ABSTRACT
BACKGROUND/AIMS: Food bolus impaction is the most common form of esophageal foreign body impaction observed in adults. Clinical guidelines recommend using the push technique or retrieval methods in such cases. The push technique can cause injuries in certain clinical situations. Notably, conventional retrieval methods are time and effort consuming. Cap-assisted endoscopic extraction of an impacted food bolus is an easy and effective technique; however, more data are needed for its validation. This study compared the capassisted extraction technique with conventional methods. METHODS: This prospective observational multicenter study compared the success and en bloc removal rates, total procedure time, and adverse events in both techniques.. RESULTS: The study included 303 patients who underwent food bolus extraction. The push technique was used in 87 patients (28.7%) and a retrieval procedure in 216 patients (71.3%). Cap-assisted extraction was performed in 106 patients and retrieval using conventional methods in 110 patients. The cap-assisted technique was associated with a higher rate of en bloc removal (80.2% vs. 15%, p<0.01), shorter procedure time (6.9±3.5 min vs. 15.7±4.1 min, p<0.001), and fewer adverse events (0/106 vs. 9/110, p<0.001). CONCLUSIONS: Cap-assisted extraction showed no adverse events, higher efficacy, and a shorter procedure time compared with conventional retrieval procedures.
Subject(s)
Adult , Humans , Foreign Bodies , Methods , Prospective StudiesABSTRACT
Hepatocellular carcinoma [HCC] is the fifth most common malignancy in the world. Although tumour markers such as alpha-foetoprotein [AFP] are widely used and important for HCC detection in clinical scenes, they still do not provide a satisfactory solution to detect HCC at the early stage. The aim of our study was to illustrate the significance of serum human telomerase reverse transcriptase messenger RNA [hTERT mRNA] as a novel biomarker for early detection of HCC. Patients and Thirty-five patients with HCC, 15 patients with liver cirrhosis, and 10 healthy subjects were sex and age matched. History taking, full physical examination, and laboratory investigations including liver function tests, hepatitis markers, AFP, and quantification of serum human telomerase reverse transcriptase mRNA [hTERT mRNA] using real-time reverse transcription polymerase chain reaction [RT-PCR] were conducted. Ultrasonography [US], triphasic computed tomography [CT], and liver biopsy were carried out. The hTERT was above the cutoff point [>144 copies/ml] in 27 HCC patients with a sensitivity of 77.14% and a specificity of 100% and with a positive predictive value [PPV] of 100% and a negative predictive value [NPV] of 65.2%. AFP was above the cutoff point [>50 ng/ml] in 23 HCC patients with a sensitivity of 65.71% and a specificity of 96% and with a PPV of 96.3% and an NPV of 53.8%. Our study also showed a statistically significant relationship between the size of the tumour in HCC patients and both AFP and hTERT, and hTERT appears to be more correlated with the size of the tumour than AFP. There is no direct correlation between hTERT or AFP and the number of focal lesions with p value >0.05. Serum hTERT mRNA is more sensitive and specific than AFP in the early detection of HCC and its level correlates with the size of the tumour