Comparison Of EMR-L And ESD In Treatment Of Patients With Gastrointestinal Neuroendocrine Tumors

Objective:Through retrospective analysis of endoscopic mucosal resection with a ligation device(EMR-L)and endoscopic submucosal dissection(ESD)in the treatment of gastrointestinal neuroendocrine tumors on perioperative clinical parameters,en bloc resection rate,complete resection rate and complications,the clinical data of the two surgical methods were compared,effectiveness and safety of EMR-L and ESD were analyzed,so as to provide a theoretical basis for the reasonable treatment options.Method:Retrospective collection of 60 patients who were admitted to the Gastroenterology Department of Shenzhen Second People’s Hospital and Shenzhen Longhua Central Hospital from January 2018 to October 2020 and were pathologically diagnosed as gastrointestinal neuroendocrine tumors as the study subjects.According to different surgical treatment schemes,they were divided into ESD group and EMR-L group,46 cases in ESD group,and 14 cases in EMR-L group.Comparison of perioperative clinical parameters(including operation time,hospitalization time,the treatment cost,the lesion size),diseased tissue resection(including en bloc resection rate,complete resection rate)and postoperative complications(including intraoperative Bleeding,delayed postoperative bleeding,perforation,postoperative abdominal discomfort).Results:1.There was no statistically significant difference in age,height,weight,and baseline data of lesions between the two groups of patients(P>0.05),and they were comparable;2.perioperative clinical parameters:ESD group had more operation time and treatment costs than the EMR-L group(P<0.05),there was no statistical difference in the time of hospitalization(P>0.05),and there was no statistical difference in the lesion size between the two groups(P>0.05);3.Resection of the diseased tissue:There was no significant difference in the en bloc resection rate and complete resection rate in the ESD group and EMR-L group(P>0.05);4.Postoperative complications:The total incidence of complications in the EMR-L group was 7.1%,which was lower than that in the ESD group 36.9%,there was a statistical difference(P<0.05),of which there was only 1 case of postoperative delayed bleeding in the EMR-L group,7 cases of intraoperative bleeding,3 cases of delayed postoperative bleeding,and 1 case of perforation,6 cases of abdominal discomfort after operation in the ESD group.Conclusion:EMR-L and ESD of endoscopic surgery in the treatment of patients with gastrointestinal neuroendocrine tumors possess the same clinical effects;EMR-L application can efficiently shorten the operation time,decrease the economic burden and reduce the complication risk.However,the selected sample size of the study is small,and more data needs to be collected to confirm its results.