牙线辅助滑轮牵引内镜黏膜下剥离术治疗早期胃癌及癌前病变的疗效与预后分析
Efficacy and prognosis analysis of pulley traction-assisted endoscopic submucosal dissection with dental floss for early gastric cancer and precancerous lesions.
作者信息
Luo Hao, Tang Jie, He Xiaotong, Shi Yinglei, Chang Yunli
机构信息
Department of Gastroenterology, Shanghai General Hospital, Shanghai, China.
Department of Gastroenterology, Jiangwan Hospital of Hongkou District, Shanghai, China.
出版信息
Front Surg. 2025 Jul 21;12:1477658. doi: 10.3389/fsurg.2025.1477658. eCollection 2025.
OBJECTIVE
To investigate the clinical efficacy of pulley traction-assisted endoscopic submucosal dissection (ESD) with dental floss in patients with early gastric cancer and precancerous lesions, and its impact on patient prognosis.
METHODS
Clinical data of 77 patients with early gastric cancer and precancerous lesions were retrospectively analyzed. The patients were divided into groups according to different treatment regimens; 38 patients in the control group underwent ESD, whereas 39 patients in the study group underwent pulley traction-assisted ESD with dental floss. Lesion resection status, perioperative indicators, gastrointestinal function indicators, complications, and recurrence were compared between the two groups.
RESULTS
The curative and resection rates in the study group were significantly higher than those in the control group, whereas the residual rate of basal lesions was significantly lower than that in the control group ( < 0.05). The study group experienced less intraoperative bleeding and had a significantly shorter operative time, anal exhaust time, first eating time, and length of hospital stay ( < 0.05). Three days postoperatively, motilin (MTL), gastrin (GAS), pepsinogen I (PG I), and pepsinogen II (PG II) levels were significantly reduced in both groups, with significantly higher levels in the study group ( < 0.05). The incidence of complications in the study group was 7.69% (3/39), which was significantly lower than that in the control group [26.32% (10/38); < 0.05]. Three months postoperatively, the quality of life scores (FACT-G) in all aspects significantly increased in both groups, with the study group showing significantly higher scores ( < 0.05). The recurrence rate at 12 months postoperatively in the study group (5.13%) was significantly lower than that in the control group (23.68%; < 0.05).
CONCLUSION
Pulley traction-assisted ESD with dental floss is effective in treating early gastric cancer and precancerous lesions.
目的
探讨牙线滑轮牵引辅助内镜黏膜下剥离术（ESD）治疗早期胃癌及癌前病变的临床疗效及其对患者预后的影响。
方法
回顾性分析77例早期胃癌及癌前病变患者的临床资料。根据不同治疗方案将患者分组；对照组38例患者接受ESD治疗，而研究组39例患者接受牙线滑轮牵引辅助ESD治疗。比较两组病变切除情况、围手术期指标、胃肠功能指标、并发症及复发情况。
结果
研究组的治愈率和切除率显著高于对照组，而基底病变残留率显著低于对照组（<0.05）。研究组术中出血较少，手术时间、肛门排气时间、首次进食时间和住院时间显著缩短（<0.05）。术后3天，两组胃动素（MTL）、胃泌素（GAS）、胃蛋白酶原I（PG I）和胃蛋白酶原II（PG II）水平均显著降低，研究组水平显著更高（<0.05）。研究组并发症发生率为7.69%（3/39），显著低于对照组[26.32%（10/38）；<0.05]。术后3个月，两组各方面生活质量评分（FACT-G）均显著提高，研究组评分显著更高（<0.05）。研究组术后12个月复发率（5.13%）显著低于对照组（23.68%；<0.05）。
结论
牙线滑轮牵引辅助ESD治疗早期胃癌及癌前病变有效。
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