• Xinxiang Central Hospital, Fourth Clinical College of Xinxiang Medical College, Endoscopic Diagnosis and Treatment Department, Xinxiang, Henan 453000, P. R. China;
LI Xiaohuan, Email: xinniankyy1220@126.com
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Objective To explore the application value of transoral snare traction in endoscopic submucosal dissection (ESD) for patients with early gastric cancer (EGC). Methods A total of 90 EGC patients admitted to Xinxiang Central Hospital from January 2020 to April 2023 were selected and randomized into a study group and a conventional group using a random number table method. The conventional group was received ESD, while the study group was received transoral snare traction in combination with ESD. Baseline data, treatment efficacy, as well as the serum inflammatory-stress factors [tumor necrosis factor alpha, interleukin-6, adrenocorticotropic hormone and cortisol, gastrointestinal hormones (motilin and gastrin), surgical indicators, gastrointestinal function recovery indicators before surgery and day 1 and 3 after surgery, postoperative complications, improvement in quality of life, and 2-year recurrence rate were compared between the two groups. The test level was set at α=0.05. Results There were no statistically significant differences in age, gender, body mass index, disease duration, longest tumor diameter, lesion location, and tumor differentiation degree between the study group and the conventional group (P>0.05). The total effective rate of treatment in the study group was higher than that in the conventional group [95.6% (43/45) vs. 80.0% (36/45), χ2=5.075, P=0.024]. The results of repeated measures analysis of variance indicated that there were statistically significant differences in the levels of inflammatory-stress factors and gastrointestinal hormones between the study group and the conventional group across groups, time, and group-time interaction effects (P<0.05). The impact of time on inflammatory-stress factors and gastrointestinal hormones varied depending on the intervention measures (P<0.001). The levels of inflammatory-stress factors in the study group increased before surgery and then decreased, and were lower than those in the control group. Meanwhile, the levels of serum motilin and gastrin in the study group continuously decreased before surgery and were lower than those in the control group. The operation duration, recovery of bowel sounds, first exhaust, first defecation, and first meal time in the study group were shorter than those in the conventional group, and the intraoperative blood loss was lower than that in the conventional group (P<0.05). The overall complication rate in the study group was lower than that in the conventional group [4.4% (2/45) vs. 17.8% (8/45), χ2= 4.050, P=0.044], and the improvement rate in quality of life was higher than that in the conventional group [77.8% (35/45) vs. 57.8% (26/45), χ2=4.121, P=0.042]. There was no significant difference in the recurrence rate between the two groups after a 2-year follow-up [6.98% (3/43) vs. 17.07%(7/41), χ2=1.191, P=0.275]. Conclusion The results of this study suggest that the treatment of early gastric cancer with transoral snare traction combined with ESD has significant efficacy, which can optimize surgical procedures, reduce inflammatory stress, improve gastrointestinal hormone levels, promote disease recovery, reduce the occurrence of complications, and achieve good short- and medium-term outcomes.

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