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Objective To evaluate the clinical value of endoscopic ultrasonography (EUS) in diagnosis and treatment of rectal carcinoid tumom, and the safety and efficacy of endoscopic submucosal dissection (ESD) for rectal carcinoid tumors. Methods All the submucous tumor considered rectal carcinoid tumor received EUS examination and according to the result to select appropriate therapeutic regimen. Results All the 45 lesions were verified rectal carcinoid tumors by pathological examination. 42 patients received endoscopic submucosal dissection. Two tumors invaded into the muscularis propria and one tumor invaded beyond serosa and with lymph node metastasis received surgical strategy. Conclusion EUS can be used to determine surgical strategy for rectal carcinoid tumor for it provides precise information of the size, depth, border, muscularis propria or vessel infiltration of the tumor. For rectal carcinoid tumors smaller than 20 mm in diameter, ESD is safe and effective.
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Objective To determine the value of EUS- guided fine needle aspiration biopsy (FNAB)for the diagnosis of submucosal lesions.MethodsWe found 28 patients with upper gastrointestinal tract solid submucosal lesions by endoseopies. EUS was performed to assess the lesions arised from the specific layer of the wall and the lymph node metastasis. After excluding extrinsic normal tissues compressing the gastrointestinaltract, EUS guided FNAB were carried out. Results Among these patients, two were extrinsic normal tissues compressing the gastrointestinal tract and all other 26 patients were examined by EUS guided FNAB. EUS- guided FNAB failed in only 3 patients. Among the other 23 patients, cytology demonstrated malignant tumors in 4 patients(lymphoma, n=2; leiomyosarcoma, n=2) and benign lesions in 19 patients(leiomyoma, n=1;lipoma, n=1 ). The results of EUS-guided FNAB were validated by surgery (n=20), endoscopic treatment (n=1) or clinical follow-up (n=7). Conclusion EUS guided FNAB is a safe and accurate method for di-agnosis of submucosal lesions.
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Objective To determine the value of endoscopic ultrasonography (EUS)-guided fine needle aspiration biopsy (FNAB) for differential diagnosis of pancreatic lesions. Methods EUS was performed in 23 patients with pancreatic lesions detected by CT, MRI, or US to assess the shape, size, and position of the lesions and the status of lymph nodes metastasis. After excluding blood vessel between the lesions and the fine needle by EUS, EUS guided FNAB was carried out. Results All patients were performed EUS-guided FNAB and only 2 patients failed. Among the other 21 patients, cytology and pathology demonstrated tumors in 10 patients (pancreatic carcinoma, n=8; pancreatic cystadenoma, n=1; non functional neuroendocrine tumor, n=1). The results of EUS-guided FNAB were evaluated by surgery (n=16), or clinical follow-up (n=7). The sensitivity was 83%, and speciality was 100%, and no complication occurred. Conclusions EUS-guided FNAB is a safe and accurate method for differential diagnosis of pancreatic lesions.
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Objective To evaluate the complication rate of secondary surgery in patients with benign thyroid disease. Methods From June 1992 to June 2003, 65 patients underwent reoperation. Operative procedures. pathology and complications were reviewed. Results The first surgery was unilateral in 27 cases (41.5%), bilateral in 38 (58.5%). Reoperation identified carcinoma in 8 cases with complications developed in 8 cases and left over permanent in 1 case (1.5%). Conclusion The complication rate of second operation is higher than that of first thyroid surgery, but still acceptable.
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ObjectiveTo assess the surgical results and implications of clinicopathologic features on the prognosis of patients with hepatic matastases from gastric adenocarcinoma. MethodsNinety one of 834 patients with primary gastric cancer were diagnosed with synchronous ( n =79) or metachronous ( n =12)hepatic metastases. Twenty-one cases underwent hepatectomy for the metastasis. Results The actuarial 1-year, 3-year survival rates after hepatic resection were respectively 69% and 30%. Solitary and metachronous metastases were significant determinants for a favorable prognosis after hepatic resection. Pathologically, tumor pseudomembrane was found in 13 out of 21 patients which was associated with a favorable prognosis. ConclusionsSolitary and metachronous hepatic metastases from gastric cancer should be treated by a surgical approach which confers a good prognosis. The formation of pseudomembrane of the metastatic tumor predicts a favourable postoperative survival.