The purpose of this study was to conduct a retrospective study about the clinical effects of endoscopic mucosal dissection on the treatment of early esophagogastric precancerous lesions. A total of 132 patients with early esophagogastric precancerous lesions who were diagnosed and treated with concurrent surgery in our hospital from January 2018 to December 2019 were included in this retrospective study. Patients were divided into endoscopic mucosal resection (EMR) group (n = 58) and endoscopic submucosal dissection (ESD) group (n = 74) according to different surgical methods. The data in the two groups were compared and analyzed in terms of surgical indicators, treatment status and incidence of postoperative complications. There were statistically significant differences between the two groups in the whole block cutting rate, fractional cutting rate and complete cutting rate (P   0.05). The incidence and recurrence of postoperative complications, including bleeding, perforation and stenosis in the two groups, were observed within 1 year of postoperative follow-up. The incidence of complications in ESD group was slightly higher than that in EMR group, and the local recurrence rate in ESD group was lower than that in EMR group (P > 0.05). ESD is an alternative surgical treatment for patients with early esophagogastric precancerous lesions.

Retrospective analysis of the clinical effects of endoscopic mucosal dissection on treatment of early esophagogastric precancerous lesions

Superficial digestive tumours resection by endoscopic mucosal resection and sub-mucosal dissection causes very few complications according to the results obtained in expert centers. This work reports the rate of complications observed in a regional hospital, also comparing the results of their therapeutic management. The first 100 patients treated by endoscopic mucosal resection and sub-mucosal dissection, conducted by conventional techniques, were studied. The usual complications (stenosis, bleeding, perforation) were identified and details of their treatment reported. The overall complication rate was 16 %. Symptomatic stenoses are observed in 4 % of patients. Secondary bleeding occurs in 5 % of cases. Endoscopic management of these complications is effective in all cases, when it is attempted. Perforations complicate 7 % of the procedures. Two patients were assigned to surgery, successfully, the other 5 patients were treated by endoscopic sutures without damage. The complication rates observed in our department are comparable with results reported by the reference western centers. Their endoscopic management is usually successful and rescue surgery is unfrequent.

Incidence and treatment of complications observed after endoscopic mucosal resection of superficial digestive tumours in a regional general hospital

Une hemorragie digestive secondaire a une rupture de varices oesophagiennes est regulierement revelatrice d'une cirrhose meconnue. L'observation d'une hypertension portale et de ses consequences sans alteration hepatique primitive doit faire penser a une hypertension portale pre-sinusoidale, et evoquer une sclerose hepatoportale. Chez ces patients, la recherche d'un trouble de coagulation est essentielle. Un etat prothrombotique est frequemment mis en evidence. Des etudes devront etre realisees de maniere a comparer les risques et les benefices d'un traitement anticoagulant chez ces patients.

Paradoxe: lorsqu'un etat prothrombotique est responsable d'une hemorragie digestive. Observation d'un cas de sclerose hepatoportale

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Incidence and treatment of complications observed after endoscopic mucosal resection of superficial digestive tumours in a regional general hospital

Paradoxe: lorsqu'un etat prothrombotique est responsable d'une hemorragie digestive. Observation d'un cas de sclerose hepatoportale