Pub Date : 2019-08-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.08.010
Yongjiang Ba, Yongxun Zhao, P. Yue, Yong Zhang, B. Bai, Yanyan Lin, Jinduo Zhang, W. Meng, Xun Li
Objective To evaluate radiography with CO2 combined with contrast agents for endoscopic drainage of unresectable hilar cholangiocarcinoma. Methods Clinical data of 43 patients with unresectable hilar cholangiocarcinoma undergoing endoscopic drainage at the First Hospital of Lanzhou University from October 2010 to October 2015 were analyzed retrospectively. According to different contrast agents in radiography, patients were divided into the study group (CO2 combined with contrast agent) and the control group (contrast agent alone). There were 23 cases in the study group and 20 cases in the control group. Total postoperative bilirubin(TBIL), white blood cell(WBC), procalcitonin(PCT)and the incidence of complications in the two groups were compared. Results The endoscopic procedure ranged from 50 min to 70 min. TBIL, WBC, PCT at 48 h and 72 h after operation in the study group were lower than those in the control group[48 h TBIL: (173.42±66.78) μmol/L VS (210.81±78.34) μmol/L, P=0.025; 72 h TBIL: (104.64±56.35) μmol/L VS (159.33±59.59) μmol/L, P=0.023; 48 h WBC: (11.51±7.78)×109/L VS (15.83±6.67)×109/L, P=0.026; 72 h WBC: (10.92±5.64)×109/L VS (14.72±4.97)×109/L, P=0.026; 48 h PCT: (0.56±0.18) ng/mL VS (1.24±0.73) ng/mL, P=0.003; 72 h PCT: (0.42±0.27) ng/mL VS (0.90±0.20) ng/mL, P=0.001]. The incidence of postoperative cholangitis in the study group was lower than that in the control group [13.0%(3/23)VS 40%(8/20), P=0.043]. Relatively low incidence of postoperative pancreatitis occurred in both groups, with no significant difference [4.3%(1/23) VS 10.0%(2/20), P=0.090]. Conclusion Radiography with CO2 combined with contrast agents during endoscopic drainage procedures for unresectable hilar cholangiocarcinoma is safe and effective, which could lower incidence of postoperative cholangitis. Key words: Bile duct neoplasms; Contrast media; Carbon dioxide; Endoscopic drainage
目的探讨CO2联合造影剂在内镜下不可切除肝门胆管癌引流中的应用价值。方法回顾性分析2010年10月至2015年10月兰州大学第一医院43例不可切除肝门胆管癌行内镜下引流术的临床资料。根据造影造影剂的不同，将患者分为研究组(CO2联合造影剂)和对照组(单独造影剂)。研究组23例，对照组20例。比较两组患者术后总胆红素(TBIL)、白细胞(WBC)、降钙素原(PCT)及并发症发生率。结果内镜下手术时间为50 ~ 70 min，研究组术后48 h、72 h TBIL、WBC、PCT均低于对照组[48 h TBIL:(173.42±66.78)μmol/L VS(210.81±78.34)μmol/L, P=0.025;72 h TBIL:(104.64±56.35)μmol/L VS(159.33±59.59)μmol/L, P=0.023;48小时白细胞:(11.51±7.78)×109 / L和(15.83±6.67)×109 / L, P = 0.026;72 h白细胞:(10.92±5.64)×109 / L和(14.72±4.97)×109 / L, P = 0.026;48 h PCT:(0.56±0.18)ng/mL VS(1.24±0.73)ng/mL, P=0.003;72 h PCT(0.42±0.27):ng / mL和(0.90±0.20)ng / mL, P = 0.001)。研究组术后胆管炎发生率低于对照组[13.0%(3/23)VS 40%(8/20)， P=0.043]。两组术后胰腺炎发生率均较低，差异无统计学意义[4.3%(1/23)VS 10.0%(2/20)， P=0.090]。结论CO2联合造影剂在内镜下引流治疗不可切除的肝门胆管癌安全有效，可降低术后胆管炎的发生率。关键词:胆管肿瘤;对比媒体;二氧化碳;内镜引流
{"title":"Value of radiography with CO2 combined with contrast agents in endoscopic drainage for hilar cholangiocarcinoma","authors":"Yongjiang Ba, Yongxun Zhao, P. Yue, Yong Zhang, B. Bai, Yanyan Lin, Jinduo Zhang, W. Meng, Xun Li","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.08.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.08.010","url":null,"abstract":"Objective \u0000To evaluate radiography with CO2 combined with contrast agents for endoscopic drainage of unresectable hilar cholangiocarcinoma. \u0000 \u0000 \u0000Methods \u0000Clinical data of 43 patients with unresectable hilar cholangiocarcinoma undergoing endoscopic drainage at the First Hospital of Lanzhou University from October 2010 to October 2015 were analyzed retrospectively. According to different contrast agents in radiography, patients were divided into the study group (CO2 combined with contrast agent) and the control group (contrast agent alone). There were 23 cases in the study group and 20 cases in the control group. Total postoperative bilirubin(TBIL), white blood cell(WBC), procalcitonin(PCT)and the incidence of complications in the two groups were compared. \u0000 \u0000 \u0000Results \u0000The endoscopic procedure ranged from 50 min to 70 min. TBIL, WBC, PCT at 48 h and 72 h after operation in the study group were lower than those in the control group[48 h TBIL: (173.42±66.78) μmol/L VS (210.81±78.34) μmol/L, P=0.025; 72 h TBIL: (104.64±56.35) μmol/L VS (159.33±59.59) μmol/L, P=0.023; 48 h WBC: (11.51±7.78)×109/L VS (15.83±6.67)×109/L, P=0.026; 72 h WBC: (10.92±5.64)×109/L VS (14.72±4.97)×109/L, P=0.026; 48 h PCT: (0.56±0.18) ng/mL VS (1.24±0.73) ng/mL, P=0.003; 72 h PCT: (0.42±0.27) ng/mL VS (0.90±0.20) ng/mL, P=0.001]. The incidence of postoperative cholangitis in the study group was lower than that in the control group [13.0%(3/23)VS 40%(8/20), P=0.043]. Relatively low incidence of postoperative pancreatitis occurred in both groups, with no significant difference [4.3%(1/23) VS 10.0%(2/20), P=0.090]. \u0000 \u0000 \u0000Conclusion \u0000Radiography with CO2 combined with contrast agents during endoscopic drainage procedures for unresectable hilar cholangiocarcinoma is safe and effective, which could lower incidence of postoperative cholangitis. \u0000 \u0000 \u0000Key words: \u0000Bile duct neoplasms; Contrast media; Carbon dioxide; Endoscopic drainage","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"587-590"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44285706","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.1007-5232.2019.08.008
Jiena Xu, Weilin Ou, Qixiang Li
Objective To investigate the value of double-balloon enteroscopy and CT enterography for the diagnosis of intestinal Crohn disease(CD). Methods Data of 125 patients with suspected CD undergoing double-balloon enteroscopy and CT enterography were reviewed. Diagnosis was made based on pathological, endoscopic findings and clinic follow-up results. Detection rates and diagnostic rates of double-balloon enteroscopy and CT enterography for intestinal CD were compared. Results The detection and diagnostic rates of intestinal CD by double-balloon endoscopy were 62.4%(78/125)and 94.8% (74/78), respectively. The sensitivity, specificity and accuracy of double-balloon enteroscopy in the diagnosis of intestinal CD were 100.0%, 92.2% and 96.8%, respectively. The detection and diagnostic rates of intestinal CD by CT enterography were 44.8%(56/125) and 89.3% (50/56) , respectively. The sensitivity, specificity and accuracy of CT enterography in the diagnosis of intestinal CD were 67.6%, 88.2% and 76.0%, respectively. Both the detection rate and the diagnostic rate of double-balloon enteroscopy in intestinal CD were higher than those of CT enterography. Conclusion Double-balloon enteroscopy shows high application value for the diagnosis of intestinal CD, but CT enterography before enteroscopy can guide the selection of endoscopic approach, reduce economic expenditure and alleviate patients′ pain, so CT enterography could be the first choice for intestinal CD patients with contraindications of enteroscopy. Key words: Crohn disease; Diagnosis; Double-balloon enteroscopy; CT enterography
{"title":"Diagnostic value of double-balloon enteroscopy and CT enterography for Crohn disease in intestine","authors":"Jiena Xu, Weilin Ou, Qixiang Li","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.08.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.08.008","url":null,"abstract":"Objective \u0000To investigate the value of double-balloon enteroscopy and CT enterography for the diagnosis of intestinal Crohn disease(CD). \u0000 \u0000 \u0000Methods \u0000Data of 125 patients with suspected CD undergoing double-balloon enteroscopy and CT enterography were reviewed. Diagnosis was made based on pathological, endoscopic findings and clinic follow-up results. Detection rates and diagnostic rates of double-balloon enteroscopy and CT enterography for intestinal CD were compared. \u0000 \u0000 \u0000Results \u0000The detection and diagnostic rates of intestinal CD by double-balloon endoscopy were 62.4%(78/125)and 94.8% (74/78), respectively. The sensitivity, specificity and accuracy of double-balloon enteroscopy in the diagnosis of intestinal CD were 100.0%, 92.2% and 96.8%, respectively. The detection and diagnostic rates of intestinal CD by CT enterography were 44.8%(56/125) and 89.3% (50/56) , respectively. The sensitivity, specificity and accuracy of CT enterography in the diagnosis of intestinal CD were 67.6%, 88.2% and 76.0%, respectively. Both the detection rate and the diagnostic rate of double-balloon enteroscopy in intestinal CD were higher than those of CT enterography. \u0000 \u0000 \u0000Conclusion \u0000Double-balloon enteroscopy shows high application value for the diagnosis of intestinal CD, but CT enterography before enteroscopy can guide the selection of endoscopic approach, reduce economic expenditure and alleviate patients′ pain, so CT enterography could be the first choice for intestinal CD patients with contraindications of enteroscopy. \u0000 \u0000 \u0000Key words: \u0000Crohn disease; Diagnosis; Double-balloon enteroscopy; CT enterography","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"577-581"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48677352","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.1007-5232.2019.08.002
Zhuoran Li, Xi Wu
{"title":"Application and doubt of expanding indication of endoscopic submucosal dissection for early gastric cancer","authors":"Zhuoran Li, Xi Wu","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.08.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.08.002","url":null,"abstract":"","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"548-551"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47739173","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.1007-5232.2019.08.006
Zi-li Xiao, P. Xiang, Feng Li, Ren-xiang Huang, Da'nian Ji, Zhijun Bao
Objective To evaluate the value of near focus narrow-band imaging (NF-NBI) in differentiating hyperplastic polyp (HP) and sessile serrated adenomas/polyp (SSA/P). Methods Data of 65 cases of pathologically confirmed HP or SSA/P with clear NF-NBI images in Huadong Hospital Affiliated to Fudan University from October 2017 to September 2018 were retrospectively analyzed. Three senior doctors observed the images of NF-NBI, including expanded crypt opening (ECO) and thick & branched vessel (TBV). The results were compared with pathological results in order to analyze differential diagnostic value of ECO and TBV for HP and SSA/P. Results Among 65 lesions, 44 were SSA/P and 21 were HP. The sensitivity, specificity, and accuracy of ECO, TBV, and ECO combined with TBV for differential diagnosis between HP and SSA/P were 80.3%(106/132), 85.7%(54/63) and 82.1%(160/195); 38.6%(51/132), 82.5%(52/63), and 52.8%(103/195); and 84.8%(112/132), 73.0%(46/63), and 81.0%(158/195), respectively. Conclusion ECO under NF-NBI has a high sensitivity for diagnosis of SSA/P. ECO combined with TBV is helpful for differential diagnosis between HP and SSA/P. Key words: Adenoma; Polyp; Near focus narrow-band imaging
{"title":"Value of near focus narrow-band imaging for differential diagnosis between hyperplastic polyp and sessile serrated adenoma/polyp","authors":"Zi-li Xiao, P. Xiang, Feng Li, Ren-xiang Huang, Da'nian Ji, Zhijun Bao","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.08.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.08.006","url":null,"abstract":"Objective \u0000To evaluate the value of near focus narrow-band imaging (NF-NBI) in differentiating hyperplastic polyp (HP) and sessile serrated adenomas/polyp (SSA/P). \u0000 \u0000 \u0000Methods \u0000Data of 65 cases of pathologically confirmed HP or SSA/P with clear NF-NBI images in Huadong Hospital Affiliated to Fudan University from October 2017 to September 2018 were retrospectively analyzed. Three senior doctors observed the images of NF-NBI, including expanded crypt opening (ECO) and thick & branched vessel (TBV). The results were compared with pathological results in order to analyze differential diagnostic value of ECO and TBV for HP and SSA/P. \u0000 \u0000 \u0000Results \u0000Among 65 lesions, 44 were SSA/P and 21 were HP. The sensitivity, specificity, and accuracy of ECO, TBV, and ECO combined with TBV for differential diagnosis between HP and SSA/P were 80.3%(106/132), 85.7%(54/63) and 82.1%(160/195); 38.6%(51/132), 82.5%(52/63), and 52.8%(103/195); and 84.8%(112/132), 73.0%(46/63), and 81.0%(158/195), respectively. \u0000 \u0000 \u0000Conclusion \u0000ECO under NF-NBI has a high sensitivity for diagnosis of SSA/P. ECO combined with TBV is helpful for differential diagnosis between HP and SSA/P. \u0000 \u0000 \u0000Key words: \u0000Adenoma; Polyp; Near focus narrow-band imaging","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"568-571"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42146142","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.1007-5232.2019.08.007
Wei-guang Qiao, Shoubin Ning, P. Wan, Yiyang Zhang, Yang Bai, Zhenyu Chen, Wen-xin Tan, Fachao Zhi
Objective To investigate the clinical application of enteroscopies in China, and to further provide evidence for popularization and promotion of enteroscopies. Methods The survey was designed between January 1st, 2017 and July 31th, 2017 with pre-survey in Guangdong Province between May 1st, 2017 and July 31st, 2017. It was conducted in Chinese mainland between August 30th, 2017 and December 30th, 2017. Data were collected through the online survey and reality survey at 385 hospitals. A total of 373 hospitals gave feedbacks and 7 hospitals were unqualified for further analysis after data checking, so 366 hospitals were included for final analysis, with a responding rate of 95.1%. Information on practice status of hospitals with enteroscopies and enteroscopists were collected. The chi-squared test was used for comparison of data between eastern and central and western regions. Results The hospitals owning enteroscopies accounted for 47.0% (172/366), 154/172 (89.5%) were tertiary referral hospitals, 112/172 (65.1%) established enteroscopy units, and 84/172 (48.8%) owned X-ray exclusive for enteroscopy. The proportion of enteroscopists with senior title was 40.3% (50/124), female enteroscopists accounted for 42.7% (53/124). Most enteroscopists aged 31-40 (50.8%) and 41-50 years (27.4%). 43.0% (74/172) hospitals employed only 1-2 enteroscopists. The diagnostic cases per year were less than 50 cases in 51.2% hospitals (88/172). The therapeutic cases per year were less than 10 cases in 51.7% hospitals (89/172). Nineteen of 124 (15.3%) of enteroscopists didn′t receive standard training. The number of hospitals performing enteroscopies in eastern regions was higher than that in central and western regions [111(51.6%) VS 61(40.4%), P=0.034]. The training background of enteroscopists in eastern regions was better than that in central and western regions. Untrained endoscopists accounted for 10.5% in eastern regions, while those accounted for 22.9% in central and western regions with significant difference(P=0.031). Conclusion Low number of patients treated and shortage of enteroscopists are obvious in Chinese mainland, especially in central and western regions. Standard training of enteroscopists is impending. Key words: Enteroscopy; Enteroscopist; Standard training; Questionaire survey
{"title":"The clinical application of enteroscopies in China: a national survey in 2017","authors":"Wei-guang Qiao, Shoubin Ning, P. Wan, Yiyang Zhang, Yang Bai, Zhenyu Chen, Wen-xin Tan, Fachao Zhi","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.08.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.08.007","url":null,"abstract":"Objective \u0000To investigate the clinical application of enteroscopies in China, and to further provide evidence for popularization and promotion of enteroscopies. \u0000 \u0000 \u0000Methods \u0000The survey was designed between January 1st, 2017 and July 31th, 2017 with pre-survey in Guangdong Province between May 1st, 2017 and July 31st, 2017. It was conducted in Chinese mainland between August 30th, 2017 and December 30th, 2017. Data were collected through the online survey and reality survey at 385 hospitals. A total of 373 hospitals gave feedbacks and 7 hospitals were unqualified for further analysis after data checking, so 366 hospitals were included for final analysis, with a responding rate of 95.1%. Information on practice status of hospitals with enteroscopies and enteroscopists were collected. The chi-squared test was used for comparison of data between eastern and central and western regions. \u0000 \u0000 \u0000Results \u0000The hospitals owning enteroscopies accounted for 47.0% (172/366), 154/172 (89.5%) were tertiary referral hospitals, 112/172 (65.1%) established enteroscopy units, and 84/172 (48.8%) owned X-ray exclusive for enteroscopy. The proportion of enteroscopists with senior title was 40.3% (50/124), female enteroscopists accounted for 42.7% (53/124). Most enteroscopists aged 31-40 (50.8%) and 41-50 years (27.4%). 43.0% (74/172) hospitals employed only 1-2 enteroscopists. The diagnostic cases per year were less than 50 cases in 51.2% hospitals (88/172). The therapeutic cases per year were less than 10 cases in 51.7% hospitals (89/172). Nineteen of 124 (15.3%) of enteroscopists didn′t receive standard training. The number of hospitals performing enteroscopies in eastern regions was higher than that in central and western regions [111(51.6%) VS 61(40.4%), P=0.034]. The training background of enteroscopists in eastern regions was better than that in central and western regions. Untrained endoscopists accounted for 10.5% in eastern regions, while those accounted for 22.9% in central and western regions with significant difference(P=0.031). \u0000 \u0000 \u0000Conclusion \u0000Low number of patients treated and shortage of enteroscopists are obvious in Chinese mainland, especially in central and western regions. Standard training of enteroscopists is impending. \u0000 \u0000 \u0000Key words: \u0000Enteroscopy; Enteroscopist; Standard training; Questionaire survey","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"572-576"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44312575","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.1007-5232.2019.08.009
Y. Tao, Liyi Zhang, Xiu-jing Sun
Objective To analyze the clinical and endoscopic characteristics of pneumatosis cystoides intestinalis (PCI) in colon. Methods Data of 116 patients with colonic PCI admitted at Beijing Friendship Hospital from January 2005 to June 2018 were retrospectively collected, including age, gender, clinical manifestations, lesion size, location, and morphology. The clinical and endoscopic characteristics of colonic PCI were analyzed. Results The 116 patients included 54 males and 62 females, with age of 59.11±13.13 years (ranged, 17-91 years). Fifty cases (43.10%) had a single lesion, and 66 cases (56.90%) had multiple lesions. The detection rate of colonic PCI was 0.40‰ (1/2 524) to 2.03‰ (8/3 945). Clinical manifestations included no symptom (24.14%, 28/116), abdominal pain (18.97%, 22/116), and elevated tumor markers (17.24%, 20/116). A total of 168 lesions were found under colonoscopy, and were single or multiple submucosal hemispherical or spherical cystic eminence of different sizes with soft surface, and some had hyperemia and erosion on the mucosal surface. The size of lesions was clearly recorded in 66 cases among the 116 patients, with 1.61±0.87 cm (ranged, 0.3-5.0 cm). The diameter of lesions was 1.0-<2.0 cm in 30 cases (45.45%). The single PCI was mostly located in ascending (38.00%, 19/50) and transverse (28.00%, 14/50) colon, and multiple PCIs were mostly located in ascending (28.81%, 34/118), sigmoid (22.03%, 26/118) and descending (17.80%, 21/118) colon. Conclusion Colonic PCI is a rare disease in clinic with non-specific clinical manifestations, and colonoscopy is an effective diagnostic method. It is apt to happen in elder patients and often found in ascending colon. Key words: Colonoscopy; Diagnosis; Pneumatosis cystoides intestinalis; Endoscopic characteristics
{"title":"Clinical and endoscopic characteristics analysis of 116 patients with pneumatosis cystoides intestinalis in colon","authors":"Y. Tao, Liyi Zhang, Xiu-jing Sun","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.08.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.08.009","url":null,"abstract":"Objective \u0000To analyze the clinical and endoscopic characteristics of pneumatosis cystoides intestinalis (PCI) in colon. \u0000 \u0000 \u0000Methods \u0000Data of 116 patients with colonic PCI admitted at Beijing Friendship Hospital from January 2005 to June 2018 were retrospectively collected, including age, gender, clinical manifestations, lesion size, location, and morphology. The clinical and endoscopic characteristics of colonic PCI were analyzed. \u0000 \u0000 \u0000Results \u0000The 116 patients included 54 males and 62 females, with age of 59.11±13.13 years (ranged, 17-91 years). Fifty cases (43.10%) had a single lesion, and 66 cases (56.90%) had multiple lesions. The detection rate of colonic PCI was 0.40‰ (1/2 524) to 2.03‰ (8/3 945). Clinical manifestations included no symptom (24.14%, 28/116), abdominal pain (18.97%, 22/116), and elevated tumor markers (17.24%, 20/116). A total of 168 lesions were found under colonoscopy, and were single or multiple submucosal hemispherical or spherical cystic eminence of different sizes with soft surface, and some had hyperemia and erosion on the mucosal surface. The size of lesions was clearly recorded in 66 cases among the 116 patients, with 1.61±0.87 cm (ranged, 0.3-5.0 cm). The diameter of lesions was 1.0-<2.0 cm in 30 cases (45.45%). The single PCI was mostly located in ascending (38.00%, 19/50) and transverse (28.00%, 14/50) colon, and multiple PCIs were mostly located in ascending (28.81%, 34/118), sigmoid (22.03%, 26/118) and descending (17.80%, 21/118) colon. \u0000 \u0000 \u0000Conclusion \u0000Colonic PCI is a rare disease in clinic with non-specific clinical manifestations, and colonoscopy is an effective diagnostic method. It is apt to happen in elder patients and often found in ascending colon. \u0000 \u0000 \u0000Key words: \u0000Colonoscopy; Diagnosis; Pneumatosis cystoides intestinalis; Endoscopic characteristics","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"582-586"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43147886","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 compare the diagnostic accuracy of white light endoscopy (WLE) and magnifying endoscopy combined with narrow-band imaging (ME-NBI) for intestinal-type gastric adenoma in benign lesions. Methods Data of patients with suspected early gastric neoplastic lesions diagnosed with WLE were collected from Shanghai Renji Hospital from January 2016 to December 2017. Patients with suspected early gastric neoplastic lesions by WLE were examined with WLE, ME-NBI and targeted biopsy again within 2 weeks. The results of WLE, ME-NBI and biopsy were recorded. Using pathological diagnosis as the golden standard, diagnostic efficacy of WLE and ME-NBI for intestinal-type gastric adenoma and other non-adenoma lesions was evaluated. Results A total of 232 patients (232 lesions) were included, i. e., 124 intestinal-type gastric adenoma and 108 other non-adenoma lesions such as atrophy, ulcers, hyperplasia, low-grade intraepithelial neoplasia, etc.. The sensitivity, negative predictive value and accuracy of ME-NBI in intestinal-type gastric adenoma were higher than those of WLE (92.7% VS 71.8%, 91.6% VS 73.7%, 91.8% VS 80.6%, all P 0.05). Conclusion Diagnostic efficacy of ME-NBI in intestinal-type gastric adenoma from other non-adenoma lesions is significantly higher than that of WLE. Key words: Adenoma; Stomach neoplasm; Endoscopy, gastrointestinal; Narrow-band imaging
目的比较白光内镜(WLE)与放大内镜联合窄带成像(ME-NBI)对肠型胃腺瘤良性病变的诊断准确性。方法收集2016年1月至2017年12月在上海仁济医院诊断为WLE的疑似早期胃肿瘤患者资料。WLE怀疑早期胃肿瘤病变的患者在2周内再次行WLE、ME-NBI及靶向活检检查。记录WLE、ME-NBI及活检结果。以病理诊断为金标准，评价WLE和ME-NBI对肠型胃腺瘤及其他非腺瘤病变的诊断效果。结果共纳入232例患者(232个病变)，即肠型胃腺瘤124例，其他非腺瘤病变如萎缩、溃疡、增生、低级别上皮内瘤变等108例。ME-NBI对肠型胃腺瘤的敏感性、阴性预测值和准确性均高于WLE (92.7% VS 71.8%、91.6% VS 73.7%、91.8% VS 80.6%， P均为0.05)。结论ME-NBI对肠型胃腺瘤其他非腺瘤病变的诊断效果明显高于WLE。关键词:腺瘤;胃肿瘤;胃肠道内窥镜检查;窄带成像技术
{"title":"Comparison of diagnostic efficacy of conventional white light endoscopy and magnifying endoscopy combined with narrow-band imaging for intestinal-type gastric adenoma in benign lesions","authors":"La-Mei Teng, Qing-Wei Zhang, Xintian Zhang, Jin-Nan Chen, Jing Zhou","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.08.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.08.004","url":null,"abstract":"Objective \u0000To compare the diagnostic accuracy of white light endoscopy (WLE) and magnifying endoscopy combined with narrow-band imaging (ME-NBI) for intestinal-type gastric adenoma in benign lesions. \u0000 \u0000 \u0000Methods \u0000Data of patients with suspected early gastric neoplastic lesions diagnosed with WLE were collected from Shanghai Renji Hospital from January 2016 to December 2017. Patients with suspected early gastric neoplastic lesions by WLE were examined with WLE, ME-NBI and targeted biopsy again within 2 weeks. The results of WLE, ME-NBI and biopsy were recorded. Using pathological diagnosis as the golden standard, diagnostic efficacy of WLE and ME-NBI for intestinal-type gastric adenoma and other non-adenoma lesions was evaluated. \u0000 \u0000 \u0000Results \u0000A total of 232 patients (232 lesions) were included, i. e., 124 intestinal-type gastric adenoma and 108 other non-adenoma lesions such as atrophy, ulcers, hyperplasia, low-grade intraepithelial neoplasia, etc.. The sensitivity, negative predictive value and accuracy of ME-NBI in intestinal-type gastric adenoma were higher than those of WLE (92.7% VS 71.8%, 91.6% VS 73.7%, 91.8% VS 80.6%, all P 0.05). \u0000 \u0000 \u0000Conclusion \u0000Diagnostic efficacy of ME-NBI in intestinal-type gastric adenoma from other non-adenoma lesions is significantly higher than that of WLE. \u0000 \u0000 \u0000Key words: \u0000Adenoma; Stomach neoplasm; Endoscopy, gastrointestinal; Narrow-band imaging","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"558-562"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43112212","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.1007-5232.2019.08.003
Si Liu, Qian Zhang, J. Xing, Xiu-jing Sun, Min Zhu, Junfeng Guo, Shengtao Zhu, Peng Li
Objective To analyze the possible influencing factors of postoperative bleeding after endoscopic submucosal dissection and endoscopic mucosal resection (ESD/EMR) for early gastric cancer. Methods Clinical data of patients receiving ESD/EMR for the diagnosis of early gastric cancer at the Endoscopy Center of Beijing Friendship Hospital from January 2013 to May 2018, including demographic information (age, gender and history), endoscopic lesion characteristics (tumor size, location and morphology) and postoperative pathological features (differentiated types and invasive depth) were collected to analyze the effects of these factors on bleeding after ESD/EMR. Results A total of 195 patients with early gastric cancer were included in the study and 9 cases (4.6%) had postoperative bleeding. The medication history of clopidogrel and main lesion sizes were statistically different between postoperative bleeding group and non-bleeding group (P=0.018 and P=0.034). Multivariate analysis showed a history of clopidogrel (OR=10.223, 95%CI: 1.143-91.468, P=0.038), multiple lesions (OR=6.412, 95%CI: 1.123-36.616, P=0.037) and lesions sizes of larger than 2 cm (OR=6.718, 95%CI: 1.130-39.935, P=0.036) were possible risk factors for postoperative bleeding. Survival analysis showed of higher postoperative bleeding risks in patients with the history of clopidogrel (P<0.001) and lesions sizes of more than 2 cm (P=0.022). Conclusion More attention should be paid to the risk of ESD/EMR postoperative bleeding in early gastric cancer patients with medication history of clopidogrel and multiple large lesions. Key words: Endoscopic mucosal resection; Risk factors; Endoscopic submucosal dissection; Early gastric cancer; Postoperative bleeding
{"title":"Influencing factors of postoperative bleeding in endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer","authors":"Si Liu, Qian Zhang, J. Xing, Xiu-jing Sun, Min Zhu, Junfeng Guo, Shengtao Zhu, Peng Li","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.08.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.08.003","url":null,"abstract":"Objective \u0000To analyze the possible influencing factors of postoperative bleeding after endoscopic submucosal dissection and endoscopic mucosal resection (ESD/EMR) for early gastric cancer. \u0000 \u0000 \u0000Methods \u0000Clinical data of patients receiving ESD/EMR for the diagnosis of early gastric cancer at the Endoscopy Center of Beijing Friendship Hospital from January 2013 to May 2018, including demographic information (age, gender and history), endoscopic lesion characteristics (tumor size, location and morphology) and postoperative pathological features (differentiated types and invasive depth) were collected to analyze the effects of these factors on bleeding after ESD/EMR. \u0000 \u0000 \u0000Results \u0000A total of 195 patients with early gastric cancer were included in the study and 9 cases (4.6%) had postoperative bleeding. The medication history of clopidogrel and main lesion sizes were statistically different between postoperative bleeding group and non-bleeding group (P=0.018 and P=0.034). Multivariate analysis showed a history of clopidogrel (OR=10.223, 95%CI: 1.143-91.468, P=0.038), multiple lesions (OR=6.412, 95%CI: 1.123-36.616, P=0.037) and lesions sizes of larger than 2 cm (OR=6.718, 95%CI: 1.130-39.935, P=0.036) were possible risk factors for postoperative bleeding. Survival analysis showed of higher postoperative bleeding risks in patients with the history of clopidogrel (P<0.001) and lesions sizes of more than 2 cm (P=0.022). \u0000 \u0000 \u0000Conclusion \u0000More attention should be paid to the risk of ESD/EMR postoperative bleeding in early gastric cancer patients with medication history of clopidogrel and multiple large lesions. \u0000 \u0000 \u0000Key words: \u0000Endoscopic mucosal resection; Risk factors; Endoscopic submucosal dissection; Early gastric cancer; Postoperative bleeding","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"552-557"},"PeriodicalIF":0.0,"publicationDate":"2019-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46989709","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 : 2019-07-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.07.005
Shuai Gong, S. Yang, H. Xue, Yun-jia Zhao, Yao Zhang, Yun-jie Gao, Hai-ying Chen, Hui Ding, Xiao-Bo Li
Objective To investigate the clinical, endoscopic and pathological features of gastritis cystica profunda (GCP). Methods A total of 40 patients with GCP confirmed by pathology who received endoscopic or surgical treatment at Renji Hospital, School of Medicine, Shanghai Jiaotong University from May 2013 to May 2018, were included in the retrospective analysis. The clinical data such as population composition, clinical manifestations, endoscopic findings and pathological results were summarized and analyzed. Results Among the 40 patients were predominantly males (75.0%, 30/40), and the mean age of onset was 61.2 years. The most common sites were cardia (32.5%, 13/40) and gastric antrum (30.0%, 12/40). The clinical symptoms of the patients were atypical and it was difficult to diagnose GCP with routine endoscopy examination. The endoscopic findings were mostly type 0-Ⅱ (50.0%, 20/40). GCP with neoplastic lesions accounted for 55% (22/40). Unconditional logistic regression analysis showed that male (P=0.013, OR=31.093, 95% CI: 2.079-464.976) and Helicobacter pylori infection (P=0.041, OR=10.225, 95% CI: 1.096-95.411) were risk factors for GCP with neoplastic lesions. Conclusion GCP commonly occurs in middle-aged and elderly men, and varies in different manifestations under white light endoscopy. GCP is not a benign lesion, but can also coexist with neoplastic lesions, which are mostly differentiated intramucosal cancer. Key words: Endoscopy, digestive system; Gastritis cystica profunda; Early gastric cancer; Endoscopic submucosal dissection
{"title":"Diagnosis and treatment of 40 cases of gastritis cystica profunda","authors":"Shuai Gong, S. Yang, H. Xue, Yun-jia Zhao, Yao Zhang, Yun-jie Gao, Hai-ying Chen, Hui Ding, Xiao-Bo Li","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.07.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.07.005","url":null,"abstract":"Objective \u0000To investigate the clinical, endoscopic and pathological features of gastritis cystica profunda (GCP). \u0000 \u0000 \u0000Methods \u0000A total of 40 patients with GCP confirmed by pathology who received endoscopic or surgical treatment at Renji Hospital, School of Medicine, Shanghai Jiaotong University from May 2013 to May 2018, were included in the retrospective analysis. The clinical data such as population composition, clinical manifestations, endoscopic findings and pathological results were summarized and analyzed. \u0000 \u0000 \u0000Results \u0000Among the 40 patients were predominantly males (75.0%, 30/40), and the mean age of onset was 61.2 years. The most common sites were cardia (32.5%, 13/40) and gastric antrum (30.0%, 12/40). The clinical symptoms of the patients were atypical and it was difficult to diagnose GCP with routine endoscopy examination. The endoscopic findings were mostly type 0-Ⅱ (50.0%, 20/40). GCP with neoplastic lesions accounted for 55% (22/40). Unconditional logistic regression analysis showed that male (P=0.013, OR=31.093, 95% CI: 2.079-464.976) and Helicobacter pylori infection (P=0.041, OR=10.225, 95% CI: 1.096-95.411) were risk factors for GCP with neoplastic lesions. \u0000 \u0000 \u0000Conclusion \u0000GCP commonly occurs in middle-aged and elderly men, and varies in different manifestations under white light endoscopy. GCP is not a benign lesion, but can also coexist with neoplastic lesions, which are mostly differentiated intramucosal cancer. \u0000 \u0000 \u0000Key words: \u0000Endoscopy, digestive system; Gastritis cystica profunda; Early gastric cancer; Endoscopic submucosal dissection","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"483-486"},"PeriodicalIF":0.0,"publicationDate":"2019-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47592889","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 : 2019-07-20DOI: 10.3760/CMA.J.ISSN.1007-5232.2019.07.007
Wei Wu, Rong Fan, Ji-hong Tan, A. Qian
Objective To investigate the efficacy and limitation of endoscopic ultrasonography(EUS) on the diagnosis of gastrointestinal submucosal tumor (SMT) prior to endoscopic resection. Methods Data of 211 patients, who were confirmed as gastrointestinal SMT before operation and received endoscopic resection for gastrointestinal submucosal tumor at Department of Gastroenterology, Shanghai Ruijin Hospital from January 2016 to December 2018 were analyzed. The value and limitation of EUS for SMT were investigated according to the final pathology. Results For the lesion distribution, 66 were in esophagus, 108 in stomach, 2 in duodenum and 35 in rectum. The accuracy of tumor origin by EUS was 99.5% (210/211). The accuracy of tumor nature by EUS was 75.8% (160/211). For the lesions originated from different locations, the diagnostic accuracy for lesion originated from esophageal mucosa/submucosa, esophageal muscularis propria, gastric mucosa/submucosa, gastric muscularis propria, duodenal submucosa, rectal mucosa/submucosa by EUS were 90.0%(54/60), 83.3%(5/6), 31.0%(13/42), 89.4%(59/66), 50.0%(1/2), 82.9%(29/35), respectively. With respect to hypoechoic lesions, leiomyoma, leiomyoma/gastrointestinal stromal tumor, and neuroendocrine tumor were the predominant type of tumor originated from esophageal mucosa, gastrointestinal muscularis propria and rectal mucosa/submucosal, respectively. Conclusion Although EUS is indispensible for the diagnosis of gastrointestinal submucosal tumor, it plays a limited role in the differential diagnosis of various lesions originated from gastric mucosa and submucosa. Since part of the submucosal tumors may be potential for malignant development, an diagnosis made by EUS should be more careful. Key words: Endoscopy; Endoscopic ultrasonography; Submucosal tumor
{"title":"Value and limitation of endoscopic ultrasonography on the diagnosis of gastrointestinal submucosal tumor prior to endoscopic resection","authors":"Wei Wu, Rong Fan, Ji-hong Tan, A. Qian","doi":"10.3760/CMA.J.ISSN.1007-5232.2019.07.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-5232.2019.07.007","url":null,"abstract":"Objective \u0000To investigate the efficacy and limitation of endoscopic ultrasonography(EUS) on the diagnosis of gastrointestinal submucosal tumor (SMT) prior to endoscopic resection. \u0000 \u0000 \u0000Methods \u0000Data of 211 patients, who were confirmed as gastrointestinal SMT before operation and received endoscopic resection for gastrointestinal submucosal tumor at Department of Gastroenterology, Shanghai Ruijin Hospital from January 2016 to December 2018 were analyzed. The value and limitation of EUS for SMT were investigated according to the final pathology. \u0000 \u0000 \u0000Results \u0000For the lesion distribution, 66 were in esophagus, 108 in stomach, 2 in duodenum and 35 in rectum. The accuracy of tumor origin by EUS was 99.5% (210/211). The accuracy of tumor nature by EUS was 75.8% (160/211). For the lesions originated from different locations, the diagnostic accuracy for lesion originated from esophageal mucosa/submucosa, esophageal muscularis propria, gastric mucosa/submucosa, gastric muscularis propria, duodenal submucosa, rectal mucosa/submucosa by EUS were 90.0%(54/60), 83.3%(5/6), 31.0%(13/42), 89.4%(59/66), 50.0%(1/2), 82.9%(29/35), respectively. With respect to hypoechoic lesions, leiomyoma, leiomyoma/gastrointestinal stromal tumor, and neuroendocrine tumor were the predominant type of tumor originated from esophageal mucosa, gastrointestinal muscularis propria and rectal mucosa/submucosal, respectively. \u0000 \u0000 \u0000Conclusion \u0000Although EUS is indispensible for the diagnosis of gastrointestinal submucosal tumor, it plays a limited role in the differential diagnosis of various lesions originated from gastric mucosa and submucosa. Since part of the submucosal tumors may be potential for malignant development, an diagnosis made by EUS should be more careful. \u0000 \u0000 \u0000Key words: \u0000Endoscopy; Endoscopic ultrasonography; Submucosal tumor","PeriodicalId":10072,"journal":{"name":"Chinese Journal of Digestive Endoscopy","volume":"36 1","pages":"491-494"},"PeriodicalIF":0.0,"publicationDate":"2019-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45299301","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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