作者：陆友祝，余超，孙玉立，肖君，韩树堂

单位：南京中医药大学附属医院 消化内镜中心，江苏 南京 210000

Authors:  LU Youzhu, YU Chao, SUN Yuli, XIAO Jun, HAN Shutang

Unit:   Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Digestive Endoscopic Center, Nanjing 210000, Jiangsu, China

摘要：

目的  探讨早期胃癌患者接受内镜粘膜下剥离术(endoscopic submucosal dissection,ESD)治疗后是否需要追加治疗,如手术或化疗。方法  回顾性分析2010年至2017年因早期胃癌于我院住院接受ESD治疗及手术或化疗的70例患者,平均随访时间为46.4月。53例单纯接受ESD治疗者为对照组,17例ESD术后追加手术或化疗者为实验组,比较两组患者的生存率、复发率及不良反应发生率(包括反酸、腹痛、腹胀、恶心、呕吐、早饱、嗳气及便秘等)是否存在差异。结果  两组患者在生存率及复发率方面无显著差异,但是对照组患者不良反应发生率显著低于实验组患者。结论  ESD是治疗早期胃癌有效且安全的方法 。

关键词： 内镜粘膜下剥离术（ESD）; 早期胃癌; 手术; 化疗

Abstract：

Objective  This study aimed to compare the efficacy and side effects of endoscopic submucosal dissection (ESD) with or without further intervention for early gastric cancer. Methods Medical records of 70 patients with EGC from January 2010 to January 2017 were respectively reviewed, and the median follow-up duration was 46.4 months. 53 patients only received ESD treatment (control group), while 17 patients received further intervention after ESD (experimental group) in which 9 patients received surgery and 8 patients received chemotherapy. Survival rate, recurrence rate and side effects were compared between the two groups. Side effects included acid reflux, stomachache, abdominal distension, nausea, vomiting, early satiety, belching, diarrhea and constipation. Results  The overall survival rate and recurrence rate had no significant difference between two groups, but the incidence rate of side effects in control group was significantly lower than experimental group except constipation. Conclusion  ESD could be an efficient and safe option for EGC patients.

Key Words:  Endoscopic submucosal dissection (ESD); Early gastric cancer; Surgery; Chemotherapy