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Safety and short-term outcomes of endoscopic submucosal dissection for early gastric cancer in elderly patients

机译:内镜黏膜下剥离术治疗老年早期胃癌的安全性和近期疗效

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Background and study aims: Endoscopic submucosal dissection (ESD) has become widely accepted as a minimally invasive treatment for early gastric cancer (EGC), and opportunities to use ESD to treat EGC in elderly patients are increasing. The objective of this study was to elucidate the safety and efficacy of ESD in elderly patients. Patients and methods: Between April 2006 and March 2013, a total of 892 patients with EGC were prospectively recruited to undergo ESD according to definite inclusion criteria. The short-term outcomes and incidence of complications in 345 of these patients who were 75 years of age or older (elderly group) were compared with the short-term outcomes and incidence of complications in the remaining 547 patients (non-elderly group). Factors associated with the occurrence of pneumonia and delirium were also investigated. Results: The R0 resection rate did not differ between the two groups (96.2?% in the elderly group vs. 96.7?% in the non-elderly group; P?=?0.65). The incidence of pneumonia (7.5?% vs. 1.8?%; P?
机译:背景和研究目的:内镜黏膜下剥离术(ESD)已被广泛接受为早期胃癌(EGC)的微创治疗方法,并且使用ESD治疗老年患者EGC的机会正在增加。这项研究的目的是阐明老年患者ESD的安全性和有效性。患者和方法:2006年4月至2013年3月,根据明确的纳入标准,前瞻性招募了892名EGC患者接受ESD。将这些年龄在75岁或以上(老年组)中的345例患者的短期结局和并发症发生率与其余547例患者(非老年组)的短期结局和并发症发生率进行了比较。还研究了与肺炎和ir妄发生有关的因素。结果:两组的R0切除率无差异(老年组为96.2%,非老年组为96.7%;P≥0.65)。老年组肺炎的发生率(7.5%vs. 1.8%; P 0.01)和of妄的发生率(10.1%vs. 1.1%; P <0.01)明显高于老年组。两组的ESD后出血发生率和穿孔发生率相似。无需急诊手术,但非老年人组中有1名患者死于吸入性肺炎。在多因素分析中,年龄≥75岁,脑血管疾病,慢性阻塞性肺疾病,del妄和残留的胃或胃管是肺炎的独立危险因素,而年龄≥75岁,糖尿病,痴呆和肺炎是独立的危险因素。 del妄。结论:对于健康状况良好的老年患者,ESD用于EGC可行。但是,患有合并症的老年患者在接受ESD治疗后,肺炎和ir妄可能会更加频繁。

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