g analysis

被引:33
作者
Huang, Rui [1 ]
Cai, Hongwei [2 ]
Zhao, Xin [1 ]
Lu, Xiaoqiang [1 ]
Liu, Min [1 ]
Lv, Wenhao [1 ]
Liu, Zhiguo [1 ]
Wu, Kaichun [1 ]
Han, Ying [1 ]
机构
[1] Fourth Mil Med Univ, Xijing Hosp Digest Dis, 127 Changle West Rd, Xian 710032, Shaanxi, Peoples R China
[2] Xi An Jiao Tong Univ, Affiliated Hosp 1, Informat Technol Dept, Xian, Shaanxi, Peoples R China
基金
中国国家自然科学基金;
关键词
ENDOSCOPIC SUBMUCOSAL DISSECTION; TUNNEL DISSECTION; ESOPHAGEAL NEOPLASIA; TRACTION; OUTCOMES; MYOTOMY;
D O I
10.1016/j.gie.2017.03.001
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background and Aims: Esophageal endoscopic submucosal dissection (ESD) is technically challenging because of the thinner wall and narrow lumen. The tunnel technique was proposed previously. This current retrospective study aimed to evaluate the efficacy of the tunnel technique in ESD of superficial esophageal squamous cell carcinoma (ESCC). Methods: Patients who underwent ESD for superficial ESCC between October 2013 and September 2015 were included in the study. Propensity score matching was used to compensate for the differences in age, sex, resected specimen size, and pathology. Treatment outcomes were compared with conventional statistic methods between the tunnel ESD group and conventional ESD group after matching. To further explore the potential variables relevant to procedure time, univariate and multivariate logistic regression analyses were applied. Results: A total of 115 lesions were included in the analysis. Propensity score matching analysis created 38 matched pairs. There was no difference on en bloc resection rate, complete resection rate, and curative rate between the 2 groups. The ESD procedure time was 38.0 (range 29.5-46.0) minutes in the tunnel ESD group and 48.0 (35.4-83.3) minutes in the conventional ESD group (P = .006). There was no difference in adverse events including postprocedural bleeding, perforation, and chest pain, but a lower rate of muscular injury (28.9% vs 52.6%; P = .036) and a less-frequent use of coagulation forceps (36.8% vs 65.8%; P = .012) were shown in the tunnel ESD group. In multivariate regression analysis for procedure time, the tunnel ESD technique (odds ratio [OR] 3.42; 95% confidence interval [CI], 1.32-8.85; P = .011) and specimen size < 40 mm (OR 8.74; 95% CI, 1.30-58.5; P = .026) were associated with a shorter procedure time. Conclusions: The endoscopic submucosal tunnel dissection improved the efficacy and safety of the ESD procedure by shortening the procedure time and reducing injury to the muscular layer.
引用
收藏
页码:831 / 838
页数:8
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