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Endoscopic“calabash”ligation and resection for small gastric mesenchymal tumors

World Journal of Gastrointestinal endoscopy 2024年第10期16卷 545-556页

作者： Xi-Min Lin Yue-Ming Peng Hao-Tian Zeng Jia-Xing Yang Zheng-Lei Xu department of gastroenterology The Second Clinical Medical CollegeJinan UniversityShenzhen 518000Guangdong ProvinceChina department of Nursing Shenzhen People’s HospitalThe Second Clinical Medical CollegeJinan UniversityShenzhen 518000Guangdong ProvinceChina department of gastroenterology Shenzhen People’s HospitalThe Second Clinical Medical CollegeJinan UniversityShenzhen 518000Guangdong ProvinceChina

BACKGROUND Gastric mesenchymal tumors(GMT)are identified as soft tissue neoplasms that arise from mesenchymal stem cells within the gastrointestinal *** pri-marily encompass gastric stromal tumors(GST),gastric leiomyomas,and gastric *** most GMT are benign,there are still potential malignant changes,especially ***,early surgical intervention is the primary treat-ment for *** have designed a simple endoscopic“calabash”ligation and resection(ECLR)procedure to treat *** efficacy and safety need to be com-pared with those of traditional endoscopic techniques,such as endoscopic sub-mucosal excavation(ESE).AIM To assess the safety and effectiveness of ECLR in managing small GMT(sGMT)with a maximum diameter≤20 mm by comparing to *** This retrospective analysis involved patients who were hospitalized in our institution between November 2021 and March 2023,underwent endoscopic resection,and received a pathological diagnosis of *** with a tumor diameter≤20 mm were chosen and categorized into two cohorts:Study and control *** study group was composed of patients treated with ECLR,whereas the control group was composed of those treated with *** on general clinical characteristics(gender,age,tumor diameter,tumor growth direction,tumor pathological type,and risk grade),surgery-related information(complete tumor resection rate,operation duration,hospitalization duration,hospitalization cost,and surgical complications),and postoperative follow-up were collected for both *** aforementioned data were subsequently analyzed and *** Five hundred and eighty-nine individuals were included,with 297 cases in the control group and 292 in the study *** propensity score matching,the final analysis incorporated 260 subjects in each *** findings indicated that the study group exhibited shorter operation duration and lowered medical expenses relative to the control ***,the study group rep

关键词： Endoscopic“calabash”ligation and resection Endoscopic submucosal excavation Gastric mesenchymal tumors Gastric stromal tumors Leiomyoma Schwannoma

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Endoscopic ultrasound-guided ethanol ablation therapy for tumors

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World Journal of gastroenterology 2013年第22期19卷 3397-3403页

作者： Wen-Ying Zhang Zhao-Shen Li Zhen-Dong Jin department of gastroenterology Changhai Hospital Second Military Medical University

Endoscopic ultrasonography (EUS) has evolved into a useful therapeutic tool for treating a broad range of tumors since being introduced into clinical practice as a diagnostic modality nearly three decades ago. In particular, EUS-guided fine-needle injection has proven a successful minimally invasive approach for treating benign lesions such as pancreatic cysts, relieving pancreatic pain through celiac plexus neurolysis, and controlling local tumor growth of unresectable malignancies by direct delivery of anti-tumor agents. One such ablative agent, ethanol, is capable of safely ablating solid or cystic lesions in hepatic tissues via percutaneous injection. Recent research and clinical interest has focused on the promise of EUS-guided ethanol ablation as a safe and effective method for treating pancreatic tumor patients with small lesions or who are poor operative candidates. Although it is not likely to replace radical resection of localized lesions or systemic treatment of metastatic tumors in all patients, EUS-guided ablation is an ideal method for patients who refuse or are not eligible for surgery. Moreover, this treatment modalitymay play an active role in the development of future pancreatic tumor treatments. This article reviews the most recent clinical applications of EUS-guided ethanol ablation in humans for treating pancreatic cystic tumors, pancreatic neuroendocrine tumors, and metastatic lesions.

关键词： Endoscopic ultrasonography Ethanol Tumor ablation Pancreas cancer Cystic tumor Neuroendocrine tumors Celiac plexus neurolysis

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Meta-analysis of capsule endoscopy in patients diagnosed or suspected with esophageal varices

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World Journal of gastroenterology 2009年第10期15卷 1254-1258页

作者： Yi Lu Rui Gao Zhuan Liao Liang-Hao Hu Zhao-Shen Li department of gastroenterology Changhai Hospital SecondMilitary Medical University 168 Changhai Road Shanghai200433 China

AIM:To review the literature on capsule endoscopy(CE) for detecting esophageal varices using conventional esophagogas troduodenoscopy(EGD)as the standard. METHODS:A strict literature search of studies comparing the yield of CE and EGD in patients diagnosed or suspected as having esophageal varices was conducted by both computer search and manual *** were extracted to estimate the pooled diagnostic sensitivity and specificity. RESULTS:There were seven studies appropriate for meta-analysis in our study,involving 446 patients. The pooled sensitivity and specificity of CE for detecting esophageal varices were 85.8%and 80.5%, *** subgroup analysis,the pooled sensitivity and specificity were 82.7%and 54.8%in screened patients,and 87.3%and 84.7%in the screened/ patients under surveillance,respectively. CONCLUSION:CE appears to have acceptable sensitivity and specificity in detecting esophageal ***,data are insufficient to determine the accurate diagnostic value of CE in the screen/ surveillance of patients alone.

关键词： Meta-analysis Esophageal varices Esophageal capsule endoscopy Sensitivity Specificity

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Bowel preparation protocol for hospitalized patients ages 50 years or older:A randomized controlled trial

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World Journal of Gastrointestinal endoscopy 2024年第1期16卷 18-28页

作者： Yu He Qi Liu Yi-Wen Chen Li-Jian Cui Kai Cao Zi-Hao Guo department of Geriatrics Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China department of gastroenterology Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Beijing Institute of Ophthalmology Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China

BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 ***,the population that is≥50 years in age requires long-term and regular *** bowel preparation is the main reason preventing patients from undergoing regular *** standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly *** To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in *** Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each ***-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort *** The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)***,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,Phospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.

关键词： Aged 50 years or older hospitalized 2-L polyethylene-glycol+30-mL lactulose+a low-residue diet Comfort

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Left inferior phrenic arterial malformation mimicking gastric varices: A case report and review of literature

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World Journal of Gastrointestinal Surgery 2024年第9期16卷 3057-3064页

作者： Han Wang Yi-Qing Tan Ping Han An-Hui Xu Han-Lin Mu Zhe Zhu Li Ma Mei Liu Hua-Ping Xie department of gastroenterology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina department of Radiology Tongren Hospital of Wuhan University(Wuhan Third Hospital)Wuhan UniversityWuhan 430063Hubei ProvinceChina department of Radiology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030Hubei ProvinceChina department of Pathology and Cell Biology Columbia University Irving medical centerNew York-Presbyterian HospitalNew YorkNY 10065United States department of gastroenterology Jianli People's HospitalJianli 433300Hubei ProvinceChina

BACKGROUND Gastric submucosal arterial dilation resulting from splenic artery occlusion represents an exceedingly rare etiology of acute upper gastrointestinal bleeding(UGIB).Although endoscopy is a widely utilized diagnostic and therapeutic modality for gastrointestinal bleeding,it has limitations in detecting arterial *** SUMMARY This report presents a rare case of massive UGIB in a 57-year-old male with a tortuous left inferior phrenic artery accompanied by splenic artery occlusion.“Gastric varices”was identified during the patient's endoscopy one year before *** initial hemostasis by endoscopic clipping,the patient experienced massive rebleeding after one month,requiring intervention with transcatheter arterial embolization(TAE)to achieve *** This is the first case to report UGIB due to a tortuous left inferior phrenic *** case highlights the limitations of endoscopy in identifying arterial abnormalities and emphasizes the potential of TAE as a viable alternative for the management of arterial bleeding in the gastrointestinal tract.

关键词： Upper gastrointestinal bleeding Left inferior phrenic artery Splenic artery occlusion Gastrointestinal endoscopy Digital subtraction angiography Case report

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Tumor size discrepancy between endoscopic and pathological evaluations in colorectal endoscopic submucosal dissection

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World Journal of Gastrointestinal endoscopy 2024年第3期16卷 136-147页

作者： Takeshi Onda Osamu Goto Toshiaki Otsuka Yoshiaki Hayasaka Shun Nakagome Tsugumi Habu Yumiko Ishikawa Kumiko Kirita Eriko Koizumi Hiroto Noda Kazutoshi Higuchi Jun Omori Naohiko Akimoto Katsuhiko Iwakiri department of gastroenterology Nippon Medical SchoolGraduate School of MedicineBunkyo-ku 113-8603TokyoJapan endoscopy Center Nippon Medical School HospitalBunkyo-ku 113-8603TokyoJapan department of Hygiene and Public Health Nippon Medical SchoolBunkyoku 113-8603TokyoJapan Center for Medical Education Nippon Medical SchoolBunkyo-ku 113-8603TokyoJapan

BACKGROUND Tumor size impacts the technical difficulty and histological curability of colorectal endoscopic submucosal dissection(ESD);however,the preoperative evaluation of tumor size is often different from histological *** influential factors on failure to obtain an accurate tumor size evaluation could help prepare optimal conditions for safer and more reliable *** This was a retrospective study conducted at a single institution.A total of 377 lesions removed by colorectal ESD at our hospital between April 2018 and March 2022 were *** first assessed the difference in size with an absolute per-centage of the scaling ***,we compared the clinicopatho-logical characteristics of the correct scaling group(>-33%and33%),which was further subdivided into the underscaling group(-33%or less of the discrepancy)and overscaling group(33%or more of the discrepancy),*** secondary outcome measures,parameters on size estimation were compared between the underscaling and correct scaling groups,as well as between the overscaling and correct scaling ***,multivariate analysis was performed in terms of the following relevant parameters on size estimation:Pathological size,location,and possible influential factors(P<0.1)in the univariate *** The mean of absolute percentage in the scaling discordance was 21%,and 91 lesions were considered to be incorrectly estimated in *** incorrect scaling was significantly remarkable in larger lesions(40 mm vs 28 mm;P<0.001)and less experience(P<0.001),and these two factors were influential on the underscaling(75 lesions;P<0.001).Conversely,compared with the correct scaling group,16 lesions in the overscaling group were significantly small(20 mm vs 28 mm;P<0.001),and the small lesion size was influential on the overscaling(P=0.002).CONCLUSION Lesions indicated for colorectal ESD tended to be underestimate

关键词： Endoscopic submucosal dissection Colorectal tumor Tumor size Size estimation Size discrepancy

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Cyst fluid glucose: An alternative to carcinoembryonic antigen for pancreatic mucinous cysts

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World Journal of gastroenterology 2019年第19期25卷 2271-2278页

作者： César Vivian Lopes department of gastroenterology and Digestive endoscopy Santa Casa Hospital

Pancreatic cystic lesions(PCLs) have been increasingly recognized in clinical practice. Although inflammatory cysts(pseudocysts) are the most common PCLs detected by cross-sectional imaging modalities in symptomatic patients in a setting of acute or chronic pancreatitis, incidental pancreatic cysts with no symptoms or history of pancreatitis are usually neoplastic cysts. For these lesions,it is imperative to identify mucinous cysts(intraductal papillary mucinous neoplasms and mucinous cystic neoplasms) due to the risk of their progression to malignancy. However, no single imaging modality alone is sufficient for a definitive diagnosis of all PCLs. The cyst fluid obtained by endoscopic ultrasound-guided fine needle aspiration provides additional information for the differential diagnosis of PCLs. Current recommendations suggest sending cyst fluid for cytology evaluation and measurement of carcinoembryonic antigen(CEA) levels. Unfortunately, the sensitivity of cytology is greatly limited, and cyst fluid CEA has demonstrated insufficient accuracy as a predictor of mucinous cysts. More recently, cyst fluid glucose has emerged as an alternative to CEA for distinguishing between mucinous and nonmucinous lesions. Herein, the clinical utility of cyst fluid glucose and CEA for the differential diagnosis of PCLs was evaluated.

关键词： Carcinoembryonic antigen Differential diagnosis Fine-needle biopsy Glucose Pancreatic cyst Tumor marker

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Feasibility of gastric endoscopic submucosal dissection with continuous low-dose aspirin for patients receiving dual antiplatelet therapy

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World Journal of gastroenterology 2019年第4期25卷 457-467页

作者： Hideaki Harada Satoshi Suehiro Daisuke Murakami Ryotaro Nakahara Takuya Nagasaka Tetsuro Ujihara Ryota Sagami Yasushi Katsuyama Kenji Hayasaka Yuji Amano department of gastroenterology New Tokyo Hospital department of endoscopy New Tokyo Hospital

BACKGROUND Endoscopic submucosal dissection(ESD) for gastric neoplasms during continuous low-dose aspirin(LDA) administration is generally acceptable according to recent guidelines. This retrospective study aimed to investigate the effect of continuous LDA on the postoperative bleeding after gastric ESD in patients receiving dual antiplatelet therapy(DAPT).AIM To investigate the feasibility of gastric ESD with continuous LDA in patients with *** A total of 597 patients with gastric neoplasms treated with ESD between January2010 and June 2017 were enrolled. The patients were categorized according to type of antiplatelet therapy(APT).RESULTS The postoperative bleeding rate was 6.9%(41/597) in all patients. Patients were divided into the following two groups: no APT(n = 443) and APT(n = 154). APT included single-LDA(n = 95) and DAPT(LDA plus clopidogrel, n = 59)subgroups. In the single-LDA and DAPT subgroups, 56 and 39 patients were received continuous LDA, respectively. The bleeding rate with continuous singleLDA(10.7%) was similar to that with discontinuous single-LDA(10.3%)(P >0.99). Although the bleeding rate with continuous LDA in patients receiving DAPT(23.1%) was higher than that with discontinuous LDA in patients receiving DAPT(5.0%), no significant difference was observed(P = 0.141).CONCLUSION The bleeding rate with continuous LDA in patients receiving DAPT was not statistically different from that with discontinuous LDA in patients receiving DAPT. Therefore, continuous LDA administration may be acceptable for ESD in patients receiving DAPT, although patients should be carefully monitored for possible bleeding.

关键词： Dual antiplatelet therapy Endoscopic submucosal dissection Low-dose aspirin Postoperative bleeding Thienopyridine

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Pleomorphic leiomyosarcoma of the maxilla with metastasis to the colon:A case report

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World Journal of Gastrointestinal endoscopy 2024年第6期16卷 361-367页

作者： Asma Alnajjar Abdulrahman Alfadda Abdullah Mohammad Alqaraawi Bader Alajlan Jean Paul Atallah Hussah Fahad AlHussaini Section of gastroenterology Department of MedicineKing Faisal Specialist Hospital&Research CentreRiyadh 11211Saudi Arabia department of Oncology King Faisal Specialist Hospital&Research CentreRiyadh 11211Saudi Arabia department of Pathology King Faisal Specialist Hospital&Research CentreRiyadh 11211Saudi Arabia

BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all *** behave aggressively and often have poor *** can affect the gastrointestinal tract and *** date,pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine *** SUMMARY The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and *** most recent positron emission tomography-computed tomography(PET-CT)scan showed uptake in the ascending and transverse colons.A colonoscopy revealed a 5.0 cm×3.5 cm×3.0 cm pedunculated polyp in the ascending *** polyp was removed using hot snare polypectomy technique and retrieved with *** examination of the polyp showed a metastatic pleomorphic *** Uptake(s)on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.

关键词： Pleomorphic leiomyosarcoma Colon polyp Hot snare polypectomy Maxillary Spindle cell tumor Case report

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Cronkhite-Canada syndrome with esophagus involvement and sixyear follow-up:A case report

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World Journal of gastroenterology 2024年第8期30卷 984-990页

作者： Yu-Chen Tang department of Endocrinology The First Affiliated Hospital of Ningbo UniversityNingbo 315000Zhejiang ProvinceChina

BACKGROUND Cronkhite-Canada syndrome(CCS)is a rare,noninherited disease characterized by gastrointestinal polyposis with diarrhea and ectodermal *** polyps are distributed through the whole digestive tract,and they are common in the stomach and colon but very uncommon in the *** SUMMARY Here,we present a case of a 63-year-old man with skin hyperpigmentation accompanied by diarrhea,alopecia,and loss of his *** data indicated anemia,hypoalbuminemia,hypocalcemia,hypokalemia,and positive fecal occult *** showed numerous polyps scattered throughout the digestive tract,including the *** was treated with nutritional support and glucocorticoids with remission of his *** Comprehensive treatment led by hormonal therapy can result in partial or full remission of clinical *** should be individualized for each patient according to their therapy *** endoscopy is necessary for assessing mucosal disease activity and detecting malignant transformation.

关键词： Cronkhite-Canada syndrome Gastrointestinal polyposis Hormonal therapy Prognosis Case report

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