ABSTRACT
Objective:To explore the function of esophageal small balloon or papillary sphincter knife in the treatment of stent implantation for colorectal malignant obstruction,and to improve the success rate of colonic stent placement in such patients.Methods:A total of 49 patients with colorectal cancer complicated with almost complete obstruction or colorectal cancer were enrolled for this study.The esophageal small balloon or papillary sphincter knife was used in the guide wires.The guide wires gradually crossed the tumor gap and they were placed in the contralateral intestinal cavity with balloon progression.X-ray was then used to confirm whether the guide wire was inserted in the lesion intestinal cavity,and then the metal bare stent was inserted.Results:The guide wires was successfully inserted with conventional methods in these 49 cases,while they were also successfully placed the guide wire and the stent in the new way.Conclusion:For the patients with colorectal cancer complicated with complete obstruction or colorectal cancer located in obviously angled location,the use of esophageal small balloon or papillary sphincter knife can help the guide wire insert.They greatly improve the success rate of stent implantation.
ABSTRACT
Objective To study the etiology,relevant factors and endoscopic characteristics of acute lower gastrointestinal tract hemorrhage.Methods A total of 938 patients receiving emergency colonoscopy for acute lower gastrointestinal tract hemorrhage were collected to study the etiological profiles.Different causes between young group and elderly group were also recorded.Results The total detectable rate of acute lower gastrointestinal tract hemorrhage in respect of causes was 96.16％ (902/938).The five leading causes were colorectal malignancy (41.26％),erosive colorectal polypus (12.37％),inflammatory bowel disease (9.59％),erosive and ulcer colitis (10.34％) and hemorrhoids (8.64％).Compared with youth and middle age patients,the incidence of colorectal malignancy (x2 =68.116,df =2,P =0.000) and colorectal polyps (x2 =9.101,df =2,P =0.011) were significantly increased in elderly patients,while incidence of inflammatory bowel disease (x2 =62.150,df=2,P =0.000) and erosive and ulcer colitis (x2 =20.292,df =2,P =0.000) were significantly decreased in those patients.Conclusions Emergency colonoscopy for diagnosis of acute lower gastrointestinal tract hemorrhage is an important measure.The major manifestation is bleeding resulting from colorectal malignancy,erosive colorectal polypus,inflammatory bowel disease,erosive and ulcer colitis and anal hemorrhoid.Age is associated with the cause of lower gastrointestinal tract bleeding induced by different kinds of lesions at the colorectum.
ABSTRACT
Objective To study the symptoms, diagnosis, treatment and prognosis of colorectal malignant melanoma.Methods Six cases of colorectal malignant melanoma diagnosed and treated in our department between 1981 and 1996 were reviewed and underwent follow-up.Results All cases had masses that could be found near dentate line in digital examination and were black or brown in color. All patients underwent operations ,operations abdomino-perineal resection for 2 cases, post pelvic excision for 2 cases, enlarged local resection for 1 case and laporotomy for 1 case.Either lymph node metastasis or liver metastasis were found prior to or during operation. All patients died within 5～23 months after being diagnosed, with average survival time of 14.7 months.Conclusions Colorectal malignant melanoma was rare and was highly of malignant with tendency of early metastasis and poor prognosis. Radical surgery combined with chemotherapy, immunotherapy and biotherapy may be effective.