Paragangliomas are rare neuroendocrine tumors that arise in sympathetic and parasympathetic paraganglion system,derived from neural crest cells.Tympanic paraganglioma is a type of head and neck paraganglioma involving...Paragangliomas are rare neuroendocrine tumors that arise in sympathetic and parasympathetic paraganglion system,derived from neural crest cells.Tympanic paraganglioma is a type of head and neck paraganglioma involving the middle ear cleft.Endoscopic transcanal approach is currently in vogue for the excision of tympanic paragangliomas that is limited to middle ear cleft.We present a series of 3 cases who underwent endoscopic excision of tympanic paraganglioma.展开更多
Endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)are useful therapeutic techniques for colorectal tumors.Currently,new techniques based on these procedures are available,such as endoscopic sub...Endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)are useful therapeutic techniques for colorectal tumors.Currently,new techniques based on these procedures are available,such as endoscopic submucosal dissection with snare(ESD-S)and endoscopic mucosal resection with pre-cutting(EMR-P).For the excision of colorectal tumors,each of these techniques has been characterized as having a high total resection rate,low recurrence rate or low complication rate.In this study,we analysed clinical trials that had recently been published,to search for the most appropriate endoscopic treatment for colorectal tumors.Our search results revealed the following:for a tumor with a diameter less than 20mm,the surgeon should choose ESD,ESD-S,EMR-P or EMR,depending on the condition of the tumor.On the other hand,to excise a tumor larger than 20mm in diameter,ESD and ESD-S should be the first choices.However,if the patient has a high risk of complications due to ESD or ESD-S,the use of EMR-P would be suitable.Because of the high possibility of canceration in a tumor larger than 20mm in diameter,EMR is not the optimal endoscopic treatment for the excision of a colorectal tumor,due to a low total resection rate and a high recurrence rate.展开更多
High-grade dysplasia(HGD) in Barrett's esophagus(BE) is the critical step before invasive esophageal adenocarcinoma.Although its natural history remains unclear,an aggressive therapeutic approach is usually indica...High-grade dysplasia(HGD) in Barrett's esophagus(BE) is the critical step before invasive esophageal adenocarcinoma.Although its natural history remains unclear,an aggressive therapeutic approach is usually indicated.Esophagectomy represents the only treatment able to reliably eradicate the neoplastic epithelium.In healthy patients with reasonable life expectancy,vagal-sparing esophagectomy,with associated low mortality and low early and late postoperative morbidity,is considered the treatment of choice for BE with HGD.Patients unfit for surgery should be managed in a less aggressive manner,using endoscopic ablation or endoscopic mucosal resection of the entire BE segment,followed by lifelong surveillance.Patients eligible for surgery who present with a long BE segment,multifocal dysplastic lesions,severe reflux symptoms,a large fixed hiatal hernia or dysphagia comprise a challenging group with regard to the appropriate treatment,either surgical or endoscopic.展开更多
文摘Paragangliomas are rare neuroendocrine tumors that arise in sympathetic and parasympathetic paraganglion system,derived from neural crest cells.Tympanic paraganglioma is a type of head and neck paraganglioma involving the middle ear cleft.Endoscopic transcanal approach is currently in vogue for the excision of tympanic paragangliomas that is limited to middle ear cleft.We present a series of 3 cases who underwent endoscopic excision of tympanic paraganglioma.
基金The National Natural Science Foundation of China(Grant No.81101566).
文摘Endoscopic submucosal dissection(ESD)and endoscopic mucosal resection(EMR)are useful therapeutic techniques for colorectal tumors.Currently,new techniques based on these procedures are available,such as endoscopic submucosal dissection with snare(ESD-S)and endoscopic mucosal resection with pre-cutting(EMR-P).For the excision of colorectal tumors,each of these techniques has been characterized as having a high total resection rate,low recurrence rate or low complication rate.In this study,we analysed clinical trials that had recently been published,to search for the most appropriate endoscopic treatment for colorectal tumors.Our search results revealed the following:for a tumor with a diameter less than 20mm,the surgeon should choose ESD,ESD-S,EMR-P or EMR,depending on the condition of the tumor.On the other hand,to excise a tumor larger than 20mm in diameter,ESD and ESD-S should be the first choices.However,if the patient has a high risk of complications due to ESD or ESD-S,the use of EMR-P would be suitable.Because of the high possibility of canceration in a tumor larger than 20mm in diameter,EMR is not the optimal endoscopic treatment for the excision of a colorectal tumor,due to a low total resection rate and a high recurrence rate.
文摘High-grade dysplasia(HGD) in Barrett's esophagus(BE) is the critical step before invasive esophageal adenocarcinoma.Although its natural history remains unclear,an aggressive therapeutic approach is usually indicated.Esophagectomy represents the only treatment able to reliably eradicate the neoplastic epithelium.In healthy patients with reasonable life expectancy,vagal-sparing esophagectomy,with associated low mortality and low early and late postoperative morbidity,is considered the treatment of choice for BE with HGD.Patients unfit for surgery should be managed in a less aggressive manner,using endoscopic ablation or endoscopic mucosal resection of the entire BE segment,followed by lifelong surveillance.Patients eligible for surgery who present with a long BE segment,multifocal dysplastic lesions,severe reflux symptoms,a large fixed hiatal hernia or dysphagia comprise a challenging group with regard to the appropriate treatment,either surgical or endoscopic.