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1.
Chinese Journal of Digestion ; (12): 680-685, 2020.
Article in Chinese | WPRIM | ID: wpr-871498

ABSTRACT

Objective:To evaluate the accuracy of white light conventional endoscopy (CE), endoscopic ultrasonography (EUS) and narrow-band imaging with magnifying endoscopy (ME-NBI) in evaluating the invasion depth of early gastric cardiac cancer, and to explore the diagnostic strategy of preoperative evaluation of invasive depth of early gastric cardiac cancer.Methods:From January 2016 to June 2019, the endoscopic images of 135 patients with early gastric cardiac cancer confirmed by pathology in Fujian Provincial Hospital were retrospectively analyzed. Intramucosal carcinoma (M) and superficial submucosal invasive carcinoma (SM1) were classified as M-SM1 cancer and compared with deep submucosal invasive cancer. The pathological diagnosis after operation was used as gold standard. The accuracy of CE, EUS, ME-NBI and the combination of them in determining the invasion depth of early gastric cardiac cancer was evaluated. Kappa test was performed for consistency test. Kappa value < 0.2 was considered as poor consistency, 0.2 to 0.4 as general consistency, more than 0.4 to 0.6 as medium consistency, more than 0.6 to 0.8 as high consistency, and 0.8 to 1.0 as close to full consistency. Results:The data of 73 patients with early gastric cardiac cancer were enrolled in this study. According to the pathological results after operation, 47 cases were M-SM1 cancer and 26 cases were deep submucosal invasive cancer. The diagnostic accuracy of CE, EUS, ME-NBI and the combination of them before operation were 79.5% (58/73), 72.6% (53/73), 65.7% (48/73) and 87.7% (64/73), respectively. The results of consistency test indicated that the consistency of CE diagnosis and pathological results after operation was medium ( Kappa=0.540, P<0.01), that of EUS and pathological results after operation was general ( Kappa=0.346, P=0.002), that of ME-NBI and pathological results after operation was poor ( Kappa=0.175, P=0.108), while that of the combination of them and pathological results after operation was high ( Kappa=0.724, P<0.01). Conclusions:Compared with single examination method, the combination of CE, EUS and ME-NBI is more accurate in evaluating the invasive depth of early gastric cardiac cancer.

2.
Article in Chinese | WPRIM | ID: wpr-871424

ABSTRACT

Objective:To evaluate the efficacy and safety of budesonide viscous suspension (BVS) in preventing extensive esophageal stenosis after endoscopic submucosal dissection(ESD).Methods:Data of 62 cases of early esophageal neoplasms or precancerous lesions receiving ESD whose postoperative mucosal defects were more than half the circumference of the esophageal lumen at Fujian Provincial Hospital from October 2014 to December 2018 were retrospectively studied. The patients were divided into the BVS group who received BVS therapy (n=24) and the control group who received no intervention (n=38). The incidence of postoperative stenosis, the number of bougie dilation procedures and complications were compared between the two groups. Risk factors for postoperative stricture were analyzed by logistic regression.Results:The incidence of postoperative stenosis [16.7% (4/24) VS 47.3% (18/38), P=0.005], the number of bougie dilation procedures (1.50±0.58 VS 2.70±1.09, P=0.039) in the BVS group were significantly lower than those in the control group. No serious adverse events such as perforation or massive hemorrhage related to BVS were observed in the BVS group. Multivariate logistic regression analysis showed circumferential extension ≥3/4 ( OR=37.970, 95% CI: 6.338-227.482) and non-intervention with BVS( OR=20.962, 95% CI: 3.374-130.243) were the independent risk factors for esophageal stricture after ESD. Conclusion:Administration of BVS is an effective and safe method to reduce the incidence of stenosis and the number of bougie dilation procedures for extensive esophageal stenosis after ESD.

3.
Article in Chinese | WPRIM | ID: wpr-871388

ABSTRACT

Objective:To preliminarily study the effect of Q self-traction endoscopic submucosal dissection (Q-ESD) on treatment of large early esophageal cancer (EEC).Methods:A retrospective analysis was performed on the data of 82 cases of large EEC (single lesion>1/2 cross-section diameter or longitudinal diameter length >5 cm) who underwent ESD on Fujian Provincial Hospital between January 2015 and December 2018. According to the treatment schedule, patients were divided into the conventional ESD group (n=44) and the Q-ESD group (n=38). The procedural area, time, and speed, en bloc resection rate, complete resection rate and complications of the two groups were analyzed.Results:All of the 82 lesions were resected completely under endoscope. There was no statistical difference in the procedural area [779.8 (329.9-2 552.5)mm 2 VS 875.7 (417.8-1 914.8)mm 2, U=155, P=0.636], procedural time [63 (41-177)min VS 59 (42-169)min, U=171, P=0.167] and complete resection rate [94.7% (36/38) VS 93.2% (41/44), χ2=0.086, P=0.769] between the Q-ESD group and the conventional ESD group. Compared with the conventional ESD group, the Q-ESD group had a faster dissection speed [14.9 (5.4-20.8) mm 2/min VS 9.0 (5.0-19.5) mm 2/min, U=142, P=0.035], lower muscularis propria injury rate [7.9% (3/38) VS 27.3% (12/44), χ2=5.123, P=0.023], and a lower stricture rate [5.3% (2/38) VS 20.5% (9/44), χ2=4.051, P=0.044]. No other adverse events occurred except for one case of perforation in the conventional ESD group. Conclusion:The new traction technique of Q-ESD is a safe and effective treatment for large EEC.

4.
Article in Chinese | WPRIM | ID: wpr-824833

ABSTRACT

Objective To analysis the risk factors of postoperative bleeding of endoscopic submucosal dissection (ESD) for early gastrointestinal cancer. Methods A retrospective study was performed on the data of 430 patients ( 449 lesions ) with early gastrointestinal cancer undergoing ESD in Fujian Provincial Hospital Digestive Endoscopic Center from June 2008 to February 2015 and in Fujian Provincial Hospital South Branch Digestive Endoscopic Center from May 2015 to April 2018. Patients with postoperative bleeding were compared with those without postoperative bleeding on the basis of general conditions, endoscopic performance, postoperative pathology and so on to analysis the risk factors for postoperative bleeding of ESD. Results Among the 430 cases (449 lesions)of early gastrointestinal cancer undergoing ESD, 16 cases ( 3. 7%) had postoperative bleeding. According to whether the occurrence of postoperative hemorrhage, patients were divided into bleeding group ( n = 16 ) and not bleeding group ( n=433) . Univariate analysis suggested that whether had hypertension was statistically significant between the two groups (χ2=4. 793, P=0. 029) , while patients age ( t=0. 465, P=0. 642) , gender (χ2=0. 035, P=0. 642), whether to have diabetes (χ2=0. 647, P=0. 421),whether to have coronary heart disease (P=1. 000), lesion size (t=1. 598, P=0. 111),whether two or more lesions (P=1. 000), lesion site (χ2=6. 183, P= 0. 289 ) , operation time ( t= 1. 335, P= 0. 201 ) , pathological grading (χ2 = 0. 687, P=0. 709),and lesion infiltration depth (χ2=0. 134, P=0. 714) were not statistically significant between the two groups. Logistic regression analysis showed that hypertension ( OR=3. 358, 95%CI:1. 227-9. 186, P=0. 018) was an independent risk factor of bleeding after ESD for early gastrointestinal cancer. Conclusion Hypertension is closely related to postoperative bleeding following ESD for early gastrointestinal cancer. Patients with hypertension are at a greater risk of bleeding after ESD.

5.
Article in Chinese | WPRIM | ID: wpr-756279

ABSTRACT

Objective To evaluate the clinical efficacy and safety of different stitching methods,over-the-scope-clip (OTSC) and metal clips combined with nylon rope (King closure),for full-layer gastric wall defect.Methods Data of 75 cases,who underwent endoscopic full-thickness resection (EFTR) of gastric SMTs from May 2015 to May 2018 in our endoscopy center were retrospectively analyzed.According to the closure method,the patients were divided into the OTSC group (20 cases) and the King closure group (55 cases).Comparison was made in gender,age,the largest diameter of tumor,the location of tumor,defect surface diameter,total operating time,defect closure time,closure success rate,the length of hospital stays,cost and postoperative complications between the two groups,Results The baseline data were comparable,and there were no significant differences in age,gender,tumor location,tumor diameter,and defect surface diameter between the two groups(all P>0.05).The success rate of closure was 100% in both groups.In terms of length of hospital stay,there was no significant difference between the two groups (t =1.13,P=0.268).The total operating time was 63.24±43.22 min in the King closure group versus 47.60± 18.13 min in the OTSC group (t =2.20,P =0.030).The closure time of the defect surface was 20.85 ± 16.35 min in the King closure group versus 10.95±5.20 min in the OTSC group (t =2.65,P=O.010).Hospitalization costs were 24 200±800 yuan in the King closure group versus 36 200±2 350 yuan in the OTSC group (t=6.21,P<0.001).Postoperative abdominal elevation radiographs in both groups indicated a small amount of subphrenic free gas,and no intervention was given due to the small amount of gas and no obvious symptoms.No late bleeding,recurrent perforation,infection or other complications occurred after operation,and all patients were discharged successfully.Six months after surgery,15 patients (27%) in the King closure group developed metal clips or nylon rope residue,which were successfully removed by endoscopy.The anastomosis clamp of nighteen patients (95%) in the OTSC group were in the original position.None of the patient received open surgery.Conclusion OTSC and King closure are both safe and effective in the treatment of full-thickness defect of gastric wall.OTSC has the advantages of short total operation time and short closure time,but with high cost.

6.
Article in Chinese | WPRIM | ID: wpr-800293

ABSTRACT

Objective@#To analysis the risk factors of postoperative bleeding of endoscopic submucosal dissection (ESD) for early gastrointestinal cancer.@*Methods@#A retrospective study was performed on the data of 430 patients (449 lesions) with early gastrointestinal cancer undergoing ESD in Fujian Provincial Hospital Digestive Endoscopic Center from June 2008 to February 2015 and in Fujian Provincial Hospital South Branch Digestive Endoscopic Center from May 2015 to April 2018. Patients with postoperative bleeding were compared with those without postoperative bleeding on the basis of general conditions, endoscopic performance, postoperative pathology and so on to analysis the risk factors for postoperative bleeding of ESD.@*Results@#Among the 430 cases (449 lesions)of early gastrointestinal cancer undergoing ESD, 16 cases (3.7%) had postoperative bleeding. According to whether the occurrence of postoperative hemorrhage, patients were divided into bleeding group (n=16) and not bleeding group (n=433). Univariate analysis suggested that whether had hypertension was statistically significant between the two groups (χ2=4.793, P=0.029), while patients age (t=0.465, P=0.642), gender (χ2=0.035, P=0.642), whether to have diabetes (χ2=0.647, P=0.421), whether to have coronary heart disease (P=1.000), lesion size (t=1.598, P=0.111), whether two or more lesions (P=1.000), lesion site (χ2=6.183, P=0.289), operation time (t=1.335, P=0.201), pathological grading (χ2=0.687, P=0.709), and lesion infiltration depth (χ2=0.134, P=0.714) were not statistically significant between the two groups. Logistic regression analysis showed that hypertension (OR=3.358, 95%CI: 1.227-9.186, P=0.018) was an independent risk factor of bleeding after ESD for early gastrointestinal cancer.@*Conclusion@#Hypertension is closely related to postoperative bleeding following ESD for early gastrointestinal cancer.Patients with hypertension are at a greater risk of bleeding after ESD.

7.
Article in Chinese | WPRIM | ID: wpr-734983

ABSTRACT

Objective To explore the diagnostic value of pink sign of iodine staining for early esophageal carcinoma. Methods Data of 312 lesions of 306 patients with suspected early esophageal carcinoma who received iodine staining from November 2015 to October 2017 were analyzed retrospectively. Lesions were divided into positive pink sign group and negative pink sign group according to the result of iodine staining. The relationship between pink sign and pathology were analyzed. Lesions recorded onset time of pink sign were divided into 4 groups by the onset time of pink sign, 0-30 s,>30-60 s,>60-90 s and>90-120 s, the diagnostic value of which was assessed with the receiver operating characteristic ( ROC) curve. Results Among the 312 lesions, 208 were identified positive pink sign, including 28 of inflammation or low-grade intraepithelial neoplasia ( LGIN ) , 180 of high-grade intraepithelial neoplasia ( HGIN ) or carcinoma, and 104 lesions were identified negative pink sign, including 69 of inflammation or LGIN, 35 of HGIN or carcinoma. The sensitivity, specificity and accuracy of positive pink sign in the diagnosis of HGIN and early esophageal carcinoma was 83. 7%, 71. 1% and 79. 8%, respectively. Multivariate analysis showed a significant association between the onset time of pink sign and histopathology ( P=0. 000, OR=0. 016, 95%CI=0. 042-0. 324) . The onset time of pink sign was recorded in 89 lesions in the positive group. The area under ROC curve of the onset time of pink sign was 0. 899, and the optimal cut-off value was 60 s, which indicated the good validity of the test with the sensitivity, specificity and accuracy of 92. 8%, 84. 2%and 91. 0%, respectively. Conclusion The pink sign of iodine staining for diagnosis of early esophageal carcinoma shows a high consistance rate, especially that appears within 60 s.

8.
Article in Chinese | WPRIM | ID: wpr-734981

ABSTRACT

Objective To study the influencing factors for outcomes of gastric low-grade intraepithelial neoplasia ( LGIN) for better LGIN treatment regimen. Methods Using magnifying endoscopy combined with narrow-band imaging ( ME-NBI ) follow-up strategy, the endoscopic features of 47 cases of LGIN in Fujian Provincial Hospital, including location, size, surface situation, demarcation line, microvascular pattern and microsurface pattern, were prospectively observed, then the factors influencing the outcome were analyzed. Results Among the 47 cases of LGIN, there were 35 cases in stable condition, whose results of biopsy and ME-NBI had no changes (stable LGIN), and the mean follow-up time was 20. 7±6. 9 months. The remaining 12 patients had progressive dysplasia (progressive LGIN), including 4 cases of high-grade intraepithelial neoplasia, and 8 cases of moderate dysplasia. The mean follow-up time was 16. 3 ± 11. 8 months. There were no significant differences between the two groups in gender (P=0. 33), mean age (P=0. 13), lesion distribution (P=0. 70), and lesion morphology (P=0. 97). The lesion size was less than 20 mm in the stable group ( 71. 4%, 25/35) , and over 20 mm in the progressive group ( 66. 7%, 8/12) , and the difference was statistically significant ( P=0. 02) . The proportion of the lesion surface heterogeneity in the progressive group was significantly higher than that in the stable group[75. 0% (9/12) VS 34. 3% (12/35),P= 0. 01 ] . The proportion of positive manifestations under ME-NBI in the progressive group was also significantly higher than that in the stable group [ 83. 3% ( 10/12 ) VS 8. 6% ( 3/35 ) , P = 0. 00 ] . Conclusion The size of lesions over 20 mm, the uneven surface and positive ME-NBI are the important factors influencing the outcome of LGIN, which are of significance for the diagnosis and treatment of LGIN.

9.
China Journal of Endoscopy ; (12): 49-52, 2017.
Article in Chinese | WPRIM | ID: wpr-609846

ABSTRACT

Objective To evaluate the efficacy of combined application of lactitol oral solution and polyethylene glycol electrolyte (PEG) powder compared with conventional method in bowel preparation before colonoscopy. Methods 205 patients who underwent colonoscopy were randomly divided into experimental group and control group. The experimental group (n = 102) were given lactitol and polyethylene glycol electrolyte powder, whereas the patients in control group (n = 103) were given polyethylene glycol electrolyte powder only. The visibility and adverse effects during colonoscopy were observed. Results The cleaning satisfaction rate was not statistically significant between the two groups. The proportion of cleanliness to grade 1 in experimental group was higher than that in control group. The incidence of adverse effects in experimental group was lower, and there was no effect on sleeping night. The compliance and tolerance of hospitalized patients were significantly improved. Conclusion Lactitol combined with polyethylene glycol electrolyte (peg) powder is safe, effective, with low incidence of adverse effect for bowel preparation in hospitalized patients.

10.
Article in Chinese | WPRIM | ID: wpr-665703

ABSTRACT

Objective To explore the value of OTSC( over-the-scope-clip) for upper digestive tract perforation. Methods Thirteen patients with old and fresh upper digestive tract perforation, treated with an OTSC clip at the Department of Digestive Endoscopy from May 2015 to June 2016, were enrolled. All OTSCs were 11/6t, and all procedures were performed by experienced endoscopists. Results Seven cases of fresh perforation were iatrogenic after treatment for gastric submucosal tumor. Six cases of old perforation included 2 cases of spontaneous esophageal rupture, 2 fistula after operations for esophageal foreign body, 1 fistula after the operation for gastric stromal tumor, and 1 anastomotic fistula after esophagectomy. Eight cases of perforation occurred in stomach and 5 in esophageal. Fresh lesion sizes were from 4 to 30 mm ( average 15. 3 mm), old lesion sizes from 5 to 10 mm(average 7. 8 mm). OTSC′s release time in fresh lesions was 6-27 min(average 15. 1 min), that in old 15-80 min(average 42. 3 min) with significant difference. Technical success rate was 100%(13/13),clinical success rate in fresh lesions was 100%(7/7),and 50% (3/6) in old lesions. No patient had special treatment or complication. Conclusion OTSC is useful and safe for the treatment of upper digestive tract perforation, which is superior for fresh perforation than for the old. The perfect time to release OTSC for old perforation is when there is no obvious fibrosis caused by inflammation. The success rate is higher when the lesion size is smaller than 30 mm. Self-releasing of OTSC is rare. The necessity and the timing to take them out still needs further study.

11.
China Journal of Endoscopy ; (12): 85-89, 2016.
Article in Chinese | WPRIM | ID: wpr-621344

ABSTRACT

Objective To study the characteristics of endoscopic diagnosis and treatment for gastrointestinal neuroendocriue tumor (GI-NETs).Methods We retrospectively collected the clinical data of 84 patients with endoscopic confirmed GI-NETs from January 2012 to November 2014, including white light, endoscopic ultrasonography, histopathology and post-treatment condition.Results Endoscopic diagnosis for NET were 84 cases, but ifnally conifrmed by pathology were 72 cases, the misdiagnosis rate was 14.3%. Of the 12 misdiagnosed cases, 5 cases were chronic inlfammation, ectopic pancreas in 2 cases, and 5 cases of hyperplasia of Brunner's glands, colorectal hyperplastic polyps, colorectal venous hemangioma, colorectal leiomyoma, metastatic squamous carcinoma respectively. Of 8 cases with EUS, all lesions derived from the submucosal layer, and 6 cases of low echo, and 2 cases of high echo (Brunner's glands) and mixed echo (venous hemangioma) respectively.Conclusions GI-NETs,which possess certain characteristics under endoscopy, may be similar with other digestive diseases, while it can increase the diagnosis accuracy by more careful observation and necessary biopsy.

12.
China Journal of Endoscopy ; (12): 56-60, 2016.
Article in Chinese | WPRIM | ID: wpr-621279

ABSTRACT

Objective To introduce improved program for traction wire production in endoscopic submucosal dis-section assisted by oral traction. Methods A retrospective analysis was performed on 40 patients who received en-doscopy intervention. Through the use of improved traction and normal traction, they were divided into experimental group and control group. Then analyze and compare their clinical data like gender, age, traction line installed perfect time, fixed lesions after hemostatic clip off times, one-time complete resection, enbloc resection rate, bleeding and perforation and other complications and other clinical conditions. Results The improvement time was (53.30 ±12.85) s in experimental group, it was significantly shorter than that in control group (105.00 ± 11.68) s ( = 3.42, <0.05). The experimental group fixed lesions after hemostatic clamp off times were significantly less than that in con-trol group (χ2=2.37, <0.05). Conclusions Using innovative methods, adequate preoperative preparation, the op-erator's tacit understanding of nursing cooperation, close attention to the disease after surgery is the key to achieve the desired results of endoscopic surgery.

13.
Article in Chinese | WPRIM | ID: wpr-481571

ABSTRACT

Objective To study the relationship between gastritis cystica profunda (GCP)and early gastric cancer (EGC),and to explore the diagnosis and treatment of GCP.Methods Clinical data of 17 patients,who were pathologically diagnosed as having GCP,including clinical symptoms,white light endo-scopic findings,magnifying endoscopic features,EUS outcomes and histopathological characteristics were an-alyzed.Results All 17 patients of GCP had no specific clinical symptoms or history of gastric surgery prior to the operation.Eight lesions were located at cardiac,4 at gastric body,4 at gastric antrum and 1 at gastric angle.As to the morphology,3 cases were type Ⅰ,3 type Ⅰ +Ⅱc,9 type Ⅱa +Ⅱc,1 type Ⅱc and 1 type Ⅱb +Ⅱc.The mean lesion size was 1.8 cm.Of 16 patients with preoperative EUS examination,11 patients were found to have cystic changes,with the diagnostic rate being 68.8%(11 /16).All 17 patients underwent ESD,14 (82.4%,14 /17)of which were found to have EGC.Postoperative pathology confirmed low grade intraepithelial neoplasia in 3 cases,high grade intraepithelial neoplasia in 7,intramucosal carcino-ma in 4,submucosal carcinoma in 3 patients.Conclusion EUS plays an important role in the diagnosis and treatment of GCP.And GCP is highly correlated with EGC,which should be managed in time.

14.
Article in Chinese | WPRIM | ID: wpr-458548

ABSTRACT

Objective To study the therapeutic value of the endoscopic papillectomy for adenoma in the major duodenal papilla.Methods All 3 1 cases with the major duodenal papilla undergoing endoscopic papillectomy from January 2008 to June 2013 were retrospectively reviewed.The clinical data,endoscopic treatment,complications and follow-up were analysed.Results Endoscopic papillectomy was performed successfully in 29 patients.Post-operative pathology showed adenoma with low-grade dysplasia in 25 cases and high-grade dysplasia in 4 cases.One patient (3. 4%,1/29 )bled during operation;and there was no bleeding after operation. There was no perforation during and after the operation. Seventeen patients (58. 6%,17/29)developed hyperamylasemia and 3 patients(10. 3%,3/29)got mild pancreatitis,which were cured by conservative treatment.During follow-up,2 patients (6. 9%,2/29)with high-grade dysplasia had tumor recurrence after 6 months and 2 years respectively.The 27 other patients had no recurrence during the follow-up period.The shortest follow-up was 1 1 months,the longest was 5 years,with a mean time of 33. 5 ±8. 5 months.Conclusion Endoscopic papillectomy is feasible and safe for early tumors of the major duodenal papilla.Although the postoperative recurrence rate is low,it still needs close follow-up.

15.
Article in Chinese | WPRIM | ID: wpr-442932

ABSTRACT

Objective To prospectively evaluate the risk factors of complete resection in early gastric cancer (EGC) with endoscopic submucosal dissection (ESD),and to guide the choice of treatment methods.Methods This study prospectively evaluated the endoscopic features of 66 EGCs,including the lesion size,presence or absence of ulceration,the extent of differentiation,invasion depth and entire margins of the EGC,then compared them with postoperative pathologic results and analysed these factors.Results The lesion size of the high grade intmepithelial neoplasia (H) group and the intramucosal carcinoma (M) group were mainly less than 30 mm (90.9% vs.88.5%),but 57.1% of the submucosal carcinoma (SM) were more than 30 mm.There was a significant difference between any two of three groups (P < 0.05).Fourteen EGCs who got ulceration without invasion beyond mucosal muscularis underwent ESD successfully,and the basal or dissected margin had no residual tumor cells confirmed pathologically.And no tumor cell infiltration or lymph node metastasis was discovered.Of 45 EGCs with ESD,the underestimation rate for horizontal extent determined by white light and chromoendoscopy was higher than that of magnifying endoscopy with narrow-band imaging (ME-NBI) (15.6% vs.2.2%,P <0.05).Diagnostic accuracy for the extent of differenciation by conventional endoscopy was 93.9% (31/32,P > 0.1),but it's unable to determine the extent of differentiation by ME-NBI.The accuracy of the group H was 84.8% (28/33),that of M was 57.7% (15/26),that of SM was 71.4% (5/7),and there was a significant difference between group H and group M (P < 0.05).Conclusion To achieve complete resection of EGC with ESD,the lesion more than 30 mm,presence of ulceration,undifferentiated type,deep infiltration should be considered as the risk factors,and it's also important to identify the horizontal extent of EGC to avoid unnecessary operation.

16.
Article in Chinese | WPRIM | ID: wpr-429217

ABSTRACT

Objective To evaluate the effects and the safety of peroral endoscopic myotomy (POEM) for achalasia (AC).Methods POEM was performed on 7 AC patients from November 2010 to November 2011.Preoperative dysphagia grade,postoperative complications and short-term and long-term efficacy were recorded.Results POEM was performed successfully on all the 7 patients.The operation time were ranging from 46 to 113 minutes,mean 73 ± 20 minutes.Subcutaneous emphysema and mediastinal emphysema occurred in 2 patients,but cured after treatment.The 1-12 month follow-up showed dysphagia of all the patients was obviously improved.Conclusion POEM is efficient and safe to relieve dysphagia of AC patients.

17.
Article in Chinese | WPRIM | ID: wpr-383288

ABSTRACT

Objective To evaluate the efficacy of endoscopic ultrasonography(EUS)guided implantation of 5-FU seeds for progressive gastric cancer.Methods A total of 23 patients with progressive gastric cancer and outflow obstruction were enrolled into the study.During the endoscopy procedure, 45-60 5-FU seeds were implanted into the tumors with guidance of EUS, with an average dose of 100 mg.Volumes of tumor were examined with 3D-EUS before and after the treatment.Results A total of 33 procedures of 5-FU implantation were performed.By measurements of 3D-EUS, the numbers of patients with complete respons, partial response, no change, progressive disease were 1, 15, 6 and 1, respectively.In terms of outflow obstruction improvement, significant effect, obvious effect and average effect were achieved in 6, 7 and 9 patients, respectively, with an overall response rate at 91.4%.Conclusion EUS-guided 5-FU seed implantation in progressive gastric cancer is safe,reliable and effective with few complications.3D-EUS may be a new method to evaluate curative effect.

18.
Article in Chinese | WPRIM | ID: wpr-380990

ABSTRACT

Objecfive To explore the value of endoscopic uhrasonography(EUS)in diagnosis and preoperative assessment of esophageal cancer.Methods A total of 57 patients with esophageal cancer were examined by EUS.The image features,depth of invasion and lymph node metastasis obtained by EUS were analyzed and compared with postoperative outcomes.Results Esophageal cancer was characterized as an irregular hypoeehoic mass with partial or total destruction of normal esophageal wall structure under EUS.Compared with post-operative pathological findings,the consistent rates of EUS diagnosis in depth of invasion,T staging,and N staging were 84.2%(48/57),87.7%(50/57)and 84.2%(48/57),respectively.Conclusion EUS exhibited high diagnostic accuracy in T staging of esophageal cancer,which is valuable in managements and prognosis of esophageal cancer.

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