Background/Aim: Conventional treatment for hypertrophic anal papillae (HAP) has effectiveness and safety concerns. This study aimed to investigate the feasibility, safety, and efficacy of transparent cap-assisted endo...Background/Aim: Conventional treatment for hypertrophic anal papillae (HAP) has effectiveness and safety concerns. This study aimed to investigate the feasibility, safety, and efficacy of transparent cap-assisted endoscopic hot snare resection for the treatment of HAP. Methods: Endoscopic and clinical data of patients treated with transparent cap-assisted endoscopic hot snare resection for HAP at the Department of Gastroenterology, First Affiliated Hospital of Yangtze University from June 2019 to June 2021, were collected and retrospectively analyzed. Results: A total of 56 patients with HAP were treated with transparent cap-assisted endoscopic hot snare resection, including 53 patients (94.6%) with single hypertrophic anal papillae and 3 patients (5.4%) with multiple HAP;51 patients (83.6%) with basal diameter <5 mm and 10 patients (16.4%) with basal diameter ≥5 mm. The procedures that were performed together with transparent cap-assisted endoscopic hot snare resection for HAP treatment included total colon examination in 56 cases (100%), endoscopic polypectomy in 20 cases (35.7%), endoscopic sclerotherapy for hemorrhoids in 29 cases (51.8%), and endoscopic rubber band ligation for hemorrhoids in 11 cases (19.6%). No patient experienced bleeding during or after HAP with transparent cap-assisted endoscopic hot snare resection. Pain level was evaluated by the visual analog score (VAS) method. 52 patients (92.9%) did not have pain and 4 patients (7.1%) had mild pain 3 days after surgery. At a postoperative follow-up of 2 to 18 months, patient satisfaction with transparent cap-assisted endoscopic hot snare resection for HAP treatment was 100% (56/56). Conclusion: Transparent cap-assisted endoscopic hot snare resection is safe and effective for treating HAP.展开更多
Current guidelines recommend cold snare polypectomy for polyps less than 10 mm in size.Conversely,endoscopic mucosal resection is still the preferred technique for larger polyps.Concerns regarding cold snare polypecto...Current guidelines recommend cold snare polypectomy for polyps less than 10 mm in size.Conversely,endoscopic mucosal resection is still the preferred technique for larger polyps.Concerns regarding cold snare polypectomy for larger polyps revolve around the difficulty in conducting en-bloc resection(resulting in piecemeal removal),and the potential for local residual polyp tissue and a high rate of recurrence.On the other hand,cold snare technique has the advantages of shortening procedure time,reducing delayed bleeding risks and lowering cost of treatment.Numerous ongoing and recent studies are focused on evaluating the risks and benefits of this technique for polyps larger than 10 mm,with the goal of providing clear guidelines in the near future.The aim of this editorial is to provide our readers with an overview regarding this subject and the latest developments surrounding it.展开更多
BACKGROUND Colorectal cancer remains a considerable challenge in healthcare nowadays.Approximately 60%-80%of colorectal cancer is caused by intestinal polyps,and resection of intestinal polyps has been proved to reduc...BACKGROUND Colorectal cancer remains a considerable challenge in healthcare nowadays.Approximately 60%-80%of colorectal cancer is caused by intestinal polyps,and resection of intestinal polyps has been proved to reduce the incidence of colorectal cancer.The vast majority of intestinal polyps can be found during colonoscopy and removed endoscopically.Therefore,more attention has been paid to the development of endoscopic resection of intestinal polyps.In this study,we compared the efficacy and safety of cold snare polypectomy(CSP)and hot snare polypectomy(HSP).AIM To investigate the efficacy and safety of CSP and HSP for colorectal polyps.METHODS Between January and December 2020,301 patients with colorectal polyps 4-9 mm in diameter were treated with endoscopic therapy in our hospital,and were divided into the CSP group(n=154)and HSP group(n=147).The operating time,incidence of bleeding and perforation,use of titanium clips,and complete resection rate were compared between the two groups.RESULTS We included 249 patients(301 polyps).No differences in gender,age,and polyp size,location,shape and type were observed between the CSP and HSP groups,and the resection rates in these two groups were 93.4%and 94.5%,respectively,with no significant difference.The use of titanium clips was 15.6%and 95.9%,the operating time was 3.2±0.5 min and 5.6±0.8 min,the delayed bleeding rate was 0%and 2.0%,and delayed perforation was 0%and 0.7%,in the CSP and HSP groups,respectively.CONCLUSIONFor sessile colorectal polyps < 10 mm, CSP had the same resection rate of impaired tissue integrityas traditional HSP had. The rate of complications was lower in the CSP group. CSP is a safe andeffective method for polypectomy.展开更多
BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphi...BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine patients.CASE SUMMARY The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and liver.His most recent positron emission tomography-computed tomography(PET-CT)scan showed uptake in the ascending and transverse colons.A colonoscopy revealed a 5.0 cm×3.5 cm×3.0 cm pedunculated polyp in the ascending colon.The polyp was removed using hot snare polypectomy technique and retrieved with Rothnet.Histopathologic examination of the polyp showed a metastatic pleomorphic leiomyosarcoma.CONCLUSION Uptake(s)on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.展开更多
Due to the high risk of morbidity and mortality associated with surgical resection in this tract,endoscopic resection(ER)has taken the place of surgical resection as the first line treatment for non-ampullary duodenal...Due to the high risk of morbidity and mortality associated with surgical resection in this tract,endoscopic resection(ER)has taken the place of surgical resection as the first line treatment for non-ampullary duodenal adenomas.However,due to the anatomical characteristics of this area,which enhance the risk of post-ER problems,ER in the duodenum is particularly difficult.Due to a lack of data,no ER technique for superficial non-ampullary duodenal epithelial tumours(SNADETs)has yet been backed by strong,high-quality evidence;yet,traditional hot snare-based techniques are still regarded as the standard treatment.Despite having a favourable efficiency profile,adverse events during duodenal hot snare polypectomy(HSP)and hot endoscopic mucosal resection,such as delayed bleeding and perforation,have been reported to be frequent.These events are primarily caused by electrocautery-induced damage.Thus,ER techniques with a better safety profile are needed to overcome these shortcomings.Cold snare polypectomy,which has already been shown as a safer,equally effective pro-cedure compared to HSP for treatment of small colorectal polyps,is being increasingly evaluated as a potential therapeutic option for non-ampullary duodenal adenomas.The aim of this review is to report and discuss the early outcomes of the first experiences with cold snaring for SNADETs.展开更多
文摘Background/Aim: Conventional treatment for hypertrophic anal papillae (HAP) has effectiveness and safety concerns. This study aimed to investigate the feasibility, safety, and efficacy of transparent cap-assisted endoscopic hot snare resection for the treatment of HAP. Methods: Endoscopic and clinical data of patients treated with transparent cap-assisted endoscopic hot snare resection for HAP at the Department of Gastroenterology, First Affiliated Hospital of Yangtze University from June 2019 to June 2021, were collected and retrospectively analyzed. Results: A total of 56 patients with HAP were treated with transparent cap-assisted endoscopic hot snare resection, including 53 patients (94.6%) with single hypertrophic anal papillae and 3 patients (5.4%) with multiple HAP;51 patients (83.6%) with basal diameter <5 mm and 10 patients (16.4%) with basal diameter ≥5 mm. The procedures that were performed together with transparent cap-assisted endoscopic hot snare resection for HAP treatment included total colon examination in 56 cases (100%), endoscopic polypectomy in 20 cases (35.7%), endoscopic sclerotherapy for hemorrhoids in 29 cases (51.8%), and endoscopic rubber band ligation for hemorrhoids in 11 cases (19.6%). No patient experienced bleeding during or after HAP with transparent cap-assisted endoscopic hot snare resection. Pain level was evaluated by the visual analog score (VAS) method. 52 patients (92.9%) did not have pain and 4 patients (7.1%) had mild pain 3 days after surgery. At a postoperative follow-up of 2 to 18 months, patient satisfaction with transparent cap-assisted endoscopic hot snare resection for HAP treatment was 100% (56/56). Conclusion: Transparent cap-assisted endoscopic hot snare resection is safe and effective for treating HAP.
文摘Current guidelines recommend cold snare polypectomy for polyps less than 10 mm in size.Conversely,endoscopic mucosal resection is still the preferred technique for larger polyps.Concerns regarding cold snare polypectomy for larger polyps revolve around the difficulty in conducting en-bloc resection(resulting in piecemeal removal),and the potential for local residual polyp tissue and a high rate of recurrence.On the other hand,cold snare technique has the advantages of shortening procedure time,reducing delayed bleeding risks and lowering cost of treatment.Numerous ongoing and recent studies are focused on evaluating the risks and benefits of this technique for polyps larger than 10 mm,with the goal of providing clear guidelines in the near future.The aim of this editorial is to provide our readers with an overview regarding this subject and the latest developments surrounding it.
文摘BACKGROUND Colorectal cancer remains a considerable challenge in healthcare nowadays.Approximately 60%-80%of colorectal cancer is caused by intestinal polyps,and resection of intestinal polyps has been proved to reduce the incidence of colorectal cancer.The vast majority of intestinal polyps can be found during colonoscopy and removed endoscopically.Therefore,more attention has been paid to the development of endoscopic resection of intestinal polyps.In this study,we compared the efficacy and safety of cold snare polypectomy(CSP)and hot snare polypectomy(HSP).AIM To investigate the efficacy and safety of CSP and HSP for colorectal polyps.METHODS Between January and December 2020,301 patients with colorectal polyps 4-9 mm in diameter were treated with endoscopic therapy in our hospital,and were divided into the CSP group(n=154)and HSP group(n=147).The operating time,incidence of bleeding and perforation,use of titanium clips,and complete resection rate were compared between the two groups.RESULTS We included 249 patients(301 polyps).No differences in gender,age,and polyp size,location,shape and type were observed between the CSP and HSP groups,and the resection rates in these two groups were 93.4%and 94.5%,respectively,with no significant difference.The use of titanium clips was 15.6%and 95.9%,the operating time was 3.2±0.5 min and 5.6±0.8 min,the delayed bleeding rate was 0%and 2.0%,and delayed perforation was 0%and 0.7%,in the CSP and HSP groups,respectively.CONCLUSIONFor sessile colorectal polyps < 10 mm, CSP had the same resection rate of impaired tissue integrityas traditional HSP had. The rate of complications was lower in the CSP group. CSP is a safe andeffective method for polypectomy.
文摘BACKGROUND Pleomorphic leiomyosarcomas make up around 8.6%of all leiomyosarcomas.They behave aggressively and often have poor prognoses.They can affect the gastrointestinal tract and retroperitoneum.To date,pleomorphic leiomyosarcoma involving the mesocolon have been reported in nine patients.CASE SUMMARY The patient was a 44-year-old man with a history of pleomorphic leiomyosarcoma of the left maxilla with metastasis to the lung and liver.His most recent positron emission tomography-computed tomography(PET-CT)scan showed uptake in the ascending and transverse colons.A colonoscopy revealed a 5.0 cm×3.5 cm×3.0 cm pedunculated polyp in the ascending colon.The polyp was removed using hot snare polypectomy technique and retrieved with Rothnet.Histopathologic examination of the polyp showed a metastatic pleomorphic leiomyosarcoma.CONCLUSION Uptake(s)on PET-CT in a patient with pleomorphic leiomyosarcoma should raise suspicion for metastasis.
文摘Due to the high risk of morbidity and mortality associated with surgical resection in this tract,endoscopic resection(ER)has taken the place of surgical resection as the first line treatment for non-ampullary duodenal adenomas.However,due to the anatomical characteristics of this area,which enhance the risk of post-ER problems,ER in the duodenum is particularly difficult.Due to a lack of data,no ER technique for superficial non-ampullary duodenal epithelial tumours(SNADETs)has yet been backed by strong,high-quality evidence;yet,traditional hot snare-based techniques are still regarded as the standard treatment.Despite having a favourable efficiency profile,adverse events during duodenal hot snare polypectomy(HSP)and hot endoscopic mucosal resection,such as delayed bleeding and perforation,have been reported to be frequent.These events are primarily caused by electrocautery-induced damage.Thus,ER techniques with a better safety profile are needed to overcome these shortcomings.Cold snare polypectomy,which has already been shown as a safer,equally effective pro-cedure compared to HSP for treatment of small colorectal polyps,is being increasingly evaluated as a potential therapeutic option for non-ampullary duodenal adenomas.The aim of this review is to report and discuss the early outcomes of the first experiences with cold snaring for SNADETs.
文摘目的比较圈套器冷切除术(cold snare polypectomy,CSP)与圈套器热切除术(hot snare polypectomy,HSP)在治疗直径4~9 mm无蒂结直肠息肉中的疗效。方法选取2021年6月至2021年11月在首都医科大学附属北京朝阳医院西院区消化科行内镜下息肉切除的187例患者,共284例息肉,其中145例息肉采用CSP治疗,139例息肉采用HSP治疗。本研究主要评价指标为息肉的完整切除率,次要评价指标为标本回收率、操作时间、治疗费用及住院时间,并发症包括术中出血率、迟发出血率及穿孔率。结果CSP组的完整切除率为90.34%,HSP组为92.09%,两组差异无统计学意义(P=0.336)。在术中出血方面,CSP组发生7例,HSP组发生5例,两组差异无统计学意义(P=0.606)。CSP组发生迟发出血1例,HSP组无迟发出血。两组均未发生穿孔。所有息肉切除所获标本均成功收回。CSP组平均操作时间短于HSP组(70.6 s vs 75.2 s,P<0.001)。CSP组治疗平均费用低于HSP组(1371.00元vs 2434.90元,P<0.001)。CSP组平均住院时间短于HSP组(2.9 d vs 3.6 d,P<0.001)。结论CSP与HSP同样为切除直径4~9 mm无蒂结直肠息肉安全、有效的治疗方式,但CSP操作更省时,患者花费更少、住院时间更短。