期刊文献+
共找到469篇文章
< 1 2 24 >
每页显示 20 50 100
Consensus on the digestive endoscopic tunnel technique 预览
1
作者 Ning-Li Chai Hui-Kai Li +45 位作者 En-Qiang Linghu Zhao-Shen Li Shu-Tian Zhang Yu Bao Wei-Gang Chen Philip WY Chiu Tong Dang Wei Gong Shu-Tang Han Jian-Yu Hao Shui-Xiang He Bing Hu1 Bing Hu2 Xiao-Jun Huang Yong-Hui Huang Zhen-Dong Jin Mouen A Khashab James Lau Peng Li Rui Li De-Liang Liu Hai-Feng Liu Jun Liu Xiao-Gang Liu Zhi-Guo Liu Ying-Cai Ma Gui-Yong Peng Long Rong Wei-Hong Sha Pateek Sharma Jian-Qiu Sheng Shui-Sheng Shi Dong Wan Seo Si-Yu Sun Gui-Qi Wang Wen Wang Qi Wu Hong Xu Mei-Dong Xu Ai-Ming Yang Fang Yao Hong-Gang Yu Ping-Hong Zhou Bin Zhang Xiao-Feng Zhang Ya-Qi Zhai 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第7期744-776,共33页
With the digestive endoscopic tunnel technique(DETT),many diseases that previously would have been treated by surgery are now endoscopically curable by establishing a submucosal tunnel between the mucosa and musculari... With the digestive endoscopic tunnel technique(DETT),many diseases that previously would have been treated by surgery are now endoscopically curable by establishing a submucosal tunnel between the mucosa and muscularis propria(MP).Through the tunnel,endoscopic diagnosis or treatment is performed for lesions in the mucosa,in the MP,and even outside the gastrointestinal(GI)tract.At present,the tunnel technique application range covers the following:(1)Treatment of lesions originating from the mucosal layer,e.g.,endoscopic submucosal tunnel dissection for oesophageal large or circular early-stage cancer or precancerosis;(2)treatment of lesions from the MP layer,per-oral endoscopic myotomy,submucosal tunnelling endoscopic resection,etc.;and(3)diagnosis and treatment of lesions outside the GI tract,such as resection of lymph nodes and benign tumour excision in the mediastinum or abdominal cavity.With the increasing number of DETTs performed worldwide,endoscopic tunnel therapeutics,which is based on DETT,has been gradually developed and optimized.However,there is not yet an expert consensus on DETT to regulate its indications,contraindications,surgical procedure,and postoperative treatment.The International DETT Alliance signed up this consensus to standardize the procedures of DETT.In this consensus,we describe the definition,mechanism,and significance of DETT,prevention of infection and concepts of DETTassociated complications,methods to establish a submucosal tunnel,and application of DETT for lesions in the mucosa,in the MP and outside the GI tract(indications and contraindications,procedures,pre-and postoperative treatments,effectiveness,complications and treatments,and a comparison between DETT and other operations). 展开更多
关键词 DIGESTIVE ENDOSCOPIC TUNNEL technique ENDOSCOPIC SUBMUCOSAL TUNNEL dissection Per-oral ENDOSCOPIC MYOTOMY SUBMUCOSAL TUNNELLING ENDOSCOPIC resection Gastrointestinal tract
在线阅读 免费下载
Success and safety of endoscopic treatments for concomitant biliary and duodenal malignant stenosis:A review of the literature 预览
2
作者 Benedetto Mangiavillano Mouen A Khashab +9 位作者 Ilaria Tarantino Silvia Carrara Rossella Semeraro Francesco Auriemma Mario Bianchetti Leonardo Henry Eusebi Chen Yen-I Luca De Luca Mario Traina Alessandro Repici 《世界胃肠外科杂志:英文版(电子版)》 2019年第2期53-61,共9页
Synchronous biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected with ampullary,peri-ampullary,and pancreatic head neoplasia.Surgical bypass is no longer the gold-standa... Synchronous biliary and duodenal malignant obstruction is a challenging endoscopic scenario in patients affected with ampullary,peri-ampullary,and pancreatic head neoplasia.Surgical bypass is no longer the gold-standard therapy for these patients,as simultaneous endoscopic biliary and duodenal stenting is currently a feasible and widely used technique,with a high technical success in expert hands.In recent years,endoscopic ultrasonography(EUS)has evolved from a diagnostic to a therapeutic procedure,and is now increasingly used to guide biliary drainage,especially in cases of failed endoscopic retrograde cholangiopancreatography(ERCP).The advent of lumen-apposing metal stents(LAMS)has expanded EUS therapeutic options,and changed the management of synchronous bilioduodenal stenosis.The most recent literature regarding endoscopic treatments for synchronous biliary and duodenal malignant stenosis has been reviewed to determine the best endoscopic approach,also considering the advent of an interventional EUS approach using LAMS. 展开更多
关键词 MALIGNANT BILIARY strictures MALIGNANT DUODENAL STENOSIS Bilio-duodenal STENOSIS BILIARY self-expandable METAL stent DUODENAL self-expandable METAL stent Lumen-apposing METAL stents Gastro-jejunostomy
在线阅读 免费下载
Guidelines for the diagnosis and treatment of chronic pancreatitis in China(2018 edition) 预览
3
作者 Wen-Bin Zou Nan Ru +15 位作者 Hao Wu Liang-Hao Hu Xu Ren Gang Jin Zheng Wang Yi-Qi Du Ya-Nan Cao Lei Zhang Xiao-Yan Chang Rong-Chun Zhang Xiao-Bin Li Yan Shen Peng Li Zhao-Shen Li Zhuan Liao Pancreatitis Group of Chinese Medical Doctor Association 《国际肝胆胰疾病杂志:英文版》 SCIE CAS CSCD 2019年第2期103-109,共7页
Chronic pancreatitis(CP)is a progressive inflammatory disease of pancreas that alters the organ’s normal structure and functions.CP seriously affects the quality of life of patients and greatly increases the public m... Chronic pancreatitis(CP)is a progressive inflammatory disease of pancreas that alters the organ’s normal structure and functions.CP seriously affects the quality of life of patients and greatly increases the public medical burden of society.In recent years,the incidence of CP has increased worldwide.The concepts of etiology and therapies have been continuously updated. 展开更多
关键词 GUIDELINES DIAGNOSIS and TREATMENT PANCREATITIS
在线阅读 下载PDF
Short-and long-term outcomes of endoscopically treated superficial non-ampullary duodenal epithelial tumors 预览
4
作者 Yuko Hara Kenichi Goda +7 位作者 Akira Dobashi Tomohiko Richard Ohya Masayuki Kato Kazuki Sumiyama Takehiro Mitsuishi Shinichi Hirooka Masahiro Ikegami Hisao Tajiri 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第6期707-718,共12页
BACKGROUND It is widely recognized that endoscopic resection(ER)of superficial nonampullary duodenal epithelial tumors(SNADETs)is technically challenging and may carry high risks of intraoperative and delayed bleeding... BACKGROUND It is widely recognized that endoscopic resection(ER)of superficial nonampullary duodenal epithelial tumors(SNADETs)is technically challenging and may carry high risks of intraoperative and delayed bleeding and perforation.These adverse events could be more critical than those occurring in other levels of the gastrointestinal tract.Because of the low prevalence of the disease and the high risks of severe adverse events,the curability including short-and long-term outcomes have not been standardized yet.AIM To investigate the curability including short-and long-term outcomes of ER for SNADETs in a large case series.METHODS This retrospective study included cases that underwent ER for SNADETs at our university hospital between March 2004 and July 2017.Short-term outcomes of ER were measured based on en bloc and R0 resection rates as well as adverse events.Long-term outcomes included local recurrence detected on endoscopic surveillance and disease-specific mortality in patients followed up for≥12 mo after ER.RESULTS In the study,131 patients with 147 SNADETs were analyzed.The 147 ERs consisted of 136 endoscopic mucosal resections(EMRs)(93%)and 11 endoscopic submucosal dissections(ESDs)(7%).The median tumor diameter was 10 mm.The pathology diagnosis was adenocarcinoma(56/147,38%),high-grade intraepithelial neoplasia(44/147,30%),or low-grade intraepithelial neoplasia(47/147,32%).The R0 resection rate was 68%(93/136)in the EMR group and 73%(8/11)in the ESD group,respectively.Cap-assisted EMR(known as EMR-C)showed a higher rate of R0 resection compared to the conventional method of EMR using a snare(78%vs 62%,P=0.06).No adverse event was observed in the EMR group,whereas delayed bleeding,intraoperative perforation,and delayed perforation in 3,3,and 5 patients occurred in the ESD group,respectively.One patient with perforation required emergency surgery.In the 43 mo median follow-up period,local recurrence was found in four EMR cases and all cases were treated endoscopically.No patient died due to tumor recu 展开更多
关键词 DUODENAL ADENOMA DUODENAL cancer ENDOSCOPIC resection ENDOSCOPIC SUBMUCOSAL DISSECTION Long-term outcome
在线阅读 免费下载
Measurement of prostaglandin metabolites is useful in diagnosis of small bowel ulcerations 预览
5
作者 Yuichi Matsuno Junji Umeno +19 位作者 Motohiro Esaki Yoichiro Hirakawa Yuta Fuyuno Yasuharu Okamoto Atsushi Hirano Shigeyoshi Yasukawa Fumihito Hirai Toshiyuki Matsui Shuhei Hosomi Kenji Watanabe Naoki Hosoe Haruhiko Ogata Tadakazu Hisamatsu Shunichi Yanai Shuji Kochi Koichi Kurahara Tsuneyoshi Yao Takehiro Torisu Takanari Kitazono Takayuki Matsumoto 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第14期1753-1763,共11页
BACKGROUND We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2A1 gene (CEAS). Crohn’s disease (CD)... BACKGROUND We recently reported on a hereditary enteropathy associated with a gene encoding a prostaglandin transporter and referred to as chronic enteropathy associated with SLCO2A1 gene (CEAS). Crohn’s disease (CD) is a major differential diagnosis of CEAS, because these diseases share some clinical features. Therefore, there is a need to develop a convenient screening test to distinguish CEAS from CD. AIM To examine whether prostaglandin E major urinary metabolites (PGE-MUM) can serve as a biomarker to distinguish CEAS from CD. METHODS This was a transactional study of 20 patients with CEAS and 98 patients with CD. CEAS was diagnosed by the confirmation of homozygous or compound heterozygous mutation of SLCO2A1. We measured the concentration of PGEMUM in spot urine by radioimmunoassay, and the concentration was compared between the two groups of patients. We also determined the optimal cut-off value of PGE-MUM to distinguish CEAS from CD by receiver operating characteristic (ROC) curve analysis. RESULTS Twenty Japanese patients with CEAS and 98 patients with CD were enrolled. PGE-MUM concentration in patients with CEAS was significantly higher than that in patients with CD (median 102.7 vs 27.9 μg/g × Cre, P < 0.0001). One log unit increase in PGE-MUM contributed to 7.3 increase in the likelihood for the diagnosis of CEAS [95% confidence interval (CI) 3.2-16.7]. A logistic regression analysis revealed that the association was significant even after adjusting confounding factors (adjusted odds ratio 29.6, 95%CI 4.7-185.7). ROC curve analysis revealed the optimal PGE-MUM cut-off value for the distinction of CEAS from CD to be 48.9 μg/g × Cre with 95.0% sensitivity and 79.6% specificity. CONCLUSION PGE-MUM measurement is a convenient, non-invasive and useful test for the distinction of CEAS from CD. 展开更多
关键词 CHRONIC enteropathy associated with SLCO2A1 gene PROSTAGLANDIN E major urinary METABOLITES CHRONIC nonspecific multiple ulcers of the SMALL INTESTINE Crohn's disease SMALL INTESTINE
在线阅读 免费下载
Quest for the best endoscopic imaging modality for computer-assisted colonic polyp staging 预览
6
作者 Georg Wimmer Michael Gadermayr +8 位作者 Gernot Wolkersd?rfer Roland Kwitt Toru Tamaki Jens Tischendorf Michael H?fner Shigeto Yoshida Shinji Tanaka Dorit Merhof Andreas Uh 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第10期1197-1209,共13页
BACKGROUND It was shown in previous studies that high definition endoscopy, high magnification endoscopy and image enhancement technologies, such as chromoendoscopy and digital chromoendoscopy [narrow-band imaging(NBI... BACKGROUND It was shown in previous studies that high definition endoscopy, high magnification endoscopy and image enhancement technologies, such as chromoendoscopy and digital chromoendoscopy [narrow-band imaging(NBI), iScan] facilitate the detection and classification of colonic polyps during endoscopic sessions. However, there are no comprehensive studies so far that analyze which endoscopic imaging modalities facilitate the automated classification of colonic polyps. In this work, we investigate the impact of endoscopic imaging modalities on the results of computer-assisted diagnosis systems for colonic polyp staging.AIM To assess which endoscopic imaging modalities are best suited for the computerassisted staging of colonic polyps.METHODS In our experiments, we apply twelve state-of-the-art feature extraction methods for the classification of colonic polyps to five endoscopic image databases of colonic lesions. For this purpose, we employ a specifically designed experimental setup to avoid biases in the outcomes caused by differing numbers of images per image database. The image databases were obtained using different imaging modalities. Two databases were obtained by high-definition endoscopy in combination with i-Scan technology(one with chromoendoscopy and one without chromoendoscopy). Three databases were obtained by highmagnification endoscopy(two databases using narrow band imaging and one using chromoendoscopy). The lesions are categorized into non-neoplastic and neoplastic according to the histological diagnosis.RESULTS Generally, it is feature-dependent which imaging modalities achieve high results and which do not. For the high-definition image databases, we achieved overall classification rates of up to 79.2% with chromoendoscopy and 88.9% without chromoendoscopy. In the case of the database obtained by high-magnification chromoendoscopy, the classification rates were up to 81.4%. For the combination of high-magnification endoscopy with NBI, results of up to 97.4% for one database and up to 84% fo 展开更多
关键词 Endoscopy Colonic POLYPS Automated diagnosis system NARROW-BAND IMAGING CHROMOENDOSCOPY IMAGING MODALITIES Image enhancement technologies
在线阅读 免费下载
Non-guided self-learning program for high-proficiency optical diagnosis of diminutive and small colorectal lesions: A single-endoscopist pilot study 预览
7
作者 Marco Bustamante-Balén Carla Satorres +6 位作者 Lorena Puchades Belén Navarro Natalia García-Morales Noelia Alonso Marta Ponce Lidia Argüello Vicente Pons-Beltrán 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第10期1278-1287,共10页
BACKGROUND The implementation of optical diagnosis(OD) of diminutive colorectal lesions in clinical practice has been hampered by differences in performance between community and academic settings. One possible cause ... BACKGROUND The implementation of optical diagnosis(OD) of diminutive colorectal lesions in clinical practice has been hampered by differences in performance between community and academic settings. One possible cause is the lack of a standardized learning tool. Since the factors related to better learning are not well described, strong evidence upon which a consistent learning tool could be designed is lacking. We hypothesized that a self-designed learning program may be enough to achieve competency in OD of diminutive lesions of the colon.AIM To assess the accuracy of OD of diminutive lesions in real colonoscopies after application of a self-administered learning program.METHODS This was a single-endoscopist prospective pilot study, in which an experienced endoscopist followed a self-designed, self-administered learning program in OD of colorectal lesions. An assessment phase divided in two halves with a 6-mo period in between without performance of OD was developed in a populationbased colorectal cancer screening program. The accomplishment of the Preservation and Incorporation of Valuable Endoscopic Innovations criteria and performance measures were calculated overall and in the two halves of the assessment phase, assessing their response to the 6-mo stopping period. The evolution of performance through blocks of 50 lesions was also assessed.RESULTS Overall, 152 patients and 522 lesions(≤ 5 mm: 399, and 6-9 mm: 123) were included. The negative predictive value for the OD of adenoma in rectosigmoid lesions diagnosed with high confidence was 91.7% (95% confidence interval(CI):87.3-96.6)The proportion of agreement on surveillance interval between OD and pathological diagnosis was higher than 95%. Overall accuracy for diminutive lesions diagnosed with high confidence was 89.5%(95%CI: 86.3-92.7). The overall accuracy of OD was similar in the two halves of the assessment phase (90.1(95%CI: 85.6-94.7) vs 88.2(95%CI: 87.9-95.9))All the other performance parameters were also equivalent, except for specificity. Specif 展开更多
关键词 Optical diagnosis Accuracy Learning POLYP COLONOSCOPY Education
在线阅读 免费下载
Chronic functional constipation is strongly linked to vitamin D deficiency 预览
8
作者 Alba Panarese Francesco Pesce +6 位作者 Piero Porcelli Giuseppe Riezzo Palma Aurelia Iacovazzi Carla Maria Leone Massimo De Carne Caterina Mammone Rinaldi Endrit Shahini 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第14期1729-1740,共12页
BACKGROUND Few studies have examined intestinal motility disorders, which are disabling conditions associated with chronic functional constipation, whose pathogenesis is actually not well-defined. AIM To investigate t... BACKGROUND Few studies have examined intestinal motility disorders, which are disabling conditions associated with chronic functional constipation, whose pathogenesis is actually not well-defined. AIM To investigate the relationship between serum 25-hydroxyvitamin D levels and functional chronic constipation associated to intestinal motility disorders. METHODS We performed a prospective case-control study, from May-June to November 2017. Glucose/lactulose breath tests, radiopaque markers (multiple capsule techniques) and wireless motility capsule analysis were used to assess colonic and oro-cecal transit time, after excluding small-intestinal bacterial overgrowth condition. Then, we measured 25-hydroxyvitamin D levels in patients with intestinal motility disorders and we further evaluated the influence of intestinal motility disorders on psychological symptoms/quality of life using validated questionnaires, the Irritable Bowel Syndrome Quality of life (IBS-QOL), the Short Form Health Survey 12, and the Hospital Anxiety and Depression Scale 14 (HADS-14 A and HADS-14 D). RESULTS We enrolled 86 patients with chronic functional constipation associated to intestinal motility disorders and 86 matched healthy subjects. Patients with intestinal motility disorders had lower 25-hydroxyvitamin D levels (P < 0.001), and they showed a significant impairment of all health-related quality of life and psychological tests (IBS-QOL, Short Form Health Survey 12-Physical Component Summary, Short Form Health Survey 12-Mental Component Summary, HADS-14 A and HADS-14 D), as compared to the control group (P < 0.001), which significantly correlated with low vitamin D levels (r =- 0.57, P < 0.001;r = 0.21, P = 0.01;r =- 0.48, P < 0.001;r =- 0.57, P < 0.001;r =- 0.29, P < 0.001, respectively). At multivariate analysis vitamin D low levels remained a significant independent risk factor for the occurrence of intestinal motility disorder (odds ratio = 1.19;95% confidence interval: 1.14-1.26, P < 0.001). CONCLUSION Vitamin D deficiency, anxiet 展开更多
关键词 Chronic CONSTIPATION INTESTINAL MOTILITY VITAMIN D Quality of life ANXIETY Depression
在线阅读 免费下载
Acute abdominal obstruction:Colon stent or emergency surgery? An evidence-based review 预览
9
作者 Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura +1 位作者 Christopher C Thompson Eduardo Guimaraes Hourneaux de Moura 《世界胃肠内镜杂志:英文版(电子版)》 2019年第3期193-208,共16页
According to the American Cancer Society and Colorectal Cancer Statistics 2017,colorectal cancer(CRC) is one of the most common malignancies in the United States and the second leading cause of cancer death in the wor... According to the American Cancer Society and Colorectal Cancer Statistics 2017,colorectal cancer(CRC) is one of the most common malignancies in the United States and the second leading cause of cancer death in the world in 2018.Previous studies demonstrated that 8%-29% of patients with primary CRC present malignant colonic obstruction(MCO). In the past, emergency surgery has been the primary treatment for MCO, although morbidity and surgical mortality rates are higher in these settings than in elective procedures. In the 1990 s, selfexpanding metal stents appeared and was a watershed in the treatment of patients in gastrointestinal surgical emergencies. The studies led to high expectations because the use of stents could prevent surgical intervention, such as colostomy, leading to lower morbidity and mortality, possibly resulting in higher quality of life. This review was designed to provide present evidence of the indication, technique, outcomes, benefits, and risks of these treatments in acute MCO through the analysis of previously published studies and current guidelines. 展开更多
关键词 Colorectal cancer ENDOSCOPY STENT Surgery PALLIATIVE
在线阅读 免费下载
Colorectal cancer screening from 45 years of age: Thesis, antithesis and synthesis 预览
10
作者 Alessandro Mannucci Raffaella Alessia Zuppardo +3 位作者 Riccardo Rosati Milena Di Leo José Perea Giulia Martina Cavestro 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第21期2565-2580,共16页
Colorectal cancer incidence and mortality in patients younger than 50 years are increasing, but screening before the age of 50 is not offered in Europe. Advancedstage diagnosis and mortality from colorectal cancer bef... Colorectal cancer incidence and mortality in patients younger than 50 years are increasing, but screening before the age of 50 is not offered in Europe. Advancedstage diagnosis and mortality from colorectal cancer before 50 years of age are increasing. This is not a detection-bias effect;it is a real issue affecting the entire population. Three independent computational models indicate that screening from 45 years of age would yield a better balance of benefits and risks than the current start at 50 years of age. Experimental data support these predictions in a sex- and race-independent manner. Earlier screening is seemingly affordable, with minimal impediments to providing younger adults with colonoscopy. Indeed, the American Cancer Society has already started to recommend screening from 45 years of age in the United States. Implementing early screening is a societal and public health problem. The three independent computational models that suggested earlier screening were criticized for assuming perfect compliance. Guidelines and recommendations should be derived from well-collected and reproducible data, and not from mathematical predictions. In the era of personalized medicine, screening decisions might not be based solely on age, and sophisticated prediction software may better guide screening. Moreover, early screening might divert resources away from older individuals with greater biological risks. Finally, it is still unknown whether early colorectal cancer is part of a continuum of disease or a biologically distinct disease and, as such, it might not benefit from screening at all. The increase in early-onset colorectal cancer incidence and mortality demonstrates an obligation to take actions. Earlier screening would save lives, and starting at the age of 45 years may be a robust screening option. 展开更多
关键词 COLONOSCOPY Guidelines Pros and CONS Early ONSET EARLY-ONSET colorectal cancer
在线阅读 免费下载
Tertiary stent-in-stent for obstructing colorectal cancer: A case report and literature review 预览
11
作者 Giuseppe Vanella Chiara Coluccio +2 位作者 Emilio Di Giulio Daniela Assisi Rocco Lapenta 《世界胃肠内镜杂志:英文版(电子版)》 2019年第1期61-67,共7页
BACKGROUND Self-expandable metal stents(SEMSs) are frequently used in the setting of palliation for occluding, inoperable colorectal cancer(CRC). Among possible complications of SEMS positioning, re-obstruction is the... BACKGROUND Self-expandable metal stents(SEMSs) are frequently used in the setting of palliation for occluding, inoperable colorectal cancer(CRC). Among possible complications of SEMS positioning, re-obstruction is the most frequent. Its management is controversial, potentially involving secondary stent-in-stent placement, which has been poorly investigated. Moreover, the issue of secondary stent-in-stent re-obstruction and of more-than-two colonic stenting has never been assessed. We describe a case of tertiary SEMS-in-SEMS placement, and also discuss our practice based on available literature.CASE SUMMARY A 66-year-old male with occluding and metastatic CRC was initially treated by positioning of a SEMS, which had to be revised 6 mo later when a symptomatic intra-stent tumor ingrowth was treated by a SEMS-in-SEMS. We hereby describe an additional episode of intestinal occlusion due to recurrence of intra-stent tumor ingrowth. This patient, despite several negative prognostic factors(splenic flexure location of the tumor, carcinomatosis with ascites, subsequent chemotherapy that included bevacizumab and two previously positioned stents(1 SEMS and 1 SEMS-in-SEMS)) underwent successful management through the placement of a tertiary SEMS-in-SEMS, with immediate clinical benefit and no procedure-related adverse events after 150 d of post-procedural follow-up. This endoscopic management has permitted 27 mo of partial control of a metastatic disease without the need for chemotherapy discontinuation and, ultimately, a good quality of life until death.CONCLUSION Tertiary SEMS-in-SEMS is technically feasible, and appears to be a safe and effective option in the case of recurrent SEMS obstruction. 展开更多
关键词 BEVACIZUMAB Colorectal neoplasms Intestinal OBSTRUCTION PALLIATIVE care Self-expandable metallic STENTS Case report
在线阅读 免费下载
Utility of linked color imaging for endoscopic diagnosis of early gastric cancer 预览
12
作者 Toshihisa Fujiyoshi Ryoji Miyahara +11 位作者 Kohei Funasaka Kazuhiro Furukawa Tsunaki Sawada Keiko Maeda Takeshi Yamamura Takuya Ishikawa Eizaburo Ohno Masanao Nakamura Hiroki Kawashima Masato Nakaguro Masahiro Nakatochi Yoshiki Hirooka 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第10期1248-1257,共10页
BACKGROUND Linked color imaging(LCI) is a method of endoscopic imaging that emphasizes slight differences in red mucosal color.AIM To evaluate LCI in diagnostic endoscopy of early gastric cancer and to compare LCI and... BACKGROUND Linked color imaging(LCI) is a method of endoscopic imaging that emphasizes slight differences in red mucosal color.AIM To evaluate LCI in diagnostic endoscopy of early gastric cancer and to compare LCI and pathological findings.METHODS Endoscopic images were obtained for 39 patients(43 lesions) with early gastric cancer. Three endoscopists evaluated lesion recognition with white light imaging(WLI) and LCI. Color values in Commission Internationale de l’Eclairage(CIE)1976 L*a*b* color space were used to calculate the color difference(ΔE) between cancer lesions and non-cancer areas. After endoscopic submucosal dissection,blood vessel density in the surface layer of the gastric epithelium was evaluated pathologically. The identical region of interest was selected for analyses of endoscopic images(WLI and LCI) and pathological analyses.RESULTS LCI was superior for lesion recognition(P < 0.0001), and ΔE between cancer and non-cancer areas was significantly greater with LCI than WLI(29.4 vs 18.6, P <0.0001). Blood vessel density was significantly higher in cancer lesions(5.96% vs4.15%, P = 0.0004). An a* cut-off of ≥ 24 in CIE 1976 L*a*b* color space identified a cancer lesion using LCI with sensitivity of 76.7%, specificity of 93.0%, and accuracy of 84.9%.CONCLUSION LCI is more effective for recognition of early gastric cancer compared to WLI as a result of improved visualization of changes in redness. Surface blood vessel density was significantly higher in cancer lesions, and this result is consistent with LCI image analysis. 展开更多
关键词 Linked COLOR imaging Early GASTRIC cancer Endoscopic SUBMUCOSAL DISSECTION VESSEL density COLOR difference
在线阅读 免费下载
Endoscopic sleeve gastroplasty: From whence we came and where we are going 预览
13
作者 Diogo Turiani Hourneaux de Moura Eduardo Guimaraes Hourneaux de Moura Christopher C Thompson 《世界胃肠内镜杂志:英文版(电子版)》 2019年第5期322-328,共7页
The most effective and durable treatment for obesity is bariatric surgery. However, less than 2% of eligible patients who fulfill the criteria for bariatric surgery undergo the procedure. As a result, there is a drive... The most effective and durable treatment for obesity is bariatric surgery. However, less than 2% of eligible patients who fulfill the criteria for bariatric surgery undergo the procedure. As a result, there is a drive to develop less invasive therapies to combat obesity. Endoscopic bariatric therapies (EBT) for weight loss are important since they are more effective than pharmacological treatments and lifestyle changes and present lower adverse event rates compared to bariatric surgery. Endoscopic sleeve gastroplasty (ESG) is a minimally invasive EBT that involves remodeling of the greater curvature. ESG demonstrated favorable outcomes in several centers, with up to 20.9% total body weight loss and 60.4% excess weight loss (EWL) on 2-year follow-up, with a low rate of severe adverse events (SAE). As such, it could be considered safe and effective in light of ASGE/ASMBS thresholds of > 25% EWL and ≤ 5% SAE, although there are no comparative trials to support this. Additionally, ESG showed improvement in diabetes mellitus type 2, hypertension, and other obesity-related comorbidities. As this procedure continues to develop there are several areas that can be addressed to improve outcomes, including device improvements, technique standardization, patient selection, personalized medicine, combination therapies, and training standardization. In this editorial we discuss the origins of the ESG, current data, and future developments. 展开更多
关键词 Endoscopy Surgery BARIATRIC Obesity Overweight COMORBIDITIES GASTROPLASTY SLEEVE ENDOSCOPIC SLEEVE GASTROPLASTY Editorial
在线阅读 免费下载
Role of endoscopic vacuum therapy in the management of gastrointestinal transmural defects 预览
14
作者 Diogo Turiani Hourneaux de Moura Bruna Furia Buzetti Hourneaux de Moura +5 位作者 Michael A Manfredi Kelly E Hathorn Ahmad N Bazarbashi Igor Braga Ribeiro Eduardo Guimaraes Hourneaux de Moura Christopher C Thompson 《世界胃肠内镜杂志:英文版(电子版)》 2019年第5期329-344,共16页
A gastrointestinal (GI) transmural defect is defined as total rupture of the GI wall, and these defects can be divided into three categories: perforations, leaks, and fistulas. Surgical management of these defects is ... A gastrointestinal (GI) transmural defect is defined as total rupture of the GI wall, and these defects can be divided into three categories: perforations, leaks, and fistulas. Surgical management of these defects is usually challenging and may be associated with high morbidity and mortality rates. Recently, several novel endoscopic techniques have been developed, and endoscopy has become a firstline approach for therapy of these conditions. The use of endoscopic vacuum therapy (EVT) is increasing with favorable results. This technique involves endoscopic placement of a sponge connected to a nasogastric tube into the defect cavity or lumen. This promotes healing via five mechanisms, including macrodeformation, microdeformation, changes in perfusion, exudate control, and bacterial clearance, which is similar to the mechanisms in which skin wounds are treated with commonly employed wound vacuums. EVT can be used in the upper GI tract, small bowel, biliopancreatic regions, and lower GI tract, with variable success rates and a satisfactory safety profile. In this article, we review and discuss the mechanism of action, materials, techniques, efficacy, and safety of EVT in the management of patients with GI transmural defects. 展开更多
关键词 GASTROINTESTINAL Endoscopy ENDOSCOPIC vacuum THERAPY Negative pressure THERAPY FISTULA LEAK PERFORATION Defect
在线阅读 免费下载
Comparison of efficacy and safety of transpancreatic septotomy,needle-knife fistulotomy or both based on biliary cannulation unintentional pancreatic access and papillary morphology 预览
15
作者 Jun Wen Tao Li +2 位作者 Yi Lu Li-Ke Bie Biao Gong 《国际肝胆胰疾病杂志:英文版》 SCIE CAS CSCD 2019年第1期73-78,共6页
Background:Precut sphincterotomy has been widely performed to facilitate selective biliary access when standard cannulation attempts failed during endoscopic retrograde cholangiopancreatography(ERCP).However,scarce da... Background:Precut sphincterotomy has been widely performed to facilitate selective biliary access when standard cannulation attempts failed during endoscopic retrograde cholangiopancreatography(ERCP).However,scarce data are available on different precut techniques for difficult biliary cannulation.This study aimed to evaluate the efficacy and safety of transpancreatic septotomy(TPS),needle-knife fistulotomy(NKF)or both based on the presence of unintentional pancreatic access and papillary morphology.Methods:Between March 2008 and December 2016,157 consecutive patients undergoing precutting for an inaccessible bile duct during ERCP were identified.Precut techniques were chosen depending on repetitive inadvertent pancreatic cannulation and the papillary morphology.We retrospectively assessed the rates of cannulation success and procedure-related complications among three groups,namely TPS,NKF,and TPS followed by NKF.Results:The baseline characteristics of the three groups were comparable.The overall success rate of biliary cannulation reached 98.1%,including 111 of 113(98.2%)with TPS,35 of 36(97.2%)with NKF and 8 of 8(100%)with NKF following TPS,without significant difference among groups.The incidences of total complications and post-ERCP pancreatitis were 9.6%and 7.6%,respectively.There was a trend towards less frequent post-ERCP pancreatitis after NKF(0%)compared with 11 cases(9.7%)after TPS and one case(12.5%)after NKF following TPS,but not significantly different(P=0.07).No severe adverse event occurred during this study period.Conclusions:The choice of precut techniques by the presence of unintended pancreatic access and the papillary morphology brought about a high success rate without increasing risk in difficult biliary cannulation. 展开更多
关键词 Difficult BILIARY CANNULATION Endoscopic retrograde cholangiopancreatography Needle-knife FISTULOTOMY PRECUT techniques Transpancreatic septotomy
在线阅读 下载PDF
Colorectal endoscopic submucosal dissection in special locations 预览
16
作者 Uayporn Kaosombatwattana Takeshi Yamamura +2 位作者 Masanao Nakamura Yoshiki Hirooka Hidemi Goto 《世界胃肠内镜杂志:英文版(电子版)》 2019年第4期262-270,共9页
Colorectal endoscopic submucosal dissection (ESD) is considered one of the most challenging endoscopic procedures for novice endoscopists. When compared with the stomach, the colon and rectum have a narrower tubular l... Colorectal endoscopic submucosal dissection (ESD) is considered one of the most challenging endoscopic procedures for novice endoscopists. When compared with the stomach, the colon and rectum have a narrower tubular lumen, greater angulation at the flexures, and a thinner muscle layer. These factors make endoscopic control and maneuverability difficult. ESD of the colorectum was considered more difficult than gastric and esophageal ESD. However, with learning from the experts, practicing, and selecting an appropriate technique, most of colorectal ESD could be performed successfully. Nevertheless, some colorectal locations are extremely specialized either from unique anatomy or given unstable scope position. Accordingly, the objective of this review was to provide endoscopists with an overview of the techniques and outcomes associated with ESD at these special colorectal locations. ESD at the discussed special locations of the ileo-colo-rectum was found to be feasible, and outcomes were comparable to those of ESD performed in non-special locations of the ileocolo- rectum. Practice for skill improvement and awareness of the unique characteristics of each special location is the key to performing successful ESD. 展开更多
关键词 COLORECTAL ENDOSCOPIC SUBMUCOSAL DISSECTION ENDOSCOPIC SUBMUCOSAL DISSECTION SPECIAL LOCATIONS
在线阅读 免费下载
Impact of gastroesophageal reflux disease on the quality of life of Polish patients 预览
17
作者 Rafal Gorczyca Piotr Pardak +1 位作者 Anna Pekala Rafal Filip 《世界临床病例杂志》 2019年第12期1421-1429,共9页
BACKGROUND Gastro-esophageal reflux disease (GERD) is a serious health and social problem leading to a considerable decrease in the quality of life of patients. Among the risk factors associated with reflux symptoms a... BACKGROUND Gastro-esophageal reflux disease (GERD) is a serious health and social problem leading to a considerable decrease in the quality of life of patients. Among the risk factors associated with reflux symptoms and that decrease the quality of life are stress, overweight and an increase in body weight. The concept of healthrelated quality of life (HRQL) covers an expanded effect of the disease on a patient’s wellbeing and daily activities and is one of the measures of widely understood quality of life. HRQL is commonly measured using a selfadministered, disease-specific questionnaires. AIM To determine the effect of reflux symptoms, stress and body mass index (BMI) on the quality of life. METHODS The study included 118 patients diagnosed with reflux disease who reported to an outpatient department of gastroenterology or a specialist hospital ward for planned diagnostic tests. Assessment of the level of reflux was based on the frequency of 5 typical of GERD symptoms. HRQL was measured by a 36-item Short Form Health Survey (SF-36) and level of stress using the 10-item Perceived Stress Scale. Multi-variable relationships were analyzed using multiple regression. RESULTS Eleven models of analysis were performed in which the scale of the SF-36 was included as an explained variable. In all models, the same set of explanatory variables: Gender, age, reflux symptoms, stress and BMI, were included. The frequency of GERD symptoms resulted in a decrease in patients’ results according to 6 out of 8 SF-36 scales- except for mental health and vitality scales. Stress resulted in a decrease in patient function in all domains measured using the SF-36. Age resulted in a decrease in physical function and in overall assessment of self-reported state of health. An increasing BMI exerted a negative effect on physical fitness and limitations in functioning resulting from this decrease. CONCLUSION In GERD patients, HRQL is negatively determined by the frequency of reflux symptoms and by stress, furthermore an increasing BMI and 展开更多
关键词 GASTROESOPHAGEAL REFLUX disease Stress PSYCHOLOGICAL factors HEALTH-RELATED quality of life OBESITY
在线阅读 免费下载
Feasibility of gastric endoscopic submucosal dissection with continuous low-dose aspirin for patients receiving dual antiplatelet therapy 预览
18
作者 Hideaki Harada Satoshi Suehiro +7 位作者 Daisuke Murakami Ryotaro Nakahara Takuya Nagasaka Tetsuro Ujihara Ryota Sagami Yasushi Katsuyama Kenji Hayasaka Yuji Amano 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第4期457-467,共11页
BACKGROUND Endoscopic submucosal dissection(ESD)for gastric neoplasms during continuous low-dose aspirin(LDA)administration is generally acceptable according to recent guidelines.This retrospective study aimed to inve... BACKGROUND Endoscopic submucosal dissection(ESD)for gastric neoplasms during continuous low-dose aspirin(LDA)administration is generally acceptable according to recent guidelines.This retrospective study aimed to investigate the effect of continuous LDA on the postoperative bleeding after gastric ESD in patients receiving dual antiplatelet therapy(DAPT).AIM To investigate the feasibility of gastric ESD with continuous LDA in patients with DAPT.METHODS A total of 597 patients with gastric neoplasms treated with ESD between January 2010 and June 2017 were enrolled.The patients were categorized according to type of antiplatelet therapy(APT).RESULTS The postoperative bleeding rate was 6.9%(41/597)in all patients.Patients were divided into the following two groups:no APT(n=443)and APT(n=154).APT included single-LDA(n=95)and DAPT(LDA plus clopidogrel,n=59)subgroups.In the single-LDA and DAPT subgroups,56 and 39 patients were received continuous LDA,respectively.The bleeding rate with continuous single-LDA(10.7%)was similar to that with discontinuous single-LDA(10.3%)(P>0.99).Although the bleeding rate with continuous LDA in patients receiving DAPT(23.1%)was higher than that with discontinuous LDA in patients receiving DAPT(5.0%),no significant difference was observed(P=0.141).CONCLUSION The bleeding rate with continuous LDA in patients receiving DAPT was not statistically different from that with discontinuous LDA in patients receiving DAPT.Therefore,continuous LDA administration may be acceptable for ESD in patients receiving DAPT,although patients should be carefully monitored for possible bleeding. 展开更多
关键词 Dual ANTIPLATELET therapy Endoscopic SUBMUCOSAL DISSECTION LOW-DOSE ASPIRIN Postoperative BLEEDING Thienopyridine
在线阅读 免费下载
Endoscopic identification of endoluminal esophageal landmarks for radial and longitudinal orientation and lesion location 预览
19
作者 Fabian Emura Rene Gomez-Esquivel +4 位作者 Carlos Rodriguez-Reyes Petros Benias Javier Preciado Michael Wallace Luis Giraldo-Cadavid 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第4期498-508,共11页
AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion location.METHODS Distance from the incisors and radial orientation were estimated for t... AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion location.METHODS Distance from the incisors and radial orientation were estimated for the main left bronchus and the left atrium landmarks in 207 consecutive patients using white light examination.A sub-study was also performed using white light followed by endoscopic ultrasound(EUS)in 25 consecutive patients to confirm the findings.The scope orientation throughout the exam was maintained at the natural axis,where the left esophageal quadrant corresponds to the area between 6 and 9 o'clock.When an anatomical landmark was identified,it was recorded with a photograph and its quadrant orientation and distance from the incisors were determined.The reference points to obtain the distances and radial orientation were as follows:the midpoint of the left main bronchus and the most intense pulsatile zone of the left atrium.With the video processor system set to moderate insufflation,measurements were obtained at the end of the patients'air expiration.RESULTS The left main bronchus and left atrium esophageal landmarks were identified using white light in 99%and 100%of subjects at a mean distance of 25.8 cm(SD 2.3),and 31.4 cm(SD 2.4)from the incisors,respectively.The left main bronchus landmark was found to be a tubular,concave,non-pulsatile,esophageal external compression,occupying approximately 1/4 of the circumference.The left atrium landmark was identified as a round,convex,pulsatile,esophageal external compression,occupying approximately 1/4 of the circumference.Both landmarks were identified using white light on the anterior esophageal quadrant.In the substudy,the left main bronchus was identified in 24(92%)patients at 25.4 cm(SD 2.1)and 26.7 cm(SD 1.9)from the incisors,by white light and EUS,respectively.The left atrium was recognized in all patients at 30.5 cm(SD 1.9),and 31.6 cm(SD 2.3)from the incisors,by both white light and EUS,respectively.EUS confirmed that the landmarks correspond 展开更多
关键词 Esophagus Natural landmark RADIAL ORIENTATION Longitudinal ORIENTATION Four-quadrants LEFT main BRONCHUS LEFT atrium
在线阅读 免费下载
Early gastric cancer diagnostic ability of ultrathin endoscope loaded with laser light source 预览
20
作者 Takuto Suzuki Yoshiyasu Kitagawa +1 位作者 Rino Nankinzan Taketo Yamaguchi 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第11期1378-1386,共9页
BACKGROUND Conventionally, the low luminous intensity, low image resolution, and difficulty in operation have been reported with the ultrathin endoscope. However, it has markedly advanced recently. The improvement of ... BACKGROUND Conventionally, the low luminous intensity, low image resolution, and difficulty in operation have been reported with the ultrathin endoscope. However, it has markedly advanced recently. The improvement of the diagnostic ability is expected.AIM To compare the early gastric cancer diagnostic ability of an ultrathin endoscope loaded with a laser light source and that of the conventional endoscope.METHODS The target subjects were 375 consecutive patients who underwent endoscopy at our hospital for post-endoscopic submucosal dissection follow-up of gastric cancer from January to August 2018. During endoscopy, the ultrathin endoscope was used in 140 patients(37.3%), and the conventional endoscope was used in235 patients(62.7%). Patient background was adjusted using the propensity score matching method, and gastric cancer detection ability was evaluated in the two groups.RESULTS The gastric cancer detection rate was 7.8% in the ultrathin endoscope group and7.0% in the conventional endoscope group, and the mean intragastric observation time was 4.1 ± 1.7 min in the ultrathin endoscope group and 4.1 ± 1.9 min in the conventional endoscope group, showing no significant differences between the groups. Moreover, the biopsy implementation rate was 31.8% in the ultrathin endoscope group and 41.1% in the conventional endoscope group, and the biopsy prediction rate was 17.9% and 13.2%, respectively, showing no significant differences between the groups.CONCLUSION The gastric cancer diagnostic ability of the ultrathin endoscope loaded with a laser light source was comparable to that of the conventional endoscope. The observation time was also comparable. Thus, endoscopy using the ultrathin endoscope loaded with the laser light source would be the first option in screening examinations of gastric cancer due to its low invasion. 展开更多
关键词 CONVENTIONAL ENDOSCOPE GASTRIC cancer LASER light source Screening ULTRATHIN ENDOSCOPE
在线阅读 免费下载
上一页 1 2 24 下一页 到第
使用帮助 返回顶部 意见反馈