Efficacy of endoscopic submucosal dissection in the treatment of early gastrointestinal lesions

BACKGROUND Endoscopic submucosal dissection (ESD) is applicable to early-stage gastrointestinal cancers, but its role in early gastrointestinal lesions is insufficiently researched. AIM To evaluated the efficacy and safety profile of ESD compared with conventional gastrectomy for managing early gastrointestinal lesions, emphasizing clinical outcomes and postoperative recovery. METHODS A retrospective review was conducted on 206 patients diagnosed with early-stage gastrointestinal lesions at the Affiliated Hospital of North Sichuan Medical College between June 2021 and June 2024. Patients were divided into two groups: 98 underwent gastrectomy and 108 received ESD. Outcomes assessed included overall treatment efficacy, postoperative complications, serum tumor marker levels, gastrointestinal hormone concentrations, and mucosal barrier integrity indices. RESULTS The ESD group showed higher overall treatment efficacy (98.15% vs 92.86%; P > 0.05) and a significant lower complication rate (5.56% vs 13.27%). ESD was also associated with reduced intraoperative blood loss (58.36 mL vs 60.31 mL; P < 0.001) and shorter operative durations (69.21 minutes vs 69.86 minutes; P = 0.001). Gastrointestinal function recovered more rapidly following ESD, with an earlier return to oral intake (2.43 days vs 2.65 days; P = 0.006). Preoperatively, ESD patients exhibited lower thymidine kinase 1 and D-lactate levels, indicating enhanced preservation of mucosal integrity. CONCLUSION For early gastrointestinal lesions, ESD represents a safe and effective alternative to conventional gastrectomy. It enables precise lesion excision with fewer complications and faster postoperative recovery.