Abstract:
BACKGROUND AND AIMS:The technical difficulties inherent in endoscopic submucosal dissection (ESD) for colorectal neoplasms may result in the failure of en bloc resection or perforation. The aim of this retrospective study was to assess the predictors of en bloc resection failure or perforation by using preoperatively available factors. METHODS:Between September 2002 and March 2013, 716 colorectal ESDs in 673 consecutive patients were performed at a tertiary cancer center. Patient characteristics, tumor location, tumor type, colonoscopy-related factors, and endoscopist experience were assessed based on a prospectively recorded institutional ESD database. Logistic regression analysis was performed to identify predictors of failure of en bloc resection or perforations, with subgroup analyses of ESDs performed by endoscopists less experienced in colorectal ESD (<40 cases) and for colonic lesions only. RESULTS:On multivariate analysis, independent predictors of failure of en bloc resection or perforations were the presence of fold convergence (odds ratio [OR] 4.4; 95% confidence interval [95% CI], 1.9-9.9), protruding type (OR 3.6; 95% CI, 1.8-7.1), poor endoscope operability (OR 3.5; 95% CI, 1.8-6.9), right-sided colonic lesions (OR 3.0; 95% CI, 1.5-6.3 vs rectal lesions), left-sided colonic lesions (OR 3.2; 95% CI, 1.7-6.3, vs rectal lesions), the presence of an underlying semilunar fold (OR 2.1; 95% CI, 1.3-3.6), and a less-experienced endoscopist (OR 2.1; 95% CI, 1.3-3.6). Among less-experienced endoscopists, colonic lesions were independent predictors (right-sided colonic lesions 8.1; 95% CI, 2.9-25.1; left-sided colonic lesions 8.1; 95% CI, 2.5-28.3 vs rectal lesions). For colonic lesions, the presence of fold convergence (OR 3.7; 95% CI, 1.6-8.6), poor endoscope operability (OR 3.6; 95% CI, 1.8-7.2), a less-experienced endoscopist (OR 3.0; 95% CI, 1.7-1.8), and the presence of an underlying semilunar fold (OR 2.7; 95% CI, 1.5-4.7) were identified predictors. CONCLUSION:This study successfully identified predictors of en bloc resection failure or perforation. Understanding these indicators could help to accurately stratify lesions according to technical difficulty and to appropriately select endoscopists.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Imai K,Hotta K,Yamaguchi Y,Kakushima N,Tanaka M,Takizawa K,Kawata N,Matsubayashi H,Shimoda T,Mori K,Ono Hdoi
10.1016/j.gie.2015.08.024subject
Has Abstractpub_date
2016-05-01 00:00:00pages
954-62issue
5eissn
0016-5107issn
1097-6779pii
S0016-5107(15)02796-0journal_volume
83pub_type
杂志文章abstract:BACKGROUND:Any innovative optical system that facilitates the early endoscopic detection of neoplastic change in the GI mucosa has the potential to greatly improve survival and quality of life for patients prone to have GI malignancies develop. The present article describes light-induced autofluorescence spectroscopy w...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2001.116563
更新日期:2001-08-01 00:00:00
abstract:BACKGROUND:Transluminal access site closure remains a major challenge in natural orifice transluminal endoscopic surgery (NOTES). OBJECTIVE:Our purpose was to develop in vivo leak tests for evaluation of the integrity of transgastric access closure. SETTINGS:Survival experiments on 12 50-kg pigs. DESIGN AND INTERVEN...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2007.12.052
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The duodenal-jejunal bypass liner (DJBL) is a new, device-based endoscopic treatment for type 2 diabetes mellitus (T2DM) and obesity. OBJECTIVE:To report serious safety events of subjects treated with the DJBL while offering a simple guideline to mitigate risk. DESIGN:Single-center observational study. SE...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2015.03.1911
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:No objective measure of the level of sedation is universally accepted. However, bispectral index monitoring is currently used to objectively measure sedation levels in several clinical settings. This study compares the temporal relationship of bispectral index levels versus the Observer's Assessment of Alert...
journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
doi:10.1067/mge.2000.107284
更新日期:2000-08-01 00:00:00
abstract::Cannulation of the accessory papilla with dorsal pancreas ductography was accomplished in 13 of 15 consecutive cases of pancreas divisum. When routine cannulation of the main pancreatic papilla fails to produce a pancreatogram or yields only a ventral pancreas, the use of intravenous secretin and a 23-gauge needle cat...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(85)71956-6
更新日期:1985-02-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究
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更新日期:2002-11-01 00:00:00
abstract:BACKGROUND:The number of applications to advanced endoscopy fellowships has increased in past years. There is limited knowledge regarding why gastroenterology fellows pursue interventional/advanced endoscopy (AE) as a career. OBJECTIVE:To explore the characteristics, goals, and motivations of applicants applying for A...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.07.025
更新日期:2012-11-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.05.318
更新日期:2014-12-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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doi:10.1067/mge.2002.122955
更新日期:2002-05-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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更新日期:1995-02-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)02832-9
更新日期:2005-04-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2012.02.003
更新日期:2012-07-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.05.021
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Needle aspiration of the pancreas is performed to differentiate pancreatic malignancy, focal chronic pancreatitis, and metastasis to the pancreas. Biopsies may be directed by using EUS, CT, US, or surgery. This study retrospectively compared the accuracy of EUS-guided, CT/US-guided, and surgical tissue sampl...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(02)70181-8
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND AND AIMS:Endoscopic resection is the cornerstone of treatment of Barrett's esophagus (BE)-related neoplasia. However, accurate histopathologic evaluation of endoscopic resection specimens can be challenging, and the preferred specimen handling method remains unknown. Therefore, the aim of our study was to co...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,随机对照试验
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更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Little is known about gastric neoplasms arising from hyperplastic polyps (HPs). OBJECTIVE:To investigate the risk factors associated with neoplasms within HPs and to evaluate the role of alterations of the p16-cyclin D1-pRb pathway in the malignant transformation of HPs. DESIGN:Retrospective, case-control ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2014.04.020
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Endoscopic sphincterotomy is difficult and sometimes impossible in patients who have undergone gastrectomy or partial gastrectomy with Billroth II reconstruction. For such patients, a novel technique was developed in which endoscopic sphincterotomy is performed via percutaneous transhepatic cholangioscopy. T...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(04)00170-1
更新日期:2004-05-01 00:00:00
abstract::The initial treatment of choice in patients with achalasia is balloon dilation. Heretofore, this procedure was performed on an in-hospital basis resulting in high patient cost. This study evaluated the safety and efficacy of pneumatic dilation as an outpatient procedure. Sixty-one procedures were performed on 50 patie...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(90)70964-9
更新日期:1990-03-01 00:00:00
abstract::Chronic radiation proctopathy is a common sequela of radiation therapy for malignancies in the pelvic region. A variety of medical and endoscopic therapies have been used for the management of bleeding from chronic radiation proctopathy. In this guideline, we reviewed the results of a systematic search of the literatu...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章,实务指引
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2003-05-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(97)70058-0
更新日期:1997-08-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1067/mge.2002.121876
更新日期:2002-03-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2005.12.035
更新日期:2006-04-01 00:00:00
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journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(98)70007-0
更新日期:1998-10-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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更新日期:2021-02-01 00:00:00
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journal_title:Gastrointestinal endoscopy
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更新日期:2014-09-01 00:00:00
abstract::The role of noninvasive evaluation of the common bile duct combined with selective preoperative endoscopic retrograde cholangiography and sphincterotomy was prospectively evaluated in 1390 consecutive patients subjected to laparoscopic cholecystectomy. Preoperative common bile duct testing included liver chemistries, ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/s0016-5107(95)70235-0
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND AND AIMS:The prevalence of gastroparesis (Gp), a chronic debilitating disorder, and resulting hospitalizations are increasing. Gastric peroral endoscopic pyloromyotomy (POP or GPOEM) is a novel technique in the treatment of refractory Gp. Despite the initial promising results of GPOEM, one-third of patients ...
journal_title:Gastrointestinal endoscopy
pub_type: 杂志文章
doi:10.1016/j.gie.2020.01.016
更新日期:2020-09-01 00:00:00