ABSTRACT
Objective To evaluate the efficacy and safety of 1 940 nm thulium laser on peroral endoscopic myotomy (POEM) for treatment of patients with achalasia of cardia. Methods Fifteen patients undergoing POEM in Beijing Friendship Hospital from February 2016 to November 2016 were enrolled and divided into 1 940 nm thulium laser group ( n＝7) and high frequency electric knife group ( n＝8) using zelen′s design, with followed-up for three months. The operation time, success rate, efficacy, and complications were compared between the two groups. Results All the procedures were successfully completed. There was no significant difference on baseline between the two groups ( P＞0. 05). The time of total operation, creating submucosal tunnel, myotomy, and closing incision were not significantly different between the two groups (all P＞0. 05). The bleeding amount, creating tunnel bleeding amount, and myotomy bleeding amount were not significantly different between the two groups (all P＞0. 05). The complication rate during operation and one week after operation was not significantly different between the two groups ( P＝0. 76).The time of creating mucosal incision for the 1 940 nm thulium laser group was longer than that of the high frequency electric knife group ( 3. 7 ± 3. 0 min VS 2. 3 ± 1. 3 min, P＝ 0. 02). After one month of follow-up, the efficiency of the 1 940 nm thulium laser group and the high frequency electric knife group was 100. 0%(7/7) and 87. 5%(7/8), respectively (P＝0. 33), and the complication rate was 14. 3%(1/7) and 12. 5%(1/8), respectively (P＝0. 92). After three months of follow-up, the efficiency of the two groups was 100. 0%(7/7) and 75. 0%( 6/8), respectively ( P＝0. 16), and the complication rate was 28. 6%(2/7) and 12. 5%(1/8), respectively (P＝0. 60). Conclusion 1 940 nm thulium laser and high frequency electric knife both have good utility on POEM.1 940 nm thulium laser decreases the operating time and bleeding compared with high frequency electric knife.
ABSTRACT
Objective To investigate the safety and effectiveness of Glifeet in bowel preparation before colonoscopy.Methods A prospective,single blind,randomized controlled trial of patients undergoing colonos-copy was conducted.A total of 67 inpatients were randomized to the control group,who received a low-residue and semiliquid diet (n =31)and the experimental group,who received Glifeet all day (n =36)before the proce-dure.All patients took polyethylene glycol electrolyte powder 1 000 ml at 7 pm on the day before colonoscopy and 2 000 ml at 8 am on the examination day.Bowel preparation quality was scored using the Boston Bowel Prepara-tion Scale (BBPS).Side effects were also observed.Results The time of the first bowel movement of the experi-mental group was significantly shorter [(77.43 ±54.21)min VS (149.35 ±118.15)min,P =0.002].An in-creased defecating frequency was observed in the experimental group,but there was no significant difference when compared with the control group (11.44 ±6.95 VS 8.74 ±3.58,P =0.055).Patient tolerance and acceptance did not differ.There was no significant difference in BBPS between the two groups.But the bowel preparation quality of the right colon was significantly better in the experimental group (2.56 ±0.50 VS 2.23 ±0.81,P =0.045). Conclusion Glifeet could meet the needs of basic energy in most patients for colonoscopy.Furthermore,Glifeet is well tolerated and can partially improve the quality of bowel preparation.