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Clinical diagnostic advances in intestinal anastomotic techniques:Hand suturing,stapling,and compression devices

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World Journal of Gastrointestinal Surgery 2024年第5期16卷 1231-1234页

作者： Ah young Lee joo young cho Division of Gastroenterology Department of Internal MedicineCha Gangnam Medical CenterCha University College of MedicineSeoul 06135South Korea

The development of intestinal anastomosis techniques,including hand suturing,stapling,and compression anastomoses,has been a significant advancement in surgical *** methods aim to prevent leakage and minimize tissue fibrosis,which can lead to stricture *** healing process involves various phases:hemostasis and inflammation,proliferation,and *** staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic *** anastomosis devices,including those made of nickel-titanium alloy,offer a minimally invasive option for various surgical challenges and have shown safety and ***,despite advancements,anastomotic techniques are evaluated based on leakage risk,with complications being a primary *** devices like Magnamosis use magnetic rings for compression anastomosis,demonstrating greater strength and patency compared to *** technology is also being explored for other medical *** there are promising results,particularly in animal models,the realworld application in humans is limited,and further research is needed to assess their safety and practicality.

关键词： Anastomoses Diagnostic advances,Anastomotic techniques Technique Intestine

Ever-changing endoscopic treatment for early gastric cancer:Yesterday-today-tomorrow

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World Journal of Gastroenterology 2014年第37期20卷 13273-13283页

作者： Mi-young Kim Jun-Hyung cho joo young cho Digestive Disease Center Soonchunhyang University Hospital

Endoscopic resection has been an optimal treatment for selected patients with early gastric cancer(EGC) based on advances in endoscopic instruments and techniques. As endoscopic submucosal dissection(ESD) has been widely used for treatment of EGC along with expanding ESD indication, concerns have been asked to achieve curative resection for EGC while guaranteeing precise prediction of lymph node metastasis(LNM). Recently, new techniques including ESD or endoscopic full-thickness resection combined with sentinel node navigation enable minimal tumor resection and a laparoscopic lymphadenectomy in cases of EGC with high risk of LNM. This review covers the development and challenges of endoscopic treatment for EGC. Moreover, a new microscopic imaging and endoscopic techniques for precise endoscopic diagnosis and minimally invasive treatment of EGC are introduced.

关键词： Endoscopic resection Early gastric cancer Confocal laser endomicroscopy Sentinel node navigation Hybrid natural orifice transluminal endoscopic surgery

Endoscopic submucosal dissection for early gastric cancer:Quo vadis?

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World Journal of Gastroenterology 2011年第21期17卷 2623-2625页

作者： Won young cho joo young cho Il Kwun Chung Jin Il Kim Jin Seok Jang Jae Hak Kim Institute for Digestive Research Digestive Disease CenterSoonchunhyang University College of Medicine Department of Internal Medicine Soonchunhyang University College of Medicine Department of Internal Medicine College of MedicineThe Catholic University of KoreaSeoul Department of Internal Medicine Dong-A University College of Medicine Department of Internal Medicine Dongguk University College of Medicine

The diagnosis of early gastric cancer(EGC) is of great interest because its endoscopic and surgical treatment presents the best chance for a *** technical development,endoscopic submucosal dissection(ESD) has been widely performed for the curative treatment of EGC in *** studies of ESD for EGC will be the next missions that overcome these limitations and global guidelines will be processed for ESD for EGC.

关键词： Endoscopic submucosal dissection Early gastric cancer

Does immunohistochemical staining have a clinical impact in early gastric cancer conducted endoscopic submucosal dissection?

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World Journal of Gastroenterology 2012年第33期18卷 4578-4584页

作者： Seong Ran Jeon joo young cho Gene Hyun Bok Tae Hee Lee Hyun Gun Kim Won young cho So young Jin Yeon Soo Kim Institute for Digestive Research Digestive Disease Center Soonchunhyang University College of Medicine Seoul 140-743 South Korea Department of Pathology Soonchunhyang University College of Medicine Seoul 140-743 South Korea Department of Internal Medicine Daejeon St. Mary's Hospital The Catholic University of Korea School of Medicine Daejeon 301-723 South Korea

AIM: To evaluate clinicopathologic parameters and the clinical significance related lymphovascular invasion (LVI) by immunohistochemical staining (IHCS) in endoscopic submucosal dissection (ESD). METHODS: Between May 2005 and May 2010, a total of 348 lesions from 321 patients (mean age 63 ± 10 years, men 74.6%) with early gastric cancer (EGC) who met indication criteria after ESD were analyzed retrospectively. The 348 lesions were divided into the absolute (n = 100, differentiated mucosal cancer without ulcer ≤ 20 mm) and expanded (n = 248) indica-tion groups after ESD. The 248 lesions were divided into four subgroups according to the expanded ESD indication. The presence of LVI was determined by factor Ⅷ-related antigen and D2-40 assessment. We compared LVI IHCS-negative group with LVI IHCSpositive in each group. RESULTS: LVI by hematoxylin-eosin staining (HES) and IHCS were all negative in the absolute group, while was observed in only the expanded groups. The positive rate of LVI by IHCS was higher than that of LVI by HES (n = 1, 0.4% vs n = 11, 4.4%, P = 0.044). LVI IHCS-positivity was observed when the cancer invaded to the mucosa 3 (M3) or submucosa 1 (SM1) levels, with a predominance of 63.6% in the subgroup that included only SM1 cancer (P < 0.01). In a univariate analysis, M3 or SM1 invasion by the tumor was significantly associated with a higher rate of LVI by IHCS, but no factor was significant in a multivariate analysis. There were no cases of tumor recurrence or metastasis during the median 26 mo follow-up. CONCLUSION: EGCs of the absolute group are immunohistochemically stable. The presence of LVI may be carefully examined by IHCS in an ESD expanded indication group with an invasion depth of M3 or greater.

关键词： Gastric cancer Endoscopic submucosal dis- section Immunohistochemical staining Lymphovascu- lar invasion Depth

Effects of TiN film coating on electrochemical behaviors of nanotube formed Ti-xHf alloys

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中国有色金属学会会刊：英文版 2009年第4期19卷 857-861页

作者： Kang LEE Won-Gi KIM joo-young cho Sang-Won EUN Han-Cheol choE Department of Dental Materials & Research Center of Nano-Interface Activation for Biomaterials College of DentistryChosun University Department of Applied Advanced Materials Korea Polytechnic Ⅴ Colleges

Ti-xHf(x=10%,20%,30% and 40%,mass fraction) alloys were prepared by arc melting,and the microstructure was controlled for 24 h at 1 000 ℃ in argon *** formation of nanotube was conducted by anodizing on Ti-Hf alloys in 1.0 mol/L H3PO4 electrolytes with small amounts of NaF at room *** then TiN coatings were coated by DC-sputtering on the anodized *** and nanotube morphology of the alloys were examined by field emission scanning electron microscopy(FE-SEM) and X-ray diffractometry(XRD).The corrosion properties of the specimens were examined through potentiodynamic test(potential range from -1 500 to 2 000 mV) in 0.9 % NaCl solution by *** microstructure shows the acicular phase and α' phase with Hf *** amorphous oxide surface is transformed to crystalline anatase *** coated nanotube surface has a good corrosion resistance.

关键词：氮化钛涂层合金制备纳米管电化学行为薄膜包衣 0.9%NaCl溶液扫描电子显微镜微观结构

Usefulness of magnifying endoscopy for iodine-unstained lesions in a high-risk esophageal cancer population

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World Journal of Gastroenterology 2010年第37期16卷 4709-4715页

作者： Ik Seong choi Jae young Jang Won young cho Tae Hee Lee Hyun Gun Kim Bo young Lee Soung Won Jeong joo young cho joon Seong Lee So young Jin Institute for Digestive Research SoonChunHyang University College of Medicine

AIM: To investigate the usefulness of magnified observations of iodine-unstained esophageal lesions in the histological diagnosis of esophageal mucosa abnormalities, in high-risk esophageal cancer groups. METHODS: The subjects included 38 patients who had at least one of the four criteria known to be highrisk factors for esophageal cancer. Following endoscopic observation, magnified observations were performed on iodine-unstained lesions of the esophagus. The total number of lesions was 43. These lesions were classified as type A (clear papilla), type B (fused papilla), and type C (non-visible papilla) according to the findings. Tissue biopsy was then carried out. Finally the histological findings were graded in terms of histological factors, and their relationships were compared. RESULTS: Of the 43 lesions, 11 were type A, 17 were type B, and 15 were type C under magnifying endoscopy. Histological findings such as inflammatory cell infiltration and basal cell hyperplasia were significantly increased in type B and type C lesions compared with type A lesions (P < 0.05). Low-grade esophageal dysplasia was apparent in 1 (9%) of 11 type A lesions, in 3 (18%) of 17 type B lesions, and in 6 (40%) of 15 type C lesions, with the highest rate in type C. CONCLUSION: Magnified observations of the esophagus, classified by papillary aspects using magnifying endoscopy of iodine-unstained lesions in high-risk esophageal cancer groups, are considered useful in estimating dysplasia and inflammation of esophageal mucosa.

关键词： Esophageal cancer Iodine Magnifying endoscopy

Long-term result of endoscopic Histoacryl （N-butyl-2-cyanoacrylate）injection for treatment of gastric varices

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World Journal of Gastroenterology 2011年第11期17卷 1494-1500页

作者： Eun Jung Kang Soung Won Jeong Jae young Jang joo young cho Sae Hwan Lee Hyun Gun Kim Sang Gyune Kim young Seok Kim young Koog Cheon young Deok cho Hong Soo Kim Boo Sung Kim Institute for Digestive Research Department of Internal MedicineSoonchunhyang University College of MedicineSeoul HospitalSeoul 140-743South Korea

AIM:To evaluate the long-term efficacy and safety of endoscopic obliteration with Histoacryl  for treatment of gastric variceal bleeding and ***:Between January 1994 and March 2010 at SoonChunHyang University Hospital,a total of 127 patients with gastric varices received Histoacryl  injections *** hundred patients underwent endoscopic Histoacryl  injections because of variceal bleeding,the other 27 patients received such injections as a prophylactic ***:According to Sarin classification,56 patients were GOV1,61 patients were GOV2 and 10 patients were *** of the varices were large(F2 or F3,111 patients).The average volume of Histoacryl  per each session was 1.7±1.3 cc and mean number of sessions was 1.3±0.6.(1 session-98 patients,2 sessions-25 patients,≥3 sessions-4 patients).Twenty-seven patients with high risk of bleeding(large or fundal or RCS+or Child C) received Histoacryl  injection as a primary prophylactic *** these patients,hepatitis B virus was the major etiology of cirrhosis,25 patients showed GOV1 or 2(92.6%)and F2 or F3 accounted for 88.9%(n=24).The rate of initial hemostasis was 98.4%and recurrent bleeding within one year occurred in 18.1%of *** hemostasis during episodes of rebleeding was achieved in 73.9%of *** survival was 50 mo (95%CI 30.5-69.5).Major complications occurred in 4 patients(3.1%).The rebleeding rate in patients with hepatocellular carcinoma or GOV2 was higher than in those with other *** of the 27 subjects who were treated prophylactically experienced treatment-related *** survival rates of the 127 patients at 6 mo,1,3,and 5 years were 92.1%,84.2%,64.2%,and 45.3%,*** 6 mo cumulative survival rate of the 27 patients treated prophylactically was 75%.CONCLUSION:Histoacryl  injection therapy is an effective treatment for gastric varices and also an effective prophylactic treatment of gastric varices which

关键词： Gastric varix Prophylaxis Histoacryl  (Nbutyl-2-cyanoacrylate) Histoacryl  injection Treatment of gastric varix

A novel device for endoscopic submucosal dissection,the Fork knife

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World Journal of Gastroenterology 2008年第43期14卷 6726-6732页

作者： Hyun Gun Kim joo young cho Gene Hyun Bok Won young cho Wan Jung Kim Bong Min Ko Jin Oh Kim joon Seong Lee Moon Sung Lee Chan Sup Shim Institute for Digestive Research Digestive Disease Research CenterSoonChunHyang University College of MedicineSeoul 140-743South Korea

AIM： To introduce and evaluate the efficacy and technical aspects of endoscopic submucosal dissection （ESD） using a novel device, the Fork knife. METHODS： From March 2004 to April 2008, ESD was performed on 265 gastric lesions using a Fork knife （Endo FS）（group A） and on 72 gastric lesions using a Flexknife （group B） at a single tertiary referral center. We retrospectively compared the endoscopic characteristics of the tumors, pathological findings, and sizes of the resected specimens. We also compared the en b/oc resection rate, complete resection rate, complications, and procedure time between the two groups. RESULTS： The mean size of the resected specimens was 4.27 ± 1.26 cm in group A and 4.29 ± 1.48 cm in group B. The en b/oc resection rate was 95.8% （254/265 lesions） in group A and 93.1% （67/72） in group B. Complete ESD without tumor cell invasion of the resected margin was obtained in 81.1% （215/265） of group A and in 73.6% （53/72） of group B. The perforation rate was 0.8% （2/265） in group A and 1.4% （1/72） in group B. The mean procedure time was 59.63 ± 56.12 min in group A and 76.65 ± 70.75 min in group B （P 〈 0.05）. CONCLUSION： The Fork knife （Endo FS） is useful for clinical practice and has the advantage of reducing the procedure time.

关键词： Fork knife Novel device Endoscopic submucosal dissection Flexknife Procedure

A case of intussuscepted Meckel’s diverticulum

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World Journal of Gastroenterology 2009年第40期15卷 5109-5111页

作者： Tae Hee Lee Jin-Oh Kim Jae joon Kim Seong Sook Hong So young Jin Hyun Gun Kim joo young cho joon Seong Lee Institute for Digestive Research SoonChunHyang College of Medicine Department of Surgery SoonChunHyang College of Medicine Department of Radiology SoonChunHyang College of Medicine Department of Pathology SoonChunHyang College of Medicine

We report colonoscopic features of an intussuscepted Meckel's diverticulum, presenting with hematochezia. A 35-year-old woman presented to the emergency room with acute onset, transient, sharp, severe epi-gastric pain that began 6 h earlier. Colonoscopy re-vealed a reddish, soft, fi st-sized polypoid lesion in the terminal ileum. The lesion was misinterpreted as a hematoma by an inexperienced endoscopist. The pa-tient began to complain of intermittent, severe peri-umbilical pain following the colonoscopic examination. Subsequent computed tomography showed an enteric intussusception. An exploratory laparotomy revealed an intussuscepted Meckel's diverticulum, with trans-mural infarction. Colonoscopy was of little use in as-sessing the intussusception. However, colonoscopic examination may be performed initially, especially in an intussuscepted Meckel's diverticulum present-ing with hematochezia. Endoscopists should note the endoscopic features of an intussuscepted Meckel's diverticulum.

关键词： Colonoscopy Intussusception Meckel's diverticulum