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Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors

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World Journal of Clinical Cases 2021年第32期9卷 9804-9814页

作者： dadang makmun Marcellus Simadibrata Murdani Abdullah Ari F Syam Hamzah Shatri Achmad Fauzi KakaRenaldi Hasan Maulahela Amanda P Utari Rabbinu R Pribadi Virly N Muzellina Saskia A Nursyirwan Division of Gastroenterology Pancreatobiliary&Digestive EndoscopyDepartment of Internal MedicineFaculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National General HospitalJakarta 10430Indonesia Clinical Epidemiology Unit Department of Internal MedicineFaculty of Medicine Universitas Indonesia-Cipto Mangunkusumo National General HospitalJakarta 10430Indonesia

BACKGROUND An increasing trend in colorectal cancer(CRC)occurring at younger ages has been observed worldwide,even though incidence is declining in the general *** currently available guidelines still recommend CRC screening for older populations,despite an alarming rise in early-onset CRC *** stratification is necessary to further determine the population most at risk for early-onset ***,epidemiological data on related clinical characteristics and potential risk factors,especially in developing countries,have not been widely *** To investigate the prevalence,demographics,clinicopathologic features,and associated factors of young-onset CRC patients in a tertiary hospital in *** Patients undergoing colonoscopy examination between 2008 and 2019,yielding a diagnosis of CRC were identified from medical *** subjects were classified into two groups according to their age at diagnosis,namely early-onset(18-49 years old)and late-onset(≥50-years-old).Demographic data,characteristics,and risk factors of both onset age groups were evaluated using the chisquare and Fisher’s exact *** Among 495 CRC patients confirmed by histopathology,205(41.4%)were classified as early-onset and 290(58.6%)as *** subjects in the earlyonset CRC group were male(53.7%),with 89.8%displaying adenocarcinoma histopathology.A majority(78%)of the early-onset CRC patients had left-sided tumors,with the rectum(41%)and rectosigmoid(17.6%)being the most common *** pain was the most frequent symptom in the early-onset CRC patients(55.6%),which was significantly higher than that in the late-onset CRC patients(43.8%,P<0.05).Early-onset CRC cases were more likely to be underweight(34.6%vs 20.0%,P<0.001)compared to late-onset CRC *** proportion of subjects with suspected hereditary nonpolyposis colorectal cancer(HNPCC)was also higher in the early-onset CRC group than in the late-onset age group(9.3%vs 4.1%,P<0.05).

关键词： Colorectal cancer Early onset Epidemiology Associated factors Tertiary hospital Indonesia

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Per oral cholangiopancreatoscopy in pancreatico biliary diseases- Expert consensus statements

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World Journal of Gastroenterology 2015年第15期21卷 4722-4734页

作者： Mohan Ramchandani Duvvur Nageshwar Reddy Sundeep Lakhtakia Manu Tandan Amit Maydeo Thoguluva Seshadri Chandrashekhar Ajay Kumar Randhir Sud Rungsun Rerknimitr dadang makmun Christopher Khor Asian Institute of Gastroenterology Baldota Institute of Digestive Sciences Gastro-enterology and Endocrinology MedIndia Hospitals Department of Gastroenterology Apollo Hospital Delhi Department of Gastro-enterology Medanta Gastroenterology and Hepatology King Chulalongkorn Memorial Hospital Department of Medicine Cipto Mangunkusumo Hospital Department of Internal Medicine Faculty of Medicine National University Hospital Department of Gastroenterology and Hepatology

AIM: To provide consensus statements on the use of per-oral cholangiopancreatoscopy(POCPS).METHODS: A workgroup of experts in endoscopic retrograde cholangiopancreatography(ERCP), endosonography, and POCPS generated consensus statements summarizing the utility of POCPS in pancreaticobiliary disease. Recommendation grades used validated evidence ratings of publications from an extensive literature ***: Six consensus statements were generated:(1) POCPS is now an important additional tool during ERCP;(2) in patients with indeterminate biliary strictures, POCS and POCS-guided targeted biopsy are useful for establishing a definitive diagnosis;(3) POCS and POCS-guided lithotripsy are recommended for treatment of difficult common bile duct stones when standard techniques fail;(4) in patients with main duct intraductal papillary mucinous neoplasms(IPMN) POPS may be used to assess extent of tumor to assist surgicalresection;(5) in difficult pancreatic ductal stones,POPS-guided lithotripsy may be useful in fragmentation and extraction of stones; and(6) additional indications for POCPS include selective guidewire placement,unexplained hemobilia, assessing intraductal biliary ablation therapy, and extracting migrated stents. CONCLUSION: POCPS is important in association with ERCP, particularly for diagnosis of indeterminate biliary strictures and for intra-ductal lithotripsy when other techniques failed, and may be useful for preoperative assessment of extent of main duct IPMN, for extraction of difficult pancreatic stones, and for unusua indications involving selective guidewire placement,assessing unexplained hemobilia or intraductal biliary ablation therapy, and extracting migrated stents.

关键词： Per oral cholangiopancreatoscopy Intraductallithotripsy Indeterninate biliary strictures Cholangioscopy Pancreatoscopy

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