Background and study aim This study aimed to assess the safety and feasibility of endoscopic submucosal dissection (ESD) using a scissors‐type knife with prophylactic closure using over‐the‐scope clip (OTSC) for superficial non‐ampullary duodenal epithelial tumors (SNADETs). Patients and methods Consecutive patients who underwent ESD for SNADETs >10 mm between January 2009 and July 2019 were retrospectively enrolled. We performed ESD using either a needle‐type knife (Flush Knife‐ESD) or a scissors‐type knife (Clutch Cutter‐ESD). Mucosal defects were prophylactically closed using three methods: conventional clip, laparoscopic closure, or OTSC. Results A total of 84 lesions were resected using the Flush Knife‐ESD and the Clutch Cutter‐ESD (37 and 47 patients, respectively), and conventional clip, laparoscopic closure, and OTSC for mucosal defect closure after ESD were applied in 13, 13, and 56 lesions, respectively. The R0 resection rate was significantly higher in the Clutch Cutter‐ESD than that in the Flush Knife‐ESD (97.9% vs 83.8%, respectively, P = 0.040). The intraoperative perforation rate was significantly lower in the Clutch Cutter‐ESD than in the Flush Knife‐ESD (0% vs 13.5%, respectively, P = 0.014). Complete closure rates of conventional clip, laparoscopic closure, and OTSC were 76.9%, 92.3%, and 98.2%, respectively (P = 0.021); and delayed perforation rates were 15.4%, 7.7%, and 1.8%, respectively (P = 0.092). Conclusions Endoscopic submucosal dissection using a scissors‐type knife with prophylactic OTSC closure is safe and feasible for the low‐invasive treatment of SNADETs.
Endoscopic diagnosis of Helicobacter pylori (H. pylori) infection, the most common cause of gastric cancer, is very important to clarify high-risk patients of gastric cancer for reducing morbidity and mortality of gastric cancer. Recently, the Kyoto classification of gastritis was developed based on the endoscopic characteristics of H. pylori infection-associated gastritis for clarifying H. pylori infection status and evaluating risk factors of gastric cancer. Recently, magnifying endoscopy with narrow-band imaging (NBI) has reported benefits of the accuracy and reproducibility of endoscopic diagnosis for H. pylori-related premalignant lesions. In addition to NBI, various types of image-enhanced endoscopies (IEEs) are available including autofluorescence imaging, blue laser imaging, and linked color imaging. This review focuses on understanding the clinical applications and the corresponding evidences shown to improve the diagnosis of gastritis based on Kyoto classification using currently available advanced technologies of IEEs.
SUMMARY To clarify the relationship between morphological changes in the corneal endothelium and ultraviolet (UV) radiation, specular microscopic examinations were performed on both eyes of 118 welders and 85 controls. The results showed: a decrease in the hexagonal cells in welders (20-29 years) in comparison with the controls (20-29) (p<005); an increase in the mean cell size of the endothelium and a decrease in the hexagonal cell population with increasing age in both groups; increases in standard deviation (SD) and the coefficient of variation (CV) of the mean cell size in both groups; increases in SD and CV of the mean number of cell sides in both groups; and no difference in the mean cell size between the two groups. These results show that UV radiation damages not only the corneal epithelium but also the endothelium, and suggest that it causes more pleomorphic change (a decrease in hexagonal cell population) than enlargement of the mean cell size.Arc welding generates visible light and much ultraviolet (UV) light. Most of the UV radiation is absorbed by the superficial layers of the cornea. UV light of 265-275 nm wavelength causes photokeratitis (keratitis superficialis diffusa).' UV light of longer wavelength reaches the corneal endothelium, and that over 295 nm reaches the lens and can cause cataracts. However, there has been no report on the effect of UV radiation on the endothelial morphology of the human cornea.UV radiation is now thought to be one of the factors promoting cataracts with aging.23 The endothelium is also affected by aging.4-"' The mean cell size of the endothelium increases4'8 and hexagonal cells of the endothelium decrease with age.' "' The effects of aging on these changes are not clear. We assumed that UV radiation has an important role in the endothelial aging phenomenon and tried to study the relationship between the endothelial changes and UV radiation in welders, who are occupationally exposed to excess UV radiation.Corrcspondcncc to Dr 1. Karai. Subjects and methodsA total of 118 Japanese male welders of mean age 44-1 years (range 24-66 years) in-two welding factories in Osaka were studied. Their mean employment duration as welders was 17 4 years (range 1-39 years). The control group comprised 85 men of mean age of 41-8 years (range 20-73 years), employees in two chemical factories (42 males), and male outpatients (43 persons) without any corneal diseases from the Department of Ophthalmology in two hospitals. The welders were asked about their length of employment as a welder, the welding method used, and personal history of ocular disease. We excluded one welder with corneal disease, and one control who had once worked in welding. We also excluded persons with myopia gravis (over -6 dioptres) from this study.Specular microscopes (Keeler-Konan camera, and Bio-Optics) were used to photograph the central corneal endothelium of both eyes of the subjects three times after treatment with ophthalmic surface anaesthetic (0.4% oxybuprocaine hydrochloride).Kodak film (Tri-X pan, ASA 4...
<b><i>Background/Aims:</i></b> The purpose of this study was to evaluate the safety and efficacy of gastric endoscopic submucosal dissection (ESD) using the Clutch Cutter (CC), a scissor-type knife, compared with those of procedures using conventional devices. <b><i>Methods:</i></b> This single-center retrospective study evaluated 237 patients with early gastric cancer: 83 who underwent ESD using the CC group and 154 who underwent ESD using the insulated-tip knife 2 (IT2 group). Clinicopathological features and technical outcomes were compared between the 2 groups using a propensity score-matched analysis. <b><i>Results:</i></b> In 61 pairs of matched patients, there was no significant difference in R0 resection, perforation, or postoperative bleeding between the CC and IT2 groups. Comparisons between the 2 groups showed similar treatment outcomes for an expert endoscopist. Nevertheless, there were significant differences between the 2 groups for nonexperts in terms of self-completion (61.7 and 24.5%, respectively, <i>p</i> < 0.001), mean procedure times (45 and 61 min, respectively, <i>p</i> = 0.002), and mean numbers of intraoperative bleeding points and bleeding points requiring hemostatic forceps (3 and 0 vs. 8 and 3, respectively, <i>p</i> < 0.001). <b><i>Conclusion:</i></b> Better self-completion rates and shorter procedure times were noted for gastric ESD using the CC by nonexperts than for that using IT2, probably due to hemostatic efficacy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.