早期胃癌患者内镜黏膜下剥离术中穿孔发生状况及相关因素

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Abstract Objective To investigate the incidence and related factors of perforation during endoscopic submucosal dissection (ESD) in patients with early gastric cancer.Methods The clinical data of 48 patients with early gastric cancer who received ESD treatment from April 2021 to December 2021 in Shangrao Municipal Hospital were retrospectively analyzed,they were divided into the occurrence group (n=10) and the non-occurrence group (n=38) according to whether intraoperative perforation occurred.Compare the incidence of perforation during ESD in patients with early gastric cancer.The basic data of the two groups were statistically compared,including age,sex,operation time,lesion diameter,degree of differentiation,lesion site,digestive tract operation history,tumor invasion depth and platelet count.The differenct information between the two groups was incorporated into the logistic regression analysis model,quantified and assigned,so as to clarify the influencing factors of perforation during ESD operation in patients with early gastric cancer.Results Among 48 patients with early gastric cancer,perforation occurred in 10 cases,accounting for 20.83% (10/48),and 38 cases had no perforation occurred,accounting for 79.17% (38/48).Univariate analysis showed that there was no significant differences in age,sex,operation time and differentiation degree between the two groups (P＞0.05).The occurrence of perforation during ESD operation in patients with early gastric cancer is related to the lesion diameter ≥2 cm,the lesion site at the cardia and fundus of stomach,the history of digestive tract operation,the depth of tumor invasion at the deep lamina propria,and the platelet count ≥400×109/L,the differences were statistically significant (P＜0.05).Taking the incidence of perforation during ESD as the dependent variable,and taking the lesion diameter,lesion location,gastrointestinal surgery history,tumor infiltration depth and platelet count as independent variables,the logistic regression model was used for multivariate analysis.The results showed that the lesion diameter(β=0.221,OR=1.247,95%CI=1.021-1.523),lesion location (β=0.436, OR=1.546,95%CI=1.152-2.075),history of gastrointestinal surgery (β=0.450, OR=1.569,95%CI=1.152-2.137),depth of tumor invasion (β=0.393, OR=1.481,95%CI=1.037-2.115),platelet count (β=0.730, OR=2.075,95%CI=1.080-3.987) were independent risk factors for perforation during ESD in patients with early gastric cancer (P＜0.05).Conclusion When the lesion diameter is ≥2 cm,the lesion site is cardia and fundus of stomach,with history of digestive tract operation,the depth of tumor invasion is deep lamina propria and the platelet count is ≥400×109/L,the incidence of perforation during ESD operation in patients with early gastric cancer is higher.

Key words： Early gastric cancer Endoscopic submucosal dissection Perforation Factor

Received: 11 January 2022

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	ZHONG Zhuluan LIU Fang

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ZHONG Zhuluan LIU Fang. Incidence and related factors of perforation during endoscopic submucosal dissection in patients with early gastric cancer[J]. 中国当代医药, 2022, 29(17): 5-8.

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https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I17/5

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