Colonoscopy techniques combining or replacing air insufflation with water infusion are becoming increasinglypopular.They were originally designed to reduce colonic spasms,facilitate cecal intubation,and lower patient ...Colonoscopy techniques combining or replacing air insufflation with water infusion are becoming increasinglypopular.They were originally designed to reduce colonic spasms,facilitate cecal intubation,and lower patient discomfort and the need for sedation.These maneuvers straighten the rectosigmoid colon and enable the colonoscope to be inserted deeply without causing looping of the colon.Water-immersion colonoscopy minimizes colonic distension and improves visibility by introducing a small amount of water.In addition,since pain during colonoscopy indicates risk of bowel perforation and sedation masks this important warning,this method has the potential to be the favored insertion technique because it promotes patient safety without sedation.Recently,this water-immersion method has not only been used for colonoscope insertion,but has also been applied to therapy for sigmoid volvulus,removal of lesions,lower gastrointestinal bleeding,and therapeutic diagnosis of abnormal bowel morphology and irritable bowel syndrome.Although a larger sample size and prospective head-to-head-designed studies will be needed,this review focuses on the usefulness of waterimmersion colonoscopy for diagnostic and therapeutic applications.展开更多
BACKGROUND Rectosigmoid endometriosis is an underdiagnosed disease responsible for abdominal pain, transit disorders and rectal bleeding. Two surgical approaches,rectosigmoid bowel resection(segmental or patch) or int...BACKGROUND Rectosigmoid endometriosis is an underdiagnosed disease responsible for abdominal pain, transit disorders and rectal bleeding. Two surgical approaches,rectosigmoid bowel resection(segmental or patch) or intramuscular layer dissection(shaving), are available.AIM To assess whether the lesion features observed via preoperative rectosigmoid endoscopic ultrasonography(RS-EUS) might predict the need for bowel resection.METHODS This multicentric retrospective study was conducted on patients with rectosigmoid endometriosis who underwent a curative surgical procedure,evaluated by RS-EUS performed by two trained operators, between January 2012 and March 2018. A univariate statistical analysis was performed on nodules' RSEUS features(thickness, width, infiltration of the submucosae, presence of a bump into the digestive lumen and presence of multiple rectosigmoid localizations). A multivariate logistic regression was then performed on the significant results.RESULTS Of the 367 patients, 73 patients with rectosigmoid endometriosis were evaluated by RS-EUS and underwent rectosigmoid surgery. After the univariate analysis was completed, thickness, width and infiltration of the submucosae were identified as potential predictive factors for bowel resection. In a multivariate logistic regression model, only thickness appeared to be a significant [odds ratio(OR) = 1.49, 95% confidence interval(CI): 1.04-2.12, P = 0.028] predictive factor for bowel resection. Receiver operating characteristic analysis performed showed that a thickness over 5.20 mm might be used as cut-off with a sensitivity of 76%, a specificity of 81%, and an area under carve = 0.82. The cut-off values for 100%sensitivity and 100% specificity were 0.90 mm and 10.00 mm, respectively. A trend concerning width to predict the need for resection was also observed(OR1.12, 95%CI: 1.00-1.26, P = 0.054)CONCLUSION The presence of a rectosigmoid nodule of endometriosis greater than 5.20 mm thick on RS-EUS might predict the need for bowel resection.展开更多
Background In the past several decades we have seen multiple advances in the reconstruction for girls born with vaginal agenesis.This study aimed to evaluate the technical feasibility,anatomical and functional outcome...Background In the past several decades we have seen multiple advances in the reconstruction for girls born with vaginal agenesis.This study aimed to evaluate the technical feasibility,anatomical and functional outcomes of one-stage laparoscopic and gasless laparoscopic vaginoplasty with sigmoid colon for the patients of vaginal agenesis （Mayer-Rokitansky-Kuster-Hauser syndrome）.Methods We did a retrospective review of a total of 150 women with Mayer-Rokitansky-Kuster-Hauser syndrome treated at Beijing Anzhen Hospital,Capital Medical University from March 2006 to August 2010.The patients were divided into the CO2 pneumoperitoneum laparoscopic group and the abdominal wall lift of gasless laparoscopic group.Sigmoid colon vaginoplasty approaches were performed in all of the patients.The surgical techniques,perioperative results,complications,anatomical and functional outcomes of vaginoplasty were recorded.Results All procedures were performed successfully.Significant differences in the operative time and intraoperative blood loss existed in the laparoscopic vaginoplasty group compared with the gasless laparoscopic vaginoplasty group.The patients who underwent sigmoid colon vaginoplasty had good cosmetic results without the problem of excessive mucus production.The postoperative complications were minimal.During a mean follow-up of 15.6 months,no stenosis or shrinkage was encountered.The subjective sexual satisfaction rate with the surgical outcomes in all patients was 83.3%.Conclusions Laparoscopic or gasless laparoscopic vaginoplasty with sigmoid colon are effective and feasible approaches for women with congenital vaginal agenesis.The procedures have satisfactory anatomical and functional results.展开更多
Recto-sigmoid endoscopic ultrasonography(RS-EUS) has first been used in the staging of pelvic deep infil-trating endometriosis in the early 1990's. Since then, although publications have been sparse, RS-EUS is rou...Recto-sigmoid endoscopic ultrasonography(RS-EUS) has first been used in the staging of pelvic deep infil-trating endometriosis in the early 1990's. Since then, although publications have been sparse, RS-EUS is routinely used for this indication in few centers. In this paper, we focus on technical aspects and operating method of rectal and sigmoid endo-sonography, and describe the most characteristic echographic presen-tations of endometriosis of the lower digestive tract. Through a literature review, results obtained with dif-ferent types of endo-rectal probes, either flexible en-doscopic, or blind rigid, are presented and compared with those of other close imaging techniques: magnetic resonance imaging and the more recent trans-vaginal sonography. As well as these two latter techniques, RS-EUS appears as an interesting method in the staging of pelvic deep infiltrating endometriosis particularly to evaluate rectal and sigmoid infiltrations. However, more prospective studies are required, to correctly define respective indications for each exam, in the light of re-cent advancements in treating this frequent disease.展开更多
In this study, we explore the application of ACP (asymptotic curve based and proportionality oriented) Alpha Beta (αβ) Nonlinear Math to analyze arithmetic and radiation transmission data. Specifically, we investiga...In this study, we explore the application of ACP (asymptotic curve based and proportionality oriented) Alpha Beta (αβ) Nonlinear Math to analyze arithmetic and radiation transmission data. Specifically, we investigate the relationship between two variables. The novel approach involves collecting elementary “y” data and subsequently analyzing the asymptotic cumulative or demulative (opposite of cumulative) Y data. In part I, we examine the connection between the common linear numbers and ideal nonlinear numbers. In part II, we delve into the relationship between X-ray energy and the radiation transmission for various thin film materials. The fundamental physical law asserts that the nonlinear change in continuous variable Y is negatively proportional to the nonlinear change in continuous variable X, expressed mathematically as dα = −Kdβ. Here: dα {Y, Yu, Yb} represents the change in Y, with Yu and Yb denoting the upper and baseline asymptote of Y. dβ {X, Xu, Xb} represents the change in X, with Xu and Xb denoting the upper and baseline asymptote of X. K represents the proportionality constant or rate constant, which varies based on equation arrangement. K is the key inferential factor for describing physical phenomena.展开更多
Chylous ascites is the accumulation of a milk-like peritoneal fluid rich in triglycerides and it is an unusual complication following surgical treatment of colorectal cancer. Conservative management is usually suffici...Chylous ascites is the accumulation of a milk-like peritoneal fluid rich in triglycerides and it is an unusual complication following surgical treatment of colorectal cancer. Conservative management is usually sufficientin patients with chylous ascites after surgery. However,we describe a patient with intractable chylous ascites after laparoscopic anterior resection for sigmoid colon cancer who failed initial conservative treatment. This patient was successfully managed by surgery.展开更多
文摘Colonoscopy techniques combining or replacing air insufflation with water infusion are becoming increasinglypopular.They were originally designed to reduce colonic spasms,facilitate cecal intubation,and lower patient discomfort and the need for sedation.These maneuvers straighten the rectosigmoid colon and enable the colonoscope to be inserted deeply without causing looping of the colon.Water-immersion colonoscopy minimizes colonic distension and improves visibility by introducing a small amount of water.In addition,since pain during colonoscopy indicates risk of bowel perforation and sedation masks this important warning,this method has the potential to be the favored insertion technique because it promotes patient safety without sedation.Recently,this water-immersion method has not only been used for colonoscope insertion,but has also been applied to therapy for sigmoid volvulus,removal of lesions,lower gastrointestinal bleeding,and therapeutic diagnosis of abnormal bowel morphology and irritable bowel syndrome.Although a larger sample size and prospective head-to-head-designed studies will be needed,this review focuses on the usefulness of waterimmersion colonoscopy for diagnostic and therapeutic applications.
文摘BACKGROUND Rectosigmoid endometriosis is an underdiagnosed disease responsible for abdominal pain, transit disorders and rectal bleeding. Two surgical approaches,rectosigmoid bowel resection(segmental or patch) or intramuscular layer dissection(shaving), are available.AIM To assess whether the lesion features observed via preoperative rectosigmoid endoscopic ultrasonography(RS-EUS) might predict the need for bowel resection.METHODS This multicentric retrospective study was conducted on patients with rectosigmoid endometriosis who underwent a curative surgical procedure,evaluated by RS-EUS performed by two trained operators, between January 2012 and March 2018. A univariate statistical analysis was performed on nodules' RSEUS features(thickness, width, infiltration of the submucosae, presence of a bump into the digestive lumen and presence of multiple rectosigmoid localizations). A multivariate logistic regression was then performed on the significant results.RESULTS Of the 367 patients, 73 patients with rectosigmoid endometriosis were evaluated by RS-EUS and underwent rectosigmoid surgery. After the univariate analysis was completed, thickness, width and infiltration of the submucosae were identified as potential predictive factors for bowel resection. In a multivariate logistic regression model, only thickness appeared to be a significant [odds ratio(OR) = 1.49, 95% confidence interval(CI): 1.04-2.12, P = 0.028] predictive factor for bowel resection. Receiver operating characteristic analysis performed showed that a thickness over 5.20 mm might be used as cut-off with a sensitivity of 76%, a specificity of 81%, and an area under carve = 0.82. The cut-off values for 100%sensitivity and 100% specificity were 0.90 mm and 10.00 mm, respectively. A trend concerning width to predict the need for resection was also observed(OR1.12, 95%CI: 1.00-1.26, P = 0.054)CONCLUSION The presence of a rectosigmoid nodule of endometriosis greater than 5.20 mm thick on RS-EUS might predict the need for bowel resection.
文摘Background In the past several decades we have seen multiple advances in the reconstruction for girls born with vaginal agenesis.This study aimed to evaluate the technical feasibility,anatomical and functional outcomes of one-stage laparoscopic and gasless laparoscopic vaginoplasty with sigmoid colon for the patients of vaginal agenesis （Mayer-Rokitansky-Kuster-Hauser syndrome）.Methods We did a retrospective review of a total of 150 women with Mayer-Rokitansky-Kuster-Hauser syndrome treated at Beijing Anzhen Hospital,Capital Medical University from March 2006 to August 2010.The patients were divided into the CO2 pneumoperitoneum laparoscopic group and the abdominal wall lift of gasless laparoscopic group.Sigmoid colon vaginoplasty approaches were performed in all of the patients.The surgical techniques,perioperative results,complications,anatomical and functional outcomes of vaginoplasty were recorded.Results All procedures were performed successfully.Significant differences in the operative time and intraoperative blood loss existed in the laparoscopic vaginoplasty group compared with the gasless laparoscopic vaginoplasty group.The patients who underwent sigmoid colon vaginoplasty had good cosmetic results without the problem of excessive mucus production.The postoperative complications were minimal.During a mean follow-up of 15.6 months,no stenosis or shrinkage was encountered.The subjective sexual satisfaction rate with the surgical outcomes in all patients was 83.3%.Conclusions Laparoscopic or gasless laparoscopic vaginoplasty with sigmoid colon are effective and feasible approaches for women with congenital vaginal agenesis.The procedures have satisfactory anatomical and functional results.
文摘Recto-sigmoid endoscopic ultrasonography(RS-EUS) has first been used in the staging of pelvic deep infil-trating endometriosis in the early 1990's. Since then, although publications have been sparse, RS-EUS is routinely used for this indication in few centers. In this paper, we focus on technical aspects and operating method of rectal and sigmoid endo-sonography, and describe the most characteristic echographic presen-tations of endometriosis of the lower digestive tract. Through a literature review, results obtained with dif-ferent types of endo-rectal probes, either flexible en-doscopic, or blind rigid, are presented and compared with those of other close imaging techniques: magnetic resonance imaging and the more recent trans-vaginal sonography. As well as these two latter techniques, RS-EUS appears as an interesting method in the staging of pelvic deep infiltrating endometriosis particularly to evaluate rectal and sigmoid infiltrations. However, more prospective studies are required, to correctly define respective indications for each exam, in the light of re-cent advancements in treating this frequent disease.
文摘In this study, we explore the application of ACP (asymptotic curve based and proportionality oriented) Alpha Beta (αβ) Nonlinear Math to analyze arithmetic and radiation transmission data. Specifically, we investigate the relationship between two variables. The novel approach involves collecting elementary “y” data and subsequently analyzing the asymptotic cumulative or demulative (opposite of cumulative) Y data. In part I, we examine the connection between the common linear numbers and ideal nonlinear numbers. In part II, we delve into the relationship between X-ray energy and the radiation transmission for various thin film materials. The fundamental physical law asserts that the nonlinear change in continuous variable Y is negatively proportional to the nonlinear change in continuous variable X, expressed mathematically as dα = −Kdβ. Here: dα {Y, Yu, Yb} represents the change in Y, with Yu and Yb denoting the upper and baseline asymptote of Y. dβ {X, Xu, Xb} represents the change in X, with Xu and Xb denoting the upper and baseline asymptote of X. K represents the proportionality constant or rate constant, which varies based on equation arrangement. K is the key inferential factor for describing physical phenomena.
文摘Chylous ascites is the accumulation of a milk-like peritoneal fluid rich in triglycerides and it is an unusual complication following surgical treatment of colorectal cancer. Conservative management is usually sufficientin patients with chylous ascites after surgery. However,we describe a patient with intractable chylous ascites after laparoscopic anterior resection for sigmoid colon cancer who failed initial conservative treatment. This patient was successfully managed by surgery.
