Comparison of the effects of endoscopic submucosal dissection and laparoscopic distal radical surgery on the rehabilitation and quality of life of patients with early gastric cancer

Objective: This study was designed to compare the effects of endoscopic submucosal dissection (ESD) and laparoscopic distal radical surgery (LDRS) on patient rehabilitation and quality of life (QoL) in patients with early gastric cancer (GC).

Methods: The clinical data of 52 patients with early GC admitted to Wuhan Union Hospital from January 2018 to December 2020 were retrospectively analyzed. Among them, 32 patients who underwent LDRS were assigned to the laparoscopic group, and the rest of the 20 patients who underwent ESD were assigned to the endoscopic group. The two groups were compared in clinical efficacy, intraoperative blood loss, operation time, postoperative hospitalization time, gastrointestinal ventilation time and postoperative complications, and the postoperative recurrence and postoperative QoL of the two groups were evaluated and recorded. Independent risk factors for recurrence of gastric cancer were analyzed by logistics regression.

Results: The laparoscopic group showed a significantly lower complete resection rate than the endoscopic group (P=0.030). The endoscopic group experienced notably less intraoperative blood loss and operation time, significantly earlier time for the first anal exhaust and shorter hospitalization time in contrast to the laparoscopic group (all P<0.05). Six months after operation, the endoscopic group had notably higher MOS 36-Item Short-Form Health Survey (SF-36) scores than the laparoscopic group (P<0.001). In addition, the laparoscopic group had a notably higher total incidence rate of complications than the endoscopic group (P<0.05). Among the 52 patients, 8 patients had recurrence. According to Logistics regression analysis, tumor diameter and invasion depth were independent risk factors for recurrence (both P<0.05).

Conclusion: With significantly better efficacy than that of LDRS, ESD is beneficial to postoperative rehabilitation and can improve the QoL of patients, and both schemes cause no significant effect on the recurrence of patients.