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Short-and long-term outcomes of endoscopically treated superficial non-ampullary duodenal epithelial tumors

World Journal of Gastroenterology 2019年第6期25卷 707-718页

作者： Yuko Hara Kenichi Goda Akira Dobashi Tomohiko Richard Ohya Masayuki Kato Kazuki Sumiyama Takehiro Mitsuishi Shinichi Hirooka Masahiro Ikegami Hisao Tajiri Department of endoscopy The Jikei University School of Medicine Department of Gastroenterology Dokkyo Medical University Department of endoscopy The Jikei University Katsushika Medical Center Department of Pathology The Jikei University School of Medicine Department of Innovative Interventional endoscopy Research The Jikei University School of Medicine

BACKGROUND It is widely recognized that endoscopic resection(ER) of superficial nonampullary duodenal epithelial tumors(SNADETs) is technically challenging and may carry high risks of intraoperative and delayed bleeding and *** adverse events could be more critical than those occurring in other levels of the gastrointestinal tract. Because of the low prevalence of the disease and the high risks of severe adverse events, the curability including short-and long-term outcomes have not been standardized *** To investigate the curability including short-and long-term outcomes of ER for SNADETs in a large case *** This retrospective study included cases that underwent ER for SNADETs at our university hospital between March 2004 and July 2017. Short-term outcomes of ER were measured based on en bloc and R0 resection rates as well as adverse events. Long-term outcomes included local recurrence detected on endoscopic surveillance and disease-specific mortality in patients followed up for ≥ 12 mo after *** In the study, 131 patients with 147 SNADETs were analyzed. The 147 ERs consisted of 136 endoscopic mucosal resections(EMRs)(93%) and 11 endoscopic submucosal dissections(ESDs)(7%). The median tumor diameter was 10 *** pathology diagnosis was adenocarcinoma(56/147, 38%), high-grade intraepithelial neoplasia(44/147, 30%), or low-grade intraepithelial neoplasia(47/147, 32%). The R0 resection rate was 68%(93/136) in the EMR group and73%(8/11) in the ESD group, respectively. Cap-assisted EMR(known as EMR-C)showed a higher rate of R0 resection compared to the conventional method of EMR using a snare(78% vs 62%, P = 0.06). No adverse event was observed in the EMR group, whereas delayed bleeding, intraoperative perforation, and delayed perforation in 3, 3, and 5 patients occurred in the ESD group, respectively. One patient with perforation required emergency surgery. In the 43 mo median follow-up period, local recurrence was found in four EMR

关键词： Duodenal adenoma Duodenal cancer Endoscopic resection Endoscopic submucosal dissection Long-term outcome

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Comparison between endoscopic sclerotherapy and band ligation for hemostasis of acute variceal bleeding

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World Journal of gastrointestinal endoscopy 2011年第5期3卷 95-100页

作者： Gustavo Oliveira Luz Fauze Maluf-Filho Sérgio Eiji Matuguma Fábio Yuji Hondo Edson Ide Jeane Martins Melo Spencer Cheng Paulo Sakai gastrointestinal endoscopy Unit Hospital das ClínicasSo Paulo University Medical School

AIM:To compare band ligation(BL) with endoscopic sclerotherapy(SCL) in patients admitted to an emergency unit for esophageal variceal rupture. METHODS:A prospective,randomized,single-center study without crossover was *** endoscopic diagnosis of esophageal variceal rupture,patients were randomized into groups for SCL or BL *** was performed by ethanolamine oleate intravascular injection both above and below the rupture point,with a maximum volume of 20 *** BL patients,banding at the rupture point was attempted,followed by ligation of all variceal tissue of the distal *** outcomes for both groups were initial failure of bleeding control(5 d) ,early re-bleeding(5 d to 6 wk),and complications,including *** May 2005 to May 2007,100 patients with variceal bleeding were enrolled in thestudy:50 SCL and 50 BL *** differences between groups were observed across gender,age,ChildPugh status,presence of shock at admission,mean hemoglobin levels,and variceal size. RESULTS:No differences were found between groups for bleeding control,early re-bleeding rates,complications,or *** 6 wk,36(80%) SCL and 33(77 %) EBL patients were alive and free of bleeding.A statistically significant association between Child-Pugh status and mortality was found,with 16%mortality in Child A and B patients and 84%mortality in Child C patients(P<0.001) . CONCLUSION:Despite the limited number of patients included,our results suggest that SCL and BL are equally efficient for the control of acute variceal bleeding.

关键词： Portal hypertension Hemorrhage Esophageal varices gastrointestinal endoscopy Ligation Sclerotherapy

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Role of endoscopic ultrasound in the diagnosis of pancreatic cancer

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World Journal of gastrointestinal Oncology 2014年第9期6卷 360-368页

作者： Juana Gonzalo-Marin Juan Jose Vila Manuel Perez-Miranda Unit of endoscopy Department of GastroenterologyQuirón Hospital Unit of endoscopy Department of GastroenterologyComplejo Hospitalario de Navarra Department of Gastroenterology Hospital Universitario Rio Hortega

Endoscopic ultrasonography(EUS) with or without fine needle aspiration has become the main technique for evaluating pancreatobiliary disorders and has proved to have a higher diagnostic yield than positron emission tomography,computed tomography(CT) and transabdominal ultrasound for recognising early pancreatic *** a diagnostic modality for pancreatic cancer,EUS has proved rates higher than 90%,especially for lesions less than 2-3 cm in size in which it reaches a sensitivity rate of 99% vs 55% for ***,EUS has a very high negative predictive value and thus EUS can reliably exclude pancreatic *** complication rate of EUS is as low as 1.1%-3.0%.New technical developments such as elastography and the use of contrast agents have recently been applied to EUS,improving its diagnostic *** has been found to be superior to the recent multidetector CT for T stagingwith less risk of overstaying in comparison to both CT and magnetic resonance imaging,so that patients are not being ruled out of a potentially beneficial *** accuracy for N staging with EUS is 64%-82%.In unresectable cancers,EUS also plays a therapeutic role by means of treating oncological pain through celiac plexus block,biliary drainage in obstructive jaundice in patients where endoscopic retrograde cholangiopancreatography is not affordable and aiding radiotherapy and chemotherapy.

关键词： Endosonography Pancreatic neoplasms endoscopy Diagnosis Neoplasm Staging Therapeutics

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Endoscopic ultrasonography and submucosal resection in the diagnosis and treatment of rectal carcinoid tumors

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Chinese Medical Journal 2007年第21期120卷 1938-1939页

作者： ZHOU Ping-hong YAO Li-qing XU Mei-dong ZHONG Yun-shi ZHANG Yi-qun CHEN Wei-feng endoscopy Center Zhongshan Hospital Fudan University Shanghai 200032 China

Rectal carcinoid tumors are often diagnosed as .submucosal tumors on radiological or endoscopic examinations. Usually, its definite size and character, the infiltration of muscularis propria and vessels can not be correctly diagnosed preoperatively. In recent years, endoscopic ultrasonography （EUS） has been used in the diagnosis of submucosal tumors of the gastrointestinal tracts , Conventional endoscopic polypectomy allows local excision of local tumors, but is often associated with tumor involvement of the resection margin necessitates further interventions.

关键词： rectal carcinoid tumor endoscopic ultrasonography

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First-line camrelizumab(a PD-1 inhibitor)plus apatinib(an VEGFR-2 inhibitor)and chemotherapy for advanced gastric cancer(SPACE):a phase 1 study

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Signal Transduction and Targeted Therapy 2024年第4期9卷 1760-1767页

作者： Xiaofeng Chen Hao Xu Xiaobing Chen Tongpeng Xu Yitong Tian Deqiang Wang Fen Guo Kangxin Wang Guangfu Jin Xiao Li Rong Wang Fengyuan Li Yongbin Ding Jie Tang Yueyu Fang Jing Zhao Liang Liu Ling Ma Lijuan Meng Zhiguo Hou Rongrong Zheng Yang Liu Ni Guan Bei Zhang Shuang Tong Shiqing Chen Xing Li Yongqian Shu Department of Oncology The First Affiliated Hospital with Nanjing Medical UniversityNanjingChina Gusu School Nanjing medical UniversitySuzhouChina Jiangsu Key Lab of Cancer Biomarkers Prevention and TreatmentCollaborative Innovation Center for Cancer Personalized MedicineNanjing Medical UniversityNanjingChina Department of General surgery The First Affiliated Hospital with Nanjing Medical UniversityNanjingChina Department of Oncology Henan Cancer Hospital Affiliated Cancer Hospital of Zhengzhou UniversityZhengzhouChina Henan Engineering Research Center of Precision Therapy of gastrointestinal Cancer&Zhengzhou Key Laboratory for Precision Therapy of gastrointestinal Cancer ZhengzhouChina Department of Oncology Digestive Disease Institute&Cancer Institute of Jiangsu UniversityAffiliated Hospital of Jiangsu UniversityZhenjiangChina Department of Oncology Suzhou Hospital of Nanjing Medical UniversitySuzhouChina Department of Oncology Nanjing PuKou People’s HospitalNanjingChina Department of Epidemiology School of Public HealthNanjing Medical UniversityNanjingChina Department of Pathology The First Affiliated Hospital with Nanjing Medical UniversityNanjingChina Department of general surgery Jurong Branch hospital of Jiangsu Province People HospitalJurongChina Department of Medical Oncology Liyang People’s HospitalLiyangChina Department of radiology Nanjing PuKou People’s HospitalNanjingChina Jiangsu Hengrui Pharmaceuticals ShanghaiChina Department of Medical Affairs 3D Medicines Inc.ShanghaiChina Shanghai OrigiMed Co. Ltd.ShanghaiChina

Patients with advanced gastric cancer typically face a grim *** phase 1a(dose escalation)and phase 1b(dose expansion)study investigated safety and efficacy of first-line camrelizumab plus apatinib and chemotherapyfor advanced gastric or gastroesophageal junction *** primary endpoints included maximum tolerated dose(MTD)in phase 1a and objective response rate(ORR)across phase 1a and *** 1a tested three dose regimens of camrelizumab,apatinib,oxaliplatin,and *** regimen 1:camrelizumab 200 mg on day 1,apatinib 250 mg every other day,oxaliplatin 100 mg/m^(2) on day 1,and S-140 mg twice a day on days *** regimen 2:same as dose regimen 1,but oxaliplatin 130mg/*** regimen3:same as dose regimen 2,but apatinib 250 mg ***-four patients were included(9 in phase 1a,25 in phase 1b).No dose-limiting toxicities occurred so no MTD was *** 3 was set for the recommended phase 2 doses and administered in phase *** confrmed ORR was 76.5%(95%CI 58.8-89.3).The median progression-free survival was 8.4 months(95%CI 5.9-not evaluable[NE]),and the median overall survival(OS)was not mature(11.6-NE).Ten patients underwent surgery after treatment and the multidisciplinary team *** 24 patients without surgery,the median OS was 19.6 months(7.8-NE).Eighteen patients(52.9%)developed grade≥3 treatment-emergent adverse *** plus apatinib and chemotherapy showed favorable clinical outcomes and manageable safety for untreated advanced gastric cancer(ChiCTR2000034109).

关键词： regimen cancer doses

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Bowel preparation experiences and needs before follow-up colonoscopy in older adult postoperative colorectal cancer patients: A qualitative study

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World Journal of gastrointestinal Surgery 2024年第9期16卷 2968-2978页

作者： Bin He Yi Xin Rui Li Fu-Cai Lin Guang-Ming Zhang Hai-Jing Zhu Wuxi Medical College The Jiangnan UniversityWuxi 214122Jiangsu ProvinceChina Department of Nursing The Tongren Hospital Shanghai Jiao Tong University School of MedicineShanghai 200335China Department of Anesthesiology The Tongren Hospital Shanghai Jiao Tong University School of MedicineShanghai 200335China Department of endoscopy The Tongren Hospital Shanghai Jiao Tong University School of MedicineShanghai 200335China

BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the ***-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)*** studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel ***,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC *** To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up *** Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November *** phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the ***'s seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview *** The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'kn

关键词： Older people Colorectal cancer Colonoscopy Bowel preparation Health promotion Nursing Qualitative research

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Optical scanning endoscope via a single multimode optical fiber

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Opto-Electronic Science 2024年第3期3卷 1-32页

作者： Guangxing Wu Runze Zhu Yanqing Lu Minghui Hong Fei Xu Department of Electrical and Computer Engineering National University of Singapore4 Engineering Drive 3117576Singapore College of Engineering and Applied Sciences and Collaborative Innovation Center of advanced Microstructures Nanjing UniversityNanjing 210023China Pen-Tung Sah Institute of Micro-Nano Science and Technology Xiamen University33 Qunxian RoadXiamen 361005China

Optical endoscopy has become an essential diagnostic and therapeutic approach in modern biomedicine for directly observing organs and tissues deep inside the human body,enabling non-invasive,rapid diagnosis and *** fiber endoscopy is highly competitive among various endoscopic imaging techniques due to its high flexibility,compact structure,excellent resolution,and resistance to electromagnetic *** the past decade,endoscopes based on a single multimode optical fiber(MMF)have attracted widespread research interest due to their potential to significantly reduce the footprint of optical fiber endoscopes and enhance imaging *** comparison with other imaging principles of MMF endoscopes,the scanning imaging method based on the wavefront shaping technique is highly developed and provides benefits including excellent imaging contrast,broad applicability to complex imaging scenarios,and good compatibility with various well-established scanning imaging *** this review,various technical routes to achieve light focusing through MMF and procedures to conduct the scanning imaging of MMF endoscopes are *** advancements in imaging performance enhancements,integrations of various imaging modalities with MMF scanning endoscopes,and applications are *** specific to this endoscopic imaging technology are analyzed,and potential remedies and avenues for future developments are discussed.

关键词： multimode optical fiber endoscope scanning imaging focusing wavefront shaping

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Spleen-preserving splenic lymph node dissection in radical total gastrectomy

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Chinese Journal of Cancer Research 2013年第4期25卷 477-478页

作者： Zhigang Jie Zhengrong Li Yi Cao Yi Liu Mengmeng Jiang Liangqing Lin Guoyang Zhang gastrointestinal Surgery First Affiliated Hospital of Nanchang University

Radical gastrectomy has been recognized as the standard surgical treatment for advanced gastric cancer, and essentially applied in a wide variety of clinical settings. The thoroughness of lymph node dissection is an important prognostic factor for patients with advanced gastric cancer. Splenic lymph node dissection is required during D2 radical gastrectomy for upper stomach cancer. This is often accompanied by removal of the spleen in the past few decades. A growing number of investigators believe, however, that the spleen plays an important role as an immune organ, and thus they encourage the application of a spleen- preserving method for splenic hilum lymph node dissection.

关键词： Gastric cancer D2 radical resection lymph node dissection splenic hilum

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Critical Update on the Diagnosis and Management of COVID-19 in advanced Cirrhosis and Liver Transplant Recipients

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Journal of Clinical and Translational Hepatology 2021年第6期9卷 947-959页

作者： Cyriac Abby Philips Mohamed Rela Arvinder Singh Soin Subhash Gupta Sudhindran Surendran Philip Augustine Department of Clinical and Translational Hepatology and The Monarch Liver Laboratory The Liver InstituteCenter of Ex-cellence in Gastrointestinal SciencesRajagiri HospitalAluvaKeralaIndia Institute of Liver Disease and Liver Trans-plantation Dr.Rela Institute&Medical CentreBharath Institute of Higher Education and ResearchChennaiIndia In-stitute of Liver Transplantation and Regenerative Medicine MedantaThe MedicityGurgaonIndia Max Centre for Liver and Biliary Sciences Max Saket HospitalNew DelhiIndia gastrointestinal Surgery and Solid Organ Transplantation Amrita Institute of Medical Sciences and Research CentreAmrita Vishwa VidyapeethamKochiKeralaIndia Gastroen-terology and advanced GI endoscopy Center of Excellence in Gastrointestinal SciencesRajagiri HospitalAluvaKeralaIndia

The novel coronavirus disease 2019(COVID-19)pandemic has impacted health care worldwide,with specific patient populations,such as those with diabetes,cardiovascular disease,and chronic lung disease,at higher risk of infection and others at higher risk of disease *** with decompensated cirrhosis fall into the latter category and are a unique group that require specific treatment and management decisions because they can develop acute-on-chronic liver *** liver transplant recipients,the atypical immunity profile due to immunosuppression protects against downstream inflammatory responses triggered by *** exhaustive review discusses the outcomes associated with COVID-19 in patients with advanced cirrhosis and in liver transplant *** focus on the immunopathogenesis of COVID-19,its correlation with the pathogenesis of advanced liver disease,and the effect of immunosuppression in liver transplant recipients to provide insight into the outcomes of this unique patient population.

关键词： Coronavirus Cirrhosis Portal hypertension Acute-on-chronic liver failure Sepsis Hepatic encephalopathy Multiple-organ failure Critical care

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Gastric per-oral endoscopic myotomy:Indications,technique,results and comparison with surgical approach

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World Journal of gastrointestinal Surgery 2022年第1期14卷 12-23页

作者： Maria Chiara Verga Stefano Mazza Francesco Azzolini Fabrizio Cereatti Clara Benedetta Conti Andrea Drago Sara Soro Biagio Elvo Roberto Grassia Gastroenterology and Digestive endoscopy Unit ASST CremonaCremona 26100Italy Gastroenterology and Digestive endoscopy Unit Ospedale San Raffaele IRCCSMilano 20132Italy Digestive and Interventional endoscopy Unit ASST MonzaMonza 20800Italy

Gastroparesis is a chronic disease of the stomach that causes a delayed gastric emptying,without the presence of a *** 30 years the authors identified pylorospasm as one of the most important pathophysiological mechanisms determining *** with EndoFLIP,a device that assesses pyloric distensibility,increased the knowledge about *** on this data,several pyloric-targeted therapies were developed to treat refractory gastroparesis:Surgical pyloroplasty and endoscopic approach,such as pyloric injection of botulinum and pyloric ***,the success of most of these techniques is still not *** 2013,the first human gastric per-oral endoscopic myotomy(GPOEM)was *** was inspired by the POEM technique,with a similar dissection method,that allows *** results of GPOEM are similar to surgical approach in term of clinical success,adverse events and post-surgical *** the last 8 years GPOEM has gained the attention of the scientific community,as a minimally invasive technique with high rate of clinical success,quickly prevailing as a promising therapy for *** surprisingly,in referral centers,its technical success rate is 100%.One of the main goals of recent studies is to identify those patients that will respond better to the therapies targeted on pylorus and to choose the better approach for each patient.

关键词： Gastric per-oral endoscopic myotomy Pyloroplasty Gastroparesis EndoFLIP Pyloromyotomy Gastroparesis cardinal symptom index

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