Whole-course flexible management model for endoscopic submucosal dissection-treated patients for early digestive tract cancer or pre-cancerous lesions: Efficacy and quality-of-life-impact

doi:10.4240/wjgs.120648

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Oct 27, 2026; 18(10): 120648
Published online Oct 27, 2026. doi: 10.4240/wjgs.120648

Whole-course flexible management model for endoscopic submucosal dissection-treated patients for early digestive tract cancer or pre-cancerous lesions: Efficacy and quality-of-life-impact

Jia-Ying Lin, Xiao-Ling Fang, Hui Chen, Qiang Chen, Xiang Jiang, Jiao-E Chen, Ling-Jun Wu

Jia-Ying Lin, Xiao-Ling Fang, Hui Chen, Qiang Chen, Xiang Jiang, Jiao-E Chen, Ling-Jun Wu, Department of Gastroenterology, Sanmen People’s Hospital, First Affiliated Hospital of Zhejiang University, Sanmenwan Branch, Taizhou 317100, Zhejiang Province, China

Co-corresponding authors: Jiao-E Chen and Ling-Jun Wu.

Author contributions: Lin JY designed the research and wrote the first manuscript; Lin JY, Fang XL, Chen H, Chen Q, and Jiang X contributed to conceiving the research and analyzing data; Chen JE and Wu LJ conducted the analysis and provided guidance for the research as co-corresponding authors; all authors reviewed and approved the final manuscript.

AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.

Institutional review board statement: This study was approved by the Ethic Committee of Sanmen People’s Hospital, No. 2025-107.

Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: No additional data are available.

Corresponding author: Ling-Jun Wu, Department of Gastroenterology, Sanmen People’s Hospital, First Affiliated Hospital of Zhejiang University, Sanmenwan Branch, No. 15 Taihe Road, Hairun Street, Sanmen, Taizhou 317100, Zhejiang Province, China. wulingjun@zjsmyy.com

Received: April 30, 2026
Revised: June 1, 2026
Accepted: June 30, 2026
Published online: October 27, 2026
Processing time: 171 Days and 18 Hours

Abstract

BACKGROUND

Minimally invasive surgery for patients with early digestive tract cancer (DTC) or precancerous lesions (PCLs) may induce perioperative adverse events (AEs) and negative emotions, potentially hindering postoperative recovery. Optimizing clinical management is therefore crucial.

AIM

To evaluate the effect of a whole-course flexible management model on patients undergoing endoscopic submucosal dissection (ESD) for early DTC or PCLs, and its impact on patients’ quality of life.

METHODS

Between December 2018 and December 2021, 92 patients undergoing ESD for early DTC or PCLs were enrolled, including 45 patients receiving conventional management (regular group) and 47 patients receiving whole-course flexible intervention management (intervention group). Perioperative indicators, including intraoperative bleeding, operation time, and hospitalization duration, as well as the incidence of AEs (abdominal pain, abdominal distension, bleeding, infection), scores on the Self-Rating Anxiety Scale, Self-Rating Depression Scale, Numeric Rating Scale, Pittsburgh Sleep Quality Index, and Short-Form 36 Health Survey, and nursing satisfaction, were compared between groups.

RESULTS

Compared with the regular group, the intervention group demonstrated significantly lower intraoperative bleeding, shorter operation time and hospitalization time, and a lower overall incidence of AEs (8.51% vs 24.44%). Post-intervention, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Numeric Rating Scale, and Pittsburgh Sleep Quality Index scores were significantly lower in the intervention group than in both baseline and the regular group, while Short-Form 36 Health Survey scores and nursing satisfaction were significantly higher (95.74% vs 75.56%).

CONCLUSION

The whole-course flexible management model exerts a beneficial effect on patients undergoing ESD for early DTC or PCLs, improving surgical outcomes, reducing AEs, alleviating negative emotions and pain, and enhancing sleep quality, quality of life, and nursing satisfaction.

Keywords: Whole-course flexible management model; Endoscopic submucosal dissection; Early digestive tract cancer; Pre-cancerous lesions; Quality of life

Core Tip: This study comparatively analyzed the intervention effects and quality-of-life outcomes of the whole-course flexible management model vs the conventional management model in patients with early digestive tract cancer or precancerous lesions. The analyses indicated that the whole-course flexible management model offered greater clinical benefits than the conventional approach, including enhanced surgical safety, accelerated recovery, reduced negative emotions, alleviated pain, and improved sleep quality and overall quality of life, accompanied by higher nursing satisfaction.