Comparison of CT virtual endoscopy with electronic colonoscopy in 30 colonic carcinoma patients

Abstract:Objective To evaluate the clinical application of CT virtual endoscopy (CTVE) in the diagnosis and treatment of colonic carcinoma. Methods We collected 30 patients pathologically proven to have colonic carcinomas as examined by CTVE and electronic colonoscopy (EC), correlating the CTVE and EC images respectively with surgical pathology in three aspects: tumor morphological features, degree of circumferential bowel wall involvement and longitudinal extent of tumor. Results CTVE imaging of colonic carcinomas showed morphological features: polypoid pattern (11 patients), ulcerative pattern (11), and infiltrative pattern (8); degree of circumferential bowel wall involvement: less than 1/2 (4 patients), from 1/2 to 3/4 (6), and more than 3/4 (20); and their longitudinal extent: 1.0-3.0?cm (7 patients), 31-5.0?cm (10), and 5.1-11.0?cm (13). Correlation of CTVE and EC with surgical pathology was found. Comparison of CTVE with surgical pathology showed tumor morphological features: concordant (26 patients), and disconcordant (4); degree of circumferential bowel wall involvement: concordant (25), disconcordant (5); and longitudinal extent of the tumor: concordant (23), disconcordant (7). Comparison of EC with surgical pathology showed tumor morphological features: concordant (22 patients), disconcordant (8); degree of circumferential bowel wall involvement: concordant (28), disconcordant (2); and longitudinal extent of the tumor: concordant (14), disconcordant (3), and undefined by EC (13). Conclusions The images obtained by CTVE in colonic carcinoma are similar to those obtained by EC. CTVE is an excellent alternative to EC for patients who cannot tolerate EC and for cases with incomplete EC.

Therapeutic effect of Western Medicine plus Traditional Chinese Medicine in the treatment of upper gastrointestinal tract perforation

OBJECTIVE: To explore the clinical efficacy of Traditional Chinese Medicine(TCM) combined with Western Medicine in the treatment of upper gastrointestinal tract perforation.METHODS: Totally 100 patients with upper gastrointestinal tract perforation hospitalized between January 2010 and January2015 were included and randomly divided into the control group and the observation group, 50 patients in each group. The patients in the control group received the conventional nonsurgical treatment of Western Medicine, whereas those in the observation group were treated by TCM plus the treatment given to the control group. The first period was defined as the closed perforation period, during which electro-acupuncture was performed at acupoints of Zusanli(ST36) and Zhongwan(Ren 12); the second period as the absorption period, during which Dachengqi Decoction was administered to restore normal bowel movement; the third period as the ulcer healing period,during which the TCM treatment was admini-stered based on the formula of Pingweisan. Patients in both groups were reexamined by endoscopy after 2 weeks of treatment.RESULTS: The time to relieve abdominal pain, the time to pass gas and the length of stay in the observation group were significantly improved compared with those in the control group(P<0.05). The cure rate of the observation group was significantly higher than that of the control group(P<0.05).After two weeks of treatment, in the observation group, the cured patients showed closed perforation, with disappearing mucosal congestion and edema, less white fur on the ulcers and shallower ulcers in the size of 3 to 5 mm; the ulcer was in the healing period and none of the patients showed acute perforation again. While in the control group, two patients were given endoscopy after 10 days of treatment, after which ulcer and acute perforation recurred.CONCLUSIONS: The treatment of upper gastrointestinal tract perforation by Western Medicine and TCM in combination could, at different stages, significantly shorten the time to relieve abdominal pain, the time to pass gas, and the length of stay, thus improving the cure rate.