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| Effect of Different ESD Surgical Procedures in the Treatment of Esophageal Cancer in the Early Stage and Its Influence on Perioperative Indicators Recurrence Risk and Safety Analysis |
| YAO Chengyun, XIE Juan, WU Ping, et al |
| Anqing First People's Hospital, Anhui Anqing 246004, China |
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Abstract Objective: To investigate the effect of different endoscopic submucosal dissection (ESD) surgical procedures in the treatment of esophageal cancer in the early stage and its effect on perioperative indicators, recurrence risk and safety. Methods: Sixty patients with early-stage esophageal cancer from January 2019 to January 2021 in our hospital were selected and grouped according to the random number table method, 30 cases each. The control group adopted conventional ESD and the observation group adopted Q method self-traction technique assisted ESD (Q-ESD). The surgical efficacy, surgical condition, pre- and post-operative traumatic stress indicators [tumour necrosis factor-α (TNF-α), C-reactive protein (CRP), cortisol (Cor), norepinephrine (NE)], quality of survival [Health Promoting Lifestyle-II (HPLP-II) score], and complication rate were compared between the two groups and followed up for 1 year to compare the recurrence rates of the two groups at 6 months and 1 year post-operatively. Results: There was no statistically significant difference between the whole resection rate of 96. 67% (29/30) and curative resection rate of 93. 33% (28/30) in the observation group and 93. 33% (28/30) and 86. 67% (26/30) in the control group (P>0. 05); the intraoperative blood loss in the observation group was less than that in the control group, the speed of dissection was greater than that in the control group, and the dissection time, operation time and hospital stay were shorter than control group. Serum TNF-α, CRP, Cor and NE levels in the two groups tended to increase before surgery and 1d, 3d and 5d after surgery, and then decreased, while serum TNF-α, CRP, Cor and NE levels in the observation group were lower than those in the control group at 1d, 3d and 5d after surgery (P<0. 05). The HPLP-II scores of physical activity, health responsibility, stress management, nutrition, interpersonal relationship, and spiritual growth were higher in both groups 1 month after surgery compared to the preoperative period, and were higher in the observation group than in the control group (P<0. 05); the complication rate in the observation group was 16. 67% (5/30) lower than that in the control group 40. 00% (12/30) (P<0. 05); 6 months and 1 year after surgery in the observation group. The recurrence rates of 0. 00% (0/30) and 7. 14% (2/28) in the observation group were not statistically significant (P>0. 05) compared with 3. 45% (1/29) and 11. 11% (3/27) in the control group. Conclusion: Q Method self-traction technique with ESD for early-stage oesophageal cancer significantly optimises the surgical situation, reduces surgical traumatic stress and facilitates post-operative recovery, and also improves the quality of survival and reduces complication rates without increasing the risk of recurrence.
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2022, Vol. 28 
