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

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BACKGROUNDMinimally 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. AIMTo 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. METHODSBetween 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. RESULTSCompared 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 4 / 25 and the regular group, while Short-Form 36 Health Survey scores and nursing satisfaction were significantly higher (95.74% vs 75.56%). CONCLUSIONThe 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.

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