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Local excision by transanal endoscopic surgery

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World Journal of Gastroenterology 2015年第31期21卷 9286-9296页

作者： Luis J García-Flórez Jorge L Otero-Díez general and Digestive surgery Service Colorectal UnitHospital San Agustín

Transanal endoscopic surgery(TES) consists of a series of anorectal surgical procedures using different devices that are introduced into the anal canal. TES has been developed significantly since it was first used in the 1980 s. The key point for the success of these techniques is how accurately patients are selected. The main indication was the resection of endoscopically unresectable adenomas. In recent years,these techniques have become more widespread which has allowed them to be applied in conservative rectal procedures for both benign diseases and selected cases of rectal cancer. For more advanced rectal cancers it should be considered palliative or,in some controlled trials,experimental. The role of newer endoscopic techniques available has not yet been defined. TES may allow for new strategies in the treatment of rectal pathology,like transanal natural orifice transluminal endoscopic surgery or total mesorectal excision.

关键词： Transanal endoscopic surgery Rectal adenoma Early

Re-evaluation of indications and outcomes of endoscopic excision procedures for colorectal tumors:a review

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Gastroenterology Report 2014年第1期2卷 27-36页

作者： Shilun Cai Yunshi Zhong Pinghong Zhou Jianmin Xu Liqing Yao endoscopic Center Zhongshan Hospital of Fudan UniversityShanghaiChina Department of general surgery Zhongshan Hospital of Fudan UniversityShanghaiChina

endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)are useful therapeutic techniques for colorectal ***,new techniques based on these procedures are available,such as endoscopic submucosal dissection with snare(ESD-S)and endoscopic mucosal resection with pre-cutting(EMR-P).For the excision of colorectal tumors,each of these techniques has been characterized as having a high total resection rate,low recurrence rate or low complication *** this study,we analysed clinical trials that had recently been published,to search for the most appropriate endoscopic treatment for colorectal *** search results revealed the following:for a tumor with a diameter less than 20mm,the surgeon should choose ESD,ESD-S,EMR-P or EMR,depending on the condition of the *** the other hand,to excise a tumor larger than 20mm in diameter,ESD and ESD-S should be the first ***,if the patient has a high risk of complications due to ESD or ESD-S,the use of EMR-P would be *** of the high possibility of canceration in a tumor larger than 20mm in diameter,EMR is not the optimal endoscopic treatment for the excision of a colorectal tumor,due to a low total resection rate and a high recurrence rate.

关键词： Colorectal cancer endoscopic excision endoscopic mucosal resection endoscopic submucosal diss

endoscopic techniques for the diagnosis of pancreatic cystic lesions

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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

Effects of endoscopic sphincterotomy on biliary epithelium:A case-control study

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World Journal of Gastroenterology 2012年第8期18卷 794-799页

作者： John Kalaitzis Antonios Vezakis George Fragulidis Irene Anagnostopoulou Spyros Rizos Efstathios Papalambros Andreas Polydorou First Department of surgery Tzaneio General Hospital of Piraeus Second Department of surgery and endoscopic unit National and Kapodistrian University of Athens Medical School Aretaieion Hospital Department of Cytology Tzaneio General Hospital of Piraeus First Department of surgery National and Kapodistrian University of Athens Medical School Laiko General Hospital

AIM: To study the long-term effects of endoscopic sphincterotomy on biliary epithelium. METHODS: This is a prospective case-control study. A total of 25 patients with a median age of 71 years (range 49-89 years) and prior endoscopic sphincterotomy (ES) for benign disease formed the fi rst group. The median time from ES was 42 mo (range 8-144 mo). Another 25 patients with a median age of 76 years (range 44-94 mo) and similar characteristics who underwent current endoscopic retrograde cholangio-pancreatography (ERCP) and ES for benign disease formed the second group (control group). Brush cytology of the biliary tree with p53 immunocytology was performed in all patients of both groups. ERCPs and recruitment were conducted at the endoscopic unit of Aretaieion University Hospital and Tzaneio Hospital, Athens, from October 2006 to June 2010. RESULTS: No cases were positive or suspicious for malignancy. Epithelial atypia was higher in the first group (32% vs 8% in the second group, P = 0.034). Acute cholangitis and previous biliary operation rates were also higher in the fi rst group (acute cholangitis, 60% vs 24% in the second group, P = 0.01; previous biliary operation, 76% vs 24% in the second group, P = 0.001). Subgroup analysis showed that previous ES was the main causal factor for atypia, which was not related to the time interval from the ES (P = 0.407). Two patients (8%) with atypia in the fi rst group were p53-positive. CONCLUSION: ES causes biliary epithelial atypia that represents mostly reactive/proliferative rather than premalignant changes. The role of p53 immunoreactivity in biliary atypia needs to be further studied.

关键词： endoscopic sphincterotomy Brush cytolo-gy Atypia Cholangiocarcinoma p53 immunocytology

Anhedonia and functional dyspepsia in obese patients:Relationship with binge eating behaviour

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World Journal of Gastroenterology 2020年第20期26卷 2632-2644页

作者： Antonella Santonicola Mario Gagliardi Giovanni Asparago Luna Carpinelli Luigi Angrisani Paola Iovino Gastroenterology unit Department of MedicineSurgery and Dentistry"Scuola Medica Salernitana"University of SalernoBaronissi 84081SalernoItaly general and endoscopic surgery unit San Giovanni Bosco HospitalNaples 80100Italy

BACKGROUND Obese patients(Ob)with a binge eating disorders(BED)behavior pattern have a higher prevalence of postprandial distress syndrome(PDS)compared to Ob without a BED behavior pattern,while an increase of PDS has been described in Ob after sleeve gastrectomy(SG).Hedonic response to a meal is dissociable from satiation in healthy *** is the lowered ability to experience *** are no studies investigating the presence of anhedonia in Ob with and without SG and its relationship to PDS *** To assess the relationship among anhedonia,BED and upper gastrointestinal symptoms in two group of morbidly Ob with and without *** Eighty-one Ob without SG,45 Ob with SG and 55 healthy controls(HC)were *** subjects fulfilled the binge eating scale(BES)to investigate BED,the validated 14 items Snaith-Hamilton pleasure scale(SHAPS)to assess Anhedonia as well as the Beck Depression Inventory-II(BDI II)and State Trait Anxiety Inventory(STAI)questionnaires to screen for depression and *** patients underwent a standardized questionnaire investigating the intensity-frequency scores(0-6)of upper gastrointestinal symptoms and were diagnosed for the presence of functional dyspepsia(FD)and its subtypes according to ROME IV *** Ob without SG who were positive for BED had a 4.7 higher risk of FD compared to Ob without SG who were negative for BED(OR:4.7;95.0%CI 1.23-18.24;P=0.02).STAI-Y2 scores were significantly higher in Ob without SG positive for BED(42.2±1.5 vs Ob negative for BED:39.6±1.0,P=0.04),while SHAPS scores and BDI II did not differ in the two groups(1.16±1.30 vs 0.89±1.02,P=0.49).A lower prevalence of BED(BES>17:11.4%vs 40.7%,P=0.001)and BDI-II(6.8±1.2 vs 13.8±1.9,P=0.005)was reported in Ob with SG than Ob without SG,on the contrary total mean scores of STAI-Y1 and STAI-Y2 were significantly higher in Ob with SG than Ob without ***-five percent of Ob with SG fulfilled the diagnosis of *** mean score

关键词： Morbid obesity Functional dyspepsia Postprandial distress syndrome Epigastric pain syndrome Anhedonia Binge eating disorders Sleeve gastrectomy

Combined laparoscopic and endoscopic treatment for bile duct diseases

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Hepatobiliary & Pancreatic Diseases International 2004年第2期3卷 284-287页

作者： Ming-Fang Qin and Hong-Bing Xu Tianjin, China Department of endoscopic surgery, Nankai Hospital, Tianjin 300100. China and Department of Hepatobiliary Surge- ry, PLA 309 Hospital, Beijing 100091 , China Department of endoscopic surgery Nankai Hospital Tianjin 300100 China. qins@***

BACKGROUND: Clinical application of laparoscopy, duo- denoscopy and choledochoscopy has been accepted as a mini-invasive surgical therapy for bile duct diseases; but ei- ther endoscopic or laparoscopic therapy alone is disadvanta- geous in its narrow indications and in failure to give full play to the individual superiority. The present study was to evaluate the procedures and therapeutic results of combined laparoscopic and endoscopic treatment for bile duct disea- ses. METHODS: Clinical data of 1990 patients with bile duct diseases treated by combination of laparoscopy, duodenos- copy and choledochoscopy in two hospitals were reviewed and analyzed. RESULTS: Patients with cholecystolithiasis and choledo- cholithiasis were treated with combined laparoscopy and duodenoscopy (n =1350) in a single operation with a cure rate of 93.6%. Those with choledocholithiasis (n =332) were treated with combined laparoscopy and choledocho- scopy with a cure rate of 100%. Combined laparoscopy, duo- denoscopy and choledochoscopy was used in 258 patients with choledocholithiasis (29 of them complicated with pan- creatitis) and 24 patients with Mirizzi's syndrome, with a cure rate of 100%. Laparoscopic choledochoenterostomy and preoperative endoscopic nasobiliary drainage were done in 26 patients with a cure rate of 100%. There were no serious operative complications. A follow-up study of 1051 patients for 3 months to 12 years (mean 7.8 years) showed that 10 patients had recurrence of stones but no stenosis of the bile duct. CONCLUSION: Combined laparoscopic and endoscopic procedures are mini-invasive and cause less pain and mini- mal operative complications.

关键词： laparoscopy duodenoscopy choledochoscopy bile duct disease

Self-expandable metallic stent placement plus laparoscopy for acute malignant colorectal obstruction

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World Journal of Gastroenterology 2013年第33期19卷 5513-5519页

作者： Jia-Min Zhou Li-Qing Yao Jian-Min Xu Mei-Dong Xu Ping-Hong Zhou Wei-Feng Chen Qiang Shi Zhong Ren Tao Chen Yun-Shi Zhong Department of endoscopic Center Zhongshan HospitalFudan University Department of general surgery Zhongshan HospitalFudan University

AIM:To investigate the clinical advantages of the stent-laparoscopy approach to treat colorectal cancer(CRC)patients with acute colorectal obstruction(ACO).METHODS:From April 2008 to April 2012,surgeryrelated parameters,complications,overall survival(OS),and disease-free survival(DFS)of 74 consecutive patients with left-sided CRC presented with ACO who underwent self-expandable metallic stent(SEMS)placement followed by one-stage open(n=58)or laparoscopic resection(n=16)were evaluated *** stent-laparoscopy group was also compared with a control group of 96 CRC patients who underwent regular laparoscopy without ACO between January 2010 and December 2011 to explore whether SEMS placement influenced the laparoscopic procedure or reduced long-term survival by influencing CRC oncological ***:The characteristics of patients among these groups were *** rate of conversion to open surgery was 12.5%in the stent-laparoscopy *** function recovery and postoperative hospital stay were significantly shorter(3.3±0.9 d vs 4.2±1.5 d and 6.7±1.1 d vs 9.5±6.7 d,P=0.016 and P=0.005),and surgical time was significantly longer(152.1±44.4 min vs 127.4±38.4 min,P=0.045)in the stent-laparoscopy group than in the stent-open ***-related complications and the rate of admission to the intensive care unit were lower in the stent-laparoscopy *** were no significant differences in the interval between stenting and surgery,intraoperative blood loss,OS,and DFS between the two stent *** with those in the stentlaparoscopy group,all surgery-related parameters,complications,OS,and DFS in the control group were ***:The stent-laparoscopy approach is a feasible,rapid,and minimally invasive option for patients with ACO caused by left-sided CRC and can achieve a favorable long-term prognosis.

关键词： Self-expandable metallic stent Colorectal cancer Endoscopy Laparoscopy Efficiency Safety

Electrohydraulic lithotripsy and rendezvous nasal endoscopic cholangiography for common bile duct stone: A case report

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World Journal of Clinical Cases 2019年第10期7卷 1149-1154页

作者： Koichi Kimura Kensuke Kudo Tomoharu Yoshizumi Takeshi Kurihara Shohei Yoshiya Yohei Mano Kazuki Takeishi Shinji Itoh Noboru Harada Toru Ikegami Tetsuo Ikeda Department of Endoscopy and endoscopic surgery Fukuoka Dental CollegeFukuoka 814-0175Japan Department of surgery and Science Graduate School of Medical SciencesKyushu UniversityFukuoka 812-8582Japan

BACKGROUND In patients with large stones in the common bile duct(CBD),advanced treatment modalities are generally ***,we present an interesting case of a huge CBD stone treated with electrohydraulic lithotripsy(EHL)by the percutaneous approach and rendezvous endoscopic retrograde cholangiography(ERC)using a nasal *** SUMMARY A 91-year-old woman underwent ERC for a symptomatic large CBD stone with a diameter of 50 *** was referred to our institution after the failure of lithotomy by ERC,and after undergoing percutaneous transhepatic biliary *** attempted to fragment the stone by transhepatic cholangioscopy using ***,the stones were too large and partly soft clay-like for ***,we attempted lithotomy with ERC and cholangioscopy by the rendezvous technique using a nasal endoscope and achieved complete *** complication was observed at the end of this *** Cholangioscopy by rendezvous technique using a nasal endoscope is a feasible and safe endoscopic method for removing huge CBD stones.

关键词： Common bile duct stone Electrohydraulic lithotripsy Rendezvous technique endoscopic retrograde cholangiography Nasal endoscop Case report

Interplay between creeping fat and gut microbiota: A brand-new perspective on fecal microbiota transplantation in Crohn's disease

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World Journal of Gastroenterology 2025年第2期31卷 138-143页

作者： Ying Wang Jie Liu Department of Life Sciences and Medicine South District of Endoscopic CenterThe First Affiliated Hospital of University of Science and Technology of ChinaUniversity of Science and Technology of ChinaHefei 230001Anhui ProvinceChina Department of Gastroenterology The First Affiliated Hospital of University of Science and Technology of ChinaHefei 230001Anhui ProvinceChina

Inflammatory bowel disease,particularly Crohn's disease(CD),has been linked to modifications in mesenteric adipose tissue(MAT)and the phenomenon known as"creeping fat"(CrF).The presence of CrF is believed to serve as a predictor for early clinical recurrence following surgical intervention in patients with ***,the incorporation of the mesentery during ileocolic resection for CD has been correlated with a decrease in surgical recurrence,indicating the significant role of MAT in the pathogenesis of *** numerous studies have indicated that dysbiosis of the gut microbiota is a critical factor in the development of CD,the functional implications of translocated microbiota within the MAT of CD patients remain *** manuscript commentary discusses a recent basic research conducted by Wu et *** their study,intestinal bacteria from individuals were transplanted into CD model mice,revealing that fecal microbiota trans-plantation(FMT)from healthy donors alleviated CD symptoms,whereas FMT from CD patients exacerbated these ***,FMT was found to affect intestinal permeability,barrier function,and the levels of proinflammatory factors and ***,these findings suggest that targeting MAT and CrF may hold therapeutic potential for patients with ***,the study did not evaluate the composition of the intestinal microbiota of the donors or the subsequent alterations in the gut ***,the gut microbiota plays a crucial role in the histopathology of CD,and thus,targeting MAT and CrF may represent a promising avenue for treatment in this patient population.

关键词： Crohn's disease Mesenteric adipose tissue Creeping fat Fecal microbiota transplantation Gut microbiota