retrospectively enrolled a matched group of 86 patients who received ESD combined with CSM-PLT or ESD alone from July 2010 to July 2020. The primary outcomes included complete resection, en bloc resection, and R0 resection.
Eighty-six patients with gSMTs were enrolled in ESD combined with CSM-PLT group and ESD group, respectively. There were no significant differences in gender, age, tumor size, tumor location, and tumor origin between the two groups. The complete resection, en bloc resection, and R0 resection rates were comparable between two groups (=1, =0.31, and =0.25, respectively). There were no significant differences in terms of hospital stays, hospitalization cost, postoperative complications, and residual rate (=0.42, =0.74, =0.65, and =1, respectively) between the two groups. However, the ESD combined with CSM-PLT was associated with a shorter procedure duration and fewer intraoperative complications ( < 0.001 and =0.024, respectively). In addition, the incidence of intraoperative bleeding in ESD combined with CSM-PLT group was significantly lower than that in ESD group (=0.04).
Both ESD combined with CSM-PLT and ESD were effective and safe modalities for the treatment of gSMTs. However, ESD combined with CSM-PLT was associated with a shorter procedure duration and fewer intraoperative complications.
本研究比较了内镜黏膜下剥离术（ESD）联合夹-套扎法（CSM-PLT）与单纯 ESD 治疗胃黏膜下肿瘤（gSMTs）的疗效和安全性。
我们回顾性纳入了 2010 年 7 月至 2020 年 7 月接受 ESD 联合 CSM-PLT 或单纯 ESD 治疗的 86 例患者的匹配组。主要结局包括完全切除、整块切除和 R0 切除。
86 例 gSMTs 患者分别纳入 ESD 联合 CSM-PLT 组和 ESD 组，两组间性别、年龄、肿瘤大小、肿瘤位置和肿瘤起源无显著差异。两组的完全切除、整块切除和 R0 切除率相当（=1，=0.31，=0.25）。两组间住院时间、住院费用、术后并发症和残余率无显著差异（=0.42，=0.74，=0.65，=1）。然而，ESD 联合 CSM-PLT 与手术时间更短、术中并发症更少相关（<0.001 和=0.024）。此外，ESD 联合 CSM-PLT 组术中出血的发生率明显低于 ESD 组（=0.04）。
ESD 联合 CSM-PLT 和单纯 ESD 均是治疗 gSMTs 的有效且安全的方法，但 ESD 联合 CSM-PLT 具有手术时间更短、术中并发症更少的优势。
