Multiband Mucosectomy Versus Endoscopic Submucosal Dissection for Treatment of Squamous Intraepithelial Neoplasia of the Esophagus.

BACKGROUND & AIMS: We compared the efficacy and safety of multiband mucosectomy (MBM) vs endoscopic submucosal dissection (ESD) for the treatment of squamous intraepithelial neoplasia of the esophagus. METHODS: We performed a retrospective study of 78 patients with squamous intraepithelial neoplasia of the esophagus who received either ESD or MBM between January 2009 and January 2011 at the Tengzhou Central People's Hospital in China. We compared rates of bloc resection and curative resection, as well as complications and local recurrence, between groups. RESULTS: Overall, there was no statistical difference in the rate of complete resection between patients who received ESD (95.8%) vs MBM (93%) (P > .05). For tumors less than 15 mm in width, ESD produced a significantly higher rate of en bloc resection (100%) and curative resection (92.3%) than MBM (44.8% and 41%; P < .05). No significant differences were found between lesions less than 15 mm. MBM had a significantly shorter procedure time (38 ± 11 min) than ESD (84 ± 35 min) (P < .05). Major bleeding occurred in 1.85% of MBM procedures and in 16.7% of ESD procedures (P > .05). ESD led to perforations in 8.3% of cases, whereas MBM did not lead to any perforations (P < .05). No significant differences were found between groups in proportions of cases with postoperative esophageal strictures (16.7% vs 14.8%; P > .05) or the 3-year rate of local recurrence (P > .05). CONCLUSIONS: Based on a retrospective comparison of patients who underwent ESD vs MBM for squamous intraepithelial neoplasia of the esophagus, ESD should be reserved for patients with larger neoplastic lesions (>15 mm), with respect to the success of attempted en bloc resection and the number of curative resections achieved. However, ESD has longer procedure times and higher rates of complication. MBM allows for safe and easy piecemeal resections, and is associated with similar levels of clinical success as ESD for lesions less than 15 mm. Large, randomized, controlled studies are needed to determine which endoscopic resection modality is superior for patients with high-grade intraepithelia neoplasms.

Hydrogen-rich gas production by cogasification of coal and biomass in an intermittent fluidized bed.

This paper presents the experimental results of cogasification of coal and biomass in an intermittent fluidized bed reactor, aiming to investigate the influences of operation parameters such as gasification temperature (T), steam to biomass mass ratio (SBMR), and biomass to coal mass ratio (BCMR) on hydrogen-rich (H2-rich) gas production. The results show that H2-rich gas free of N2 dilution is produced and the H2 yield is in the range of 18.25~68.13 g/kg. The increases of T, SBMR, and BCMR are all favorable for promoting the H2 production. Higher temperature contributes to higher CO and H2 contents, as well as H2 yield. The BCMR has a weak influence on gas composition, but the yield and content of H2 increase with BCMR, reaching a peak at the BCMR of 4. The H2 content and yield in the product gas increase with SBMR, whilst the content of CO increases first and then decreases correspondingly. At a typical case, the relative linear sensitivity coefficients of H2 production efficiency to T, SBMR, and BCMR were calculated. The results reveal that the order of the influence of the operation parameters on H2 production efficiency is T > SBMR > BCMR.

Simultaneous endoscopic submucosal dissection for multiple early gastric cancers in a low volume center.

The aim of the study is to evaluate the safety and efficacy of simultaneous endoscopic submucosal dissection (ESD) for multiple early gastric cancers.A total of 70 solitary early gastric cancers from 70 patients and 20 multiple early gastric cancers from 10 patients were included in this retrospective study. The curative resection rate, en bloc resection rate, procedure-related complications, and local recurrence were compared between the 2 groups.There was no statistical difference in the rate of complete resection, en bloc resection, and curative resection between the 2 groups (P > .05). No significant difference was found with respect to the occurrence of postoperative bleeding (P > .05). Procedure time was significantly longer in the simultaneous group than that in the single group (87.6 ±â€Š25.1 min vs 54.6 ±â€Š22.0 min, P = .004). The overall incidence of synchronous early gastric cancer was 7.5%.Simultaneous ESD for multiple early gastric cancers is a safe and feasible choice in low-volume hospital. The entire stomach should be examined meticulously during and after ESD. Larger randomized studies are needed to validate our results.