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首页> 外文期刊>Surgical Endoscopy >Argon plasma coagulation is safe and effective for treating smaller gastric lesions with low-grade dysplasia: A comparison with endoscopic submucosal dissection
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Argon plasma coagulation is safe and effective for treating smaller gastric lesions with low-grade dysplasia: A comparison with endoscopic submucosal dissection

机译：氩气血浆凝集术治疗低度不典型增生的较小胃部病变安全有效：与内镜黏膜下剥离术比较

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Background and aims: The best therapeutic modality has not been established for gastric low-grade adenomas or dysplasia (LGD), which can progress to invasive carcinoma despite a low risk. This study aims to investigate the clinical efficacy, safety, and local recurrence after argon plasma coagulation (APC) treatment of gastric LGD compared with endoscopic submucosal dissection (ESD). Patients and methods: A total of 320 patients with gastric LGD ≤2.0 cm treated with APC or ESD between 2004 and 2011 were retrospectively analyzed. We compared local recurrence rate, complication rate, procedure time, and admission to hospital between APC and ESD groups. Results: Of the 320 patients, 116 patients were treated with APC and 204 with ESD. During follow-up, local recurrence was more common in the APC group (3.8 %, 4/106) than the ESD group (0.5 %, 1/188; log-rank test P = 0.036). However, all patients with local recurrence (n = 5) were treated by additional APC, and followed up without further recurrences. ESD was complicated by two perforations (1.0 %, 2/204) compared with no perforations in the APC group (0 %, 0/116). Bleeding complications were not different between the APC (1.7 %, 2/116) and ESD (2.0 %, 4/204) groups. Procedure time was shorter in the APC (7.8 ± 5.1 min) than the ESD (53.1 ± 38.1 min) group (P < 0.001). The proportion of hospitalization was less in the APC group (31.0 %, 36/116) than the ESD group (100.0 %, 204/204) (P < 0.001). Conclusions: APC can be a good treatment option for patients with LGD ≤2.0 cm.
机译：背景和目的：尚未确定针对胃低度腺瘤或异型增生（LGD）的最佳治疗方式，尽管其风险低，但仍可进展为浸润性癌。这项研究旨在探讨与内镜黏膜下剥离术（ESD）相比，氩气血浆凝集（APC）治疗胃LGD后的临床疗效，安全性和局部复发。患者和方法：回顾性分析了2004年至2011年间接受APC或ESD治疗的320例胃LGD≤2.0cm的胃LGD患者。我们比较了APC和ESD组之间的局部复发率，并发症发生率，手术时间和入院率。结果：320例患者中，有116例接受了APC治疗，204例接受了ESD治疗。在随访期间，与ESD组（0.5％，1/188;对数秩检验P = 0.036）相比，APC组（3.8％，4/106）的局部复发更为常见。但是，所有局部复发的患者（n = 5）均接受了额外的APC治疗，并随访，无进一步复发。与两个穿孔（1.0％，2/204）相比，ESD复杂，而APC组中没有穿孔（0％，0/116）。 APC（1.7％，2/116）和ESD（2.0％，4/204）组之间的出血并发症无差异。 APC（7.8±5.1分钟）的手术时间比ESD（53.1±38.1分钟）组的手术时间短（P <0.001）。 APC组的住院比例（31.0％，36/116）小于ESD组（100.0％，204/204）（P <0.001）。结论：APC可以作为LGD≤2.0cm的患者的良好治疗选择。

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