The recurrence of colorectal adenoma(CRA)is high.Although there are guidelines for colonoscopy surveillance after polypectomy in other countries,little is known about its recurrence rate and recurrence peak,especially...The recurrence of colorectal adenoma(CRA)is high.Although there are guidelines for colonoscopy surveillance after polypectomy in other countries,little is known about its recurrence rate and recurrence peak,especially in China.The aim of the present research is to investigate how long after polypectomy follow-up should take and to analyze risk factors of recurrence.1208 patients who received polypectomies fromfive clinical research centers in four regions of China(Shanghai,Guangzhou,Nanjing and Beijing)were included.They were divided into 4 groups:group A(follow-up≤1 year after poly-pectomy),group B(follow-up 2–3 years after polypect-omy),group C(follow-up 4–5 years after polypectomy),and group D(follow-up>5 years after polypectomy).The sex,age,adenoma location,size,number,and pathological characteristics were compared.On the whole,the recur-rence rate was 59.46%in group A,61.09%in group B,78.07%in group C,and 87.12%in group D,which indicated an increased tendency with a prolonged follow-up duration.There was a significant difference between group A and C or D,and between group B and C or D(P<0.01),but there was no statistical difference between group A and B.Additionally,the recurrent patients in thefirst year had a recurrence rate of 97.33%in thefirst three years(59.46/61.09),which means that the peak of recurrence was almost entirely concentrated in thefirst year.The recurrence rate was higher in males and the elder.The risk factors included multiple numbers,villous feature,high-grade dysplasia of medium or smaller size and location in the distal colon.In conclusion,the peak of recurrence was almost totally concentrated in thefirst year;meanwhile,thefirst year follow-up is of critical importance in China.It may not be necessary to do the follow-up examination during the second and third years,but after three years,another colonoscopy should be undertaken.展开更多
Dear Editor,Severe acute respiratory syndrome coronavirus(SARSCo V)is the causative agent of the 2002–2003 SARS pandemic,which resulted in more than 8000 human infections worldwide and an approximately 10%fatality ra...Dear Editor,Severe acute respiratory syndrome coronavirus(SARSCo V)is the causative agent of the 2002–2003 SARS pandemic,which resulted in more than 8000 human infections worldwide and an approximately 10%fatality rate(Ksiazek et al.2003;Peiris et al.2004).The virus infects both upper airway and alveolar epithelial cells,resulting in mild to severe lung injury in展开更多
AIM： To summarize our experience with the application of self-expanding metallic stent （SEMS） in the management of acute left-sided colorectal malignant obstruction. METHODS： A retrospective chart review of all pa...AIM： To summarize our experience with the application of self-expanding metallic stent （SEMS） in the management of acute left-sided colorectal malignant obstruction. METHODS： A retrospective chart review of all patients undergoing placement of SENS between April 2000 and January 2004 was performed. RESULTS： Insertion of SENS was attempted in 26 patients under fluoroscopic guidance with occasional endoscopic assistance. The sites of lesions were located in splenic flexure of two patients, left colon of seven patients, sigmoid colon of eight patients and rectum of nine patients. The intended uses of SENS were for palliation in 7 patients and as a bridge to elective surgery in 19 patients. In the latter group, placement of SENS allowed for preoperative systemic and bowel preparation and the following one-stage anastomosis. Successful stent placement was achieved in 22 （85%） of the 26 patients. The clinical bowel obstruction resolved 24 hours after successful stent placement in 21 （95%） patients. Three SENS-related minor complications occurred, two stents migrated and one caused anal pain. CONCLUSION： SEMS represents an effective and safe tool in the management of acute malignant colorectal obstruction. As a bridge to surgery, SEMS can provide time for systematic support and bowel preparation and obviate the need for fecal diversion or on-table lavage. As a palliative measure, SEMS can eliminate the need for emergent colostomy.展开更多
基金supported by grant from the Ministry of Health,China(No:200802094)Ministry of Education,China(No:20090073110077)to Jingyuan Fanggrant from Shanghai JiaoTong University School of Medicine Foundation for Science and Technology(No:BXJ0914)to Huimin Chen.
文摘The recurrence of colorectal adenoma(CRA)is high.Although there are guidelines for colonoscopy surveillance after polypectomy in other countries,little is known about its recurrence rate and recurrence peak,especially in China.The aim of the present research is to investigate how long after polypectomy follow-up should take and to analyze risk factors of recurrence.1208 patients who received polypectomies fromfive clinical research centers in four regions of China(Shanghai,Guangzhou,Nanjing and Beijing)were included.They were divided into 4 groups:group A(follow-up≤1 year after poly-pectomy),group B(follow-up 2–3 years after polypect-omy),group C(follow-up 4–5 years after polypectomy),and group D(follow-up>5 years after polypectomy).The sex,age,adenoma location,size,number,and pathological characteristics were compared.On the whole,the recur-rence rate was 59.46%in group A,61.09%in group B,78.07%in group C,and 87.12%in group D,which indicated an increased tendency with a prolonged follow-up duration.There was a significant difference between group A and C or D,and between group B and C or D(P<0.01),but there was no statistical difference between group A and B.Additionally,the recurrent patients in thefirst year had a recurrence rate of 97.33%in thefirst three years(59.46/61.09),which means that the peak of recurrence was almost entirely concentrated in thefirst year.The recurrence rate was higher in males and the elder.The risk factors included multiple numbers,villous feature,high-grade dysplasia of medium or smaller size and location in the distal colon.In conclusion,the peak of recurrence was almost totally concentrated in thefirst year;meanwhile,thefirst year follow-up is of critical importance in China.It may not be necessary to do the follow-up examination during the second and third years,but after three years,another colonoscopy should be undertaken.
基金funded by the National Natural Science Foundation of China Grant (81290341) to ZLSthe National Institute of Allergy and Infectious Diseases of the National Institutes of Health (Award Number R01AI110964) to PD and ZLS+2 种基金United States Agency for International Development (USAID) Emerging Pandemic Threats PREDICT project Grant (Cooperative Agreement No. AID-OAA-A-14-00102) to PDSingapore NRFCRP Grant (NRF2012NRF-CRP001–056)CD-PHRG Grant (CDPHRG/0006/2014) to LFW
文摘Dear Editor,Severe acute respiratory syndrome coronavirus(SARSCo V)is the causative agent of the 2002–2003 SARS pandemic,which resulted in more than 8000 human infections worldwide and an approximately 10%fatality rate(Ksiazek et al.2003;Peiris et al.2004).The virus infects both upper airway and alveolar epithelial cells,resulting in mild to severe lung injury in
文摘AIM： To summarize our experience with the application of self-expanding metallic stent （SEMS） in the management of acute left-sided colorectal malignant obstruction. METHODS： A retrospective chart review of all patients undergoing placement of SENS between April 2000 and January 2004 was performed. RESULTS： Insertion of SENS was attempted in 26 patients under fluoroscopic guidance with occasional endoscopic assistance. The sites of lesions were located in splenic flexure of two patients, left colon of seven patients, sigmoid colon of eight patients and rectum of nine patients. The intended uses of SENS were for palliation in 7 patients and as a bridge to elective surgery in 19 patients. In the latter group, placement of SENS allowed for preoperative systemic and bowel preparation and the following one-stage anastomosis. Successful stent placement was achieved in 22 （85%） of the 26 patients. The clinical bowel obstruction resolved 24 hours after successful stent placement in 21 （95%） patients. Three SENS-related minor complications occurred, two stents migrated and one caused anal pain. CONCLUSION： SEMS represents an effective and safe tool in the management of acute malignant colorectal obstruction. As a bridge to surgery, SEMS can provide time for systematic support and bowel preparation and obviate the need for fecal diversion or on-table lavage. As a palliative measure, SEMS can eliminate the need for emergent colostomy.
