Long-term outcomes of peroral endoscopic myotomy for achalasia in pediatric patients: a prospective, single-center study.

Background: Peroral endoscopic myotomy (POEM) has been developed to provide a less-invasive myotomy for achalasia in adults but seldom has been used in pediatric patients.

Objective: To evaluate the feasibility, safety, and efficacy of POEM for pediatric patients with achalasia.

Design: Single-center, prospective study.

Endoscopic submucosal dissection of esophageal granular cell tumor.

Background: Esophageal granular cell tumor (GCT) is a rare benign tumor with malignant potential. With wide application of endoscopic techniques, the esophageal GCT discovery rate and treatment strategy has changed. This study was to preliminarily evaluate outcomes of endoscopic diagnosis and treatment for esophageal GCT.

Thoracic CT after peroral endoscopic myotomy for the treatment of achalasia.

Background: Peroral endoscopic myotomy (POEM) is a promising new endoscopic method for the treatment of achalasia.

Objective: The aim of this study was to analyze the value of routine postoperative CT of the chest to detect POEM-associated adverse events.

Design: Single-center, retrospective study.

Risk factors for postoperative stricture after endoscopic submucosal dissection for superficial esophageal carcinoma.

Background And Study Aims: Endoscopic submucosal dissection (ESD) is accepted as an established treatment modality for superficial esophageal carcinoma (SEC). The aim of this study was to identify risk factors for postoperative stricture after ESD for SEC.

Patients And Methods: This was a retrospective study at a single institution.

Re-evaluation of indications and outcomes of endoscopic excision procedures for colorectal tumors: a review.

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.

[Clinical efficacy of tissue adhesive on intractable bleeding during endoscopic submucosal dissection].

Objective: To investigate the efficacy of tissue adhesive on intractable bleeding during endoscopic submucosal dissection(ESD) and delayed bleeding.

Methods: A total of 9874 patients with gastrointestinal mucosal or submucosal tumors underwent ESD in our center from September 2006 to August 2013 and intractable bleeding occurred during ESD in 5 cases. Under the condition of no effective hemostasis methods, the tissue adhesive injection or spray were used to stop the bleeding.

MicroRNA-31 contributes to colorectal cancer development by targeting factor inhibiting HIF-1α (FIH-1).

The molecular mechanisms underlying colorectal cancer (CRC) tumorigenesis remain incompletely understood, partially contributing to the mortality of CRC. Advances in identification of novel mechanisms are therefore in an urgent need to fill the gap of our knowledge in CRC development. Here, we performed both in vitro and in vivo experiments along with in silico analysis to identify a new regulatory circuit that stimulated CRC tumorigenesis.

[Evaluation of the application of endoscopic submucosal dissction in gastrointestinal cysts].

Objective: To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for the treatment of gastrointestinal cysts.

Methods: Clinicopathological data of 40 patients with gastrointestinal cyst undergoing ESD in our center during January 2008 and February 2012 were analyzed retrospectively. Complications, en bloc resection rate, and local recurrence were assessed.

Submucosal tunneling endoscopic resection for submucosal tumors of the esophagogastric junction originating from the muscularis propria layer: a feasibility study (with videos).

Background: The esophagogastric junction (EGJ) is a difficult location for endoscopic resection due to its narrow lumen and sharp angle. Potential increased risks of perforation and mediastinal infection exist, especially for submucosal tumors (SMTs) originating from the muscularis propria (MP) layer. We previously demonstrated the safety and efficacy of submucosal tunneling endoscopic resection (STER) for upper gastrointestinal SMTs, but the feasibility of STER for the removal of SMTs at the EGJ requires systematic investigation.

[Submucosal tunneling endoscopic resection in the treatment of rectal submucosal tumors originating from muscularis propria].

Objective: To evaluate the clinical value of submucosal tunneling endoscopic resection (STER) for rectal submucosal tumors (SMT) originating from muscularis propria.

Methods: Clinicopathological data of 8 cases with rectal SMT originating from muscularis propria undergoing STER in our center from March 2011 to March 2013 were analyzed retrospectively.

Results: En bloc STER was performed successfully in all the 8 cases.

[Prevention and treatment of complications during and after endoscopic mucosal band ligation for esophageal precancerous lesions and early cancer].

Objective: To investigate the prevention and treatment of complications during and after endoscopic mucosal band ligation (EMBL) for precancerous lesions and early cancer in the esophagus.

Methods: Clinical data of 47 patients with esophageal precancerous lesions and early cancer undergoing EMBL in our center from June 2011 to August 2013 were reviewed retrospectively. Complications and associated treatment during operation, after operation and during follow-up were analyzed.

[Membrane-covered self-expanding stents in the treatment of high-positioned esophageal stenosis or fistula].

Objective: To investigate the efficacy and safety of membrane-covered self-expanding metal stent in the treatment of high-positioned esophageal diseases, including esophageal stenosis, esophagotracheal fistula and anastomotic stricture.

Methods: Clinical data of 84 patients who underwent stenting in our center from May 2005 to July 2013 were retrospectively analyzed. Of 84 patients, 31 were diagnosed as esophageal malignant stenosis, 2 compression stenosis, 10 radiation stenosis, 4 recurrent malignant stenosis, 27 anastomotic stricture, 1 esophageal stenosis after endoscopic submucosal dissection (ESD), 7 esophageal-tracheal fistula, 1 esophageal-mediastinal fistula, and 1 remnant stomach fistula.

[Narrow band imaging versus iodine staining for margin determination of early esophageal cancer during endoscopic submucosal dissection].

Objective: To compare the clinical value of narrow band imaging (NBI) and iodine staining for margin determination of early esophageal cancer during endoscopic submucosal dissection (ESD).

Methods: Clinical data of 87 patients with early esophageal cancers undergoing endoscopic submucosal dissection (ESD) were analyzed retrospectively. Patients were assigned to NBI group and iodine staining group according to the staining method before ESD operation.

Endoscopic mucosal resection/endoscopic submucosal dissection for gastric heterotopic pancreas.

Background/aims: To study the features of gastric heterotopic pancreas and to evaluate the feasibility, efficacy, and safety of endoscopic resection for treatment of this condition.

Materials And Methods: Between August 2007 and December 2010, 60 gastric heterotopic pancreas patients were treated using endoscopic mucosal resection/endoscopic submucosal dissection. The definitive histological diagnosis of heterotopic pancreas was made after the endoscopic treatment.

Peroral endoscopic myotomy for idiopathic achalasia: randomized comparison of water-jet assisted versus conventional dissection technique.

Background: Peroral endoscopic myotomy (POEM) has recently been introduced as a promising alternative to laparoscopic Heller myotomy for idiopathic achalasia. Several proposed technical modifications are yet to be tested in randomized trials.

Objective: The objective of our study was to evaluate efficacy and safety of water-jet (WJ) assisted POEM versus the conventional (C) technique.

New progress in endoscopic treatment of esophageal diseases.

The technique of endoscopic submucosal dissection (ESD), which was developed for en bloc resection of large lesions in the stomach, has been widely accepted for the treatment of the entire gastrointestinal tract. Many minimally invasive endoscopic therapies based on ESD have been developed recently. Endoscopic submucosal excavation, submucosal tunneling endoscopic resection and laparoscopic-endoscopic cooperative surgery have been used to remove submucosal tumors, especially tumors which originate from the muscularis propria of the digestive tract.

Self-expandable metallic stent placement plus laparoscopy for acute malignant colorectal obstruction.

Aim: To investigate the clinical advantages of the stent-laparoscopy approach to treat colorectal cancer (CRC) patients with acute colorectal obstruction (ACO).

Methods: From April 2008 to April 2012, surgery-related parameters, complications, overall survival (OS), and disease-free survival (DFS) of 74 consecutive patients with left-sided CRC presented with ACO who underwent self-expandable metallic stent (SEMS) placement followed by one-stage open (n = 58) or laparoscopic resection (n = 16) were evaluated retrospectively. The stent-laparoscopy group was also compared with a control group of 96 CRC patients who underwent regular laparoscopy without ACO between January 2010 and December 2011 to explore whether SEMS placement influenced the laparoscopic procedure or reduced long-term survival by influencing CRC oncological characteristics.

Endoscopic full-thickness resection of colonic submucosal tumors originating from the muscularis propria: an evolving therapeutic strategy.

Endoscopic resection of colonic submucosal tumors (SMTs) is challenging and carries a high risk of perforation. In this prospective pilot study we aimed to evaluate the feasibility, safety, and efficacy of endoscopic full-thickness resection of colonic SMTs. The study enrolled 19 consecutive patients with colonic SMTs 3 cm in size or smaller.

Peroral endoscopic myotomy for the treatment of achalasia: a clinical comparative study of endoscopic full-thickness and circular muscle myotomy.

Background: A circular muscle myotomy preserving the longitudinal outer esophageal muscular layer is often recommended during peroral endoscopic myotomy (POEM) for achalasia. However, because the longitudinal muscle fibers of the esophagus are extremely thin and fragile, and completeness of myotomy is the basis for the excellent results of conventional surgical myotomy, this modification needs to be further debated. Here, we retrospectively analyzed our prospectively maintained POEM database to compare the outcomes of endoscopic full-thickness and circular muscle myotomy.

Laparoscopic direct suture of perforation after diagnostic colonoscopy.

Background: Increasing colonoscopy use increases the incidence of iatrogenic colon perforation. Operative management of iatrogenic colonoscopic perforation is diverse. This study retrospectively reviewed our experiences in treating diagnostic colonoscopy-associated bowel perforation by laparoscopic direct suturing.

[Analysis of the short-term efficacy and safety of endoscopic mucosal band ligation in the treatment of esophageal precancerous lesions and esophageal early cancer].

Objective: To evaluate the short-term efficacy and safety of endoscopic mucosal band ligation(EMBL) in the treatment of esophageal precancerous lesions and esophageal early cancer.

Methods: Clinicopathological data of 21 cases with esophageal precancerous lesions and esophageal early cancer undergoing EMBL at the Endoscopic Center in Zhongshan Hospital of Fudan University from January 2012 to November 2012 were analyzed retrospectively. Short-term efficacy and complications after operation were summarized.

[Application and evaluation of the new technique of minimal endoscopic dissection for gastrointestinal tract submucosal tumor].

Submucosal tumors (SMTs) are occasionally found in the gastrointestinal tract during endoscopy. Endoscopic ultrasonography(EUS) can not reliably distinguish benign from malignant SMTs, because the exact histopathologic features of the lesion can not be defined. With the introduction of endoscopic submucosal dissection(ESD), gastrointestinal SMTs can be diagnosed and resected endoscopically.

[Analysis of associated factors of lymph node metastasis in intramucosal early gastric cancer].

Objective: To analyze the associated predictive factors of lymph node metastasis in intramucosal early gastric cancer, and to provide reference for individualized treatment protocol.

Methods: Clinical data of 498 patients who were pathologically confirmed to be intramucosal early gastric cancer after radical resection of gastric cancer were retrospectively reviewed. Univariate and multivariate analyses were applied to evaluate the associated factors.

Clinical impact of endoscopic submucosal dissection for gastric neuroendocrine tumors: a retrospective study from mainland China.

As a minimally invasive technique, endoscopic resection may benefit patients diagnosed with early stage gastrointestinal neuroendocrine tumors (NETs). However, no studies have yet been published in which endoscopic submucosal dissection (ESD) has been applied for gastric NETs. For the first time a research group in China applied ESD to remove gastric NETs, and indicated that ESD should be considered for treatment of eligible gastric NETs because the technique shows a high histologically complete resection rate, provides accurate histopathological evaluation, has a low complication rate, and can be performed within a reasonable timeframe.