设为首页 | 加入收藏
| 欢迎光临本站!

消化内镜学分会官方网站

当前位置:文献追踪 > 国内外期刊

对早期胃癌进行內镜切除后的內镜结果和控瘤效果:1370例绝对和扩大适应症

发布日期:2014-1-29 12:40:18 文章来源:GIE 作者次数:1267
    背景
    目前随着适应症标准越来越广泛,像内镜黏膜切除术(EMR)和内镜黏膜下层剥离术(ESD)等对早期胃癌(EGC)的內镜治疗指导方针也一直在发展。
    目的
    根据绝对适应症标准、扩大适应症标准和內镜检查方法,确定內镜治疗的临床效果
    设计
    回顾性研究
    环境
    患者
    自1994年7月至2009年1月对1447例患者共进行了1627份早期胃癌(EGC)的内镜黏膜切除术(EMR)或内镜黏膜下剥离术(ESD)。
    干预
    内镜黏膜切除术(EMR)和内镜黏膜下剥离术(ESD)。
    主要测量结果
    以适应症标准为基础的内镜黏膜切除术(EMR)或内镜黏膜下剥离术(ESD)后的临床结果。
    结果
    尽管绝对适应症组中的完整切除率高于扩展指标组(95.9%对88.4%,P <0.001),而且其并发症发生率低于扩展指标组(6.8%对9.8%,P =0.054);但是在中值为32个月(四分位间距为22-48个月)的随访期间两组间的局部复发率没有差异,其复发率分别为0.9%、1.1%且P=0.783。在扩展指标组中ESD(内镜黏膜下剥离术)的完整切除率明显高于EMR(内镜黏膜切除术)(83.0%对91.1%,P =0.006)
    局限性
    回顾性研究。
    结论
    扩展指标组中的ESD的临床结果易于患者接受,且完整切除率相对较高,局部复发率较低。
    缩写词EGC为早期胃癌,ESD为视镜黏膜下切除术
     
    ------------------------------------------------------------------------------------------------------------------
    Endoscopic and oncologic outcomes after endoscopic resection for early gastric cancer: 1370 cases of absolute and extended indications
    Background
    Current guidelines for endoscopic management such as EMR and endoscopic submucosal dissection (ESD) in early gastric cancer (EGC) are in evolution, with broader indication criteria.
    Objective
    To determine the clinical outcomes of endoscopic treatment, based on absolute indication and extended indication criteria and endoscopic methods.
    Design
    Retrospective study.
    Setting
    Tertiary-care, academic medical center.
    Patients
    EMR or ESD was performed on 1627 cases of EGC in 1447 patients from July 1994 to January 2009.
    Intervention
    EMR and ESD.
    Main Outcome Measurements
    Clinical outcomes of EGC after EMR or ESD, based on the indication criteria.
    Results
    Although the complete resection rate was higher (95.9% vs 88.4%; P < .001), and the complication rate was lower (6.8% vs 9.8%; P = .054) in the absolute than in the extended indication group, there was no between-group difference in the local recurrence rate (0.9% vs 1.1%; P = .783) at a median follow-up period of 32 months (interquartile range 22-48 months). In the extended indication group, ESD resulted in a significantly higher complete resection rate than EMR (83.0% vs 91.1%; P = .006).
    Limitations
    Retrospective study.
    Conclusion
    ESD in the extended indication group showed acceptable clinical outcomes with a relatively high complete resection rate and a low local recurrence rate.
     
     
    (作者:)
相关评论
用户名: 登录