Zhi-feng Zhao

A comparative study on endoscopy treatment in rectal carcinoid tumors.

Background: To investigate the advantages and disadvantages of various endoscopic resection methods for rectal carcinoid tumors. Methods: A retrospective analysis of 3 types of endoscopic resection techniques for rectal carcinoid tumors was performed. The surgical time and the complication rate were compared between 30 patients who underwent conventional endoscopic mucosal resection (EMR), cap-assisted endoscopic mucosal resection (EMR-C), or endoscopic submucosal dissection (ESD). All rectal carcinoid tumors were under 1 cm and were treated in our center between January 2002 and January 2008. Results: Ten patients underwent each surgical approach. All cases were pathologically diagnosed as rectal carcinoid tumors. One-time complete resection rates using the conventional EMR, EMR-C, and ESD were 80%, 100%, and 100%, respectively. The operation time ranged from 5 to 53 minutes for the conventional EMR group, from 4 to 7 minutes for the EMR-C group, and from 16 to 35minutes for the ESD group. The average follow-up time for the 30 patients was 18.43±9.76 months. There were no recurrent or metastatic cases. Conclusions: Endoscopic resection for rectal carcinoid tumors below 1 cm was safe. Considering the clinical efficacy, surgical time, and intraoperative complication rate, EMR-C may be the best endoscopic excision method.

Endoscopic diagnosis and treatment of esophageal cavernous lymphangioma.

The purpose of this paper is to identify the characteristic endoscopic findings in patients with esophageal cavernous lymphangioma and assess the efficacy of endoscopic techniques in the management of this disease. We retrospectively analyzed data from 6 patients who were diagnosed with esophageal cavernous lymphangioma by endoscopy and histologic evaluation. All patients underwent endoscopic resection of the tumor at our hospital between January 2010 and June 2011. Four male and 2 female patients, with a mean age of 48.2±15.2 years (range, 35 to 77 y) with esophageal cavernous lymphangioma, who underwent endoscopy followed by endoscopic resection were included in this report. The lesions varied from 0.4 to 1.2 cm in diameter, with a mean size of 0.78±0.26 cm. Endoscopy revealed dilated lymphatic channels beneath the surface epithelium of the lesion in all patients. An endoscopic ultrasound revealed that all lesions were multicystic and located in the submucosal layer. Histologic examination confirmed the initial diagnosis in all patients. Endoscopy plays an important role in the diagnosis of esophageal cavernous lymphangioma, with dilated lymphatic channels beneath the surface epithelium of the lesion being a characteristic endoscopic feature. Endoscopic ultrasonography is a useful tool to differentiate cavernous lymphangioma from other esophageal tumors. Endoscopic resection of esophageal cavernous lymphangioma was safe and effective in all of the analyzed cases.

Use of a mechanical lithotripter to aid in the removal of an impacted razor blade in the esophagus

1. Gupta V, Anupam Lal A, Sinha SK, et al. Leiomyomatosis of the esophagus: experience over a decade. J Gastrointest Surg 2009;13:206-11. 2. Lee LS, Nance M, Kaiser LR, et al. Familial massive leiomyoma with esophageal leiomyomatosis: an unusual presentation in a father and his 2 Figure 2. High-resolution manometry demonstrating isobaric esophagea incomplete relaxation to liquid swallow. Impedance demonstrates conti