Clinical Research Of ESD In The Treatment Of Early Esophageal Cancer And Precancerous Lesions

Objectives: To investigate the efficacy and safety of endoscopic submucosal dissection(ESD)in the treatment of early esophageal cancer and precancerous lesions,and to explore the clinical value of ESD in the treatment of early esophageal cancer and precancerous lesions.Methods: This research retrospectively analyzed the clinical data of 62 patients with early esophageal cancer and precancerous lesions treated by endoscopic submucosal dissection(ESD)in the Department of Gastroenterology,Handan Central Hospital from September 2016 to December 2018.This research evaluates general condition,pathological results,curative effect indexes(en bloc resection rate,complete resection rate,curative resection rate),complications and recurrence rate in a comprehensive manner.Results: A total of 62 patients with early esophageal cancer and precancerous lesions completed ESD treatment.Among these people,45 were male and 17 were female,whose average age was 63.82±7.96 years.The lesions were located in the upper esophagus in 9 cases,the middle esophagus in 37 cases,and the lower esophagus in 16 cases.The average length of the lesions was 31.34±10.71 mm,the average operation time was 70.73±24.86 min,the average hospital stay was 11.06±3.14 d,and the average hospitalization cost was 25890.31±4945.55 yuan.Postoperative pathological diagnosis was LGIN,HGIN and squamous cell carcinoma was 4 cases(6.45%),43 cases(69.36%)and 15 cases(24.19%)respectively.The overall coincidence rate of preoperative and postoperative pathological diagnosis was 67.74%(42/62).The en bloc resection rate was 100.00%,the complete resection rate was 96.77%(60/62),and the curative resection rate was 96.77%(60/62).The incidence of complications was 11.29%(7/62),including 1case of intraoperative perforation(1.61%)and 6 cases of postoperative stenosis(9.68%),all improved by endoscopic treatment,without intraoperative massive bleeding or postoperative delayed bleeding.The average follow-up of this research was15.50±6.42 months,with a recurrence rate of 0.00%.Conclusions: ESD is an effective and safe minimally invasive treatment for early esophageal cancer and precancerous lesions.Under this treatment,high en bloc and curative resection rate,controllable complications,a low recurrence rate could be obtained,a complete pathological data could be collected as well.Moreover,it enabledshort hospital stay and low cost for patients.Overall,ESD has a widely-applied value and good development prospect in city-level hospital.