Synthetic evaluation of precancerous lesions and early esophageal cancers after endoscopic submucosal dissection / 中南大学学报(医学版)

OBJECTIVE@#To evaluate the safety and prognosis for patients with early esophageal cancer and precancerous lesions after endoscopic submucosal dissection (ESD).
@*METHODS@#A total of 89 patients were admitted to the Department of internal medicine in the First People's Hospital of Anqing from August 2008 to August 2011. All patients were treated with ESD at the early stage of esophageal cancer and precancerous lesions. The patients' laboratory data and relevant medical history were collected. The postoperative complications and long-term effects of ESD were analyzed.
@*RESULTS@#Eighty-nine patients were followed up with 100% response rate. Among 89 cases, 16 were early esophageal cancer, 38 were high-grade esophageal neoplasia and 35 were low-grade esophageal neoplasia. The one-time whole piece resection rate, complete resection rate and curative resection rate was 93.3% (84/89), 92.1% (82/89) and 92.1% (82/89), respectively. Two cases suffered intraoperative perforation with a rate of 2.2% and these 2 patients performed the intraoperative endoscopic repair; one case suffered the postoperative delayed bleeding with a rate of 1.1% and the patient underwent the conservative treatment; three cases suffered the esophageal stenosis with a rate of 3.4%. All patients were followed-up for 10-58 (36.3±21.2) months. In this period, one case recurred after ESD for 3 years with a rate of 1.1%; two cases were dead. The three-year survival rate was 97.8%.
@*CONCLUSION@#The early esophageal cancer and precancerous lesions can be treated with ESD. The method is safe and the prognosis is good.

Comparison on the therapeutic efficacies of endoscopic submucosal dissection and surgical operation treatment of early gastrointestinal cancers / 中国医师杂志

Objective To compare the therapeutic efficacies of endoscopic submucosal dissection and surgical operation treatment of early gastrointestinal cancers.Methods Sixty patients with early gastrointestinal cancer were divided into the endoscopic submucosal dissection (ESD) treatment group (n =33patients) and surgical operation treatment group (n =27 patients).During the treatment,success rate,survival time,recurrence and metastasis,nutritional status,adverse reaction and complication rate,hospital stay,and cost of treatment were observed for two groups.Results No statistical significances in success rate,survival time,recurrence and metastasis were found between two groups (P ＞ 0.05).The rate of normal nutritional status value was 90.9％ (30/33) in group ESD and 66.7％ (18/27) in the surgical group with a statistically significant difference between two groups (P ＜ 0.05).The rate of adverse reaction and complication was 9.09％ (3/33) in group ESD and 59.2％ (16/27) in the surgical group with a statistically significant difference between two groups (P ＜ 0.05,P ＜ 0.01).The average length of stay (14,81 ± 3.27) days and the average hospitalization expenses (10562.01 ± 3060.08) Yuan were occurred in the group ESD.The average length of hospital stay (19.22 ± 6.91)days and the average hospitalization expenses (16587.87 ±5664.50)Yuan were occurred in the surgical group.The average length of hospital stay in surgical group was longer 4,41 days than group ESD.The average hospitalization expense in surgical group was 6025.86 yuan more than the ESD group.Conclusions The curative effects of ESD treatment was similar to surgical operation,and there was a lower postoperative adverse reaction rate,a shorter time of hospitalization,a relatively low cost of treatment for ESD treatment compared to the surgical operation.Moreover,ESD treatment can especially keep the gastrointestinal integrity for patients,and the life quality rises significantly.

Clinical study of TACE combined PEI in treatment of primary hepatic carcinoma / 介入放射学杂志

Objective To compare the transcatheter hepatic arterial chemoembolization(TACE) combined percutaneous ethanol injection(PEI)in treating primary hepatic carcinoma and the simple TACE treatment. Methods 64 primary hepatic carcinoma patients were divided into union treatment group(n = 32)and TACE group(n = 32),with TACE combined PEI treatment and simple TACE treatment,respectively. The tumor size,AFP change,one year,two years,three years survival time and median survival time were observed and recorded during the course of treatment. Results The tumor shrinkage rates and the AFP transferring into negative rates of the union and simple TACE groups were 84.4%,62.7% and 77.4%,50% respectively after the treatment with significant difference between the two groups. The 1 years,2 years,3 years and median survival rates of the union and simple TACE groups were 96.9%,71.9%,37.5%,34.5 mo and 81.3%,31.3%,12.5%,19.5 mo,respectively,showing conspicuously significance of both groups. Conclusion TACE combined PEI for primary hepatic carcinoma is a better treatment of choice.