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Mucosal resection

Takahito Sugase, Tomoki Makino, Makoto Yamasaki, Koji Tanaka, Tadayoshi Hashimoto, Yasuhiro Miyazaki, Tsuyoshi Takahashi, Yukinori Kurokawa, Kiyokazu Nakajima, Masayuki Mano, Eiichi Morii, Masaki Mori, Yuichiro Doki
INTRODUCTION: We aimed to analyze the clinical and histological effects of chemotherapy in superficial esophageal squamous cell carcinoma (SESCC). METHODS: We analyzed tumor samples from five patients with cT1bN1M0 who underwent subtotal esophagectomy following two courses of a new triplet chemotherapy regimen including docetaxel, cisplatin, and 5-fluorouracil (DCF). To assess the histological effects of chemotherapy, resected specimens were analyzed by macroscopic examination, hematoxylin & eosin (HE) staining, immunohistochemical (IHC) staining (p53, Ki-67 and cytokeratin) and periodic acid-Schiff (PAS) staining...
June 16, 2018: Esophagus: Official Journal of the Japan Esophageal Society
Douglas K Rex, Evelien Dekker
We review our approach to resection of colorectal polyps <20 mm in size. Careful inspection of all lesions is appropriate to assess the type of lesion (adenoma vs serrated) and evaluate the risk of cancer, which is highly associated with lesion size. Polyp resection is in the midst of a "cold revolution," particularly for lesions <10 mm in size, but also for some larger lesions. Cold forceps are sometimes appropriate for 1- to 2-mm lesions that can be engulfed in one bite, but we use cold snaring for almost the entire set of lesions <10 mm...
June 14, 2018: Gastrointestinal Endoscopy
J E Yap, P Jaiswal, L Ton, R Szynkarek, B M Attar, S Gandhi
WHAT IS KNOWN AND OBJECTIVE: Elbasvir/grazoprevir is an all-oral regimen approved for patients with hepatitis C virus (HCV) genotypes 1 and 4, and in renal insufficiency. However, to date, no data exist on the efficacy of this regimen when it is crushed and administered through a percutaneous endoscopic gastrostomy (PEG) tube. Here, we illustrate the case of a 63-year-old man who is the only known patient with HCV infection in the English literature to have successfully achieved a sustained viral response (SVR) when elbasvir/grazoprevir oral combination was administered through a PEG tube...
June 15, 2018: Journal of Clinical Pharmacy and Therapeutics
Carolyn Moore, Leslie Ray Matthews, Omar Danner, Assad Taha, Aviva Bashan-Gilzenrat, Jonathan Nguyen, Ed Childs, Kahdi Udobi
To review the entity "black esophagus" and sequela of a slipped laparoscopic adjustable band. The patient's history, physical examination, imaging, and endoscopic findings were reviewed. Detailed review of pathophysiology, presentation, diagnosis, management, and natural history was conducted. "Black esophagus," also known as acute esophageal necrosis (AEN), is a rare condition resulting in black discoloration of the mid to distal esophagus with less than a hundred reported cases. It has not been previously documented in bariatric surgery or following laparoscopic adjustable gastric banding...
June 15, 2018: Obesity Surgery
Jongmin Sim, Hyun Hee Koh, Sangjoon Choi, Jinah Chu, Tae Sung Kim, Hojoong Kim, Joungho Han
Background: Pulmonary nodular lymphoid hyperplasia (PNLH) is a non-neoplastic pulmonary lymphoid disorder that can be mistaken for malignancy on radiography. Herein, we present nine cases of PNLH, emphasizing clinicoradiological findings and histological features. Materials and Methods: We analyzed radiological and clinicopathological features from the electronic medical records of nine patients (eight females and one male) diagnosed with PNLH. IgG and IgG4 immunohistochemical staining was performed in three patients...
June 15, 2018: Journal of Pathology and Translational Medicine
Maham Hayat, Sultan Mahmood, John T Maple
A 62-year-old male with long-standing esophageal reflux underwent endoscopy at an outside institution that reported multiple polypoid lesions in upper esophagus and a small focal area of nodular mucosa at the gastroesophageal junction(GEJ). Biopsies of the proximal esophageal polyps demonstrated hyperplastic mucosa with ulceration, reactive epithelial changes, and focal intestinal metaplasia. Biopsies from the nodular GEJ mucosa were described as Barrett's esophagus with low grade dysplasia. An upper endoscopy performed at our medical center found multiple semi-pedunculated esophageal polyps between 18-24 cm from the incisors (Figure A)...
June 11, 2018: Clinical Gastroenterology and Hepatology
Luca Napolitano, Mathew Waku, Gustavo Maggi, Franco Ciarelli
Cystic intestinal pneumatosis (CIP) is the presence of gas bubbles inside the wall of the intestine. In literature it has been reported to be associated with a variety of clinical conditions such as: superior mesenteric ischemia, intestinal perforation, bowel necrosis, infections which can cause mucosal alterations and therefore increasing its permeability, necrotizing enterocolitis in babies, trauma, intestinal obstruction, autoimmune and pulmonary pathologies. Its presence is usually documented by radiological techniques such as abdominal X-ray, CT scan and endoscopy and are usually characterized by the typical pattern of gas bubbles in the wall of the intestine...
March 19, 2018: Annali Italiani di Chirurgia
Shohei Eto, Masashi Ishikawa, Michihito Asanoma, Yoshihiko Tashiro, Kazuo Matsuyama, Takehito Oshio
A 62-year-old man underwent endoscopic mucosal resection for early gastric cancer. The follow-up computed tomography revealed biliary dilatation. The tumor was located in the lower bile duct with biliary dilatation, and no evidence of metastasis in other organs was noted. The patient underwent subtotal stomach-preserving pancreatoduodenectomy with pancreaticogastrostomy and Billroth I anastomosis. At 13 months after the operation, gastrointestinal endoscopy revealed a tumor lesion in the pancreaticogastrostomy site...
May 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Christopher John Kiely, Paul Pavli, Claire Louise O'Brien
BACKGROUND: Using culture-based methods, bacterial translocation from the gut to draining mesenteric lymph nodes (LNs) is seen in 5% of normal controls and up to 33% of patients with IBD. Many bacteria can't be cultured so these methods are unable to capture the full spectrum of bacteria present. AIMS: To detect viable bacteria in LNs of patients with IBD and non-IBD controls using bacterial RNA as a surrogate for viability and to compare them with the same patient's gut microbiome...
June 11, 2018: Internal Medicine Journal
Kexin He, Lili Zhao, Shoushan Bu, Li Liu, Xiang Wang, Min Wang, Zhining Fan
 Esophageal caustic stricture is a stubborn disease and postoperative restenosis limits the clinical efficacy of endoscopic dilation. Autologous mucosal grafts have been successfully applied in the treatment of urethral stricture and in the prevention of stricture after extensive mucosal resection. We aimed to use mucosal autografting performed endoscopically to treat refractory esophageal stricture. METHODS : Three patients with intractable corrosive esophageal stricture were treated endoscopically by combining dilation with autologous mucosal transplantation...
June 11, 2018: Endoscopy
Takashi Toyonaga, Yoshiko Ohara, Shinichi Baba, Hiroshi Takihara, Manabu Nakamoto, Hitoshi Orita, Junji Okuda
BACKGROUND:  Although endoscopic submucosal dissection has enabled complete tumor resection and accurate pathological assessment in a manner that is less invasive than surgery, the complete resection of lesions with severe fibrosis in the submucosal layer and exhibiting the muscle-retracting sign is often difficult. We have devised a new method, peranal endoscopic myectomy (PAEM), for rectal lesions with severe fibrosis, in which dissection is performed between the inner circular and outer longitudinal muscles, and have examined the usefulness and safety of this new technique...
June 8, 2018: Endoscopy
Rita Barosa, Noor Mohammed, Bjorn Rembacken
Background and Aims: Endoscopic mucosal resection is an effective and safe procedure to manage large non-pedunculated colonic polyps for which residual/recurrent adenoma is the main drawback. Size/Morphology/Site/Access score determines polypectomy difficulty. We aimed to describe residual/recurrent adenoma rate according to Size/Morphology/Site/Access and to select the ize/Morphology/Site/Access cut-off to predict low residual/recurrent adenoma. Methods: This was a retrospective cohort study of endoscopic mucosal resection for large non-pedunculated colonic polyps performed in a tertiary centre...
May 2018: United European Gastroenterology Journal
Ricardo Küttner-Magalhães, Mário Dinis-Ribeiro, Marco J Bruno, Ricardo Marcos-Pinto, Carla Rolanda, Arjun D Koch
Introduction: Endoscopic mucosal resection and endoscopic submucosal dissection are demanding procedures. This study aims to establish face, content and expert validity of the live porcine model in performing endoscopic mucosal resection, endoscopic submucosal dissection, complication management and to assess it as a training tool. Material and methods: Tutors and trainees participating in live porcine model endoscopic mucosal resection and endoscopic submucosal dissection workshops filled out a questionnaire regarding the realism of the model compared to human setting and its role as a learning tool...
May 2018: United European Gastroenterology Journal
Yunho Jung, Jong Wook Kim, Jeong-Sik Byeon, Hoon Sup Koo, Sun-Jin Boo, Jun Lee, Young Hwangbo, Yoon Mi Jeen, Hyun Gun Kim
BACKGROUND: Endoscopic submucosal dissection (ESD) with snaring (hybrid ESD) bridges the gap between ESD and endoscopic mucosal resection. We evaluated factors predictive of en bloc and complete resection of large colorectal neoplasms using hybrid ESD. METHODS: This was a prospective clinical study of 78 patients who underwent hybrid ESD for excision of colorectal neoplasms (≥ 2 cm) between May 2015 and September 2016 at six university hospitals. We evaluated lesion and patient characteristics, endoscopist experience level (< 50 or ≥ 50 cases with colorectal ESD), and technical factors such as concurrent fibrosis, completion of a circumferential incision, degree of submucosal dissection (< 50 or ≥ 50%), and visualization during snaring (< 50 or ≥ 50%)...
June 7, 2018: Digestive Diseases and Sciences
Yajie Zhang, Yu Han, Jie Xiang, Hecheng Li
BACKGROUND: Esophageal schwannomas are extremely rare, with few cases reported in the literature. Traditionally, resection of esophageal schwannoma is typically performed using thoracotomy or video-assisted thoracic surgery. However, large, irregular tumors may increase the surgical difficulties of complete enucleation and lead to potential mucosal damage. Moreover, a subtotal esophagectomy cannot be avoided in some conditions. Here, we report the first case of robot-assisted enucleation of a large dumbbell-shaped esophageal schwannoma...
June 5, 2018: BMC Surgery
Mami Yoshitomi, Suguru Hasegawa, Ryo Takahashi, Koya Hida, Kenji Kawada, Yoshiharu Sakai
INTRODUCTION: Local excision (LE) is used in early rectal cancer and other pathologies for diagnostic purposes and curative treatment, as well as for palliative surgery in patients who are medically unfit for radical resection. Recently, transanal minimally invasive surgery (TAMIS) has been increasingly accepted as a means for performing LE. Here, we present a TAMIS technique for LE to which endoscopic submucosal dissection was applied. MATERIALS AND SURGICAL TECHNIQUE: We used conventional laparoscopic instruments, including a 10-mm 30° camera...
May 2018: Asian Journal of Endoscopic Surgery
Edward C Kuan, Frederick Yoo, Pratik B Patel, Brooke M Su, Marvin Bergsneider, Marilene B Wang
Objectives/Hypotheses  The endoscopic endonasal approach (EEA) is the workhorse endoscopic procedure for sellar and parasellar pathology. Various reconstruction techniques have been reported following EEA surgery, ranging from no reconstruction to vascularized flaps. We review our institution's experience with sellar reconstruction following EEA and propose an evidence-based algorithm. Design  Retrospective review. Setting  Tertiary academic medical center. Participants  Patients who underwent endoscopic EEA surgery for sellar or parasellar pathology between March 1, 2013 and August 31, 2016...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
Jihye Kim, Jee Hyun Kim, Joo Young Lee, Jaeyoung Chun, Jong Pil Im, Joo Sung Kim
BACKGROUND: The incidence of rectal neuroendocrine tumors (NETs) is rapidly increasing because of the frequent use of endoscopic screening for colorectal cancers. However, the clinical outcomes of endoscopic resection for rectal NETs are still unclear. The aim of this study was to assess the rates of histologically complete resection (H-CR) and recurrence after endoscopic mucosal resection (EMR) for rectal NETs. METHODS: A retrospective analysis was performed on patients who underwent EMR for rectal NETs between January 2002 and March 2015 at Seoul National University Hospital...
June 5, 2018: BMC Gastroenterology
M-J Chen, I-C Wu, Y-J Chen, T-E Wang, Y-F Chang, C-L Yang, W-C Huang, W-K Chang, B-S Sheu, M-S Wu, J-T Lin, C-H Chu
A number of clinical guidelines on nutrition therapy in cancer patients have been published by national and international societies; however, most of the reviewed data focused on gastrointestinal cancer or non-cancerous abdominal surgery. To collate the corresponding data for esophageal cancer (EC), a consensus panel was convened to aid specialists from different disciplines, who are involved in the clinical nutrition care of EC patients. The literature was searched using MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the ISI Web of Knowledge...
May 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Dandan Huang, Qiang Zhan, Shudong Yang, Qi Sun, Zhiyi Zhou
INTRODUCTION: Synchronous double superficial gastric cancer with gastritis cystica profunda (GCP) and submucosal lipoma is a rare disease and is difficult to diagnose and treat. CASE PRESENTATION: A 61-year-old man was referred to our hospital with upper abdominal discomfort for the past 10 days. One year ago, the patient underwent surgery for duodenal ulcer and perforation. The diseases were diagnosed by magnifying endoscopy with narrowband imaging and pathological methods...
June 2018: Medicine (Baltimore)
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