Application value and safety evaluation of ESD in treatment of colorectal precancerous lesions / 中国内镜杂志

ABSTRACT

Objective To explore the application value and evaluate the safety of ESD in treatment of early colorectal cancer. Methods The clinical data of patients with early colorectal cancer admitted from May 2014 to May 2016 were retrospectively analyzed. According to the different operation methods, the patients were divided into EMR group and ESD group. The changes of clinical efficacy, safety and inflammatory index level were compared between the two groups. Results 126 patients were involved in the study. The operative time was longer than that of the lesion diameter < 2 cm (P < 0.05) when the lesion diameter was more than 2 cm. The operative time of ESD group was longer than that of EMR group. The resection rate and complete resection rate of lesion were higher than that of EMR group (P < 0.05). When the diameter of lesion was ≥ 2 cm, the operation time of ESD group was longer than that of EMR group. In EMR group, the whole and complete resection rate were lower than that in the diameter less than 2 cm (P < 0.05). There was no significant difference in the levels of TNF- α IL-6 and CD3+and CD4+between the two groups before operation (P > 0.05), but one week after operation, the levels of CRP, TNF- α and IL-6 was lower than that of EMR group (P < 0.05), while the levels of CD3+and CD4+were higher (P < 0.05). There was no significant difference in the incidence and recurrence rate of anastomotic leakage (P > 0.05). The incidence of hemorrhage in ESD group was higher than that in EMR group (P < 0.05). Conclusion ESD was effective in treatment of early colorectal cancer. The stress response was small and the recurrence rate was low, but the bleeding rate was higher than that in EMR group, so the monitoring should be strengthened.