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Clinical and endoscopic data of 6 patients with colorectal mucosa associated lymphoid tissue (MALT) lymphoma who were diagnosed by endoscopy in the Digestive Endoscopy Center of Jiangsu Province Hospital of Chinese Medicine from January 2015 to June 2021 were retrospectively analyzed. There were 2 males and 4 females with aged from 62 to 87 years. The lesions were located in rectum in 3 cases, transverse colon in 1 case, sigmoid colon in 1 case, and sigmoid colon and rectum in 1 case. There were 1 case of polyposis type, 2 cases of inflammation type, and 3 cases of submucosal tumor type. The "tree-like appearance (TLA)" found in 5 cases. Endoscopic resection, surgery combined with chemotherapy, Helicobacter pylori eradication and follow-up were performed on 2, 1, 1 and 2 cases, respectively. Five cases had a good prognosis after 21-73 months follow-up, and 1 case had lost to follow-up. No recurrence was found in endoscopic and imaging review. Colorectal MALT lymphoma should be considered when colonoscopy detects a submucosal lesion with TLA sign on the left colon. Endoscopic resection has the potential to be a first-line treatment in the context of early diagnosis.
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A total of three early gastric cancers (EGC)patients with submucosal severe fibrosis were successfully treated by endoscopic precise muscular dissection (EPMD) from May 2018 to August 2020.All the three lesions were en bloc resection and specimens were not damaged. The maximum diameter of specimens and fibrosis areas were 2.0-5.7 cm and 0.5-0.8 cm, respectively. The operation time was from 30 to 70 mins. Intraoperative perforation occurred in one case, post-operation fever cccured in one case, and no delayed perforation or bleeding occured. Two cases were cured resection and one case was non-cured resection without additional treatment. No recurrence or metastasis was observed during follow-up period.According to primary results, EPMD can be used for EGC with submucosal severe fibrosis, but the safety and effectiveness need clinical validation with more samples.
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Objective:To investigate the clinical value of magnifying endoscopy and high frequency endoscopic ultrasonography (HFUS) in the diagnosis and recurrence monitoring of gastric mucosa-associated lymphoid tissue lymphoma (GML).Methods:A total of 15 patients with newly diagnosed GML in the Jiangsu Province Hospital of Chinese Medicine from October 2016 to October 2019 were collected. The general data, clinical manifestations, Lugano staging, gastroscope performance, magnifying endoscopic performance, HFUS performance and helicobacter pylori infection were retrospectively analyzed. The efficacy and follow-up were also analyzed.Results:The most common symptom of 15 patients with GML was upper abdominal discomfort, followed by weight loss and anemia. The frequent site of GML was the middle 1/3 of the stomach (10 cases) and the most common type was diffuse (8 cases). The positive helicobacter pylori were detected in 9 cases. The positive tree-like appearance (TLA) was found in 13 cases under magnifying endoscopy; after the treatment, 2 cases had positive TLA. The unclear 1-3 layer structure of gastric wall in lesions was observed by using HFUS, accompanied with hypoechoic alteration. After the treatment, HFUS reexamination showed that the 1-5 layer structure of gastric wall disappeared in one patient, the pathological results confirmed that GML transformed into diffuse large B-cell lymphoma.Conclusion:Magnifying endoscopy combined with HFUS has an important application value in therapeutic efficacy evaluation and recurrence monitoring of GML; HFUS may has a certain clinical value in the progress assessment of GML.
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Objective To investigate the clinic effect of tunnel technique on endoscopic submucosal dissection(ESD)for massive colorectal laterally spreading tumor(LST). Methods A retrospective study was conducted on the data of patients with colorectal large area LST(the shortest diameter>4 cm) undergoing ESD by tunnel technique from January 2015 to June 2016 in Digestive Endoscopy Center of Jiangsu Province Hospital of Traditional Chinese Medicine. The size of resected specimens, operation time, complications, pathology results, the number of en bloc resection and curative resection were analyzed. Results A total of 14 cases were collected, including 7 males and 7 females. The longest diameters of resected specimens were from 4.0 to 7.0 cm with mean size of 5.18 ± 0.49 cm. The operation times were from 40 to 120 min with mean time of 63.57±12.95 min. Intraoperative perforation occurred in 2 cases but no delayed perforation and bleeding occurred. Postoperative pathology showed 1 patient with adenoma hyperplasia with crypt abscess,3 patients with low grade intraepithelial neoplasia,6 patients with high grade intraepithelial neophasia,1 patient with carcinoma in situ, 1 patient with carcinoma in M3, and 2 patients with carcinoma in SM1. The number of cases who received en bloc resection, complete resection, and curative resection were 13, 13, and 13, respectively. Conclusion ESD by tunnel technique is safe and effective in the treatment of colorectal large area LST,which is worth popularizing in clinics.
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Objective To evaluate the efficacy of biliary tract prosthesis and pancreatic duct stents for advanced periampullary carcinoma. Methods A total of 36 patients were diagnosed as advanced periampullary carcinoma pathologically or clinically, with strictures both in pancreatic and biliary ducts confirmed by imaging. Teflon stents were firstly implanted through endoscopy to the narrowed pancreatic ducts, expansible metal prosthesis were then implanted to the biliary tract. If failed, the metal stents were given through percutaneous transhepatic biliary drainage (PTCD) pathway. Serum levels of liver enzymes, amylase and clinical manifestations were observed before and after operation. Results Teflon stents were successfully implanted into pancreatic ducts in all patients. Metal prostheses into bile ducts were endoscopically implanted in 29 cases, and via PTCD in 7, including 2 cases of Billroth Ⅱ gastrectomy. The levels of liver enzymes significantly decreased (P<0.01) after stents implacement. The levels of amylase (plasma and urine) and lipase increased in 15 cases, but they were corrected to normal levels after adequate treatments. Rates of abdominal pain relieving and diahhrea improvement were 82.4% (28/34) and 88.2% (15/17), respectively. Conclusion The combined implacement of biliary tract prosthesis and pancreatic duct stents is safe and effective in relieving malignant obstruction in periampullary carcinoma.