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Endoscopic techniques for the diagnosis of pancreatic cystic lesions

World Journal of Gastroenterology 2025年第1期31卷 1-7页

作者： Sahib Singh Saurabh Chandan Rakesh Vinayek Jahnvi Dhar Jayanta Samanta Gabriele Capurso Ivo Boskoski Cristiano Spada Jorge D Machicado Stefano Francesco Crinò Antonio Facciorusso Department of Internal Medicine Sinai HospitalBaltimoreMD 21215United States Division of Gastroenterology and Hepatology Creighton University School of MedicineOmahaNE 68131United States Department of Gastroenterology Sinai Hospital of BaltimoreBaltimoreMD 21215United States Department of Gastroenterology Postgraduate Institute of Medical Education and ResearchChandigarh 160012India Division of Pancreato-Biliary endoscopy and Endosonography Pancreas Translational and Clinical Research CenterIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilano 20132Italy Digestive endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRoma 00168Italy Department of Gastroenterology and endoscopy Catholic UniversityRoma 00168Italy Department of Gastroenterology University of Michigan HealthAnn ArborMI 48107United States Department of endoscopy University of VeronaVerona 37121VenetoItaly Gastroenterology Unit Department of Medical and Surgical SciencesUniversity of FoggiaFoggia 71122Italy

Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans,with few patients presenting with abdominal pain or other *** accurate diagnosis of cysts is important as management depends on the type(neoplastic or non-neoplastic).Cross-sectional imaging is fast being replaced with endoscopic ultrasound(EUS)and various techniques based on that such as EUS-guided fine needle aspiration,EUS-guided needle confocal laser endomicroscopy,EUS-through-the-needle biopsy,and contrast-enhanced *** studies have reported varying diagnostic and adverse event rates with these *** addition,American,European,and Kyoto guidelines for the diagnosis and management of pancreatic cysts have provided different *** this editorial,we elaborate on the clinical guidelines,recent studies,and comparison of different endoscopic methods for the diagnosis of pancreatic cysts.

关键词： Endoscopic ultrasound Fine needle aspiration Needle confocal laser endomicroscopy Through-the-needle biopsy Contrast-enhanced endoscopic ultrasound

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Emerging molecular classifications and therapeutic implications for gastric cancer

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Chinese Journal of Cancer 2016年第8期35卷 393-402页

作者： Tao Chen Xiao-Yue Xu Ping-Hong Zhou endoscopy Center Zhongshan Hospital of Fudan University endoscopy research institute Fudan University

Gastric cancer(GC) is a highly aggressive and life-threatening *** with radical surgical removal and front-line chemotherapy,more than half of GCs locally relapse and metastasize at a distant *** dismal outcomes reflect the ineffectiveness of a one-size fits-all approach for a highly heterogeneous disease with diverse etiological causes and complex molecular *** recent comprehensive genomic and molecular profiling has led to our deepened understanding of *** emerging molecular classification schemes based on the genetic,epigenetic,and molecular signatures are providing great promise for the development of more effective therapeutic strategies in a more personalized and precise *** this end,the Cancer Genome Atlas(TCGA) research network conducted a comprehensive molecular evaluation of primary GCs and proposed a new molecular classification dividing GCs into four subtypes:Epstein-Barr virus-associated tumors,microsatellite unstable tumors,genomically stable tumors,and tumors with chromosomal *** review primarily focuses on the TCGA molecular classification of GCs and discusses the implications on novel targeted therapy *** believe that these fundamental findings will support the future application of targeted therapies and will guide our efforts to develop more efficacious drugs to treat human GCs.

关键词： Gastric cancer Molecular classification Personalized therapy The Cancer Genome Atlas research network

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Endoscopic submucosal dissection for foregut neuroendocrine tumors:An initial study

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World Journal of Gastroenterology 2012年第40期18卷 5799-5806页

作者： Quan-Lin Li Yi-Qun Zhang Wei-Feng Chen Mei-Dong Xu Yun-Shi Zhong Li-Li Ma Wen-Zheng Qin Jian-Wei Hu Ming-Yan Cai Li-Qing Yao Ping-Hong Zhou endoscopy Center and endoscopy research institute Zhongshan HospitalFudan UniversityShanghai 200032China

AIM： To evaluate the feasibility and efficacy of endo- scopic submucosal dissection （ESD） for foregut neuro- endocrine tumors （NETs）. METHODS： From April 2008 to December 2010, pa- tients with confirmed histological diagnosis of foregut NETs were included. None had regional lymph node enlargement or distant metastases to the liver or lung on preoperative computerized tomography scanning or endoscopic ultrasonography （EUS）. ESD was attempted under general anesthesia. After making several mark-ing dots around the lesion, a mixture solution was injected into the submucosa. The mucosa was incised outside the marking dots. Dissection of the submu- cosal layer beneath the tumor was performed under direct vision to achieve complete en bloc resection of the specimen. Tumor features, clinicopathological char- acteristics, complete resection rate, and complications were evaluated. Foregut NETs were graded as G1, G2, or G3 on the basis of proliferative activity by mitotic count or Ki-67 index. All patients underwent regular follow-up to evaluate for any local recurrence or dis- tant metastasis. RESULTS： Those treated by ESD included 24 patients with 29 foregut NETs. The locations of the 29 lesions are as follows： esophagus （n = 1）, cardia （n = 1）, stomach （n = 23）, and duodenal bulb （n = 4）. All le- sions were found incidentally during routine upper gastrointestinal endoscopy for other indications, and none had symptoms of carcinoid syndrome. Preop- erative EUS showed that all tumors were confined to the submucosa. Among the 24 gastric lesions, 16 le- sions in 11 patients were type I gastric NETs arising in chronic atrophic gastritis with hypergastrinemia, while the other 8 solitary lesions were type Ⅲ because of absence of atrophic gastritis in these cases. All of the tumors were removed in an en bloc fashion. The av- erage maximum diameter of the lesions was 9.4 mm （range： 2-30 ram）, and the procedure time was 20.3 rain （range： 10-45 rain）. According to the World Health Orga

关键词： Endoscopic submucosal dissection Neuro-endocrine tumor Foregut

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Endoscopic resection of colorectal granular cell tumors

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World Journal of Gastroenterology 2015年第48期21卷 13542-13547页

作者： Iri Take Qiang Shi Zhi-peng Qi Shi-lun Cai li-Qing Yao ping-hong Zhou Yun-Shi Zhong endoscopy Center Zhongshan Hospital of Fudan University endoscopy research institute of Fudan University

AIM: To determine the feasibility and effectiveness of endoscopic resection for the treatment of colorectal granular cell tumors(GCTs). METHODS: This was a retrospective study performed at a single institution. From January 2008 to April 2015, we examined a total of 11 lesions in 11 patients who were treated by an endoscopic procedure for colorectal GCTs in the endoscopy Center, Zhongshan hospital of Fudan University, Shanghai, China. Either endoscopic mucosal resection or endoscopic submucosal dissection(ESD) was performed by three surgeons with expertise in endoscopic treatment. The pre- and postoperative condition and follow-up of these patients were evaluated by colonoscopy and endoscopic ultrasonography(EUS).RESULTS: Of these 11 lesions, 2 were located in the cecum, 3 were in the ileocecal junction, 5 were in the ascending colon, and 1 was in the rectum. The median maximum diameter of the tumors was 0.81 cm(range 0.4-1.2 cm). The en bloc rate was 100%, and the complete resection rate was 90.9%(10/11). postoperative pathology in one patient showed a tumor at the cauterization margin. however, during ESD, this lesion was removed en bloc, and no tumor tissue was seen in the wound. No perforations or delayed perforations were observed and emergency surgery was not required for complications. All patients were followed up to May 2015, and none had recurrence, metastasis, or complaints of ***: Endoscopic treatment performed by endoscopists with sufficient experience appears to be feasible and effective for colorectal GCTs.

关键词： Endoscopic submucosal dissection granularcell tumors Endoscopic mucosal resection colorectal

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Endoscopic features and treatments of gastric cystica profunda

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World Journal of Gastroenterology 2024年第7期30卷 673-684页

作者： Zi-Han Geng Yan Zhu Pei-Yao Fu Yi-Fan Qu Wei-Feng Chen Xia Yang Ping-Hong Zhou Quan-Lin Li endoscopy Center and endoscopy research institute Zhongshan HospitalFudan UniversityShanghai 200032China

BACKGROUND Gastric cystica profunda(GCP)represents a rare condition characterized by cystic dilation of gastric glands within the mucosal and/or submucosal *** is often linked to,or may progress into,early gastric cancer(EGC).AIM To provide a comprehensive evaluation of the endoscopic features of GCP while assessing the efficacy of endoscopic treatment,thereby offering guidance for diagnosis and *** This retrospective study involved 104 patients with GCP who underwent endoscopic *** demographic and clinical data,regular patient followups were conducted to assess local *** Among the 104 patients diagnosed with GCP who underwent endoscopic resection,12.5%had a history of previous gastric *** primary site predominantly affected was the cardia(38.5%,n=40).GCP commonly exhibited intraluminal growth(99%),regular presentation(74.0%),and ulcerative mucosa(61.5%).The leading endoscopic feature was the mucosal lesion type(59.6%,n=62).The average maximum diameter was 20.9±15.3 mm,with mucosal involvement in 60.6%(n=63).Procedures lasted 73.9±57.5 min,achieving complete resection in 91.3%(n=95).Recurrence(4.8%)was managed via either surgical intervention(n=1)or through endoscopic resection(n=4).Final pathology confirmed that 59.6%of GCP cases were associated with *** analysis indicated that elderly males were more susceptible to GCP associated with ***,multivariate analysis identified lesion morphology and endoscopic features as significant risk *** analysis demonstrated no statistically significant difference in recurrence between GCP with and without EGC(P=0.72).CONCLUSION The findings suggested that endoscopic resection might serve as an effective and minimally invasive treatment for GCP with or without EGC.

关键词： Gastric cystica profunda Early gastric cancer Endoscopic features Endoscopic resection endoscopy

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Ligation-assisted endoscopic submucosal resection with circumferential mucosal incision for duodenal carcinoid tumor

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World Journal of Gastroenterology 2015年第34期21卷 10041-10044页

作者： Iri Take Qiang Shi Zhi-peng Qi Shi-lun Cai li-Qing Yao ping-hong Zhou Yun-Shi Zhong endoscopy Center Zhongshan Hospital of Fudan University endoscopy research institute of Fudan University

Here we present the case of a 64-year-old female with a duodenal carcinoid tumor treated by ligation-assisted endoscopic submucosal resection(ESMR-L) with circumferential mucosal incision(CMI). Band ligation was effective in resecting the duodenal carcinoid tumor after CMI,with an uneventful post-procedural course. Histopathological examination showed clear tumor margins at deeper tissue levels. Thus,in the present case,ESMR-L with CMI was useful for the treatment of duodenal carcinoid tumor.

关键词： Carcinoid tumor Submucosal tumor Duodenum Ligation

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Weight loss endoscopy: Development, applications, and current status

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World Journal of Gastroenterology 2016年第31期22卷 7069-7079页

作者： Nitin Kumar Bariatric endoscopy institute

Obesity and its comorbidities- including diabetes and obstructive sleep apnea- have taken a large and increasing toll on the United States and the rest of the world. The availability of commercial, clinical, and operative therapies for weight management have not been effective at a societal level. Endoscopic bariatric therapy is gaining acceptance as more effective than diet and lifestyle measures, and less invasive than bariatric surgery. Various endoscopic therapies are analogues of the restrictive or bypass components of bariatric surgery, utilizing gastric remodeling or intestinal anastomosis to achieve proven weight loss and metabolic benefits. Others, such as aspiration therapy, employnovel mechanisms of action. Intragastric balloons have recently been approved by the United States Food and Drug Administration, and a number of other technologies have completed large multicenter trials(such as AspireA ssist aspiration therapy and Primary Obesity Surgery Endolumenal). Endoscopic sleeve gastroplasty and transoral outlet reduction for endoscopic revision of gastric bypass have proven safe and effective in a number of studies. As devices are approved for use, data will continue to accumulate for safety, effectiveness, and cost effectiveness. Bariatric endoscopists should be prepared to appropriately target and apply various endoscopic bariatric therapies in the context of a comprehensive long-term weight management program.

关键词： Weight loss Intragastric balloon Gastric balloon Orbera Reshape dual balloon Endoscopic sleeve Endoscopic sleeve gastroplasty Primary Obesity surgery endolumenal Gastric bypass Gastric bypass revision Obesity

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Submucosal tunneling endoscopic biopsy and myotomy for management of unknown esophageal stenosis

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Gastroenterology Report 2022年第1期10卷 635-637页

作者： Xiao-Yue Xu Zi-Han Geng Tian-Yin Chen Quan-Lin Li Ming-Yan Cai Jia-Xin Xu Dan-Feng Zhang Jian-Wei Hu Ping-Hong Zhou endoscopy Center and endoscopy research institute Zhongshan HospitalFudan UniversityShanghai Collaborative Innovation Center of EndoscopyShanghaiP.R.China

Introduction Esophageal stenosis is usually congenital or secondary to esophageal injury,esophagitis,and esophageal neoplasia[1,2].The mainstay treatment for benign esophageal stenosis is dilatation with either balloons or esophageal bougienage[3,4].A self-expandable metal stent(SEMS)is recommended for malignant and refractory esophageal stenosis[5].The treatment can be distinct according to different *** ultrasonography-guided fine-needle aspiration/biopsy(EUS-FNA/FNB)may be conducive to clarifying the etiology of esophageal ***,the small amount of tissue obtained by EUS-FNA/FNB may provide less pathological *** we report a new technique—submucosal tunneling endoscopic biopsy and myotomy(STEBM)derived from the peroral endoscopic myotomy(POEM)procedure to relieve stenosis and get a sufficient amount of tissue to make a definite diagnosis.

关键词： esophageal stenosis biopsy

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How to avoid overtreatment of benign colorectal lesions:Rationale for an evidence-based management

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World Journal of Gastroenterology 2022年第47期28卷 6619-6631页

作者： Marco Bustamante-Balén Gastrointestinal endoscopy Unit Gastrointestinal Endoscopy Research GroupHospital Universitari Ⅰ Politècnic La FeHealth Research Institute Hospital La Fe(ⅡSLaFe)Valencia 46026Spain

Implementing population-based screening programs for colorectal cancer has led to an increase in the detection of large but benign histological ***,endoscopic mucosal resection can be considered the standard technique for the removal of benign lesions of the colon due to its excellent safety profile and good clinical ***,several studies from different geographic areas agree that many benign colon lesions are still referred for ***,the referral rate to surgery is not decreasing over the years,despite the theoretical improvement of endoscopic resection *** article will review the leading causes for benign colorectal lesions to be referred for surgery and the influence of the endoscopist experience on the referral *** will also describe how to categorize a polyp as complex for resection and consider an endoscopist as an expert in endoscopic *** finally,we will propose a framework for the accurate and evidence-based treatment of complex benign colorectal lesions.

关键词： Colorectal polyps Endoscopic mucosal resection Colorectal surgery

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Technical feasibility of salvage endoscopic full-thickness resection for a giant gastrointestinal stromal tumor located in low rectum after imatinib:a case report

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Gastroenterology Report 2023年第1期11卷 527-529页

作者： Jingyi Liu Bing Li Pinghong Zhou Mingyan Cai Yunshi Zhong endoscopy Center Zhongshan Hospital of Fudan UniversityShanghaiP.R.China endoscopy research institute of Fudan University ShanghaiP.R.China Shanghai Collaborative Innovation Center of endoscopy ShanghaiP.R.China endoscopy Center Xuhui HospitalZhongshan Hospital of Fudan UniversityShanghaiP.R.China

Introduction Gastrointestinal stromal tumors(GISTs)in adults are nearly 10%–30%with a potential malignant tendency[1].Colorectal GISTs account for 5%of all cases and have a higher progression risk with a poor prognosis[2,3].Rectal GISTs usually need radical operations such as laparoscopy to obtain tumor-free ***,it is difficult for surgery to preserve the anal function because of the tumor size and ***,we report a case of a 70-year-old female with a giant GIST located in the lower rectum,which was removed by function-preserving endoscopic minimally invasive resection after routine imatinib therapy.

关键词： rectum resection routine

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