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Endoscopic mucosal resection of large hyperplastic polyps in 3 patients with Barrett’s esophagus

World Journal of Gastroenterology 2006年第35期12卷 5699-5704页

作者： Antonella De Ceglie Gabriella Lapertosa Sabrina Blanchi Marcello Di Muzio massimo Picasso Rosangela Filiberti Francesco Scotto massimo conio Department of Gastroenterology National Cancer Institute Bari Italy Department of Surgical and Morphological Sciences Division of Pathology University of Genova Genova Italy Department of Gastroenterology General Hospital Sanremo Italy Department of Pathology General Hospital Sanremo Italy Division of Enviromental Epidemiology and Biostatistics National Cancer Research Institute Genova Italy

AIM： To report the endoscopic treatment of large hyperplastic polyps of the esophagus and esophagogastric junction （EGJ） associated with Barrett＇s esophagus （BE） with low-grade dysplasia （LGD）, by endoscopic rnucosal resection （EMR）. METHODS： Cap fitted EMR （EMR-C） was performed in 3 patients with hyperplastic-inflammatory polyps （HIPs） and BE. RESULTS： The polyps were successfully removed in the 3 patients. In two patients, with short segment BE （SSBE）（≤ 3 cm）, the metaplastic tissue was completely excised. A 2 cm circumferential EMR was performed in one patient with a polyp involving the whole EGJ. A simultaneous EMR-C of a BE-associated polypoid dysplastic lesion measuring 1 cm × 10 cm, was also carried out. In the two patients, histologic assessment detected LGD in BE. No complications occurred. Complete neosquamous reepithelialization occurred in the two patients with SSBE. An esophageal recurrence occurred in the remaining one and was successfully retreated by EMR. CONCLUSION： EMR-C appears to be a safe and effective method for treating benign esophageal mucosal lesions, allowing also the complete removal of SSBE.

关键词： Hyperplastic polyps Endoscopic mucosal resection Barrett's esophagus

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Acute small bowel obstruction caused by endometriosis:A case report and review of the literature

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World Journal of Gastroenterology 2008年第21期14卷 3430-3434页

作者： Antonella De Ceglie Claudio Bilardi Sabrina Blanchi massimo Picasso massimo conio Marcello Di Muzio Alberto Trimarchi Department of Gastroenterology Giovanni Paolo ⅡCancer InstituteBari 70126Italy Department of Gastroenterology General HospitalSanremo 18038Italy Department of Pathology General HospitalSanremo 18038Italy Department of Surgery General HospitalSanremo 18038Italy

Gastrointestinal involvement of endometriosis has been found in 3%-37% of menstruating women and exclusive localization on the ileum is very rare(1%-7%).Endometriosis of the distal ileum is an infrequent cause of intestinal obstruction,ranging from 7% to 23% of all cases with intestinal *** report a case in which endometrial infiltration of the small bowel caused acute obstruction requiring emergency surgery,in a woman whose symptoms were not related to *** of the resected specimen showed that endometriosis was mainly prevalent in the muscularis propria and submucosa and that the mucosa was not ulcerated but had inflammation and glandular *** lymph node involvement,with a cystic glandular pattern was also detected.

关键词： Endometriosis Small bowel Ileum Obstruction Abdominal pain Intestinal resection

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Endoscopic mucosal resection for high-grade dysplasia and intramucosal carcinoma in Barrett's esophagus: An Italian experience

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World Journal of Gastroenterology 2005年第42期11卷 6650-6655页

作者： massimo conio Alessandro Repici Renzo Cestari Sabrina Blanchi Gabriella Lapertosa Guido Missale Domenico Della Casa Vincenzo Villanacci Pier Gigi Calandri Rosangela Filiberti Department of Gastroenterology Sanremo Italy Department of Gastroenterology Molinette Hospital TorinoItaly Department of Surgical-Surgery Endoscopy Spedali Civili University of BresciaItaly Department of Internal Medicine University of Genova Italy Division of Pathology University of Genova Italy 2nd Department of Pathology Spedali Civili University of Brescia Italy Anesthesia and Resuscitation Unit National Institute for Cancer Research Genova Italy Epidemiology and Biostatistics National Institute for Cancer Research Genova Italy

AIM： To evaluate endoscopic mucosal resection （EMR） in patients with high-grade dysplasia （HGD） and/or intramucosal cancer （IMC） in Barrett＇s esophagus （BE）. METHODS： Between June 2000 and December 2003, 39 consecutive patients with HGD （35） and/or IMC （4） underwent EMR. BE 〉30 mm was present in 27 patients. In three patients with short segment BE （25.0%）, HGD was detected in a normal appearing BE. Lesions had a mean diameter of 14.8＋10.3 ram. Mucosal resection was carried out using the cap method. RESULTS： The average size of resections was 19.7± 9.4×14.6＋8.2 mm. Histopathologic assessment postresection revealed 5 low-grade dysplasia （LGD）（12.8%）, 27 HGD （69.2%）, 2 IMC （5.1%）, and 5 SMC （-12.8%）. EMR changed the pre-treatment diagnosis in 10 patients （25.6%）. Three patients with SMC underwent surgery. Histology of the surgical specimen revealed 1 TON0 and 2 TIN0 lesions. The remaining two patients were cancer free at 32.5 and 45.6 mo, respectively. A metachronous lesion was detected after 25 mo in one patient with HGD. Intra-procedural bleeding, controlled at endoscopy, occurred in four patients （10.3%）. After a median follow-up of 34.9 mo, all patients remained in remission. CONCLUSION： In the medium term, EMR is effective and safe to treat HGD and/or IMC within BE and is a valuable staging method. It could become an alternative to surgery.

关键词： Endoscopic mucosal resection Barrett'sesophagus High-grade dysplasia Intramucosal cancer

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