Pub Date : 2019-10-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.10.004
Chunmei Guo, Jing Wu, Hong Liu, Yadan Wang
Objective To investigate clinicopathological characteristics, diagnosis and treatment of multiple primary colorectal carcinoma (MPCC). Methods From January 2008 to March 2017, 42 patients diagnosed with MPCC underwent surgery at Beijing Shijitan Hospital, Capital Medical University. Their clinicopathological features, diagnosis and treatment were analyzed. Results These 42 MPCC patients accounted for 7.1% (42/592) colorectal cancer patients in the same period. There were 64 intestinal cancer lesions in 32 patients (76.2%) with synchronous carcinoma (SC), and 20 intestinal cancer lesions in 10 patients (23.8%) with metachronous carcinoma(MC), where the interval between the first and the recurrent was 18-105 months. The proportion of patients in the SC group with highly to moderately differentiated adenocarcinoma was significantly higher compared with that of the MC group (P 0.05). Among 42 patients undergoing radical operation, 6 received colonic metallic stent implantation as a bridge to elective resection in 10 patients with colonic obstruction. Conclusion MPCC, mainly two-lesion cancer, is most commonly found in sigmoid colon and rectum. Those with poorly differentiated cancer, mucinous carcinoma and those complicated with adenoma should be closely followed up with colonoscopy. Colonic metallic stent implantation as a bridge to elective resection may improve the detection rate of SC. Key words: Colorectal neoplasms; Neoplasms, multiple primary; DNA mismatch repair; Synchronous carcinoma; Metachronous carcinoma
{"title":"Clinicopathological characteristics and treatment of multiple primary colorectal carcinoma","authors":"Chunmei Guo, Jing Wu, Hong Liu, Yadan Wang","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.10.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.10.004","url":null,"abstract":"Objective \u0000To investigate clinicopathological characteristics, diagnosis and treatment of multiple primary colorectal carcinoma (MPCC). \u0000 \u0000 \u0000Methods \u0000From January 2008 to March 2017, 42 patients diagnosed with MPCC underwent surgery at Beijing Shijitan Hospital, Capital Medical University. Their clinicopathological features, diagnosis and treatment were analyzed. \u0000 \u0000 \u0000Results \u0000These 42 MPCC patients accounted for 7.1% (42/592) colorectal cancer patients in the same period. There were 64 intestinal cancer lesions in 32 patients (76.2%) with synchronous carcinoma (SC), and 20 intestinal cancer lesions in 10 patients (23.8%) with metachronous carcinoma(MC), where the interval between the first and the recurrent was 18-105 months. The proportion of patients in the SC group with highly to moderately differentiated adenocarcinoma was significantly higher compared with that of the MC group (P 0.05). Among 42 patients undergoing radical operation, 6 received colonic metallic stent implantation as a bridge to elective resection in 10 patients with colonic obstruction. \u0000 \u0000 \u0000Conclusion \u0000MPCC, mainly two-lesion cancer, is most commonly found in sigmoid colon and rectum. Those with poorly differentiated cancer, mucinous carcinoma and those complicated with adenoma should be closely followed up with colonoscopy. Colonic metallic stent implantation as a bridge to elective resection may improve the detection rate of SC. \u0000 \u0000 \u0000Key words: \u0000Colorectal neoplasms; Neoplasms, multiple primary; DNA mismatch repair; Synchronous carcinoma; Metachronous carcinoma","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"731-736"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47638890","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 investigate the clinical value of gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery on patients with cholecystolithiasis. Methods A retrospective study was performed on data of 15 patients with cholecystolithiasis, who underwent gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery from April 2018 to July 2018. The operative data, including situation of operation, operative time, intraoperative hemorrhage, and postoperative complications were recorded. Results The procedure was performed successfully in all patients with a mean operative time of 108±12 min (ranged from 92-129 min). The intraoperative hemorrhage was 10-30 mL. Eight patients suffered from slight right upper abdominal pain, and 7 patients felt slight pain in umbilical a week after surgery. No fever, incision infection, umbilical hemia, peritonitis, and ascites were reported. The clear-liquid diet was recommended for one day after operation, and postoperative activity was allowed since the second day after operation. All patients were discharged on the fourth or fifth day, and all recovered to their normal life at one week after discharge. Follow-up showed that the scar was small and hidden in umbilical without visible incision after one month. Ultrasonic examination results showed that gallbladder contractile function worked perfectly in four patients and no gallbladder stone was found after three months. Conclusion Gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery is a safe and effective option for patients with cholecystolithiasis, provides excellent cosmetic outcomes, and can be appropriately carried out under the strict control of surgical indications. Key words: Cholecystolithiasis; Natural orifice transluminal endoscopic surgery; Transumbilicus; Gallbladder-preserving cholelithotomy
{"title":"Clinical value of gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery","authors":"Xiaojian He, Da-zhou Li, Jian-qiang Liu, Chuanshen Jiang, Xiaolan L Zhang, Gang Liu, Wulian Lin, Donggui Hong, Wen Wang, Bingcan Yang, Shen-ling Li, Xiao-dong Wen, Liqing Wang, Shu-ping Ding","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.10.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.10.005","url":null,"abstract":"Objective \u0000To investigate the clinical value of gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery on patients with cholecystolithiasis. \u0000 \u0000 \u0000Methods \u0000A retrospective study was performed on data of 15 patients with cholecystolithiasis, who underwent gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery from April 2018 to July 2018. The operative data, including situation of operation, operative time, intraoperative hemorrhage, and postoperative complications were recorded. \u0000 \u0000 \u0000Results \u0000The procedure was performed successfully in all patients with a mean operative time of 108±12 min (ranged from 92-129 min). The intraoperative hemorrhage was 10-30 mL. Eight patients suffered from slight right upper abdominal pain, and 7 patients felt slight pain in umbilical a week after surgery. No fever, incision infection, umbilical hemia, peritonitis, and ascites were reported. The clear-liquid diet was recommended for one day after operation, and postoperative activity was allowed since the second day after operation. All patients were discharged on the fourth or fifth day, and all recovered to their normal life at one week after discharge. Follow-up showed that the scar was small and hidden in umbilical without visible incision after one month. Ultrasonic examination results showed that gallbladder contractile function worked perfectly in four patients and no gallbladder stone was found after three months. \u0000 \u0000 \u0000Conclusion \u0000Gallbladder-preserving cholelithotomy by natural orifice transumbilical endoscopic surgery is a safe and effective option for patients with cholecystolithiasis, provides excellent cosmetic outcomes, and can be appropriately carried out under the strict control of surgical indications. \u0000 \u0000 \u0000Key words: \u0000Cholecystolithiasis; Natural orifice transluminal endoscopic surgery; Transumbilicus; Gallbladder-preserving cholelithotomy","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"737-740"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44251480","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 : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.09.011
Si-jie Hao, Hang He, Feng Yang, Y. Di, Yuqin Jin, C. Jin, D. Fu, L. Zhong
Objective To evaluate the diagnostic efficiency and accuracy of endoscopic ultrasonography (EUS) on vascular involvement of pancreatic cancer. Methods Patients, suspected pancreatic cancer with vascular involvement by CT scan in Huashan Hospital, Fudan University from January 2014 to March 2019, were enrolled prospectively in the study. EUS was performed to evaluate the vascular involvement compared with surgical pathological results. Results A total of 132 patients with pancreatic cancer were enrolled in the study, and they all underwent EUS observation and radical resection with vessels resection. There were 103 cases of cancer in pancreatic head, 19 cancers in pancreatic neck and 10 cancers in distal pancreas. The diagnostic sensitivity, specificity and accuracy of EUS was 97.4% (113/116), 81.2% (13/16), and 95.5% (126/132), respectively for pancreatic cancers with vein involvement; while was 33.3% (2/6), 90.0% (81/90), and 86.5% (83/96), respectively, for pancreatic cancers with superior mesentery artery involvement. Conclusion EUS may play a key role in diagnosis of vascular involvement of pancreatic cancer, and be helpful for the surgical decision marking. Key words: Pancreatic neoplasms; Endoscopic ultrasonography; Vascular involvement
{"title":"Application of endoscopic ultrasonography on diagnosis of vascular involvement for pancreatic cancer","authors":"Si-jie Hao, Hang He, Feng Yang, Y. Di, Yuqin Jin, C. Jin, D. Fu, L. Zhong","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.09.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.09.011","url":null,"abstract":"Objective \u0000To evaluate the diagnostic efficiency and accuracy of endoscopic ultrasonography (EUS) on vascular involvement of pancreatic cancer. \u0000 \u0000 \u0000Methods \u0000Patients, suspected pancreatic cancer with vascular involvement by CT scan in Huashan Hospital, Fudan University from January 2014 to March 2019, were enrolled prospectively in the study. EUS was performed to evaluate the vascular involvement compared with surgical pathological results. \u0000 \u0000 \u0000Results \u0000A total of 132 patients with pancreatic cancer were enrolled in the study, and they all underwent EUS observation and radical resection with vessels resection. There were 103 cases of cancer in pancreatic head, 19 cancers in pancreatic neck and 10 cancers in distal pancreas. The diagnostic sensitivity, specificity and accuracy of EUS was 97.4% (113/116), 81.2% (13/16), and 95.5% (126/132), respectively for pancreatic cancers with vein involvement; while was 33.3% (2/6), 90.0% (81/90), and 86.5% (83/96), respectively, for pancreatic cancers with superior mesentery artery involvement. \u0000 \u0000 \u0000Conclusion \u0000EUS may play a key role in diagnosis of vascular involvement of pancreatic cancer, and be helpful for the surgical decision marking. \u0000 \u0000 \u0000Key words: \u0000Pancreatic neoplasms; Endoscopic ultrasonography; Vascular involvement","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"666-670"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46403580","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 : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.09.010
Shuang Li, Defa Zhang, W. Lu, D. Hu, Jia Li, Xiao-Nv Guo, Xiaofen Yue, Rui Fu, Xiangjun Ji, J. Wen
Objective To identify the independent risk factors of esophageal varices (EV) in cirrhosis by endoscopic ultrasonography (EUS), and further to establish a risk assessment model for predicting EV occurrence and evaluate the clinical predictive value of the model. Methods A retrospective cohort study was used in this study. Data of patients with cirrhosis without varicosity, who were hospitalized in Tianjin Second People's Hospital from September 2014 to March 2017 were collected. The location, diameter, and number of esophageal collateral circulation were measured by EUS. The non-selective beta blocker (NSBB) medication history and antiviral therapy were recorded. The time of the first EUS examination was taken as the starting point and the follow-up period was set up as 18 months. The end point was the occurrence of EV or the end of follow-up. The independent risk factors of EV occurrence were determined by univariate and multivariate logistic regression analysis, and the risk assessment model of EV occurrence was constructed. The predictive value of evaluation model for disease was studied by ROC analysis. Hosmer-Lemeshow goodness of fit was used to test the fitting efficiency of the evaluation model. Results A total of 638 subjects were recruited initially, 13 of them were lost in the course of the study. Finally, 625 cases were included in the study. Among them, 369 cases did not develop EV (the non-progress group) and 256 cases developed EV (the progress group). (1) Multivariate logistic regression analysis showed that 7 independent risk factors were selected into the risk assessment model of EV occurrence, and were assigned corresponding scores: no NSBB (3 points), no antiviral treatment (2 points), Child-Pugh stage B (1 point), the diameter of peri-ECV>2 mm (1 point), the number of peri-ECV≥5 (3 points), the diameter of para-ECV≥5 mm (4 points), and the number of para-ECV≥5 (4 points). (2) In the risk assessment model, the risk factor scores ranged from 1 to 4 with a total score of 0-18. The predicted incidence of EV increased from 0.003 to 1.000 with the increase of the score. (3) In the risk assessment model, the total risk score ≤2 was assigned into low-risk group, 3-5 into medium-risk group, and ≥6 into high-risk group. The actual EV incidence of each risk stratification was 2.78% in the low-risk group, 36.36% in the medium-risk group and 93.91% in the high-risk group, respectively. (4) The ROC analysis showed that area under curve (AUC) was 0.947 (P<0.05), suggesting that the risk assessment model had a good effect on predicting disease progression. Hosmer-Lemeshow test showed that P was 0.450, suggesting that the model fitted well. Conclusion The risk assessment model based on EUS can accurately predict the occurrence of EV, and is simple and easy to use. The model can provide scientific basis for the prevention and rational treatment of EV in liver cirrhosis. Key words: Liver cirrhosis; Varicose veins; Endoso
{"title":"A risk assessment model for esophageal varices occurrence based on endoscopic ultrasonography","authors":"Shuang Li, Defa Zhang, W. Lu, D. Hu, Jia Li, Xiao-Nv Guo, Xiaofen Yue, Rui Fu, Xiangjun Ji, J. Wen","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.09.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.09.010","url":null,"abstract":"Objective \u0000To identify the independent risk factors of esophageal varices (EV) in cirrhosis by endoscopic ultrasonography (EUS), and further to establish a risk assessment model for predicting EV occurrence and evaluate the clinical predictive value of the model. \u0000 \u0000 \u0000Methods \u0000A retrospective cohort study was used in this study. Data of patients with cirrhosis without varicosity, who were hospitalized in Tianjin Second People's Hospital from September 2014 to March 2017 were collected. The location, diameter, and number of esophageal collateral circulation were measured by EUS. The non-selective beta blocker (NSBB) medication history and antiviral therapy were recorded. The time of the first EUS examination was taken as the starting point and the follow-up period was set up as 18 months. The end point was the occurrence of EV or the end of follow-up. The independent risk factors of EV occurrence were determined by univariate and multivariate logistic regression analysis, and the risk assessment model of EV occurrence was constructed. The predictive value of evaluation model for disease was studied by ROC analysis. Hosmer-Lemeshow goodness of fit was used to test the fitting efficiency of the evaluation model. \u0000 \u0000 \u0000Results \u0000A total of 638 subjects were recruited initially, 13 of them were lost in the course of the study. Finally, 625 cases were included in the study. Among them, 369 cases did not develop EV (the non-progress group) and 256 cases developed EV (the progress group). (1) Multivariate logistic regression analysis showed that 7 independent risk factors were selected into the risk assessment model of EV occurrence, and were assigned corresponding scores: no NSBB (3 points), no antiviral treatment (2 points), Child-Pugh stage B (1 point), the diameter of peri-ECV>2 mm (1 point), the number of peri-ECV≥5 (3 points), the diameter of para-ECV≥5 mm (4 points), and the number of para-ECV≥5 (4 points). (2) In the risk assessment model, the risk factor scores ranged from 1 to 4 with a total score of 0-18. The predicted incidence of EV increased from 0.003 to 1.000 with the increase of the score. (3) In the risk assessment model, the total risk score ≤2 was assigned into low-risk group, 3-5 into medium-risk group, and ≥6 into high-risk group. The actual EV incidence of each risk stratification was 2.78% in the low-risk group, 36.36% in the medium-risk group and 93.91% in the high-risk group, respectively. (4) The ROC analysis showed that area under curve (AUC) was 0.947 (P<0.05), suggesting that the risk assessment model had a good effect on predicting disease progression. Hosmer-Lemeshow test showed that P was 0.450, suggesting that the model fitted well. \u0000 \u0000 \u0000Conclusion \u0000The risk assessment model based on EUS can accurately predict the occurrence of EV, and is simple and easy to use. The model can provide scientific basis for the prevention and rational treatment of EV in liver cirrhosis. \u0000 \u0000 \u0000Key words: \u0000Liver cirrhosis; Varicose veins; Endoso","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"659-665"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42298491","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 : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.09.012
Xin Ye, Bo Sun, Kunke Wang
Objective To evaluate diagnostic efficacy of endoscopic ultrasonography (EUS) for extra-hepatic bile duct dilation of unknown reasons which failed to be identified by traditional radiological methods. Methods Data of consecutive 892 patients who underwent EUS from February 2016 to September 2017 were retrospectively studied. Final diagnosis was determined by endoscopic retrograde cholangiopancreatography (ERCP)-based biopsy, surgical pathology, or a follow-up of at least 10 months. Results A total of 82 patients with extra-hepatic bile duct dilation (width ≥ 7 mm) and mean age of 61.5±9.6 years were included. The width of common bile duct was 13.0±4.25 mm. Reasons for extra-hepatic bile duct dilation could be determined by EUS in most patients with abnormal liver function. No malignant causes were detected in patients with normal liver function. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of EUS were 92.7%, 100.0%, 96.3%, 100.0%, and 93.2%, respectively. Conclusion For patients with dilated extra-hepatic bile duct without clear etiology, EUS may be an alternative for determining the etiology of extra-hepatic bile duct dilation. For those with extra-hepatic bile duct dilation with abnormal liver function, malignant causes should not be neglected. Key words: Common bile duct diseases; Cholangiopancreatography, endoscopic retrograde; Endosonography; Diagnostic techniques, digestive system
{"title":"Diagnostic value of endoscopic ultrasonography for extra-hepatic bile duct dilation of unknown reasons","authors":"Xin Ye, Bo Sun, Kunke Wang","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.09.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.09.012","url":null,"abstract":"Objective \u0000To evaluate diagnostic efficacy of endoscopic ultrasonography (EUS) for extra-hepatic bile duct dilation of unknown reasons which failed to be identified by traditional radiological methods. \u0000 \u0000 \u0000Methods \u0000Data of consecutive 892 patients who underwent EUS from February 2016 to September 2017 were retrospectively studied. Final diagnosis was determined by endoscopic retrograde cholangiopancreatography (ERCP)-based biopsy, surgical pathology, or a follow-up of at least 10 months. \u0000 \u0000 \u0000Results \u0000A total of 82 patients with extra-hepatic bile duct dilation (width ≥ 7 mm) and mean age of 61.5±9.6 years were included. The width of common bile duct was 13.0±4.25 mm. Reasons for extra-hepatic bile duct dilation could be determined by EUS in most patients with abnormal liver function. No malignant causes were detected in patients with normal liver function. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of EUS were 92.7%, 100.0%, 96.3%, 100.0%, and 93.2%, respectively. \u0000 \u0000 \u0000Conclusion \u0000For patients with dilated extra-hepatic bile duct without clear etiology, EUS may be an alternative for determining the etiology of extra-hepatic bile duct dilation. For those with extra-hepatic bile duct dilation with abnormal liver function, malignant causes should not be neglected. \u0000 \u0000 \u0000Key words: \u0000Common bile duct diseases; Cholangiopancreatography, endoscopic retrograde; Endosonography; Diagnostic techniques, digestive system","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"671-675"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46944153","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 : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.09.014
D. He, Xiaotong Wang, Bingrong Liu, Jiansheng Li, Dan Liu, Pu Zheng, Yanyan Zheng
Objective To assess the efficacy and safety of the endoscopic anti-reflux mucosectomy for gastroesophageal reflux disease. Methods Data of 18 patients with gastroesophageal reflux disease who underwent endoscopic anti-reflux mucosectomy at the First Affiliated Hospital of ZhengZhou University from December 2015 to July 2018 were retrospectively studied. The therapeutic effects (improvement of heartburn and reflux symptoms, 24 h esophageal pH monitoring) and complications were analyzed. Results Anti-reflux mucosectomy was performed successfully in all patients with successful rate of 100%. ESD was performed in 8 cases and EMR in 10 cases.24 h esophageal pH monitoring results showed that the Demeester score, the time percentage of pH < 4, total reflux events and reflux times of pH < 4 with time longer than 5 minutes after treatment were significantly lower than those before treatment (20.16±9.12 VS 74.16±20.03, (2.70±0.88)% VS (6.42±1.37)%, 43.78±19.68 VS 156.56±41.22, 2.89±1.68 VS 9.89±2.95, all P<0.05). No bleeding, perforation or infection was observed after the procedure. During a follow-up period of 3-34 months, symptom relief rate was 89% (16/18). A tightened cardiac was noted in 18 cases and recovery of mucosal damage was found in 16 patients. Conclusion Anti-reflux mucosectomy is safe, effective and easy to operate for gastroesophageal reflux disease. Key words: Gastroesophageal reflux; Anti-reflux mucosectomy; Endoscopic therapy
目的评价内镜下抗反流黏膜切除术治疗胃食管反流病的疗效和安全性。方法回顾性分析2015年12月至2018年7月在郑州大学第一附属医院接受内镜下抗反流粘膜切除术的18例胃食管反流病患者的资料。分析治疗效果（改善烧心和反流症状，24小时食管pH值监测）和并发症。结果所有患者均成功实施了抗反流粘膜切除术，成功率100%。ESD 8例，EMR 10例。24小时食管pH监测结果显示，治疗后Demester评分、pH<4的时间百分比、总反流事件和pH<4超过5分钟的反流次数显著低于治疗前（20.16±9.12 VS 74.16±20.03，（2.70±0.88）%VS（6.42±1.37）%，43.78±19.68 VS 156.56±41.22，2.89±1.68 VS 9.89±2.95，P均<0.05）。在3-34个月的随访期间，症状缓解率为89%（16/18）。18例患者出现心脏紧缩，16例患者出现粘膜损伤恢复。结论抗反流粘膜切除术治疗胃食管反流病安全、有效、操作简便。关键词：胃食管反流；抗反流粘膜切除术；内镜治疗
{"title":"Clinical evaluation of endoscopic anti-reflux mucosectomy for gastroesophageal reflux disease","authors":"D. He, Xiaotong Wang, Bingrong Liu, Jiansheng Li, Dan Liu, Pu Zheng, Yanyan Zheng","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.09.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.09.014","url":null,"abstract":"Objective \u0000To assess the efficacy and safety of the endoscopic anti-reflux mucosectomy for gastroesophageal reflux disease. \u0000 \u0000 \u0000Methods \u0000Data of 18 patients with gastroesophageal reflux disease who underwent endoscopic anti-reflux mucosectomy at the First Affiliated Hospital of ZhengZhou University from December 2015 to July 2018 were retrospectively studied. The therapeutic effects (improvement of heartburn and reflux symptoms, 24 h esophageal pH monitoring) and complications were analyzed. \u0000 \u0000 \u0000Results \u0000Anti-reflux mucosectomy was performed successfully in all patients with successful rate of 100%. ESD was performed in 8 cases and EMR in 10 cases.24 h esophageal pH monitoring results showed that the Demeester score, the time percentage of pH < 4, total reflux events and reflux times of pH < 4 with time longer than 5 minutes after treatment were significantly lower than those before treatment (20.16±9.12 VS 74.16±20.03, (2.70±0.88)% VS (6.42±1.37)%, 43.78±19.68 VS 156.56±41.22, 2.89±1.68 VS 9.89±2.95, all P<0.05). No bleeding, perforation or infection was observed after the procedure. During a follow-up period of 3-34 months, symptom relief rate was 89% (16/18). A tightened cardiac was noted in 18 cases and recovery of mucosal damage was found in 16 patients. \u0000 \u0000 \u0000Conclusion \u0000Anti-reflux mucosectomy is safe, effective and easy to operate for gastroesophageal reflux disease. \u0000 \u0000 \u0000Key words: \u0000Gastroesophageal reflux; Anti-reflux mucosectomy; Endoscopic therapy","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"682-685"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48380240","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}
{"title":"Endoscopic ultrasonography-guided biliary drainage: a new option of biliary drainage","authors":"Chuntao Liu","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.09.005","url":null,"abstract":"随着治疗性内镜超声技术(EUS)的发展，内镜超声引导下胆管穿刺引流术(EUS-BD)已成为新一代胆管引流技术，为胆道梗阻患者提供了微创胆道引流的新选择。EUS-BD作为ERCP失败后的胆管引流替代措施的疗效已得到公认，但其安全性仍略逊于经内镜逆行胰胆管造影术(ERCP)。随着EUS-BD专用附件的不断开发，不良事件的发生率将得到进一步降低。未来通过对EUS-BD操作方法的进一步优化及标准化，将有望使其成为与ERCP并列的初始胆管引流措施之一。","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"639-641"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49039704","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 : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.09.008
Jie Yang, Shu Zhang, Yanni Zhu, Guifang Xu, Song Zhang, C. Peng, Jun Yang, Lei Wang, X. Zou, Ying Lyu
Objective To study the feasibility of establishing human 3D pancreatic cancer organoids with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) specimen. Methods A total of 9 patients with suspected pancreatic masses were prospectively included in this study from June 2017 to January 2018. EUS-FNA was performed for initial diagnosis. The biopsy tissues were obtained from a COOK 22-gauge FNA needle for organoid establishment, and the growth status in vitro was observed. Results Nine specimens of pancreatic lesions obtained from EUS-FNA were enrolled. Successful establishment of organoids was achieved in 5 cases, which were all confirmed to be pancreatic cancer histopathologically. In the process of generating, the growth rate of organoids increased correspondingly. The pathological morphology of these organoids was similar to the corresponding pancreatic tissues in HE staining. Conclusion Pancreatic cancer organoids can be successfully created by means of EUS-FNA. Establishment of these organoids can potentially provide excellent models for patients with pancreatic cancer in guiding precision treatment. Key words: Carcinoma, pancreatic ductal; Endoscopic ultrasonography-guided fine-needle aspiration; Organoid; Precision medicine
{"title":"Establishment of pancreatic cancer organoids with endoscopic ultrasonography-guided fine-needle aspiration specimen: a prospective pilot study","authors":"Jie Yang, Shu Zhang, Yanni Zhu, Guifang Xu, Song Zhang, C. Peng, Jun Yang, Lei Wang, X. Zou, Ying Lyu","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.09.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.09.008","url":null,"abstract":"Objective \u0000To study the feasibility of establishing human 3D pancreatic cancer organoids with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) specimen. \u0000 \u0000 \u0000Methods \u0000A total of 9 patients with suspected pancreatic masses were prospectively included in this study from June 2017 to January 2018. EUS-FNA was performed for initial diagnosis. The biopsy tissues were obtained from a COOK 22-gauge FNA needle for organoid establishment, and the growth status in vitro was observed. \u0000 \u0000 \u0000Results \u0000Nine specimens of pancreatic lesions obtained from EUS-FNA were enrolled. Successful establishment of organoids was achieved in 5 cases, which were all confirmed to be pancreatic cancer histopathologically. In the process of generating, the growth rate of organoids increased correspondingly. The pathological morphology of these organoids was similar to the corresponding pancreatic tissues in HE staining. \u0000 \u0000 \u0000Conclusion \u0000Pancreatic cancer organoids can be successfully created by means of EUS-FNA. Establishment of these organoids can potentially provide excellent models for patients with pancreatic cancer in guiding precision treatment. \u0000 \u0000 \u0000Key words: \u0000Carcinoma, pancreatic ductal; Endoscopic ultrasonography-guided fine-needle aspiration; Organoid; Precision medicine","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"649-653"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42859898","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 : 2019-09-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.09.013
Xuan Zhao, Sumin Zhu, L. Miao, Shi Lihong, W. Xiaohong, Yanbin Wang, Jinchen Wang, Simin Guo
Objective To study the therapeutic value of endoscopic ultrasonography-guided hepaticogastrostomy(EUS-HG) for patients with high malignant biliary obstructive jaundice. Methods A total of 56 patients with high malignant obstructive jaundice hospitalized at the Second Affiliated Hospital of Nanjing Medical University and the Second Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2017 were included in the study. There were 29 males and 27 females with median age of 72 (60-82) years. Patients were randomized into two groups according to the random number table, the EUS-HG group (n=20) treated with EUS-HG and the percuteneous transhepatic cholangiodrainge(PTCD) group (n=36) treated with PTCD. The operative success rate, curative effect, complications and operation cost were compared between the two groups, and the median unblock period of plastic double pig tail stent was observed. Results (1)The success rates were 100% in both groups. (2) Preoperative and one-month postoperative levels of the following were tested and compared. Levels of total bilirubin were 362.15±138.27 μmol/L, 56.85±28.57 μmol/L in the EUS-HG group and 356.47±130.69 μmol/L, 60.93±25.79 μmol/L in the PTCD group, respectively. Levels of alkaline phosphatase were 896.57±357.29 U/L, 146.59±48.63 U/L in the EUS-HG group and 883.65±364.32 U/L, 151.57±49.73 U/L in the PTCD group, respectively. Levels of alanine aminotransferase were 252.36±38.77 U/L, 60.29±31.57 U/L in the EUS-HG group and 246.26±32.57 U/L, 62.56±32.87 U/L in the PTCD group. Levels of aspartate aminotransferase were 259.37±30.64 U/L, 62.28±26.58 U/L in the EUS-HG group and 242.37±29.52 U/L, 60.28±29.57 U/L in the PTCD group, and there was no significant difference between the two groups (P>0. 05). CRP levels were 52.57±31.95 mg/L, 16.95±8.77 mg/L in the EUS-HG group and 53.42±35.79 mg/L, 25.13±14.77 mg/L in the PTCD group (P 0.05]. (4) The incidence of total complications in the EUS-HG group (20.0%, 4/20) was significantly lower than that in the PTCD group (47.2%, 17/36, P 0.05). (6) The median unblock period of double pig tail plastic stents in EUS-HG group patients was 102 days. Conclusion EUS-HG is a safe and effective method for the treatment of high malignant biliary obstructive jaundice. It can be used as the first choice for treatment after failure of conventional ERCP. Key words: Jaundice, obstructive; Punctures; Drainage, postural; Endoscopic ultrasonography-guided hepaticogastrostomy
{"title":"Therapeutic value of endoscopic ultrasonography-guided hepaticogastrostomy for high malignant biliary obstructive jaundice","authors":"Xuan Zhao, Sumin Zhu, L. Miao, Shi Lihong, W. Xiaohong, Yanbin Wang, Jinchen Wang, Simin Guo","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.09.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.09.013","url":null,"abstract":"Objective \u0000To study the therapeutic value of endoscopic ultrasonography-guided hepaticogastrostomy(EUS-HG) for patients with high malignant biliary obstructive jaundice. \u0000 \u0000 \u0000Methods \u0000A total of 56 patients with high malignant obstructive jaundice hospitalized at the Second Affiliated Hospital of Nanjing Medical University and the Second Affiliated Hospital of Xuzhou Medical University from January 2014 to December 2017 were included in the study. There were 29 males and 27 females with median age of 72 (60-82) years. Patients were randomized into two groups according to the random number table, the EUS-HG group (n=20) treated with EUS-HG and the percuteneous transhepatic cholangiodrainge(PTCD) group (n=36) treated with PTCD. The operative success rate, curative effect, complications and operation cost were compared between the two groups, and the median unblock period of plastic double pig tail stent was observed. \u0000 \u0000 \u0000Results \u0000(1)The success rates were 100% in both groups. (2) Preoperative and one-month postoperative levels of the following were tested and compared. Levels of total bilirubin were 362.15±138.27 μmol/L, 56.85±28.57 μmol/L in the EUS-HG group and 356.47±130.69 μmol/L, 60.93±25.79 μmol/L in the PTCD group, respectively. Levels of alkaline phosphatase were 896.57±357.29 U/L, 146.59±48.63 U/L in the EUS-HG group and 883.65±364.32 U/L, 151.57±49.73 U/L in the PTCD group, respectively. Levels of alanine aminotransferase were 252.36±38.77 U/L, 60.29±31.57 U/L in the EUS-HG group and 246.26±32.57 U/L, 62.56±32.87 U/L in the PTCD group. Levels of aspartate aminotransferase were 259.37±30.64 U/L, 62.28±26.58 U/L in the EUS-HG group and 242.37±29.52 U/L, 60.28±29.57 U/L in the PTCD group, and there was no significant difference between the two groups (P>0. 05). CRP levels were 52.57±31.95 mg/L, 16.95±8.77 mg/L in the EUS-HG group and 53.42±35.79 mg/L, 25.13±14.77 mg/L in the PTCD group (P 0.05]. (4) The incidence of total complications in the EUS-HG group (20.0%, 4/20) was significantly lower than that in the PTCD group (47.2%, 17/36, P 0.05). (6) The median unblock period of double pig tail plastic stents in EUS-HG group patients was 102 days. \u0000 \u0000 \u0000Conclusion \u0000EUS-HG is a safe and effective method for the treatment of high malignant biliary obstructive jaundice. It can be used as the first choice for treatment after failure of conventional ERCP. \u0000 \u0000 \u0000Key words: \u0000Jaundice, obstructive; Punctures; Drainage, postural; Endoscopic ultrasonography-guided hepaticogastrostomy","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"676-681"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41854109","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 : 2019-08-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.08.005
Hai-qing Hu, Haijing Zhang, Chunlu Jin
Objective To study the safety and efficacy of peroral endoscopic cardial constriction (PECC) for gastroesophageal reflux disease (GERD). Methods A total of 27 patients with GERD who visited the Affiliated Hospital of Inner Mongolia Medical University from August 2016 to December 2017 and met the inclusion criteria received PECC. The 24 h esophageal pH-resistance monitoring (DeMeester) scores, GERD health-related quality of life (GERD-HRQL) scores, GERD-questionnaires (GERD-Q) symptom scores and clinical efficacy before and after operation were compared. Results DeMeester score at 3 months (Z=-6.940, P=0.001) and 6 months (Z=-6.307, P=0.001) after treatment, GERD-HRQL score at 3 months (t=11.499, P=0.001) and 6 months (t=10.959, P=0.001) as well as GERD-Q symptom score at 3 months (t=30.647, P=0.001) and 6 months (t=27.217, P =0.001) after surgery significantly decreased, compared with those before. The curative rates were 81.5% (22/27) and 77.8% (21/27) at 3 months and 6 months after operation. Conclusion PECC, a new method for the treatment of GERD with good short-term effect, safety and feasibility, can be recommended for clinical application. Key words: Cardia; Gastroesophageal reflux; Efficiency; Safety; Peroral endoscopic cardial constriction
{"title":"Clinical value of peroral endoscopic cardial constriction for gastroesophageal reflux disease","authors":"Hai-qing Hu, Haijing Zhang, Chunlu Jin","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.08.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.08.005","url":null,"abstract":"Objective \u0000To study the safety and efficacy of peroral endoscopic cardial constriction (PECC) for gastroesophageal reflux disease (GERD). \u0000 \u0000 \u0000Methods \u0000A total of 27 patients with GERD who visited the Affiliated Hospital of Inner Mongolia Medical University from August 2016 to December 2017 and met the inclusion criteria received PECC. The 24 h esophageal pH-resistance monitoring (DeMeester) scores, GERD health-related quality of life (GERD-HRQL) scores, GERD-questionnaires (GERD-Q) symptom scores and clinical efficacy before and after operation were compared. \u0000 \u0000 \u0000Results \u0000DeMeester score at 3 months (Z=-6.940, P=0.001) and 6 months (Z=-6.307, P=0.001) after treatment, GERD-HRQL score at 3 months (t=11.499, P=0.001) and 6 months (t=10.959, P=0.001) as well as GERD-Q symptom score at 3 months (t=30.647, P=0.001) and 6 months (t=27.217, P =0.001) after surgery significantly decreased, compared with those before. The curative rates were 81.5% (22/27) and 77.8% (21/27) at 3 months and 6 months after operation. \u0000 \u0000 \u0000Conclusion \u0000PECC, a new method for the treatment of GERD with good short-term effect, safety and feasibility, can be recommended for clinical application. \u0000 \u0000 \u0000Key words: \u0000Cardia; Gastroesophageal reflux; Efficiency; Safety; Peroral endoscopic cardial constriction","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"563-567"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48054034","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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