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Objective:To study the efficacy of dental floss traction-assisted endoscopic submucosal dissection (ESD) for gastric angle mucosal lesions.Methods:Data of 127 patients with gastric angle mucosal lesions admitted to the endoscopic center of the First Affiliated Hospital of Xiamen University from January 2015 to December 2018 were retrospectively analyzed. According to the surgical methods, patients were divided into the dental floss traction-assisted ESD group (the traction group, n=51) and the traditional ESD group (the traditional group, n=76). The 41 fibrosis cases were further divided into the traction group (n=23) and the traditional group (n=18). The operation time, en block resection rate, curative resection rate and the incidence of adverse events such as bleeding, muscle layer injury and perforation were compared between the two groups.Results:There was no significant difference in age, sex, lesion size or morphology between the traction group and the traditional group ( P > 0.05). The operation time of the traction group was significantly shorter than that of the traditional group (65.4±36.5 min VS 103.5±43.2 min, P=0.012). The en block resection rate was higher in the traction group [100.00% (51/51) VS 90.79% (69/76), P=0.026], and the curative resection rate was higher too [94.12% (48/51) VS 81.58% (62/76), P=0.042]. The incidences of muscular layer damage [5.88% (3/51) VS 25.00% (19/76), P=0.010] and intraoperative bleeding [47.06% (24/51)VS 82.89% (63/76), P=0.010] were lower in the traction group. Perforation occurred in two patients (2.63%) of fibrosis in the traditional group; no perforation occurred in the traction group. There was no significant difference in the perforation incidence ( P=0.243). In the cases of fibrosis, the operation time of the traction group was significantly shorter compared with that of the traditional group (81.4±29.3 min VS 119.3±37.6 min, P=0.010). The en block resection rate and curative resection rate were also higher in the traction group [100.00% (23/23) VS 72.22% (13/18), P=0.007; 95.65% (22/23) VS 72.22% (13/18), P=0.035]. The incidences of muscular layer damage [8.70% (2/23) VS 72.22% (13/18), P=0.001] and intraoperative bleeding [78.26% (18/23) VS 100.00% (18/18), P=0.035] were lower in the traction group. Conclusion:The dental floss traction-assisted ESD is safe and effective for gastric angle mucosal lesions and fibrotic lesions, with shorter operation time, higher curative resection rate and lower incidence of adverse events.
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Objective To investigate the feasibility and efifcacy of endoscopic submucosal dissection (ESD) for gastrointestinal neuroendocrine neoplasms (GI-NENs).Methods 52 patients with conifrmed histological diagnosis of GI-NENs performed ESD from January 2011 to December 2015 were included. The endoscopic morphology of tumor was summarized. Complete resection rate, complications, clinicopathological characteristics, and follow-up results were evaluated.Results There were 16 cases of stomach, 9 cases of colon and rectum 27 cases. Most of the lesions were submucosal uplift. A few of lesions looked like polyps. All the lesions were one-time whole diseased. 44 lesions were NET-G1, 8 lesions were NET-G2. Complete resection rate was 94.23%. 2 cases of rectal lesions infringemented intrinsic muscle layer, and got additional surgery. 1 case of rectal perforation, which was managed by endoscopic treatment and conservative treatment. All cases did not appear haemorrhage. During a mean follow-up period of 22.6 months, local recurrences occurred in 1 case of stomach, and treated with second line ESD. No cases lymph node and distant metastasis were found.Conclusion ESD appears to be a feasible, safe and effective treatment for GI-NENs with strict endoscopic treatment indications.
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Objective To assess the prevalence of gastroesophageal reflux disease(GERD) in the population of Fujian province, and to analyze the risk factors in relation to the disease. Methods A survey on GERD symptoms and its related factors was carried out in the population of Fuzhou city in Fujian province using a stratified random sampling method. According to reflux disease questionnaire (RDQ) score, the subjects were divided to GERD group with Sc≥ 12 and control group with Sc＜ 12.The risk factors related to GERD were compared between two groups. Results A total of 1347residents were investigated. The prevalence of GERD was 8.76 %, and male to female ratio wasincreased in population above 40 years of age (P＜0.05). The incidence of GERD in subjects with different occupations was as follows: the businessmen [17.91%(12/67)], retirees [13.48%(12/89)]and soldiers [2.94%(2/68)]. Symptoms including abdominal distension, belching, nausea, vomiting,dyspepsia were common in GERD group compared to control group (P ＜ 0.01). Besides, the laryngitis, pharyngitis and mouth ulcer were common in GERD group compared to control group ( P＜0.05). The risk factors of GERD were eating greasy (OR= 1.589) and sweetmeat (OR= 2.413),overeating (OR = 2.053), constipation (OR = 1.650), acridity food (OR = 1.366 ), coffee (OR =1.295), strong tea (OR= 1.362). Conclusions The prevalence of GERD is high in the population of Fujian province, and many factors are closely related to reflux.
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Objective To assess the prevalence and related factors of gastroesophageal reflux disease (GERD) in troops stationed in southern China. Methods An investigation with validated questionnaire and stratified random sampling method was carried out in troops stationed in southern China to survey the prevalence of GERD and its related factors. According to the definition of reflux disease questionnaire (RDQ) score,the severity and frequency of the dominant symptoms of GERD,such as heartburn,acid regurgitation,food reflux and non-cardiogenic chest pain were scored. People with score equaled to and higher than 12 (Sc≥12) were assigned to patient group,and those with score lower than 12 (Sc0.05). Subjects in the patient group had a higher incidence of abdominal distension,belching,nausea,vomiting,abdominal pain compared with control group. A higher incidence of laryngitis,pharyngitis and ulcerative stomatitis (P