AIM:To identify the determinants of endoscopic submucosal dissection(ESD) operation time.METHODS:This investigation was conducted as a single-center,prospective study in which ESD was performed by the same endoscopist...AIM:To identify the determinants of endoscopic submucosal dissection(ESD) operation time.METHODS:This investigation was conducted as a single-center,prospective study in which ESD was performed by the same endoscopist at the Chinese PLA General Hospital.A total of 173 patients underwent ESD operations performed by Dr.Lu from July 2007 to December 2011,and 183 lesions were enrolled.Patient gender,age,tumor location,gross type,tumor size,pathological type and adhesions were recorded prospectively.The order of treatment represented the experience of the operator.Univariate analysis and multivariate analysis were performed to evaluate the relationships between these factors and ESD procedure time.RESULTS:Univariate analysis showed the ESD time was closely related to the gender(P = 0.0210),tumor size(P < 0.0001),location(P < 0.0001),gross type(P < 0.0001) and adhesion(P = 0.0010).The surgical proficiency level was associated with ESD time in unit area(P < 0.0001).Multivariate analysis revealed that the ESD time was positively correlated with tumor size(P < 0.0001),adhesion(P < 0.0001) and location(P < 0.0001),but negatively correlated with surgical proficiency level(P = 0.0046).CONCLUSION:Large tumor size,adjacency to the cardia,and adhesion are predictors of a long ESD time,whereas high surgical proficiency level predicts a short ESD time.展开更多
A case-control study involving 203 cases of pelvic endometriosis seen from 1987- 1989 , and 406 randomly selected and age-matched community controls was conducted in order to provide information relevant to effective ...A case-control study involving 203 cases of pelvic endometriosis seen from 1987- 1989 , and 406 randomly selected and age-matched community controls was conducted in order to provide information relevant to effective prophylxais of the disease. The diagnosis was confirmed by pathology from laparotomy and/or laparoscopy. A questionnaire focused on menstrual, marital and reproductive status , professional exposure and physical activities ,and the results were analyzed by a conditional logistic regression model. Women characterized by earlier menarche(≤ 12 years) and longer period(≥8 days) were found to be associated with an elevated incurring risk, and a trend of increasing risk associated with primary dysmenorrhea (RR =2. 1 for mild to moderate and RR= 5. 2 for severe dysmenorrhea), energetic physical activity during menstruation (RR =2. 1) , and allergic diathesis(RR=1 . 8) was seen. An inverse relationship was observed between the number of pregnancies and risk of endometriosis,and the protective effect was most significant when only the number of full-term pregnancies was counted.The risk factors of endometriosis are discussed, and intensive treatment of primary dysmenorrhea and avoidance of strenuous exercise during menstruation are identified as important measures in the prevention of endometriosis.展开更多
文摘AIM:To identify the determinants of endoscopic submucosal dissection(ESD) operation time.METHODS:This investigation was conducted as a single-center,prospective study in which ESD was performed by the same endoscopist at the Chinese PLA General Hospital.A total of 173 patients underwent ESD operations performed by Dr.Lu from July 2007 to December 2011,and 183 lesions were enrolled.Patient gender,age,tumor location,gross type,tumor size,pathological type and adhesions were recorded prospectively.The order of treatment represented the experience of the operator.Univariate analysis and multivariate analysis were performed to evaluate the relationships between these factors and ESD procedure time.RESULTS:Univariate analysis showed the ESD time was closely related to the gender(P = 0.0210),tumor size(P < 0.0001),location(P < 0.0001),gross type(P < 0.0001) and adhesion(P = 0.0010).The surgical proficiency level was associated with ESD time in unit area(P < 0.0001).Multivariate analysis revealed that the ESD time was positively correlated with tumor size(P < 0.0001),adhesion(P < 0.0001) and location(P < 0.0001),but negatively correlated with surgical proficiency level(P = 0.0046).CONCLUSION:Large tumor size,adjacency to the cardia,and adhesion are predictors of a long ESD time,whereas high surgical proficiency level predicts a short ESD time.
文摘A case-control study involving 203 cases of pelvic endometriosis seen from 1987- 1989 , and 406 randomly selected and age-matched community controls was conducted in order to provide information relevant to effective prophylxais of the disease. The diagnosis was confirmed by pathology from laparotomy and/or laparoscopy. A questionnaire focused on menstrual, marital and reproductive status , professional exposure and physical activities ,and the results were analyzed by a conditional logistic regression model. Women characterized by earlier menarche(≤ 12 years) and longer period(≥8 days) were found to be associated with an elevated incurring risk, and a trend of increasing risk associated with primary dysmenorrhea (RR =2. 1 for mild to moderate and RR= 5. 2 for severe dysmenorrhea), energetic physical activity during menstruation (RR =2. 1) , and allergic diathesis(RR=1 . 8) was seen. An inverse relationship was observed between the number of pregnancies and risk of endometriosis,and the protective effect was most significant when only the number of full-term pregnancies was counted.The risk factors of endometriosis are discussed, and intensive treatment of primary dysmenorrhea and avoidance of strenuous exercise during menstruation are identified as important measures in the prevention of endometriosis.
