检索结果-南通市图书馆

Endoscopic submucosal dissection for colorectal neoplasms:A review

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2014年第43期20卷 16153-16158页

作者： Taku Sakamoto Genki Mori Masayoshi Yamada Yuzuru Kinjo Eriko So Seiichiro Abe Yosuke Otake Takeshi Nakajima Takahisa Matsuda Yutaka Saito endoscopy division National Cancer Center Hospital

The introduction of colorectal endoscopic submucosal dissection(ESD)has expanded the application of endoscopic treatment,which can be used for lesions with a low metastatic potential regardless of their *** has the advantage of achieving en bloc resection with a lower local recurrence rate compared with that of piecemeal endoscopic mucosal ***,in the past,surgery was indicated in patients with large lesions spreading to almost the entire circumference of the rectum,regardless of the depth of invasion,as endoscopic resection of these lesions was technically ***,a prime benefit of ESD is significant improvement in the quality of life for patients who have large rectal *** the other hand,ESD is not as widely applied in the treatment of colorectal neoplasms as it is in gastric cancers owing to the associated technical difficulty,longer procedural duration,and increased risk of *** diversify the available endoscopic treatment strategies for superficial colorectal neoplasms,endoscopists performing ESD need torecognize its indications,the technical issues involved in its application,and the associated *** review outlines the methods and type of devices used for colorectal ESD,and the training required by endoscopists to perform this procedure.

关键词： Colorectum Endoscopic submucosal dissection Short-term outcomes Training indication for endoscopic treatment

Management and associated factors of delayed perforation after gastric endoscopic submucosal dissection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第44期21卷 12635-12643页

作者： Haruhisa Suzuki Ichiro Oda Masau Sekiguchi Seiichiro Abe Satoru Nonaka Shigetaka Yoshinaga Takeshi Nakajima Yutaka Saito endoscopy division National Cancer Center Hospital

AIM: To identify the actual clinical management and associated factors of delayed perforation after gastric endoscopic submucosal dissection(ESD).METHODS: A total of 4943 early gastric cancer(EGC) patients underwent ESD at our hospital between January 1999 and June 2012. We retrospectively assessed the actual management of delayed perforation. In addition, to determine the factors associated with delayed perforation, after excluding 123 EGC patients with perforations that occurred during the ESD procedure, we analyzed the following clinicopathological factors among the remaining 4820 EGC patients by comparing the ESD cases with delayed perforation and the ESD cases without perforation: age, sex, chronological periods, clinical indications for ESD, status of the stomach, location, gastric circumference, tumor size, invasion depth, presence/absence of ulceration, histological type, type of resection, and procedure ***: Delayed perforation occurred in 7(0.1%) cases. The median time until the occurrence of delayed perforation was 11 h(range, 6-172 h). Three(43%) of the 7 cases required emergency surgery, while four were conservatively managed without surgical intervention. Among the 4 cases with conservative management, 2 were successfully managed endoscopically using the endoloop-endoclip technique. The median hospital stay was 18 d(range, 15-45 d). There were no delayed perforation-related deaths. Based on a multivariate analysis, gastric tube cases(OR = 11.0; 95%CI: 1.7-73.3; P = 0.013) were significantly associated with delayed ***: Endoscopists must be aware of not only the identified factors associated with delayed perforation, but also how to treat this complicationeffectively and promptly.

关键词： Early gastric cancer Endoscopic submucosal dissect

Incidence and localization of lymphoid follicles in early colorectal neoplasms

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2005年第43期11卷 6863-6866页

作者： Kuang-I Fu Yasushi Sano Shigeharu Kato Takahiro Fujii Ikura Koba Takayuki Yoshino Atsushi Ochiai Shigeaki Yoshida Takahiro Fujimori division of Gastrointestinal Oncology and Digestive endoscopy division of Pathology Department of Surgical and Molecular Pathology

AIM： TO investigate the incidence and Iocalizations of lymphoid follicles （LFs） in early colorectal neoplasms in human beings. METHODS： From July 1992 to September 1999, a total of 1 324 early colorectal neoplasms were removed endoscopically or surgically at our hospital; 1 031 （77.9%） were available for analysis in this study. Localization of LFs was defined histologically： as submucosal LFs, if located under the muscularis mucosa; and as intramucosal LFs, if located across or over the muscularis RESULTS： Histologically, the materials included 903 intramucosal neoplasms and 128 submucosal cancers. Overall incidence of LFs was 27.2% （280/1 031）. The incidence of LFs was significantly higher in females （33.6% vs 24.9%, P = 0.0064）, the right-sided colon （32.2% vs 25.6%, P = 0.0403） and in flat or depressed type lesions （34.6% vs 25.2%, P〈O.O001） as compared to males, left-sided colon and protruding type lesions, respectively. The incidences of intramucosal neoplasms and submucosal cancers were 24.3% and 43.8%, respectively （P〈O.O001）. Localizations of LFs （intramucosal LF/submucosal LF） in depressed, flat, and protruding types were 1/24, 14/36, and 131/74, respectively. CONCLUSION： The incidence of LFs in early human colorectal neoplasms significantly differs by gender, location, macroscopic type, and histology. Moreover,localization significantly differs by macroscopic type.

关键词： Lymphoid follicle Early colorectal neoplasm Carcinogenesis

Meta-analysis and systematic review of colorectal endoscopic mucosal resection

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2009年第34期15卷 4273-4277页

作者： Srinivas R Puli Yasuo Kakugawa Takuji Gotoda Daphne Antillon Yutaka Saito Mainor R Antillon division of Gastroenterology and Hepatology University of Missouri-Columbia endoscopy division National Cancer Center Hospital

AIM:To evaluate the proportion of successful complete cure en-bloc resections of large colorectal polyps achieved by endoscopic mucosal resection(EMR). METHODS:Studies using the EMR technique to resect large colorectal polyps were *** complete cure en-bloc resection was defined as one piece margin-free polyp *** were searched for in Medline,Pubmed,and the Cochrane Control Trial Registry,among other sources. RESULTS:An initial search identified 2620 reference articles,from which 429 relevant articles were selected and *** was extracted from 25 studies(n =5221)which met the inclusion *** the studies used snares to perform *** proportion of en-bloc resections using a random effect model was 62.85%(95%CI:51.50-73.52).The pooled proportion for complete cure en-bloc resections using a random effect model was 58.66%(95%CI:47.14-69.71).With higher patient load(>200 patients),this complete cure en-bloc resection rate improves from 44.19%(95%CI: 24.31-65.09)to 69.17%(95%CI:51.11-84.61). CONCLUSION:EMR is an effective technique for the resection of large colorectal polyps and offers an alternative to surgery.

关键词： Meta-analysis Systematic review Polyps Endoscopic mucosal resection En-bloc resection

Size does not determine the grade of malignancy of early invasive colorectal cancer

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2009年第22期15卷 2708-2713页

作者： Takahisa Matsuda Yutaka Saito Takahiro Fujii Toshio Uraoka Takeshi Nakajima Nozomu Kobayashi Fabian Emura Akiko Ono Tadakazu Shimoda Hiroaki Ikematsu Kuang-I Fu Yasushi Sano Takahiro Fujimori endoscopy division National Cancer Center Hospital Clinical Laboratory division National Cancer Center Hospital division of Digestive endoscopy and Gastrointestinal Oncology National Cancer Center Hospital East Department of Surgical and Molecular Pathology Dokkyo University School of Medicine

AIM： To clarify the clinicopathological characteristics of small and large early invasive colorectal cancers （EI-CRCs）, and to determine whether malignancy grade depends on size. METHODS： A total of 583 consecutive EI-CRCs treated by endoscopic mucosal resection or surgery at the National Cancer Center Hospital between 1980 and 2004 were enrolled in this study. Lesions were classified into two groups based on size： small （≤10 ram） and large （〉10 ram）. Clinicopathological features, incidence of lymph node metastasis （LNM） and risk factors for LNM, such as depth of invasion, lymphovascular invasion （LVI） and poorly differentiated adenocarcinoma （PDA） were analyzed in all resected specimens. RESULTS： There were 120 （21%） small and 463 （79%） large lesions. Histopathological analysis of the small lesion group revealed submucosal deep cancer （sin： 1〉1000 μm） in 90 （75%） cases, LVI in 26 （22%） cases, and PDA in 12 （10%） cases. Similarly, the large lesion group exhibited submucosal deep cancer in 380 （82%） cases, LVI in 125 （27%） cases, and PDA in 79 （17%） cases. The rate of LNM was 11.2% and 12.1% in the small and large lesion groups, ***： Small EI-CRC demonstrated the same aggressiveness and malignant potential as large cancer.

关键词： Colorectal cancer Submucosal invasion Lymph node metastasis Endoscopic mucosal resection

Decreased levels of plasma adiponectin associated with increased risk of colorectal cancer

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2010年第10期16卷 1252-1257页

作者： Sayaka Otake Hiroaki Takeda Shoichiro Fujishima Tadahisa Fukui Tomohiko Orii Takeshi Sato Yu Sasaki Shoichi Nishise Sumio Kawata Department of Gastroenterology Yamagata University Faculty of Medicine division of endoscopy Yamagata University Hospital

AIM:To investigate the association between adiponectin levels and risk of colorectal adenoma and cancer (early and advanced).METHODS: A cross-sectional study in a cohort of hospital-based patients was conducted between January 2004 and March 2006 at Yamagata University Hospital. Male subjects, who had colorectal tumors detected by endoscopic examination, were enrolled according to inclusion and exclusion criteria. Based on the T factor of the TNM system, intraepithelial carcinoma and submucosally invasive carcinoma were def ined as early cancer, and invasion into the muscularis propria or deeper was defined as advanced cancer. The plasma levels of glucose, insulin, total cholesterol, triglyceride, high sensitivity C-reactive protein, insulin like growth factor (IGF)-1, IGF binding protein-3, adiponectin, leptin, and resistin were measured. Each factor level was designated low or high, and the risk of adenoma or cancer was estimated by univariate and multivariate logistic regression ***: We enrolled 124 male subjects (47 with adenoma, 34 with early cancer, 17 with advanced cancer, and 26 without tumors as controls). In patients with adenoma, high triglyceride and low adiponectin were associated with a significant increase in the odds ratio (OR) by univariate analysis. Only a low adiponectin level was related to increased adenoma risk, with an adjusted OR for low level (<11 μg/mL) to high (≥11 μg/mL) of 5.762 (95% confidence interval (CI):1.683-19.739, P=0.005). In the patients with early cancer, high body mass index, high triglyceride, and low adiponectin were associated with a significant increase in OR in univariate analysis. Imultivariate analysis, only low adiponectin was significantly associated with early cancer, with an adjusted OR of 4.495 (95% CI:1.090-18.528, P=0.038). However, in patients with advanced cancer, low adiponectin was not recognized as a significant risk factor for advanced ***: A decreased level of adiponectin is str

关键词： Adenoma Early colorectal cancer Metabolic syndrome Adipokines Colonoscopy Resistin Leptin Body mass index

Effectiveness of narrow-band imaging magnification for invasion depth in early colorectal cancer

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2010年第14期16卷 1727-1734页

作者： Masakatsu Fukuzawa Yutaka Saito Takahisa Matsuda Toshio Uraoka Takao Itoi Fuminori Moriyasu division of endoscopy National Cancer Center Hospital Tokyo 1040045 Japan division of Gastroenterology and Hepatology Tokyo Medical University Tokyo 1600023 Japan Department of endoscopy Okayama University Hospital Okayama 7008558 Japan Microvasculature

AIM: To evaluate the surface microvascular patterns of early colorectal cancer (ECC) using narrow-band imaging (NBI) with magnification and its effectiveness for invasion depth diagnosis. METHODS: We studied 112 ECC lesions [mucosal/ submucosal superficial (m/sm-s), 69; sm-deep (sm-d), 43] ≥ 10 mm that subsequently underwent endoscopic or surgical treatment at our hospital. We compared microvascular architecture revealed by NBI with magnification to histological findings and then to magnifi- cation colonoscopy pit pattern diagnosis. RESULTS: Univariate analysis indicated vessel density: non-dense (P < 0.0001); vessel regularity: negative (P < 0.0001); caliber regularity: negative (P < 0.0001); vessel length: short (P < 0.0001); and vessel meandering: positive (P = 0.002) occurred significantly more often with sm-d invasion than m/sm-s invasion. Multivariate analysis showed sm-d invasion was independently associated with vessel density: non-dense[odds ratio (OR) = 402.5, 95% confidence interval (CI): 12.4-13 133.1] and vessel regularity: negative (OR = 15.9, 95% CI: 1.2-219.1). Both of these findings when combined were an indicator of sm-d invasion with sensitivity, specificity and accuracy of 81.4%, 100% and 92.9%, respectively. Pit pattern diagnosis sensitivity, specificity and accuracy, meanwhile, were 86.0%, 98.6% and 93.8%, respectively, thus, the NBI with magnification findings of non-dense vessel density and negative vessel regularity when combined together were comparable to pit pattern diagnosis. CONCLUSION: Non-dense vessel density and/or negative vessel regularity observed by NBI with magnification could be indicators of ECC sm-d invasion.

关键词： Colorectal neoplasms Narrow-band imaging Microvasculature

Difficult colorectal polypectomy:Technical tips and recent advances

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2023年第17期29卷 2600-2615页

作者： Sukit Pattarajierapan Hiroyuki Takamaru Supakij Khomvilai Surgical endoscopy Colorectal division Department of SurgeryFaculty of MedicineChulalongkorn UniversityBangkok 10330Thailand endoscopy division National Cancer Center HospitalTokyo 104-0045Japan

Colonoscopy has been shown to be an effective modality to prevent colorectal cancer(CRC)*** reduction is achieved by detecting and removing adenomas,which are precursors of *** colorectal polyps are small and do not pose a significant challenge for trained and skilled ***,up to 15%of polyps are considered“difficult”,potentially causing life-threatening complications.A difficult polyp is defined as any polyp that is challenging for the endoscopist to remove owing to its size,shape,or *** polypectomy techniques and skills are required to resect difficult colorectal *** were various polypectomy techniques for difficult polyps such as endoscopic mucosal resection(EMR),underwater EMR,Tip-in EMR,endoscopic submucosal dissection(ESD),or endoscopic full-thickness *** selection of the appropriate modality depends on the morphology and endoscopic *** technologies have been developed to aid endoscopists in performing safe and effective polypectomies,especially complex procedures such as *** advances include video endoscopy system,equipment assisting in advanced polypectomy,and closure devices/techniques for complication *** should know how to use these devices and their availability in practice to enhance polypectomy *** review describes several useful strategies and tips for managing difficult colorectal *** also propose the stepwise approach for difficult colorectal polyps.

关键词： Adenoma Colonic polyps Colonoscopy Endoscopic mucosal resection Endoscopic submucosal dissection Polypectomy

Early endoscopic ultrasonography in acute biliary pancreatitis: A prospective pilot study

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

World Journal of Gastroenterology 2015年第36期21卷 10427-10434页

作者： Andrea Anderloni Marianna Galeazzi Marco Ballarè Michela Pagliarulo Marco Orsello Mario Del Piano Alessandro Repic Digestive endoscopy Unit Division of GastroenterologyHumanitas Research Hospital Gastrointestinal and endoscopy Unit AOU "Maggiore della Carità"28100 NovaraItaly

AIM: To investigate the clinical usefulness of early endoscopic ultrasonography(EUS) in the management of acute biliary pancreatitis(ABP).METHODS: All consecutive patients entering the emergency department between January 2010 and December 2012 due to acute abdominal pain and showing biochemical and/or radiological findings consistent with possible ABP were prospectively enrolled. Patients were classified as having a low,moderate,or high probability of common bile duct(CBD) stones,according to the established risk stratification. Exclusion criteria were: gastrectomy or patient in whom the cause of biliary obstruction was already identified by ultrasonography. All enrolled patients underwent EUS within 48 h of their admission. Endoscopic retrograde cholangiopancreatography was performed immediately after EUS only in those cases with proven CBD stones or sludge. The following parameters were investigated:(1) clinical: age,sex,fever;(2) radiological: dilated CBD; and(3) biochemical: bilirubin,AST,ALT,g GT,ALP,amylase,lipasis,PCR. Association between presence of CBD stone at EUS and the individual predictors wereassessed by univariate logistic regression. Predictors significantly associated with CBD stones(P < 0.05) were entered in a multivariate logistic regression ***: A total of 181 patients with pancreatitis were admitted to the emergency department between January 2010 and December 2012. After exclusion criteria a total of 71 patients(38 females,53.5%,mean age 58 ± 20.12 years,range 27-89 years; 33 males,46.5%,mean age 65 ± 11.86 years,range 41-91 years) were included in the present study. The probability of CBD stones was considered low in 21 cases(29%),moderate in 26(37%),and high in the remaining 24(34%). The 71 patients included in the study underwent EUS,which allowed for a complete evaluation of the target sites in all the cases. The procedure was completed in a mean time of 14.7 min(range 9-34 min),without any notable *** overall CBD

关键词： Acute biliary pancreatitis Choledocolithiasis Comm