2. EVALUATION OF ADVERSE EVENTS AND NURSING CARE OUTCOMES AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION FOR TREATMENT OF EARLY ESOPHAGEAL CANCER
Main Article Content
Abstract
Objective: To evaluate adverse effects and nursing care outcomes in patients undergoing endoscopic submucosal dissection (ESD) for early-stage esophageal cancer.
Subjects and methods: A retrospective and prospective cohort study including 44 patients with early-stage esophageal cancer treated with ESD at 108 Military Central Hospital, from March 2023 to December 2024.
Results: All patients were male, with a mean age of 60.9 ± 7.9 years. A history of alcohol abuse and/or smoking was reported in most of patients. All patients were closely monitored for key indicators immediately after the procedure and throughout hospitalization. The most common adverse symptoms following ESD were chest pain (77.3%), sore throat (63.6%), and difficulty swallowing (43.2%). Apart from one patient who developed subcutaneous emphysema (2.3%), no other complications such as gastrointestinal bleeding, esophageal perforation, or pneumonia were observed. Nursing care was effective, with good adherence to treatment protocols. Parenteral nutrition and pain management were the most commonly prescribed interventions in the early postoperative period. The average hospital stay was 4.73 ± 1.92 days.
Conclusions: ESD is a safe treatment for early-stage esophageal cancer, with a low postoperative complication rate. The most frequently observed adverse effects were chest pain, sore throat, and difficulty swallowing. Nursing care should focus primarily on pain management and nutritional support in the early postoperative period
Article Details
Keywords
Endoscopic submucosal dissection, early-stage esophageal cancer, adverse event, nursing care
References
[2] Njei B, McCarty T.R, Birk J.W, Trends in esophageal cancer survival in United States adults from 1973 to 2009: A SEER database analysis, J Gastroenterol Hepatol, 2009, 31 (6): 1141-6, doi: 10.1111/jgh.13289.
[3] Jacobs M, Macefield R.C et al, Meta-analysis shows clinically relevant and long-lasting deterioration in health-related quality of life after esophageal cancer surgery, Qual Life Res, 2014, 23 (4): 1097-115, doi: 10.1007/s11136-013-0545-z.
[4] Ono S, Fujishiro M, Niimi K, Goto O et al, Long-term outcomes of endoscopic submucosal dissection for superficial esophageal squamous cell neoplasms, Gastrointest Endosc, 2009, 70 (5): 860-6, doi: 10.1016/j.gie.2009.04.044.
[5] Nagami Y, Ominami M, Shiba M, Minamino H et al, The five-year survival rate after endoscopic submucosal dissection for superficial esophageal squamous cell neoplasia, Dig. Liver Dis, 2017, 49 (4): 427-433.
[6] Park H.C, Kim D.H, Gong E.J et al, Ten-year experience of esophageal endoscopic submucosal dissection of superficial esophageal neoplasms in a single center, Korean J Intern Med, 2016, 31 (6): 1064-1072.
[7] Yousefi M.S, Sharifi-Esfahani M, Amiji N.P et al, Esophageal cancer in the world: incidence, mortality and risk factors, Biomedical Research and Therapy, 2018, 5 (7): 2504-2517.
[8] Vissagi P, Barberio B, Ghisa M et al, Modern Diagnosis of Early esophageal cancer: from blood biomarkers to advanced endoscopy and artificial intelligence, Cancers, 2021, 13 (13), 3162, https://doi.org/10.3390/cancers13133162.
[9] Zhang Y, Ding H, Chen T et al, Outcomes of endoscopic submucosal dissection vs. esophagectomy for T1 esophageal squamous cell carcinoma in a real-world cohort, Clin Gastroenterol Hepatol, 2019, 17: 73-81, e3, doi: 10.1016/j.cgh.2018.04.038.
[10] Tsujii Y, Nishida T, Nishiyama O, Yamamoto K et al, Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms: a multicenter retrospective cohort study, Endoscopy, 2015, 47: 775-783, doi: 10.1055/s-0034-1391844.
[11] Wei An, Jing Zhang et al, Endoscopic submucosal dissection versus esophagectomy for early esophageal squamous cell carcinoma with tumor invasion to different depths, Am J Cancer Res, 2020, 10 (9): 2977-2992.
[12] Mai Văn Hạnh, Phạm Quốc Đạt, Đánh giá kết quả chăm sóc người bệnh sau phẫu thuật cắt đoạn thực quản tạo hình nội soi và một số yếu tố liên quan tại Bệnh viện K năm 2020-2021, Tạp chí Y học Việt Nam, 2022, tập 508, số 2, doi: http://doi.org/10.51298/vmj.v508i2.1583.