Study On The 5-year Survival Rate And Recurrence Rate After ESD Of Early Esophageal Cancer And The Intervention Effect Of Traditional Chinese Medicine

Purposes:1.To review the 5-year survival rate,recurrence rate and quality of life of patients with early esophageal cancer after ESD,and to evaluate the long-term efficacy of ESD in the treatment of early esophageal cancer.2.To evaluate the clinical efficacy of Chinese herbal medicine Shenshu Ercao Decoction in the treatment of patients with early esophageal cancer after ESD.Methods:the haitai case system of jiangsu hospital of traditional Chinese medicine was used to collect the patients who received endoscopic treatment for esophageal mucosal lesions in the digestive endoscopy center from January 2010 to January 2014,and whose postoperative pathology met the diagnostic criteria for early esophageal cancer.Search original paper cases according to the number of admission to the medical record room,take photos of the cases that meet the requirements of return visit,collect information,and make Excel sheets.The patients were revisited by telephone according to the contact information registered during hospitalization,and the gastroscopy and pathological results of the previous reviews were recorded,as well as whether the patient took Shenshu Ercao Decoction and the time of taking the medicine.The patients who took Shenshu Ercao Decoction and those who did not were divided into the traditional Chinese medicine group and the control group,and the recurrence rate and symptom improvement of the two groups were compared by statistical software.Results:a total of 53 patients with early esophageal cancer were successfully revisited,with no death(1 case),survival rate(100.0%),recur:rence rate(0.0%),recurrence rate(7 cases)and recurrence rate(13.2%).The results showed that the recurrence rate of tumor with infiltration depth up to submucosa,multiple lesions,and postoperative alcohol and tobacco addiction was higher.Among the 53 patients,30 patients in the traditional Chinese medicine group,1 patient had recurrent neoplasia,23 patients in the control group,and 6 patients had recurrent neoplasia,the difference was statistically significant(P<0.05),suggesting that Shenshu Ercao Decoction could inhibit esophageal mucosal epithelial dysplasia to some extent.There were 23 patients who took Chinese medicine for more than 1 year,and there was no recurrence of neoplasia in 1 patient;there were 7 patients who took Chinese medicine for less than 1 year,and 1 case of recurrence of neoplasia,and the difference was statistically significant(P<0.05),suggesting that the longer the time of taking Shenshu Ercao Decoction,the better the effect of inhibiting esophageal mucosal epithelial dysplasia.One month after ESD surgery,the scores of symptoms of retrosternal pain,full of thoracic diaphragm,acid regurgitation,nausea and vomiting,difficulty in falling asleep,poor appetite,and fatigue in the traditional Chinese medicine group were lower than those in the control group(P<0.05),and there was no statistical difference in the scores of symptoms of eating infarction and choking between the two groups(P<0.05).Six months after ESD surgery,the single symptom scores of the two groups were lower,although the single symptom scores of the traditional Chinese medicine group were slightly lower than the control group,but the comparison was not statistically significant(P>0.05).It is suggested that Shenshu Ercao Decoction can help improve the postoperative symptoms of early esophageal cancer ESD.Most of the 53 patients had a good postoperative life,and 5 patients had postoperative esophageal stenosis,which was relieved after endoscop.ic dilatation and stent implantation.The factors related to esophageal stenosis were analyzed:the maximum diameter of the lesion,the area of the lesion resected,and the ratio of the total area of the lesion resected to the circumference of the esophagus were the related factors influencing the esophageal stenosis after ESD.Conclusions:1.ESD is effective in the treatment of early esophageal cancer.2.Shenshu Ercao Decoction can help improve postoperative symptoms of ESD,inhibit esophageal mucosal epithelial dysplasia to a certain extent,slow down the precancerous process of esophageal cancer,and thus prevent early esophageal cancer.