AIM:To evaluate the efficacy of cola treatment for gastric phytobezoars,including diospyrobezoars.METHODS:A total of 17 patients(range:48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuva...AIM:To evaluate the efficacy of cola treatment for gastric phytobezoars,including diospyrobezoars.METHODS:A total of 17 patients(range:48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed.Three liters of cola lavage(10 cases) or drink(7 cases) were initially used,and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare.The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola.RESULTS:After 3 L of cola lavage or drinking,a complete dissolution of bezoars was achieved in four patients(23.5%),while 13 cases(76.5%) were only partially dissolved.Phytobezoars(4 of 6 cases) were observed more frequently than diospyrobezoars(0 of 11) in the group that underwent complete dissolution(P = 0.006).Gender,symptom duration,size of bezoar and method of cola administration were not significantly different between the two groups.Twelve of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic fragmentation.CONCLUSION:The rate of complete dissolution with three liters of cola was 23.5%,but no case of diospyrobezoar was completely dissolved using this method.However,pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars.展开更多
Objective To discuss the surgical procedures and its advantages and disadvantages.Methods Theunilateral trans-septal endonasal approach was employed. Zero degree neuroendoscope was used for nasal mucosal dissection an...Objective To discuss the surgical procedures and its advantages and disadvantages.Methods Theunilateral trans-septal endonasal approach was employed. Zero degree neuroendoscope was used for nasal mucosal dissection and exploration of anterior wall of sphenoid sinus. The sphenoidotomy was done with the anatomic landmark of inferior margin of middle turbinate and ostia . After the identification of internal carotid artery and optic nerve, the pituitary fossa was opened. Then cut the dura , the margin between adenoma and normal tissue was very clear under endoscope. tumor can be removed safely. There were two patients with suprasellar extension, 30-degree endoscope was used and excellent visualization and tumor removal were obtained. Results No severe complication occurred. Conclusion Endoscopic assisted transsphenoidal pituitary surgery is practical because the operation is done under excellent illumination and visualization.展开更多
This article analyses the literature regarding the value of computer-assisted systems in esogastroduodenoscopy-quality monitoring and the assessment of gastric lesions.Current data show promising results in upper-endo...This article analyses the literature regarding the value of computer-assisted systems in esogastroduodenoscopy-quality monitoring and the assessment of gastric lesions.Current data show promising results in upper-endoscopy quality control and a satisfactory detection accuracy of gastric premalignant and malignant lesions,similar or even exceeding that of experienced endoscopists.Moreover,artificial systems enable the decision for the best treatment strategies in gastriccancer patient care,namely endoscopic vs surgical resection according to tumor depth.In so doing,unnecessary surgical interventions would be avoided whilst providing a better quality of life and prognosis for these patients.All these performance data have been revealed by numerous studies using different artificial intelligence(AI)algorithms in addition to white-light endoscopy or novel endoscopic techniques that are available in expert endoscopy centers.It is expected that ongoing clinical trials involving AI and the embedding of computer-assisted diagnosis systems into endoscopic devices will enable real-life implementation of AI endoscopic systems in the near future and at the same time will help to overcome the current limits of the computer-assisted systems leading to an improvement in performance.These benefits should lead to better diagnostic and treatment strategies for gastric-cancer patients.Furthermore,the incorporation of AI algorithms in endoscopic tools along with the development of large electronic databases containing endoscopic images might help in upper-endoscopy assistance and could be used for telemedicine purposes and second opinion for difficult cases.展开更多
文摘AIM:To evaluate the efficacy of cola treatment for gastric phytobezoars,including diospyrobezoars.METHODS:A total of 17 patients(range:48 to 78 years) with symptomatic gastric phytobezoars treated with cola and adjuvant endoscopic therapy were reviewed.Three liters of cola lavage(10 cases) or drink(7 cases) were initially used,and then endoscopic fragmentation was done for the remnant bezoars by using a lithotripsy basket or a polypectomy snare.The overall success of dissolving a gastric phytobezoars with using three liters of cola and the clinical and endoscopic findings were compared retrospectively between four cases of complete dissolution by using only cola and 13 cases of partial dissolution with cola.RESULTS:After 3 L of cola lavage or drinking,a complete dissolution of bezoars was achieved in four patients(23.5%),while 13 cases(76.5%) were only partially dissolved.Phytobezoars(4 of 6 cases) were observed more frequently than diospyrobezoars(0 of 11) in the group that underwent complete dissolution(P = 0.006).Gender,symptom duration,size of bezoar and method of cola administration were not significantly different between the two groups.Twelve of 13 patients with residual bezoars were completely treated with a combination of cola and endoscopic fragmentation.CONCLUSION:The rate of complete dissolution with three liters of cola was 23.5%,but no case of diospyrobezoar was completely dissolved using this method.However,pretreatment with cola may be helpful and facilitate endoscopic fragmentation of gastric phytobezoars.
文摘Objective To discuss the surgical procedures and its advantages and disadvantages.Methods Theunilateral trans-septal endonasal approach was employed. Zero degree neuroendoscope was used for nasal mucosal dissection and exploration of anterior wall of sphenoid sinus. The sphenoidotomy was done with the anatomic landmark of inferior margin of middle turbinate and ostia . After the identification of internal carotid artery and optic nerve, the pituitary fossa was opened. Then cut the dura , the margin between adenoma and normal tissue was very clear under endoscope. tumor can be removed safely. There were two patients with suprasellar extension, 30-degree endoscope was used and excellent visualization and tumor removal were obtained. Results No severe complication occurred. Conclusion Endoscopic assisted transsphenoidal pituitary surgery is practical because the operation is done under excellent illumination and visualization.
文摘This article analyses the literature regarding the value of computer-assisted systems in esogastroduodenoscopy-quality monitoring and the assessment of gastric lesions.Current data show promising results in upper-endoscopy quality control and a satisfactory detection accuracy of gastric premalignant and malignant lesions,similar or even exceeding that of experienced endoscopists.Moreover,artificial systems enable the decision for the best treatment strategies in gastriccancer patient care,namely endoscopic vs surgical resection according to tumor depth.In so doing,unnecessary surgical interventions would be avoided whilst providing a better quality of life and prognosis for these patients.All these performance data have been revealed by numerous studies using different artificial intelligence(AI)algorithms in addition to white-light endoscopy or novel endoscopic techniques that are available in expert endoscopy centers.It is expected that ongoing clinical trials involving AI and the embedding of computer-assisted diagnosis systems into endoscopic devices will enable real-life implementation of AI endoscopic systems in the near future and at the same time will help to overcome the current limits of the computer-assisted systems leading to an improvement in performance.These benefits should lead to better diagnostic and treatment strategies for gastric-cancer patients.Furthermore,the incorporation of AI algorithms in endoscopic tools along with the development of large electronic databases containing endoscopic images might help in upper-endoscopy assistance and could be used for telemedicine purposes and second opinion for difficult cases.
