胃腫瘍に対する内視鏡的胃粘膜下層切開剥離術(ESD)におけるクリニカルパスの検討

概要

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A clinical pathway for treating gastric tumor with endoscopic submucosal dissection (ESD) was introduced in our department in May 2004. We studied 30 patients (27 patients with early gastric cancer and 3 patients with adenoma) who underwent ESD at our department. We compared the 20 patients who underwent ESD after the introduction of the clinical pathway with the 10 patients who underwent ESD before its introduction in terms of sex, age, tumor size (longest diameter), tumor location, complications, and operating time. Postoperative course includes the timing of eating resumption, intravenous infusion cessation, and postoperative hospital days. The percentage of patients with tumors in the U and M regions was higher among those who had ESD after the clinical pathway introduction (p=0.039). The two groups showed no significant differences in other aspects. Eating resumption, intravenous infusion cessation, postoperative hospital days negatively deviated from the time specified by the clinical pathway in 7, 9, and 16 patients, respectively, The variance of postoperative hospital days were results of complications such as bleeding and perforation.
東京女子医科大学の論文