ABSTRACT
Objective To compare the effectiveness and safety of endoscopic polycyclic mucosal resection(EMBM)and endo-scopic submucosal dissection(ESD)in the treatment of esophageal intraepithelial neoplasia.Methods 85 cases of esophageal intra-epithelial neoplasia patients,including 45 cases treated by EMBM and 40 cases treated by ESD.To compare the efficacy,complica-tions,operation time,and medical fees of the two treatment methods by analysis of relevant clinical data.Results Once resection rate of the EMBM treatment group was 97.8%(44/45),and 95.0%(38/40)for the ESD treatment group,there is no significant difference between the two groups(P>0.05);Endoscopy of both treated patients in the postoperative 1,3,6,and 12 months showed no recurrence;The complications incidence of bleeding and perforation of the EMBM treated group(8.89%,0)was significantly lower than that of the ESD treated group(35.00%,15.00%),P<0.05;The average operation time of the EMBM treated group [(26.5±14.2)min]was significantly lower than that of the ESD treated group[(65.2±26.1)min],P<0.05;The total cost of hospitalization of the ESD treated group(18 000 yuan)was significantly higher than the EMBM treated group(8 500 yuan),P<0.05.Conclusion Compared with ESD,EMBM has an easier operation,less complications and patient consuming,and it is suitable for application in primary hospitals.
ABSTRACT
BACKGROUND/AIMS: Laterally spreading tumors (LST) were growthed along the colonic wall. These tumors were high malignant potential compared to colon polyp. We analyzed clinicopathological characteristics of these tumors. METHODS: From June 1996 to June 2001, twenty nine patients were diagnosed by colonoscopy. These lesions were classificated macroscopic (granular type and nongranular type) and microscopic findings. RESULTS: 20 male and 9 female were enrolled (mean age, 68.1). Among the LST, 41.4% were 20~30 mm in diameter, and 7% were larger than 30 mm. According to macroscopic findings granular types were 72.4% (21/29) and nongranular types were 27.6% (8/29). In macroscopic findings, tubular types were 48.4% (14/29), malignant changes were 31.3% (9/29). Tumor size was only significant factor in malignant potential of LST (p=0.004). Endoscopic mucosal resection was performed in 72.4% (21/29), operation in 8 (27.6%). Rate of submucosal invasion in LST was 3.4% (1/29, sm1). Recurrent rate of endoscopic treatment group was 9.5% (2/21). CONCLUSIONS: Most of LST were good indication for endoscopic treatment, but larger tumor size and irregular surface of tumor were suspected to be submucosal invasion. Therefore these lesions were performed other procedures as endoscopic ultrasound or computerized tomography for invasion depth.