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Perforation associated with endoscopic submucosal dissection for duodenal neoplasm without a papillary portion

World Journal of Gastrointestinal Surgery 2017年第7期9卷 161-166页

作者： Yasuhiro Matsuda Kazuki Sakamoto Naoki Kataoka Tomoyuki Yamaguchi Masafumi Tomita Shinichiro Makimoto Department of Surgery Kishiwada Tokushukai HospitalKishiwada CityOsaka 596-8522Japan

AIM To investigate predictors of perforation after endoscopic resection(ER) for duodenal neoplasms without a papillary *** This was a single-center, retrospective, cohort study conducted between April 2003 and September 2014. A total of 54 patients(59 lesions) underwent endoscopic mucosal resection(EMR)(n = 36) and endoscopic submucosal dissection(ESD)(n = 23). Clinical features, outcomes, and predictors of perforation were *** Cases of perforation occurred in eight(13%) patients(95%CI: 4.7%-22.6%). Three ESD cases required sur-gical management because they could not be repaired by clipping. Delayed perforation occurred in two ESD cases, which required surgical management, although both patients underwent prophylactic clipping. All patients with perforation who required surgery had no postoperative complications and were discharged at anaverage of 13.2 d after ER. Perforation after ER showed a significant association with a tumor size greater than20 mm(P = 0.014) and ESD(P = 0.047).CONCLUSION ESD for duodenal neoplasms exceeding 20 mm may be associated with perforation. ESD alone is not recom-mended for tumor treatment, and LECS should be con-sidered as an alternative.

关键词： duodenal neoplasm Endoscopic submucosal dissection Laparoscopic and endoscopic cooperative surgery

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Diagnostic role of 18F-fluorodeoxyglucose positron emission tomography for follicular lymphoma with gastrointestinal involvement

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World Journal of Gastroenterology 2012年第44期18卷 6427-6436页

作者： Masaya Iwamuro Hiroyuki Okada Katsuyoshi Takata Katsuji Shinagawa Shigeatsu Fujiki Junji Shiode Atsushi Imagawa Masashi Araki Toshiaki Morito Mamoru Nishimura Motowo Mizuno Tomoki Inaba Seiyu Suzuki Yoshinari Kawai Tadashi Yoshino Yoshiro Kawahara Akinobu Takaki Kazuhide Yamamoto Department of Gastroenterology and Hepatology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Endoscopy Okayama University HospitalOkayama 700-8558Japan Department of Pathology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Hematology and Oncology Okayama University Graduate School of MedicineDentistryand Pharmaceutical SciencesOkayama 700-8558Japan Department of Internal Medicine Tsuyama Central HospitalTsuyama 708-0841Japan Department of Internal Medicine Okayama Saiseikai General HospitalOkayama 700-8511Japan Department of Gastroenterology Mitoyo General HospitalKanonji 769-1695Japan Department of Internal Medicine Kagawa Rosai HospitalMarugame 763-8502Japan Department of Anatomic Pathology Kagawa Rosai HospitalMarugame 763-8502Japan Department of Internal Medicine Okayama Citizens' HospitalOkayama 700-8557Japan Department of Internal Medicine Hiroshima City HospitalHiroshima 730-8518Japan Department of Gastroenterology Kagawa Prefectural Central HospitalTakamatsu 760-8557Japan Department of Internal Medicine Sumitomo Besshi HospitalNiihama 792-8543Japan Department of Gastroenterology Onomichi Municipal HospitalOnomichi 722-8503Japan

AIM:To investigate the capacity for 18F-fluorodeoxyglucose(18F-FDG) positron emission tomography(PET) to evaluate patients with gastrointestinal lesions of follicular ***:This retrospective case series consisted of 41 patients with follicular lymphoma and gastrointestinal involvement who underwent 18F-FDG-PET and endoscopic evaluations at ten different institutions between November 1996 and October *** for endoscopic,radiological,and biological examinations performed were retrospectively reviewed from clinical records.A semi-quantitative analysis of 18F-FDG uptake was performed for each involved area by calculating the maximum standardized uptake value(SUVmax).Based on the positivity of 18F-FDG uptake in the gastrointestinal lesions analyzed,patients were subdivided into two *** identify potential predictive factors for 18F-FDG positivity,these two groups were compared with respect to gender,age at diagnosis of lymphoma,histopathological grade,pattern of follicular dendritic cells,mitotic rate,clinical stage,soluble interleukin-2 receptor levels detected by 18F-FDG-PET,lactate dehydrogenase(LDH) levels,hemoglobin levels,bone marrow involvement,detectability of gastrointestinal lesions by computed tomography(CT) scanning,and follicular lymphoma international prognostic index(FLIPI) ***:Involvement of follicular lymphoma in the stomach,duodenum,jejunum,ileum,cecum,colon,and rectum was identified in 1,34,6,3,2,3,and 6 patients,*** patient had esophageal *** total,19/41(46.3%) patients exhibited true-positive 18F-FDG uptake in the lesions present in their gastrointestinal *** contrast,false-negative 18F-FDG uptake was detected in 24 patients(58.5%),while false-positive 18F-FDG uptake was detected in 5 patients(12.2%).In the former case,2/19 patients had both 18F-FDG-positive lesions and 18F-FDGnegative lesions in the gastrointestinal *** patients with 18F-FDG avidity,the SUVmax value of the involved gast

关键词： Follicular lymphoma Gastrointestinal endoscopy F-fluorodeoxyglucose positron emission tomography Gastrointestinal lymphoma duodenal neoplasm

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