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

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.