A Comparing Of Endoscopic Submucosal Dissection (ESD)with Surgery In Early Esophageal Cancer

Back ground: Endoscopic submucosal dissection is emerging as an alternative to surgical therapy in patients early esophageal cancer(EEC)given the low likelihood of lymph node metastases. Long term outcomes of patients treated ESD and surgically for Esophageal squamous cell carcinoma(ESCC)are few.Objective:To discuss the efficacy of ESD and surgical treatment of early esophageal cancer and to compare their advantages and disadvantages, to provide reference and guidance for the treatment of early esophageal cancer.Methods: Patients treated for EEC between November 2007 and November 2015 were included. According to the different treatment methods, patients were divided into an ESD group(treated endoscopically) and a Surgery group(treated surgically). The relative economic indexes, tumor characteristics, complications and survival rate were compared and analyzed by retrospective study.Results: According to strict inclusion and exclusion criteria,96 patients were included of which 43(45 %) were in the ESD group and 53(55%) were in the Surgery group. There were no significant differences in gender, age, tumor characteristics, and follow-up time between the two groups. The relevant time( length of operation, fasting time, time of gastrointestinal decompression, hospital stay after operation, hospital days) of Surgery group was longer(p<0.001),the related costs(surgery costs, inspection fee, hospitalization expenses)was higher(p<0.001). The incidence of intraoperative(6.9% vs30.2%) and postoperative complications(11.6% vs35.8%)was lower in group ESD(p<0.05). There were 2 cases(4.7%) recurrence in the ESD group, and there was no recurrence in the surgical operation group. There was a significant difference. The 3 year survival rates of ESD group and surgical group was90.0%and90.3% and there were no significant difference between two groups(p>0.05).QLQ-C30 EORTC was used to compare the quality of life of patients, and the ESD group had a higher quality of life.Conclusions: ESD is an effective method for the treatment of early esophageal cancer.Overall survival in patients ECC when treated ESD appears to be comparable to that of patients treated surgically. It can be used as the primary treatment of early esophageal cancer.