Various traction devices have been developed to secure a visual field and sufficient tension at the dissection plane during endoscopic submucosal dissection(ESD).However,few large-scale studies have investigated the e...Various traction devices have been developed to secure a visual field and sufficient tension at the dissection plane during endoscopic submucosal dissection(ESD).However,few large-scale studies have investigated the effectiveness of traction devices in gastric ESD.Clip-with-line(CWL)is one such traction device that is widely used in cases of gastric ESD.The CONNECT-G trial was the first multicenter randomized controlled trial to compare conventional ESD with CWLassisted ESD(CWL-ESD)for superficial gastric neoplasms.Overall,no significant intergroup difference was observed in terms of the gastric ESD procedure time.However,subgroup analysis according to lesion location revealed a significant reduction in the procedure time of gastric ESD for the lesion located at the greater curvature of the middle and upper third of the stomach in the CWL-ESD group.In this subgroup analysis,lesion location was categorized as follows:anterior wall,posterior wall,lesser curvature,and greater curvature of the upper,middle,and lower thirds of the stomach.However,the gastric ESD procedure time showed no significant difference,except for lesions located at the greater curvature of the upper and middle thirds of the stomach.The traction direction of CWL in the stomach was limited to the cardia and changed depending on the lesion location.Therefore,outcomes of the CONNECT-G trail suggest that the effectiveness of CWL was influenced by lesion location,i.e.,traction direction.Further studies are warranted to investigate the optimal traction direction in gastric ESD.展开更多
Background:This study aimed to evaluate the long-term penile size among patients who underwent extensive metoidioplasty.Methods:An evaluation was conducted on 7 out of 14 patients(mean age:29.71±13.76 years)who p...Background:This study aimed to evaluate the long-term penile size among patients who underwent extensive metoidioplasty.Methods:An evaluation was conducted on 7 out of 14 patients(mean age:29.71±13.76 years)who participated in a 2015 study that introduced a postoperative protocol to improve penile size after extensive metoidioplasty.Five transsexual females(46XX karyotype)and two patients with 5-alpha reductase deficiency were retrospectively followed up in 2023 to assess the long-term efficacy of the protocol at a specialized clinic in a general hospital in Tehran,Iran.All participants were informed about the study and consented to participate.Results:Five patients achieved increased penile size from their 2015 measurements(mean,29.00±13.34 mm).Five patients requested a larger sized penile traction device to continue the protocol.Conclusion:The long-term implementation of this protocol can result in increased penile size.We advise highly motivated patients to continue practicing the protocol to achieve better results.展开更多
文摘Various traction devices have been developed to secure a visual field and sufficient tension at the dissection plane during endoscopic submucosal dissection(ESD).However,few large-scale studies have investigated the effectiveness of traction devices in gastric ESD.Clip-with-line(CWL)is one such traction device that is widely used in cases of gastric ESD.The CONNECT-G trial was the first multicenter randomized controlled trial to compare conventional ESD with CWLassisted ESD(CWL-ESD)for superficial gastric neoplasms.Overall,no significant intergroup difference was observed in terms of the gastric ESD procedure time.However,subgroup analysis according to lesion location revealed a significant reduction in the procedure time of gastric ESD for the lesion located at the greater curvature of the middle and upper third of the stomach in the CWL-ESD group.In this subgroup analysis,lesion location was categorized as follows:anterior wall,posterior wall,lesser curvature,and greater curvature of the upper,middle,and lower thirds of the stomach.However,the gastric ESD procedure time showed no significant difference,except for lesions located at the greater curvature of the upper and middle thirds of the stomach.The traction direction of CWL in the stomach was limited to the cardia and changed depending on the lesion location.Therefore,outcomes of the CONNECT-G trail suggest that the effectiveness of CWL was influenced by lesion location,i.e.,traction direction.Further studies are warranted to investigate the optimal traction direction in gastric ESD.
文摘Background:This study aimed to evaluate the long-term penile size among patients who underwent extensive metoidioplasty.Methods:An evaluation was conducted on 7 out of 14 patients(mean age:29.71±13.76 years)who participated in a 2015 study that introduced a postoperative protocol to improve penile size after extensive metoidioplasty.Five transsexual females(46XX karyotype)and two patients with 5-alpha reductase deficiency were retrospectively followed up in 2023 to assess the long-term efficacy of the protocol at a specialized clinic in a general hospital in Tehran,Iran.All participants were informed about the study and consented to participate.Results:Five patients achieved increased penile size from their 2015 measurements(mean,29.00±13.34 mm).Five patients requested a larger sized penile traction device to continue the protocol.Conclusion:The long-term implementation of this protocol can result in increased penile size.We advise highly motivated patients to continue practicing the protocol to achieve better results.
