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Analysis of ABC (D) stratification for screening patients with gastric cancer

World Journal of Gastroenterology 2011年第43期17卷 4793-4798页

作者： Tomohiro Kudo Satoru Kakizaki Naondo Sohara yasuhiro onozato Shinichi Okamura Yoshikatsu Inui Masatomo Mori Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashi Department of Endoscopy and Endoscopic Surgery Shirakawa Clinic Inui Clinic of Internal Medicine

AIM:To evaluate the value of ABC(D) stratification [combination of serum pepsinogen and Helicobacter pylori(***) antibody]of patients with gastric ***:Ninety-five consecutive patients with gastric cancer were enrolled into the *** serum pepsinogenⅠ(PGⅠ) /pepsinogenⅡ(PGⅡ) and *** antibody levels were *** were classified into five groups of ABC(D) stratification according to their serological *** findings of atrophic gastritis and histological differentiation were also analyzed in relation to the ABC(D) ***:The mean patient age was(67.9±8.9) *** patients(3.2%) were classified into group A,7 patients(7.4%) into group A',27 patients(28.4%) into group B,54 patients(56.8%) into group C,and 4patients(4.2%) into group D,*** were only three cases in group A when the patients taking acid proton pump inhibitors and those who had undergone eradication therapy for ***(group A') were *** three cases had mucosal atrophy in the grey zone according to the diagnostic manual of ABC(D) ***,the mean age of the patients with well differentiated adenocarcinoma was significantly higher than that of the patients with poorly differentiated adenocarcinoma(P<0.05) .There were no differences in the pattern of atrophy in the endoscopies between the well differentiated and poorly differentiated ***:ABC(D) stratification is a good method for screening patients with gastric *** is needed for grey zone cases to check the extent of mucosal atrophy.

关键词： Gastric cancer Helicobacter pylori Pepsinogen ABC (D) stratification Cancer screening

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Analysis of colonoscopic perforations at a local clinic and a tertiary hospital

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World Journal of Gastroenterology 2012年第35期18卷 4898-4904页

作者： Toshihiko Sagawa Satoru Kakizaki Haruhisa Iizuka yasuhiro onozato Naondo Sohara Shinichi Okamura Masatomo Mori Department of Medicine and Molecular Science Gunma University Graduate School of Medicine Center of Gastroenterology Maebashi Red Cross Hospital Department of Endoscopy and Endoscopic Surgery Shirakawa Clinic

AIM： To define the clinical characteristics, and to as- sess the management of colonoscopic complications at a local clinic. METHODS： A retrospective review of the medical re- cords was performed for the patients with iatrogenic colon perforations after endoscopy at a local clinic be- tween April 2006 and December 2010. Data obtained from a tertiary hospital in the same region were also analyzed. The underlying conditions, clinical presenta- tions, perforation locations, treatment types （operative or conservative） and outcome data for patients at the local clinic and the tertiary hospital were compared. RESULTS： A total of 10 826 colonoscopies, and 2625 therapeutic procedures were performed at a local clinic and 32 148 colonoscopies, and 7787 therapeutic proce-dures were performed at the tertiary hospital. The clinic had no perforations during diagnostic colonoscopy and 8 （0.3%） perforations were determined to be related to therapeutic procedures. The perforation rates in each therapeutic procedure were 0.06% （1/1609） in polyp- ectomy, 0.2% （2/885） in endoscopic mucosal resection （EMR）, and 3.8% （5/131） in endoscopic submucosal dis- section （ESD）. Perforation rates for ESD were significantly higher than those for polypectomy or EMR （P 〈 0.01）. All of these patients were treated conservatively. On the oth- er hand, three （0.01%） perforation cases were observed among the 24 361 diagnostic procedures performed, and these cases were treated with surgery in a tertiary hospi- tal. Six perforations occurred with therapeutic endoscopy （perforation rate, 0.08%; 1 per 1298 procedures）. Perfo- ration rates for specific procedure types were 0.02% （1 per 5500） for polypectomy, 0.17% （1 per 561） for EMR, 2.3% （1 per 43） for ESD in the tertiary hospital. There were no differences in the perforation rates for each therapeutic procedure between the clinic and the tertiary hospital. The incidence of iatrogenic perforation requiring surgical treatment was quite low in both the clinic

关键词： Colonoscopy Colon perforation Endoscopicclipping Endoscopic submucosal dissection Endoscopicmucosal resection Polypectomy

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Can endoscopic submucosal dissection be safely performed in a smaller specialized clinic?

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World Journal of Gastroenterology 2013年第4期19卷 528-535页

作者： Naondo Sohara Satoshi Hagiwara Riki Arai Haruhisa Iizuka yasuhiro onozato Satoru Kakizaki Department of Endoscopy and Endoscopic Surgery Shirakawa ClinicMaebashiGunma 371-0051Japan Department of Medicine and Molecular Science Gunma University Graduate School of MedicineMaebashiGunma 371-8511Japan

AIM:To investigate whether endoscopic submucosal dissection(ESD) can be safely performed at small clinics,such as the Shirakawa ***:One thousand forty-seven ESDs to treat gastrointestinal tumors were performed at the Shirakawa Clinic from April 2006 to March *** efficacy,technical feasibility and associated complications of the procedures were *** ESD procedures were performed by five *** was induced with propofol for esophagogastorduodenal ***:One thousand forty-seven ESDs were performed to treat 64 patients with esophageal cancer(E),850 patients with gastric tumors(G:764 patients with cancer,82 patients with adenomas and four others),four patients with duodenal cancer(D) and 129 patients with colorectal tumors(C:94 patients with cancer,21 patients with adenomas and 14 others).The en bloc resection rate was 94.3%(E:96.9%,G:95.8%,D:100%,C:79.8%).The median operation time was 46 min(range:4-360 min) and the mean size of the resected specimens was 18 mm(range:2-150 mm).No mortal complications were observed in association with the ESD *** occurred in 12 cases(1.1%,E:1 case,G:9 cases,D:1 case,C:1 case) and postoperative bleeding occurred in 53 cases(5.1%,G:51 cases,D:1 case,C:1 case);however,no case required either emergency surgery or blood *** of the perforations and postperative bleedings were resolved by endoscopic clipping or *** other problematic complication observed was pneumonia,which was treated with conservative ***:ESD can be safely performed in a clinic with established therapeutic methods and medical services to address potential complications.

关键词： Endoscopic submucosal dissection Complication Perforation Clinic

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