Comparison of the efficacy of endoscopic mucosal resection and endoscopic submucosal dissection in thetreatment of early gastric cancer and precancerous lesions

Abstract

Objective To compare the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) in the treatment of early gastric cancer (EGC) and precancerous lesions. Methods From January 2015 to January 2016, sixty patients with EGC and precancerous lesions admitted to Wuxi Second People’s Hospital were divided into EMR group (32 cases) and ESD group (28 cases). The operative time and dietary restriction, intraoperative hemorrhage, postoperative pathology, the rate of total excision, curative resection, local recurrence, tumor residual, intraoperative and postoperative adverse reactions and the prognosis between the two groups were compared and analyzed. Results The operation time of ESD group was longer than that of EMR group [(53.35±7.12) min vs (34.23±5.74) min,t=2.009, P=0.043], the intraoperative blood loss was more than that of EMR group, with statistically significant differences [(10.26±3.42) ml vs (3.35±0.71) ml, t=2.511, P=0.018]. The total excision rate and curative resection rate of lesions in ESD group were significantly higher than those in EMR group (92.9% vs 62.5%, χ2=7.693, P=0.006; 78.6% vs 43.8%, χ2=7.545, P=0.006). The adverse reaction rate of ESD group was 14.3% (4/28), higher than that of EMR group 3.1% (1/32), and the difference was statistically significant (χ2=8.765, P=0.001). There was no significant difference in the 2-year overall survival rate between the two groups (χ2=0.643, P=0.423). Conclusion Compared with EMR, ESD may be a safe and effective surgical procedure for the treatment of EGC and precancerous lesions. Key words: Stomach neoplasms; Precancerous conditions; Endoscopic mucosal resection; Endoscopic submucosal dissection; Early gastric cancer