内镜黏膜下剥离术(ESD)与内镜黏膜切除术(EMR)是消化道内镜手术中的两种重要手术方式,目前基于两者又出现了改良的新术式:ESD-S(ESD with snare,ESD联合圈套器法)与EMRP术(EMR with precutting,预环切EMR法)。这四种手术方式在治疗结直...内镜黏膜下剥离术(ESD)与内镜黏膜切除术(EMR)是消化道内镜手术中的两种重要手术方式,目前基于两者又出现了改良的新术式:ESD-S(ESD with snare,ESD联合圈套器法)与EMRP术(EMR with precutting,预环切EMR法)。这四种手术方式在治疗结直肠肿瘤中具有各自不同的优缺点,如较高的完全切除率,较低的并发症风险等。综合近几年国际发表的临床试验,笔者认为:对于直径小于20 mm的结直肠肿瘤,可根据肿瘤的情况,选择ESD术、ESD-S术,EMR-P术或者EMR术。对于直径大于20 mm的肿瘤,ESD术与ESD-S术由于其较低的复发率与较高的完全切除率,可以作为处理此类肿瘤的首选。如上述两种术式风险较高,可以采用EMR-P进行处理。EMR术由于完全切除率较低,复发率偏高,而大于20 mm肿瘤恶变风险较高,不适合用于这类肿瘤的切除。展开更多
内镜黏膜切除术（EMR）与内镜黏膜下剥离术（ESD）都具有侵袭小、术后疼痛轻微、康复快等特点,可用于早期胃肠道黏膜及黏膜下病变的微创治疗。EMR一般不适用于病灶直径〉20mm的病变,研究表明其整块切除率为42.9%,完全切除率为32.9%。ES...内镜黏膜切除术（EMR）与内镜黏膜下剥离术（ESD）都具有侵袭小、术后疼痛轻微、康复快等特点,可用于早期胃肠道黏膜及黏膜下病变的微创治疗。EMR一般不适用于病灶直径〉20mm的病变,研究表明其整块切除率为42.9%,完全切除率为32.9%。ESD对于较大病灶可完全整块剥离,且复发率低,但对设备和技术要求较高。目前在ESD与EMR的基础上出现了改进,如ESD-S（ESD with snare，ESD联合圈套器法）、EMR—P（EMR with precutting，预环切EMR法）。展开更多
Nasal lobular capillary haemangioma (CH), also known as pyogenic granuloma, is a benign lesion of unknown etiology commonly associated with pregnancy, oral contraceptive pills, and trauma. Marked by epistaxis and nasa...Nasal lobular capillary haemangioma (CH), also known as pyogenic granuloma, is a benign lesion of unknown etiology commonly associated with pregnancy, oral contraceptive pills, and trauma. Marked by epistaxis and nasal obstruction, the condition involves benign capillary proliferation with a microscopically distinctive lobular architecture, affecting the skin and mucous membranes of the oral cavity and nasal region. This aim of this article is to report a case of lateral nasal capillary haemangioma in a 39-year-old female, who presented in our facilities having experienced spontaneous epistaxis on the left side of the nose for the previous three months. Endoscopy revealed a protruding left intranasal mass arising from the lateral nasal wall in the region of the middle turbinate and osteo-meatal complex. The patient underwent endoscopic excision of the mass and did excellently well thereafter with no recurrence.展开更多
Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the t...Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the tumour as much as possible. The likelihood of recurrence is high in spite of complete surgical resection. A 52-year-old female patient presented with complaints of decreased vision in right eye, nasal bleeding, nasal blockage and difficulties in swallowing. CT scan and nasal biopsy were performed which confirmed the diagnosis of clivus chordoma. The CT scan showed extension into nasopharynx, nasal cavity and oropharynx pushing onto the soft palate. Surgical excision of the mass was performed with coblator by both intraoral and intra nasal approach [3]. On follow-up, nasal endoscopy and CT were done;the patient was relieved of the symptoms and was clinically better.展开更多
文摘内镜黏膜下剥离术(ESD)与内镜黏膜切除术(EMR)是消化道内镜手术中的两种重要手术方式,目前基于两者又出现了改良的新术式:ESD-S(ESD with snare,ESD联合圈套器法)与EMRP术(EMR with precutting,预环切EMR法)。这四种手术方式在治疗结直肠肿瘤中具有各自不同的优缺点,如较高的完全切除率,较低的并发症风险等。综合近几年国际发表的临床试验,笔者认为:对于直径小于20 mm的结直肠肿瘤,可根据肿瘤的情况,选择ESD术、ESD-S术,EMR-P术或者EMR术。对于直径大于20 mm的肿瘤,ESD术与ESD-S术由于其较低的复发率与较高的完全切除率,可以作为处理此类肿瘤的首选。如上述两种术式风险较高,可以采用EMR-P进行处理。EMR术由于完全切除率较低,复发率偏高,而大于20 mm肿瘤恶变风险较高,不适合用于这类肿瘤的切除。
文摘内镜黏膜切除术（EMR）与内镜黏膜下剥离术（ESD）都具有侵袭小、术后疼痛轻微、康复快等特点,可用于早期胃肠道黏膜及黏膜下病变的微创治疗。EMR一般不适用于病灶直径〉20mm的病变,研究表明其整块切除率为42.9%,完全切除率为32.9%。ESD对于较大病灶可完全整块剥离,且复发率低,但对设备和技术要求较高。目前在ESD与EMR的基础上出现了改进,如ESD-S（ESD with snare，ESD联合圈套器法）、EMR—P（EMR with precutting，预环切EMR法）。
文摘Nasal lobular capillary haemangioma (CH), also known as pyogenic granuloma, is a benign lesion of unknown etiology commonly associated with pregnancy, oral contraceptive pills, and trauma. Marked by epistaxis and nasal obstruction, the condition involves benign capillary proliferation with a microscopically distinctive lobular architecture, affecting the skin and mucous membranes of the oral cavity and nasal region. This aim of this article is to report a case of lateral nasal capillary haemangioma in a 39-year-old female, who presented in our facilities having experienced spontaneous epistaxis on the left side of the nose for the previous three months. Endoscopy revealed a protruding left intranasal mass arising from the lateral nasal wall in the region of the middle turbinate and osteo-meatal complex. The patient underwent endoscopic excision of the mass and did excellently well thereafter with no recurrence.
文摘Chordomas are dysembryogenic tumors originating from the notochordal process [1] [2]. They are aggressive tumours with unique diagnostic and management challenges. Primary therapy is complete surgical removal of the tumour as much as possible. The likelihood of recurrence is high in spite of complete surgical resection. A 52-year-old female patient presented with complaints of decreased vision in right eye, nasal bleeding, nasal blockage and difficulties in swallowing. CT scan and nasal biopsy were performed which confirmed the diagnosis of clivus chordoma. The CT scan showed extension into nasopharynx, nasal cavity and oropharynx pushing onto the soft palate. Surgical excision of the mass was performed with coblator by both intraoral and intra nasal approach [3]. On follow-up, nasal endoscopy and CT were done;the patient was relieved of the symptoms and was clinically better.
