期刊文献+
共找到26篇文章
< 1 2 >
每页显示 20 50 100
Gastric per-oral endoscopic myotomy: Current status and future directions 预览
1
作者 Alexander Podboy Joo Ha Hwang +5 位作者 Linda A Nguyen Patricia Garcia Thomas A Zikos Afrin Kamal George Triadafilopoulos John O Clarke 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第21期2581-2590,共10页
Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by t... Gastroparesis, or symptomatic delayed gastric emptying in the absence of mechanical obstruction, is a challenging and increasingly identified syndrome. Medical options are limited and the only medication approved by the Food and Drug Administration for treatment of gastroparesis is metoclopramide, although other agents are frequently used off label. With this caveat, first-line treatments for gastroparesis include dietary modifications, antiemetics and promotility agents, although these therapies are limited by suboptimal efficacy and significant medication side effects. Treatment of patients that fail first-line treatments represents a significant therapeutic challenge. Recent advances in endoscopic techniques have led to the development of a promising novel endoscopic therapy for gastroparesis via endoscopic pyloromyotomy, also referred to as gastric per-oral endoscopic myotomy or per-oral endoscopic pyloromyotomy. The aim of this article is to review the technical aspects of the per-oral endoscopic myotomy procedure for the treatment of gastroparesis, provide an overview of the currently published literature, and outline potential next directions for the field. 展开更多
关键词 Gastroparesis GASTRIC per-oral ENDOSCOPIC MYOTOMY Per-oral ENDOSCOPIC PYLOROMYOTOMY MYOTOMY ENDOSCOPIC MYOTOMY Peroral ENDOSCOPIC MYOTOMY GASTRIC emptying
在线阅读 免费下载
Outcomes of per oral endoscopic pyloromyotomy in gastroparesis worldwide 预览
2
作者 Parit Mekaroonkamol Rushikesh Shah Qiang Cai 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第8期909-922,共14页
Per oral endoscopic pyloromyotomy(POP),also known as gastric per-oral endoscopic myotomy(GPOEM),is a novel procedure with promising potential for the treatment of gastroparesis.As more data emerge and the procedure is... Per oral endoscopic pyloromyotomy(POP),also known as gastric per-oral endoscopic myotomy(GPOEM),is a novel procedure with promising potential for the treatment of gastroparesis.As more data emerge and the procedure is becoming more recognized in clinical practice,its safety and efficacy need to be carefully evaluated.Appropriate patient selection for favorable clinical success prediction after GPOEM also needs additional research.This review aims to systemically summarize the existing data on clinical outcomes of POP.Symptomatologic responses to the procedure,its adverse effects,procedural techniques,and predictive factors of clinical success are also discussed. 展开更多
关键词 Gastroparesis PER ORAL ENDOSCOPIC PYLOROMYOTOMY Gastric per-oral ENDOSCOPIC myotomy PYLOROMYOTOMY OUTCOMES
在线阅读 免费下载
Consensus on the digestive endoscopic tunnel technique 预览
3
作者 Ning-Li Chai Hui-Kai Li +45 位作者 En-Qiang Linghu Zhao-Shen Li Shu-Tian Zhang Yu Bao Wei-Gang Chen Philip WY Chiu Tong Dang Wei Gong Shu-Tang Han Jian-Yu Hao Shui-Xiang He Bing Hu1 Bing Hu2 Xiao-Jun Huang Yong-Hui Huang Zhen-Dong Jin Mouen A Khashab James Lau Peng Li Rui Li De-Liang Liu Hai-Feng Liu Jun Liu Xiao-Gang Liu Zhi-Guo Liu Ying-Cai Ma Gui-Yong Peng Long Rong Wei-Hong Sha Pateek Sharma Jian-Qiu Sheng Shui-Sheng Shi Dong Wan Seo Si-Yu Sun Gui-Qi Wang Wen Wang Qi Wu Hong Xu Mei-Dong Xu Ai-Ming Yang Fang Yao Hong-Gang Yu Ping-Hong Zhou Bin Zhang Xiao-Feng Zhang Ya-Qi Zhai 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第7期744-776,共33页
With the digestive endoscopic tunnel technique(DETT),many diseases that previously would have been treated by surgery are now endoscopically curable by establishing a submucosal tunnel between the mucosa and musculari... With the digestive endoscopic tunnel technique(DETT),many diseases that previously would have been treated by surgery are now endoscopically curable by establishing a submucosal tunnel between the mucosa and muscularis propria(MP).Through the tunnel,endoscopic diagnosis or treatment is performed for lesions in the mucosa,in the MP,and even outside the gastrointestinal(GI)tract.At present,the tunnel technique application range covers the following:(1)Treatment of lesions originating from the mucosal layer,e.g.,endoscopic submucosal tunnel dissection for oesophageal large or circular early-stage cancer or precancerosis;(2)treatment of lesions from the MP layer,per-oral endoscopic myotomy,submucosal tunnelling endoscopic resection,etc.;and(3)diagnosis and treatment of lesions outside the GI tract,such as resection of lymph nodes and benign tumour excision in the mediastinum or abdominal cavity.With the increasing number of DETTs performed worldwide,endoscopic tunnel therapeutics,which is based on DETT,has been gradually developed and optimized.However,there is not yet an expert consensus on DETT to regulate its indications,contraindications,surgical procedure,and postoperative treatment.The International DETT Alliance signed up this consensus to standardize the procedures of DETT.In this consensus,we describe the definition,mechanism,and significance of DETT,prevention of infection and concepts of DETTassociated complications,methods to establish a submucosal tunnel,and application of DETT for lesions in the mucosa,in the MP and outside the GI tract(indications and contraindications,procedures,pre-and postoperative treatments,effectiveness,complications and treatments,and a comparison between DETT and other operations). 展开更多
关键词 DIGESTIVE ENDOSCOPIC TUNNEL technique ENDOSCOPIC SUBMUCOSAL TUNNEL dissection Per-oral ENDOSCOPIC MYOTOMY SUBMUCOSAL TUNNELLING ENDOSCOPIC resection Gastrointestinal tract
在线阅读 免费下载
Pancreatoscopy: An update 预览
4
作者 Luca De Luca Alessandro Repici +3 位作者 Adea Kocollari Francesco Auriemma Mario Bianchetti Benedetto Mangiavillano 《世界胃肠内镜杂志:英文版(电子版)》 2019年第1期22-30,共9页
Per-oral pancreatoscopy (POPS) is an endoscopic procedure to visualize the main pancreatic duct. POPS specifically has the advantage of direct visualization of the pancreatic duct, allowing tissue acquisition and dire... Per-oral pancreatoscopy (POPS) is an endoscopic procedure to visualize the main pancreatic duct. POPS specifically has the advantage of direct visualization of the pancreatic duct, allowing tissue acquisition and directed therapies such as stones lithotripsy. The aim of this review is to analyze and summarize the literature around pancreatoscopy. Pancreatoscopy consists of the classic technique of the mother-baby method in which a mini-endoscope is passed through the accessory channel of the therapeutic duodenoscope. Pancreatoscopy has two primary indications for diagnostic purpose. First, it is used for visualization and histological diagnosis of intraductal papillary mucinous neoplasms. In these cases, POPS is very useful to assess the extent of malignancy and for the study of the intraductal papillary mucinous neoplasm in order to guide the surgery resection margins. Second, it is used to determine pancreatic duct strictures, particularly important in cases of chronic pancreatitis, which is associated with both benign and malignant strictures. Therefore POPS allows differentiation between benign and malignant disease and allows mapping the extent of the tumor prior to surgical resection. Also tissue sampling is possible, but it can be technically difficult because of the limited maneuverability of the biopsy forceps in the pancreatic ducts. Pancreatoscopy can also be used for therapeutic purposes, such as pancreatoscopy-guided lithotripsy in chronic painful pancreatitis with pancreatic duct stones. The available data for the moment suggests that, in selected patients, pancreatoscopy has an important and promising role to play in the diagnosis of indeterminate pancreatic duct strictures and the mapping of main pancreatic duct intraductal papillary mucinous neoplasms. However, further studies are necessary to elucidate and validate the pancreatoscopy role in the therapeutic algorithm of chronic pancreatitis. 展开更多
关键词 PANCREATOSCOPY Per-oral PANCREATOSCOPY Endoscopic RETROGRADE CHOLANGIOPANCREATOGRAPHY SpyGlass
在线阅读 免费下载
Role of digital single-operator cholangioscopy in the diagnosis and treatment of biliary disorders 预览
5
作者 Petko Karagyozov Irina Boeva Ivan Tishkov 《世界胃肠内镜杂志:英文版(电子版)》 2019年第1期31-40,共10页
Due to the need for improvement in the diagnosis and minimally invasive therapy of the bile duct disorders new technologies for cholangioscopy have been recently developed. Per-oral cholangioscopy has become an import... Due to the need for improvement in the diagnosis and minimally invasive therapy of the bile duct disorders new technologies for cholangioscopy have been recently developed. Per-oral cholangioscopy has become an important diagnostic and therapeutic tool leading to avoidance of aggressive and unnecessary surgery in many clinical scenarios. This paper focuses on the newly developed SpyGlass DS technology, its advantages, and the technique of single-operator cholangioscopy (SOC), biliary indications and possible adverse events. We also review the available literature; discuss the limitations and future expectations. Digital SOC (D-SOC) is a useful technique, which provides endoscopic imaging of the biliary tree, optical diagnosis, biopsy under direct vision and therapeutic interventions. The implementations are diagnostic and therapeutic. Diagnostic indications are indeterminate biliary strictures, unclear filling defects, staging of cholangiocarcinoma, staging of ampullary tumors (extension into the common bile duct), unclear bile duct dilation, exploring cystic lesions of the biliary tree, unexplained hemobilia, posttransplant biliary complications. Therapeutic indications are lithotripsy of difficult stones, retrieval of migrated stents, foreign body removal, guide wire placement, transpapillary gallbladder drainage and endoscopic tumor ablative therapy. Most studied and established indications are the diagnosis of indeterminate biliary stricture and intraductal lithotripsy of difficult stones. The adverse events are not different and more common compared to those of Endoscopic retrograde cholangiopancreatography (ERCP) alone. D-SOC is a safe and effective procedure, adjunct to the standard ERCP and the newly available digital technology overcomes many of the limitations of the previous generations of cholangioscopes. 展开更多
关键词 Per-oral CHOLANGIOSCOPY DIGITAL single-operator CHOLANGIOSCOPY Difficult stones INDETERMINATE strictures Endoscopic retrograde cholangiopancreatography BILIARY interventions
在线阅读 免费下载
Endoscopic foregut surgery and interventions:The future is now.The state-of-the-art and my personal journey 预览
6
作者 Kenneth J Chang H.H.Chao 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第1期1-41,共41页
In this paper,I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgicall... In this paper,I reviewed the emerging field of endoscopic surgery and present data supporting the contention that endoscopy can now be used to treat many foregut diseases that have been traditionally treated surgically.Within each topic,the content will progress as follows:“lessons learned”,“technical considerations”and“future opportunities”.Lessons learned will provide a brief background and update on the most current literature.Technical considerations will include my personal experience,including tips and tricks that I have learned over the years.Finally,future opportunities will address current unmet needs and potential new areas of development.The foregut is defined as“the upper part of the embryonic alimentary canal from which the pharynx,esophagus,lung,stomach,liver,pancreas,and part of the duodenum develop”.Foregut surgery is well established in treating conditions such as gastroesophageal reflux disease(GERD),achalasia,esophageal diverticula,Barrett’s esophagus(BE)and esophageal cancer,stomach cancer,gastric-outlet obstruction,and obesity.Over the past decade,remarkable progress in interventional endoscopy has culminated in the conceptualization and practice of endoscopic foregut surgery for various clinical conditions summarized in this paper.Regarding GERD,there are now several technologies available to effectively treat it and potentially eliminate symptoms,and the need for long-term treatment with proton pump inhibitors.For the first time,fundoplication can be performed without the need for open or laparoscopic surgery.Long-term data going out 5-10 years are now emerging showing extended durability.In respect to achalasia,per-oral endoscopic myotomy(POEM)which was developed in Japan,has become an alternative to the traditional Heller’s myotomy.Recent meta-analysis show that POEM may have better results than Heller,but the issue of post-POEM GERD still needs to be addressed.There is now a resurgence of endoscopic treatment of Zenker’s diverticula with improved technique(Z-POEM)an 展开更多
关键词 Endoscopy FOREGUT diseases GASTROESOPHAGEAL reflux disease ENDOSCOPIC sleeve GASTROPLASTY ENDOSCOPIC submucosal dissection Per-oral ENDOSCOPIC MYOTOMY Endo-hepatology
在线阅读 免费下载
Endoscopic treatment of esophageal achalasia 预览
7
《世界胃肠内镜杂志:英文版(电子版)》 2016年第2期30-39,共10页
Achalasia is a motility disorder of the esophaguscharacterized by dysphagia, regurgitation of undigestedfood, chest pain, weight loss and respiratory symptoms.The most common form of achalasia is the idiopathic one.Di... Achalasia is a motility disorder of the esophaguscharacterized by dysphagia, regurgitation of undigestedfood, chest pain, weight loss and respiratory symptoms.The most common form of achalasia is the idiopathic one.Diagnosis largely relies upon endoscopy, barium swallowstudy, and high resolution esophageal manometry(HRM). Barium swallow and manometry after treatmentare also good predictors of success of treatment as it isthe residue symptomatology. Short term improvementin the symptomatology of achalasia can be achievedwith medical therapy with calcium channel blockers orendoscopic botulin toxin injection. Even though fewpatients can be cured with only one treatment andrepeat procedure might be needed, long term relief fromdysphagia can be obtained in about 90% of cases witheither surgical interventions such as laparoscopic Hellermyotomy or with endoscopic techniques such pneumaticdilatation or, more recently, with per-oral endoscopicmyotomy. Age, sex, and manometric type by HRM arealso predictors of responsiveness to treatment. Olderpatients, females and type Ⅱ achalasia are better aftertreatment compared to younger patients, males andtype Ⅲ achalasia. Self-expandable metallic stents are analternative in patients non responding to conventionaltherapies. 展开更多
关键词 ACHALASIA High resolution manometrysubtypes Eckardt SCORE Per-oral endoscopic MYOTOMY PNEUMATIC DILATATION Botulin TOXIN MYOTOMY
在线阅读 免费下载
经内镜逆行胰胆管造影术的若干进展 预览 被引量:2
8
作者 王向平 潘阳林 郭学刚 《临床肝胆病杂志》 CAS 北大核心 2018年第3期473-481,共9页
作为一项成熟应用于胆胰疾病的高级内镜诊疗技术,经内镜逆行胰胆管造影(ERCP)近几年来在治疗理念和技术方面有了一些新的发展。对ERCP的若干进展进行了阐述,主要包括:运用胰管支架、非甾体抗炎类药物及大量水化预防术后胰腺炎,覆膜... 作为一项成熟应用于胆胰疾病的高级内镜诊疗技术,经内镜逆行胰胆管造影(ERCP)近几年来在治疗理念和技术方面有了一些新的发展。对ERCP的若干进展进行了阐述,主要包括:运用胰管支架、非甾体抗炎类药物及大量水化预防术后胰腺炎,覆膜金属支架用于治疗良性胆管狭窄,恶性胆管狭窄的腔内射频消融治疗,体外冲击波碎石术和覆膜金属支架治疗慢性胰腺炎,经口胆道镜应用于胆管狭窄定性诊断和巨大难治性结石,困难插管的定义和预切开技术的时机以及胃肠道重建术后ERCP。 展开更多
关键词 胰胆管造影术 内窥镜逆行 经口胆管镜 胆管括约肌预切 胰腺炎 胆管狭窄
在线阅读 下载PDF
经口内镜下肌切开术治疗贲门失弛症的临床疗效分析 预览
9
作者 周煜燊 何利平 《创伤与急诊电子杂志》 2018年第2期81-86,共6页
目的 探讨经口内镜下肌切开术治疗贲门失弛症的临床疗效.方法 回顾性分析本院 2010 年 8 月至 2017 年 12 月确诊为贲门失弛症并于本科室行经口内镜下肌切开术(per-oral endoscopic myotomy, POEM) 手术的 48 例患者的临床资料,根据... 目的 探讨经口内镜下肌切开术治疗贲门失弛症的临床疗效.方法 回顾性分析本院 2010 年 8 月至 2017 年 12 月确诊为贲门失弛症并于本科室行经口内镜下肌切开术(per-oral endoscopic myotomy, POEM) 手术的 48 例患者的临床资料,根据有无既往诊疗史将患者分为 2 组,无既往诊疗史组 34 例,有既往诊疗史组 14 例,分析 2 组患者术后以及随访过程中并发症发生情况及临床疗效.结果 48 例患者 POEM 手术均顺利完成.肌切开长度4-11 cm,随访时间 3-88个月,术前Eckardt评分3-11分,平均(7.54±1.76)分,术后Eckardt评分0 - 5 分,平均(1.67±1.31)分,较术前明显降低(P〈0.05), 3个月后 4例Eckardt评分〉3分,其中1例行第二次POEM手术,随访至目前(61个月) Eckardt评分〈3分.术后并发症发生率 20.8%(10/48),无一例与手术相关死亡病例,所有并发症经对症、保守治疗后痊愈,无-例追加外科手术.2 组患者在并发症的发生率以及疗效上的差异无统计学意义.结论 POEM手术并发症的发生以及疗效与既往诊疗史无关,是-种治疗贲门失弛症安全、有效的手术方式,且有较好的远期疗效. 展开更多
关键词 贲门失弛症 经口内镜下肌切开术 疗效 并发症
在线阅读 下载PDF
Submucosal tunnel endoscopy: Peroral endoscopicmyotomy and peroral endoscopic tumor resection 预览 被引量:2
10
作者 Nikolas Eleftheriadis Haruhiro Inoue +3 位作者 Haruo Ikeda Manabu Onimaru Roberta Maselli Grace Santi 《世界胃肠内镜杂志:英文版(电子版)》 2016年第2期86-103,共18页
Peroral endoscopic myotomy (POEM) is an innovative,minimally invasive, endoscopic treatment for esophagealachalasia and other esophageal motility disorders,emerged from the natural orifice transluminal endoscopicsur... Peroral endoscopic myotomy (POEM) is an innovative,minimally invasive, endoscopic treatment for esophagealachalasia and other esophageal motility disorders,emerged from the natural orifice transluminal endoscopicsurgery procedures, and since the first human caseperformed by Inoue in 2008, showed exciting results ininternational level, with more than 4000 cases globallyup to now. POEM showed superior characteristics thanthe standard 100-year-old surgical or laparoscopic Hellermyotomy (LHM), not only for all types of esophagealachalasia [classical (Ⅰ), vigorous (Ⅱ), spastic (Ⅲ),Chicago Classification], but also for advanced sigmoidtype achalasia (S1 and S2), failed LHM, or other esophagealmotility disorders (diffuse esophageal spasm,nutcracker esophagus or Jackhammer esophagus). POEMstarts with a mucosal incision, followed by submucosaltunnel creation crossing the esophagogastric junction(EGJ) and myotomy. Finally the mucosal entry is closedwith endoscopic clip placement. POEM permittedrelatively free choice of myotomy length and localization.Although it is technically demanding procedure, POEMcan be performed safely and achieves very goodcontrol of dysphagia and chest pain. Gastroesophagealreflux is the most common troublesome side effect,and is well controllable with proton pump inhibitors.Furthermore, POEM opened the era of submucosal tunnelendoscopy, with many other applications. Based onthe same principles with POEM, in combination withnew technological developments, such as endoscopicsuturing, peroral endoscopic tumor resection (POET), issafely and effectively applied for challenging submucosalesophageal, EGJ and gastric cardia tumors (submucosaltumors), emerged from muscularis propria. POET showedup to know promising results, however, it is restricted tospecialized centers. The present article reviews the recentdata of POEM and POET and discussed controversialissues that need further study and future perspectives. 展开更多
关键词 Achalasia Heller MYOTOMY Laparoscopicmyotomy Per-oral ENDOSCOPIC MYOTOMY Natural orificetransluminal ENDOSCOPY SURGERY ENDOSCOPIC submucosaldissection SUBMUCOSAL ENDOSCOPY LES Transluminaltechnique Minimally invasive SURGERY Peroral ENDOSCOPIC TUMORECTOMY EndoFLIP
在线阅读 免费下载
Microvasculature of the esophagus and gastroesophageal junction: Lesson learned from submucosal endoscopy 预览
11
作者 Roberta Maselli Haruhiro Inoue +6 位作者 Haruo Ikeda Manabu Onimaru Akira Yoshida Esperanza Grace Santi Hiroki Sato Bu'Hussain Hayee Shin-Ei Kudo 《世界胃肠内镜杂志:英文版(电子版)》 2016年第19期690-696,
Advanced therapeutic endoscopy,in particular endoscopic mucosal resection,endoscopic submucosal dissection,per-oral endoscopic myotomy,submucosal endoscopic tumor resection opened a new era where direct esophageal vis... Advanced therapeutic endoscopy,in particular endoscopic mucosal resection,endoscopic submucosal dissection,per-oral endoscopic myotomy,submucosal endoscopic tumor resection opened a new era where direct esophageal visualization is possible.Combining these information with advanced diagnostic endoscopy,the esophagus is organized,from the luminal side to outside,into five layers(epithelium,lamina propria with lamina muscularis mucosa,submucosa,muscle layer,adventitia).A specific vascular system belonging to each layer is thus visible: Mucosa with the intra papillary capillary loop in the epithelium and the sub-epithelial capillary network in the lamina propria and,at the lower esophageal sphincter(LES) level with the palisade vessels; submucosa with the drainage vessels and the spindle veins at LES level; muscle layer with the perforating vessels; periesophageal veins in adventitia.These structures are particularly important to define endoscopic landmark for the gastro-esophageal junction,helpful in performing submucosal therapeutic endoscopy. 展开更多
关键词 微脉管系统 食道的解剖 Submucosal 内视镜检查法 每口头的内视镜的肌切开术 先进成像
在线阅读 免费下载
床头高度对经口内镜下食管肌切开术患者术后疼痛的影响分析 被引量:1
12
作者 邱晓珏 杨婷 丁伟伟 《中国煤炭工业医学杂志》 2016年第9期1304-1307,共4页
目的探讨床头高度对经口内镜下食管肌切开术患者术后疼痛的影响。方法收集2014年12月—2015年9月于该科成功行POEM术的贲门失弛缓症患者60例,按入院顺序随机分为三组,其中A组为床头抬高0°、B组为床头抬高10°~15°、C组为... 目的探讨床头高度对经口内镜下食管肌切开术患者术后疼痛的影响。方法收集2014年12月—2015年9月于该科成功行POEM术的贲门失弛缓症患者60例,按入院顺序随机分为三组,其中A组为床头抬高0°、B组为床头抬高10°~15°、C组为床头抬高30°~45°。观察各组患者POEM术后第一天、二天、三天疼痛情况,分别给予疼痛评分并记录,统计疼痛频次,应用止痛药物频次。结果三组患者在年龄、性别、疾病史、内镜治疗方式等方面差异无统计学意义(P〉0.05)。三组患者术后第一、二、三天疼痛缓解有效率、疼痛频次、应用止痛药物频次差异有统计学意义(P〈0.05)。结论床头抬高30°~45°能够更好地降低膈肌、减轻对食管的牵拉,从而减少胃食管反流的发生、缓解POEM术后切口疼痛,并减少疼痛发生频次,减少止痛药物应用。 展开更多
关键词 经口内镜下食管肌切开术 床头高度 疼痛评分
Recent advancement of therapeutic endoscopy in theesophageal benign diseases 预览
13
作者 Robert Bechara Haruhiro Inoue. 《世界胃肠内镜杂志:英文版(电子版)》 2015年第5期481-495,共15页
Over the past 30 years, the field of endoscopy haswitnessed several advances. With the advent ofendoscopic mucosal resection, removal of large mucosallesions have become possible. Thereafter, endoscopicsubmucosal rese... Over the past 30 years, the field of endoscopy haswitnessed several advances. With the advent ofendoscopic mucosal resection, removal of large mucosallesions have become possible. Thereafter, endoscopicsubmucosal resection was refined, permitting en blocremoval of large superficial neoplasms. Such techniqueshave facilitated the development of antirefluxmucosectomy, a promising novel treatment for gastroesophagealreflux. The introduction and use of overthe scope clips has allowed for endoscopic closureof defects in the gastrointestinal tract, which weretraditionally treated with surgical intervention. With thedevelopment of per-oral endoscopic myotomy (POEM),the treatment of achalasia and spastic disorders ofthe esophagus have been revolutionized. From thesubmucosal tunnelling technique developed for POEM,Per oral endoscopic tumor resection of subepithelialtumors was made possible. Simultaneously, advancesin biotechnology have expanded esophageal stentingcapabilities with the introduction of fully covered metaland plastic stents, as well as biodegradable stents.Once deemed a primarily diagnostic tool, endoscopy hasquickly transcended to a minimally invasive interventionand therapeutic tool. These techniques are reviewedwith regards to their application to benign disease ofthe esophagus. 展开更多
关键词 Per-oral endoscopic MYOTOMY Per-oralendoscopic tumor resection ANTIREFLUX MUCOSECTOMY Submucosal TUMORS Subepithelial TUMORS Over thescope clips Stents GASTROESOPHAGEALREFLUX disease
在线阅读 免费下载
Techniques and efficacy of flexible endoscopic therapy ofZenker's diverticulum 预览
14
作者 Yaseen Perbtani Alejandro Suarez Mihir S Wagh 《世界胃肠内镜杂志:英文版(电子版)》 2015年第3期206-212,共7页
Zenker's diverticulum (ZD) is an abnormal hypopharyngealpouch often presenting with dysphagia. Treatment isoften sought with invasive surgical management of thediverticulum being the only mode of definitive therapy... Zenker's diverticulum (ZD) is an abnormal hypopharyngealpouch often presenting with dysphagia. Treatment isoften sought with invasive surgical management of thediverticulum being the only mode of definitive therapy.Primarily done by an open transcervical approachin the past, nowadays treatment is usually providedby otolaryngologists using a less invasive trans-oraltechnique with a rigid endoscope. When first described,this method grew into acceptance quickly due to itssimilar efficacy and vastly improved safety profilecompared to the open transcervical approach. However,the main limitation with this approach is that it may notbe suitable for all patients. Nonetheless, progress inthe field of natural orifice endoscopic surgery over thelast 10-20 years has led to the increase in utilization ofthe flexible endoscope in the treatment of ZD. Primarilyperformed by interventional gastroenterologists, thisapproach overcomes the prior limitation of its surgicalcounterpart and allows adequate visualization of thediverticulum independent of the patient's body habitus.Additionally, it may be performed without the useof general anesthesia and in an outpatient setting,thus further increasing the utility of this modality,especially in elderly patients with other comorbidities.Today, results in more than 600 patients have beendescribed in various published case series usingdifferent techniques and devices demonstrating a highpercentage of clinical symptom resolution with lowrates of adverse events. In this article, we present ourexperience with flexible endoscopic therapy of Zenker'sdiverticulum and highlight the endoscopic technique,outcomes and adverse events related to this minimallyinvasive modality. 展开更多
关键词 Zenker's DIVERTICULUM FLEXIBLE ENDOSCOPY Natural orifice endoscopic surgery Per-oral ENDOSCOPY DYSPHAGIA Cricopharyngeus MYOTOMY Cricopharyngeusseptotomy
在线阅读 免费下载
经口内镜下肌切开术与球囊扩张治疗贲门失弛缓症的疗效比较 预览 被引量:5
15
作者 邓治良 姜泊 《中华临床医师杂志(电子版)》 2015年第12期51-54,共4页
目的:对比球囊扩张术(PD)与经口内镜下肌切开术(POEM)的疗效。方法本研究为回顾性研究,纳入了由2011年7月到2013年7月总共102例明确诊断为贲门失弛缓症的患者。其中77例患者接受了POEM,另外25例患者接受了PD。观察并对比两组患... 目的:对比球囊扩张术(PD)与经口内镜下肌切开术(POEM)的疗效。方法本研究为回顾性研究,纳入了由2011年7月到2013年7月总共102例明确诊断为贲门失弛缓症的患者。其中77例患者接受了POEM,另外25例患者接受了PD。观察并对比两组患者术前术后症状缓解情况、下段食管括约肌压力、手术时长、术中和术后并发症、手术风险以及住院时长等。结果 POEM组含有77例患者,而PD组有25例患者。经过一系列术前检查,发现两组患者之间的BMI、性别、年龄以及术前的食管测压、Eckardt评分并没有存在显著差异。术后3个月时两组患者均获得明显的临床缓解, POEM组患者的Eckardt评分(1.40±1.20 vs.1.48±1.42, P<0.777)以及术后LES压力[(14.45±6.14)mmHg vs.(16.84±7.34)mmHg,P<0.874]和PD组相比并没有统计学差异。而POEM组患者的手术耗时[(60.54±24.02)min vs.(23.91±3.68)min,P<0.00]、住院时长[(9.49±4.45)d vs.(5.76±2.26)d,P<0.00]以及术中并发症发生率(18.2%vs.0%,P=0.00)均要显著高于PD组。但术后12个月时的随访复查发现PD组的Eckardt评分(1.18±1.08 vs.4.23±2.06,P<0.00)和LES压力[(13.42±5.56)mmHg vs.(38.27±9.13)mmHg,P<0.00]显著高于POEM组。结论相比POEM术,PD术简单易行,安全性相对较高,且两者对于治疗贲门失弛缓症都有良好的短期疗效。但对于PEOM患者,症状缓解更加稳定,症状不会复发。而接受PD治疗的患者,往往未来需要接受重复或更进一步治疗。 展开更多
关键词 食管失弛症 气囊扩张术 经口内镜下肌切开术 并发症
在线阅读 下载PDF
Laimer纤维在贲门失弛缓症患者中的表现情况 被引量:1
16
作者 王宇菲 令狐恩强 +4 位作者 王向东 杜红 孟江云 王红斌 朱静 《中华消化内镜杂志》 2014年第3期130-132,共3页
目的探讨Laimer纤维在贲门失弛缓症(AC)患者中的发生情况及其形态学特征。方法收集107例行经口内镜下肌切开术(POEM)治疗的AC患者的病例资料,重新筛查每例患者的POEM手术视频,根据患者性别、年龄段、AC内镜下Ling分型及Laimer纤... 目的探讨Laimer纤维在贲门失弛缓症(AC)患者中的发生情况及其形态学特征。方法收集107例行经口内镜下肌切开术(POEM)治疗的AC患者的病例资料,重新筛查每例患者的POEM手术视频,根据患者性别、年龄段、AC内镜下Ling分型及Laimer纤维所在部位分类统计Laimer纤维发现率并行对比分析。结果44例存在Laimer纤维,发现率为41.12%(44/107)。不同性别、不同年龄段AC患者中发现率比较差异均无统计学意义(P〉0.05);LingIIb型发现率最高(46.15%,12/26),其次为I型(45.83%,22/48),Ⅲ型无发现,Ling各型发现率比较差异无统计学意义(X2=2.042,P=0.564);Laimer纤维均位于食管下段括约肌中,食管右侧壁发现率最高(36.45%,39/107),其次为食管左侧壁(3.74%,4/107),食管前壁无发现,食管各部位发现率比较差异有统计学意义(X2=107.468,P=0.000),但是食管不同部位黏膜隧道开口者发现率比较差异无统计学意义(X2=7.055,P=0.070)。结论Laimer纤维较为普遍存在于AC患者食管下段括约肌中,且多见于食管右侧壁,但与AC的发病关系以及对食管下段括约肌功能的影响尚需进一步研究验证。 展开更多
关键词 Laimer纤维 贲门失弛缓症 经口内镜下肌切开术 食管下段括约肌
预览 被引量:4
17
作者 David Friedel Rani Modayil +2 位作者 Shahzad Iqbal James H Grendell Stavros N Stavropoulos 《世界胃肠内镜杂志:英文版(电子版)》 2013年第9期420-427,共8页
Achalasia is an uncommon esophageal motility disorder characterized by the selective loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower esophageal sphincter.Per-oral endosc... Achalasia is an uncommon esophageal motility disorder characterized by the selective loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower esophageal sphincter.Per-oral endoscopic myotomy(POEM) is a novel modality for the treatment of achalasia performed by gastroenterologists and surgeons.It represents a natural orifice transluminal endoscopic surgery(NOTES) approach to Heller myotomy.POEM has the minimal invasiveness of an endoscopic procedure that can duplicate results of the surgical Heller myotomy.POEM is conceptually similar to a surgical myotomy without the inherent external incisions and post-operative care associated with surgery.Initial high success and low complications rates promise a great future for this technique.In fact,POEM has been successfully performed on patients with end-stage achalasia as an initial treatment reserving esophagectomy for those without good response.The volume of POEMs performed worldwide has grown exponentially.In fact,surgeons who have performed Heller myotomy have embraced POEM as the preferred intervention for achalasia.However,the niche of POEM remains to be defined and long term results are awaited.We describe our experience with POEM having performed the first POEM outside of Japan in 2009,the evolution of our technique,and give our perspective on its future. 展开更多
关键词 Per-oral ENDOSCOPIC MYOTOMY ACHALASIA Heller MYOTOMY Natural orifice transluminal ENDOSCOPIC SURGERY Minimally invasive SURGERY
在线阅读 免费下载
贲门失弛缓症的研究进展 预览 被引量:17
18
作者 王爽 刘冰熔 《世界华人消化杂志》 CAS 北大核心 2013年第1期75-81,共7页
贲门失弛缓症是一种罕见的原发性食管动力障碍性疾病,以食管下段括约肌的松弛功能受损,食管蠕动波减少或消失,食管同步收缩为特征.由于本病的发病机制仍不明确,现有的治疗方式主要以缓解由食管下段括约肌引起的功能性梗阻为目的,同时保... 贲门失弛缓症是一种罕见的原发性食管动力障碍性疾病,以食管下段括约肌的松弛功能受损,食管蠕动波减少或消失,食管同步收缩为特征.由于本病的发病机制仍不明确,现有的治疗方式主要以缓解由食管下段括约肌引起的功能性梗阻为目的,同时保持降低食管下段括约肌压力与预防发生胃食管返流性疾病之间的平衡.本病的治疗方式包括药物治疗,介入治疗,手术治疗和中医整脊疗法.本文就贲门失弛缓症的最新治疗进展作一综述,重点讨论贲门失弛缓症现有的主要治疗方式包括气囊扩张术,Heller肌切开术及经口内镜下肌切开术(per-oral endoscopic myotomy,POEM)的进展. 展开更多
关键词 贲门失弛缓症 治疗 Heller肌切开 经口内镜下肌切开术 内镜下气囊扩张术
在线阅读 免费下载
贲门失迟缓症的内镜下治疗进展 预览 被引量:8
19
作者 康雪兰 张学彦 《胃肠病学和肝病学杂志》 CAS 2013年第5期475-477,共3页
贲门失弛缓症是一种食管动力障碍性疾病,至今病因及发病机制仍不十分明确,其治疗主要在于缓解症状,内镜下的治疗方法主要有:内镜下注射肉毒杆菌毒素、气囊扩张术、支架置入术和经口内镜下肌切开术等。
关键词 贲门失弛缓 肉毒杆菌毒素 气囊扩张 经口内镜下肌切开术
在线阅读 免费下载
贲门失弛缓症的内镜下分型在隧道技术中的应用 预览 被引量:9
20
作者 令狐恩强 李惠凯 《中国继续医学教育》 2011年第12期共3页
目的 经口内镜下肌切开术(per-oral endoscopic myotomy,POEM)是一种治疗贲门失弛缓症的有前景的技术,本研究拟提出一种内镜下的对贲门失弛缓症的新的分型,期望这种新的分型能够便利地用于术前评价贲门失弛缓症患者能否进行POEM治疗,并... 目的 经口内镜下肌切开术(per-oral endoscopic myotomy,POEM)是一种治疗贲门失弛缓症的有前景的技术,本研究拟提出一种内镜下的对贲门失弛缓症的新的分型,期望这种新的分型能够便利地用于术前评价贲门失弛缓症患者能否进行POEM治疗,并能有助于操作者之间进行POEM相关的学术交流。方法 回顾我院2000年10月到2011年9月消化内镜中心数据库中的贲门失弛缓症患者的内镜下资料,对内镜下采集的图片进行筛选,对于能够清楚显示食管下段及贲门形态的贲门失弛缓症患者的资料纳入分析,并用我们提出的这一新的内镜下Ling分型对患者进行分型。Ling分型共分三型:Ling Ⅰ型、Ling Ⅱ型和Ling Ⅲ型。结果 从数据库中共检索出贲门失弛缓症患者976例,食管下段及贲门形态显示清楚符合纳入标准的636例,图片不符合纳入标准的340例。636例中Ling Ⅰ型占64.5%( 410/636),Ling Ⅱ型占32.7%(208/636),Ling Ⅲ型占2.8%(18/636)。结论 内镜下Ling分型将贲门失弛缓症患者分为三型,这一分型能够便利地用于评价贲门失弛缓症POEM治疗的可行性,并为POEM相关的学术交流提供了一种参照工具。 展开更多
关键词 贲门失弛缓症 Ling分型 内镜下 经口内镜下肌切开术
在线阅读 免费下载
上一页 1 2 下一页 到第
使用帮助 返回顶部 意见反馈