ABSTRACT
Background/Aims@#Endoscopic treatment (ET) has been applied for decades to treat subepithelial tumors, including gastrointestinal stromal tumors (GISTs). However, the efficacy of ET remains debatable. In this study, we evaluated the efficacy and safety of ET for GISTs in the upper gastrointestinal tract. @*Methods@#This retrospective single-center study included 97 patients who underwent ET. All patients were enrolled from July 2014 to July 2018. Parameters such as demographics, size, resection margin, complications, pathological features, procedure time, total cost, and follow-up were investigated and analyzed. @*Results@#Our study achieved 100% en bloc resection and 77.4% (72/93) R0 resection. The most common location was the fundus with a mean tumor size of 2.1±1.43 cm. The mean age, procedure time, hospital stay, and cost were 59.7±11.29 years, 64.7±35.23 minutes, 6.8 days, and 5,337 dollars, respectively. According to National Institutes of Health classification, 63 (64.9%), 26 (26.8%), 5 (5.2%), and 3 (3.1%) patients belonged to the very low, low, intermediate, and high risk classification, respectively. Immunohistochemistry results showed a 100% positive rate of CD34, DOG-1, CD117, and Ki67. A mean follow-up of 21.3±13.0 months showed no recurrence or metastasis. @*Conclusions@#ET is effective and safe for curative removal of GISTs in the upper gastrointestinal tract, and it can be a treatment of choice for patients with no metastasis.
ABSTRACT
The objective of study is to compare the diagnostic accuracy of helical computed tomography and ultrasonography in acute appendicitis using histopathology as gold standard. Validation study. Department of Radiology CMH/MH Rawalpindi, from 06 April 2007 to 02 January 2008. Thirty cases of clinically suspected acute appendicitis were included in the study selected on non probability convenience sampling technique. Computed tomography and graded compression ultrasonography of right lower quadrant of abdomen were conducted and results compared with histopathological findings. Amongst 30 patients who underwent computed tomography and graded compression ultrasonography examinations of right lower quadrant for diagnosis of acute appendicitis, on computed tomography 19 were diagnosed with acute appendicitis, 10 were diagnosed as not having the disease and 01 patient diagnosed as not having appendicitis on computed tomography did not improve clinically, was operated upon and histopathology proved it as acute appendicitis. While on graded compression ultrasonography 15 were diagnosed with acute appendicitis, 11 were diagnosed as not having the disease and 04 patients diagnosed as not having appendicitis on ultrasonography, did not improve clinically, were operated upon and histopathology proved it as acute appendicitis. This showed that CT scan has sensitivity of 95%, specificity 100%, positive predictive value 100%, negative predictive value 90.91% and overall accuracy of 96.67% while ultrasonography has sensitivity of 78.9%, specificity 100%, positive predictive value 100%, negative predictive value 73.33% and overall accuracy of 86.67%.We concluded that Helical computed tomography is highly accurate in diagnosing acute appendicitis as compared to ultrasonography and it helps to reduce negative appendectomy rate