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Objective To evaluate the therapeutic effectiveness and safety of endoscopic submucosal dissection (ESD) with improved snare for colorectal polyps and submucosal tumors.Methods The clinical data such as clinical pathological characteristics, en bloc resection rate, curative resection rate, complications and follow-up results of 20 patients with colorectal polyps or submucosal tumors, who were treated by ESD, were retrospectively analyzed.Results 20 patients (total 24 lesions) with colorectal polyps or submucosal tumors were performed ESD operation successfully, in which 16 cases (total 20 lesions) were treated by ESD with improved snare (the trial group), 4 cases were treated by ESD with HOOK knife (the control group).The surgical success rate was 100.0% (24/24), the en blot resection rate was 100.0% (24/24). The mean polyps diameter in the trial group was (2.4 ± 0.9) cm (1.2~4.0 cm), while that in the control group was (2.2 ± 0.6) cm (1.5~3.0 cm). The mean procedure time in the trial group was (83.3 ± 23.9) min (45.0~120.0 min), while the control group was (66.2 ± 15.4) min (45.0~80.0 min), compared with the control group, the trial group need more times to complete the operation. The postoperative pathology as follows: 15 cases were adenoma (including 3 cases of adenoma with partial gland high-grade intraepithelial neoplasia), 1 case was hyperplastic polyp, 1 case was high-grade intraepithelial neoplasia, 2 cases were neuroendocrine tumor (total 4 lesions) 1 case was stromal tumor. Except for 1 case of stromal tumor from the muscularis propria was taken full thickness resection, no patient appeared complications such as hemorrhage, perforation, infection. No patient need intraoperative and postoperative surgical treatment.Conclusion Improved snare can be used to endoscopic submucosal dissection for large colorectal polyps and submucosal tumors safely and effectively, expanded the use and indications of snare in endoscopic resection, but need more times to completed the operation.
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Objective To evaluate the cleanliness and tolerance of different administration speed on polyethylene glycol electrolyte solution (PEG-ES) for colonoscopy preparation. Methods 97 consecutive asymptomatic individuals underwent colonoscopy and therapy were enrolled and randomly assigned into 2 groups. Subjects in group A drank 2000 ml PEG-ES (1000 ml every 10 ~ 20 min rapidly) within 1 h before colonoscopy;Subjects in group B drank 2000 ml PEG-ES (250 ml every 10 min) within 2 h before colonoscopy. The total time of drinking PEG-ES, the first defecation time and total numbers of defecation after drinking PEG-ES, score and degree of Boston bowel preparation scale (BBPS) and PEG-ES related adverse effects of the two groups were assessed and compared. Results There were no significant differences in gender, age and cecal insertion rate between group A and group B (P > 0.05). The total time of drinking PEG-ES, the first defecation time in group A were significant faster than those in group B, while total numbers of defecation was significantly more than that in group B (P 0.05). Conclusions Both regimens met the requirement of conventional colonoscopy and therapy, while rapid drinking PEG-ES within 1 h provides more better colonic cleansing quality for colonoscopy preparation.
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To analyze the polyps in the aspects of distribution, helicobacter pylori ( HP) infection and the use of proton pump inhibitors ( PPI) in different histological types of gastric polyps;to observe the morphosis under endos-copy histopathology and the surveillance situation in colonic polyps. The infection rates of HP in gastric hyperplasic polyps, inflammatory polyps and adenomatous polyps were 31.11%, 45.31% and 58.33%;the using rate of PPI among inflammatory polyps patients was higher. The main histopathological type of colonic polyps was adenomatous polyps;20 cases of colorectal polypectomy surveillance of 2 years had recurrence. The occurrence of gastric adeno-matous polyps may be related to HP infection;PPI had no obvious correlation with the pathological type of the gas-tric polyps. Colorectal adenoma should strengthen the surveillance colonoscopy of postpolypectomy.
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Objective To explore the clinical correlation of the variation of plasma homocysteine (HCY), melatonin (MLT) and ulceative colitis (UC). Methods The clinical data of 112 UC patients was collected, and 110 normal healthy persons as control. The level of plasma HCY and MLT was detected by high pressure liquid chromatography-fluorescence detection (HPLC-FD) method. The level of plasma folate ( FA) and vitamin B12 was detected by enzyme-linked immunosorbent assay (ELISA) method. The correlation of these four indexes and UC was analyzed. Results The serum level of HCY in UC patients was significantly higher than that in normal healthy persons [(11. 27± 7.26) μmol/L vs (8. 19±4. 81) μmol/L, P = 0. 000]. The serum level of MLT in UC patients was significantly lower than that in normal healthy persons [(49. 06 + 31. 40) pg/ml vs (64. 28±41. 16) pg/ml,P=0. 008]. The serum level of FA in UC patients was significantly lower than that in normal healthy persons [(7. 64 + 1.95) nmol/L vs (9. 14 + 1.23) nmol/L, P = 0. 005]. The serum level of vitamin B12 in UC patients was significantly lower than that in normal healthy persons [(108. 64 ±32. 22) pmol/L vs (112. 64±33. 33) pmol/L, P = 0. 004]. There was no correlation between plasma HCY, MLT and UC disease activity degree, range, disease duration, erythrocyte sedimentation rate (ESR), or C reactive protein (CRP) in UC patients. There was no significant correlation between MLT and HCY in UC patients. Conclusions The serum level of HCY is higher in UC patients than that in normal control, and MLT is lower than that in normal control. However there is no significant correlation between them.