Endoscopic submucosal dissection for early gastric cancer and precancerous lesions enhances postoperative recovery and mitigates complication risks

Abstract

BACKGROUND

Early gastric cancer (EGC) or precancerous lesions (PCLs) are generally small tumors and carry a diminished chance of nodal infiltration. Thus far, very few studies have examined how endoscopic submucosal dissection (ESD) affects postoperative recovery and complications in such patients.

AIM

To evaluate the influence of ESD on postoperative recovery and complications in patients with EGC or PCL.

METHODS

The study population included patients with EGC and PCL admitted to The First People’s Hospital of Fuyang District between December 2022 and December 2024, who were divided into the research (n = 65) and control (n = 55) groups if they underwent ESD and laparoscopic radical gastrectomy, respectively. Therapeutic outcomes (en bloc and curative resection rates), surgical parameters (incision length, intraoperative bleeding, and operative duration), postoperative recovery indices (time to first ambulation/flatus/first oral intake, and hospital stay duration), complications (infection, outflow obstruction, bleeding, and perforation), and tumor markers [carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 125/19-9] were comparatively evaluated.

RESULTS

Compared with the control group, the research group achieved a significantly higher en bloc resection rate but a notably lower curative resection rate. Additionally, the research group demonstrated shorter incision lengths, reduced intraoperative bleeding, and shorter operative duration. Regarding postoperative recovery, the research group demonstrated earlier ambulation, faster bowel function restoration, quicker oral intake resumption, and shorter hospital stays. Furthermore, an evidently lower overall complication rate was recorded in the research group, as well as markedly reduced postoperative CEA, CA125, and CA19-9 concentrations.

CONCLUSION

When performed for EGC and PCLs, ESD demonstrates advantages such as higher en bloc resection (although lower curative resection rates), surgical trauma minimization, shortened operative duration, and faster recovery. Moreover, it is effective in reducing serum tumor marker levels while maintaining favorable safety.

Keywords: Endoscopic submucosal dissection; Early gastric cancer; Precancerous lesions; Postoperative recovery; Complications

Core Tip: This study examined how endoscopic submucosal dissection (ESD) influences postoperative recovery and complications in early gastric cancer (EGC) or precancerous lesions (PCLs). Compared with laparoscopic radical gastrectomy, performing ESD for treating EGC and PCLs led to superior en bloc resection, shortened surgical incision length, intraoperative bleeding reduction, and shorter operative duration. Moreover, it effectively accelerated postoperative recovery, lowered complications, and improved serum tumor marker expression.