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Risk Factors Associated with Progression to Surgery in Patients with Ischemic Colitis. 缺血性结肠炎患者进展到手术治疗的相关风险因素。
Pub Date : 2024-10-25 DOI: 10.4166/kjg.2024.055
Je-Seong Kim, Ho-Jin Choi, Chan-Mook Im, Ga-Ram You, Young-Eun Seo, Chae-June Lim, Jae-Woong Lim, Hyung-Hoon Oh, Young-Eun Joo

Background/aims: Ischemic colitis (IC), the most common ischemic syndrome affecting the gastrointestinal tract, results from a decreased blood supply to the colon. Persistent symptoms can lead to complications, necessitating surgery. This study assessed the clinical characteristics and risk factors for poor outcomes in IC.

Methods: This retrospective observational study examined the medical records of 141 patients diagnosed pathologically with IC via surgery or colonoscopy at Chonnam National University Hwasun Hospital between April 2004 and August 2023.

Results: Eighteen (12.8%) and 123 (87.2%) patients were diagnosed by surgical biopsy and biopsy with colonoscopy, respectively. Multivariate analysis identified right-sided colon involvement, fever, and the absence of hematochezia as risk factors for the progression to surgery (odds ratio [OR]=5.924, 95% confidence interval [CI] 1.009-34.767, p=0.049; OR=24.139, 95% CI 5.209-111.851, p<0.001; and OR=0.076, 95% CI 0.013-0.446, p=0.004, respectively). The in-hospital mortality was 5.7% (8/141), and the patients who died exhibited higher rates of shock. The median (interquartile range) hospital stay was 11 (1-219) days. Patients who had longer hospital stays (≥14 days) had a significantly higher rate of fever but a lower rate of hematochezia.

Conclusions: A multidisciplinary approach is crucial for determining the need for surgery in patients with right-sided colon involvement, fever, or the absence of hematochezia.

背景/目的:缺血性结肠炎(IC)是影响胃肠道最常见的缺血性综合征,是结肠供血减少的结果。持续的症状会导致并发症,因此有必要进行手术治疗。本研究评估了 IC 的临床特征和不良后果的风险因素:这项回顾性观察研究调查了 2004 年 4 月至 2023 年 8 月期间全南国立大学华山医院通过手术或结肠镜检查病理诊断为 IC 的 141 名患者的病历:通过手术活检和结肠镜活检确诊的患者分别为 18 人(12.8%)和 123 人(87.2%)。多变量分析发现,右侧结肠受累、发热和无血性便血是进展到手术的风险因素(几率比[OR]=5.924,95% 置信区间[CI] 1.009-34.767,p=0.049;OR=24.139,95% CI 5.209-111.851,p结论:多学科方法对结肠癌的诊断至关重要:对于右侧结肠受累、发热或无血性便血的患者,多学科方法对于确定是否需要手术至关重要。
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引用次数: 0
[Efficacy of Fecal Microbial Transplantation for Improving Symptoms of Irritable Bowel Syndrome - A Pilot Study for Voluntary Participants in Korea]. [粪便微生物移植对改善肠易激综合征症状的疗效--针对韩国自愿参与者的试点研究]。
Pub Date : 2024-10-25 DOI: 10.4166/kjg.2024.107
Jung Won Lee, Nayoung Kim

Background/aims: Irritable bowel syndrome (IBS) is a chronic, intractable functional disease. It is inferred that fecal microbiota transplantation (FMT) may have favorable efficacy on IBS by gut microbial modification. The aim of this study was to investigate the efficacy of FMT for improving severity in patients with IBS.

Methods: Patients who voluntarily wanted FMT were consecutively enrolled. The study subjects were classified by subtype of IBS by the ROME IV criteria. The IBS-symptom severity score (IBS-SSS) was used to evaluate the efficacy of FMT. The subjects completed a questionnaire at baseline week 0 and weeks 4, 12, and 24 after FMT. FMT was performed by esophagogastroduodenoscopy using frozen stock stool solution. If the follow-up IBS-SSS achieved less than 75 points, it was defined as remission. Adverse events were also gathered.

Results: Twenty-one subjects were included from October 2023 until July 2024. There were 7 patients with IBS-C, 10 patients with IBS-D, 2 patients with IBS-M, and 2 patients with IBS-U type. The mean SSS of the IBS-D group was 244.0±64.2, which was higher than IBS-C group (192.9±85.4). Alleviations in IBS-SSS after FMT were observed in 19 subjects (19/21, 90.5%) at week 4. At week 12, 71.4% (5/7) in the IBS-C group and 20.0% (2/10) in the IBS-D group achieved remission. The remission states were maintained up to week 24 and no serious adverse events were reported.

Conclusions: FMT might be an effective treatment option for improving symptoms of mild to moderate IBS, especially IBS-C.

背景/目的:肠易激综合征(IBS)是一种慢性、难治的功能性疾病。据推断,粪便微生物群移植(FMT)可通过改变肠道微生物对肠易激综合征产生良好疗效。本研究旨在探讨粪便微生物群移植对改善肠易激综合征患者病情严重程度的疗效:方法:连续招募自愿接受 FMT 的患者。研究对象根据 ROME IV 标准按 IBS 亚型分类。肠易激综合征症状严重程度评分(IBS-SSS)用于评估 FMT 的疗效。受试者在 FMT 后第 0 周、第 4 周、第 12 周和第 24 周填写问卷。FMT 通过食管胃十二指肠镜使用冷冻粪便溶液进行。如果随访的 IBS-SSS 评分低于 75 分,则被定义为缓解。此外,还收集了不良事件:从 2023 年 10 月到 2024 年 7 月,共纳入 21 名受试者。其中有 7 名 IBS-C 型患者、10 名 IBS-D 型患者、2 名 IBS-M 型患者和 2 名 IBS-U 型患者。IBS-D 组的平均 SSS 为 244.0±64.2,高于 IBS-C 组(192.9±85.4)。第 4 周时,19 名受试者(19/21,90.5%)的 IBS-SSS 在 FMT 治疗后得到缓解。第 12 周时,IBS-C 组中有 71.4%(5/7)和 IBS-D 组中有 20.0%(2/10)的患者病情得到缓解。缓解状态一直维持到第24周,且无严重不良反应报告:结论:FMT 可能是改善轻度至中度肠易激综合征(尤其是肠易激综合征-C)症状的有效治疗方案。
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引用次数: 0
Histopathological Features of Chronic Gastritis and its Association with Helicobacter pylori Infection. 慢性胃炎的组织病理学特征及其与幽门螺旋杆菌感染的关系
Pub Date : 2024-10-25 DOI: 10.4166/kjg.2024.063
Gargi Tignath Shukla, Sunita Yadav, Ajay Shukla, Krishna Kumar Yadav, Amit V Varma, Sirish Nandedekar, Mili Senger, Sudha Gupta

Background/aims: A Helicobacter pylori (H. pylori) infection is the most common cause of chronic gastritis (CG), with approximately 50% of the world's population infected. Long-term infection increases the risk of progression to gastric cancer. This study evaluated the histopathological changes in CG using the Updated Sydney System (USS) to estimate the prevalence and correlation of H. pylori gastritis with other histological variables.

Methods: This research was a prospective observational study conducted in the Department of Pathology of a tertiary care teaching hospital in Central India. The study was conducted between Feb 2017 to April 2018. Two antral biopsies were taken per patient, one for a Rapid Urease Test and the second for routine histopathology. All samples were analyzed according to the USS.

Results: CG was found in 83.84% of total dyspeptic patients. The most common age group was 31-40 years, with a male preponderance. Of 109 gastric antral biopsies with histopathological evidence of chronic gastritis, neutrophilic activity, intestinal metaplasia, atrophy, and lymphoid aggregates were present in 50 (45.87%), 10 (9.2%), 23 (21.10%), and 11(10.09%) cases, respectively. The prevalence of H. pylori was 46.78%, and its association with the degree of chronic inflammation and intestinal metaplasia was statistically significant.

Conclusions: H. pylori was significantly associated with the degree of chronic inflammation and intestinal metaplasia. Hence, this study suggests a vigorous search for H. pylori should be initiated if chronic inflammation and intestinal metaplasia are seen in antral gastric biopsies.

背景/目的:幽门螺杆菌(H. pylori)感染是慢性胃炎(CG)最常见的病因,全球约有 50% 的人口受到感染。长期感染会增加发展为胃癌的风险。本研究采用更新悉尼系统(USS)评估了慢性胃炎的组织病理学变化,以估算幽门螺杆菌胃炎的患病率及其与其他组织学变量的相关性:本研究是一项前瞻性观察研究,在印度中部一家三级教学医院的病理科进行。研究时间为 2017 年 2 月至 2018 年 4 月。每位患者取两份前列腺活检样本,一份用于快速尿素酶测试,另一份用于常规组织病理学检查。所有样本均按照 USS 进行分析:在所有消化不良患者中,83.84%的患者患有胃癌。最常见的年龄组为 31-40 岁,男性居多。在109例有慢性胃炎组织病理学证据的胃前区活检中,分别有50例(45.87%)、10例(9.2%)、23例(21.10%)和11例(10.09%)出现中性粒细胞活动、肠化生、萎缩和淋巴聚集。幽门螺杆菌的感染率为 46.78%,其与慢性炎症和肠化生程度的关系具有统计学意义:结论:幽门螺杆菌与慢性炎症和肠化生程度密切相关。因此,本研究建议,如果在前胃活检中发现慢性炎症和肠化生,则应积极寻找幽门螺杆菌。
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引用次数: 0
[A New Paradigm in Diagnosing Functional Gastroduodenal Disorders: High-Resolution Electrogastrography]. [诊断功能性胃十二指肠疾病的新范例:高分辨率胃电图]。
Pub Date : 2024-10-25 DOI: 10.4166/kjg.2024.101
Seung Han Kim

High-resolution electrogastrography (HR-EGG) presents a new paradigm in diagnosing and treating functional gastroduodenal disorders. Unlike traditional electrogastrography, HR-EGG allows for a more precise analysis of the gastric electrical activity, offering improved diagnostic accuracy. Recent studies have revealed the clinical potential of HR-EGG, particularly in detecting abnormal electrical patterns in patients with functional dyspepsia and gastroparesis, supporting the development of novel therapeutic strategies. The non-invasive HR-EGG method has shown promise in identifying new biomarkers. Moreover, further integration of artificial intelligence, is expected to enhance diagnostic efficiency and develop more refined treatment models for functional gastrointestinal disorders.

高分辨率胃电图(HR-EGG)为诊断和治疗功能性胃十二指肠疾病提供了一种新的模式。与传统的胃电图不同,HR-EGG 可以更精确地分析胃电活动,提高诊断的准确性。最近的研究揭示了 HR-EGG 的临床潜力,特别是在检测功能性消化不良和胃痉挛患者的异常胃电模式方面,为开发新型治疗策略提供了支持。无创的 HR-EGG 方法在确定新的生物标记物方面已显示出前景。此外,人工智能的进一步整合有望提高诊断效率,并为功能性胃肠病开发出更精细的治疗模型。
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引用次数: 0
Acute Gastropathy Associated with Bowel Preparation According to Age: Oral Sulfate Tablets versus 1-L Polyethylene Glycol with Ascorbic Acid. 与肠道制剂有关的急性胃病(按年龄分类):口服硫酸盐片剂与含抗坏血酸的 1 升聚乙二醇相比
Pub Date : 2024-10-25 DOI: 10.4166/kjg.2024.094
Jin Young Yoon, Su Bee Park, Moon Hyung Lee, Min Seob Kwak, Jae Myung Cha

Background/aims: The use of 1-L polyethylene glycol with ascorbate (PEG/Asc) and oral sulfate tablets (OST) as low-volume bowel preparation agents has gradually increased. However, these agents may induce acute gastropathy during bowel preparation, particularly in elderly populations. This study aimed to compare the incidence of acute gastropathy of 1-L PEG/Asc and OST according to age, as well as efficacy and safety.

Methods: This retrospective study included patients who underwent esophagogastroduodenoscopy (EGD) and colonoscopy for screening on the same day and underwent bowel preparation using OST or 1-L PEG/Asc. We collected EGD findings related to acute gastropathy, bowel-cleansing score using the Boston Bowel Preparation Scale (BBPS), polyp or adenoma detection rate (ADR), and laboratory parameters.

Results: Of 4,711 patients, 1,758, 2,241, and 712 were in the younger (18-49 years), middle-aged (50-64 years), and older (≥65 years) groups, respectively. In all age groups, the OST group had higher rates of acute gastropathy than the 1-L PEG/Asc group. The younger-, middle-, and older-aged groups had OST and 1-L PEG/Asc usage rates of 42.9% and 11.6%, 41.2% and 16.0%, and 41.5% and 16.4%, respectively. Notably, in the younger group, the total BBPS and ADR scores were significantly higher in the OST group than in the 1-L PEG/Asc group; however, these did not differ in the other age groups.

Conclusions: Acute gastropathy was more strongly associated with OST than with 1-L PEG/Asc in all age groups. Therefore, physicians should consider acute gastropathy associated with low-volume agents in all age groups when performing bowel preparation.

背景/目的:1-L 聚乙二醇抗坏血酸盐(PEG/Asc)和口服硫酸盐片剂(OST)作为低容量肠道准备剂的使用逐渐增多。然而,这些药物可能会在肠道准备过程中诱发急性胃病,尤其是在老年人群中。本研究旨在比较 1-L PEG/Asc 和 OST 不同年龄段的急性胃病发生率以及疗效和安全性:这项回顾性研究纳入了在同一天接受食管胃十二指肠镜(EGD)和结肠镜筛查并使用 OST 或 1-L PEG/Asc 进行肠道准备的患者。我们收集了与急性胃病相关的胃肠镜检查结果、使用波士顿肠道准备量表(BBPS)进行的肠道清洁评分、息肉或腺瘤检出率(ADR)以及实验室参数:在 4711 名患者中,年轻组(18-49 岁)、中年组(50-64 岁)和老年组(≥65 岁)分别有 1758 人、2241 人和 712 人。在所有年龄组中,OST 组的急性胃病发生率均高于 1-L PEG/Asc 组。年轻组、中年组和老年组的 OST 和 1-L PEG/Asc 使用率分别为 42.9% 和 11.6%、41.2% 和 16.0%,以及 41.5% 和 16.4%。值得注意的是,在年轻组中,OST 组的 BBPS 和 ADR 总分显著高于 1-L PEG/Asc 组;但其他年龄组的 BBPS 和 ADR 总分没有差异:结论:在所有年龄组中,急性胃病与 OST 的相关性均高于 1-L PEG/Asc。因此,医生在进行肠道准备时应考虑到所有年龄组的急性胃病都与低容量药物有关。
{"title":"Acute Gastropathy Associated with Bowel Preparation According to Age: Oral Sulfate Tablets versus 1-L Polyethylene Glycol with Ascorbic Acid.","authors":"Jin Young Yoon, Su Bee Park, Moon Hyung Lee, Min Seob Kwak, Jae Myung Cha","doi":"10.4166/kjg.2024.094","DOIUrl":"https://doi.org/10.4166/kjg.2024.094","url":null,"abstract":"<p><strong>Background/aims: </strong>The use of 1-L polyethylene glycol with ascorbate (PEG/Asc) and oral sulfate tablets (OST) as low-volume bowel preparation agents has gradually increased. However, these agents may induce acute gastropathy during bowel preparation, particularly in elderly populations. This study aimed to compare the incidence of acute gastropathy of 1-L PEG/Asc and OST according to age, as well as efficacy and safety.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent esophagogastroduodenoscopy (EGD) and colonoscopy for screening on the same day and underwent bowel preparation using OST or 1-L PEG/Asc. We collected EGD findings related to acute gastropathy, bowel-cleansing score using the Boston Bowel Preparation Scale (BBPS), polyp or adenoma detection rate (ADR), and laboratory parameters.</p><p><strong>Results: </strong>Of 4,711 patients, 1,758, 2,241, and 712 were in the younger (18-49 years), middle-aged (50-64 years), and older (≥65 years) groups, respectively. In all age groups, the OST group had higher rates of acute gastropathy than the 1-L PEG/Asc group. The younger-, middle-, and older-aged groups had OST and 1-L PEG/Asc usage rates of 42.9% and 11.6%, 41.2% and 16.0%, and 41.5% and 16.4%, respectively. Notably, in the younger group, the total BBPS and ADR scores were significantly higher in the OST group than in the 1-L PEG/Asc group; however, these did not differ in the other age groups.</p><p><strong>Conclusions: </strong>Acute gastropathy was more strongly associated with OST than with 1-L PEG/Asc in all age groups. Therefore, physicians should consider acute gastropathy associated with low-volume agents in all age groups when performing bowel preparation.</p>","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515690","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}
引用次数: 0
[Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea]. [韩国内镜逆行胰胆管造影术的质量指标]。
Pub Date : 2024-09-25 DOI: 10.4166/kjg.2024.067
Ki-Hyun Kim, Hyung Ku Chon, Tae Jun Song, Dong Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyung Chung, Jin Lee, Miyoung Choi

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that requires abundant clinical experience and endoscopic skills, and can lead to various complications, some of which may progress to life-threatening conditions. With expanding indications and technological advancements, ERCP is widely utilized, enhancing procedural accessibility. However, without proper quality management, the procedure can pose significant risks. Quality management in ERCP is essential to ensure safe and successful procedures and meet societal demands for improved healthcare competitiveness. To address these concerns, the Korean Society of Pancreatobiliary Endoscopy has developed a Korean-specific ERCP quality indicator reflecting domestic medical environments and realities. Initially, based on a review of foreign ERCP quality indicators and related literatures, key questions were formulated for five pre-procedural items, three intra-procedural items, and four post-procedural items. Descriptions and recommendations for each item were selected through peer evaluation. The developed Korean-specific ERCP quality indicator was reviewed by external experts based on the latest evidence and consensus in this fields. This Korean-specific indicator is expected to significantly contribute to improving ERCP quality in Korea, as it is tailored to local needs.

内镜逆行胰胆管造影术(ERCP)是一种需要丰富临床经验和内镜技术的手术,可能导致各种并发症,其中一些可能发展成危及生命的情况。随着适应症的扩大和技术的进步,ERCP 得到了广泛应用,提高了手术的可及性。然而,如果没有适当的质量管理,手术可能会带来巨大风险。ERCP的质量管理对于确保手术的安全和成功以及满足社会对提高医疗竞争力的需求至关重要。为了解决这些问题,韩国胰胆内镜学会制定了韩国特有的ERCP质量指标,以反映国内的医疗环境和现实情况。最初,根据对国外ERCP质量指标和相关文献的回顾,为五个术前项目、三个术中项目和四个术后项目制定了关键问题。每个项目的说明和建议都是通过同行评价筛选出来的。根据该领域的最新证据和共识,外部专家对所制定的韩国ERCP质量指标进行了审查。该韩国专用指标符合当地需求,预计将大大有助于提高韩国的ERCP质量。
{"title":"[Quality Indicators of Endoscopic Retrograde Cholangiopancreatography in Korea].","authors":"Ki-Hyun Kim, Hyung Ku Chon, Tae Jun Song, Dong Won Ahn, Eaum Seok Lee, Yun Nah Lee, Yoon Suk Lee, Tae Joo Jeon, Chang Hwan Park, Kwang Bum Cho, Dong Wook Lee, Jin-Seok Park, Seung Bae Yoon, Kwang Hyung Chung, Jin Lee, Miyoung Choi","doi":"10.4166/kjg.2024.067","DOIUrl":"https://doi.org/10.4166/kjg.2024.067","url":null,"abstract":"<p><p>Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure that requires abundant clinical experience and endoscopic skills, and can lead to various complications, some of which may progress to life-threatening conditions. With expanding indications and technological advancements, ERCP is widely utilized, enhancing procedural accessibility. However, without proper quality management, the procedure can pose significant risks. Quality management in ERCP is essential to ensure safe and successful procedures and meet societal demands for improved healthcare competitiveness. To address these concerns, the Korean Society of Pancreatobiliary Endoscopy has developed a Korean-specific ERCP quality indicator reflecting domestic medical environments and realities. Initially, based on a review of foreign ERCP quality indicators and related literatures, key questions were formulated for five pre-procedural items, three intra-procedural items, and four post-procedural items. Descriptions and recommendations for each item were selected through peer evaluation. The developed Korean-specific ERCP quality indicator was reviewed by external experts based on the latest evidence and consensus in this fields. This Korean-specific indicator is expected to significantly contribute to improving ERCP quality in Korea, as it is tailored to local needs.</p>","PeriodicalId":94245,"journal":{"name":"The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335615","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}
引用次数: 0
Case of Undifferentiated Carcinoma with Osteoclast-like Giant Cells Associated with a Mucinous Cystic Neoplasm of the Pancreas: A Diagnostic Conundrum. 胰腺黏液性囊性瘤伴有破骨细胞样巨细胞的未分化癌病例:诊断难题。
Pub Date : 2024-09-25 DOI: 10.4166/kjg.2024.059
Gargi Kapatia, Akriti Jindal, Gourav Kaushal, Ankita Soni, Manjit Kaur Rana

Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC) is a rare histological subtype of pancreatic ductal adenocarcinoma according to the World Health Organization classification of digestive system tumors. This subtype is exceptionally uncommon, accounting for less than 1% of pancreatic malignant tumors. This paper presents a rare case of a 62-year-old female patient diagnosed with UC-OGC. The patient initially presented with symptoms, including epigastric pain and the presence of an abdominal mass, which led to further investigation and the eventual diagnosis of this unusual and challenging form of pancreatic cancer.

根据世界卫生组织对消化系统肿瘤的分类,具有破骨细胞样巨细胞的未分化癌(UC-OGC)是胰腺导管腺癌的一种罕见组织学亚型。这种亚型非常罕见,占胰腺恶性肿瘤的比例不到 1%。本文介绍了一例罕见病例,患者是一名 62 岁的女性,被诊断为 UC-OGC。患者最初表现出上腹疼痛和腹部肿块等症状,随后接受了进一步检查,最终确诊为这种不寻常且具有挑战性的胰腺癌。
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引用次数: 0
[Neoadjuvant Therapy for Resectable or Borderline Resectable Pancreatic Cancer]. [可切除或边缘可切除胰腺癌的新辅助治疗]。
Pub Date : 2024-09-25 DOI: 10.4166/kjg.2024.079
Sang Hoon Lee

Surgical resection of a primary tumor is the only effective curative treatment for patients with localized pancreatic cancer without a distant metastasis. Nevertheless, most patients eventually develop postoperative recurrence caused by micrometastases. The risk increases if a complete resection is not achieved. Three surgical stages have emerged for a preoperative assessment based on resectability: resectable, borderline resectable, and unresectable. Although controversial, considerable research has focused on the role of neoadjuvant therapy in all forms of potentially resectable pancreatic cancer. While upfront surgery with adjuvant chemotherapy remains the standard of care for patients with resectable pancreatic cancer, there is growing evidence that neoadjuvant chemotherapy improves overall survival without increasing the resection rate in patients with borderline resectable pancreatic cancer. This review describes the current treatment strategies for resectable and borderline resectable pancreatic cancer and summarizes the results of the latest clinical trials.

对于没有远处转移的局部胰腺癌患者来说,手术切除原发肿瘤是唯一有效的根治性治疗方法。然而,大多数患者最终会因微小转移而导致术后复发。如果不能实现完全切除,风险就会增加。根据可切除性,术前评估分为三个手术阶段:可切除、边缘可切除和不可切除。尽管存在争议,但相当多的研究都集中在新辅助治疗在所有形式的潜在可切除胰腺癌中的作用上。虽然前期手术和辅助化疗仍是可切除胰腺癌患者的标准治疗方法,但越来越多的证据表明,新辅助化疗可提高边缘可切除胰腺癌患者的总生存率,而不会增加切除率。本综述介绍了目前针对可切除和边缘可切除胰腺癌的治疗策略,并总结了最新的临床试验结果。
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引用次数: 0
A Case of Colonic Intussusception with Post-polypectomy Electrocoagulation Syndrome and Review of Literature: How to Manage Intussusception Following Colonoscopy? 一例结肠肠套叠伴息肉切除术后电凝综合征病例及文献综述:结肠镜检查后如何处理肠套叠?
Pub Date : 2024-09-25 DOI: 10.4166/kjg.2024.083
Kyung Hoe Kim, Joo-Seok Kim, Moon-Soo Lee, Hyun-Young Han, Joo Heon Kim

Colonic intussusception is often reported to be related to malignancy in adults. Colonoscopy itself with or without polypectomy is known to be a rare cause of colonic intussusception. We encountered a case in which an individual was diagnosed with intussusception following colonoscopy. The patient was a 44-year-old female who, on the same day, had undergone a colonoscopy including endoscopic mucosal resection for a polyp in the ascending colon. She visited the emergency room with complaints of right-sided abdominal pain. Abdominal examination revealed peritoneal irritation in the right upper quadrant. Abdominal CT revealed colocolic intussusception near the hepatic flexure. This was suspected to have been induced by post-polypectomy electrocoagulation syndrome. A laparoscopic right hemicolectomy was performed because conducting a reduction trial through colonoscopy involves a high risk of peritonitis, in addition to a low likelihood of spontaneous reduction of intussusception due to the additional edema and ischemia resulting from the polypectomy. The patient was discharged without complications six days after the surgery. Though some cases have been reported, there is no treatment strategy for intussusception following colonoscopy. Therefore, we report this case of colonic intussusception following colonoscopy, which was found to be caused by Post-polypectomy Electrocoagulation Syndrome, with a literature review.

据报道,成人结肠肠套叠通常与恶性肿瘤有关。众所周知,结肠镜检查本身加或不加息肉切除术是导致结肠肠套叠的罕见原因。我们遇到过一个病例,患者在接受结肠镜检查后被诊断为肠套叠。患者是一名 44 岁的女性,当天接受了结肠镜检查,包括内镜下升结肠息肉粘膜切除术。她因主诉右侧腹痛到急诊就诊。腹部检查发现右上腹有腹膜刺激症状。腹部 CT 显示肝曲附近有结肠肠套叠。怀疑是由息肉切除术后电凝综合征引起的。患者接受了腹腔镜右半结肠切除术,因为通过结肠镜进行肠套叠缩小术的风险很高,而且由于息肉切除术造成的额外水肿和缺血,肠套叠自发缩小的可能性也很低。患者在术后六天无并发症出院。虽然已有一些病例报道,但目前还没有针对结肠镜检查后肠套叠的治疗策略。因此,我们报告了这例结肠镜检查后结肠肠套叠的病例,并对其进行了文献综述。
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引用次数: 0
[Current Status of Chemotherapy in Colorectal Cancer: Updated Treatment Strategies]. [大肠癌化疗现状:最新治疗策略]。
Pub Date : 2024-09-25 DOI: 10.4166/kjg.2024.087
Jae Hyun Kim, Seun Ja Park

Colorectal cancer remains a significant health burden in South Korea, being the third most diagnosed cancer in the country. Despite advances in treatment, patients with metastatic colorectal cancer still face limited survival rates, with resection often deemed impossible for the majority. This review discusses the current state of chemotherapy in colorectal cancer treatment, focusing on both adjuvant chemotherapy post-surgery and palliative chemotherapy for metastatic cases. The article highlights recent updates in treatment guidelines, including the use of immunotherapy and the role of circulating tumor DNA (ctDNA) in personalized medicine. The integration of these novel approaches aims to enhance treatment efficacy, improve patient survival, and reduce recurrence rates, paving the way for more tailored and effective therapeutic strategies in colorectal cancer management.

在韩国,结直肠癌仍然是一个沉重的健康负担,是韩国第三大确诊癌症。尽管治疗手段不断进步,但转移性结直肠癌患者的生存率仍然有限,大多数患者往往无法接受切除手术。这篇综述讨论了结直肠癌化疗的现状,重点是手术后的辅助化疗和转移性病例的姑息化疗。文章重点介绍了最近更新的治疗指南,包括免疫疗法的使用和循环肿瘤 DNA (ctDNA) 在个性化医疗中的作用。整合这些新方法的目的是提高治疗效果、改善患者生存率和降低复发率,为在结直肠癌治疗中采用更有针对性、更有效的治疗策略铺平道路。
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引用次数: 0
期刊
The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi
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