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Recanalization of anastomotic occlusion following rectal cancer surgery using a rendezvous endoscopic technique with transillumination:A case report

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World Journal of Gastroenterology 2024年第37期30卷 4149-4155页

作者： Jun Chi Guang-Yu Luo hong-bo shan Jun-Zhong Lin Xiao-Jun Wu Jian-Jun Li Department of Endoscopy Sun Yat-Sen University Cancer CenterGuangzhou 510060Guangdong ProvinceChina State Key Laboratory of Oncology in South China Guangzhou 510060Guangdong ProvinceChina Guangdong Provincial Clinical Research Center for Cancer Guangzhou 510060Guangdong ProvinceChina Department of Colorectal Surgery Sun Yat-Sen University Cancer CenterGuangzhou 510060Guangdong ProvinceChina

BACKGROUND Colorectal anastomotic occlusion is a serious complication of colorectal cancer *** several treatment strategies have been proposed,the mana-gement of anastomotic occlusion remains *** this report,we present a case of anastomotic occlusion recanalization performed using a novel technique involving two endoscopes,one for radial incision and the other serving as a guide *** novel technique offers significant advantages in terms of operational feasibility,reduced invasiveness,rapid recovery,and shortened hospital *** SUMMARY A 37-year-old man underwent low anterior resection and prophylactic double-lumen ileostomy for rectal cancer in June,*** months later,complete anastomotic occlusion was observed on ***,we developed a novel atresia recanalization *** endoscopes were placed,one through the colonic anastomosis and the other through the anus.A radial incision was successfully made from the colonic side,guided by the light of the endoscope from the anal *** recanal-ization was performed within 20 *** weeks after recanalization,colonoscopy revealed that the diameter of the colorectal anastomosis was approximately 16 mm and the patient therefore underwent stoma reversal in *** the follow-up period of approximately one year,the patient remained well and no stenosis or obstruction symptoms were *** Endoscopic atresia recanalization of colorectal anastomotic occlusion assisted by an opposing light source is safe and effective.

关键词： Endoscopy Atresia recanalization Anastomotic occlusion Light source Case report

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Effects of omeprazole in improving concurrent chemoradiotherapy efficacy in rectal cancer

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World Journal of Gastroenterology 2017年第14期23卷 2575-2584页

作者： Jin-Liang Zhang Min Liu Qing Yang Shi-Yong Lin hong-bo shan Hui-Yun Wang Guo-Liang Xu Department of Medical Oncology Guangdong Medical University Affiliated Longhua Central Hospital Department of Internal Medicine The University of Hong Kong-Shenzhen Hospital Department of Endoscopy and Laser State Key Laboratory of Oncology in South ChinaSun Yat-Sen University Cancer Center Department of Experimental Research State Key Laboratory of Oncology in South ChinaSun Yat-Sen University Cancer Center Department of Endoscopy and Laser Sun Yat-Sen University Cancer Center

AIM To explore the effects of omeprazole on chemoradiotherapy efficacy and tumor recurrence in rectal cancer. METHODS The medical data of 125 rectal cancer patients who received the same neoadjuvant chemoradiotherapy(CRT) followed by surgery were retrospectively collected. Patients who received omeprazole(OME) orally at a dose of 20 mg at least once daily for six days and/or intravenously at 40 mg a day were recognized as eligible OME users(EOU). Otherwise, patients were regarded as non-eligible OME users(non-EOU).Moreover, a preferred OME dose cut-off of 200 mg on tumor recurrence was obtained by receiver operating characteristic(ROC) curves. Patients were divided into two groups: the effective OME group(EOG, OME ≥ 200 mg) and the non-effective OME group(non-EOG, OME < 200 mg). RESULTS The good response rate of CRT efficacy(50.8%) in EOU was significantly increased compared with nonEOU(30.6%)(P = 0.02). The recurrence rate in the EOG was 10.3%, which was significantly lower compared with 31.3% in non-EOG(P = 0.025). The good response rate of CRT efficacy in EOG was 55.2%, which was obviously higher compared with 36.5% in non-EOG, with a significant difference(P = 0.072). Multivariate Cox analysis demonstrated that OME(nonEOG and EOG) was an independent and significant impact factor for DFS(P = 0.048, HR = 0.30, 95%CI: 0.09-0.99).CONCLUSION When applied as an adjuvant drug in cancer treatment for relieving common side effects of chemotherapy, omeprazole has a synergetic effect in improving CRT efficacy and decreasing rectal cancer recurrence.

关键词： Omeprazole Chemoradiotherapy efficacy Recurrence Rectal cancer

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Primary intestinal non-Hodgkin's lymphoma:A clinicopathologic analysis of 81 patients

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World Journal of Gastroenterology 2011年第41期17卷 4625-4631页

作者： Guo-Bao Wang Guo-Liang Xu Guang-Yu Luo hong-bo shan Yin Li Xiao-Yan Gao Jian-Jun Li Rong Zhang Department of Laser Treatment and Endoscopy Sun Yat-Sen University Cancer Center Guangzhou 510060 Guangdong ProvinceChina State Key Laboratory of On-cology in South China Guangzhou 510060 Guangdong Province China

AIM:To analyze the clinicopathologic features and the prognosis of primary intestinal ***:Patients were included in the study based on standard diagnostic criteria for primary gastrointesti-nal lymphoma,and were treated at Sun Yat-sen Univer-sity Cancer Centre between 1993 and ***:The study comprised 81 *** most common site was the ileocaecal ***-two point two percent patients had low-grade B-cell ***-one point nine percent patients had high-grade B-cell lymphoma and 25.9% patients had T-cell *** patients had localized *** were more patients and more early stage diseases in the latter period,and the origin sites *** ma-jority of patients received the combined treatment,andabout 20% patients only received nonsurgical *** wverall survival and event-free survival rates after 5 years were 71.6% and 60.9% *** mul-tivariate analysis revealed that small intestine and ileo-caecal region localization,B-cell phenotype,and normal lactate dehydrogenase were independent prognostic factors for better patient *** based treat-ment did not improve the survival ***:Refined stratification of the patients according to the prognostic variables may allow indi-vidualized *** treatment may be an optimal therapeutic modality for selected patients.

关键词： Gastrointestinal lymphoma Non-Hodgkin'slymphoma Gastrointestinal oncology Prognostic factors

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Managing esophageal fistulae by endoscopic transluminal drainage in esophageal cancer patients with superior mediastinal sepsis after esophagectomy

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Chinese Journal of Cancer 2013年第8期32卷 469-473页

作者： Yu-Zhen Zheng Shu-Qin Dai hong-bo shan Xiao-Yan Gao Lan-Jun Zhang Xun Cao Jian-Fei Zhu Jun-Ye Wang State Key Laboratory of Oncology in South China Department of Thoracic Oncology Sun Yat-sen University Cancer Center Clinical Laboratory Sun Yat-sen University Cancer Center Department of Laser and Endoscopy Sun Yat-sen University Cancer Center

The management of postoperative leaks into the mediastinum after esophagectomy remains a challenge. We describe our clinical management of this complication through endoscopic transluminal drainage. Between 2008 and 2011, 4 patients with esophageal squamous cell carcinoma (ESCC) who underwent McKeown-type esophagectomy with two-field lymphadenectomy experienced complicated anastomotic fistulae in the presence of superior mediastinal sepsis. All 4 patients underwent endoscopic transluminal drainage, and all survived. The mean healing period was 50 days (range, 31 to 58 days), the mean stay in the intensive care unit was 7.3 days (range, 1 to 18 days), and the mean hospital stay was 64.5 days (range, 49 to 70 days). Endoscopically guided transluminal drainage should be considered for ESCC patients with superior mediastinal fistulae after esophagectomy.

关键词：临床管理食管癌败血症引流腔内内镜患者鳞状细胞癌

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Endoscopic ultrasonography for staging of T1a and T1b esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2014年第5期20卷 1340-1347页

作者： Long-Jun He hong-bo shan Guang-Yu Luo Yin Li Rong Zhang Xiao-Yan Gao Guo-Bao Wang Shi-Yong Lin Guo-Liang Xu Jian-Jun Li Department of Endoscopy Sun Yat-sen University Cancer Center Guangdong Esophageal Cancer Institute Department of Endoscopy State Key Laboratory of Oncology in South China Department of Endoscopy Collaborative Innovation Center for Cancer Medicine

AIM: To investigate the accuracy of Endoscopic ultrasound (EUS) in staging and sub-staging T1a and T1b esophageal squamous cell carcinoma (ESCC).

关键词： Endoscopic ultrasound Esophageal cancer Squamous carcinoma Early cancer Stage

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Extraesophageal saline enhances endoscopic ultrasonography to differentiate esophagus and adjacent organs

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World Journal of Gastroenterology 2014年第35期20卷 12551-12558页

作者： Jian-Jun Li hong-bo shan Long-Jun He Thomas D Wang Huan Xiong Li-Ming Chen Xiao-Hai Li Xin-Xin Huang Guang-Yu Luo Yin Li Guo-Liang Xu Department of Endoscopy Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaGuangdong Esophageal Cancer Institute Division of Gastroenterology University of Michigan Department of Medical Record Statistics The First Affiliated HospitalSun Yat-sen University Department of Cardiothoracic Surgery The First Affiliated Hospital of Guangzhou University of Traditional Chinese MedicineGuangzhou 5100405Guangdong ProvinceChina

AIM: To distinguish between the esophagus and adjacent organs using extraesophageal saline injection (ESI) in a canine model.

关键词： Esophageal cancer Endoscopic ultrasonography Extraesophageal saline injection Aorta Trachea Staging

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Evaluation of preoperative staging for esophageal squamous cell carcinoma

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World Journal of Gastroenterology 2016年第29期22卷 6683-6689页

作者： Lin-Na Luo Long-Jun He Xiao-Yan Gao Xin-Xin Huang hong-bo shan Guang-Yu Luo Yin Li Shi-Yong Lin Guo-Bao Wang Rong Zhang Guo-Liang Xu Jian-Jun Li Department of Endoscopy Sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South China Guangdong Esophageal Cancer Institute Collaborative Innovation Center for Cancer Medicine

Esophageal squamous cell carcinoma(ESCC) is known for its rapid progression and poor outcomes. China has the highest incidence and mortality in the world. Diagnoses made at early stages and accurate staging are associated with better outcomes, all of which can play a significant role in the selection of treatment protocols. ESCC is staged according to the widely accepted TNM system. Common imaging modalities used in staging ESCC before treatment include endoscopy, computed tomography(CT), positron emission tomography(PET) and magnetic resonance imaging(MRI). Endoscopic ultrasound is useful for staging tumor depth and nodal status. Narrow band imaging is valuable for early stage disease assessment. CT and PET provide additional valuable information regarding node and metastasis staging. The ability of MRI to delineate ESCC is continuously being improved and adds information regarding locoregional status to routine examinations.

关键词： Esophageal squamous cell carcinoma Endoscopic ultrasound Computed tomography Positron emission tomography Magnetic resonance imaging Staging

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Superficial esophageal lesions detected by endoscopic ultrasound enhanced with submucosal edema

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World Journal of Gastroenterology 2013年第47期19卷 9034-9042页

作者： Jian-Jun Li Long-Jun He hong-bo shan Thomas D Wang Huan Xiong Li-Ming Chen Guo-Liang Xu Xiao-Hai Li Xin-Xin Huang Guang-Yu Luo Yin Li Rong Zhang Department of Endoscopy Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer Medicine Division of Gastroenterology University of MichiganAnn ArborMI 48109United States Department of Medical Record Statistics The First Affiliated HospitalSun Yat-sen University Department of Cardiothoracic Surgery The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine

AIM:To determine if there is consistency between endoscopic ultrasound(EUS)findings and pathological results for detecting lesions of different depth in the esophageal ***:A canine(Beagle)model was established in which lesions of different depths were created in the esophageal mucosa by thermal ***-two hours later,these lesions and adjacent tissue in the esophagus were examined by *** findings including infiltrating depth,strength of echogenicity and homogeneity were *** were sacrificed and tissue specimens were *** then compared the EUS findings with the pathology ***:Thermal burns created at different power settings caused lesions of different depth in the esophageal *** the echo strength was shifted from high,medium,to low echogenicity,an increase in the infiltrating depth of the lesion was noted,which coincided with results of the pathology *** submucosal edema visualized by EUS was also detected by ***,because of the enhancement caused by the submucosal edema,the lesions invading into the submucosa were easily visualized by ***:There is consistency between EUS findings and pathological results of esophageal lesions with different *** edema can serve as an ultrasonic contrast agent.

关键词： Endoscopic ultrasound Pathology Lesion Esophagus Canine

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Ultrasound-guided fine needle aspiration of retropharyngeal lymph nodes after radiotherapy for nasopharyngeal carcinoma: a novel technique for accurate diagnosis

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Cancer Communications 2018年第1期38卷 229-236页

作者： Long-Jun He Chuanbo Xie Yin Li Lin-Na Luo Ke Pan Xiao-Yan Gao Li-Zhi Liu Jian-Ming Gao Guang-Yu Luo hong-bo shan Ming-Yuan Chen Chong Zhao Wei-Jun Fan Ping Yang Guo-Liang Xu Jian-Jun Li State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapySun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Endoscopy Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Cancer Prevention Research Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Melanoma Medical Oncology The University of Texas MD Anderson Cancer CenterHoustonTX 77054USA Department of Imaging and Invention Radiology Sun Yat-sen University Cancer CenterGuangzhou 510060Guang-dongP.R.China Department of Radiation Oncology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Nasopharyngeal Oncology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China Department of Pathology Sun Yat-sen University Cancer CenterGuangzhou 510060GuangdongP.R.China

Background:Enlarged retropharyngeal lymph nodes(RLNs)are very common in patients with nasopharyngeal carcinoma(NPC)undergoing *** most suitable treatment option for enlarged RLNs depends on the pathological ***,RLN sampling is difficult and imminent in the clinic *** recently developed a novel minimally invasive technique termed endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)for sam-pling RLN tissues sufficient for pathological or cytological ***:We enrolled 30 post-radiotherapy patients with NPC with suspected RLN metastasis detected via mag-netic resonance imaging(MRI).The EUS probe was introduced into the nasopharynx via the nostrils,and EUS was then used to scan the retropharyngeal space and locate the RLN in the anterior carotid ***-FNA was subsequently *** safety and efficacy of using EUS-FNA to sample the RLN tissues were ***:Strips of tissue were successfully sampled from all patients using *** the 30 patients,23 were confirmed to have cancer cells in the biopsied tissues via pathology or cytology examinations with 1 EUS-FNA biopsy *** seven cases without confirmed cancer cells were subsequently reanalyzed by using another EUS-FNA biopsy session,and two more cases were confirmed possessing cancer *** other five patients without con-firmed cancer cells were closely followed with MRI every month for 3 *** follow-up for 3 months,three patients were still considered cancer-free due to the presence of RLNs with stable or shrinking *** rest two patients who showed progressive disease underwent a third EUS-FNA biopsy procedure and were further confirmed to be cancer *** the whole cohort reported here,the EUS-FNA procedure was not associated with any severe ***:EUS-FNA is a safe and effective diagnostic approach for sampling tissues from the RLNs in patients with suspected recurrent NPC.

关键词： Fine needle aspiration Endoscopic ultrasonography Retropharyngeal lymph node Nasopharyngeal carcinoma

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Value of transrectal ultrasonography for tumor node metastasis restaging in patients with locally advanced rectal cancer after neoadjuvant chemoradiotherapy

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Gastroenterology Report 2013年第3期1卷 186-192页

作者： Hai-Hua Peng Kai-Yun You Cheng-Tao Wang Rong Huang hong-bo shan Jian-Hua Zhou Xiao-Qing Pei Yuan-hong Gao Bi-Xiu Wen Meng-Zhong Liu Department of Radiation Oncology First Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina Department of Radiotherapy Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in Southern ChinaGuangzhouChina Department of Endoscopy and Laser Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in Southern ChinaGuangzhouChina Department of Ultrasonography Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in Southern ChinaGuangzhouChina

Objective:To explore the value of transrectal ultrasonography(TRUS)for tumor node metastasis(TNM)restaging for patients with locally advanced rectal cancer after neoadjuvant chemoradiotherapy(neo-CRT).Methods:One hundred and forty-nine patients with locally advanced rectal cancer(cT3-4 or cN+)who underwent TRUS after neo-CRT were retrospectively *** restaging was compared with the results of post-operative pathological TNM ***:After neo-CRT,the accuracy of TRUS for diagnosing T-staging was 30.9%,with 60.4%(90/149)of cases *** sensitivity of TRUS for T-staging(T0 vs T1 vs T2 vs T3 vs T4)were 16.3%,0%,12.5%,42.6%and 75.0%,*** accuracy of TRUS for diagnosing N-staging after neo-CRT was 81.2%,with the sensitivities of N0 and N+were 93.3%and 31.0%,*** neo-CRT,27.5%(41/149)of patients achieved pathologically complete response(pCR).The sensitivity,specificity,positive predictive value and negative predictive values of TRUS for pCR were 17.1%,99.1%,87.5%and 75.9%,***:TRUS can be applied for restaging T4 and N0,and has potential for screening out patients with pCR in those with locally advanced rectal cancer after neo-CRT,although some stages are overestimated for T-staging and its sensitivity for predicting pCR is low.

关键词： Rectal cancer neo-chemoradiotherapy(neo-CRT) transrectal ultrasonography(TRUS) TNM restaging

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