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Endoscopic full-thickness resection for treating small tumors originating from the muscularis propria in the gastric fundus: An improvement in technique over 15 years

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World Journal of gastrointestinal Oncology 2019年第11期11卷 1054-1064页

作者： Nan Ge Jin-Long Hu Fei Yang Fan Yang Si-Yu Sun endoscopy center Shengjing Hospital of China Medical University

BACKGROUND The fundus of the stomach is regarded as a difficult area for endoscopic resection of small tumors originating from the muscularis propria(MP tumors).Three endoscopic resection techniques have been developed to treat these tumors,including ligation-assisted endoscopic full-thickness resection(L-EFTR),snareassisted EFTR(S-EFTR),and endoscopic submucosal dissection-assisted EFTR(EEFTR).To date,no studies have compared these *** We aimed to evaluate and compare S-EFTR with L-EFTR and E-EFTR for treating small MP tumors in the gastric *** We retrospectively reviewed patients with primary small MP tumors in the gastric fundus and treated by these three techniques between January 2016 and December 2018 at Shengjing Hospital,*** demographic and clinicopathologic data,including sex,age,tumor size,surgeon details,and pathological results,were *** regarding operation duration,cost,enbloc resection,and severe complications were also extracted and *** A total of 36 patients(27 women)with a mean age of 55.8±10.20 years were included in this *** mean tumor size was 9.0±3.98 *** the methods showed a 100%en-bloc resection rate and 0%severe complication *** was no statistically significant difference among the three groups in the operation duration(P=0.148).The cost comparison for the whole procedure was as follows:E-EFTR>L-EFTR>S-EFTR(5837.5±7212.96 CNY,5970.7±3465.27 CNY,5852.0±6438.25 CNY,respectively,P<0.001).CONCLUSION S-EFTR,L-EFT,and E-EFTR are all effective for resection of small MP tumors in the gastric fundus.S-EFTR is superior in terms of cost-effectiveness.

关键词： Endoscopic full-thickness resection Ligation Muscularis propria Snare Endoscopic submucosal dissection Cost

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

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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

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Non-guided self-learning program for high-proficiency optical diagnosis of diminutive and small colorectal lesions: A single-endoscopist pilot study

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World Journal of Gastroenterology 2019年第10期25卷 1278-1287页

作者： Marco Bustamante-Balén Carla Satorres Lorena Puchades Belén Navarro Natalia García-Morales Noelia Alonso Marta Ponce Lidia Argüello Vicente Pons-Beltrán gastrointestinal endoscopy Research Group Gastrointestinal Endoscopy UnitDigestive Diseases DepartmentLa Fe Polytechnic University Hospital Digestive Diseases Department La Fe Polytechnic University Hospital gastrointestinal endoscopy Unit Digestive Diseases DepartmentLa Fe Polytechnic University Hospital

BACKGROUND The implementation of optical diagnosis(OD) of diminutive colorectal lesions in clinical practice has been hampered by differences in performance between community and academic settings. One possible cause is the lack of a standardized learning tool. Since the factors related to better learning are not well described, strong evidence upon which a consistent learning tool could be designed is lacking. We hypothesized that a self-designed learning program may be enough to achieve competency in OD of diminutive lesions of the *** To assess the accuracy of OD of diminutive lesions in real colonoscopies after application of a self-administered learning *** This was a single-endoscopist prospective pilot study, in which an experienced endoscopist followed a self-designed, self-administered learning program in OD of colorectal lesions. An assessment phase divided in two halves with a 6-mo period in between without performance of OD was developed in a populationbased colorectal cancer screening program. The accomplishment of the Preservation and Incorporation of Valuable Endoscopic Innovations criteria and performance measures were calculated overall and in the two halves of the assessment phase, assessing their response to the 6-mo stopping period. The evolution of performance through blocks of 50 lesions was also *** Overall, 152 patients and 522 lesions(≤ 5 mm: 399, and 6-9 mm: 123) were included. The negative predictive value for the OD of adenoma in rectosigmoid lesions diagnosed with high confidence was 91.7% [95% confidence interval(CI):87.3-96.6]. The proportion of agreement on surveillance interval between OD and pathological diagnosis was higher than 95%. Overall accuracy for diminutive lesions diagnosed with high confidence was 89.5%(95%CI: 86.3-92.7). The overall accuracy of OD was similar in the two halves of the assessment phase [90.1(95%CI: 85.6-94.7) vs 88.2(95%CI: 87.9-95.9)]. All the other performance parameters we

关键词： Optical diagnosis Accuracy Learning Polyp Colonoscopy Education

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A laterally-spreading tumor in a colonic interposition treated by endoscopic submucosal dissection

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World Journal of Gastroenterology 2010年第3期16卷 392-394页

作者： Hideaki Bando Hiroaki Ikematsu Kuang-I Fu Yasuhiro Oono Takashi Kojima Keiko Minashi Tomonori Yano Takahisa Matsuda Yutaka Saito Kazuhiro Kaneko Atsushi Ohtsu Department of gastrointestinal Oncology & endoscopy National Cancer Center Hospital EastKashiwanoha 6-5-1KashiwaChiba 277-8577Japan Department of Gastroenterology Juntendou University Nerima Hospital endoscopy Division National Cancer Center Hospital

Herein we describe an early colonic carcinoma which developed in a colonic interposition 14 years after surgery for esophageal cancer, which was successfully treated by endoscopic submucosal dissection (ESD). An 80-year-old man underwent colonic interposition between the upper esophagus and stomach after surgery for an early esophageal squamous cell carcinoma in 1994. He received a surveillance endoscopy, and a laterally-spreading tumor of granular type, approximately 20 mm in size, was identified in the colonic interposition. An endoscopic biopsy revealed moderately differentiated adenocarcinoma histologically, however, we diagnosed the lesion as an intramucosal carcinoma based on the endoscopic findings. The lesion was safely and completely removed en bloc by ESD using a bipolar knife. Histologically, the lesion was an intramucosal moderately differentiated adenocarcinoma in a tubular adenoma.

关键词： Colonic interposition Early colonic carc inoma Endoscopic submucosal dissection

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Endoscopic ultrasound fine needle aspiration vs fine needle biopsy in solid lesions:A multi-center analysis

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World Journal of Clinical Cases 2021年第34期9卷 10507-10517页

作者： Diogo Turiani Hourneaux Moura Thomas R McCarty Pichamol Jirapinyo Igor Braga Ribeiro Galileu Ferreira Ayala Farias Antonio Coutinho Madruga-Neto Marvin Ryou Christopher C Thompson gastrointestinal endoscopy Unit University of Sao Paulo School of MedicineSão PauloSP 05403-010Brazil Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115United States Division of gastrointestinal endoscopy University of São Paulo Medical SchoolSão PauloSP 01246-903Brazil

BACKGROUND While endoscopic ultrasound(EUS)-guided fine needle aspiration(FNA)is considered a preferred technique for tissue sampling for solid lesions,fine needle biopsy(FNB)has recently been *** To compare the accuracy of FNB vs FNA in determining the diagnosis of solid *** A retrospective,multi-center study of EUS-guided tissue sampling using FNA vs FNB *** outcomes included diagnostic test characteristics(i.e.,sensitivity,specificity,accuracy),use of rapid on-site evaluation(ROSE),and adverse *** analyses were performed by type of lesion and diagnostic yield with or without ROSE.A multivariable logistic regression was also *** A total of 1168 patients with solid lesions(n=468 FNA;n=700 FNB)underwent EUS-guided *** age was 65.02±12.13 ***,sensitivity,specificity and accuracy were superior for FNB vs FNA(84.70%vs 74.53%;99.29%vs 96.62%;and 87.62%vs 81.55%,respectively;P0.05).Multivariate analysis showed no significant predictor for better *** subgroup analyses,FNB was superior to FNA for non-pancreatic lesions;however,there was no difference between the techniques among pancreatic *** adverse event was reported in each *** FNB is superior to FNA with equivalent diagnostic test characteristics compared to FNA+ROSE in the diagnosis of non-pancreatic solid *** results suggest that EUS-FNB may eliminate the need of ROSE and should be employed as a first-line method in the diagnosis of solid lesions.

关键词： Endoscopic ultrasound-guided tissue acquisition Fine needle aspiration Fine needle biopsy Solid lesions Endoscopic ultrasound Cancer

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Crohn’s disease as the intestinal manifestation of pan-lymphatic dysfunction:An exploratory proposal based on basic and clinical data

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World Journal of Gastroenterology 2024年第1期30卷 34-49页

作者： Yu-Wei Zhou Yue Ren Miao-Miao Lu Ling-Ling Xu Wei-Xin Cheng Meng-Meng Zhang Lin-Ping Ding Dong Chen Jian-Guo Gao Juan Du Ci-Liang Jin Chun-Xiao Chen Yun-Fei Li Tao Cheng Peng-Lei Jiang Yi-Da Yang Peng-Xu Qian Peng-Fei Xu Xi Jin Department of Gastroenterology The First Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Gastroenterology The Second Hospital of JiaxingJiaxing 314000Zhejiang ProvinceChina endoscopy center Children’s Hospital of Zhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Gastroenterology The Second People’s Hospital of Yuhang DistrictHangzhou 310000Zhejiang ProvinceChina Department of Gastroenterology Hangzhou Shangcheng District People’s HospitalHangzhou 310003Zhejiang ProvinceChina Department of Colorectal Surgery The First Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Gastroenterology The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Women’s Hospital and Institute of Genetics Zhejiang University School of MedicineHangzhou 310000Zhejiang ProvinceChina center of Stem Cell and Regenerative Medicine and Bone Marrow Transplantation CenterThe First Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina Department of Infectious Disease The First Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310003Zhejiang ProvinceChina

Crohn’s disease(CD)is caused by immune,environmental,and genetic *** can involve the entire gastrointestinal tract,and although its prevalence is rapidly increasing its etiology remains *** biological and small-molecule drugs have advanced the treatment of CD;however,a considerable proportion of patients are non-responsive to all known *** achieve a breakthrough in this field,innovations that could guide the further development of effective therapies are of utmost *** this review,we first propose the innovative concept of pan-lymphatic dysfunction for the general distribution of lymphatic dysfunction in various diseases,and suggest that CD is the intestinal manifestation of pan-lymphatic dysfunction based on basic and clinical preliminary *** supporting evidence is fully summarized,including the existence of lymphatic system dysfunction,recognition of the inside-out model,disorders of immune cells,changes in cell plasticity,partial overlap of the underlying mechanisms,and common gut-derived fatty and bile acid *** benefit of this novel concept is that it proposes adopting the zebrafish model for studying intestinal diseases,especially CD,as this model is good at presenting and mimicking lymphatic *** importantly,the ensuing focus on improving lymphatic function may lead to novel and promising therapeutic strategies for CD.

关键词： Inflammatory bowel disease Crohn’s disease Lymphatic system Inside-out model Immune cells Zebrafish

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Advancements in endoscopic hemostasis for non-variceal upper gastrointestinal bleeding

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World Journal of gastrointestinal endoscopy 2024年第7期16卷 376-384页

作者： Xue Jing Li Brian M Fung Department of Gastroenterology and Hepatology Banner-University Medical Center PhoenixPhoenixAZ 85006United States

Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and ***,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI *** this review,we provide an overview of novel endoscopic treatments that can be used to achieve ***,we discuss the efficacy and applicability of over-thescope clips,hemostatic agents,TTS doppler ultrasound,and endoscopic ultrasound,each of which offer an effective method of reducing rates of GI rebleeding.

关键词： Doppler probe Endoscopic ultrasound endoscopy techniques gastrointestinal bleeding Hemospray Hemostasis Hemostatic agents Over-the-scope clips Ovesco

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Long-term outcomes of endoscopic submucosal dissection for undifferentiated type early gastric cancer over 2 cm with R0 resection

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World Journal of gastrointestinal endoscopy 2024年第6期16卷 326-334页

作者： Jun Yong Bae Chang Beom Ryu Moon Sung Lee Kulwinder S Dua Internal Medicine and Digestive Disease center Seoul Medical CenterSeoul 02053South Korea Internal Medicine and Digestive Disease center and Research Institute Soon Chun Hyang University of School of MedicineBucheon 14584South Korea Department of Medicine Medical College of WisconsinMilwaukeeWI 53226United States

BACKGROUND Endoscopic submucosal dissection(ESD)for over 2 cm in size undifferentiated type(UD type)early gastric cancer(EGC)confined to the mucosa is not only challenging,but also long-term outcomes are not well *** To evaluate the long-term outcomes of ESD done for UD type EGCs confined to the mucosa over 2 cm in size and compare the results with those where the lesions were less than 2 *** 143 patients with UD type EGC confirmed on histology after ESD at a tertiary hospital were *** with synchronous and metachronous lesions and a case with emergency surgery after ESD were excluded.A total of 137 cases were enrolled.79 cases who underwent R0 resection were divided into 2 cm or less(group A)and over 2 cm(group B)in *** Among 79 patients who underwent R0 resection,the number in group A and B were 51 and 28,*** mean follow-up period(SD)was 79.71±45.42 *** was a local recurrence in group A(1/51,2%)and group B(1/28,3.6%)*** patient in group A underwent surgery while the patient in group B underwent repeated ESD with no further recurrences in both *** was no regional lymph node metastasis,distant metastasis,and deaths in both *** R0 resection strategy for ESD on lesions over 2 cm,20.4%(28/137)of patients were able to avoid surgery compared with expanded *** If R0 resection is achieved by ESD,UD type EGCs over 2 cm also showed good and similar clinical outcomes as compared to lesions less than 2 cm when followed for over 5 *** R0 resection strategy,several patients can avoid surgery.

关键词： Undifferentiated type early gastric cancer Endoscopic submucosal dissection Long term outcomes Over 2 cm Early gastric cancer

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High-definition colonoscopy with i-Scan:Better diagnosis for small polyps and flat adenomas

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World Journal of Gastroenterology 2012年第37期18卷 5231-5239页

作者： Pier Alberto Testoni Chiara Notaristefano Cristian Vailati Milena Di Leo Edi Viale Division of Gastroenterology and gastrointestinal endoscopy Vita-Salute San Raffaele UniversityScientific Institute San Raffaele

AIM： To investigate if high-definition （HD） colonoscope with i-Scan gave a higher detection rate of mucosal le- sions vs standard white-light instruments. METHODS： Data were collected from the computer- ized database of the endoscopy unit of our tertiary referral center. We retrospectively analyzed 1101 con- secutive colonoscopies that were performed over 1 year with standard white-light （n = 849） or HD＋ with i-Scan （n = 252） instruments by four endoscopists, in an outpatient setting. Colonoscopy records included patients＇ main details and family history for colorectal cancer, indication for colonoscopy （screening, diagnos- tic or surveillance）, type of instrument used （standard white-light or HD＋ plus i-Scan）, name of endoscopist and bowel preparation. Records for each procedure included whether the cecum was reached or not and the reason for failure, complications during or imme- diately after the procedure, and number, size, location and characteristics of the lesions. Polyps or protruding lesions were defined as sessile or pedunculated, and nonprotruding lesions were defined according to Paris classification. For each lesion, histological diagnosis was recorded. RESULTS： Eight hundred and forty-nine colonosco- pies were carried with the standard white-light video colonoscope and 252 with the HD＋ plus i-Scan video colonoscope, The four endoscopists did 264, 300, 276 and 261 procedures, respectively; 21.6%, 24.0%, 21.7% and 24.1% of them with the HD＋ plus i-Scan technique. There were no significant differences be- tween the four endoscopists in either the number of procedures done or the proportions of each imaging technique used. Both techniques detected one or more mucosal lesions in 522/1101 procedures （47.4%）. The overall number of lesions recognized was 1266; 645 in the right colon and 621 in the left. A significantly higher number of colonoscopies recognized lesions in the HD＋ plus i-Scan mode （171/252 = 67.9%） than with the standard white-light technique （4

关键词： Colonoscopy High-definition+ with i-Scancolonoscopy White-light colonoscopy Colonic polyps Nonprotruding lesions Adenoma detection rate With-drawal time Surface enhancement Contrast enhance-ment Tone enhancement

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Clinical-based phenotypes in children with pediatric post-COVID-19 condition

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World Journal of Pediatrics 2024年第7期20卷 682-691页

作者： Lieke C.E.Noij Jelle M.Blankestijn Coen R.Lap Marlies A.van Houten Giske Biesbroek Anke-Hilse Maitland-van der Zee Mahmoud I.Abdel-Aziz Johannes B.van Goudoever Mattijs W.Alsem Caroline L.H.Brackel Kim J.Oostrom Simone Hashimoto Suzanne W.J.Terheggen-Lagro Department of Pediatric Pulmonology and Allergy Amsterdam UMCLocation AMCEmma Children’s HospitalAmsterdam University Medical CenterRoom G2-222Meibergdreef 91105AZAmsterdamThe Netherlands Department of Pulmonary Medicine Amsterdam UMCAmsterdamThe Netherlands Department of Pediatrics Spaarne GasthuisHoofddorpThe Netherlands Department of Pediatrics Emma Children’s HospitalAmsterdam University Medical CenterAmsterdamThe Netherlands Department of Rehabilitation Medicine Amsterdam Movement SciencesMeibergdreef 9AmsterdamThe Netherlands Department of Paediatric Pulmonology Department of PaediatricsTergooi MCHilversumThe Netherlands Department of Child and Adolescent Psychiatry and Psychosocial Care Amsterdam UMCAmsterdam Reproduction and DevelopmentAmsterdamThe Netherlands

Background Pediatric post coronavirus disease 2019(COVID-19)condition(PPCC)is a heterogeneous syndrome,which can significantly affect the daily lives of *** study aimed to identify clinically meaningful phenotypes in children with PPCC,to better characterize and treat this *** Participants were children with physician-diagnosed PPCC,referred to the academic hospital Amsterdam UMC in the Netherlands between November 2021 and March *** factors and information on post-COVID symptoms,comorbidities,and impact on daily life were *** clusters were identified using an unsupervised and unbiased approach for mixed data *** Analysis of 111 patients(aged 3–18 years)revealed three distinct clusters within *** 1(n=62,median age=15 years)predominantly consisted of girls(74.2%).These patients suffered relatively more from exercise intolerance,dyspnea,and smell *** 2(n=33,median age=13 years)contained patients with an even gender distribution(51.5%girls).They suffered from relatively more sleep problems,memory loss,gastrointestinal symptoms,and *** 3(n=16,median age=11 years)had a higher proportion of boys(75.0%),suffered relatively more from fever,had significantly fewer symptoms(median of 5 symptoms compared to 8 and 10 for clusters 1 and 2 respectively),and experienced a lower impact on daily *** This study identified three distinct clinical PPCC phenotypes,with variations in sex,age,symptom patterns,and impact on daily *** findings highlight the need for further research to understand the potentially diverse underlying mechanisms contributing to post-COVID symptoms in children.

关键词： Adolescents Clusters Long COVID Pediatric Phenotypes Post-COVID syndrome

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