Effect of endoscopic submucosal dissection on gastrointestinal function and nutritional status in patients with early gastric cancer

Background: Gastric cancer (GC) endangers the survival and prognosis of patients worldwide. Improving the prognosis of patients with early GC (EGC) is crucial to prolong their survival time.

Aim: To analyze the effects of endoscopic submucosal dissection (ESD) on gastrointestinal function and nutritional status in patients with EGC.

Methods: Eighty patients with EGC between January 2021 and January 2024 were divided according to different surgical protocol into following two groups: 42 patients who underwent ESD in the ESD group and 38 patients treated with endoscopic mucosal resection (EMR) in the EMR group. Two groups were compared in the operative indices, lesion resection rate, postoperative recovery of gastrointestinal function, nutritional status, and incidence of surgical complications.

Results: The overall resection rate of the lesion in the ESD group was higher. The operative bleeding volume and operation time were higher and gastrointestinal ventilation time was shorter in the ESD group than those in the EMR group (P< 0.05). The nutritional statuses of the two groups decreased after operation; however, the levels of albumin, prealbumin, hemoglobin, and transferrin were higher in the ESD group than in the EMR group (P < 0.05). The post-operative pepsinogen (PG) I level in the ESD group was higher than that in the EMR group, and the PG II level was lower than that in the EMR group (P < 0.05). The incidence of postoperative complications was compared between the two groups (P > 0.05).

Conclusion: ESD can promote the immediate recovery of patient's postoperative gastrointestinal function, improve their nutritional level, and signifies its application in patients with EGC.