Pub Date : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.12.011
Cong Xu, Di Zhang
Objective To study the incidence, influencing factors and corresponding treatment of complications of endoscopic retrograde cholangiopancreatography (ERCP) in children with pancreaticobiliary diseases. Method Clinical data of 172 children aged under 16 years with pancreaticobiliary diseases receiving ERCP between January 2008 and December 2017 in Hangzhou First People′s Hospital were studied retrospectively. Anesthesia type, diagnosis, therapeutic methods and postoperative complications were analyzed. Results A total of 375 ERCP procedures were performed on 172 patients, among whom there were 210 cases (56.0%) of bile duct diseases and 245 (65.3%) pancreatic diseases. Dissection of pancreatic duct and biliary duct, calculus removal, insertion of endoprosthesis and drainage of pancreatic duct or biliary duct were performed. The success rate of ERCP was 99.5% (373/375). The incidence of complications was 6.7% (25/375) including 13 cases (3.5%) of post-ERCP pancreatitis, 8 cases (2.1%) of bleeding, and 6 cases (1.6%) of postoperative cholangitis. All the complications were cured. No severe pancreatitis, perforation or ERCP-related death occured. The first ERCP procedure and repeated cannulations were the risk factors of post-ERCP pancreatitis (P<0.05). Children had higher risk of post-ERCP bleeding after endoscopic sphincterotomy (P<0.05). Conclusion The incidence of post-ERCP complications in children is similar to that of adults and is related to therapeutic methods. More attention and timely treatment should be given to those children. ERCP can be effectively and safely for children operated by an experienced endoscopic physician with appropriate therapeutic methods. Key words: Cholangiopancreatography, endoscopic retrograde; Pancreatic diseases; Bile duct diseases; Child; Postoperative complications
{"title":"Complications of endoscopic retrograde cholangiopancreatography in children with pancreaticobiliary diseases","authors":"Cong Xu, Di Zhang","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.12.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.12.011","url":null,"abstract":"Objective \u0000To study the incidence, influencing factors and corresponding treatment of complications of endoscopic retrograde cholangiopancreatography (ERCP) in children with pancreaticobiliary diseases. \u0000 \u0000 \u0000Method \u0000Clinical data of 172 children aged under 16 years with pancreaticobiliary diseases receiving ERCP between January 2008 and December 2017 in Hangzhou First People′s Hospital were studied retrospectively. Anesthesia type, diagnosis, therapeutic methods and postoperative complications were analyzed. \u0000 \u0000 \u0000Results \u0000A total of 375 ERCP procedures were performed on 172 patients, among whom there were 210 cases (56.0%) of bile duct diseases and 245 (65.3%) pancreatic diseases. Dissection of pancreatic duct and biliary duct, calculus removal, insertion of endoprosthesis and drainage of pancreatic duct or biliary duct were performed. The success rate of ERCP was 99.5% (373/375). The incidence of complications was 6.7% (25/375) including 13 cases (3.5%) of post-ERCP pancreatitis, 8 cases (2.1%) of bleeding, and 6 cases (1.6%) of postoperative cholangitis. All the complications were cured. No severe pancreatitis, perforation or ERCP-related death occured. The first ERCP procedure and repeated cannulations were the risk factors of post-ERCP pancreatitis (P<0.05). Children had higher risk of post-ERCP bleeding after endoscopic sphincterotomy (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000The incidence of post-ERCP complications in children is similar to that of adults and is related to therapeutic methods. More attention and timely treatment should be given to those children. ERCP can be effectively and safely for children operated by an experienced endoscopic physician with appropriate therapeutic methods. \u0000 \u0000 \u0000Key words: \u0000Cholangiopancreatography, endoscopic retrograde; Pancreatic diseases; Bile duct diseases; Child; Postoperative complications","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"928-932"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46875196","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.12.003
Xiaoyue Xu, M. Cai, Xian-li Cai, Pin Wang, Quan-Lin Li, Bo-qun Zhu, W. Qin, Wei-feng Chen, Yi-Qun Zhang, Y. Zhong, L. Yao
Objective To investigate the feasibility and safety of endoscopic trans-gastric gallbladder-preserving cholecystolithotomy (ETGC) for gallstones. Methods The clinical data of 84 cholecystolithiasis patients, who received ETGC at Endoscopic Center of Zhongshan Hospital from March 2017 to May 2019 were analyzed retrospectively. The operation completion rate, operation time, complications and recurrence of calculus were summarized. Results In the 84 cases of cholecystolithiasis, there were 19 cases (22.6%) of single stone, 53 cases (63.1%) of multiple stones, and 12 cases (14.3%) of gallstones with gallbladder polyps. A total of 82 patients (97.6%) successfully completed ETGC with median operation time of 88 min. Ten patients (12.2%) suffered from abdominal pain after operation, of which 6 patients relieved after conservative treatments. The other 4 cases, including 2 cases of hemoperitoneum, 1 case of biliary fistula, and 1 case of choledocholithiasis with obstructive jaundice, were recovered after corresponding interventions. As of June 14, 2019, 5 cases were lost to follow-up (follow-up rate was 93.9%, 77/82). Residual stones were found in 2 cases (2.6%, 2/77). Stone recurrence was discovered in 4 cases (5.2%, 4/7), and 2 cases (2.6%, 2/77) had cholesterol crystallization in gallbladder. Conclusion ETGC is minimally invasive, feasible and safe in treatment of cholecystolithiasis, and can retain the function of gallbladder. However, how to completely remove the stones and avoid residue by ETGC still needs further exploration, and its long-term efficacy still needs further observation. Key words: Cholecystolithiasis; Endoscopic trans-gastric cholecystolithotomy; Stone residue; Stone recurrence
{"title":"A preliminary study of endoscopic trans-gastric gallbladder-preserving cholecystolithotomy for cholecystolithiasis (with video)","authors":"Xiaoyue Xu, M. Cai, Xian-li Cai, Pin Wang, Quan-Lin Li, Bo-qun Zhu, W. Qin, Wei-feng Chen, Yi-Qun Zhang, Y. Zhong, L. Yao","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.12.003","url":null,"abstract":"Objective \u0000To investigate the feasibility and safety of endoscopic trans-gastric gallbladder-preserving cholecystolithotomy (ETGC) for gallstones. \u0000 \u0000 \u0000Methods \u0000The clinical data of 84 cholecystolithiasis patients, who received ETGC at Endoscopic Center of Zhongshan Hospital from March 2017 to May 2019 were analyzed retrospectively. The operation completion rate, operation time, complications and recurrence of calculus were summarized. \u0000 \u0000 \u0000Results \u0000In the 84 cases of cholecystolithiasis, there were 19 cases (22.6%) of single stone, 53 cases (63.1%) of multiple stones, and 12 cases (14.3%) of gallstones with gallbladder polyps. A total of 82 patients (97.6%) successfully completed ETGC with median operation time of 88 min. Ten patients (12.2%) suffered from abdominal pain after operation, of which 6 patients relieved after conservative treatments. The other 4 cases, including 2 cases of hemoperitoneum, 1 case of biliary fistula, and 1 case of choledocholithiasis with obstructive jaundice, were recovered after corresponding interventions. As of June 14, 2019, 5 cases were lost to follow-up (follow-up rate was 93.9%, 77/82). Residual stones were found in 2 cases (2.6%, 2/77). Stone recurrence was discovered in 4 cases (5.2%, 4/7), and 2 cases (2.6%, 2/77) had cholesterol crystallization in gallbladder. \u0000 \u0000 \u0000Conclusion \u0000ETGC is minimally invasive, feasible and safe in treatment of cholecystolithiasis, and can retain the function of gallbladder. However, how to completely remove the stones and avoid residue by ETGC still needs further exploration, and its long-term efficacy still needs further observation. \u0000 \u0000 \u0000Key words: \u0000Cholecystolithiasis; Endoscopic trans-gastric cholecystolithotomy; Stone residue; Stone recurrence","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"886-890"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43480625","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.12.008
Jianqi Li, Menghua Cheng, Wen-xia Chen, Hongyu Ren, Jun Liu
Objective To investigate the effects of Helicobacter pylori (HP) radical treatment on diagnosis of early gastric cancer using conventional white light endoscopy (WLE), chromoendoscopy of indigo carmine dye added to acetic acid, and magnifying endoscopy with narrow band imaging (ME-NBI). Methods Between January 2013 and March 2018, patients without HP (successful cured before six months) or with HP (no radical treatment for HP in recent 6 months), who underwent endoscopy examinations in the Department of Gastroenterology of Ezhou Hospital, People′s Hospital of Wuhan University or the Department of Gastroenterology of Union Hospital, Tongji Medical College Huazhong University of Science and Technology were enrolled in the study. Endoscopy examinations were performed according to the order of conventional WLE, chromoendoscopy using indigo carmine dye added to acetic acid, and ME-NBI. Among the patients finally diagnosed as early gastric cancer by histopathology, 120 patients without HP and 120 patients with HP were continuously collected, and included in the radical treatment group and the non-radical treatment group, respectively. Diagnostic reliabilities of WLE, chromoendoscopy, and ME-NBI for early gastric cancer between the two groups were statistically analyzed. Results There were no statistical differences between the two groups in terms of hospital source (χ2=2.637, P=0.104), gender composition (χ2=0.074, P=0.785), mean age (t=0.582, P=0.561), and lesion morphology (χ2=0.179, P=0.914). The detection rates of early gastric cancer in the radical treatment group using WLE [75.0% (80/120) VS 81.7% (98/120), χ2=7.046, P=0.008], chromoendoscopy [57.5% (69/120) VS 93.3% (112/120), χ2=41.554, P<0.001], and ME-NBI [90.0% (108/120) VS 98.3% (118/120), χ2=7.585, P=0.006] were significantly lower than those in the non-radical treatment group. In the radical treatment group, chromoendoscopy had the lowest detection rate of early gastric cancer, followed by WLE (χ2=2.142, P=0.143) and ME-NBI (χ2=32.736, P<0.001), while ME-NBI had the highest detection rate of early gastric cancer, which higher than that of WLE (χ2= 19.247, P<0.001). Conclusion The diagnosis of early gastric cancer by WLE, chromoendoscopy using the indigo carmine dye added to acetic acid and ME-NBI becomes more difficult after radical treatment of HP. Among the above three endoscopic methods, ME-NBI has the highest diagnostic efficacy, and becomes the first choice for the clinical diagnosis of early gastric cancer after radical treatment of HP. Key words: Helicobacter pylori; Early gastric cancer; White light endoscopy; Chromoendoscopy; Magnifying endoscopy with narrow band imaging
{"title":"Effects of radical treatment of Helicobacter pylori on endoscopic diagnosis of early gastric cancer","authors":"Jianqi Li, Menghua Cheng, Wen-xia Chen, Hongyu Ren, Jun Liu","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.12.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.12.008","url":null,"abstract":"Objective \u0000To investigate the effects of Helicobacter pylori (HP) radical treatment on diagnosis of early gastric cancer using conventional white light endoscopy (WLE), chromoendoscopy of indigo carmine dye added to acetic acid, and magnifying endoscopy with narrow band imaging (ME-NBI). \u0000 \u0000 \u0000Methods \u0000Between January 2013 and March 2018, patients without HP (successful cured before six months) or with HP (no radical treatment for HP in recent 6 months), who underwent endoscopy examinations in the Department of Gastroenterology of Ezhou Hospital, People′s Hospital of Wuhan University or the Department of Gastroenterology of Union Hospital, Tongji Medical College Huazhong University of Science and Technology were enrolled in the study. Endoscopy examinations were performed according to the order of conventional WLE, chromoendoscopy using indigo carmine dye added to acetic acid, and ME-NBI. Among the patients finally diagnosed as early gastric cancer by histopathology, 120 patients without HP and 120 patients with HP were continuously collected, and included in the radical treatment group and the non-radical treatment group, respectively. Diagnostic reliabilities of WLE, chromoendoscopy, and ME-NBI for early gastric cancer between the two groups were statistically analyzed. \u0000 \u0000 \u0000Results \u0000There were no statistical differences between the two groups in terms of hospital source (χ2=2.637, P=0.104), gender composition (χ2=0.074, P=0.785), mean age (t=0.582, P=0.561), and lesion morphology (χ2=0.179, P=0.914). The detection rates of early gastric cancer in the radical treatment group using WLE [75.0% (80/120) VS 81.7% (98/120), χ2=7.046, P=0.008], chromoendoscopy [57.5% (69/120) VS 93.3% (112/120), χ2=41.554, P<0.001], and ME-NBI [90.0% (108/120) VS 98.3% (118/120), χ2=7.585, P=0.006] were significantly lower than those in the non-radical treatment group. In the radical treatment group, chromoendoscopy had the lowest detection rate of early gastric cancer, followed by WLE (χ2=2.142, P=0.143) and ME-NBI (χ2=32.736, P<0.001), while ME-NBI had the highest detection rate of early gastric cancer, which higher than that of WLE (χ2= 19.247, P<0.001). \u0000 \u0000 \u0000Conclusion \u0000The diagnosis of early gastric cancer by WLE, chromoendoscopy using the indigo carmine dye added to acetic acid and ME-NBI becomes more difficult after radical treatment of HP. Among the above three endoscopic methods, ME-NBI has the highest diagnostic efficacy, and becomes the first choice for the clinical diagnosis of early gastric cancer after radical treatment of HP. \u0000 \u0000 \u0000Key words: \u0000Helicobacter pylori; Early gastric cancer; White light endoscopy; Chromoendoscopy; Magnifying endoscopy with narrow band imaging","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"911-916"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45801341","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}
China is one of the countries with a high incidence of colorectal tumors. Early colorectal tumors can be eradicated through minimally invasive endoscopic treatment, and improving the diagnosis and treatment level of early colorectal tumors in China is an urgent task. Colonoscopy is an important technique for detecting early colorectal tumors. Blue light imaging and linkage imaging can provide detailed observation of the color, vascular information, and surface structure information of mucosal lesions, which is of great significance for the discovery and diagnosis of early colorectal cancer. This article provides a brief introduction to the principles of blue light imaging and linkage imaging, combined with the experience of our unit in the examination of colon lesions, in order to bring benefits to colleagues.
{"title":"Colonic lesion inspection strategy based on blue light imaging and linked color imaging","authors":"Wei-guang Qiao, Zhenyu Chen, Wen-xin Tan, Wenjian Guo","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.12.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.12.002","url":null,"abstract":"我国是结直肠肿瘤的高发国家之一。早期结直肠肿瘤经内镜下微创治疗即可根治，提高我国早期结直肠肿瘤的诊疗水平是当务之急。结肠镜检查是发现早期结直肠肿瘤的重要技术，蓝光成像和联动成像可对黏膜病变的色泽、血管信息和表面结构信息进行精细观察，对早期结直肠癌的发现和诊断具有重要意义。本文就蓝光成像和联动成像的原理，结合本单位的使用体会对结肠病变检查策略作简短介绍，以期为同行带来获益。","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"881-885"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46012804","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.12.005
Z. Dai
Objective To analyze the risk factors of cancer recurrence in stomach after non-curative endoscopic resection for early gastric cancer (EGC). Methods Data of 59 patients with early gastric cancer, who underwent non-curative resection at endoscopy center of Shanghai Renji Hospital from October 2008 to June 2018, were analyzed with the univariate Logistic regression for the risk factors of cancer recurrence in the stomach. Results The follow-up period ranged from 4 to 77 months, with the median time of 40 months. There were 11 cases of cancer recurrence in the stomach. The univariate Logistic regression analysis showed lymphatic vessel invasion (OR=8.63, 95%CI: 1.24-60.04, P=0.030) and eCura high-risk grading (OR=7.31, 95%CI: 1.05-51.10, P=0.045) were risk factors for cancer recurrence in the stomach. Conclusion The routine eCura grading assessment can be considered after non-cure resection. Patients with lymphatic vessel invasion or high-risk eCura category are not recommended for follow-up; patients with low-risk eCura grading can be followed up by regular endoscopy and attention should be paid to whether there are abnormalities around the original lesion. Key words: Stomach neoplasms; Neoplasm recurrence; Risk factors; Non-curative endoscopic resection
{"title":"Risk factors of cancer recurrence in stomach after non-curative endoscopic resection for early gastric cancer","authors":"Z. Dai","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.12.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.12.005","url":null,"abstract":"Objective \u0000To analyze the risk factors of cancer recurrence in stomach after non-curative endoscopic resection for early gastric cancer (EGC). \u0000 \u0000 \u0000Methods \u0000Data of 59 patients with early gastric cancer, who underwent non-curative resection at endoscopy center of Shanghai Renji Hospital from October 2008 to June 2018, were analyzed with the univariate Logistic regression for the risk factors of cancer recurrence in the stomach. \u0000 \u0000 \u0000Results \u0000The follow-up period ranged from 4 to 77 months, with the median time of 40 months. There were 11 cases of cancer recurrence in the stomach. The univariate Logistic regression analysis showed lymphatic vessel invasion (OR=8.63, 95%CI: 1.24-60.04, P=0.030) and eCura high-risk grading (OR=7.31, 95%CI: 1.05-51.10, P=0.045) were risk factors for cancer recurrence in the stomach. \u0000 \u0000 \u0000Conclusion \u0000The routine eCura grading assessment can be considered after non-cure resection. Patients with lymphatic vessel invasion or high-risk eCura category are not recommended for follow-up; patients with low-risk eCura grading can be followed up by regular endoscopy and attention should be paid to whether there are abnormalities around the original lesion. \u0000 \u0000 \u0000Key words: \u0000Stomach neoplasms; Neoplasm recurrence; Risk factors; Non-curative endoscopic resection","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"897-900"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45402095","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.12.009
F. Shen, C. Qu, Yi Zhang, Min Zhou, Zhen-ke Deng, Hua-ying Zhu, Jingyang Zhu, Guangjin Chen, Xi Zhang, Lei Xu
Objective To evaluate the safety and efficacy of foam sclerotherapy for bleeding internal hemorrhoids. Methods Consecutive adult patients (aged 18-60 years) with bleeding hemorrhoids were prospectively enrolled between March 2017 and March 2018. All patients were randomly assigned to the foam sclerotherapy (FS) group and the liquid sclerotherapy (LS) group. The foam and liquid sclerotherapy of hemorrhoids nucleus was performed by cap-assisted colonic endoscopy. Results A total of 108 patients were enrolled, including 62 males (57.4%) with mean age of 44.0±7.6 years. There was no significant difference in gender, age, or body mass index between the FS (n = 55) group and the LS (n =53) group. The total amount of lauromacrogol injection in the FS group was 3.7±0.9 mL, which was significantly lower than that in the LS group (8.0±2.2 mL, P<0.001). In the LS group, 8 patients (15.1%) developed bleeding after needle removal, which was significantly higher than that in the FS group [5.5%(3/53), P=0.022]. Significant pain was found in 2 patients (3.8%) in the LS group and 0 in the FS group (P= 0.025). The short-term cure rate and effective rate of the FS group were 87.3% (48/55) and 9.1% (5/55), while those were 69.8% (37/53) and 22.6% (12/53) in the LS group, respectively (P=0.046). Conclusion Foam sclerotherapy is safe and effective in the treatment of bleeding internal hemorrhoids. Key words: Hemorrhoids; Sclerosing solutions; Hemostasis, endoscopic; Sclerotherapy
{"title":"Therapeutic effects of endoscopic foam sclerotherapy for bleeding internal hemorrhoids","authors":"F. Shen, C. Qu, Yi Zhang, Min Zhou, Zhen-ke Deng, Hua-ying Zhu, Jingyang Zhu, Guangjin Chen, Xi Zhang, Lei Xu","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.12.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.12.009","url":null,"abstract":"Objective \u0000To evaluate the safety and efficacy of foam sclerotherapy for bleeding internal hemorrhoids. \u0000 \u0000 \u0000Methods \u0000Consecutive adult patients (aged 18-60 years) with bleeding hemorrhoids were prospectively enrolled between March 2017 and March 2018. All patients were randomly assigned to the foam sclerotherapy (FS) group and the liquid sclerotherapy (LS) group. The foam and liquid sclerotherapy of hemorrhoids nucleus was performed by cap-assisted colonic endoscopy. \u0000 \u0000 \u0000Results \u0000A total of 108 patients were enrolled, including 62 males (57.4%) with mean age of 44.0±7.6 years. There was no significant difference in gender, age, or body mass index between the FS (n = 55) group and the LS (n =53) group. The total amount of lauromacrogol injection in the FS group was 3.7±0.9 mL, which was significantly lower than that in the LS group (8.0±2.2 mL, P<0.001). In the LS group, 8 patients (15.1%) developed bleeding after needle removal, which was significantly higher than that in the FS group [5.5%(3/53), P=0.022]. Significant pain was found in 2 patients (3.8%) in the LS group and 0 in the FS group (P= 0.025). The short-term cure rate and effective rate of the FS group were 87.3% (48/55) and 9.1% (5/55), while those were 69.8% (37/53) and 22.6% (12/53) in the LS group, respectively (P=0.046). \u0000 \u0000 \u0000Conclusion \u0000Foam sclerotherapy is safe and effective in the treatment of bleeding internal hemorrhoids. \u0000 \u0000 \u0000Key words: \u0000Hemorrhoids; Sclerosing solutions; Hemostasis, endoscopic; Sclerotherapy","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"917-922"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43205732","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 : 2019-12-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.12.010
P. Pan, Sheng-Bing Zhao, Rundong Wang, Shuling Wang, Hong-Bo Sun, T. Xia, Xin Chang, Lun Gu, Zhao-shen Li, Yu Bai
Objective To evaluate the clinical value of a commercial low-residue diet (LRD) for bowel preparation of colonoscopy. Methods This study was a prospective, endoscopist-blind, and randomized controlled trial. Participants were randomly assigned to two groups according to administration of LRD: the experimental group and the control group. Bowel preparation quality, compliance and tolerability of the two groups were compared. Results A total of 61 patients were enrolled, with 32 in the experimental group and 29 in the control group. The outcomes were as follows: Boston Bowel Preparation Scale (BBPS) (7.8±1.0 VS 7.1±1.3, P=0.037), the rate of bowel preparation adequacy (87.5% VS 79.3%, P=0.388), compliance rate of dietary restriction (78.1% VS 55.2%, P=0.057), preparation completion rate (93.8% VS 93.1%, P=0.919), cecal intubation rate (both were 100.0%) and cecum arrival time (9.1±2.9 min VS 9.8±3.7 min, P=0.417), incidence of adverse (3.1% VS 3.4%, P=0.944), and hunger rate before colonoscopy (34.4% VS 48.3%, P=0.102). Conclusion The LRD for bowel preparation of colonoscopy significantly improves BBPS, but its effect on improving the bowel preparation adequacy, patient compliance and tolerability needs to be confirmed by further larger-scale trials. Key words: Colonoscopy; Enteral nutrition; Food, formulated; Recommended dietary allowances; Bowel preparation
目的探讨低残粮在结肠镜术前肠准备中的应用价值。方法本研究为前瞻性、内镜盲、随机对照试验。根据LRD的给药情况，将参与者随机分为实验组和对照组。比较两组患者的肠道准备质量、依从性和耐受性。结果共纳入61例患者，实验组32例，对照组29例。结果如下:波士顿肠准备量表(BBPS)(7.8±1.0 VS 7.1±1.3,P=0.037)、肠准备充分率(87.5% VS 79.3%， P=0.388)、饮食限制依从率(78.1% VS 55.2%， P=0.057)、准备完成率(93.8% VS 93.1%， P=0.919)、盲肠插管率(均为100.0%)和盲肠到达时间(9.1±2.9 min VS 9.8±3.7 min, P=0.417)、不良反应发生率(3.1% VS 3.4%， P=0.944)、结肠镜检查前饥饿率(34.4% VS 48.3%， P=0.102)。结论LRD用于结肠镜下肠准备可显著改善BBPS，但其在改善肠准备充分性、患者依从性和耐受性方面的作用有待进一步大规模试验证实。关键词:结肠镜检查;肠内营养;的食物,制定;建议膳食摄入量;肠道准备
{"title":"Evaluation of a low-residue diet for bowel preparation of colonoscopy","authors":"P. Pan, Sheng-Bing Zhao, Rundong Wang, Shuling Wang, Hong-Bo Sun, T. Xia, Xin Chang, Lun Gu, Zhao-shen Li, Yu Bai","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.12.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.12.010","url":null,"abstract":"Objective \u0000To evaluate the clinical value of a commercial low-residue diet (LRD) for bowel preparation of colonoscopy. \u0000 \u0000 \u0000Methods \u0000This study was a prospective, endoscopist-blind, and randomized controlled trial. Participants were randomly assigned to two groups according to administration of LRD: the experimental group and the control group. Bowel preparation quality, compliance and tolerability of the two groups were compared. \u0000 \u0000 \u0000Results \u0000A total of 61 patients were enrolled, with 32 in the experimental group and 29 in the control group. The outcomes were as follows: Boston Bowel Preparation Scale (BBPS) (7.8±1.0 VS 7.1±1.3, P=0.037), the rate of bowel preparation adequacy (87.5% VS 79.3%, P=0.388), compliance rate of dietary restriction (78.1% VS 55.2%, P=0.057), preparation completion rate (93.8% VS 93.1%, P=0.919), cecal intubation rate (both were 100.0%) and cecum arrival time (9.1±2.9 min VS 9.8±3.7 min, P=0.417), incidence of adverse (3.1% VS 3.4%, P=0.944), and hunger rate before colonoscopy (34.4% VS 48.3%, P=0.102). \u0000 \u0000 \u0000Conclusion \u0000The LRD for bowel preparation of colonoscopy significantly improves BBPS, but its effect on improving the bowel preparation adequacy, patient compliance and tolerability needs to be confirmed by further larger-scale trials. \u0000 \u0000 \u0000Key words: \u0000Colonoscopy; Enteral nutrition; Food, formulated; Recommended dietary allowances; Bowel preparation","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"923-927"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46995521","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 : 2019-11-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.11.004
Junfeng Guo, Xiu-jing Sun, Qian Zhang, J. Xing, Min Zhu, Bin Cao, Shutian Zhang
Objective To compare the efficacy and safety of endoscopic submucosal dissection(ESD) and surgery in the treatment of early gastric cancer. Methods Clinical data of patients with early gastric cancer who received ESD or surgery in Beijing Friendship Hospital from June 2012 to May 2018 were collected. Complete resection rate, complication incidence, hospital stay and expenses between the two groups were compared. Results There was no significant difference between two groups in complete resection rate[95.7%(245/256) VS 99.0%(97/98), P=0.191], or the complication incidence [5.9%(15/256) VS 8.2%(8/98), P=0.471]. Hospital stay was shorter in the ESD group than that in the surgery group(11.5±3.7 d VS 19.4±13.0 d, P=0.000). Expenses were less in the ESD group than those in the surgery group (27 383.1±10 143.0 yuan VS 78 004.3±79 027.8 yuan, P=0.000). Conclusion The efficacy and safety of ESD are comparable with surgery in the treatment of early gastric cancer, but ESD is superior to surgery in hospital stay and expenses. Key words: Surgical procedures, operative; Early gastric cancer; Endoscopic submucosal dissection
目的比较内镜下粘膜剥离术(ESD)与手术治疗早期胃癌的疗效和安全性。方法收集2012年6月至2018年5月北京友谊医院接受ESD或手术治疗的早期胃癌患者的临床资料。比较两组患者的全切率、并发症发生率、住院时间及费用。结果两组患者全切率[95.7%(245/256)VS 99.0%(97/98)， P=0.191]、并发症发生率[5.9%(15/256)VS 8.2%(8/98)， P=0.471]差异无统计学意义。ESD组住院时间短于手术组(11.5±3.7 d VS 19.4±13.0 d, P=0.000)。ESD组费用低于手术组(27 383.1±10 143.0元VS 78 004.3±79 027.8元，P=0.000)。结论ESD治疗早期胃癌的疗效和安全性与手术相当，但在住院时间和费用上均优于手术。关键词:外科手术;早期胃癌;内镜下粘膜夹层
{"title":"Evaluation of endoscopic submucosal dissection and surgery in the diagnosis and treatment of early gastric cancer","authors":"Junfeng Guo, Xiu-jing Sun, Qian Zhang, J. Xing, Min Zhu, Bin Cao, Shutian Zhang","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.11.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.11.004","url":null,"abstract":"Objective \u0000To compare the efficacy and safety of endoscopic submucosal dissection(ESD) and surgery in the treatment of early gastric cancer. \u0000 \u0000 \u0000Methods \u0000Clinical data of patients with early gastric cancer who received ESD or surgery in Beijing Friendship Hospital from June 2012 to May 2018 were collected. Complete resection rate, complication incidence, hospital stay and expenses between the two groups were compared. \u0000 \u0000 \u0000Results \u0000There was no significant difference between two groups in complete resection rate[95.7%(245/256) VS 99.0%(97/98), P=0.191], or the complication incidence [5.9%(15/256) VS 8.2%(8/98), P=0.471]. Hospital stay was shorter in the ESD group than that in the surgery group(11.5±3.7 d VS 19.4±13.0 d, P=0.000). Expenses were less in the ESD group than those in the surgery group (27 383.1±10 143.0 yuan VS 78 004.3±79 027.8 yuan, P=0.000). \u0000 \u0000 \u0000Conclusion \u0000The efficacy and safety of ESD are comparable with surgery in the treatment of early gastric cancer, but ESD is superior to surgery in hospital stay and expenses. \u0000 \u0000 \u0000Key words: \u0000Surgical procedures, operative; Early gastric cancer; Endoscopic submucosal dissection","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"811-814"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44345593","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 : 2019-11-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.11.007
Min Zhu, Xiu-jing Sun, Xiao Li, Qian Zhang, J. Xing, Bin Cao, Junfeng Guo, Shutian Zhang
Objective To investigate the risk factors of operation time of endoscopic submucosal dissection (ESD) for superficial gastric lesions. Methods Clinicopathologic data of 193 patients (195 lesions) diagnosed with early gastric cancer preoperatively who received ESD in Beijing Friendship Hospital from January 2015 to December 2017 were retrospectively collected, including basic information (age, gender, body mass index, comorbidities), lesion characteristics (size, location, morphology), the operators′ experience of ESD, operation time, and postoperative pathology, etc. Univariate analysis was performed to find the risk factors of ESD operation time, and logistic regression analysis was performed on the factors with statistical differences in univariate analysis to find the independent risk factors of ESD operation time over 120 min. Results The mean age of the patients was 63.34±9.11 years. The median time of ESD operation was 120.00 (95.00, 165.00) min and the median size of the lesions was 1.50 (1.00, 2.38) cm. Early gastric cancer was diagnosed by postoperative pathology in 164 lesions (84.10%), among which 162 lesions (98.78%) achieved en bloc resection, and 148 lesions (90.24%) achieved curative resection. The gender (P=0.018), location(P 0.05). Multivariate analysis showed that the lesion located in cardia/fundus of stomach (OR=5.656, 95%CI: 2.291-13.964, P 2 cm in size (OR=2.761, 95%CI: 1.229-6.205, P=0.014) were independent risk factors for the operation time longer than 120 min. Conclusion Lesions located in the cardia/fundus, body of stomach and >2 cm in size are independent risk factors for long operation time of ESD. Key words: Risk factors; Stomach neoplasms; Superficial gastric lesions; Endoscopic submucosal dissection; Operation time
{"title":"Predictors for operation time of endoscopic submucosal dissection for superficial gastric lesions","authors":"Min Zhu, Xiu-jing Sun, Xiao Li, Qian Zhang, J. Xing, Bin Cao, Junfeng Guo, Shutian Zhang","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.11.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.11.007","url":null,"abstract":"Objective \u0000To investigate the risk factors of operation time of endoscopic submucosal dissection (ESD) for superficial gastric lesions. \u0000 \u0000 \u0000Methods \u0000Clinicopathologic data of 193 patients (195 lesions) diagnosed with early gastric cancer preoperatively who received ESD in Beijing Friendship Hospital from January 2015 to December 2017 were retrospectively collected, including basic information (age, gender, body mass index, comorbidities), lesion characteristics (size, location, morphology), the operators′ experience of ESD, operation time, and postoperative pathology, etc. Univariate analysis was performed to find the risk factors of ESD operation time, and logistic regression analysis was performed on the factors with statistical differences in univariate analysis to find the independent risk factors of ESD operation time over 120 min. \u0000 \u0000 \u0000Results \u0000The mean age of the patients was 63.34±9.11 years. The median time of ESD operation was 120.00 (95.00, 165.00) min and the median size of the lesions was 1.50 (1.00, 2.38) cm. Early gastric cancer was diagnosed by postoperative pathology in 164 lesions (84.10%), among which 162 lesions (98.78%) achieved en bloc resection, and 148 lesions (90.24%) achieved curative resection. The gender (P=0.018), location(P 0.05). Multivariate analysis showed that the lesion located in cardia/fundus of stomach (OR=5.656, 95%CI: 2.291-13.964, P 2 cm in size (OR=2.761, 95%CI: 1.229-6.205, P=0.014) were independent risk factors for the operation time longer than 120 min. \u0000 \u0000 \u0000Conclusion \u0000Lesions located in the cardia/fundus, body of stomach and >2 cm in size are independent risk factors for long operation time of ESD. \u0000 \u0000 \u0000Key words: \u0000Risk factors; Stomach neoplasms; Superficial gastric lesions; Endoscopic submucosal dissection; Operation time","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"826-830"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44072623","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 establish the in vitro porcine gastric model of submucosal eminence lesion and to evaluate its application to endoscopic submucosal dissection(ESD). Methods Silicone rubber impression materials and steel balls with diameters of 1 cm, 2 cm, and 3 cm were used to make three pairs of spherical cavities. And then raw ground beef was put into spherical cavities and boiled for 20 minutes to make spherical mass models. Six isolated porcine stomach with esophagus and duodenum were selected. The mass models with diameters of 1 cm, 2 cm and 3 cm were imbedded respectively into the submucosa of fundus, body, and antrum of porcine stomach through the incision on serosal layer. The submucosal masses were observed by endoscopy and endoscopic ultrasonography and ESD was performed. Results A total of 18 mass models were constructed in 6 porcine stomachs, of which 17 models were successfully established and 1 failed. Typical endoscopic characteristics of gastric submucosal eminence lesions were found in 17 models. Endoscopic ultrasonography showed that these models originated from submucosal layer and demonstrated mixed echo. There were no significant differences between mucosa of lesions and that of surrounding areas. ESD was successfully performed in the porcine gastric models of submucosal eminence lesions, and all models were not broken or detached. Conclusion The in vitro porcine gastric model of submucosal eminence lesions can well replicate disease status and provide a suitable model for study on endoscopic therapy of submucosal eminence lesion and training of endoscopists. Key words: Disease model, animal; Isolated porcine stomach; Gastric submucosal eminence lesions; Endoscopic submucosal dissection
{"title":"Application of in vitro porcine gastric model of submucosal eminence lesion in endoscopic submucosal dissection","authors":"Ying-sheng Zhou, Hui‐quan Zhu, Jia-min Wang, Man-man Wang, Yuanyuan Fang, Rong-xiang Li, Huan Peng","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.11.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.11.008","url":null,"abstract":"Objective \u0000To establish the in vitro porcine gastric model of submucosal eminence lesion and to evaluate its application to endoscopic submucosal dissection(ESD). \u0000 \u0000 \u0000Methods \u0000Silicone rubber impression materials and steel balls with diameters of 1 cm, 2 cm, and 3 cm were used to make three pairs of spherical cavities. And then raw ground beef was put into spherical cavities and boiled for 20 minutes to make spherical mass models. Six isolated porcine stomach with esophagus and duodenum were selected. The mass models with diameters of 1 cm, 2 cm and 3 cm were imbedded respectively into the submucosa of fundus, body, and antrum of porcine stomach through the incision on serosal layer. The submucosal masses were observed by endoscopy and endoscopic ultrasonography and ESD was performed. \u0000 \u0000 \u0000Results \u0000A total of 18 mass models were constructed in 6 porcine stomachs, of which 17 models were successfully established and 1 failed. Typical endoscopic characteristics of gastric submucosal eminence lesions were found in 17 models. Endoscopic ultrasonography showed that these models originated from submucosal layer and demonstrated mixed echo. There were no significant differences between mucosa of lesions and that of surrounding areas. ESD was successfully performed in the porcine gastric models of submucosal eminence lesions, and all models were not broken or detached. \u0000 \u0000 \u0000Conclusion \u0000The in vitro porcine gastric model of submucosal eminence lesions can well replicate disease status and provide a suitable model for study on endoscopic therapy of submucosal eminence lesion and training of endoscopists. \u0000 \u0000 \u0000Key words: \u0000Disease model, animal; Isolated porcine stomach; Gastric submucosal eminence lesions; Endoscopic submucosal dissection","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"831-835"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44261705","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：