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Hypopharyngeal Cancer: Epidemiological, Clinical and Paraclinical Aspects at the University Hospital Center (CHU) Gabriel Toure in Bamako 预览
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作者 K. Doumbia-Singare F. I. Kone +9 位作者 M. Doumbia B. Guindo S. Soumaoro N. Cisse N. F. Konate K. Diarra M. Sangare S.-K. Timbo M. Keita A. G. Mohamed 《耳鼻喉(英文)》 2020年第1期46-51,共6页
Introduction: Hypopharyngeal cancers are ubiquitous cancers. These are very lymphophilic cancers;cervical lymph node metastases are present in 60% to 80% of patients at the time of diagnosis. Alcohol and tobacco have ... Introduction: Hypopharyngeal cancers are ubiquitous cancers. These are very lymphophilic cancers;cervical lymph node metastases are present in 60% to 80% of patients at the time of diagnosis. Alcohol and tobacco have been implicated in their genesis. Objective: To study the epidemiological, clinical and paraclinical aspects of hypopharyngeal cancer in the ENT department of the CHU Gabriel Toure. Patients and Methods: It is a retrospective and prospective quantitative study covering a period of 4 years from June 2014 to July 2018;all patients who presented with hypopharyngeal cancer were included. Results: Thirty-five (35) patients were collected during the study period. The mean age of the patients was 44 ± 14 years with extremes of 16 and 78 years. The sex ratio was 0.47. Dysphagia was the reason for consultation at 100%. The average consultation time was 14 months, with extremes of 3 to 26 months. Smoking intoxication was found in 13 patients. The piriform sinus was interested in 52%. More than half of the patients were received at the advanced stage (T3 - T4). The histology was dominated by the well-differentiated epidermal carcinoma (91%). Conclusion: Hypopharyngeal cancer is common and occurs at all ages. T3 - T4 tumors are bad factors, hence early diagnosis and appropriate management are important for improving the prognosis. 展开更多
关键词 Cancer HYPOPHARYNX Imaging Endoscopy HISTOLOGY
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Lack of proper reimbursement is hampering adoption of minimally invasive gastrointestinal endoscopy in North America 预览
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作者 Shahzad Iqbal Aman Ali +1 位作者 Arham Razzaq Eman Shahzad 《世界胃肠内镜杂志:英文版(电子版)》 2020年第1期49-52,共4页
Endoscopic submucosal dissection(ESD)and related procedures are minimally invasive and cost-effective alternates to surgery.However,there is no approved or listed current procedural terminology(CPT)for ESD.We aimed to... Endoscopic submucosal dissection(ESD)and related procedures are minimally invasive and cost-effective alternates to surgery.However,there is no approved or listed current procedural terminology(CPT)for ESD.We aimed to review the current reimbursement process hurdles for ESD procedures in private practice model in United States.We reviewed the data of two advanced endoscopists(one in New York and other in Pennsylvania State)performing ESD in their private practice set-ups.We found the reimbursement process was complex,with number of refusals varied from 0-9 for ESD procedures.It was not paid at all in 8.3%of cases by the medical insurance.Endoscopic mucosal resection,which is considered inferior as compared to ESD,but has a listed CPT,was denied in only 0.83%cases.Our data highlights the billing hurdles by the endoscopists to adopt ESD-related procedures in private practice model. 展开更多
关键词 Endoscopic submucosal dissection Lack of reimbursement Current procedural terminology Minimally invasive gastrointestinal endoscopy North America
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腔镜甲状腺手术的演变和发展
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作者 武亚东 赵宁 +2 位作者 张翊乔 王鈢 朱明玥 《中国综合临床》 2020年第1期83-86,共4页
人工和机器人腔镜甲状腺手术的不断发展,有效地减少了甲状腺手术并发症及颈部瘢痕的形成,得到了广大外科医师及患者的认可。但是,人工和机器人腔镜甲状腺手术发展至今,其衍生的术式及入路种类繁多,不同的术式及入路具备各自的优劣势。... 人工和机器人腔镜甲状腺手术的不断发展,有效地减少了甲状腺手术并发症及颈部瘢痕的形成,得到了广大外科医师及患者的认可。但是,人工和机器人腔镜甲状腺手术发展至今,其衍生的术式及入路种类繁多,不同的术式及入路具备各自的优劣势。在适应证范围内,人工和机器人腔镜甲状腺手术与传统甲状腺手术的效果相当,应用前景更加广阔。 展开更多
关键词 腔镜 甲状腺手术 机器人 手术入路
Use of omental patch and endoscopic closure technique as an alternative to surgery after endoscopic full thickness resection of gastric intestinal stromal tumors: A series of cases 预览
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作者 Amit H Sachdev Shahzad Iqbal +1 位作者 Igor Braga Ribeiro Diogo Turiani Hourneaux de Moura 《世界临床病例杂志》 2020年第1期120-125,共6页
BACKGROUND Gastrointestinal stromal tumors(GISTs)originate from interstitial cells of Cajal.GISTs can occur anywhere along the gastrointestinal tract.Large lesions have traditionally been removed surgically.However,wi... BACKGROUND Gastrointestinal stromal tumors(GISTs)originate from interstitial cells of Cajal.GISTs can occur anywhere along the gastrointestinal tract.Large lesions have traditionally been removed surgically.However,with recent innovations in advanced endoscopy,GISTs located within the stomach are now removed endoscopically.We describe a new innovative endoscopic technique to close large and hard to access defects after endoscopic full-thickness resection of gastric GISTs.CASE SUMMARY We present a series of three patients who were diagnosed with a gastric GIST.All patients underwent full-thickness endoscopic resection.In all cases,for closure of the surgical bed,conventional endoscopic techniques including hemoclips,endoloop and suturing were unsuccessful.We performed a new technique in which we pulled omental fat into the gastric lumen and completely closed the defect using endoscopic devices.All patients performed well post-procedure and computed tomography was carried out one day after the procedures which showed no extravasation of contrast.CONCLUSION The omental plug technique may be used as an alternative to surgery in selected cases of gastric perforation. 展开更多
关键词 Gastric perforation Gastrointestinal stromal tumors Gastric tumor SURGERY Endoscopy SUTURING
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内镜下治疗食管-胃连通型静脉曲张的研究进展 预览
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作者 崔美兰 闫会敏 郑欢伟 《临床肝胆病杂志》 CAS 北大核心 2020年第1期190-193,共4页
食管胃静脉曲张破裂出血是肝硬化常见且危重的并发症之一,再出血率及病死率高,食管-胃连通型静脉曲张属于特殊类型静脉曲张,内镜下治疗方法主要包括内镜下静脉曲张硬化术、内镜下组织胶注射及联合序贯治疗等,但在具体方法的选择上还存... 食管胃静脉曲张破裂出血是肝硬化常见且危重的并发症之一,再出血率及病死率高,食管-胃连通型静脉曲张属于特殊类型静脉曲张,内镜下治疗方法主要包括内镜下静脉曲张硬化术、内镜下组织胶注射及联合序贯治疗等,但在具体方法的选择上还存在一些争议。现就近年来国内外食管-胃连通型静脉曲张内镜下治疗的进展予以综述。 展开更多
关键词 肝硬化 食管和胃静脉曲张 内窥镜检查 消化系统
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真菌感染引起蝶窦黏液性囊肿1例并文献复习 预览
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作者 汤加家 李爱民 《安徽医药》 CAS 2020年第1期147-149,共3页
目的对真菌性蝶窦囊肿的临床特点进行分析,减少误诊误治。方法复习徐州医科大学附属连云港医院一例少见的由真菌感染引起蝶窦黏液性囊肿病例临床资料,并检索相关文献。结果该例慢性真菌性蝶窦囊肿病程较长,药物治疗效果较差,手术治疗后... 目的对真菌性蝶窦囊肿的临床特点进行分析,减少误诊误治。方法复习徐州医科大学附属连云港医院一例少见的由真菌感染引起蝶窦黏液性囊肿病例临床资料,并检索相关文献。结果该例慢性真菌性蝶窦囊肿病程较长,药物治疗效果较差,手术治疗后痊愈。结论真菌性蝶窦囊肿病程较长,当临床上出现长期不明原因的鼻塞、脓涕,且保守治疗未见好转时,为避免误诊误治,除常规鼻部检查外,还应及时行鼻窦或头颅CT检查有助于确诊;手术切除辅助药物治疗是该病最佳治疗方案。 展开更多
关键词 真菌病 蝶窦炎 引流术 内窥镜检查 鼻窦炎 蝶窦囊肿 颅底肿瘤
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High-definition optical magnification with digital chromoendoscopy detects gastric mucosal changes in dyspeptic-patients 预览
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作者 Carlos Robles-Medranda Manuel Valero +5 位作者 Miguel Puga-Tejada Roberto Oleas Jorge Baquerizo-Burgos Miguel Soria-Alcívar Haydee Alvarado-Escobar Hannah Pitanga-Lukashok 《世界胃肠内镜杂志:英文版(电子版)》 2020年第1期23-32,共10页
BACKGROUND Accurate detection of gastric infection by Helicobacter pylori(H.pylori)and premalignant lesions are important for effective provision of treatment,preventing the development of gastric neoplasia.Optical en... BACKGROUND Accurate detection of gastric infection by Helicobacter pylori(H.pylori)and premalignant lesions are important for effective provision of treatment,preventing the development of gastric neoplasia.Optical enhancement systems with optical magnification improved the identification of mucosal superficial and vascular patterns in patients with dyspepsia.AIM To evaluate an optical enhancement system with high-definition magnification,for diagnosis of normal gastric mucosa,H.pylori-associated gastritis,and gastric atrophy.METHODS A cross-sectional,nonrandomized study from November 2015 to April 2016 performed in a single-tertiary academic center from Ecuador.Seventy-two consecutive patients with functional dyspepsia according to the Rome III criteria,were tested for H.pylori using a stool antigen test and were assigned to an Hp+group or an Hp−control group.Esophagogastroduodenoscopy with highdefinition optical magnification and digital chromoendoscopy was performed,and patients were classified into 4 groups,in accordance to the microvasculararchitecture pattern of the mucosa.Interobserver and intraobserver agreement among operators were calculated.RESULTS Of the 72 participants,35 were Hp+and 37 were Hp−.Among 10 patients with normal mucosal histology in biopsy samples,90%had a Type I pattern of microvascular architecture by endoscopy.Among participants with type IIa and type IIb patterns,significantly more were Hp+than Hp−(32 vs 8),and most(31 out of 40)had histological diagnoses of chronic active gastritis.Two of the three participants with a histological diagnosis of atrophy had a type III microvascular pattern.The type I pattern predicted normal mucosa,type IIa–IIb predicted H.pylori infection,and type III predicted atrophy with sensitivities of 90.0%,91.4%,and 66.7%,respectively.The intraobserver and interobserver agreements had kappa values of 0.91 and 0.89,respectively.CONCLUSION High-definition optical magnification with digital chromoendoscopy is useful for diagnosis of normal gastric mucosa 展开更多
关键词 GASTRITIS Helicobacter pylori Gastric mucosa ATROPHIC ENDOSCOPY Digestive system
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Recent advances in diagnostic upper endoscopy 预览
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作者 Jun-Liang Teh Asim Shabbir +1 位作者 Soon Yuen Jimmy Bok-Yan So 《世界胃肠病学杂志:英文版》 SCIE CAS 2020年第4期433-447,共15页
BACKGROUND Esophageo-gastro-duodenoscopy(EGD)is an important procedure used for detection and diagnosis of esophago-gastric lesions.There exists no consensus on the technique of examination.AIM To identify recent adva... BACKGROUND Esophageo-gastro-duodenoscopy(EGD)is an important procedure used for detection and diagnosis of esophago-gastric lesions.There exists no consensus on the technique of examination.AIM To identify recent advances in diagnostic EGDs to improve diagnostic yield.METHODS We queried the PubMed database for relevant articles published between January 2001 and August 2019 as well as hand searched references from recently published endoscopy guidelines.Keywords used included free text and MeSH terms addressing quality indicators and technological innovations in EGDs.Factors affecting diagnostic yield and EGD quality were identified and divided into the follow segments:Pre endoscopy preparation,sedation,examination schema,examination time,routine biopsy,image enhanced endoscopy and future developments.RESULTS We identified 120 relevant abstracts of which we utilized 67 of these studies in our review.Adequate pre-endoscopy preparation with simethicone and pronase increases gastric visibility.Proper sedation,especially with propofol,increases patient satisfaction after procedure and may improve detection of superficial gastrointestinal lesions.There is a movement towards mandatory picture documentation during EGD as well as dedicating sufficient time for examination improves diagnostic yield.The use of image enhanced endoscopy and magnifying endoscopy improves detection of squamous cell carcinoma and gastric neoplasm.The magnifying endoscopy simple diagnostic algorithm is useful for diagnosis of early gastric cancer.CONCLUSION There is a steady momentum in the past decade towards improving diagnostic yield,quality and reporting in EGDs.Other interesting innovations,such as Raman spectroscopy,endocytoscopy and artificial intelligence may have widespread endoscopic applications in the near future. 展开更多
关键词 Upper endoscopy GASTROSCOPY Quality indicators Gastric cancer
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超声内镜引导下支架置入引流术治疗感染性胰腺坏死 预览
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作者 王丹松 齐峰 《中国卫生标准管理》 2020年第1期38-40,共3页
目的探讨超声内镜引导下支架置入引流术治疗感染性胰腺坏死的临床价值。方法研究纳入2017年12月—2019年1月期间本院收治的60例感染性胰腺坏死(infectious pancreatic necrosis,IPN)患者,按照盲选方法将其分为对照组30例和研究组30例,... 目的探讨超声内镜引导下支架置入引流术治疗感染性胰腺坏死的临床价值。方法研究纳入2017年12月—2019年1月期间本院收治的60例感染性胰腺坏死(infectious pancreatic necrosis,IPN)患者,按照盲选方法将其分为对照组30例和研究组30例,分别采用开腹引流治疗方法和超声内镜引导下支架置入引流术治疗,对比两组的疗效和安全性。结果研究组的临床疗效优于对照组,差异有统计学意义(P<0.05)。与对照组相比,研究组患者的并发症发生率明显更低,差异有统计学意义(P<0.05),但是对照组和研究组的死亡率对比差异无统计学意义(P>0.05)。结论IPN患者采用超声内镜引导下支架置入引流术治疗疗效可靠,且安全性高。 展开更多
关键词 超声 内镜 支架置入引流术 感染性胰腺坏死 死亡率 并发症
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Endoscopic Kyoto classification of Helicobacter pylori infection and gastric cancer risk diagnosis 预览
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作者 Osamu Toyoshima Toshihiro Nishizawa Kazuhiko Koike 《世界胃肠病学杂志:英文版》 SCIE CAS 2020年第5期466-477,共12页
Recent advances in endoscopic technology allow detailed observation of the gastric mucosa.Today,endoscopy is used in the diagnosis of gastritis to determine the presence/absence of Helicobacter pylori(H.pylori)infecti... Recent advances in endoscopic technology allow detailed observation of the gastric mucosa.Today,endoscopy is used in the diagnosis of gastritis to determine the presence/absence of Helicobacter pylori(H.pylori)infection and evaluate gastric cancer risk.In 2013,the Japan Gastroenterological Endoscopy Society advocated the Kyoto classification,a new grading system for endoscopic gastritis.The Kyoto classification organized endoscopic findings related to H.pylori infection.The Kyoto classification score is the sum of scores for five endoscopic findings(atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness with or without regular arrangement of collecting venules)and ranges from 0 to 8.Atrophy,intestinal metaplasia,enlarged folds,and nodularity contribute to gastric cancer risk.Diffuse redness and regular arrangement of collecting venules are related to H.pylori infection status.In subjects without a history of H.pylori eradication,the infection rates in those with Kyoto scores of 0,1,and≥2 were 1.5%,45%,and 82%,respectively.A Kyoto classification score of 0 indicates no H.pylori infection.A Kyoto classification score of 2 or more indicates H.pylori infection.Kyoto classification scores of patients with and without gastric cancer were 4.8 and 3.8,respectively.A Kyoto classification score of 4 or more might indicate gastric cancer risk. 展开更多
关键词 Gastric cancer Helicobacter pylori Endoscopy Kyoto classification Atrophy Intestinal metaplasia Enlarged fold NODULARITY Diffuse redness Regular arrangement of collecting venules
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宫颈管内镜下宫颈锥切术治疗高级别宫颈上皮内瘤变的效果分析
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作者 郭静 杨丹 +2 位作者 付小萌 贾东琪 姜娟 《中国综合临床》 2020年第1期5-8,共4页
目的探讨宫颈管内镜下宫颈锥切术应用于高级别宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的临床效果。方法选取2017年6月至2019年6月哈尔滨市第一医院收治的CINⅡ、Ⅲ级患者100例,采用随机数字表法将患者分为对照组与观察... 目的探讨宫颈管内镜下宫颈锥切术应用于高级别宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)的临床效果。方法选取2017年6月至2019年6月哈尔滨市第一医院收治的CINⅡ、Ⅲ级患者100例,采用随机数字表法将患者分为对照组与观察组,每组各50例。对照组采用传统的宫颈冷刀锥切术,观察组采用宫颈管内镜下宫颈锥切术。比较两种手术方式的治疗效果。结果观察组的标本切缘阳性率明显低于对照组[8%(4/50)与18%(9/50)],两组比较差异有统计学意义(χ^2=4.98,P<0.05)。随访1年,观察组的治愈率高于对照组[96%(48/50)与84%(40/50)],残留率和复发率均低于对照组[6%(3/50)与14%(7/50),2%(1/50)与8%(4/50)],差异均有统计学意义(χ^2值分别为10.56、3.98、13.96,P均<0.05)。观察组的术后并发症发生率明显低于对照组[6%(3/50)与18%(9/50)],差异有统计学意义(χ^2=11.25,P<0.05)。而两组患者术中出血量、手术时间、伤口愈合时间比较差异均无统计学意义(t值分别为1.46、1.26、0.98,P均>0.05)。结论宫颈管内镜下宫颈锥切术治疗高级别CIN,可准确定位病灶,切除有效率高,复发率低,手术并发症少。 展开更多
关键词 宫颈锥切术 内镜 宫颈上皮内瘤变
胃神经内分泌肿瘤的临床病理特征及内镜表现 预览
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作者 白冰 仓顺东 +2 位作者 阚云珍 温一阳 邝胜利 《现代肿瘤医学》 CAS 2020年第2期260-264,共5页
目的:探讨胃神经内分泌肿瘤(gastric neuroendocrine neoplasms,gNEN)临床病理特征及内镜表现。方法:回顾性分析2014年1月至2016年1月河南省人民医院行内镜活检并病理诊断为gNEN的40例患者临床资料,探讨其临床病理学特征及内镜表现。结... 目的:探讨胃神经内分泌肿瘤(gastric neuroendocrine neoplasms,gNEN)临床病理特征及内镜表现。方法:回顾性分析2014年1月至2016年1月河南省人民医院行内镜活检并病理诊断为gNEN的40例患者临床资料,探讨其临床病理学特征及内镜表现。结果:40例gNEN患者的临床表现多为非特异性症状,仅1例伴有反复腹泻的类癌综合征表现;病变部位最常见于胃体(20/40,50%);大体分型以隆起型为主17例(42.5%);病理分型中NET 17例(42.5%),NEC 22例(55.0%),MANEC 1例(2.5%),不同性别gNEN患者的病理分型差异无统计学意义。突触素(Synaptophysin,Syn)染色阳性38例(95.0%),嗜铬颗粒A(chromogranin A,CgA)染色阳性25例(62.5%);NET、NEC组织中Syn阳性率均高于CgA阳性率,具有统计学意义;I型gNEN 17例(42.5%),II型3例(7.5%),III型20例(50.0%);行内镜下EMR/ESD模式治疗的13例(32.5%),活检后采用单纯手术治疗的6例(15.0%),手术并辅助化疗的18例(45.0%),3例(7.5%)明确诊断时已有远处转移仅行姑息治疗。结论:gNEN发病率逐年上升,临床医生应熟悉该肿瘤的临床病理特征及其内镜下的表现,做到早期诊断,明确病理分期并规范个体化治疗。 展开更多
关键词 胃神经内分泌肿瘤 内镜检查 临床病理特征
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Miniature gastrointestinal endoscopy:Now and the future 预览
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作者 John J McGoran Mark E McAlindon +4 位作者 Prasad G Iyer Eric J Seibel Rehan Haidry Laurence B Lovat Sarmed S Sami 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第30期4051-4060,共10页
Since its original application,gastrointestinal(GI)endoscopy has undergone many innovative transformations aimed at expanding the scope,safety,accuracy,acceptability and cost-effectiveness of this area of clinical pra... Since its original application,gastrointestinal(GI)endoscopy has undergone many innovative transformations aimed at expanding the scope,safety,accuracy,acceptability and cost-effectiveness of this area of clinical practice.One method of achieving this has been to reduce the caliber of endoscopic devices.We propose the collective term“Miniature GI Endoscopy”.In this Opinion Review,the innovations in this field are explored and discussed.The progress and clinical use of the three main areas of miniature GI endoscopy(ultrathin endoscopy,wireless endoscopy and scanning fiber endoscopy)are described.The opportunities presented by these technologies are set out in a clinical context,as are their current limitations.Many of the positive aspects of miniature endoscopy are clear,in that smaller devices provide access to potentially all of the alimentary canal,while conferring high patient acceptability.This must be balanced with the costs of new technologies and recognition of device specific challenges.Perspectives on future application are also considered and the efforts being made to bring new innovations to a clinical platform are outlined.Current devices demonstrate that miniature GI endoscopy has a valuable place in investigation of symptoms,therapeutic intervention and screening.Newer technologies give promise that the potential for enhancing the investigation and management of GI complaints is significant. 展开更多
关键词 ULTRATHIN ENDOSCOPY CAPSULE ENDOSCOPY SINGLE FIBER ENDOSCOPY
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Role of endoscopy in acute gastrointestinal bleeding in real clinical practice:An evidence-based review 预览
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作者 Kyoungwon Jung Won Moon 《世界胃肠内镜杂志:英文版(电子版)》 2019年第2期68-83,共16页
Although upper gastrointestinal bleeding is usually segregated from lower gastrointestinal bleeding,and guidelines for gastrointestinal bleeding are divided into two separate sections,they may not be distinguished fro... Although upper gastrointestinal bleeding is usually segregated from lower gastrointestinal bleeding,and guidelines for gastrointestinal bleeding are divided into two separate sections,they may not be distinguished from each other in clinical practice.Most patients are first observed with signs of bleeding such as hematemesis,melena,and hematochezia.When a patient with these symptoms presents to the emergency room,endoscopic diagnosis and treatment are considered together with appropriate initial resuscitation.Especially,in cases of variceal bleeding,it is important for the prognosis that the endoscopy is performed immediately after the patient stabilizes.In cases of suspected lower gastrointestinal bleeding,full colonoscopy after bowel preparation is effective in distinguishing the cause of the bleeding and treating with hemostasis.The therapeutic aspect of endoscopy,using the mechanical method alone or injection with a certain modality rather than injection alone,can increase the success rate of bleeding control.Therefore,it is important to consider the origin of bleeding and how to approach it.In this article,we aim to review the role of endoscopy in diagnosis,treatment,and prognosis in patients with acute gastrointestinal bleeding in a real clinical setting. 展开更多
关键词 ENDOSCOPY GASTROINTESTINAL BLEEDING ENDOSCOPIC BLEEDING control Emergency BOWEL preparation BEDSIDE ENDOSCOPY Second-look ENDOSCOPY
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Training in video capsule endoscopy: Current status and unmet needs 预览
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作者 Apostolos Koffas Faidon-Marios Laskaratos Owen Epstein 《世界胃肠内镜杂志:英文版(电子版)》 2019年第6期395-402,共8页
Since its introduction to clinical practice nearly 20 years ago, wireless capsule endoscopy has revolutionized the landscape in the diagnosis and management of small bowel diseases. Over the past 10 years, capsule end... Since its introduction to clinical practice nearly 20 years ago, wireless capsule endoscopy has revolutionized the landscape in the diagnosis and management of small bowel diseases. Over the past 10 years, capsule endoscopy has evolved beyond the small intestine and a range of capsules are now available to examine the esophagus, stomach and colon. Because of its ease of use, tolerability, paucity of complications and ability to visualize the entire gastrointestinal tract, capsule endoscopy has entered the mainstream of clinical practice. This review of the literature summarizes the current state of capsule training and highlights the limited data available to assess reader competence and standards expected of an independent practitioner. There are neither standardized teaching strategies nor national or international metrics for accreditation of physicians and nonphysicians interested in mastering this examination. Summating the few publications, there appears to be consensus that diagnostic expertise improves with experience, and that trainees should be fully supervised for at least 20 full case studies. Formative and summative assessment is advisable and the number of taught cases should not be the sole determinant of competence. The review also highlights differences in recommendations from major national gastroenterology societies. Finally, the authors discuss areas of unmet needs in teaching and learning for capsule endoscopy. 展开更多
关键词 SMALL BOWEL CAPSULE ENDOSCOPY COLON CAPSULE ENDOSCOPY TRAINING
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Device-assisted enteroscopy: A review of available techniques and upcoming new technologies 预览
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作者 Markus Schneider Jorg Hollerich Torsten Beyna 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第27期3538-3545,共8页
The advent of video capsule endoscopy into clinical routine more than 15 years ago led to a substantial change in the diagnostic approach to patients with suspected small bowel diseases, often indicating a deep entero... The advent of video capsule endoscopy into clinical routine more than 15 years ago led to a substantial change in the diagnostic approach to patients with suspected small bowel diseases, often indicating a deep enteroscopy procedure for diagnostical confirmation or endoscopic treatment. Device assisted enteroscopy was developed in 2001 and for the first time established a practicable, safe and effective method for evaluation of the small bowel.Currently with double-balloon enteroscopy, single-balloon enteroscopy and spiral enteroscopy three different platforms are available in clinical routine.Summarizing, double-balloon enteroscopy seems to offer the deepest insertion depth to the small bowel going hand in hand with the disadvantage of a longer procedural duration. Manual spiral enteroscopy seems to be a faster procedure but without reaching the depth of the DBE in currently available data. Finally,single-balloon enteroscopy seems to be the least complicated procedure to perform. Despite substantial improvements in the field of direct enteroscopy,even nowadays deep endoscopic access to the small bowel with all available methods is still a complex procedure, cumbersome and time-consuming and requires high endoscopic skills. This review will give an overview of the currently available techniques and will further discuss the role of the upcoming new technology of the motorized spiral enteroscopy(PowerSpiral). 展开更多
关键词 Small BOWEL disease CAPSULE ENDOSCOPY ENTEROSCOPY PowerSpiral ENTEROSCOPY ENDOSCOPY
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肠气囊肿症的临床及内镜下特点分析 预览
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作者 黎俊 杨柳 董丽凤 《中国内镜杂志》 2019年第9期53-58,共6页
目的探讨肠气囊肿症(PCI)的临床、内镜下特点及诊治方法,以提高认识。方法回顾性分析北京市垂杨柳医院诊断的10例PCI患者的临床、内镜特点和治疗效果,分析误诊原因。结果10例PCI患者均经肠镜明确诊断,病变主要位于右半结肠,立位腹平片... 目的探讨肠气囊肿症(PCI)的临床、内镜下特点及诊治方法,以提高认识。方法回顾性分析北京市垂杨柳医院诊断的10例PCI患者的临床、内镜特点和治疗效果,分析误诊原因。结果10例PCI患者均经肠镜明确诊断,病变主要位于右半结肠,立位腹平片和腹部CT可见沿肠管分布的大小不等的葡萄样囊腔。经吸氧、肠道益生菌及内镜治疗后,所有患者症状明显缓解。结论PCI是一种罕见疾病,临床症状缺乏特征性,以腹痛、腹泻和腹胀等消化道症状多见,容易误诊。内镜下使用注射针穿刺抽吸囊泡内气体,是一种有效的治疗方法。 展开更多
关键词 肠气囊肿症 结肠 囊肿 内镜检查 诊断 内镜治疗 体层摄影术
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Endoscopic characteristics of small intestinal malignant tumors observed by balloon-assisted enteroscopy 预览
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作者 Tomofumi Horie Naoki Hosoe +10 位作者 Kaoru Takabayashi Yukie Hayashi Kenji JL Limpias Kamiya Ryoichi Miyanaga Shinta Mizuno Kayoko Fukuhara Seiichiro Fukuhara Makoto Naganuma Masayuki Shimoda Haruhiko Ogata Takanori Kanai 《世界胃肠内镜杂志:英文版(电子版)》 2019年第5期373-382,共10页
BACKGROUND Capsule endoscopy and balloon-assisted enteroscopy (BAE) enable visualization of rare small bowel conditions such as small intestinal malignant tumors. However, details of the endoscopic characteristics of ... BACKGROUND Capsule endoscopy and balloon-assisted enteroscopy (BAE) enable visualization of rare small bowel conditions such as small intestinal malignant tumors. However, details of the endoscopic characteristics of small intestinal malignant tumors are still unknown. AIM To elucidate the endoscopic characteristics of small intestinal malignant tumors. METHODS From March 2005 to February 2017, 1329 BAE procedures were performed at Keio University Hospital. Of these procedures, malignant tumors were classified into three groups, Group 1: epithelial tumors including primary small intestinal cancer, metastatic small intestinal cancer, and direct small intestinal invasion by an adjacent organ cancer;Group 2: small intestinal malignant lymphoma;and Group 3, small intestinal gastrointestinal stromal tumors. We systematically collected clinical and endoscopic data from patients’ medical records to determine the endoscopic characteristics for each group.RESULTS The number of patients in each group was 16 (Group 1), 23 (Group 2), and 6 (Group 3), and the percentage of solitary tumors was 100%, 43.5%, and 100%, respectively (P < 0.001). Patients’ clinical background parameters including age, symptoms, and laboratory data were not significantly different between the groups. Seventy-five percent of epithelial tumors (Group 1) were located in the upper small intestine (duodenum and ileum), and approximately 70% of gastrointestinal stromal tumors (Group 3) were located in the jejunum. Solitary protruding or mass-type tumors were not seen in malignant lymphoma (Group 2)(P < 0.001). Stenosis was seen more often in Group 1,(68.8%, 27.3%, and 0%;Group 1, 2, and 3, respectively;P = 0.004). Enlarged white villi inside and/or surrounding the tumor were seen in 12.5%, 54.5%, and 0% in Group 1, 2, and 3, respectively (P = 0.001). CONCLUSION The differential diagnosis of small intestinal malignant tumors could be tentatively made based on BAE findings. 展开更多
关键词 Small INTESTINE MALIGNANT Tumor Double BALLOON ENTEROSCOPY BALLOON ENTEROSCOPY Video CAPSULE ENDOSCOPY ENDOSCOPY
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Upper Gastrointestinal Endoscopic Outcomes in Patients with Gastrointestinal Symptoms: Retrospective Analysis at a Tertiary Care Hospital 预览
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作者 Iftikhar Haider Naqvi Abu Talib +15 位作者 Muqadus Tabraze Omer Mustafa Siddiqui Maheen Fatima Hussaini Neha Saleem Paryani Rida Effendi Samrah lnam Siddiqui Syeda Zuhaa Hassan Maham Munawar Zaiya Waseem Ameer Ahmed Khan Zafir Zohab Hussain Khan S. Zain Naeem Rizvi Sofia Fatima Farooqui Misbah Munaf Hasan Obaid Faryal Khan 《肠胃病学期刊(英文)》 2019年第8期141-157,共17页
Background: Endoscopic procedures are frequently performed to rule out any disease process which eventuates with either a positive or negative outcome. Association of patient demographics, clinical features with endos... Background: Endoscopic procedures are frequently performed to rule out any disease process which eventuates with either a positive or negative outcome. Association of patient demographics, clinical features with endoscopic outcomes are of paramount importance for better understanding and practice of endoscopy. Objectives: This study aimed to determine the frequency of positive endoscopic findings in patients with gastrointestinal symptoms compared to those with negative findings. As a secondary objective, the association between relevant demographics, symptoms, laboratory investigations and procedural outcomes of the participants and positive endoscopic findings were also assessed. Methods: A retrospective analysis of all the patients who underwent esophagogastroduodenoscopy from January 2017 to December 2017 was conducted. A total of 1066 endoscopy records were retrieved and using a convenience sampling technique, relevant data were manually entered to the questionnaires. Records with incomplete or inconsistent data were disregarded as per the exclusion criteria, resulting in 1011 patient records ultimately utilized for the study. All data were entered and analyzed using IBM SPSS 23.0. Results: The study comprised a total of 1011 patients where 52.2% were females and 47.8% males while the mean age of patients was 42.16 ± 15.45. Positive endoscopic findings were observed in 88.1%, where the most common finding was gastritis (49.1%). Approximately 14.5% had positive investigation findings for HBsAg and 23.1% were seropositive for anti-HCV antibody. P-values statistically significant were for age (p = 0.044), hematemesis (p = 0.002), betel quid addiction (p = 0.044), anti-HCV antibody (p = 0.043), HCV-RNA (p = 0.041) and “H. pylori” antigen (p = 0.032). Conclusion: Both genders were almost equally included where most patients presented between the 3rd and 5th decades of life. A high incidence of gastritis was noted. Positive endoscopic findings were associated with betel quid addiction and with Hepatitis C inf 展开更多
关键词 ESOPHAGOGASTRODUODENOSCOPY ENDOSCOPY GASTRITIS ESOPHAGEAL VARICES
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Endoscopic response to tumor necrosis factor inhibitors predicts long term benefits in Crohn’s disease 预览
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作者 Ignacio Alfaro Maria Carme Masamunt +10 位作者 Nuria Planell Alicia López-García Jesús Castro Marta Gallego Rebeca Barastegui Angel Giner Alejandro Vara Azucena Salas Elena Ricart Julián Panés Ingrid Ordás 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第14期1764-1774,共11页
BACKGROUND Identifying predictors of therapeutic response is the cornerstone of personalized medicine. AIM To identify predictors of long-term mucosal healing (MH) in patients with Crohn's disease (CD) treated wit... BACKGROUND Identifying predictors of therapeutic response is the cornerstone of personalized medicine. AIM To identify predictors of long-term mucosal healing (MH) in patients with Crohn's disease (CD) treated with tumor necrosis factor α(TNF-α) inhibitors. METHODS Prospective single center study. Consecutive patients with clinically active CD requiring treatment with a TNF-α inhibitor were included. A baseline segmental CD Endoscopic Index of Severity (CDEIS)≥ 10 in at least one segment or the presence of ulcerations were required for inclusion. Clinical, biological and endoscopic data were obtained at baseline, weeks 14 and 46. Endoscopic response (ER) was defined as a decrease ≥ 50% from baseline CDEIS and MH as partial CDEIS ≤ 5 in all segments. RESULTS Of 62 patients were included. At baseline, median CD Activity Index and CDEIS were 201 and 6.7, respectively with a significant reduction after one year of treatment (53 and 3.0 respectively, P < 0.001). At week 14, 56% of patients achieved ER and 34% MH. At week 46, the corresponding percentages were 52% and 44%. Baseline disease characteristics or biomarkers did not predict MH. A decrease from baseline CDEIS at week 14 of at least 80% was the best predictor of MH at week 46 (59% sensitivity and 91% specificity;area under the curve = 0.778).CONCLUSION Clinical and biomarker data are not useful predictors of response to TNF-α inhibitors in CD, whereas ER to induction therapy, defined as 80% reduction in global CDEIS, is a robust predictor of long-term MH. Achievement of this endoscopic endpoint may be considered as a therapeutic target for anti-TNF-α therapy. 展开更多
关键词 Crohn’s DISEASE Endoscopy MUCOSAL HEALING Crohn’s DISEASE ENDOSCOPIC Index of SEVERITY Tumor NECROSIS factor
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