简介：

简介：Amongthevariousdiagnosticmodalitiesforsmallbowelhemangioma,videocapsuleendoscopy(VCE)anddouble-balloonenteroscopy(BE)canberecommendedaspartofthework-upinpatientswithobscuregastrointestinalbleeding(OGIB).BEissuperiortoVCEintheaccuracyofdiagnosisandtherapeuticpotential,whileinmostcasestotalenteroscopycannotbeachievedthroughonlytheantegradeorretrogradeBEprocedures.Astreatmentforsmallbowelbleeding,especiallyspoutbleeding,localizationofthelesionforthedecisionofBEinsertionfacilitatesearlytreatment,suchasendoscopichemostaticclipping,allowingpatientstoavoiduselesstransfusionandtheworseningoftheirdiseaseintolife-threateningstatus.ApplyingendoscopicIndiainkmarkingpriortolaparoscopicsurgicalresectionisaparticularlyusefultechniqueformoreminimallyinvasivetreatment.WereporttwocasesofsmallbowelhemangiomafoundinexaminationsforOGIBthatweretreatedwithcombinationoflaparoscopicandendoscopicmodalities.

简介：

简介：

简介：

简介：Objective:Toinvestigatethefeaturesofthepreoperativeclinicopathologiccharacteristicsincorrelationwithlymphnodemetastasis.Methods:Thepreoperativeclinicopathologiccharacteristicsandlymphnodemetastasisof265patientswithearlygastriccarcinomawereanalyzedretrospectively.Results:Thethreeclinicopathologiccharacteristics,maximumcancerdiameter>2cmunderendoscope,poordifferentiationandexcavatedtypeweresignificanthighriskindependentpreoperativeclinicopathologiccharacteristics(P<0.05).Thepatientswhohadnoneofthethreepreoperativeclinicopathologiccharacteristicshadnolymphnodemetastasis,while27.27%ofthepatientswhohadallthethreepreoperativeclinicopathologiccharacteristicshadN2lymphnodemetastasis.Conclusion:Thethreepreoperativeclinicopathologiccharacteristics,maximumcancerdiameterunderendoscope,celldifferentiationandgrosstypewereveryusefultoevaluatetheextentoflymphnodemetastasis.

简介：Thereisalackofinvestigationintothebiologicalcharacteristicsandpreoperativesystemictherapy(PST)foroccultbreastcancer(OBC).Forthisstudy,departmentalrecordsinBreastDiseaseCenterofPekingUniversityFirstHospitalfromJanuary2008toDecember2015wereretrospectivelyreviewedtoidentifycasesofOBC.Elevencaseswereincluded,andallpatientswerefemale,withamedianageof56(range:29–75)years.Thesensitivityofmagneticresonanceimaging(MRI)was100%,andthefalsepositiveratewas33.3%.Basedonhistologicanalysisoftheaxillarynode,9(81.8%)casesweregrade3,and2(18.2%)casesweregrade2;4(36.4%)caseswere≥10%estrogenreceptor(ER)positiveand6(54.5%)humanepidermalgrowthreceptor2(HER2)positive.Ninecases(81.8%)exhibitedover30%Ki67expression.PSTwasperformedin5ofthe11cases.Thelymphnoderesponseratewas100%(5/5),butnocompleteremissionwasachieved.Inconclusion,aggressivesubtypeswerepredominantamongtheincludedcases,andPSTshouldbeconsideredforOBCtreatmentoptions.

简介：Preoperativestagingoftheaxillainwomenwithinvasivebreastcancerusingultrasound-guidedneedlebiopsy(UNB)identifiesapproximately50%ofpatientswithaxillarynodalmetastasespriortosurgicalintervention.Althoughmoderatelysensitive,itisahighlyspecificstagingstrategythatisrarelyfalsely-positive,henceapositiveUNBallowspatientstobetriagedtoaxillarylymph-nodedissection(ALND)avoidingpotentiallyunnecessarysentinelnodebiopsy(SNB).Inthisreview,weextendourpreviousworkthroughanupdatedliteraturesearch,focusingonstudiesthatreportdataonUNButility.Basedondatafor10,934breastcancerpatients,sourcedfrom35studies,apositiveUNBallowedtriageof1,745cases(simpleproportion16%)toaxillarysurgicaltreatment:theutilityofUNBwasamedian19.8%[interquartilerange(IQR)11.6%-26.7%]acrossthesestudies.Wealsomodelleddatafromasubgroupofstudies,andestimatedthatamongstpatientswithmetastasestoaxillarynodes,theoddsratio(OR)forhighnodaldiseaseburdenforapositiveUNBversusanegativeUNBwas4.38[95%confidenceinterval(95%CI):3.13,6.13],P<0.001.Fromthismodel,theestimatedproportionwithhighnodaldiseaseburdenwas58.9%(95%CI:50.2%,67.0%)forapositiveUNB,whereastheestimatedproportionwithhighnodaldiseaseburdenwas24.6%(95%CI:17.7%,33.2%)ifUNBwasnegative.Overall,axillaryUNBhasgoodclinicalutilityandapositiveUNBcaneffectivelytriagetoALND.However,theevolvinglandscapeofaxillarysurgicaltreatmentmeansthatUNBwillhaverelativelylessutilitywheresurgeonshavemodifiedtheirpracticetoomissionofALNDforminimalnodalmetastaticdisease.

简介：Superficialnon-ampullaryduodenalepithelialtumor(SNADET)isdefinedasasporadictumorthatisconfinedtothemucosaorsubmucosathatdoesnotarisefromVater’spapilla,anditincludesadenomaandadenocarcinoma.Recentdevelopmentsinendoscopictechnology,suchashigh-resolutionendoscopyandimage-enhancedendoscopy,mayincreasethechancesofdetectingSNADETlesions.However,becauseSNADETisrare,littleisknownaboutitspreoperativeendoscopicdiagnosis.TheuseofendoscopicresectionforSNADET,whichhasnoriskofmetastasis,isincreasing,buttheincidenceofcomplications,suchasperforation,issignificantlyhigherthaninanyotherpartofthedigestivetract.Apreoperativediagnosisisrequiredtodistinguishbetweenlesionsthatshouldbefollowedupandthosethatrequiretreatment.Retrospectivestudieshaverevealedcertainendoscopicfindingsthatsuggestmalignancy.Inrecentyears,severalnewimagingmodalitieshavebeendevelopedandexploredforrealtimediagnosisoftheselesiontypes.EstablishinganendoscopicdiagnostictooltodifferentiatebetweenadenomaandadenocarcinomainSNADETlesionsisrequiredtoselectthemostappropriatetreatment.ThisreviewdescribesthecurrentstateofknowledgeaboutpreoperativeendoscopicdiagnosisofSNADETs,suchasduodenaladenomaandduodenaladenocarcinoma.Newerendoscopictechniques,includingmagnifyingendoscopy,mayhelptoguidethesediagnostics,buttheiradditionaladvantagesremainunclear,andfurtherstudiesarerequiredtoclarifytheseissues.

简介：

简介：5α；-reductase禁止者(5α；-RIs),包括finasteride和dutasteride，是为良性的prostatic增生(BPH)的通常使用的医药治疗。许多研究报导了那外科手术前5α；-RI为BPH在外科期间在intraoperative出血上有影响，但是它仍然在争论。那么，我们进行了效果的系统的评论和5α的机制；为BPH流血的intraoperative上的-RIs。MEDLINE，EMBASE，控制试用的控制小道收款机和参考检索研究列出的Cochrane在分析被寻找。包含15不同使随机化的控制试用(RCT)和1156个病人的一个总数的十六份出版物在分析被使用，包括为finasteride的10RCT和为dutasteride的五RCT。我们在resected前列腺标本发现那外科手术前的finasteride治疗减少microvessel密度(MVD)。全部的血损失，血损失都极大地作为与控制相比在finasteride组每在血色素的resected前列腺织物和减少的克被减少。Dutasteride看起来没在流血上有效果。这元分析证明外科手术前的finasteride治疗能减少intraoperative出血在为BPH的外科期间。外科手术前的dutasteride没在intraoperative上有效果出血，而是进一步高质量的未来的研究仍然被需要证实这观察。

简介：Objective:Tocreateanomogramtopredicttheincidenceoflymphnodemetastasis(LNM)inearlygastriccancer(EGC)patientsandtoexternallyvalidatethenomogram.Methods:Toconstructthenomogram,weretrospectivelyanalyzedaprimarycohortof272EGCpatients.Univariateanalysisandabinarylogisticregressionwereperformed.AnomogrampredictingtheincidenceofLNMinEGCpatientswascreated.Thediscriminationabilityofthenomogramwasmeasuredusingtheconcordanceindex(c-index),andthenomogramwasalsocalibrated.Then,anotherprospectivecohortof81patientswasanalyzedtovalidatethenomogram.Results:Intheprimarycohort,LNMwaspathologicallyconfirmedin37(13.6%)patients.Inmultivariateanalysis,thepresenceofanulcer,themaximumlesiondiameterobservedviagastroscopy,thethicknessofthelesionobservedviaendoscopicultrasonography,andthepresenceofenlargedlymphnodesoncomputedtomography(CT)wereindependentriskfactorsforLNM.Anomogramwasthencreatedbasedontheregressionmodelwiththec-indexof0.905,andthecalibrationcurveofthenomogramfellapproximatelyontheideal45-degreeline.Thecut-offscoreofthenomogramwas110,andthesensitivity,specificity,positivepredictiveandnegativepredictivevaluesofthenomogramintheprimarycohortwere81.1%,86.0%,47.6%and96.7%,respectively,andintheprospectivevalidationcohortwere75.0%,91.0%,60.0%and95.5%,respectively.Thecalibrationcurveoftheexternalvalidationcohortwasalmostonthe45-degreeline.Conclusions:WedevelopedaneffectivenomogrampredictingtheincidenceofLNMforEGCpatients.

简介：

简介：Objective:Thisworkaimedtostudythesafetyandefficacyofpreoperativeintestinalstentdecompressioncombinedwithlaparoscopicsurgerytotreatleft-sidedcolorectalcancerwithobstruction(LCCO).Methods:Retrospectiveanalysiswasconductedondataobtainedfrom21LCCOpatientsadmittedtoTheFirstAffiliatedHospitalofZhejiangChineseMedicineUniversityduringMarch2008andDecember2011.Toremovetheintestinalobstruction,preoperativeintestinalstentplacementundercolonoscopicguidancewasperformed.Approximately7to10daysaftertheoperation,laparoscopicradicalsurgeryofcolorectalcancerwasconducted.Results:Amongthe21casesstudied,laparoscopicsurgerywassuccessfulin20patients.Emergentlaparotomywasconductedinonepatientbecauseoftumorinvasionintheureter.Thedurationoftheoperationrangedfrom180to320min,andtheaveragetimewas220min.Therecoverytimeforbowelfunctionrangedfrom2to5dayswithanaveragetimeof3days.Postoperativeinfectionoftheincisionoccurredinonecase.Noanastomoticleakagewasobservedinanyofthecases.Conclusion:Preoperativeintestinalstentdecompression,combinedwithprimarystagelaparoscopicsurgery,isasafeandeffectivemethodforthetreatmentofLCCO.

简介：ＣＯＮＧＥＮＩＴＡＬＥＸＰＲＥＳＳＩＯＮＯＦｍｄｒ１ＧＥＮＥＩＮＦＲＥＳＨＣＡＮＣＥＲＴＩＳＳＵＥＳＦＲＯＭＳＥＶＥＲＡＬＨＩＧＨＩＮＣＩＤＥＮＣＥＮＥＯＰＬＡＳＭＳＷＩＴＨＯＵＴＰＲＥＯＰＥＲＡＴＩＶＥＣＨＥＭＯＴＨＥＲＡＰＹＺｈａｎｇＹａｎｍ...

简介：无