The Clinical Study On Endoscopic Mucosal Resection And Endoscopic Submucosal Dissection For Early Rectal Carcinoma

Objective To evaluate whether endoscopic mucosal resection and endoscopic submucosal dissection are efficient and safe for rectal mucosal carcinoma.Methods Collect the clinical data of patients whose pathological results were rectal mucosal carcinoma between January2006and December2011. Fifty-seven patients were included. Thirty-one patients underwent endoscopic therapy, and the others underwent radical surgery. We compare the two groups from complete resection rate, complication occurrence rate, recovery after operation, hospitalization cost, local recurrence rate, distal metastasis occurrence rate, mortality rate, fecal incontinence rate.Results The complete resection rate of the two groups was100%. The complication occurrence rate of endoscopic therapy group was significant lower than that of radical surgery group(12.9%vs38.5%)(p=0.034) The recovery time of endoscopic therapy group was significantly shorter than that of radical surgery group:length of stay5.9d(2～12d) vs13.1d(9～20d)。(p=0.000); days to1st diet1.1d(0～2d) vs3.5d(3～5d)。(p=0.000); analgesic-used rate3.2%(1/31) vs23.1%(6/26)(p=0.039); days to urination0vs4.2d(2-9d)(p=0.000); days to peristalsis recovery0vs3.1d(3-4d)(p=0.000)。 The hospitalization cost of radical surgery group was significant higher than that of endoscopic therapy group:35599(27277～68662) vs13677(8681-22373)(p=0.000) The mean follow-up period of endoscopic therapy group was28months(range from5months to68months), and that of radical surgery group was26months(range from6months to62months).(P>0.05) In the follow-up period, local recurrence and distant metastasis was not be seen in both two groups. No dead case was seen in the follow-up period. The results of long-term quality of life were obviously different between the two groups. The fecal dysfunction rate of radical surgery group was significantly higher than that of endoscopic therapy group (38.1%vs0)(p=0.029)Conclusion Endoscopic therapy(Endoscopic mucosal resection and endoscopic submucosal dissection) is equal to the radical surgery in the treatment of rectal mucosal carcinoma with lower complication occurrence rate, shorter recovery time, less hospitalization cost and better defecation function.