Pub Date : 2019-04-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.04.008
R. Zhang, Xiuxue Feng, Meng Li, Qi-yang Huang
Objective To evaluate the efficiency and safety of full-spectrum endoscopy for detection of major duodenal papilla. Methods Patients underwent painless gastroscopy in Chinese PLA General Hospital from March 2017 to December 2017 were enrolled and randomly divided into two groups according to random number method. The group A underwent conventional gastroscopy, and the group B underwent full-spectrum endoscopy. The detection rate of major duodenal papilla was calculated and compared between the two groups. Results A total of 100 patients were recruited in the study, including 51 in the group A and 49 in the group B. The whole detection rate of major duodenal papilla of the group B was higher than that of the group A [79.59% (39/49) VS 41.18% (21/51), χ2=15.366, P=0.000]. There was no statistical difference on the whole plus partial detection rate of major duodenal papilla between the two groups [100.00% (49/49) VS 92.16% (47/51), χ2=2.221, P=0.136]. All patients completed endoscopy examination succesfully without bleeding, peforation or death. Conclusion With the broad view-field, full-spectrum endoscopy is useful to improve the efficiency and safety in detection of major duodenal papilla. Key words: Endoscopy; Full-spectrum gastroscopy; Major duodenal papilla; Diagnosis
{"title":"Detection of major duodenal papilla using full-spectrum endoscopy: a randomized controlled trial","authors":"R. Zhang, Xiuxue Feng, Meng Li, Qi-yang Huang","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.04.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.04.008","url":null,"abstract":"Objective \u0000To evaluate the efficiency and safety of full-spectrum endoscopy for detection of major duodenal papilla. \u0000 \u0000 \u0000Methods \u0000Patients underwent painless gastroscopy in Chinese PLA General Hospital from March 2017 to December 2017 were enrolled and randomly divided into two groups according to random number method. The group A underwent conventional gastroscopy, and the group B underwent full-spectrum endoscopy. The detection rate of major duodenal papilla was calculated and compared between the two groups. \u0000 \u0000 \u0000Results \u0000A total of 100 patients were recruited in the study, including 51 in the group A and 49 in the group B. The whole detection rate of major duodenal papilla of the group B was higher than that of the group A [79.59% (39/49) VS 41.18% (21/51), χ2=15.366, P=0.000]. There was no statistical difference on the whole plus partial detection rate of major duodenal papilla between the two groups [100.00% (49/49) VS 92.16% (47/51), χ2=2.221, P=0.136]. All patients completed endoscopy examination succesfully without bleeding, peforation or death. \u0000 \u0000 \u0000Conclusion \u0000With the broad view-field, full-spectrum endoscopy is useful to improve the efficiency and safety in detection of major duodenal papilla. \u0000 \u0000 \u0000Key words: \u0000Endoscopy; Full-spectrum gastroscopy; Major duodenal papilla; Diagnosis","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"261-264"},"PeriodicalIF":0.0,"publicationDate":"2019-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45078516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.04.007
Yinpu Wang, Y. Qu, Fu-mei Jia, Xiaobudai Liu, Hai-feng Liu
Objective To investigate the value of high resolution microendoscopy (HRME) for assessment of mucosal healing in patients with ulcerative colitis (UC) during clinical remission. Methods A total of 30 UC patients were randomly selected to collect HRME images. Pathological results were used as the gold standard to establish the diagnostic criteria of HRME on evaluation of colonic mucosal status. And then a prospective study was performed on 67 patients, who underwent standard endoscopy to evaluate colonic mucosal status and obtain biopsy specimens. The specimens were collected for HRME imaging. The accuracy of standard endoscopy and HRME in assessing ulcerative colonic mucosal healing was compared. Results According to the gland morphology, gland arrangement, gland opening and inflammatory cell infiltration, the HRME criteria for assessing UC mucosal status were formulated and divided into 0-3 grades with 4 levels. The prospective study of 67 patients with 113 sites showed that the sensitivity, specificity, positive predictive value, and negative predictive value of standard endoscopy for assessing mucosal healing in UC patients were 44.68% (21/47), 90.91% (60/66), 77.78% (21/27), and 69.77% (60/86), respectively, and the corresponding indicators of HRME imaging was 87.23% (41/47), 95.45% (63/66), 93.18% (41/44), and 91.30% (63/69), respectively. Compared with pathological results, the Kappa value of the consistency test of standard endoscopy and HRME imaging were 0.379 and 0.835, respectively (both P<0.05). Conclusion HRME can achieve real-time virtual pathological imaging of colonic mucosa for UC patients, which is more accurate than standard endoscopy for assessing mucosal healing. Key words: Colitis, ulcerative; Mucosal healing; Assessment; High-resolution microendoscopy
{"title":"Evaluative value of high-resolution microendoscopy on mucosal healing in ulcerative colitis","authors":"Yinpu Wang, Y. Qu, Fu-mei Jia, Xiaobudai Liu, Hai-feng Liu","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.04.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.04.007","url":null,"abstract":"Objective \u0000To investigate the value of high resolution microendoscopy (HRME) for assessment of mucosal healing in patients with ulcerative colitis (UC) during clinical remission. \u0000 \u0000 \u0000Methods \u0000A total of 30 UC patients were randomly selected to collect HRME images. Pathological results were used as the gold standard to establish the diagnostic criteria of HRME on evaluation of colonic mucosal status. And then a prospective study was performed on 67 patients, who underwent standard endoscopy to evaluate colonic mucosal status and obtain biopsy specimens. The specimens were collected for HRME imaging. The accuracy of standard endoscopy and HRME in assessing ulcerative colonic mucosal healing was compared. \u0000 \u0000 \u0000Results \u0000According to the gland morphology, gland arrangement, gland opening and inflammatory cell infiltration, the HRME criteria for assessing UC mucosal status were formulated and divided into 0-3 grades with 4 levels. The prospective study of 67 patients with 113 sites showed that the sensitivity, specificity, positive predictive value, and negative predictive value of standard endoscopy for assessing mucosal healing in UC patients were 44.68% (21/47), 90.91% (60/66), 77.78% (21/27), and 69.77% (60/86), respectively, and the corresponding indicators of HRME imaging was 87.23% (41/47), 95.45% (63/66), 93.18% (41/44), and 91.30% (63/69), respectively. Compared with pathological results, the Kappa value of the consistency test of standard endoscopy and HRME imaging were 0.379 and 0.835, respectively (both P<0.05). \u0000 \u0000 \u0000Conclusion \u0000HRME can achieve real-time virtual pathological imaging of colonic mucosa for UC patients, which is more accurate than standard endoscopy for assessing mucosal healing. \u0000 \u0000 \u0000Key words: \u0000Colitis, ulcerative; Mucosal healing; Assessment; High-resolution microendoscopy","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"255-260"},"PeriodicalIF":0.0,"publicationDate":"2019-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45720007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.03.009
Xiao‐hou Xi, Mingxin Zhang, Liping Cui, Qiang Lin, Weijia Dou, Shuguang Zhao, Liu Zhenxiong, Xuxia Wang, Jing-Jie Wang
Objective To investigate the effectiveness and safety of oral olive oil combined with polyethylene glycol electrolyte (PEG) on bowel preparation before colonoscopy for chronic constipation patients. Methods A randomized, single-blind, prospective study was conducted on 180 patients with chronic constipation, who underwent colonoscopy at Tangdu Hospital of the Fourth Military Medical University from November 2017 to May 2018. Patients were randomly divided into three groups. Patients in group A took 60 mL olive oil and a piece of crystal sugar at 7: 30 pm the day before colonoscopy, followed by 1 500 mL PEG at 8: 00 pm before the test, and 1 500 mL PEG at 5: 00 am the day of colonoscopy. Patients in group B took 60 mL olive oil and a piece of crystal sugar after administration of PEG at 8: 00 pm the day before colonoscopy, followed by 1 500 mL PEG at 5: 00 am the day of colonoscopy. The group C was given 1 500 mL PEG at 8: 00 pm the day before colonoscopy, and another 1 500 mL PEG at 5: 00 am the day of colonoscopy. We recorded the time of first defecation after taking medication, the number of defecation before sleep, the total number of defecation, the score of Boston bowel preparation scale (BBPS) of the right, middle and left colon, and the adverse reactions, and compared the data among the three groups. The measurement data was compared using the analysis of variance. After the difference was found, the LSD-t test was used to compare between the two groups. The enumeration data was compared using the Pearson χ2 test. Results One patient in the group B terminated colonoscopy due to unable to continue cooperation during the examination. Group B and C both excluded one patient because of a large mass found in the descending colon of patients. Finally, there were 60 cases in the group A, 58 in the group B, and 59 in the group C. There was no statistical difference between the three groups in the general resource (P>0.05). The time of first defecation after taking medication for the group A, B and C was (2.25±2.32) h, (2.43±2.39) h and (3.36±2.79) h respectively, with statistical difference (F=3.36, P=0.037). The time of first defecation was longer in the group C than that of the group A and B (P=0.016 and P=0.046, respectively). The number of defecation before sleep for the group A, B and C was 3.47±2.09, 3.24±1.76 and 2.49±1.58 respectively, with statistical difference (F=4.65, P=0.011). The number of defecation before sleep was lesser in the group C than that of the group A and B (P=0.004, P=0.027, respectively). The total number of defecation for the group A, B and C was 7.20±2.67, 6.81±2.31 and 5.64±2.22 respectively. The difference among the three groups was statistically significant (F=6.68, P=0.002). For the group A and B, the total number of defecation was both more than that of the group C (P=0.001, P=0.010). There were no statistical differences among the three groups in the BBPS score of the left and middle colon and the t
目的探讨口服橄榄油联合聚乙二醇电解质（PEG）对慢性便秘患者结肠镜检查前肠道准备的有效性和安全性。方法对2017年11月至2018年5月在第四军医大学唐都医院接受结肠镜检查的180例慢性便秘患者进行随机、单盲、前瞻性研究。患者被随机分为三组。A组患者在结肠镜检查前一天晚上7:30服用60mL橄榄油和一块冰糖，然后在测试前晚上8:00服用1500mL PEG，并在结肠镜当天早上5:00服用1500mL聚乙二醇。B组患者在结肠镜检查前一天晚上8:00服用PEG后，服用60mL橄榄油和一块冰糖，然后在结肠镜当天早上5:00服用1500mL PEG。C组在结肠镜检查前一天晚上8点给药1500 mL PEG，在结肠镜检当天早上5点给药1 500 mL PEG。我们记录了服药后首次排便的时间、睡前排便次数、排便总数、右、中、左结肠波士顿肠道准备量表（BBPS）评分和不良反应，并比较了三组之间的数据。使用方差分析对测量数据进行比较。发现差异后，使用LSD-t检验对两组进行比较。计数数据采用Pearsonχ2检验进行比较。结果B组1例患者因检查过程中无法继续配合而终止结肠镜检查。B组和C组都排除了一名患者，因为在患者的降结肠中发现了大的肿块。最后，A组60例，B组58例，C组59例。三组在一般资源上无统计学差异（P>0.05）。A、B和C组服药后首次排便时间分别为（2.25±2.32）h、（2.43±2.39）h和（3.36±2.79）h，差异有统计学意义（F=3.36，P=0.037）。C组首次排便时间长于A组和B组（分别为P=0.016和P=0.046）。A、B和C组的睡前排便次数分别为3.47±2.09、3.24±1.76和2.49±1.58，差异有统计学意义（F=4.65，P=0.011）。A、B和C组的排便总数分别为7.20±2.67、6.81±2.31和5.64±2.22。三组之间的差异具有统计学意义（F=6.68，P=0.002）。A组和B组的排便总数均多于C组（P=0.001，P=0.010）。三组之间左、中结肠的BBPS评分和总BBPS评分没有统计学差异（均P>0.05），B和C分别为2.03±0.82、1.95±0.87和1.53±0.80，具有统计学差异（F=6.38，P=0.002），并且C组低于A和B组（分别为P=0.001，P=0.006）。服药后的不良反应包括恶心、呕吐、腹痛和腹胀，A组分别报告7例、3例、0例和3例，B组分别报告5例、3例行、0例行和6例行，C组分别报告4例、2例行、1例行和4例行，结论橄榄油组与PEG组相比，能提高慢性便秘患者右半结肠的清洁度，缩短用药后首次排便时间，增加睡前排便次数和排便准备总次数。结肠镜检查前一晚在PEG之前或之后服用橄榄油对肠道准备和不良反应没有显著影响。关键词：结肠镜检查；橄榄油；聚乙二醇电解质；慢性便秘；肠道准备
{"title":"Clinical effect of oral olive oil combined with polyethylene glycol electrolyte on bowel preparation for chronic constipation patients","authors":"Xiao‐hou Xi, Mingxin Zhang, Liping Cui, Qiang Lin, Weijia Dou, Shuguang Zhao, Liu Zhenxiong, Xuxia Wang, Jing-Jie Wang","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.03.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.03.009","url":null,"abstract":"Objective \u0000To investigate the effectiveness and safety of oral olive oil combined with polyethylene glycol electrolyte (PEG) on bowel preparation before colonoscopy for chronic constipation patients. \u0000 \u0000 \u0000Methods \u0000A randomized, single-blind, prospective study was conducted on 180 patients with chronic constipation, who underwent colonoscopy at Tangdu Hospital of the Fourth Military Medical University from November 2017 to May 2018. Patients were randomly divided into three groups. Patients in group A took 60 mL olive oil and a piece of crystal sugar at 7: 30 pm the day before colonoscopy, followed by 1 500 mL PEG at 8: 00 pm before the test, and 1 500 mL PEG at 5: 00 am the day of colonoscopy. Patients in group B took 60 mL olive oil and a piece of crystal sugar after administration of PEG at 8: 00 pm the day before colonoscopy, followed by 1 500 mL PEG at 5: 00 am the day of colonoscopy. The group C was given 1 500 mL PEG at 8: 00 pm the day before colonoscopy, and another 1 500 mL PEG at 5: 00 am the day of colonoscopy. We recorded the time of first defecation after taking medication, the number of defecation before sleep, the total number of defecation, the score of Boston bowel preparation scale (BBPS) of the right, middle and left colon, and the adverse reactions, and compared the data among the three groups. The measurement data was compared using the analysis of variance. After the difference was found, the LSD-t test was used to compare between the two groups. The enumeration data was compared using the Pearson χ2 test. \u0000 \u0000 \u0000Results \u0000One patient in the group B terminated colonoscopy due to unable to continue cooperation during the examination. Group B and C both excluded one patient because of a large mass found in the descending colon of patients. Finally, there were 60 cases in the group A, 58 in the group B, and 59 in the group C. There was no statistical difference between the three groups in the general resource (P>0.05). The time of first defecation after taking medication for the group A, B and C was (2.25±2.32) h, (2.43±2.39) h and (3.36±2.79) h respectively, with statistical difference (F=3.36, P=0.037). The time of first defecation was longer in the group C than that of the group A and B (P=0.016 and P=0.046, respectively). The number of defecation before sleep for the group A, B and C was 3.47±2.09, 3.24±1.76 and 2.49±1.58 respectively, with statistical difference (F=4.65, P=0.011). The number of defecation before sleep was lesser in the group C than that of the group A and B (P=0.004, P=0.027, respectively). The total number of defecation for the group A, B and C was 7.20±2.67, 6.81±2.31 and 5.64±2.22 respectively. The difference among the three groups was statistically significant (F=6.68, P=0.002). For the group A and B, the total number of defecation was both more than that of the group C (P=0.001, P=0.010). There were no statistical differences among the three groups in the BBPS score of the left and middle colon and the t","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"193-197"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47238879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.03.008
Meng-jiang He, Wei-feng Chen, Yi-Qun Zhang, Quan-Lin Li, Y. Zhong, Lili Ma, P. Zhou
Objective To evaluate the safety and efficacy of endoscopic submucosal dissection(ESD)for superficial hypopharyngeal neoplasm. Methods Clinicopathological data of 9 patients, who received ESD for superficial hypopharyngeal neoplasm in Zhongshan Hospital affiliated to Fudan University from September 2015 to March 2018, were retrospectively analyzed. Results Nine patients including 7 males and 2 females with mean age of 61.2 years (48-80 years)were included. The mean diameter of lesions was 16.3 mm (5-27 mm), and the mean operation time was 52.2 min(30-90 min). No bleeding, perforation, emphysema or dyspnea during or after ESD occurred. The mean length of hospitalization was 4.6 days (3-7 days). Pathology indicated 1 high grade intraepithelial neoplasia and 8 squamous cell cancer, and all cases of squamous cell cancer were constrained within lamina propria. One patient had positive horizontal margin and received radiotherapy. No recurrence, metastasis or stenosis was found during 10.2 months (3-29 months)of follow-up. Conclusion ESD is a safe and effective option for superficial hypopharyngeal neoplasm. Key words: Endoscopy; Hypopharyngeal neoplasms; Endoscopic submucosal dissection
{"title":"Clinical value of endoscopic submucosal dissection for superficial hypopharyngeal neoplasm (with video)","authors":"Meng-jiang He, Wei-feng Chen, Yi-Qun Zhang, Quan-Lin Li, Y. Zhong, Lili Ma, P. Zhou","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.03.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.03.008","url":null,"abstract":"Objective \u0000To evaluate the safety and efficacy of endoscopic submucosal dissection(ESD)for superficial hypopharyngeal neoplasm. \u0000 \u0000 \u0000Methods \u0000Clinicopathological data of 9 patients, who received ESD for superficial hypopharyngeal neoplasm in Zhongshan Hospital affiliated to Fudan University from September 2015 to March 2018, were retrospectively analyzed. \u0000 \u0000 \u0000Results \u0000Nine patients including 7 males and 2 females with mean age of 61.2 years (48-80 years)were included. The mean diameter of lesions was 16.3 mm (5-27 mm), and the mean operation time was 52.2 min(30-90 min). No bleeding, perforation, emphysema or dyspnea during or after ESD occurred. The mean length of hospitalization was 4.6 days (3-7 days). Pathology indicated 1 high grade intraepithelial neoplasia and 8 squamous cell cancer, and all cases of squamous cell cancer were constrained within lamina propria. One patient had positive horizontal margin and received radiotherapy. No recurrence, metastasis or stenosis was found during 10.2 months (3-29 months)of follow-up. \u0000 \u0000 \u0000Conclusion \u0000ESD is a safe and effective option for superficial hypopharyngeal neoplasm. \u0000 \u0000 \u0000Key words: \u0000Endoscopy; Hypopharyngeal neoplasms; Endoscopic submucosal dissection","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"188-192"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48036463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.03.007
Wei Jiang, Zhuqing Gao, M. Cui, Yongjun Wang
Objective To investigate the effects of changing the pancreatic stent number based on the last procedure on the prognosis of children and adolescents with recurrent chronic pancreatitis. Methods Data of 11 pediatric patients (3-16 years old) with chronic pancreatitis, undergoing ERCP for at least twice were retrospectively analyzed. Based on whether the number of stents changed in the second procedure, patients were divided into the control group(more than once and no change in the number), and the changing group(more than once and change in the stent number in the second procedure). The hospitalization and surgery percentage and number of hospitalizations due to abdominal pain in follow-up period were compared to study whether number change of stents was efficient to cure pediatric patients with chronic pancreatitis. Results Eleven pediatric patients undergoing at least 2 ERCP procedures were recruited into our group. The hospitalization percentages were 140%(n=7) and 33.3%(n=2) in the control group(n=5) and the changing group (n=6) respectively(P<0.001). The number of hospitalizations due to abdominal pain was 1.5 and 0.8 in the control group and the changing group respectively (P<0.001). The percentage of patient hospitalizations due to abdominal pain significantly reduced in the changing group (P=0.003). Conclusion Increase in pancreatic stent number in the second procedure in pediatric patients can decrease hospital admissions related to the pancreatitis. Key words: Pancreatitis, chronic; Stents; Cholangiopancreatography, endoscopic retrograde; Adolescent
{"title":"Effects of pancreatic stent number on the management of recurrent chronic pancreatitis in children and adolescents","authors":"Wei Jiang, Zhuqing Gao, M. Cui, Yongjun Wang","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.03.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.03.007","url":null,"abstract":"Objective \u0000To investigate the effects of changing the pancreatic stent number based on the last procedure on the prognosis of children and adolescents with recurrent chronic pancreatitis. \u0000 \u0000 \u0000Methods \u0000Data of 11 pediatric patients (3-16 years old) with chronic pancreatitis, undergoing ERCP for at least twice were retrospectively analyzed. Based on whether the number of stents changed in the second procedure, patients were divided into the control group(more than once and no change in the number), and the changing group(more than once and change in the stent number in the second procedure). The hospitalization and surgery percentage and number of hospitalizations due to abdominal pain in follow-up period were compared to study whether number change of stents was efficient to cure pediatric patients with chronic pancreatitis. \u0000 \u0000 \u0000Results \u0000Eleven pediatric patients undergoing at least 2 ERCP procedures were recruited into our group. The hospitalization percentages were 140%(n=7) and 33.3%(n=2) in the control group(n=5) and the changing group (n=6) respectively(P<0.001). The number of hospitalizations due to abdominal pain was 1.5 and 0.8 in the control group and the changing group respectively (P<0.001). The percentage of patient hospitalizations due to abdominal pain significantly reduced in the changing group (P=0.003). \u0000 \u0000 \u0000Conclusion \u0000Increase in pancreatic stent number in the second procedure in pediatric patients can decrease hospital admissions related to the pancreatitis. \u0000 \u0000 \u0000Key words: \u0000Pancreatitis, chronic; Stents; Cholangiopancreatography, endoscopic retrograde; Adolescent","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"185-187"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47876883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.03.004
Jian-feng Yu, Jian-yu Hao, Dong-fang Wu
Objective To compare the safety and effectiveness of endoscopic retrograde biliary drainage (ERBD) and endoscopic nasobiliary drainage (ENBD) in treatment of acute cholangitis. Methods A retrospective analysis was performed on data of 272 patients with acute cholangitis who underwent emergent endoscopic retrograde cholangiopancreatography (ERCP) in Beijing Chaoyang Hospital from January 2009 to June 2017. Patients were divided into ERBD group (n=143) and ENBD group (n=129) according to the drainage measures. In the ERBD group, there were 63 cases of grade Ⅰ (mild) acute cholangitis, 51 of grade Ⅱ (moderate), and 29 of grade Ⅲ (severe), and the corresponding cases in the ENBD group were 54, 37 and 38, respectively. The rate of improvement of inflammation, ERCP-related complications and interventions to drainage were compared between the two groups in all patients and each grade. Results The rates of improvement of inflammation in the ERBD group and the ENBD group were 89.5% (128/143) and 94.6% (122/129), respectively, in overall patients (χ2=2.399, P=0.126), 93.7% (59/63) and 98.1% (53/54), respectively, in grade Ⅰ patients (χ2=0.548, P=0.459), 90.2% (46/51) and 94.6% (35/37), respectively, in grade Ⅱ patients (χ2=0.125, P=0.724), and 79.3% (23/29) and 89.5% (34/38), respectively, in grade Ⅲ patients (χ2=0.657, P=0.418). The incidence of ERCP-related complications in the ERBD group and the ENBD group were 11.9% (17/143) and 7.8% (10/129), respectively, in overall patients (χ2=1.298, P=0.225), 9.5% (6/63) and 7.4% (4/54), respectively, in grade Ⅰ patients (χ2=0.006, P=0.939), 13.7% (7/51) and 8.1% (3/37), respectively, in grade Ⅱ patients (χ2=0.230, P=0.632), and 13.8% (4/29) and 7.9% (3/38), respectively, in grade Ⅲ patients (χ2=0.144, P=0.705). There were no significant differences in the rate of improvement of inflammation and ERCP-related complications between the two groups. The incidences of interventions to drainage in the ERBD group and the ENBD group were 10.5% (15/143) and 3.1% (4/129), respectively, in overall patients (χ2=5.699, P=0.017), 6.3% (4/63) and 1.9% (1/54), respectively, in grade Ⅰ patients (χ2=0.548, P=0.495), 9.8% (5/51) and 5.4% (2/37), respectively, in grade Ⅱ patients (χ2=0.125, P=0.724), and 20.7% (6/29) and 2.6% (1/38), respectively, in grade Ⅲ patients (χ2=3.965, P=0.046). There were significant differences in the incidence of interventions to drainage between the two groups in overall and grade Ⅲ patents. Conclusion ERBD and ENBD are equally safe and effective in treatment of different grades of acute cholangitis, but ENBD can reduce the incidence of interventions to drainage. Key words: Cholangiopancreatography, endoscopic retrograde; Stent; Nasobiliary drainage; Acute cholangitis
{"title":"Comparison between endoscopic retrograde biliary drainage and endoscopic nasobiliary drainage in treatment of acute cholangitis","authors":"Jian-feng Yu, Jian-yu Hao, Dong-fang Wu","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.03.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.03.004","url":null,"abstract":"Objective \u0000To compare the safety and effectiveness of endoscopic retrograde biliary drainage (ERBD) and endoscopic nasobiliary drainage (ENBD) in treatment of acute cholangitis. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was performed on data of 272 patients with acute cholangitis who underwent emergent endoscopic retrograde cholangiopancreatography (ERCP) in Beijing Chaoyang Hospital from January 2009 to June 2017. Patients were divided into ERBD group (n=143) and ENBD group (n=129) according to the drainage measures. In the ERBD group, there were 63 cases of grade Ⅰ (mild) acute cholangitis, 51 of grade Ⅱ (moderate), and 29 of grade Ⅲ (severe), and the corresponding cases in the ENBD group were 54, 37 and 38, respectively. The rate of improvement of inflammation, ERCP-related complications and interventions to drainage were compared between the two groups in all patients and each grade. \u0000 \u0000 \u0000Results \u0000The rates of improvement of inflammation in the ERBD group and the ENBD group were 89.5% (128/143) and 94.6% (122/129), respectively, in overall patients (χ2=2.399, P=0.126), 93.7% (59/63) and 98.1% (53/54), respectively, in grade Ⅰ patients (χ2=0.548, P=0.459), 90.2% (46/51) and 94.6% (35/37), respectively, in grade Ⅱ patients (χ2=0.125, P=0.724), and 79.3% (23/29) and 89.5% (34/38), respectively, in grade Ⅲ patients (χ2=0.657, P=0.418). The incidence of ERCP-related complications in the ERBD group and the ENBD group were 11.9% (17/143) and 7.8% (10/129), respectively, in overall patients (χ2=1.298, P=0.225), 9.5% (6/63) and 7.4% (4/54), respectively, in grade Ⅰ patients (χ2=0.006, P=0.939), 13.7% (7/51) and 8.1% (3/37), respectively, in grade Ⅱ patients (χ2=0.230, P=0.632), and 13.8% (4/29) and 7.9% (3/38), respectively, in grade Ⅲ patients (χ2=0.144, P=0.705). There were no significant differences in the rate of improvement of inflammation and ERCP-related complications between the two groups. The incidences of interventions to drainage in the ERBD group and the ENBD group were 10.5% (15/143) and 3.1% (4/129), respectively, in overall patients (χ2=5.699, P=0.017), 6.3% (4/63) and 1.9% (1/54), respectively, in grade Ⅰ patients (χ2=0.548, P=0.495), 9.8% (5/51) and 5.4% (2/37), respectively, in grade Ⅱ patients (χ2=0.125, P=0.724), and 20.7% (6/29) and 2.6% (1/38), respectively, in grade Ⅲ patients (χ2=3.965, P=0.046). There were significant differences in the incidence of interventions to drainage between the two groups in overall and grade Ⅲ patents. \u0000 \u0000 \u0000Conclusion \u0000ERBD and ENBD are equally safe and effective in treatment of different grades of acute cholangitis, but ENBD can reduce the incidence of interventions to drainage. \u0000 \u0000 \u0000Key words: \u0000Cholangiopancreatography, endoscopic retrograde; Stent; Nasobiliary drainage; Acute cholangitis","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"169-175"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45943646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.03.006
Yonghua Shen, Hao Zhu, Lei Wang, Ying Lyu, X. Zou
Objective To investigate the value of endoscopic ultrasound (EUS)-guided drainage via upper gastrointestinal tract for peripancreatic fluid collection. Methods The clinical data of 103 patients with peripancreatic fluid collection undergoing EUS-guided drainage via upper gastrointestinal tract from May 2006 to July 2017 in Nanjing Drum Tower Hospital were retrospectively analyzed, the treatment and postoperative complications were summarized. Results Among the 103 patients, 101 (98.1%) were punctured successfully, and patients were punctured mostly through the gastric wall (97.1%, 100/103). There were 29 cases of metal stent placement, and 66 plastic stent placement. Ten patients underwent ERCP with pancreatic stent placement. After operation, 8 patients underwent percutaneous drainage, and 1 surgical drainage. Complications occurred in 14 (13.6%) cases, including stent displacement in 5 cases, and postoperative infection in 9 cases. There was no perforation, bleeding, pancreatic fistula, other serious complications or death. Conclusion EUS-guided drainage is safe and reliable for peripancreatic fluid collection. Key words: Endosonography; Peripancreatic fluid collection; Drainage; Efficiency; Safety
{"title":"Endoscopic ultrasound-guided drainage via upper gastrointestinal tract for peripancreatic fluid collection: an analysis of 103 cases","authors":"Yonghua Shen, Hao Zhu, Lei Wang, Ying Lyu, X. Zou","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.03.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.03.006","url":null,"abstract":"Objective \u0000To investigate the value of endoscopic ultrasound (EUS)-guided drainage via upper gastrointestinal tract for peripancreatic fluid collection. \u0000 \u0000 \u0000Methods \u0000The clinical data of 103 patients with peripancreatic fluid collection undergoing EUS-guided drainage via upper gastrointestinal tract from May 2006 to July 2017 in Nanjing Drum Tower Hospital were retrospectively analyzed, the treatment and postoperative complications were summarized. \u0000 \u0000 \u0000Results \u0000Among the 103 patients, 101 (98.1%) were punctured successfully, and patients were punctured mostly through the gastric wall (97.1%, 100/103). There were 29 cases of metal stent placement, and 66 plastic stent placement. Ten patients underwent ERCP with pancreatic stent placement. After operation, 8 patients underwent percutaneous drainage, and 1 surgical drainage. Complications occurred in 14 (13.6%) cases, including stent displacement in 5 cases, and postoperative infection in 9 cases. There was no perforation, bleeding, pancreatic fistula, other serious complications or death. \u0000 \u0000 \u0000Conclusion \u0000EUS-guided drainage is safe and reliable for peripancreatic fluid collection. \u0000 \u0000 \u0000Key words: \u0000Endosonography; Peripancreatic fluid collection; Drainage; Efficiency; Safety","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"181-184"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41580933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To evaluate the efficacy and safety of X-ray guided endoscopic gastrojejunostomy using stent in treatment of malignant gastric outlet obstruction (GOO). Methods Six hospitalized patients with malignant GOO underwent X-ray guided endoscopic gastrojejunostomy using stent in the department of gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University between March 2017 and June 2017. The technical success rate, clinical success rate, procedure time, adverse events and follow-up were recorded and analyzed in this retrospective study. Results The stent was successfully placed in the 6 patients with 100% (6/6) technical success rate. The mean procedure time was 91.7±51.8 min. After the procedure, all patients were fed liquid or semi-liquid diet, and the GOO score system was increased from 0-1 before operation to 2-3 after operation. The clinical success rate was 100% (6/6). Peritonitis was observed in 2 patients during operation, and resolved by abdominal drainage. Gastrointestinal bleeding occurred in 1 patient after operation, which was resolved with conservative treatment. During a mean follow-up period of 78.6 days (range 32-100 days), there was no recurrence of obstruction symptoms except that 1 patient died because of tumor progress 60 days after procedure. Conclusion The X-ray guided endoscopic gastrojejunostomy using stent is feasible and safe to treat malignant GOO with a reliable short-term efficacy. Key words: Fluoroscopy; Gastroscopes; Gastric outlet obstruction; Gastrojejunostomy
{"title":"Clinical value of X-ray guided endoscopic gastrojejunostomy using stent (with video)","authors":"Guangchuan Wang, Q. Pei, Guangjun Huang, Xiaoli Wang, Junyong Zhang, Yongjun Shi, H. Qiao","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.03.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.03.005","url":null,"abstract":"Objective \u0000To evaluate the efficacy and safety of X-ray guided endoscopic gastrojejunostomy using stent in treatment of malignant gastric outlet obstruction (GOO). \u0000 \u0000 \u0000Methods \u0000Six hospitalized patients with malignant GOO underwent X-ray guided endoscopic gastrojejunostomy using stent in the department of gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University between March 2017 and June 2017. The technical success rate, clinical success rate, procedure time, adverse events and follow-up were recorded and analyzed in this retrospective study. \u0000 \u0000 \u0000Results \u0000The stent was successfully placed in the 6 patients with 100% (6/6) technical success rate. The mean procedure time was 91.7±51.8 min. After the procedure, all patients were fed liquid or semi-liquid diet, and the GOO score system was increased from 0-1 before operation to 2-3 after operation. The clinical success rate was 100% (6/6). Peritonitis was observed in 2 patients during operation, and resolved by abdominal drainage. Gastrointestinal bleeding occurred in 1 patient after operation, which was resolved with conservative treatment. During a mean follow-up period of 78.6 days (range 32-100 days), there was no recurrence of obstruction symptoms except that 1 patient died because of tumor progress 60 days after procedure. \u0000 \u0000 \u0000Conclusion \u0000The X-ray guided endoscopic gastrojejunostomy using stent is feasible and safe to treat malignant GOO with a reliable short-term efficacy. \u0000 \u0000 \u0000Key words: \u0000Fluoroscopy; Gastroscopes; Gastric outlet obstruction; Gastrojejunostomy","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"176-180"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41374056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.03.010
Shuang Li, Zhihong Jiang, Defa Zhang, W. Lu, D. Hu, Jia Li, Xiao-Nv Guo, Xiangjun Ji, J. Wen
Objective To assess the clinical value of endoscopic ultrasonography (EUS) for predicting esophageal varices (EV) progression in patients with hepatitis B virus (HBV)-related hepatocirrhosis. Methods A retrospective cohort study was performed on 299 HBV-related hepatocirrhosis patients with light EV in Tianjin Second People′s Hospital admitted from September 2014 to September 2015. The diameter and number of peri-esophageal collateral veins (ECV) and para-ECV were measured and described by EUS. The first EUS examination time was the starting point, and the follow-up of 24 months or EV progression was the end. Risk factors of EV progression were evaluated by multivariate Cox regression model, and the predictive value of EUS for EV progression was analyzed by receiver operating characteristic (ROC) curve. Results The cumulative incidence of EV progression was 2.3% (7/299), 14.8% (44/297), 33.7% (96/285) and 40.0% (120/273) at 6 months, 12 months, 18 months and 24 months of follow-up, respectively. The results of multivariate Cox regression analysis showed that the diameter of peri-ECV (P=0.011 2, HR=1.323 2, 95%CI: 1.065 6-1.642 9), the number of peri-ECV (P=0.000 1, HR=1.366 6, 95%CI: 1.163 4-1.605 2) and para-ECV diameter (P=0.000 2, HR=1.364 1, 95%CI: 1.155 8-1.610 0) were risk factors for EV progression. The use of nucleoside analogues treating HBV (P=0.002 0, HR=0.496 9, 95%CI: 0.318 6-0.775 1) and non-selective β-blockers descending portal venous pressure (P=0.076 5, HR=0.573 2, 95%CI: 0.309 7-1.061 1)were the protective factors for EV progression. The results of ROC curve analysis showed that the diameter of peri-ECV[P<0.001, area under the curve (AUC)=0.850, 95%CI: 0.804-0.895], the number of peri-ECV (P<0.001, AUC=0.831, 95%CI: 0.784-0.878), the diameter of para-ECV (P<0.001, AUC=0.924, 95%CI: 0.895-0.954), and the number of para-ECV (P<0.001, AUC=0.761, 95%CI: 0.704-0.817) had higher predictive value for EV progression; and the optimum cut-off values of each index were 1.85 mm, 3.5, 3.35 mm, and 4.5, respectively. The accuracies of prediction for EV progression were 76.60%, 75.19%, 84.48% and 70.29%, respectively. Conclusion EUS can be used to predict EV progression in HBV-related hepatocirrhosis patients. Peri-ECV diameter>1.85 mm, number>3.5, and para-ECV diameter>3.35 mm, number>4.5 suggest a high risk of EV progression. For patients with HBV-related hepatocirrhosis complicated with mild EV, nucleoside analogues to anti-HBV and non-selective β-blockers to reduce portal hypertension can prevent EV progression. Key words: Endoscopy, digestive system; Liver cirrhosis; Esophageal varices; Endoscopic ultrasonography; Predict
{"title":"A retrospective study of endoscopic ultrasonography for predicting progression of esophageal varices in patients with hepatitis B virus-related hepatocirrhosis","authors":"Shuang Li, Zhihong Jiang, Defa Zhang, W. Lu, D. Hu, Jia Li, Xiao-Nv Guo, Xiangjun Ji, J. Wen","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.03.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.03.010","url":null,"abstract":"Objective \u0000To assess the clinical value of endoscopic ultrasonography (EUS) for predicting esophageal varices (EV) progression in patients with hepatitis B virus (HBV)-related hepatocirrhosis. \u0000 \u0000 \u0000Methods \u0000A retrospective cohort study was performed on 299 HBV-related hepatocirrhosis patients with light EV in Tianjin Second People′s Hospital admitted from September 2014 to September 2015. The diameter and number of peri-esophageal collateral veins (ECV) and para-ECV were measured and described by EUS. The first EUS examination time was the starting point, and the follow-up of 24 months or EV progression was the end. Risk factors of EV progression were evaluated by multivariate Cox regression model, and the predictive value of EUS for EV progression was analyzed by receiver operating characteristic (ROC) curve. \u0000 \u0000 \u0000Results \u0000The cumulative incidence of EV progression was 2.3% (7/299), 14.8% (44/297), 33.7% (96/285) and 40.0% (120/273) at 6 months, 12 months, 18 months and 24 months of follow-up, respectively. The results of multivariate Cox regression analysis showed that the diameter of peri-ECV (P=0.011 2, HR=1.323 2, 95%CI: 1.065 6-1.642 9), the number of peri-ECV (P=0.000 1, HR=1.366 6, 95%CI: 1.163 4-1.605 2) and para-ECV diameter (P=0.000 2, HR=1.364 1, 95%CI: 1.155 8-1.610 0) were risk factors for EV progression. The use of nucleoside analogues treating HBV (P=0.002 0, HR=0.496 9, 95%CI: 0.318 6-0.775 1) and non-selective β-blockers descending portal venous pressure (P=0.076 5, HR=0.573 2, 95%CI: 0.309 7-1.061 1)were the protective factors for EV progression. The results of ROC curve analysis showed that the diameter of peri-ECV[P<0.001, area under the curve (AUC)=0.850, 95%CI: 0.804-0.895], the number of peri-ECV (P<0.001, AUC=0.831, 95%CI: 0.784-0.878), the diameter of para-ECV (P<0.001, AUC=0.924, 95%CI: 0.895-0.954), and the number of para-ECV (P<0.001, AUC=0.761, 95%CI: 0.704-0.817) had higher predictive value for EV progression; and the optimum cut-off values of each index were 1.85 mm, 3.5, 3.35 mm, and 4.5, respectively. The accuracies of prediction for EV progression were 76.60%, 75.19%, 84.48% and 70.29%, respectively. \u0000 \u0000 \u0000Conclusion \u0000EUS can be used to predict EV progression in HBV-related hepatocirrhosis patients. Peri-ECV diameter>1.85 mm, number>3.5, and para-ECV diameter>3.35 mm, number>4.5 suggest a high risk of EV progression. For patients with HBV-related hepatocirrhosis complicated with mild EV, nucleoside analogues to anti-HBV and non-selective β-blockers to reduce portal hypertension can prevent EV progression. \u0000 \u0000 \u0000Key words: \u0000Endoscopy, digestive system; Liver cirrhosis; Esophageal varices; Endoscopic ultrasonography; Predict","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"198-203"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45738933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.02.003
Rong Wang, Chuanjie Deng, Jun Zhu, Xin Jiang, Guo-an Hua, Yingying Chen, Xiao-Yu Huang, Xiaodong Xu
Objective To evaluate the diagnostic value of acetic acid spray combined with narrow-band imaging (NBI) for early gastric cancer and precancerous lesion. Methods A total of 136 gastric cancers and precancerous lesions from 132 patients detected by screening endoscopy from November 2015 to November 2017 in Guangming Chinese Medicine Hospital of Pudong New Area, Shanghai were enrolled in this study, and were divided into NBI group, acetic acid spray group, and acetic acid spray combined with NBI group (combination group). The image clarity, microsurface pattern, microvascular pattern, demarcation line, and mucosal whitening time were observed, and value of the 3 methods in diagnosis of early gastric cancer and precancerous lesions was analyzed. Results Image clarity of micro glandular in combination group was significantly better than that in NBI group and acetic acid spray group (χ2=8.766, P=0.003; χ2=5.273, P=0.022), and image clarity of microvascular in combination group was significantly better than that in NBI group (χ2=7.457, P=0.006). The overall diagnostic coincidence rate with pathology of combination group, NBI group, and acetic acid spray group was 91.9% (125/136), 85.3% (116/136), and 89.7% (122/136), respectively. The diagnostic sensitivity of irregular or missing microsurface, irregular or missing microvascular, obvious demarcation line, mucosal whitening time <30 s for carcinoma (including high grade intraepithelial neoplasia, early carcinoma and infiltrating carcinoma) were 92.3%, 91.3%, 92.3% and 90.4%, respectively, in the combination group, and the diagnostic specificity of above indicators were 93.8%, 93.8%, 96.9% and 90.6%, respectively, accuracy were 92.6%, 91.9%, 93.4% and 90.4%, respectively. For observation of microsurface, the combination group was superior to the NBI group (χ2=7.378, P=0.007), but there was no significant difference compared with the acetic acid spray group (χ2=0.427, P=0.513); the acetic acid spray group was superior to the NBI group (χ2=4.405, P=0.036). For observation of microvascular, the combination group was not significantly better than the NBI group (χ2=2.398, P=0.122). For observation of demarcation line, the combination group was not significantly better than the NBI group (χ2=2.722, P=0.099) and the acetic acid spray group (χ2=0.216, P=0.642). There was no difference between the acetic acid spray group and the NBI group (χ2=1.433, P=0.231) in observation of demarcation line. Conclusion Acetic acid spray combined with NBI has a good consistency with pathological results with high diagnostic sensitivity and specificity, and can clearly show microsurface of early gastric cancers and precancerous lesions compared to single NBI. Key words: Diagnosis; Acetic acid, staining; Narrow-band imaging; Early gastric cancer; Precancerous lesions
{"title":"Diagnostic value of acetic acid spray combined with narrow-band imaging for early gastric cancer and precancerous lesion","authors":"Rong Wang, Chuanjie Deng, Jun Zhu, Xin Jiang, Guo-an Hua, Yingying Chen, Xiao-Yu Huang, Xiaodong Xu","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.02.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.02.003","url":null,"abstract":"Objective \u0000To evaluate the diagnostic value of acetic acid spray combined with narrow-band imaging (NBI) for early gastric cancer and precancerous lesion. \u0000 \u0000 \u0000Methods \u0000A total of 136 gastric cancers and precancerous lesions from 132 patients detected by screening endoscopy from November 2015 to November 2017 in Guangming Chinese Medicine Hospital of Pudong New Area, Shanghai were enrolled in this study, and were divided into NBI group, acetic acid spray group, and acetic acid spray combined with NBI group (combination group). The image clarity, microsurface pattern, microvascular pattern, demarcation line, and mucosal whitening time were observed, and value of the 3 methods in diagnosis of early gastric cancer and precancerous lesions was analyzed. \u0000 \u0000 \u0000Results \u0000Image clarity of micro glandular in combination group was significantly better than that in NBI group and acetic acid spray group (χ2=8.766, P=0.003; χ2=5.273, P=0.022), and image clarity of microvascular in combination group was significantly better than that in NBI group (χ2=7.457, P=0.006). The overall diagnostic coincidence rate with pathology of combination group, NBI group, and acetic acid spray group was 91.9% (125/136), 85.3% (116/136), and 89.7% (122/136), respectively. The diagnostic sensitivity of irregular or missing microsurface, irregular or missing microvascular, obvious demarcation line, mucosal whitening time <30 s for carcinoma (including high grade intraepithelial neoplasia, early carcinoma and infiltrating carcinoma) were 92.3%, 91.3%, 92.3% and 90.4%, respectively, in the combination group, and the diagnostic specificity of above indicators were 93.8%, 93.8%, 96.9% and 90.6%, respectively, accuracy were 92.6%, 91.9%, 93.4% and 90.4%, respectively. For observation of microsurface, the combination group was superior to the NBI group (χ2=7.378, P=0.007), but there was no significant difference compared with the acetic acid spray group (χ2=0.427, P=0.513); the acetic acid spray group was superior to the NBI group (χ2=4.405, P=0.036). For observation of microvascular, the combination group was not significantly better than the NBI group (χ2=2.398, P=0.122). For observation of demarcation line, the combination group was not significantly better than the NBI group (χ2=2.722, P=0.099) and the acetic acid spray group (χ2=0.216, P=0.642). There was no difference between the acetic acid spray group and the NBI group (χ2=1.433, P=0.231) in observation of demarcation line. \u0000 \u0000 \u0000Conclusion \u0000Acetic acid spray combined with NBI has a good consistency with pathological results with high diagnostic sensitivity and specificity, and can clearly show microsurface of early gastric cancers and precancerous lesions compared to single NBI. \u0000 \u0000 \u0000Key words: \u0000Diagnosis; Acetic acid, staining; Narrow-band imaging; Early gastric cancer; Precancerous lesions","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"91-97"},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43765910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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