摘要:

PURPOSE:A transparent plastic cap of 17 mm in outer diameter, 15 mm in inner diameter, and 10 mm in length can be easily attached to the tip of a colonoscope. By using the cap, a better view of the lesions hiding at the opposite side of the fold can be obtained. When a flat colonic lesion is found, a submucosal injection of saline solution is performed, the target mucosa is sucked inside the cap, snared under a full endoscopic suction, and resected by an electrical current. This procedure is called endoscopic mucosal resection using transparent cap‐fitted endoscope (EMRC). Feasibility of the cap‐fitted colonoscope for screening colonoscopic examination and mucosal resection was evaluated.MATERIALS AND METHODS:One hundred forty patients were randomly allocated for screening with a normal colonoscope (NCF) or that with the cap‐fitted colonoscope (CCF). Average time for insertion up to the cecum, patients' discomfort during insertion expressed in 4 degrees, and average number of lesions found in one patient were compared. Thirty lesions randomly allocated for mucosal resection with conventional strip biopsy or EMRC were also evaluated.RESULTS:Time consumed for insertion up to the cecum with the CCF (12.4±6.6 minutes) was the same as that with the NCF (12.3±5.2 minutes), and there was no significant difference in patients' discomfort; however, the average number of lesions found in one patient was larger when using the CCF (0.86±0.96) than when using the NCF (0.58±0.81). For mucosal resection, 40 flat or wide‐based lesions including 6 mucosal carcinomas were resected with EMRC. We experienced only one pinhole perforation of the ascending colon by heat damage, which was treated successfully by surgery. There was no other major complication or recurrence.CONCLUSION:The cap‐fitted endoscope was equal in maneuverability, was excellent in sensitivity in comparison with the regular colonoscope, and was thought to be feasible both in screening and mucosal resection.

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

&NA;Presented is what is believed to be the first reported case of a defunctionalized limb of small intestine serving as a reservoir forClostridium difficile.Because of the altered intestinal continuity, the ensuing enteritis and colitis failed to respond to nonoperative management. Current treatment strategies are reviewed. Surgical intervention, including restoration of normal gastrointestinal continuity, should be considered early in the hospital course of this patient population.

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

PURPOSE:Restorative proctocolectomy has been advocated in the treatment of idiopathic megacolon, provided there is normal sphincter function. We report two patients undergoing this procedure, despite abnormal sphincter function.METHODS:Anorectal manometry and detailed symptom review were performed both preoperatively and at various stages postoperatively in two young patients with idiopathic megarectum.RESULTS:Both patients had progressive sphincter recovery postoperatively, shown both manometrically and with symptomatic review.CONCLUSION:Low preoperative sphincter pressures in young patients with idiopathic megarectum may not preclude successful outcome after restorative proctocolectomy.

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID