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世界胃肠病学杂志（英文版）
世界胃肠病学杂志（英文版）

潘伯荣

周刊

1007-9327

wjg@wjgnet.com

010-85381901-628

100025

北京市朝阳区东四环中路62号楼远洋国际中心D座903室

世界胃肠病学杂志（英文版）/Journal World Journal of GastroenterologyCSCDCSTPCDSCI
查看更多>>主要报道和刊登国内外、特别是我国消化病学者具有创造性的、有较高学术水平的基础和临床研究论文、研究快报等. 对具有中国特色的研究论文, 如食管癌、胃癌、肝癌、大肠癌、病毒性肝炎、幽门螺杆菌、中医中药、中西医结合和基于作者自己研究工作为主的综述性论文, 将优先发表. 读者对象为基础研究或临床研究的消化专业工作者。
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    Prognostic factors for recurrence of gastrointestinal bleeding due to Dieulafoy's lesion

    Yuliana Jamanca-PomaAntonio Velasco-GuardadoConcepción Pi(n)ero-PérezRenzo Calderón-Begazo...
    5734-5738页
    查看更多>>摘要：AIM:To analyze the effectiveness of the endoscopic therapy and to identify prognostic factors for recurrent bleeding.METHODS:Retrospective study of patients with gastrointestinal bleeding secondary to Dieulafoy's lesion (DL) from 2005 to 2011.We analyzed the demographic characteristics of the patients,risk factors for gastrointestinal bleeding,endoscopic findings,characteristics of the endoscopic treatment,and the recurrence of bleeding.We included cases in which endoscopy described a lesion compatible with Dieulafoy.We excluded patients who had potentially bleeding lesions such as angiodysplasia in other areas or had undergone other gastrointestinal endoscopic procedures.RESULTS:Twenty-nine patients with DL were identified.Most of them were men with an average age of 71.5 years.Fifty-five percent of the patients received antiaggregatory or anticoagulant therapy.The most common location for DL was the stomach (51.7％).The main type of bleeding was oozing in 65.5％ of cases.In 27.6％ of cases,there was arterial (spurting) bleeding,and 6.9％ of the patients presented with an adherent clot.A single endoscopic treatment was applied to nine patients (31％); eight of them with adrenaline and one with argon,while 69％ of the patients received combined treatment.Six patients (20.7％)presented with recurrent bleeding at a median of 4 d after endoscopy (interquartile range =97.75).Within these six patients,the new endoscopic treatment obtained a therapeutic success of 100％.The presence of arterial bleeding at endoscopy was associated with a higher recurrence rate for bleeding (50％ vs 33.3％ for other type of bleeding) [P =0.024,odds ratio (OR) =8.5,95％ CI =1.13-63.87].The use of combined endoscopic treatment prevented the recurrence of bleeding (10％ vs 44.4％ of single treatment) (P =0.034,OR =0.14,95％ CI =0.19-0.99).CONCLUSION:Endoscopic treatment of DL is safe and effective.Adrenaline monotherapy and arterial (spurting) bleeding are associated with a high rate of bleeding recurrence.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Incidence of human papilloma virus in esophageal squamous cell carcinoma in patients from the Lublin region

    Andrzej D(a)browskiWojciech Kwa(s)niewskiTomasz SkoczylasWieslawa Bednarek...
    5739-5744页
    查看更多>>摘要：AIM:TO assess the prevalence of human papilloma virus (HPV) in esophageal squamous cell carcinoma (ESCC) in the south-eastern region of Poland.METHODS:The study population consisted of 56 ESCC patients and 35 controls.The controls were patients referred to our department due to other nonesophageal and non-oncological disorders with no gross or microscopic esophageal pathology as confirmed by endoscopy and histopathology.In the ESCC patients,samples were taken from normal mucosa (56 mucosa samples) and from the tumor (56 tumor samples).Tissue samples from the controls were taken from normal mucosa of the middle esophagus (35 control samples).Quantitative determination of DNA was carried out using a spectrophotometric method.Genomic DNA was isolated using the QIAamp DNA Midi Kit.HPV infection was identified following PCR amplification of the HPV gene sequence,using primers MY09 and MY11 complementary to the genome sequence of at least 33 types of HPV.The sequencing results were computationally analyzed using the basic local alignment search tool database.RESULTS:In tumor samples,HPV DNA was identified in 28 of 56 patients (50％).High risk HPV phenotypes (16 or/and 18) were found in 5 of 56 patients (8.9％),low risk in 19 of 56 patients (33.9％) and other types of HPV (37,81,97,CP6108) in 4 of 56 patients (7.1％).In mucosa samples,HPV DNA was isolated in 21 of 56 patients (37.5％).High risk HPV DNA was confirmed in 3 of 56 patients (5.3％),low risk HPV DNA in 12 of 56 patients (21.4％),and other types of HPV in 6 of 56 patients (10.7％).In control samples,HPV DNA was identified in 4 of 35 patients (11.4％) with no high risk HPV.The occurrence of HPV in ESCC patients was significantly higher than in the controls [28 of 56 (50％)vs 4 of 35 (11.4％),P ＜ 0.001].In esophageal cancer patients,both in tumor and mucosa samples,the predominant HPV phenotypes were low risk HPV,isolated 4 times more frequently than high risk phenotypes [19 of 56 (33.9％) vs 5 of 56 (8.9％),P ＜ 0.001].A higher prevalence of HPV was identified in female patients (71.4％ vs 46.9％).Accordingly,the high risk phenotypes were isolated more frequently in female patients and this difference reached statistical significance [3of 7 (42.9％) vs 2 of 49 (4.1％),P ＜ 0.05].Of the pathological characteristics,only an infiltrative pattern of macroscopic tumor type significantly correlated with the presence of HPV DNA in ESCC samples [20 of 27 (74.1％) vs 8 of 29 (27.6％) for ulcerative or protruding macroscopic type,P ＜ 0.05].The occurrence of total HPV DNA and both HPV high or low risk phenotypes did not significantly differ with regard to particular grades of cellular differentiation,phases in depth of tumor infiltration,grades of nodal involvement and stages of tumor progression.CONCLUSION:Low risk HPV phenotypes could be one of the co-activators or/and co-carcinogens in complex,progressive,multifactorial and multistep esophageal carcinogenesis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Intussusception due to inflammatory fibroid polyp: A case report and comprehensive literature review

    Sami Akbulut
    5745-5752页
    查看更多>>摘要：AIM:To give an overview of the literature on intussusception due to inflammatory fibroid polyp (IFP).METHODS:We present a new case of ileal intussusception due to IFP and a literature review of studies published in English language on intussusception due to IFP,accessed via PubMed and Google Scholar databases.For the search,the keywords used were:intussusception,IFP,intussusception and IFP,intussusception due to IFP,and IFP presenting as intussusception.The search covered all articles from 1976 to November 2011.RESULTS:We present a 38-year-old woman who was admitted 10 d after experiencing abdominal pain,vomiting,and nausea.Ultrasonography demonstrated small bowel intussusception.An ileal intussusception due to a mass lesion 50 cm proximal to the ileocecal junction was found during laparotomy.Partial ileal resection and anastomosis were performed.A diagnosis of ileal IFP was made based on the immunohistochemical findings.In addition,a total of 56 reports concerning 85 cases of intussusception due to IFP meeting the aforementioned criteria was included in the literature review.The patients were aged 4 to 81 years (mean,49 ± 16.2 years); 44 were women (mean,51.8 ± 14.3years) and 41 were men (mean,46 ± 17.5 years).According to the location of the IFP,ileal intussusception was found in 63 patients,while 17 had jejunal,three had colonic,and two had ileojejunal intussusception.CONCLUSION:Although IFPs are rare and benign,surgery is the only solution in case of intestinal obstruction.Differential diagnosis should be made via immunohistochemical examination.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Evaluation of sorafenib for hepatocellular carcinoma by contrast-enhanced ultrasonography: A pilot study

    Kazue ShiozawaManabu WatanabeYoshinori KikuchiTakahide Kudo...
    5753-5758页
    查看更多>>摘要：AIM:TO determine the usefulness of arrival time parametric imaging (AtPI) using contrast-enhanced ultrasonography (CEUS) with Sonazoid in evaluating early response to sorafenib for hepatocellular carcinoma (HCC).METHODS:Fourteen advanced HCC patients who received sorafenib 400/800 mg/d for at least 4 wk and were followed up by CEUS were enrolled in this study.CEUS was performed before treatment and 2 and 4 wk after treatment,and images of the target lesion in the arterial phase were recorded for each patient.The images were analyzed by AtPI.Color mapping (CM) images obtained by AtPI were compared before and after the treatment.In these CM images,the mean arrival time of the contrast agent in the region of interest from the starting point [mean time (MT)] was calculated.In each patient,differences between MT before and MT 2 and 4 wk after the treatment were compared with responses evaluated 4-8 wk after the treatment by dynamic computed tomography (CT),and statistical analysis was performed.Modified response evaluation criteria in solid tumors was used for the response evaluation.RESULTS:In CM images both 2 and 4 wk after the treatment,delays in the arrival time of the contrast agent were noted in 8 of the 14 patients.In the other 6 patients,no color changes were observed in the tumor,or red and/or yellow increase,suggesting a decrease in blood flow velocity between images 2 and 4 wk after the treatment and those before the treatment.Dynamic CT could be performed 4-8 wk after the treatment in 13 of the 14 patients.Median differences in the MT were 1.13 s and 1.015 s,2 and 4 wk after the treatment,respectively,in the 8 patients who showed stable disease (SD)/partial response (PR) on dynamic CT.Median differences in the MT were-0.39 s and -0.95 s,2 and 4 wk after the treatment,respectively,in the 5 patients who showed progressive disease (PD).Differences in the median MT between SD/PR and PD groups were significant 2 and 4 wk after the treatment with P =0.019 and P =0.028,respectively.CONCLUSION:AtPI by CEUS using Sonazoid is suggested to be useful for evaluating early responses to sorafenib.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Nutritional status in relation to lifestyle in patients with compensated viral cirrhosis

    Fumikazu HayashiChika MomokiMiho YuikawaYuko Simotani...
    5759-5770页
    查看更多>>摘要：AIM:To assess the nourishment status and lifestyle of non-hospitalized patients with compensated cirrhosis by using noninvasive methods.METHODS:The subjects for this study consisted of 27 healthy volunteers,59 patients with chronic viral hepatitis,and 74 patients with viral cirrhosis,from urban areas.We assessed the biochemical blood tests,anthropometric parameters,diet,lifestyle and physical activity of the patients.A homeostasis model assessment-insulin resistance (HOMA-IR) value of ≥2.5 was considered to indicate insulin resistance.We measured height,weight,waist circumference,arm circumference,triceps skin-fold thickness,and handgrip strength,and calculated body mass index,arm muscle circumference (AMC),and arm muscle area (AMA).We interviewed the subjects about their dietary habits and lifestyle using health assessment computer software.We surveyed daily physical activity using a pedometer.Univariate and multivariate logistic regression modeling were used to identify the relevant factors for insulin resistance.RESULTS:The rate of patients with HOMA-IR ≥ 2.5 (which was considered to indicate insulin resistance)was 14 (35.9％) in the chronic hepatitis and 17 (37.8％)in the cirrhotic patients.AMC (％) (control vs chronic hepatitis,111.9％ ± 10.5％ vs 104.9％ ± 10.7％,P =0.021; control vs cirrhosis,111.9％ ± 10.5％ vs 102.7％ ± 10.8％,P =0.001) and AMA (％) (control vs chronic hepatitis,128.2％ ± 25.1％ vs 112.2％ ±22.9％,P =0.013; control vs cirrhosis,128.2％ ±25.1％ vs 107.5％ ± 22.5％,P =0.001) in patients with chronic hepatitis and liver cirrhosis were significantly lower than in the control subjects.Handgrip strength (％) in the cirrhosis group was significantly lower than in the controls (control vs cirrhosis,92.1％± 16.2％ vs 66.9％ ± 17.6％,P ＜ 0.001).The results might reflect a decrease in muscle mass.The total nutrition intake and amounts of carbohydrates,protein and fat were not significantly different amongst the groups.Physical activity levels (kcal/d) (control vs cirrhosis,210 ± 113 kcal/d vs 125 ± 74 kcal/d,P =0.001),number of steps (step/d) (control vs cirrhosis,8070 ±3027 step/d vs 5789 ± 3368 step/d,P =0.011),and exercise (Ex) (Ex/wk) (control vs cirrhosis,12.4 ± 9.3 Ex/wk vs 7.0 ± 7.7 Ex/wk,P =0.013) in the cirrhosis group was significantly lower than the control group.The results indicate that the physical activity level of the chronic hepatitis and cirrhosis groups were low.Univariate and multivariate logistic regression modeling suggested that Ex was associated with insulin resistance (odds ratio,6.809; 95％ CI,1.288-36.001; P =0.024).The results seem to point towards decreased physical activity being a relevant factor for insulin resistance.CONCLUSION:Non-hospitalized cirrhotic patients may need to maintain an adequate dietary intake and receive lifestyle guidance to increase their physical activity levels.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Correlations between endoscopic and clinical disease activity indices in intestinal Behcet's disease

    Hyun Jung LeeYoun Nam KimHui Won JangHan Ho Jeon...
    5771-5778页
    查看更多>>摘要：AIM:To develop a novel endoscopic severity model of intestinal Behcet's disease (BD) and to evaluate its feasibility by comparing it with the actual disease activity index for intestinal Behcet's disease (DAIBD).METHODS:We reviewed the medical records of 167 intestinal BD patients between March 1986 and April 2011.We also investigated the endoscopic parameters including ulcer locations,distribution,number,depth,shape,size and margin to identify independent factors associated with DAIBD.An endoscopic severity model was developed using significant colonoscopic variables identified by multivariate regression analysis and its correlation with the DAIBD was evaluated.To determine factors related to the discrepancy between endoscopic severity and clinical activity,clinical characteristics and laboratory markers of the patients were analyzed.RESULTS:A multivariate regression analysis revealed that the number of intestinal ulcers (≥ 2,P =0.031)and volcanoshaped ulcers (P =0.001) were predictive factors for the DAIBD.An endoscopic severity model (Y)was developed based on selected endoscopic variables as follows:Y =47.44 + 9.04 x non-Ileocecal area + 11.85 x ≥ 2 of intestinal ulcers + 5.03 x shallow ulcers + 12.76 x deep ulcers + 4.47 x geographicshaped ulcers + 26.93 x volcano-shaped ulcers + 8.65x ≥ 20 mm of intestinal ulcers.However,endoscopic parameters used in the multivariate analysis explained only 18.9％ of the DAIBD variance.Patients with severe DAIBD scores but with moderately predicted disease activity by the endoscopic severity model had more symptoms of irritable bowel syndrome (21.4％vs 4.9％,P =0.026) and a lower rate of corticosteroid use (50.0％ vs 75.6％,P =0.016) than those with severe DAIBD scores and accurately predicted disease by the model.CONCLUSION:Our study showed that the number of intestinal ulcers and volcano-shaped ulcers were predictive factors for severe DAIBD scores.However,the correlation between endoscopic severity and DAIBD (r=0.434) was weak.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Bisphosphonate use and gastrointestinal tract cancer risk:Meta-analysis of observational studies

    Yun Hwan OhChan YoonSang Min Park
    5779-5788页
    查看更多>>摘要：AIM:To perform a meta-analysis of observational studies to further elucidate the relationship between oral bisphosphonate use and gastrointestinal cancer risk.METHODS:Systematic literature search was conducted in MEDLINE,EMBASE,and the Cochrane Library to identify studies through January 2011.Search terms were "bisphosphonates" or trade names of the drugs,and "observational studies" or "cohort studies" or "case-control studies".Two evaluators reviewed and selected articles on the basis of predetermined selection criteria as followed:(1) observational studies (casecontrol or cohort studies) on bisphosphonate use; (2)with at least 2 years of follow-up; and (3) reported data on the incidence of cancer diagnosis.The DerSimonian and Laird random effects model were used to calculate the pooled relative risk (RR) with 95％ confidence interval (CI).Two-by-two contingency table was used to calculate the outcomes not suitable for meta-analysis.Subgroup meta-analyses were conducted for the type of cancer (esophageal,gastric and colorectal cancers).Sensitivity analyses were performed to examine the effect sizes when only studies with long-term follow-up (mean 5 years; subgroup 3 years) were included.RESULTS:Of 740 screened articles,3 cohort studies and 3 case-control studies were included in the analyses.At first,4 cohort studies and 3 case-control studies were selected for the analyses but one cohort study was excluded because the cancer outcomes were not categorized by type of gastrointestinal cancer.More than 124 686 subjects participated in the 3 cohort studies.The mean follow-up time in all of the cohort studies combined was approximately 3.88 years.The 3 casecontrol studies reported 3070 esophageal cancer cases and 15 417 controls,2018 gastric cancer cases and 10 007 controls,and 11 574 colorectal cancer cases and 53 955 controls.The percentage of study participants who used bisphosphonate was 2.8％ among the cases and 2.9％ among the controls.The meta-analysis of all the studies found no significant association between bisphosphonate use and gastrointestinal cancer.Also no statistically significant association was found in a meta-analysis of long-term follow-up studies.There was no negative association between bisphosphonate use and the incidence of esophageal cancer in the overall analysis (RR 0.96,95％ CI:0.65-1.42,I2 =52.8％,P =0.076) and no statistically significant association with long-term follow-up (RR 1.74,95％ CI:0.97-3.10,I2 =58.8％,P =0.119).No negative association was found in the studies reporting the risk of gastric cancer (RR 0.89,95％ CI:0.71-1.13,I2 =0.0％,P =0.472).In case of colorectal cancer,there was no association between colorectal cancer and bisphosphonate use (RR 0.62,95％ CI:0.30-1.29,I2 =88.0％,P =0.004) and also in the analysis with long-term follow-up (RR 0.61,95％ CI:0.28-1.35,I2 =84.6％,P =0.011).CONCLUSION:Oral bisphosphonate use had no significant effect on gastrointestinal cancer risk.However,this finding should be validated in randomized controlled trials with long-term follow-up.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Effect of ezetimibe on the prevalence of cholelithiasis

    Assaf SteinDoron HermoniAvishay ElisFred M Konikoff...
    5789-5792页
    查看更多>>摘要：AIM:To investigate the prevalence of cholelithiasis among patients treated with ezetimibe.METHODS:A retrospective,case-control study based on computerized medical records from patients of the Clalit Health Services,Sharon-Shomron region,from 2000 to 2009.Patients 20-85 years of age,who had been treated with ezetimibe and statins or statins only for at least 6 mo,and who had an abdominal ultrasound were included in the study.Collected data included age,gender,ezetimibe treatment duration,presence of hypothyroidism or diabetes,and existence of cholelithiasis as determined by ultrasound.Excluded were subjects after gallbladder resection,with hemolysis,myeloproliferative or inflammatory bowel diseases,and those treated with ursodeoxycholic acid and fibrates.Patients treated with statins and ezetimibe (study group) were compared to patients treated with statins only (control group).RESULTS:The study group included 25 patients and the control group 168.All patients in the study were treated with statins.The study group included 13 males (52％) and 12 females (48％),the control group 76 males (45％) and 92 (55％) females (P =0.544).The groups did not differ in age (mean age:68 ± 8 years,range 53-85 years vs mean age:71 ± 8 years,range 51-85 years; P =0.153) or in the rate of diabetic and hypothyroid patients [11 (44％) vs 57 (33％),P =0.347 in the study group and 5 (20％) vs 23 (14％),P =0.449 in the control group,respectively].Patients in the study group were treated with ezetimibe for an average of 798 ± 379 d.Cholelithiasis was found in 4 (16％) patients in the study group and in 33 (20％)patients in the control group (P =0.666).CONCLUSION:Ezetimibe does not appear to influence the prevalence of gallstones.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Treatment of chronic hepatitis delta virus with peg-interferon and factors that predict sustained viral response

    Shaikh SamiullahDevrajani BikharamNasreen
    5793-5798页
    查看更多>>摘要：AIM:To observe the efficacy of peg-interferon in the treatment of hepatitis delta virus (HDV) and to identify the factors that would be predictive of the sustained viral response (SVR).METHODS:This prospective study was conducted in Medical Unit Ⅳ of the Liaquat University of Medical and Health Sciences Hospital Jamshoro from June 2008 to September 2011.This study cohort included all patients of either sex who presented during this time with hepatitis B surface antigen positivity,hepatitis B virus DNA ＞ 20 000 IU/mL,serum glutamic pyruvic transaminase (SGPT) ＞ 2(upper limit of normal),HDV-RNA positivity with fibrosis stage ≥ 2.Informed consent was obtained from each of these individuals.Patients were diagnosed with hepatitis D on the basis of detectable viral antibodies and the presence of HDV-RNA in their serum.A liver biopsy was performed in all cases and fibrosis staging was performed in accordance with the METAVIR scoring system.All eligible patients were administered peg-interferon at a weekly dosage of 1.5 tg/kg body weight for 48 wk.HDV-RNA was assayed at the end of this treatment period and again at 24 wk later.A biochemical response was determined by a normalization of SGPT at the end of the treatment or during follow up.The end of treatment response was defined by a HDV-RNA negative status.A sustained virological response was defined by undetectable serum HDV-RNA at six months after the end of treatment.RESULTS:Among the 277 patients enrolled in our present study,238 completed a course of peg-interfer-on therapy of which 180 (75.6％) were male and 58 (24.4％) female.Biochemical responses were achieved in 122/238 (51,3％) patients.End of treatment responses were achieved in 71/238 (29.8％) cases.A SVR was achieved in 70 of these patients (29.4％).A strong association was found between the SVR and the end of treatment responses (P =0.001),biochemical responses (P =0.001) and the degree of fibrosis (P =0.002).CONCLUSION:Peg-interferon therapy can induce remission in nearly one third of patients harboring HDV.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Endoscopic submucosal dissection for foregut neuroendocrine tumors: An initial study

    Quan-Lin LiYi-Qun ZhangWei-Feng ChenMei-Dong Xu...
    5799-5806页
    查看更多>>摘要：AIM:TO evaluate the feasibility and efficacy of endoscopic submucosal dissection (ESD) for foregut neuroendocrine tumors (NETs).METHODS:From April 2008 to December 2010,patients with confirmed histological diagnosis of foregut NETs were included.None had regional lymph node enlargement or distant metastases to the liver or lung on preoperative computerized tomography scanning or endoscopic ultrasonography (EUS).ESD was attempted under general anesthesia.After making several marking dots around the lesion,a mixture solution was injected into the submucosa.The mucosa was incised outside the marking dots.Dissection of the submucosal layer beneath the tumor was performed under direct vision to achieve complete en bloc resection of the specimen.Tumor features,clinicopathological characteristics,complete resection rate,and complications were evaluated.Foregut NETs were graded as G1,G2,or G3 on the basis of proliferative activity by mitotic count or Ki-67 index.All patients underwent regular follow-up to evaluate for any local recurrence or distant metastasis.RESULTS:Those treated by ESD included 24 patients with 29 foregut NETs.The locations of the 29 lesions are as follows:esophagus (n =1),cardia (n =1),stomach (n =23),and duodenal bulb (n =4).All lesions were found incidentally during routine upper gastrointestinal endoscopy for other indications,and none had symptoms of carcinoid syndrome.Preoperative EUS showed that all tumors were confined to the submucosa.Among the 24 gastric lesions,16 lesions in 11 patients were type I gastric NETs arising in chronic atrophic gastritis with hypergastrinemia,while the other 8 solitary lesions were type Ⅲ because of absence of atrophic gastritis in these cases.All of the tumors were removed in an en bloc fashion.The average maximum diameter of the lesions was 9.4 mm (range:2-30 mm),and the procedure time was 20.3 min (range:10-45 min).According to the World Health Organization 2010 classification,histological evaluation determined that 26 lesions were NET-G1,2 gastric lesions were NET-G2,and 1 esophageal lesion was neuroendocrine carcinoma (NEC).Complete resection was achieved in 28 lesions (28/29,96.6％),and all of them were confined to the submucosa in histopathologic assessment with no lymphovascular invasion.The remaining patient with NEC underwent additional surgery because the resected specimens revealed angiolymphatic and muscularis invasion,as well as incomplete resection.Delayed bleeding occurred in 1 case 3 d after ESD,which was managed by endoscopic treatment.There were no procedure-related perforations.During a mean follow-up period of 24.4 mo (range:12-48mo),local recurrence occurred in only 1 patient 7 mo after initial ESD.This patient successfully underwent repeat ESD.Metastasis to lymph nodes or distal organs was not observed in any patient.No patients died during the study period.CONCLUSION:ESD appears to be a safe,feasible,and effective procedure for providing accurate histopathological evaluations and curative treatment for eligible foregut NETs.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普