Anisakiasis can involve any part of the digestive tract, but most cases reported have involved the stomach;few reports have described colonic anisakiasis. Furthermore, asymptomatic colonic anisakiasis has been reporte...Anisakiasis can involve any part of the digestive tract, but most cases reported have involved the stomach;few reports have described colonic anisakiasis. Furthermore, asymptomatic colonic anisakiasis has been reported to be very rare. A 58-year-old Japanese male asymptomatically received colonoscopy due to a fecal occult blood testing positive, and an <em>Anisakis</em> larva was removed in the ascending colon. After colonoscopy, an detailed questionings concerning eating raw fish revealed that the patient ate the liver of raw filefish 21 days before the colonoscopy. Thus, questionings concerning eating the raw fish were very important and helpful for correct diagnosis. This case report demonstrated that colonic anisakiasis can be diagnosed by colonoscopy before severe complications (intestinal obstruction, perforation, and cancer development) occur. Also, biopsy forceps could be used to remove the <em>Anisakis</em> worms, demonstrating that diagnosis and treatment can be simultaneously performed.展开更多
BACKGROUND Colorectal cancer is a common malignant tumor of the digestive tract.The relationship between sentinel polyps(rectal polyps with proximal colon cancer)and proximal colon cancer has received extensive attent...BACKGROUND Colorectal cancer is a common malignant tumor of the digestive tract.The relationship between sentinel polyps(rectal polyps with proximal colon cancer)and proximal colon cancer has received extensive attention in recent years.However,there is still no clear conclusion regarding the relationship.AIM To investigate the clinical characteristics of sentinel polyps and their correlation with proximal colon cancer.METHODS A retrospective analysis of 2587 patients with rectal polyps from January 2006 to December 2017 was performed.According to whether or not proximal colon cancer was diagnosed,the patients were divided into either a sentinel polyp group(192 patients)or a pure rectal polyp group(2395 patients).The endoscopic features,clinicopathological features,therapeutic effects,and short-term prognosis were analyzed and compared between the two groups.RESULTS The mean age of patients in the sentinel polyp group was generally higher than that of the pure rectal polyp group,and the positivity rates of anemia,stool occult blood,and tumor markers of the sentinel polyp group were also significantly higher than those in the rectal polyp group(χ^2=90.56,P<0.01;χ^2=70.30,P<0.01;χ^2=92.80,P<0.01).The majority of the patients in the sentinel polyp group had multiple polyps,large polyps,adenomatous polyps,or sessile polyps(χ^2=195.96,P<0.01;χ^2=460.46,P<0.01;χ^2=94.69,P<0.01;χ^2=48.01,P<0.01).Most of the proximal colon cancers were Duke’s A and B stages in the sentinel polyp group.In the pure rectal polyp group,2203 patients underwent endoscopic treatment,and all of the patients were cured and discharged.In the sentinel polyp group,65 patients underwent radical operation,and 61 patients received endoscopic submucosal dissection or endoscopic mucosal resection.Additionally,21 patients were lost to follow-up after 6-12 mo,and the loss rate was 10.94%.A total of 63.16%of patients experienced remission without tumor recurrence or metastasis,33.33%of patients experienced tumors regression or improved symptoms,and展开更多
目的:探讨分析腹部无辅助切口经直肠取标本的腹腔镜右半结肠癌根治术(NOSESⅧ式B法)的安全性与临床疗效。方法:回顾性收集分析自2017年01月至2021年12月期间在中国医学科学院肿瘤医院与滦州市人民医院行腹部无辅助切口经阴道取标本的腹...目的:探讨分析腹部无辅助切口经直肠取标本的腹腔镜右半结肠癌根治术(NOSESⅧ式B法)的安全性与临床疗效。方法:回顾性收集分析自2017年01月至2021年12月期间在中国医学科学院肿瘤医院与滦州市人民医院行腹部无辅助切口经阴道取标本的腹腔镜右半结肠癌根治术(NOSES式Ⅷ式A法)和NOSESⅧ式B法患者的临床病理资料。比较两组患者临床病理特征、手术结果、术后恢复、术后并发症、术后复发转移情况等。结果:共有81患者纳入研究,其中行NOSES式Ⅷ式A法患者共57例,行NOSES式Ⅷ式B法患者共24例。NOSES式Ⅷ式B法组男性患者比例显著高于NOSES式Ⅷ式A法组(91.7%vs 0,P<0.001)。两组患者其余基线资料无统计学差异(P>0.05)。两组患者平均手术时间[(176.6 vs 167.3)min,P=0.529]与术中出血量[(35.5 vs 31.2)mL,P=0.733]无明显统计学差异。两组患者术后第1天(4.3 vs 4.5,P=0.852)、第3天(4.0 vs 4.3,P=0.572)、第5天(2.5 vs 2.3,P=0.742)视觉模拟评分法(visual analogue scale,VAS)评分相似。两组患者在术后并发症方面无统计学差异(14.0%vs 12.5%,P=0.854)。两组患者术后首次排气时间[(2.0 vs 1.8)days,P=0.893]和术后住院时间[(7.0 vs 6.8)days,P=0.904]相似。术后病理方面,两组患者的淋巴结清扫数量[(24.6 vs 25.2)枚,P=0.319]、标本切除长度[(32.1 vs 33.2)cm,P=0.395]、肿瘤大小[(3.3 vs 2.8)cm,P=0.195]等方面无显著统计学差异。术后3个月内,NOSESⅧB组患者未出现与直肠切开相关并发症,如直肠流血、直肠狭窄、感觉异常、盆腔脓肿等。随访期间,NOSESⅧA组共有6例患者出现局部复发和远处转移,NOSESⅧB组共2例患者出现远处转移。两组患者均无切口、盆腔、直肠肠腔、阴道等标本取出途径肿瘤复发与转移。结论:NOSESⅧ式B法是安全可行的,亦具有创伤小、恢复快、疼痛轻等短期优势。在严格把握手术适应证和遵守无菌无瘤原则的前提下,该术式并不会展开更多
文摘Anisakiasis can involve any part of the digestive tract, but most cases reported have involved the stomach;few reports have described colonic anisakiasis. Furthermore, asymptomatic colonic anisakiasis has been reported to be very rare. A 58-year-old Japanese male asymptomatically received colonoscopy due to a fecal occult blood testing positive, and an <em>Anisakis</em> larva was removed in the ascending colon. After colonoscopy, an detailed questionings concerning eating raw fish revealed that the patient ate the liver of raw filefish 21 days before the colonoscopy. Thus, questionings concerning eating the raw fish were very important and helpful for correct diagnosis. This case report demonstrated that colonic anisakiasis can be diagnosed by colonoscopy before severe complications (intestinal obstruction, perforation, and cancer development) occur. Also, biopsy forceps could be used to remove the <em>Anisakis</em> worms, demonstrating that diagnosis and treatment can be simultaneously performed.
文摘BACKGROUND Colorectal cancer is a common malignant tumor of the digestive tract.The relationship between sentinel polyps(rectal polyps with proximal colon cancer)and proximal colon cancer has received extensive attention in recent years.However,there is still no clear conclusion regarding the relationship.AIM To investigate the clinical characteristics of sentinel polyps and their correlation with proximal colon cancer.METHODS A retrospective analysis of 2587 patients with rectal polyps from January 2006 to December 2017 was performed.According to whether or not proximal colon cancer was diagnosed,the patients were divided into either a sentinel polyp group(192 patients)or a pure rectal polyp group(2395 patients).The endoscopic features,clinicopathological features,therapeutic effects,and short-term prognosis were analyzed and compared between the two groups.RESULTS The mean age of patients in the sentinel polyp group was generally higher than that of the pure rectal polyp group,and the positivity rates of anemia,stool occult blood,and tumor markers of the sentinel polyp group were also significantly higher than those in the rectal polyp group(χ^2=90.56,P<0.01;χ^2=70.30,P<0.01;χ^2=92.80,P<0.01).The majority of the patients in the sentinel polyp group had multiple polyps,large polyps,adenomatous polyps,or sessile polyps(χ^2=195.96,P<0.01;χ^2=460.46,P<0.01;χ^2=94.69,P<0.01;χ^2=48.01,P<0.01).Most of the proximal colon cancers were Duke’s A and B stages in the sentinel polyp group.In the pure rectal polyp group,2203 patients underwent endoscopic treatment,and all of the patients were cured and discharged.In the sentinel polyp group,65 patients underwent radical operation,and 61 patients received endoscopic submucosal dissection or endoscopic mucosal resection.Additionally,21 patients were lost to follow-up after 6-12 mo,and the loss rate was 10.94%.A total of 63.16%of patients experienced remission without tumor recurrence or metastasis,33.33%of patients experienced tumors regression or improved symptoms,and
文摘目的:探讨分析腹部无辅助切口经直肠取标本的腹腔镜右半结肠癌根治术(NOSESⅧ式B法)的安全性与临床疗效。方法:回顾性收集分析自2017年01月至2021年12月期间在中国医学科学院肿瘤医院与滦州市人民医院行腹部无辅助切口经阴道取标本的腹腔镜右半结肠癌根治术(NOSES式Ⅷ式A法)和NOSESⅧ式B法患者的临床病理资料。比较两组患者临床病理特征、手术结果、术后恢复、术后并发症、术后复发转移情况等。结果:共有81患者纳入研究,其中行NOSES式Ⅷ式A法患者共57例,行NOSES式Ⅷ式B法患者共24例。NOSES式Ⅷ式B法组男性患者比例显著高于NOSES式Ⅷ式A法组(91.7%vs 0,P<0.001)。两组患者其余基线资料无统计学差异(P>0.05)。两组患者平均手术时间[(176.6 vs 167.3)min,P=0.529]与术中出血量[(35.5 vs 31.2)mL,P=0.733]无明显统计学差异。两组患者术后第1天(4.3 vs 4.5,P=0.852)、第3天(4.0 vs 4.3,P=0.572)、第5天(2.5 vs 2.3,P=0.742)视觉模拟评分法(visual analogue scale,VAS)评分相似。两组患者在术后并发症方面无统计学差异(14.0%vs 12.5%,P=0.854)。两组患者术后首次排气时间[(2.0 vs 1.8)days,P=0.893]和术后住院时间[(7.0 vs 6.8)days,P=0.904]相似。术后病理方面,两组患者的淋巴结清扫数量[(24.6 vs 25.2)枚,P=0.319]、标本切除长度[(32.1 vs 33.2)cm,P=0.395]、肿瘤大小[(3.3 vs 2.8)cm,P=0.195]等方面无显著统计学差异。术后3个月内,NOSESⅧB组患者未出现与直肠切开相关并发症,如直肠流血、直肠狭窄、感觉异常、盆腔脓肿等。随访期间,NOSESⅧA组共有6例患者出现局部复发和远处转移,NOSESⅧB组共2例患者出现远处转移。两组患者均无切口、盆腔、直肠肠腔、阴道等标本取出途径肿瘤复发与转移。结论:NOSESⅧ式B法是安全可行的,亦具有创伤小、恢复快、疼痛轻等短期优势。在严格把握手术适应证和遵守无菌无瘤原则的前提下,该术式并不会
