• Title/Summary/Keyword: 내시경 절제

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Clinical Availability of Endoscopic Incision and Submucosal Dissection for the Treatment of Gastric Neoplasms (위종양성 병변에 대한 내시경 절개 점막하 박리법의 임상적 유용성)

  • Jung, Yoon-Ho;Eun, Soo-Hoon;Cho, Joo-Young;Jung, In-Seop;Ryu, Chang-Beom;Lee, Joon-Seong;Lee, Moon-Sung;Kim, Boo-Sung;Shim, Chan-Sup
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.76-83
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    • 2006
  • Purpose: Endoscopic incision and submucosal dissection (EISD) is a technique that is being implemented for the resection of gastric adenomas and early gastric cancer (EGC). Since EISD requires a high degree of skill and experience, and due to its association with a moderate risk of gastrointestinal bleeding, its use has been limited. The objective of this study is to investigate the clinical benefits of EISD based upon clinical data on the EISD procedure. Materials and Methods: This study was conducted at Soonchunhyang University Hospital and it included 179 gastric adenoma and early gastric carcinoma lesions from 164 patients who had undergone an EISD from February 2003 to May 2005. Results: Among the total of 179 lesions, the distributions of EGC and adenomas were 70.3% (126/179) and 23.4% (42/179) respectively. The sizes of lesions were divided into 10 mm or less, $11{\sim}20\;mm,\;21{\sim}30\;mm$ and greater than 31 mm and each rates are 10.0% (18/179), 46.3% (83/179), 30% (50/179) and 15.0% (28/179). Among 120 cases which could be measured depth of lesion in according to pathologic findings, m1 (0.8%, 1/120), m2 (38.3%, 46/120), m3 (25%, 57/120), sm1 (11.7%, 14/120), sm2 (1.6%, 2/120) were diagnosed as early stages of gastric cancer. The complete resection rate was 85.2% (150/176) and en-bloc resection rate was 96.0% (169/176). Complications as such as perforation and bleeding developed in 4.4%(8/179) and 21.2% (38/179), respectively. Conclusion: EISD is an effective in the endoscopic treatment for gastric adenoma and early gastric cancers. However, further evaluation of this method and long-term follow-up will be necessary for an evaluation of the recurrence rate after resection of a tumor.

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The Role of Endoscopy for Tumorous Conditions of the Upper Gastrointestinal Tract in Children (내시경으로 진단된 소아 상부 위장관의 종양성 질환에 대한 고찰)

  • Kim, Hye Young;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.1
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    • pp.31-40
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    • 2005
  • Purpose: This study aimed to provide, as a basic material, the experiences of endoscopy in diagnosis and treatment of tumorous conditions in the upper gastrointestinal tract in children. Methods: The objects were 26 patients diagnosed as having tumorous conditions in the upper gastrointestinal tract among 1,283 patients who underwent upper gastrointestinal endoscopic examination at the Department of Pediatrics, Pusan National University Hospital, from January 1994 to July 2004 retrospectively. The characteristics of patients, the chief complaints for endoscopic examination, the sorts of tumors diagnosed, the endoscopic findings of tumors, and the treatment of tumors were analysed. Results: 1) Eleven male and fifteen female were included, whose mean age was $6.93{\pm}4.02years$. 2) The chief complaints for endoscopic examination were abdominal pain (80.7%), vomiting or nausea (30.8%), and gastrointestinal beeding (30.7%) in order. 3) Six cases of ectopic pancreas, five cases of sentinel polyp, three cases of papilloma and vallecular cyst, two cases of Brunner's gland hyperplasia and gastric submucosal tumor, one case of gastrointestinal stromal tumor, duodenal intramural hematoma, T cell lymphoma, lipoma, and Peutz-Jeghers syndrome were diagnosed by endoscopy with or without biopsy. 4) The location of tumors was in the pharynx (19.2%), esophagus (7.7%), gastro-esophageal junction (23.0%), stomach (30.7%) and duodeneum (26.9%). 5) The size of tumors was less than 10 mm in 53.8%, 10~20 mm in 26.9%, more than 20 mm 19.2%. 6) Treatments for tumors included resection by laser, surgical resection, endoscopic polypectomy with a forcep or snare, and observation 7) There was no significant complication. Conclusion: Various and not a few tumors were found in the upper gastrointestinal tract. The endoscopy was accurate, effective, and safe means for diagnosis and treatment of those lesions in children.

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Helicobacter pylori Eradication and Risks of Metachronous Recurrence after Endoscopic Resection of Gastric Adenoma: A Systematic Review and Meta-Analysis (위선종의 내시경 절제 후 이시성 재발의 예방을 위한 헬리코박터 제균 치료: 체계적 문헌분석 및 메타분석)

  • Kim, Jie-Hyun;Nam, Su Youn;Chun, Jaeyoung;Youn, Young Hoon;Park, Hyojin
    • Journal of Digestive Cancer Reports
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    • v.8 no.2
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    • pp.91-96
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    • 2020
  • The effect of Helicobacter pylori (H. pylori) eradication on the development of metachronous recurrence after endoscopic resection (ER) of gastric adenoma is not well defined. The aim of this study was to assess the efficacy of H. pylori eradication after ER of gastric adenoma for the prevention of metachronous recurrence. A systematic literature review and meta-analysis were conducted using the databases Ovid-MEDLINE, EMBASE, Cochrane Library, KoreaMed, and KMBASE. Thus, a systematic review and meta-analysis was performed to investigate this relationship. Pooled risk ratio for metachronous gastric lesions with regard to H. pylori eradication was calculated, and heterogeneity was also measured. Five eligible studies were finally identified in systematic review, and included in meta-analysis. H. pylori eradication was associated with overall 55% lower odds of metachronous events (RR=0.55; 95 % CI 0.34-0.92). Based on the best available evidence, eradication of H. pylori can also provide protection against metachronous recurrence after ER of gastric adenoma.

Retroperitoneal endoscopic lumbar sympathectomy - 2 cases report - (후복막강 내시경을 이용한 요추 교감신경절 절제술 - 2례 보고 -)

  • Lee, Song-Am;Kim, Kwang-Taik;Baek, Man-Jong;Lee, In-Sung;Kim, Hyoung-Mook;Kim, Hark-Jei;Lee, Gun
    • Journal of Chest Surgery
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    • v.31 no.2
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    • pp.203-207
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    • 1998
  • We have experienced 2 patients who underwent retroperitoneal endoscopic lumbar sympathectomy(RELS) for bilateral plantar hyperhidrosis. They had underwent thoracic sympathectomy by thoracoscopy 20 months and 1 month ago, respectively. The first patient had to be converted to the open procedure due to pneumoperitonium and she was reoperated due to continous sweating by the incomplete sympathectomy on right side. At follow-up after 70 and 30 days postoperatively, RELS results were graded as excellent, good, fair, or poor. The first patient was very satisfied as "Excellent" and the second was slightly less satisfied as "Good" with compensatory hyperhidrosis at perianal area. This RELS is a feasible procedure to plantar hyperhydrosis patients with less pain, minimal scar, short period of convalescence, and short hospital stay.short hospital stay.

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Endoscopic Therapy for Pancreatic Benign Neoplasms (췌장 양성 종양의 내시경적 치료)

  • Hwang, Jun Seong;Ko, Sung Woo
    • Journal of Digestive Cancer Reports
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    • v.9 no.1
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    • pp.25-32
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    • 2021
  • Since Endoscopic ultrasound (EUS) was introduced in the 1980s, EUS has evolved from a diagnostic tool to a therapeutic modality for patients with pancreatic neoplasms. Traditionally, treatment policy of pancreatic benign neoplasms (PBN) has been a dichotomous approach to observation or surgery. However, EUS guided treatment provides an alternative option with minimally invasiveness for patients with PBN. This review aimed to provide the role of EUS guided treatment for PBN.

Role of Endoscopic Ultrasound in the Assessment of Superficial Esophageal Cancer (조기 식도암에서 내시경초음파의 역할)

  • Cho, Yu Kyung
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.19-22
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    • 2011
  • Endoscopic ultrasound in the diagnosis of esophageal carcinoma is an indispensable procedure, not only to discuss the preoperative staging of the lesion, but also to evaluate the therapeutic effect of chemo-radiation therapy. The recent increase in the incidence of superficial esophageal cancer and promising developments in potentially curative endoscopic therapies have placed EUS to a central position in decision making. Recent data have called into question the staging accuracy of EUS to distinguish mucosal from submucosal lesions, particularly in patients with early disease. In those cases, diagnostic endoscopic resection may be useful for staging and curative in superficial lesions. Nonetheless, EUS has been regarded as the most accurate staging tool and should be performed to identify potential candidates for endoscopic resection.

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Changes in Pediatric Gastrointestinal Endoscopy: Review of a Recent Hospital Experience (일개 대학병원에서의 소아 위장관 내시경 시술의 최근 경험)

  • Park, Kyung-Heui;Park, Jae-Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.20-27
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    • 2007
  • Purpose: This study was performed to review the recent experiences of pediatric gastrointestinal (GI) endoscopy done in one university hospital. Methods: A retrospective review of medical records was conducted of 1,040 pediatric cases who underwent GI endoscopy at the Pusan National University Hospital between January 2001 to June 2005. Results: A total of 1,040 endoscopies (upper 840 and lower 200) were performed. The male/female ratio was 1.25:1. Neonates and infants accounted for 6.0% and 16.5% respectively. Half of the children were below 5 years (mean age $8.5{\pm}2.1$ years). Upper and lower GI diagnostic endoscopies were performed in 634 and 163 children respectively. Abdominal pain (38.8%), vomiting (19.4%), foreign body (17.7%), and hematemesis (10.3%) were the main reasons for esophagogastroduodenoscopy. Hematochezia (56.0%), abdominal pain (27.5%) and diarrhea (3.0%) were the main reasons for colonoscopy. Upper GI therapeutic procedures included retrieval of foreign bodies, balloon dilatations of esophageal stricture, PEG, and variceal ligation in 148, 27, 15, and 3 children, respectively. Therapeutic lower GI endoscopies were performed in 37 children (polypectomy in 92%, argon lazer cauterization for angiodysplasia in 4%). Conclusion: GI endoscopy played an important role in the diagnosis and treatment of GI diseases in children. Procedures in younger aged children, cases evaluated by colonoscopy and therapeutic endoscopies are increasing in pediatric practice.

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Fistula Formation Between the Disc and Dura after Percutaneous Endoscopic Lumbar Discectomy - A Case Report - (경피적 내시경 요추 추간판 절제술 후 발생한 추간판과 경막 사이의 누공 형성 - 증례 보고 -)

  • Kim, Hak Sun;Kim, Hyoung Bok;Chung, Hoon-Jae;Yang, Jea Ho
    • Journal of Korean Society of Spine Surgery
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    • v.25 no.4
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    • pp.180-184
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    • 2018
  • Study Design: Case report Objectives: To document fistula formation between the disc and dura by an unrecognized dural tear after percutaneous endoscopic lumbar discectomy (PELD). Summary of Literature Review: The risk of durotomy is relatively low with PELD, but cases of unrecognized durotomies have been reported. An effective diagnostic tool for such situations has not yet been identified. Materials and Methods: A patient twice underwent transforaminal PELD under the diagnosis of a herniated lumbar disc at L4-5. She still complained of intractable pain and motor weakness around the left lower extremity at 6 months postoperatively. Magnetic resonance imaging showed no specific findings suggestive of violation of the nerve root. However, L5 and S1 nerve root injury was noted on electromyography. An exploratory operation was planned to characterize damage to the neural structures. Results: In the exploration, a dural tear was found at the previous operative site, along with a fistula between the disc and dura was also found at the dural tear site. The durotomy site was located on the ventrolateral side of the dura and measured approximately 5 mm. The durotomy site was repaired with Nylon 5-0 and adhesive sealants. The patient's preoperative symptoms diminished considerably. Conclusions: Fistula formation between the disc and dura can be caused by an unrecognized dural tear after PELD. Discography is a reliable diagnostic tool for fistulas formed by an unrecognized durotomy.

Endoscopic Submucosal Dissection for Simultaneous Presence of GIST and Submucosal Tumor Type MALT-Lymphoma on the Stomach ? (동시에 발견된 위장관 간질 종양과 점막하 종양 형태의 MALT 림프종의 내시경 치료)

  • In Kyung Yoo;Hoon Jai Chun;Yoon Tae Jeen;Bora Keum;Eun Sun Kim;Hyuk Soon Choi;Seung Joo Nam
    • Journal of Digestive Cancer Research
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    • v.2 no.1
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    • pp.24-27
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    • 2014
  • A 42-year-old female was referred to our department after find out submucosal tumor type lesion on cardia at local clinics. She experienced no specific symptom. On gastroscopy, two distinct neoplasms were detected. One of which was located in the cardia anterior wall of the stomach with the size of 2.0×1.1 cm, and the other one was localized in the cardia posterior wall of the stomach and its size was 1.5×1.2 cm. We performed endoscopic submucosal dissection. Pathological evaluation revealed the diagnosis of gastrointestinal stromal tumor (GIST) at the cardia anterior wall and malignant lymphoma from the mass localized cardia posterior wall of the stomach. We would like to report these rare synchronous tumors which were successfully treated by endoscopic resection in the same patient

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A Case of Long Segment Myomectomy for the Treatment of Esophageal Hemangioma (식도 근육 절제로 치료한 식도 혈관종 치험 1예)

  • 이현주;김영태;성숙환;김주현
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.206-210
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    • 2003
  • Hemangiomas in the esophagus comprise less than 3% of all benign esophageal neoplasms. They are frequently small and easily treated with resection via either endoscopy or thoracotomy. We report a cavernous hemangioma occurred in the distal esophagus successfully treated with circumferential myomectomy.