摘要:

Abstract:Endoscopic ultrasonography (EUS) was performed in 32 patients with ulcerative colitis. The EUS findings were classified into 5 types based on our criteria. The relationship between the type of EUS finding and clinical severity, endoscopic grading, extent of disease, and therapeutic measures were examined. The type of EUS finding tended to correlate with both the clinical severity and endoscopic grading. There was also a correlation between the extent of the disease and the EUS findings. Therapeutic measures differed according to the type of EUS finding. Consequently, EUS was considered to be useful for the objective assessment and grading of the disease and for predicting prognosis. (Dig Endoc 1994; 6 : 3–

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00654.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:This is a retrospective study of the results of total colonofiberscopy performed on 180 postoperative patients with colorectal cancer. We divided the patients into two groups: “Group A” that had no concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery and “Group B” that had a concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery, and compared them. Colorectal polyps were found in 77 patients (42.8%), recurrent cancers in 9 patients (5.0%). and metachronous cancers in 6 patients (3.3%). respectively. In Group A, no abnormality was found in 65.7% (69/ 105), which was significantly higher compared with 33.3% (25/75) of Group B (p<0.0001). The detection ratio of polyps in Group B was significantly higher than that of Group A (61.3% versus 29.5%. p<0.0001). The number of detected polyps in Group B was also large. As for the time required to detect the polyps, no difference was found between the two groups. There was no certain tendency for the location in which the polyp developed, and polyps were found in any portion of the residual colon and rectum. The development of metachronous cancer was found in 3 patients (2.8%) in Group A and 3 patients (4.0%) in Group B, which indicated a higher ratio for Group B, but statistically no significant difference was confirmed. In the metachronous cancer group, more than half were in the early stage, and even with the advanced cancers, the diameter of the tumor was small. In all of them, a curative resection were performed, and they were found to be Dukes’A and B in which no spreading was found to the lymphnodes.From the above, we can conclude that a follow‐up using total colonoscopy is useful, and that a postoperative follow‐up total colonofiberscopy should be performed on postoperative patients with colorectal cancer within 6 months after surgery regardless of the presence of a concurrent polyp and/or synchronous multiple carcinoma besides the main lesion at the time of surgery. Also a follow‐up schedule must be conducted once a year after the first follow‐up using the endoscopic method. (Dig End

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00655.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:The incidence of back pain in patients with peptic ulcers in relation to the location of the ulceration was investigated. One hundred and seventeen patients with gastric ulcers and 35 patients with duodenal ulcers consecutively seen over the past five years were the subjects in this study. The location of the ulceration was assessed by endoscopy in all cases.Forty‐eight out of 117 (41.0%) and 11 out of 35 (31.4%) patients with gastric and duodenal ulcers respectively complained of back pain with or without other symptoms. Further, there were 7 patients with gastric ulcers and 1 with duodenal ulcers who had only back pain or had back pain with other symptoms other than epigastric pain.There were no significant differences between the location of ulceration and the symptoms i. e., epigastric and back pain.Back pain in this study is considered to be a referred pain via visceral afferent pathways, and it may occur more commonly than has been earlier documented.It should be taken into consideration also that some patients with peptic ulcers complain of back pain as their main symptom. (Dig Endosc 1944; 6 : 17

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00656.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:An endoscopic retrograde cholangiography (ERC) was performed in 303 patients before laparoscopic cholecystectory. The ERC was successful in 275 patients (90.8%). Common bile duct stones were diagnosed in 9 of 275 patients (3.3%). These had not been suspected on the basis of the clinical and laboratory data or ultrasonography results in 8 of them. An endoscopic papilotomy (EPT) was successful in all 9 patients with choledocholithiasis before laparoscopic cholecystectomy. Anatomical variations, such as origin of the cystic duct from the right or left hepatic duct and an accessory bile duct, were detected in 6 patients (2.2%). Preoperative ERC proved useful in determining the biliary anatomy or detecting unsuspected stones. (Dig Endosc 1994; 6 : 24–2

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00657.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:To determine the therapeutic effect of photodynamic therapy (PDT) using a new photosensitizer 2.4‐bis (1‐decyloxyethyl)‐Ca‐deuteroporphyI diaspartic acid (Ga ‐DP), 20 female Syrian golden hamsters with experimentally induced pancreatic cancer were irradiated with a pulsed Nd : YAG laser with a Q switch after administration of Ga ‐DP. To induce pancreatic cancer, N‐nitroso‐bis‐(2‐oxypropyI) amine (BOP) at 10 mg/kg body weight was injected subcutaneously once a week for eight weeks. Ten of the twenty animals served as a control group. The other ten received laser treatment beginning 20 weeks after BOP administration. Twenty‐four hours after intravenous injection of 3 mg/kg Ga‐DP, pulsed Nd : YAG laser irradiation was performed using a Q switch with 1 W of power output for 3–5 minutes at a frequency of 300 Hz. Elimination or necrosis of the entire tumor resulted with tumors 6–10 mm in diameter in 6 animals. In 3 animals which had tumors more than 12 mm in diameter, cancer cells remained at the margins of the treated area. These results were felt to not only reflect the thermal effect of laser therapy, but also the effect of PDT combined with Ga‐DP. They suggest that Ga‐DP could become a clinically valuable photosensitizer in combination with P

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00658.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:This study was performed to assess the efficacy of endoscopic injection therapy with absolute ethanol to prevent emergency surgery and recurrent bleeding in patients with peptic ulcers. We compared two different treatment protocols of peptic ulcers with active bleeding or with visible vessels on the ulcer bed. In group I (1981–1984, control group), 45 patients underwent emergency endoscopy with spraying 0.1% epinephrine and thrombin, but no other endoscopic hemostatic procedure. In group II (1989–1992, experimental group), we performed endoscopic injection therapy with absolute ethanol for peptic ulcers in 46 patients. The background characteristics of the patients were not different in the two groups. The rate of successful initial hemostasis tended to be greater in the ethanol injection group compared with the control group without significance. The ultimate hemostatic rate in the ethanol injection group was markedly and significantly greater compared to the control group (P<0.05). Ultimate hemostasis by ethanol injection was performed effectively in peptic ulcers with spurting and oozing hemorrhage and in the non‐bleeding peptic ulcers with visible vessels at the initial endoscopy (P<0.05 for each). These results indicate that ethanol injection therapy by endoscopy achieves ultimate hemostasis and prevents emergency surgery due to hemorrhage from peptic ulcers. (Dig Endoc 1994; 6 :

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00659.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:We studied 12 patients using endoscopic injection sclerotherapy (EIS) guided by endoscopic color Doppler ultrasonography (ECDUS). The ECDUS was performed with a PENTAX FG‐32UA (7.5MH2, convex type) and a HlTACHl EUB 565 as a display machine.The EIS needle, as well as changes in intramural blood flow before and after EIS were clearly observed with the ECDUS.When the sclerosant was injected properly into the esophageal varices, the blood flow in the esophageal varices could not be detected with color Doppler flow imaging nor with fast‐Fourier transform (FFT) analysis. Therefore EIS was safely performed with an adequate volume of sclerosant having been accurately injected into the varices.Of the disadvantages of this technique, the forceps channel was found to be a bit narrow, and the anterior view was somewhat oblique. Even so, EIS guided by ECDUS is surely a promising method for the treatment of esophageal varices, especially once the technical difficulties are overcome. (Dig Endosc 1994; 6 : 39

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00660.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:Twenty‐eight high risk patients with acute cholangitis due to large common bile duct stones underwent endoscopic stenting for biliary drainage. Seventeen patients were subsequently readmitted for stone extraction after a mean interval of 4 months, 13 on an elective basis and 4 because of recurrent cholangitis. Six patients were noted to have spontaneous reduction in stone size and two had complete stone disintegration. Endoscopic stone extraction was successful in 15 patients. Two patients in whom the stone extraction failed had their stents changed. Two patients died of nonbiliary related causes. The remaining patients were asymptomatic during a follow up period of 4 to 19 months. Endoscopic stenting provides effective temporary drainage for acute cholangitis. Elective stone extraction can be performed when sepsis is controlled. In elderly high risk patients, stenting can be used as a definitive treatment for large common duct stones. (Dig Endosc 1994; 6 : 45

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00661.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:From April 1991, we performed successful laparoscopic cholecystectomy (LC) on 221 patients. Among them, 198 patients were treated using the standard procedure based on four‐trocar insertion. We developed a new three‐port LC, which might have several cosmetic advantages, and used it with 23 selective patients with non‐inflammatory cholecystolithiasis. LC was conducted in all of the patients without any technical difficulties using the three ports method. The mean operating time was 52 minutes and was 10 minutes longer than for four‐port LC. As regards the cosmetic benefits, a 10‐mm port for the laparoscope was inserted through the inside of the umbilicus. This wound scar cannot be distinguished from the normal umbilical configuration after complete wound healing and there are only two small recognizable surgery scars. We believe this three‐port method has more cosmetic advantages, and its application could be gradually extended. (Dig Endosc 1994

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00662.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

Abstract:Laparoscopy assisted colectomy with extracorporeal anastomosis was carried out in five patients. In three patients, the lesions were carcinoma with submucosal invasion and the histological results of the polypectomy specimen indicated the necessity of the subsequent colectomy. In the other two patients the lesions were either adenoma or carcinoma in adenoma. Under pneumoperitoneum, mobilization of the colon was performed using the laparoscopic technique. In three patients the mesenteric vessels of a segment of the colon were ligated and divided extracorporeally. In two patients the mesenteric vessels were clipped and divided intracorporeally. In all cases, extracorporeal resection of the colon and hand suture anastomosis were performed. Surgery time ranged from 3 hours and 20 minutes to 4 hours and 50 minutes. No postoperative complications were experinced. Four patients began to walk on the first postoperative day. Postoperative administration of analgesics was needed in four patients for two days or less after the operation. In all but one case, bowel sounds were audible from the first post‐operative day onwards. In only one patient was the postoperative recovery delayed. Although sufficient future studies should be accumulated to confirm the advantages of this procedure, we can expect that laparoscopy assisted colectomy will become a useful procedure for benign and early malignant lesions in which colonoscopic removal was not possible or was suspected to be insufficient. (Dig Endosc 1944; 6 : 52

ISSN:0915-5635    

DOI:10.1111/j.1443-1661.1994.tb00663.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY