AIM:To study costs of laparoscopic and open liver and pancreatic resections,all the compiled data from available observational studies were systematically reviewed.METHODS:A systematic review of the literature was per...AIM:To study costs of laparoscopic and open liver and pancreatic resections,all the compiled data from available observational studies were systematically reviewed.METHODS:A systematic review of the literature was performed using the Medline,Embase,Pub Med,and Cochrane databases to identify all studies published up to 2013 that compared laparoscopic and open liver[laparoscopic hepatic resection(LLR)vs open liver resection(OLR)]and pancreatic[laparoscopic pancreatic resection(LPR)vs open pancreatic resection]resection.The last search was conducted on October 30,2013.RESULTS:Four studies reported that LLR was associated with lower ward stay cost than OLR(2972 USD vs 5291 USD).The costs related to equipment(3345USD vs 2207 USD)and theatre(14538 vs 11406)were reported higher for LLR.The total cost was lower in patients managed by LLR(19269 USD)compared to OLR(23419 USD).Four studies reported that LPR was associated with lower ward stay cost than OLR(6755vs 9826 USD).The costs related to equipment(2496USD vs 1630 USD)and theatre(5563 vs 4444)were reported higher for LPR.The total cost was lower in the LPR(8825 USD)compared to OLR(13380 USD).CONCLUSION:This systematic review support the economic advantage of laparoscopic over open approach to liver and pancreatic resection.展开更多
Esophageal achalasia is a chronic and progressive motility disorder characterized by absence of esophageal body peristalsis associated with an impaired relaxation of lower esophageal sphincter(LES) and usually with an...Esophageal achalasia is a chronic and progressive motility disorder characterized by absence of esophageal body peristalsis associated with an impaired relaxation of lower esophageal sphincter(LES) and usually with an elevated LES pressure, leading to an altered passage of bolus through the esophago-gastric junction. A definitive cure for achalasia is currently unavailable. Palliative treatment options provide only food and liquid bolus intake and relief of symptoms. Endoscopic therapy for achalasia aims to disrupt or weaken the lower esophageal sphincter. Intra-sphincteric injection of botulinum toxin is reserved for elderly or severely ill patients. Pneumatic dilation provides superior results than botulinum toxin injection and a similar mediumterm efficacy almost comparable to that attained after surgery. Per oral endoscopic myotomy is a promising option for treating achalasia, but it requires increased experience and further objective and long-term follow up. This article will review different endoscopic treatments in achalasia, and summarize the short-term and long-term outcomes.展开更多
Squamous papilloma of the esophagus is a rare benign lesion of the esophagus. Radiofrequency ablation is an established endoscopic technique for the eradication of Barrett esophagus. No cases of endoscopic ablation of...Squamous papilloma of the esophagus is a rare benign lesion of the esophagus. Radiofrequency ablation is an established endoscopic technique for the eradication of Barrett esophagus. No cases of endoscopic ablation of esophageal papilloma by radiofrequency ablation(RFA) have been reported. We report a case of esophageal papilloma successfully treated with a single session of radiofrequency ablation. Endoscopic ablation of the lesion was achieved by radiofrequency using a new catheter inserted through the working channel of endoscope. The esophageal ablated tissue was removed by a specifically designed cup. Complete ablation was confirmed at 3 mo by endoscopy with biopsies. This case supports feasibility and safety of as a new potential indication for BarrxTM RFA in patients with esophageal papilloma.展开更多
文摘AIM:To study costs of laparoscopic and open liver and pancreatic resections,all the compiled data from available observational studies were systematically reviewed.METHODS:A systematic review of the literature was performed using the Medline,Embase,Pub Med,and Cochrane databases to identify all studies published up to 2013 that compared laparoscopic and open liver[laparoscopic hepatic resection(LLR)vs open liver resection(OLR)]and pancreatic[laparoscopic pancreatic resection(LPR)vs open pancreatic resection]resection.The last search was conducted on October 30,2013.RESULTS:Four studies reported that LLR was associated with lower ward stay cost than OLR(2972 USD vs 5291 USD).The costs related to equipment(3345USD vs 2207 USD)and theatre(14538 vs 11406)were reported higher for LLR.The total cost was lower in patients managed by LLR(19269 USD)compared to OLR(23419 USD).Four studies reported that LPR was associated with lower ward stay cost than OLR(6755vs 9826 USD).The costs related to equipment(2496USD vs 1630 USD)and theatre(5563 vs 4444)were reported higher for LPR.The total cost was lower in the LPR(8825 USD)compared to OLR(13380 USD).CONCLUSION:This systematic review support the economic advantage of laparoscopic over open approach to liver and pancreatic resection.
文摘Esophageal achalasia is a chronic and progressive motility disorder characterized by absence of esophageal body peristalsis associated with an impaired relaxation of lower esophageal sphincter(LES) and usually with an elevated LES pressure, leading to an altered passage of bolus through the esophago-gastric junction. A definitive cure for achalasia is currently unavailable. Palliative treatment options provide only food and liquid bolus intake and relief of symptoms. Endoscopic therapy for achalasia aims to disrupt or weaken the lower esophageal sphincter. Intra-sphincteric injection of botulinum toxin is reserved for elderly or severely ill patients. Pneumatic dilation provides superior results than botulinum toxin injection and a similar mediumterm efficacy almost comparable to that attained after surgery. Per oral endoscopic myotomy is a promising option for treating achalasia, but it requires increased experience and further objective and long-term follow up. This article will review different endoscopic treatments in achalasia, and summarize the short-term and long-term outcomes.
文摘Squamous papilloma of the esophagus is a rare benign lesion of the esophagus. Radiofrequency ablation is an established endoscopic technique for the eradication of Barrett esophagus. No cases of endoscopic ablation of esophageal papilloma by radiofrequency ablation(RFA) have been reported. We report a case of esophageal papilloma successfully treated with a single session of radiofrequency ablation. Endoscopic ablation of the lesion was achieved by radiofrequency using a new catheter inserted through the working channel of endoscope. The esophageal ablated tissue was removed by a specifically designed cup. Complete ablation was confirmed at 3 mo by endoscopy with biopsies. This case supports feasibility and safety of as a new potential indication for BarrxTM RFA in patients with esophageal papilloma.
