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Complexity of Giant GIST Case Series and Review of the Literature

Open Journal of Gastroenterology 2022年第6期12卷 137-152页

作者： Remy Mckey Mohamad Alskafi Houda Khatoun Hassan Salame salah ezzedine Department of Gastroenterology Rafik Hariri University Hospital Beirut Lebanon Department of Radiology Beirut Cardiac Institute Rasoul Aazam Hospital Beirut Lebanon

Background: Gastrointestinal stromal tumors are the most common type of mesenchymal tumors of the GI tract, most commonly found in the stomach and intestines. They are thought to grow from the interstitial cells of Cajal (ICCs) or precursors of these cells. They have an insidious onset and may grow to a very large size depending on the site of origin. Material and method: We present a case series of three patients who had very large GISTs that had different presentations and outcomes. Patients were from different backgrounds and all were above 50 years old. Each one had a palpable mass in the abdomen in the initial presentation with a multilobulated mass at imaging devoting malignant behavior and higher risk of the tumor. They are managed according to guidelines and treated with Imatinib, but none of them had genetic and molecular studies of the tumor due to non-availability of the test. Conclusion: As a conclusion, GISTs are not easy to diagnose especially in the early phase of the disease and it may take years for it to become clinically relevant. Thence a thorough medical history and physical exam with imaging and endoscopies are the main diagnostic modalities with the importance of molecular profiling that will guide therapy and predicting prognosis.

关键词： Gastrointestinal Stromal Tumor GIST GI Malignancy Imatinib Case Series

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Medical treatment for sphincter of oddi dysfunction:Can it replace endoscopic sphincterotomy?

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World Journal of Gastroenterology 2012年第14期18卷 1610-1615页

作者： Véronique Vitton salah ezzedine Jean-Michel Gonzalez Mohamed Gasmi Jean-Charles Grimaud Marc Barthet Department of Gastroenterology Hôpital NordChemin des Bourrely13915 Marseille cedex 20France

AIM:To report the results of a medical management of sphincter of oddi dysfunction(SOD) after an intermediate follow-up ***:A total of 59 patients with SOD(2 men and 57 women,mean age 51 years old) were included in this prospective *** medical treatment for one year,the patients were clinically re-evaluated after an average period of 30 ***:The distribution of the patients according to the Milwaukee's classification was the following:11 patients were type 1,34 were type 2 and 14 were type *** patients underwent an endoscopic sphincterotomy(ES) after one year of medical *** median intermediate follow-up period was 29.8 ± 3 mo(3-72 mo).The initial effectiveness of the medical treatment was complete,partial and poor among 50.8%,13.5% and 35%,respectively,of the *** the end of the follow-up period,37 patients(62.7%) showed more than 50% *** rate of improvement in patients who required ES was not significantly different compared with the patients treated conservatively(64.2% vs 62.2%,respectively).CONCLUSION:Our study confirms that conservative medical treatment could be an alternative to endoscopic sphincterotomy because,after an intermediate follow-up period,the two treatments show the same success rates.

关键词：药物治疗功能障碍括约肌内镜超氧化物歧化酶保守治疗平均年龄平均周期

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Large endoscopic mucosal resection for colorectal tumors exceeding 4 cm

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World Journal of Gastroenterology 2010年第5期16卷 588-595页

作者： Philippe Ah Soune Charles Ménard ezzedine salah Ariadne Desjeux Jean-Charles Grimaud Marc Barthet Department of Gastroenterology Hpital NordChemin des Bourrely13915 Marseille cedex 20France

AIM:To evaluate the feasibility and the outcome of endoscopic mucosal resection(EMR)for large colorectal tumors exceeding 4 cm(LCRT)undergoing piecemeal resection. METHODS:From January 2005 to April 2008,146 digestive tumors larger than 2 cm were removed with the EMR technique in our *** these,34 tumors were larger than 4 cm and piecemeal resection was carried out on 26 colorectal *** mean age of the patients was 71 *** mean follow-up duration was 12 mo. RESULTS:LCRTs were located in the rectum,left colon,transverse colon and right colon in 58%,15%, 4%and 23%of cases,*** were sessile tumors larger than 4 cm with a mean size of 4.9 cm (4-10 cm).According to the Paris classification,34%of the tumors were typeⅠs,58%typeⅡa,4%typeⅡb and 4%typeⅡ*** examination showed tubulous adenoma in 31%,tubulo-villous adenoma in 27%,villous adenoma in 42%,high-grade dysplasia in38%,in situ carcinoma in 19%of the cases and mucosal carcinoma(m2)in 8%of the *** two cases(7.7%)of procedural bleeding that occurred were managed endoscopically and one small perforation was treated with *** follow-up,recurrence of the tumor occurred in three patients(12%),three of whom received endoscopic treatment. CONCLUSION:EMR for tumors larger than 4 cm is a safe and effective procedure that could compete with endoscopic submucosal dissection,despite providing incomplete histological assessment.

关键词： Endoscopic mucosal resection Perforation Colorectal carcinoma Large polyps

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