Goals: To prospectively assess the safety and efficacy of high- frequency ultrasound assisted mini- probe endoscopic mucosal resection for the treatment of colorectal submucosal tumors. Primary endpoints were tumor fr...Goals: To prospectively assess the safety and efficacy of high- frequency ultrasound assisted mini- probe endoscopic mucosal resection for the treatment of colorectal submucosal tumors. Primary endpoints were tumor free vertical/horizontal resection margins and positive histopathologic diagnosis. Outcome data over a 24- month period were assessed. Background: A 20- MHz high- frequency mini- probe ultrasound is an accurate modality for the diagnosis of stage T1m and T1 colorectal lesions. Few studies have addressed the safety and efficacy of this technology as applicable to submucosal lesions of the colorectum. Methods: Thirty patients underwent high- frequency mini- probe ultrasound- guided endoscopic mucosal resection of 30 lesions (< 20 mm diameter) using the inject and cut technique. Repeat endoscopy and ultrasound was performed at 3, 6, and 12 months post- “ index" resection. Results: A total of 27 lesions (90% ) underwent complete resection with negative histologic margin status (median diameter, 8 mm; range, 3- 20 mm). No statistical difference (P >0.1 ) was observed between submucosal lesion position and histologic resection margin negativity. Three rectal lesions (10% ) within the submucosal layer 3 failed to separate from the muscularis and underwent transanal excision of tumor. Bleeding occurred in 1 patient (3% ). No recurrence was evident at the resection site in 27 cases (median follow- up, 9 months; range, 4- 18 months). Conclusions: High- frequency mini- probe ultrasound- guided endoscopic mucosal resection is a safe and effective therapeutic modality for submucosal lesions of the colorectum. The technique offers a single- stage diagnostic and therapeutic technique for selected submucosal lesions and may offer an alternative to surgical resection.展开更多
AIM: To evaluate the quality of gastric ulcer healing after different antiulcer treatment by endoscopic ultrasonography(EUS).METHODS: The patients were divided into three groups, and received lansoprazole, amoxicillin...AIM: To evaluate the quality of gastric ulcer healing after different antiulcer treatment by endoscopic ultrasonography(EUS).METHODS: The patients were divided into three groups, and received lansoprazole, amoxicillin and clarithromycinfor 1 wk. Then group A took lansoprazole combined with tepreton for 5 wk, group B took lansoprazole and group C took tepreton for 5 wk. Endoscopy and EUS were performed before and 6 wk after medication. RESULTS: There was no significant difference in cumulative healing rate to S stage between the groups (89%, 82%vs83%,P＞0.05). The rate of white scar formation was significantly higher in group A than in groups B and C (67%, 36%, 50%, P＜0.05). The average contraction rates of the width of ulcer crater, length of disrupted muscularis propria layer and hypoechoic area were higher in groupA than in groups B and C (0.792±0.090, 0.660±0.105 vs0.668±0.143, P＜0.05). The hypoechoic area disappeared in four cases of group A, one of group B and two of group C. The percentage of hypoechoic area disappearance was higher in group A than in the other two groups (44%, 9%vs 17%, P＜0.05). Gastric ulcer healing was better ingroup A.CONCLUSION: The combined administration of proton pump inhibitors and mucosal protective agent can improve gastric ulcer healing.展开更多
文摘Goals: To prospectively assess the safety and efficacy of high- frequency ultrasound assisted mini- probe endoscopic mucosal resection for the treatment of colorectal submucosal tumors. Primary endpoints were tumor free vertical/horizontal resection margins and positive histopathologic diagnosis. Outcome data over a 24- month period were assessed. Background: A 20- MHz high- frequency mini- probe ultrasound is an accurate modality for the diagnosis of stage T1m and T1 colorectal lesions. Few studies have addressed the safety and efficacy of this technology as applicable to submucosal lesions of the colorectum. Methods: Thirty patients underwent high- frequency mini- probe ultrasound- guided endoscopic mucosal resection of 30 lesions (< 20 mm diameter) using the inject and cut technique. Repeat endoscopy and ultrasound was performed at 3, 6, and 12 months post- “ index" resection. Results: A total of 27 lesions (90% ) underwent complete resection with negative histologic margin status (median diameter, 8 mm; range, 3- 20 mm). No statistical difference (P >0.1 ) was observed between submucosal lesion position and histologic resection margin negativity. Three rectal lesions (10% ) within the submucosal layer 3 failed to separate from the muscularis and underwent transanal excision of tumor. Bleeding occurred in 1 patient (3% ). No recurrence was evident at the resection site in 27 cases (median follow- up, 9 months; range, 4- 18 months). Conclusions: High- frequency mini- probe ultrasound- guided endoscopic mucosal resection is a safe and effective therapeutic modality for submucosal lesions of the colorectum. The technique offers a single- stage diagnostic and therapeutic technique for selected submucosal lesions and may offer an alternative to surgical resection.
基金Supported by the Grant from the Eisai Human Health Care Company
文摘AIM: To evaluate the quality of gastric ulcer healing after different antiulcer treatment by endoscopic ultrasonography(EUS).METHODS: The patients were divided into three groups, and received lansoprazole, amoxicillin and clarithromycinfor 1 wk. Then group A took lansoprazole combined with tepreton for 5 wk, group B took lansoprazole and group C took tepreton for 5 wk. Endoscopy and EUS were performed before and 6 wk after medication. RESULTS: There was no significant difference in cumulative healing rate to S stage between the groups (89%, 82%vs83%,P＞0.05). The rate of white scar formation was significantly higher in group A than in groups B and C (67%, 36%, 50%, P＜0.05). The average contraction rates of the width of ulcer crater, length of disrupted muscularis propria layer and hypoechoic area were higher in groupA than in groups B and C (0.792±0.090, 0.660±0.105 vs0.668±0.143, P＜0.05). The hypoechoic area disappeared in four cases of group A, one of group B and two of group C. The percentage of hypoechoic area disappearance was higher in group A than in the other two groups (44%, 9%vs 17%, P＜0.05). Gastric ulcer healing was better ingroup A.CONCLUSION: The combined administration of proton pump inhibitors and mucosal protective agent can improve gastric ulcer healing.
