ABSTRACT
To conduct a meta-analysis of observational studies to explore the relationships between cholecystectomy and the risk of esophageal and gastric cancer [GC]. The study design was retrospective, and carried out in the First People's Hospital of Nantong, Jiangsu, China from January 2012 to April 2012. Studies were identified by a literature search of MEDLINE and EMBASE through March 31, 2012, and by manually searching the reference lists of pertinent articles. The summary relative risks [SRRs] with their 95% confidence intervals [CIs] were calculated with a random-effects model. A total of 12 estimates from 6 independent studies [including 1,622 esophageal cancer [EC] cases and 2,314 GC cases] were included in this meta-analysis. We found that cholecystectomy was not associated with risk of EC and GC [EC: SRRs - 1.03; 95% CI: 0.94-1.13; heterogeneity: p=0.496; I2=0; n=4 studies; [GC: SRRs - 1.03; 95% CI: 0.93-1.13; heterogeneity: p=0.652; I2=0; n=5 studies]]. Sub-grouped analyses revealed that these null associations were independent of geographic location and study design. Based on 2 studies, we found patients undergoing cholecystectomy at least 10 years before had an elevated risk of esophageal adenocarcinoma [EAC]. The results of this meta-analysis suggest that cholecystectomy does not increase the risk of esophageal squamous cell carcinoma and GC development, but may increase EAC risk. More epidemiological research of a prospective design is needed to further clarify these associations in the future
ABSTRACT
Objective To evaluate the value of miniprobe sonography (MPS) in diagnosing gastrointestinal submucosal protrusive lesions and selecting the indicated manual for treatment. Methods According to the sizes, properties, and depth of SMTs in the gastrointestinal tract detected by the MPS, different methods of resection were performed. Results Of 24 cases, 11 SMTs lying in submucosa under 2cm in diameter (2 benign gastrointestinal stromal tumors, 3 lipomas, 5 cysts, 1 granular cell tumor) were attempted with EMR or argon plasma coagulation (APC) ; there were no complications of hemorrhage or perforation. Thirteen SMTs lying in muscularis propria or with size of SMTs above 2 cm in diameter (4 malignant GISTs, 6 benign GISTs, 1 lipoma, 2 aberrant pancreas) were performed by surgical resection. Preoperative diagnoses of SMTs by MPS were consentient with their histological diagnoses. Conclusion MPS may detect the size, property, and depth of SMTs in the gastrointestinal tract and is helpful in selecting indicated cases for endoscopic resection. Endoscopic therapy of SMTs lying in mucosa or submucosa under 2cm in diameter is a safe and effective procedure.