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Efficacy, risk factors and complications of endoscopic polypectomy: Ten year experience at a single center

World Journal of Gastroenterology 2008年第15期14卷 2364-2369页

作者： Pierluigi Consolo Carmelo luigiano Giuseppe Strangio Maria Grazia Scaffidi Giuseppa Giacobbe Giovanna Di Giuseppe Agata Zirilli luigi familiari Department of Medicine and Pharmacology University Hospital "G. Martino" Via Consolare Valeria Messina 98100 Italy Department of Statistics University of Messina Messina 98100 Italy

AIM: To examine the efficacy and complications of colonoscopic resection of colorectal polypoid lesions. METHODS: We retrospectively reviewed 1354 polypectomies performed on 1038 patients over a ten- year period. One hundred and sixty of these were performed for large polyps, those measuring ≥ 20 mm. Size, shape, location, histology, the technique of polypectomy used, complications, drugs assumption and associated intestinal or extra intestinal diseases were analyzed. For statistical analysis, the Pearson χ2 test, NPC test and a Binary Logistic Regression were used. RESULTS: The mean patient age was 65.9 ± 12.4 years, with 671 men and 367 women. The mean size of polyps removed was 9.45 ± 9.56 mm while the size of large polyps was 31.5 ± 10.8 mm. There were 388 pedunculated and 966 sessile polyps and the most common location was the sigmoid colon (41.3%). The most frequent histology was tubular adenoma (55.9%) while for the large polyps was villous (92/160 -57.5%). Coexistent malignancy was observed in 28 polyps (2.1%) and of these, 20 were large polyps. There were 17 procedural bleeding (1.3%) and one perforation. The statistical analysis showed that cancer is correlated to polyp size (P < 0.0001); sessile shape (P < 0.0001) and bleeding are correlated to cardiac disease (P = 0.034), tubular adenoma (P = 0.016) and polyp ***: The endoscopic resection is a simple and safe procedure for removing colon rectal neoplastic lesions and should be considered the treatment of choice for large colorectal polyps. The polyp size is an important risk factor for malignancy and for bleeding.

关键词：结肠癌息肉切除术内窥镜风险因子

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Oldest biliary endoprosthesis in situ

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World Journal of Gastrointestinal Endoscopy 2013年第7期5卷 356-358页

作者： Pierluigi Consolo Giuseppe Scalisi Stefano F Crinò Andrea Tortora Giuseppa Giacobbe Marcello Cintolo luigi familiari Socrate Pallio Digestive Endoscopy Unit University Hospital98100 Messina Italy

The advantages of endoscopic retrograde cholangio-pancreatography over open surgery have made it the predominant method of treating patients with choledo-cholithiasis. After sphincterotomy, however, 10%-15% of common bile duct stones cannot be removed with a basket or balloon. The methods for managing "irretrievable stones" include surgery, mechanical lithotripsy, intraductal or extracorporeal shock wave lithotripsy and biliary stenting. The case presented was a referred 82-year-old Caucasian woman with a 7-year-old plastic biliary endoprosthesis in situ . To the best of our knowledge the examined endoprosthesis is the oldest endo-prosthesis in situ reported in the literature. Endoscopic biliary endoprosthesis placement remains a simple and safe procedure for patients with stones that are difficult to manage by conventional endoscopic methods and for patients who are unfit for surgery or who are high surgical risks. To date no consensus has been reached regarding how long a biliary prosthesis should remain in situ . Long-term biliary stenting may have a role in selected elderly patients if stones extraction has failed because the procedure may prevent stones impaction and cholangitis.

关键词： Common bile duct stones Cholangitis Biliary endoprosthesis Endoscopic retrograde cholangio-pancreatography Endoscopic sphincterotomy

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