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To evaluate the value of forward-return way in endoscopic resection for the treatment of gastric fundus stromal tumor, patients with gastric fundus stromal tumor in muscularis propria diagnosed by endoscopy and endoscopic ultrasonography at the Department of Digestive Endoscopy of the Fourth Affiliated Hospital of China Medical University from June 2020 to June 2021 were prospectively enrolled in the study. All patients were treated with endoscopic full-thickness resection under general anesthesia with endotracheal intubation. The success of forward-return way, endoscopic procedure, operation performance, pathological classifications and complications were analyzed. A total of 12 patients were enrolled. All of them were confirmed as having stromal tumor by postoperative pathology, with 10 of very low risk and 2 of low risk. Forward-return way was successful in 9 patients and failed in 3 patients. Nine patients were successfully treated with endoscopic procedure eventually. No intraoperative bleeding occurred in any patient. In endoscopic resection, the scores of same direction of forward and backward, endoscopic field of view, and endoscopic body stability were all 2.00 points. Forward-return way has clinical application value for the endoscopic treatment of gastric fundus stromal tumor.
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To evaluate the clinical effects and pathological characteristics of gastric tumors of fundic gland type treated with endoscopic submucosal dissection (ESD), data of 7 patients who treated by ESD and whose postoperative pathology indicated gastric adenocarcinoma of fundic gland type or gastric oxyntic gland adenoma in Endoscopic Center of Beijing Chao-Yang Hospital of Capital Medical University from August 2018 to June 2022 were collected. The clinical characteristics, surgical complications, preoperative and postoperative pathological data and follow-up data were evaluated. The lesions of the 7 patients were all located at gastric fundus, and were treated by ESD successfully. No bleeding, perforation or other complications occurred during and after the operation. Postoperative pathology showed that tumor cells originated from deep mucosa with an invasive growth pattern. Most of tumor surfaces were covered with normal concave epithelium. Tumors infiltrated into submucosa in 4 patients, and submucosa infiltration depth was more than 500 μm (550 μm) in 1 patient. Immunohistochemistry showed that MUC-6 was diffusely positive, indicating that the tumor originated from the main cell source. The expressions of MUC-2, MUC-5AC, CDX-2, CD10, and CgA were negative in all cases. With the mean follow-up time of 21 months, the ulcer healed well after the operation, with no recurrence. Gastric tumors of fundic gland type have relatively unique biological characteristics, and ESD is the preferred treatment. In addition, the histological characteristics can be used to differentiate from other gastric tumors by immunohistochemistry.
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Objective:To evaluate the risks and benefits of endoscopic ligation and tissue adhesive injection for tortuous gastric varices.Methods:A total of 193 patients with esophagogastric varices, who underwent endoscopic variceal ligation or endoscopic tissue adhesive injection in Department of Gastroenterology of the First Affiliated Hospital of Anhui Medical University from June 2015 to June 2020, were included in the retrospective analysis. These cases were connected vessels (type Le and gf based on LDRf standard) of tortuous gastric varices (F1 in Hashizume standard). According to the treatment, the patients were divided into three groups: gastric fundus and esophageal ligation group (endoscopic ligation of gastric fundus and esophageal varices, 32 cases), tissue adhesive group (endoscopic tissue adhesive injection of gastric varices, endoscopic ligation of esophageal varices, 71 cases) and esophageal ligation group (endoscopic ligation of esophageal varices, 90 cases). The re-bleeding rate, the effectiveness rate, the significant effectiveness rate and complications of the three groups were compared.Results:The rates of re-bleeding in gastric fundus and esophageal ligation group, tissue adhesive group and esophageal ligation group were 18.75% (6/32), 12.68% (9/71) and 3.33% (3/90), respectively.There was significant difference only between gastric fundus and esophageal ligation group and esophageal ligation group ( χ2=6.110, P<0.016). The effectiveness rates of the three groups were all 100.00%. The significant effectiveness rates in gastric fundus and esophageal ligation group, tissue adhesive group and esophageal ligation group were 37.50% (12/32), 25.35% (18/71) and 14.44% (13/90), respectively. There was significant difference only between gastric fundus and esophageal ligation group and esophageal ligation group ( χ2=7.702, P<0.016). No pulmonary infection, hepatic encephalopathy, spontaneous bacterial peritonitis or perforation occurred in the three groups.The incidences of chest pain or abdominal pain in gastric fundus and esophageal ligation group, tissue adhesive group and esophageal ligation group were 18.75% (6/32), 11.27% (8/71) and 2.22% (2/90), respectively.There was significant difference only between gastric fundus and esophageal ligation group and esophageal ligation group ( χ2=10.524, P<0.016). There was no significant difference in the incidence of fever, nausea or vomiting among the three groups ( P>0.05). Conclusion:Simultaneous endoscopic ligation of gastric fundus and esophageal varices, and endoscopic tissue adhesive injection of gastric varices combined with endoscopic ligation of esophageal varices is of no benefit for patients with tortuous gastric varices, but endoscopic ligation of esophageal varices alone may yield more benefit.
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Objective To analyze the serum gastric function and Helicobacter pylori ( HP ) infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps.Methods From December 2017 to December 2018, 135 patients with gastric polyps and pathologically confirmed gastric hyperplastic polyps and gastric fundic gland polyps were enrolled in the hospital of Xuzhou Medical University.Among them, 68 patients with hyperplastic polyps, 67 cases of the gastric fundic gland polyps.Serum Hp antibodies ( UreA, UreB, VacA, CagA antibodies ) were qualitatively detected by immunoblotting.Eighty patients with chronic superficial gastritis were selected as the control group.Three groups of serum pepsinogen?I ( PG?I),pepsinogen?Ⅱ( PG?Ⅱ),gastrin were detected by enzyme?linked immunosorbent assay (ELISA).Gastrin?17( G?17) and calculate PGⅠ and PGⅡ ratio( PGR).Results The levels of serum PGⅡ(13.13(8.15,20.30) μg ／L) and G17 (8.44(3.72,27.17) pmol／L) in the gastric hyperplastic polyp group were higher than those in the control group (9.16(5.56,15.14) μg／L and 1.83(0.87,5.95) pmol／L) ( P＜0.05),and the PGR level was lower than the control group ( P＜0.05);serum PGI ( 120.12 ( 86.72,174.70) μg／L), PGII ( 11.92 ( 7.27,22.26) μg／L),G17 ( 5.68 ( 1.79, 14.65) pmol／L) in the gastric fundic gland polyp group was higher than the control group (( 101.32 (79.17,131.33) μg ／L,9.16 ( 5.56,15.14) μg ／L,1.83 ( 0.87,5.95) pmol／L) ( P 均＜0.05)) ( P＜0.05); serum G17 (8.44(3.72,27.17) pmol／L) level in gastric hyperplastic polyp group was higher than gastric fundus polyp group (5.68(1.79,14.65) pmol／L) ( P＜0.05); Hp infection rate in gastric hyperplastic polyp group61.76%(42／68)was higher than that in the gastric fundic gland polyp group40.30%(27／67) (P＜0.05),and type I Hp was the main one (P＜0.05).The serum PGⅡ and G17 levels in the gastric hyperplastic polyp group were higher than those of Hp negative ( all P＜0.05).There were no significant differences in serum PGI, PGⅡ, G17, and PGR levels between the HP?positive and negative?positive patients in the gastric fundus polyp group.The serum PGI and PGR levels in the hypertrophic polyp group were higher than those in the HPⅡ type ( all P＜0.05).There was no significant difference in the levels of serum PGⅠ,PGⅡ,G17,and PGR between the gastric fundic gland polyps group and the type Ⅱ.Conclusion Serum PG and G17 levels in patients with gastric hypertrophic polyps and gastric fundic gland polyps are higher than those in patients with chronic superficial gastritis.Patients with gastric hyperplastic polyps have higher HP infection rate and abnormal gastric function than gastric fundic gland polyps.
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Objective:To study the clinical effect and safety of transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of liver cirrhosis with esophageal variceal bleeding.Methods:86 cases of cirrhotic patients with esophageal and gastric varices bleeding admitted in our hospital from August 2013 to April 2015 were selected and randomly divided into the control group and the observation group with 43 cases in each group.The control group underwent percutaneous transhepatic coronary vein embolization (PTVE) treatment,while the observation group were treated with TIPS.The success rate of surgery,the incidence of various complications,the long-term survival rate and the symptoms and the changes of liver function after operation were compared between the two groups of patients.Results:The portal vein pressure after operation in the observation group was significantly lower than that of the control group (P=0.00),at 3 months,6 months and 12 months after operation,the rebleeding rate in the observation group were significantly lower than that of the control group (P＜0.05),but the incidence of hepatic encephalopathy showed no significant difference between the two groups (P＞0.05);before operation and at 6 months and 12 months after operation,the Child-Pugh score,serum TBIL,DBIL levels showed no significant difference between the two groups (P＞0.05),at 3 months after operation,the Child-Pugh score,serum TBIL,DBIL levels in the observation group were significantly higher than those of the control group (P＜0.01);the 1 year survival rate showed no significant difference between two groups (P=0.72).Conclusion:TIPS could effectively improve the symptoms of varicose veins,better on liver function damage,and enhance the long-term survival high rate with high safely in the treatment of esophageal variceal bleeding in patients with cirrhosis.
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Recent studies showed that gastric mucosa was more susceptible to injury by invasion factors with aging, however,the studies were mainly on gastric antral mucosa,fundic mucosa was rarely studied.Aims:To investigate the effect of aging on related biological activity factors in gastric fundic mucosa in beagle dogs.Methods:Nineteen beagle dogs were assigned into younger group (aged 1-5 years),junior elderly group (aged 6-8 years)and senior elderly group (aged≥9 years).The contents of MDA,LPO,MPO in gastric fundic mucosa were determined by TBA method.The contents of PTEN,TE,survivin,caspase-3,caspase-9,ZO-1,CGRP,VEGF,COX-1 and COX-2 were assessed by ELISA.Results:Compared with younger group and junior elderly group,contents of MDA,LPO,MPO,PTEN,TE,ZO-1 ,CGRP,VEGF, COX-1 and COX-2 were significantly increased in senior elderly group (P0.05 ).The content of survivin in junior elderly group and senior elderly group was significantly decreased when compared with younger group (P =0.000 ).Conclusions:Disadvantaging changes of biological activity factors are found in gastric fundic mucosa in elderly beagles dogs,however, gastric mucosal blood flow, mucosa regeneration and epithelial tight junction related biological activity factors are significantly increased in senior elderly beagle dogs,which may be a phenomenon of degeneration-compensation.
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Objective To evaluate the feasibility and safety of cap-assisted endoscopic nylon loop ligation (C-ENLL) as a new and simple method on gastric fundus submucosal tumors. Methods 74 cases with small gastric fundus submucosal tumors ≤2.00 cm in diameter were reviewed between January 2015 and June 2016. All cases were treated by C-ENLL. The clinical efficacy was analyzed. Results All the 74 patients underwent endoscopic ultrasonography before operation, 70 cases originated from the muscularis propria, 3 cases originated from the muscularis mucosae, 1 case originated from the submucosa. The average diameter of the lesions ranged 0.50 ～ 1.80 cm. C-ENLL achieved an en bloc resection rate of 100.0％, with a mean total procedure time of 26 min. Two patients developed delayed perforation, were treated with nylon rope and metal clip purse suture wound. All of whom were managed successfully. There was no delayed bleeding after operation. Pathological examination showed that 66.2％ (49/74) of the tumors were gastrointestinal stromal tumors. No tumor recurrence was observed during the follow-up. Conclusion The C-ENLL may be a feasible and safe method for the treatment of small gastric fundus submucosal tumors.
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Objective To investigate endoscopic ultrasonography diagnosis and classification of gastric fundus-cardiac tumors originated from the muscularis propria. Methods One hundred and two patients with gastric fundus-cardiac submucosal tumors originated from the muscularis propria were diagnosed by endoscopic ultrasonography from Jan, 2011 to Jun, 2015. All patients were treated by endoscopy or surgery, and diagnosed by postoperative pathology and immunohistochemistry staining. These cases were analyzed retrospectively. Results The 102 patients with gastric fundus-cardiac tumors originated from the muscularis propria included 39 men and 63 women. Their ages were from 25-85 years old, average 56.22± 11.98 years. The tumor sizes were from 0.4 to 10.4cm, average 3.72± 2.18cm. The patients were diagnosed having leiomyoma in 81 and interstitialoma in 21 by preoperative endoscopic ultrasonography. Postoperative pathology and immunohistochemistry staining confirmed that leiomyoma was misdiagnosed as mesenchymoma in 5 patients. The misdiagnosis rate of endoscopic ultrasonography for gastric fundus-cardiac tumors originated from the muscularis propria was 4.9% (5/102). In leiomyomas, isolated nodular type was seen in 29 cases, earthworm type in 21, and multiple nodular type in 36. Conclusion Endoscopic ultrasonography is a safe effective important method for diagnosis and classification of gastric fundus-cardiac submucosal tumors originated from the muscularis propria.
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Objective To discuss the effect of pericardial devascularization plus gastric fundus transaction in advance schis?tosomiasis patients with portal hypertension. Methods Thirty?six advanced schistosomiasis patients with portal hypertension treated with devascularization plus gastric fundus transaction(a portal hypertension group),as well as 10 patients treated with modified Sugiura operation(a modified Sugiura operation group)in the Third People’s Hospital of Yangxin County since 2006 were chosen as the observation objects,and the clinical effects of the two groups were observed and compared. Results The op?eration time,indwelling time of stomach tube,time to taking food after operation,drainage tube removal time of the portal hy?pertension group were all shorten than those of the modified Sugiura operation group(all P0.05). In addition,1 case with delayed gastric emptying and 1 case with stomal leak of esopha?gus happened in the modified Sugiura operation group,while no corresponding complications happened in the portal hyperten?sion group. Conclusions Pericardial devascularization plus gastric fundus is a relatively easy procedure which has a good short?term clinical effect,and therefore it is suitable for application in primary hospitals. However,its long?term effect still needs fur?ther observation.
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Objective To investigate the relationship among infection of the gastric fundus gland polyps and Hp,and the use of proton pump inhibitors(PPI).Methods From January 2012 to January 2014,89 cases of gastric fundus gland polyps who were treated in the First Central Hospital of Baoding were selected as the observation group.Fifty cases of the same period for the examination of the superficial gastritis were selected as the control group.First,the occurrence of glandular polyps in the observation group was counted statistically,and then Hp infection,taking PPI,H2RA and gastric mucosal protective agent were compared with control group.Another 50 cases of gastric cancer patients were selected,then the Ki-67 antigen test was used for contrast analysis among the three groups.Results The occurrence proportion of undic gland polyps occurred in fundic,gastric body,cardiac and gastric antrum were 34.83％ (31/89),43.82％ (39/89),12.36％ (11/89) and 8.99％(8/89) respectively,the difference was significant (x2=5.192,P=0.001),and more in the form of a single appearance,accounting for 65.17％(58/89).The Hp infection rate of the observation group was 50.56％ (45/89),compared with 54.00％ (27/59) of control group,the difference was not statistically significant (x2=0.152,P=0.697),and the Hp infection intensity of observation group concentrated in the low and mild,while in the control group,the high intensity was the main.Ki-67 antigen test comparison showed that expression in the gastric cancer group was 82.00％ (41/50),significantly higher than that of the observation group(23.60％ (21/89)),the difference was statistically significant(x2=44.196,P=0.000).Conclusion Hp infection and long-term administration of PPI,H2RA,gastric mucosal protective agent are not the risk factors of gastric gland polyps.And the gastric fundus gland polyps are in the benign disease condition,do not have the deterioration tendency.
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OBJECTIVE: To determine clinical variables that can predict the need for division of the short gastric vessels (SGV), based on the gastric fundus tension, assessing postoperative outcomes in patients submitted or not to section of these vessels. METHODS:We analyzed data from 399 consecutive patients undergoing laparoscopic fundoplication for gastroesophageal reflux disease (GERD). The section of the SGV was performed according to the surgeon evaluation, based on the fundus tension. Patients were divided into two groups: not requiring SGV section (group A) or requiring SGV section (group B). RESULTS:The section was not necessary in 364 (91%) patients (Group A) and required in 35 (9%) patients (Group B). Group B had proportionally more male patients and higher average height. The endoscopic parameters were worse for Group B, with larger hiatal hernias, greater hernias proportion with more than four centimeters, more intense esophagitis, higher proportion of Barrett's esophagus and long Barrett's esophagus. Male gender and grade IV-V esophagitis were considered independent predictors in the multivariate analysis. Transient dysphagia and GERD symptoms were more common in Group B. CONCLUSION:The division of the short gastric vessels is not required routinely, but male gender and grade IV-V esophagitis are independent predictors of the need for section of these vessels.
OBJETIVO: Determinar variáveis clínicas que possam predizer a necessidade de secção dos vasos gástricos curtos (VGC), baseado na tensão do fundo gástrico, avaliando os resultados pós-operatórios em pacientes submetidos ou não à secção destes vasos. MÉTODOS:Foram analisados os dados de 399 pacientes consecutivos submetidos à fundoplicatura total laparoscópica para a doença do refluxo gastroesofágico (DRGE). A secção dos VGC foi realizada de acordo com a avaliação do cirurgião, baseado na tensão do fundo gástrico. Os pacientes foram distribuídos em dois grupos: sem necessidade de secção dos VGC (grupo A) ou com necessidade de secção dos VGC (grupo B). RESULTADOS:A secção não foi necessária em 364 (91%) pacientes (Grupo A) e necessária em 35 (9%) pacientes (Grupo B). O Grupo B tinha proporcionalmente mais pacientes do sexo masculino e maior estatura média. Os parâmetros endoscópicos foram piores para o Grupo B, com maiores hérnias hiatais, maior proporção de hérnias com mais de quatro centímetros, esofagite mais intensa, maior proporção de esôfago de Barrett e esôfago de Barrett longo. O sexo masculino e as esofagites graus IV-V foram considerados fatores preditivos independentes na análise multivariada. A disfagia transitória e os sintomas de DRGE foram mais comuns no Grupo B. CONCLUSÃO:A secção dos vasos gástricos curtos não é necessária rotineiramente, porém o sexo masculino e as esofagites graus IV-V são fatores preditivos independentes da necessidade da secção destes vasos.
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Humans , Aortic Aneurysm , Blood Vessel Prosthesis , Endovascular Procedures , Mesenteric IschemiaABSTRACT
Objective To investigate the safety and effectiveness of endoscopic resection of tumors originated from gastric fundus muscularis propria.Methods Data of 53 patients with tumors originated from gastric fundus muscularis propria detected by endoscopic ultrasonograpy,treated by endoscopic resection and followed up at our hospital between January 2012 and June 2014 were reviewed.The postoperative pathology and complications were retrospectively analyzed to evaluate the therapeutic effect and safety.Results The procedure was successfully performed on all patients and all lesions were removed in one procedure.The lesion size ranged from 0.5 to 4.5 cm and the operation time was 25-155 min[mean(46.7 ±18.2)min].Mild bleeding (5 ~150 ml)occurred in all cases,which was successfully managed by argon plasma coagulation,hot biopsy probe or endoclip.Perforation occurred in 8 patients(8 /53),seven of whom were closed with titanium clips and titanium clips combined with nylon cord.Laparoscopic intervention was applied to 1 case because of severe perforation.Gastrointestinal decompression,acid suppression with proton pump inhibitors and antibiotics were performed on all cases.No severe hemorrhage occurred.The average length of hospitalization was (5.3 ± 1.4)days(3-14 d).Pathology confirmed 46 cases of gastrointestinal stromal tumors and 7 cases of leiomyoma. The patients were followed up for 3 to 27 months,and no tumor residue or recurrence was observed. Conclusion Endoscopic resection is a method not only to get the accurate pathologic diagnosis but also to meet principle of the local resection for stomach.It is safe,effective and worthy of recommendation.
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BACKGROUND/AIMS: DA-9701 significantly improved gastric accommodation by increasing the postprandial gastric volume. In this study, we investigated how DA-9701 affects the rat gastric fundus relaxation. METHODS: Gastric fundus muscle strips (9 longitudinal and 7 circular muscles) were obtained from rats. Electrical field stimulation (EFS) was performed at various frequencies (1, 5, 10 and 20 Hz) and train durations (1, 5, 10 and 20 seconds) to select optimal condition for experiments. Isometric force measurements were performed in response to EFS. Peak and nadir were observed during the first 1 minute after initiation of EFS in control state and after sequential addition of atropine (1 microM), DA-9701 (0.5, 5, 25 and 50 microg), N-nitro-L-arginine (L-NNA, 100 microM), MRS2500 (1 microM) and tetrodotoxin (TTX, 1 microM) to the organ bath. RESULTS: The optimal frequency and duration of EFS to evoke nerve-mediated relaxation was determined as 5 Hz for 10 seconds. Addition of L-NNA in the presence of atropine and DA-9701 (50 microg) decreased nadir by inhibiting relaxation from -0.054 +/- 0.021 g to -0.022 +/- 0.015 g (P = 0.026) in longitudinal muscles. However, subsequent application of MRS2500 in the presence of atropine, DA-9701 (50 microg) and L-NNA did not affect nadir. In circular muscles, subsequent addition of L-NNA and MRS2500 in the presence of atropine and DA-9701 (50 microg) did not show significant change of nadir. CONCLUSIONS: Our data suggest that the effect of DA-9701 on the rat gastric fundus relaxation is mainly mediated by nitrergic rather than purinergic pathway.
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Animals , Rats , Atropine , Baths , Gastric Fundus , Muscles , Relaxation , TetrodotoxinABSTRACT
Objective To investigate the short-term and long-term effect of cornary-caval shunt accompanied by pericardial devascularization in the treatment of upper gastrointestinal bleeding caused by portal hypertension.Methods Eleven patients with portal hypertension underwent cornary-caval shunt accompanied by partial pericardial devascularization were chosen.Of the 11 patients 6 applied autogenous splenic veins for graft and in 5 cases the coronary vein and inferior vena cava were anastomosed directly.Results Of the 11 patients,no operative mortality or early rebleeding.All patients were followed up from 5 months to 11 years with an average of 5 years and 3 months,of whom two died,others having no rebleeding or hepatic encephalopathy.Conclusion Cornary-caval shunt is a highly selective portosystemic shunt.Cornary-caval shunt accompanied by pericardial devascularization is a surgical treatment of upper gastrointestinal bleeding caused by portal hypertension for its apparent regional antihypertensive effect,the normal blood flow of liver,and reduction of the incidence of rebleeding.
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Objective Toobserve the effect of botulinum toxin type A (BTX-A) on the SP-induced smooth muscle contractility of gastric body and gastric fundus, so as to investigate the role of BTX-A in the binding between SP and NKi receptor. Methods Muscle strips were prepared from gastric body and gastric fundus and were randomly divided into control group, SP group, SP+APTL-SP (NKi receptor antagonist) group, BTX-A group, BTX-A+SP group, and SP+BTX-A group. The contractility data were recorded by physiological experimental system of Biolap420E. Results SP significantly enhanced the tension and amplitude of gastric body contractility and the tension of gastric fundus contractility (P<0. 01). APTL-SP signficantly inhibited SP-induced smooth muscle contractility tension m gastric body and gastric fundus (P<0. 01). BTX-A significantly mhibited the smooth muscle contractility amplitude in gastric body and gastric fundus (P<0. 01). BTX-A significantly inhibited SP-induced smooth muscle contractility, including the tension (P<0. 05, 0. 01) and amplitude (P<0. 01) in the gastric body and gastric fundus. After BTX-A treatment, SP did not enhance the smooth muscle contractility of the gastic body and gastric fundus in vitro. Conclusion SP can enhance the spontaneous contractility of smooth muscle in the gastric body and gastric fundus; BTX-A can inhibitSP-induced smooth muscle contractility of both gastric body and gastric fundus.
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Objective Toobserve the effect of botulinum toxin type A (BTX-A) on the SP-induced smooth muscle contractility of gastric body and gastric fundus, so as to investigate the role of BTX-A in the binding between SP and NKi receptor. Methods Muscle strips were prepared from gastric body and gastric fundus and were randomly divided into control group, SP group, SP+APTL-SP (NKi receptor antagonist) group, BTX-A group, BTX-A+SP group, and SP+BTX-A group. The contractility data were recorded by physiological experimental system of Biolap420E. Results SP significantly enhanced the tension and amplitude of gastric body contractility and the tension of gastric fundus contractility (P<0. 01). APTL-SP signficantly inhibited SP-induced smooth muscle contractility tension m gastric body and gastric fundus (P<0. 01). BTX-A significantly mhibited the smooth muscle contractility amplitude in gastric body and gastric fundus (P<0. 01). BTX-A significantly inhibited SP-induced smooth muscle contractility, including the tension (P<0. 05, 0. 01) and amplitude (P<0. 01) in the gastric body and gastric fundus. After BTX-A treatment, SP did not enhance the smooth muscle contractility of the gastic body and gastric fundus in vitro. Conclusion SP can enhance the spontaneous contractility of smooth muscle in the gastric body and gastric fundus; BTX-A can inhibitSP-induced smooth muscle contractility of both gastric body and gastric fundus.
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ObjectiveTo investigate the clinical value of endoscopic esophageal submucosal tunnel resection of gastric fundus-cardiac tumors originating from muscularis propria.Methods Clinical date of 18 patients with gastric fundus-cardiac submucosal tumors originating from muscularis propria who underwent endoscopic esophageal submucosal tunnel resection from January 2011 to December 2011 were retrospectively collected and analyzed.ResultsAll lesions were successfully and completely resected in 18 patients,with sizes ranging from 0.7 cm to 7.2 cm,mean (2.43 ± 1.91 ) cm.Pneumoretroperitoneum,pneumomediastinum and pneumohypoderma occured during the procedure in 2 cases,but spontaneously resolved in 3 days.Fever with increased WBC within 24 h after the procedure occurred in one patient,and was cured in two days with antibiotics.There were no severe complications including bleeding,perforation or death.All patients could have liquid diet 3 days later after the operation.Follow-up endoscopy at 1 week after the operation showed a healing of esophageal incision.ConclusionEndoscopic esophageal submucosal tunnel resection is a safe and effective method for gastric fundus-cardiac submucosal tumors originating from the muscularis propria,lessening the difficulty of traditional endoscopic resection.
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BACKGROUND/AIMS: There is an ongoing debate on the relationship between gastric fundic gland polyps and increased incidence of colorectal neoplasia in Caucasians. However, there was no report on the relationship between gastric fundic gland polyp and colorectal neoplasia in Korea. The aim of this study was to identify the characteristics of gastric fundic gland polyps and whether a relationship exists between fundic gland polyps and colorectal neoplasia in Korean population. METHODS: Persons who underwent an esophagogastroduodenoscopy and colonoscopy from 1992 to 2007 at the Health Promotion Center of Incheon St. Mary's Hospital, The Catholic University of Korea were reviewed retrospectively. The relationship between gastric fundic gland polyps and colorectal neoplasia were analyzed. RESULTS: Among 22,451 subjects, fundic gland polyps were found in 328 subjects (1.5%). Fundic gland polyps were more common in women than in men (odds ratio of 6.25; 95% CI of 4.68-8.34). The odds ratios for colorectal neoplasia in all subjects with gastric fundic gland polyps were 0.56 (95% CI of 0.33-0.95) and men who were 50 years of age or older had an odds ratio of 2.81 (95% CI of 1.03-7.66) as compared to the control group. However, age and sex-adjusted odds ratios for all gastric fundic gland polyps were 0.73 (95% CI of 0.42-1.26), for men 1.78 (95% CI of 0.80-3.98), and for women 0.37 (95% CI of 0.16-0.87). CONCLUSIONS: Surveillance colonoscopy in patients with fundic gland polyps can be performed in the same manner as general population in Korea.
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Adult , Female , Humans , Male , Middle Aged , Age Factors , Colorectal Neoplasms/epidemiology , Endoscopy, Gastrointestinal , Gastric Fundus/pathology , Odds Ratio , Polyps/epidemiology , Republic of Korea , Retrospective Studies , Sex FactorsABSTRACT
PURPOSE: The aim of this study was to determine proportions of upper third gastric cancer (UTG) among all gastric cancers and analyze clinicopathological features of the disease. MATERIALS AND METHODS: The medical records of 12,300 patients who underwent gastric surgery between 1986 and 2006 at Seoul National University Hospital (SNUH) were retrospectively reviewed. Clinicopathological features of 1,260 patients with UTG and 9,929 patients with middle or lower third gastric cancer (MLG) were compared, and annual proportions of UTG were evaluated. RESULTS: The proportion of patients with UTG rapidly increased from 2.6% in 1986 to 12.5% in 1992. However, linear regression analysis showed that the rate of increase was reduced (0.21%/year) after 1992 (12.5% to 14.2% from 1992 to 2006). Compared with the MLG group, the UTG group had a lower proportion of (22.3% vs. 39.7%, P<0.001) and a greater proportion of stage III/IV disease (39.4% vs. 31.7%, P<0.001). The UTG group also had larger tumors than the MLG group in stages I/II and III (3.5 cm/5.3 cm/6.5 cm vs. 3.2 cm/5.0 cm/5.8 cm, P=0.020/0.028 /<0.001), a higher proportion of undifferentiated cancer (63.1% vs. 53.7%, P<0.001), and less intestinal Lauren's type (38.8% vs. 47.4%, P<0.001). The 5-year survival rate of the UTG group was significantly lower than that of the MLG group in stages I/II and III (85.6%/63.1%/34.2% vs. 91.6%/ 69.2%/44.7%, P<0.001/0.028/0.006). CONCLUSIONS: The proportion of UTGs has increased over the last two decades at SNUH, but the rate of increase has been greatly reduced since 1992. The UTG group showed a poorer prognosis compared with the MLG group in stages I/II and III.
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Humans , Gastric Fundus , Incidence , Linear Models , Medical Records , Prognosis , Retrospective Studies , Stomach Neoplasms , Survival RateABSTRACT
PURPOSE: The aim of this study was to determine proportions of upper third gastric cancer (UTG) among all gastric cancers and analyze clinicopathological features of the disease. MATERIALS AND METHODS: The medical records of 12,300 patients who underwent gastric surgery between 1986 and 2006 at Seoul National University Hospital (SNUH) were retrospectively reviewed. Clinicopathological features of 1,260 patients with UTG and 9,929 patients with middle or lower third gastric cancer (MLG) were compared, and annual proportions of UTG were evaluated. RESULTS: The proportion of patients with UTG rapidly increased from 2.6% in 1986 to 12.5% in 1992. However, linear regression analysis showed that the rate of increase was reduced (0.21%/year) after 1992 (12.5% to 14.2% from 1992 to 2006). Compared with the MLG group, the UTG group had a lower proportion of (22.3% vs. 39.7%, P<0.001) and a greater proportion of stage III/IV disease (39.4% vs. 31.7%, P<0.001). The UTG group also had larger tumors than the MLG group in stages I/II and III (3.5 cm/5.3 cm/6.5 cm vs. 3.2 cm/5.0 cm/5.8 cm, P=0.020/0.028 /<0.001), a higher proportion of undifferentiated cancer (63.1% vs. 53.7%, P<0.001), and less intestinal Lauren's type (38.8% vs. 47.4%, P<0.001). The 5-year survival rate of the UTG group was significantly lower than that of the MLG group in stages I/II and III (85.6%/63.1%/34.2% vs. 91.6%/ 69.2%/44.7%, P<0.001/0.028/0.006). CONCLUSIONS: The proportion of UTGs has increased over the last two decades at SNUH, but the rate of increase has been greatly reduced since 1992. The UTG group showed a poorer prognosis compared with the MLG group in stages I/II and III.