Effect of titanium clip combined with nylon rope traction on endoscopic submucosal dissection for early gastric horn cancer#br#
MA Shangji1 ZHENG Yang1 ZHANG Xiaojie2 XIANG Zhengguo1▲
1.Department of Gastroenterology, the 904th Hospital of the Joint Logistic Support Force of the Chinese People’s Liberation Army, Jiangsu Province, Wuxi 214000, China;
2.Experimental Center of Medical Science, Soochow University, Jiangsu Province, Suzhou 215006, China
Abstract：Objective To observe the effect of titanium clip combined with nylon rope traction in endoscopic submucosal dissection (ESD) for early gastric horn cancer. Methods A total of 96 patients with early gastric horn cancer in the 904th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army from August 2017 to August 2019 were selected as the research objects. They were divided into the observation group and the control group by random lottery method, with 48 cases in each group. The control group was treated with conventional ESD, and the observation group was treated with titanium clip combined with nylon rope traction on the basis of the control group. The perioperative indexes of the two groups were observed. Inflammatory response and stress response indexes (interleukin-6 [IL-6], tumor necrosis factor -α [TNF-α], epinephrine [E], norepinephrine [NE]), genetic molecules [transforming growth factor-α [TGF-α], cyclin [cyclin C]) were determined before and after surgery and postoperative complications between the two groups were compared. Results The operative time in the observation group was short than the control group, times of submucosal supplementary injection was less than the control group, intraoperative gastric perforation and intraoperative bleeding were lower than those in the control group (P ＜ 0.05). Three days after operation the levels of IL-6, TNF-α, NE, and E in the two groups were higher than before operation, and the observation group was lower than the control group (P ＜ 0.05). The overall analysis showed that there were statistically significant differences between groups, time points and interactions (P < 0.05). Intra-group comparison: levels of TGF-α and cyclin E in both groups were significantly higher than before operation one week and one month after operation, and one month after operation was lower than one week after operation (P < 0.05). Comparison between groups: there was no significant difference in TGF-α and cyclin E between the two groups before operation (P > 0.05). The levels of TGF-α and cyclin E in the observation group were significantly lower than those in the control group at one week and one month after operation. There was no significant difference in postoperative complication rate between the two groups (P ＞ 0.05). Conclusion Titanium clip combined with nylon rope traction in ESD of early angular gastric cancer can significantly reduce the operation time and intraoperative bleeding, which has clinical promotion value.
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