Objectives: To clarify the optimal length of the antral cuff (LAC) in patients after pylorus-preserving gastrectomy (PPG), we investigated relationships between LAC and postgastrectomy disorder (PGD) such as postprand...Objectives: To clarify the optimal length of the antral cuff (LAC) in patients after pylorus-preserving gastrectomy (PPG), we investigated relationships between LAC and postgastrectomy disorder (PGD) such as postprandial abdominal fullness (PAF), and between LAC and gastric empting function (GEF) in PPG patients. Background: The main cause of PGD in PPG patients has been considered to be LAC. Relationships between LAC and PGD and GEF in PPG patients are still unknown. Methods: Of 50 patients who underwent PPG in our hospital from January 2001 to December 2015 were divided into 2 groups [Group A, short LAC of 1.5 to 2.5 cm (n = 24);Group B, long LAC of 2.6 to 3.5 cm (n = 26)]. The relationships among LAC, PGD, and GEF were retrospectively studied. Results: LAC was clearly shorter in group A than group B (P < 0.01). PAF, appetite and food consumption per meal were clearly more favorable in group B than in group A (P < 0.01, respectively). Symptomatic reflux esophagitis (RE), early dumping syndrome, decreased percent body weight for pre-illness, endoscopic RE and endoscopic gastritis in the remnant stomach were more frequent in group A than group B. Gastric stasis in the remnant stomach was clearly more frequent in group A than group B (P < 0.01). GEF with the solid diet in group A was clearly more delayed than in group B (P Conclusions: Patients with a short LAC showed worse postoperative QOL and delayed GEF with the solid diet compared with a long LAC.展开更多
Endoscopic cryotherapy is a technique utilized for the ablation of target tissue within the gastrointestinal tract.A cryotherapy system utilizes the endoscopic application of cryogen such as liquid nitrogen,carbon dio...Endoscopic cryotherapy is a technique utilized for the ablation of target tissue within the gastrointestinal tract.A cryotherapy system utilizes the endoscopic application of cryogen such as liquid nitrogen,carbon dioxide or liquid nitrous oxide.This leads to disruption of cell membranes,apoptosis,and thrombosis of local blood vessels within the target tissue.Several trials utilizing cryotherapy for Barrett’s esophagus(BE)with variable dysplasia,gastric antral vascular ectasia(GAVE),esophageal carcinoma,radiation proctitis,and metastatic esophageal carcinomas have shown safety and efficacy.More recently,liquid nitrogen cryotherapy(cryodilation)was shown to be safe and effective for the treatment of a benign esophageal stricture which was refractory to dilations,steroid injections,and stenting.Moreover,liquid nitrogen cryotherapy is associated with less post procedure pain as compared to radiofrequency ablation in BE with comparable ablation rates.In patients with GAVE,cryotherapy was found to be less tedious as compared to argon plasma coagulation.Adverse events from cryotherapy most commonly include chest pain,esophageal strictures,and bleeding.Gastric perforations did occur as well,but less often.In summary,endoscopic cryotherapy is a promising and growing field,which was first demonstrated in BE,but the use now spans for several other disease processes.Larger randomized controlled trials are needed before its role can be established for these different diseases.展开更多
文摘Objectives: To clarify the optimal length of the antral cuff (LAC) in patients after pylorus-preserving gastrectomy (PPG), we investigated relationships between LAC and postgastrectomy disorder (PGD) such as postprandial abdominal fullness (PAF), and between LAC and gastric empting function (GEF) in PPG patients. Background: The main cause of PGD in PPG patients has been considered to be LAC. Relationships between LAC and PGD and GEF in PPG patients are still unknown. Methods: Of 50 patients who underwent PPG in our hospital from January 2001 to December 2015 were divided into 2 groups [Group A, short LAC of 1.5 to 2.5 cm (n = 24);Group B, long LAC of 2.6 to 3.5 cm (n = 26)]. The relationships among LAC, PGD, and GEF were retrospectively studied. Results: LAC was clearly shorter in group A than group B (P < 0.01). PAF, appetite and food consumption per meal were clearly more favorable in group B than in group A (P < 0.01, respectively). Symptomatic reflux esophagitis (RE), early dumping syndrome, decreased percent body weight for pre-illness, endoscopic RE and endoscopic gastritis in the remnant stomach were more frequent in group A than group B. Gastric stasis in the remnant stomach was clearly more frequent in group A than group B (P < 0.01). GEF with the solid diet in group A was clearly more delayed than in group B (P Conclusions: Patients with a short LAC showed worse postoperative QOL and delayed GEF with the solid diet compared with a long LAC.
文摘Endoscopic cryotherapy is a technique utilized for the ablation of target tissue within the gastrointestinal tract.A cryotherapy system utilizes the endoscopic application of cryogen such as liquid nitrogen,carbon dioxide or liquid nitrous oxide.This leads to disruption of cell membranes,apoptosis,and thrombosis of local blood vessels within the target tissue.Several trials utilizing cryotherapy for Barrett’s esophagus(BE)with variable dysplasia,gastric antral vascular ectasia(GAVE),esophageal carcinoma,radiation proctitis,and metastatic esophageal carcinomas have shown safety and efficacy.More recently,liquid nitrogen cryotherapy(cryodilation)was shown to be safe and effective for the treatment of a benign esophageal stricture which was refractory to dilations,steroid injections,and stenting.Moreover,liquid nitrogen cryotherapy is associated with less post procedure pain as compared to radiofrequency ablation in BE with comparable ablation rates.In patients with GAVE,cryotherapy was found to be less tedious as compared to argon plasma coagulation.Adverse events from cryotherapy most commonly include chest pain,esophageal strictures,and bleeding.Gastric perforations did occur as well,but less often.In summary,endoscopic cryotherapy is a promising and growing field,which was first demonstrated in BE,but the use now spans for several other disease processes.Larger randomized controlled trials are needed before its role can be established for these different diseases.
