|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Management of a large mucosal defect after duodenal endoscopic resection显示文摘Duodenal endoscopic resection is the most difficult type of endoscopic treatment in the gastrointestinal tract(GI) and is technically challenging because of anatomical specificities. In addition to these technical difficulties, this procedure is associated with a significantly higher rate of complication than endoscopic treatment in other parts of the GI tract. Postoperative delayed perforation and bleeding are hazardous complications, and emergency surgical intervention is sometimes required. Therefore, it is urgently necessary to establish a management protocol for preventing serious complications. For instance, the prophylactic closure of large mucosal defects after endoscopic resection may reduce the risk of hazardous complications. However, the size of mucosal defects after endoscopic submucosal dissection(ESD) is relatively large compared with the size after endoscopic mucosal resection, making it impossible to achieve complete closure using only conventional clips. The over-the-scope clip and polyglycolic acid sheets with fibrin gel make it possible to close large mucosal defects after duodenal ESD. In addition to the combination of laparoscopic surgery and endoscopic resection, endoscopic full-thickness resection holds therapeutic potential for difficult duodenal lesions and may overcome the disadvantages of endoscopic resection in the near future. This review aims to summarize the complications and closure techniques of large mucosal defects and to highlight some directions for management after duodenal endoscopic treatment. | Shintaro Fujihara Hirohito Mori Hideki Kobara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Tsutomu Masaki | 2016 | World Journal of Gastroenterology2016，22，29： | 10 |
| 2 | Reduction effect of bacterial counts by preoperative saline lavage of the stomach in performing laparoscopic and endoscopic cooperative surgery显示文摘AIM:To investigate the effects of gastric lavage with2000 mL of saline in laparoscopic and endoscopic cooperative surgery.METHODS:Twenty two patients who were diagnosed with a gastric gastrointestinal stromal tumor were enrolled.In former term,irrigations of the stomach were conducted whenever it was necessary,not systematically(Non systemic lavage group).In latter term,the stomach was thoroughly cleaned with 2000 mL of saline using an endoscope with a water jet,and Duodenal balloon occlusion was conducted to prevent refluxedbile and pancreatic juice(Systemic lavage+balloon occlusion group).The gastric wall was sprayed with 20mL of distilled water,and 20 mL of gastric juice was collected in a sterile tube and submitted for culture.20mL of ascites was also collected from the laparoscopic ports and submitted for culture.We compared WBC,CRP,BT between two groups,and verify the reduction effect of bacterial counts in Systemic lavage+balloon occlusion group.RESULTS:WBC count before,1 d after,and 3 d after laparoscopic and endoscopic cooperative surgery(LECS)were 5060(95%CI:4250-9640),12140(6050-14110),and 6910(5320-12520)in Non systemic lavage group,4400(3660-7620),8910(6480-10980),and 5950(4840-7860)in Systemic lavage+balloon occlusion group.Significant differences between two groups at the day after LECS(P=0.029)and the 3 d after LECS(P=0.042).CRP levels in Non systemic lavage group and in Systemic lavage+balloon occlusion group were significantly different at the day after LECS(P=0.005)and the 3 d after LECS(P=0.028).BTs(℃)in Non systemic lavage group and in Systemic lavage+balloon occlusion group were also significantly different at the day after LECS(P=0.004)and the 3 d after LECS(P=0.006).In a logarithmic comparison,bacterial load before gastric lavage,after lavage,and ascites culture were 6.08(95%CI:4.04-6.97),0.48(0-0.85),and 0.21(0-0.56).The bacterial counts before and after gastric lavage were significantly suppressed(P=0.007),but no significant difference between gastric juice culture after lavage and ascites(P=0.154).CONCLUSION:Pre-LECS lavage with 2000 mL of saline exhibited a bacteria-reducing effect equivalent to disinfectants and obtained favorable results in terms of clinical symptoms and data. | Hirohito Mori Hideki Kobara Takaaki Tsushimi Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Joji Tani Hisaaki Miyoshi Asahiro Morishita Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，42： | 9 |
| 3 | Two rare gastric hamartomatous inverted polyp cases suggest the pathogenesis of growth显示文摘Gastric hamartomatous inverted polyps(GHIP)are difficult to diagnose accurately because of inversion into the submucosal layer.GHIP are diagnosed using the pathological characteristics of the tumor,including the fibroblast cells,smooth muscle,nerve components,glandular hyperplasia,and cystic gland dilatation.Although Peutz-Jeghers syndrome,juvenile polyposis,and Cowden disease are hereditary,it is rare to encounter 2 cases of monostotic and asymptomatic gastric hamartomas.The pathogeneses of hamartomatous inverted polyps and inverted hyperplastic polyps remain controversial because of the paucity of reported cases.There are 3 hypotheses regarding the pathogenesis of complete gastric inverted polyps.Based on our experience with 2 successive,rare GHIP cases,we affirm the hypothesis that after a hamartomatous change occurs in the submucosal layer,some of these components are exposed to the gastric mucosa and,consequently,form a hypertrophic lesion.In Case 1,our hypothesis explains why a tiny hypertrophic change was first detected on the top of the submucosal tumor using a detailed narrow band imaging-magnified endoscopy.There was no confirmation that the milky white mucous and calcification structures were exuding directly from the biopsy site like Case 1,and in Case 2 the presence of this mucous was indirectly confirmed during an endoscopic submucosal dissection(ESD).Regarding the pathogenesis of GHIP,a submucosal hamartomatous change may occur prior to the growth of hypertrophic portions.An en bloc resection using ESD is recommended for treatment. | Hirohito Mori Hideki Kobara Takaaki Tsushimi Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，19： | 7 |
| 4 | Rectal perforations and fistulae secondary to a glycerin enema:Closure by over-the-scope-clip显示文摘Rectal perforations due to glycerin enemas(GE) typically occur when the patient is in a seated or lordotic standing position.Once the perforation occurs and peritonitis results,death is usually inevitable.We describe two cases of rectal perforation and fistula caused by a GE.An 88-year-old woman presented with a large rectal perforation and a fistula just after receiving a GE.Her case was further complicated by an abscess in the right rectal wall.The second patient was a 78-year-old woman who suffered from a rectovesical fistula after a GE.In both cases,we performed direct endoscopic abscess lavage with a saline solution and closed the fistula using an over-the-scope-clip(OTSC) procedure.These procedures resulted in dramatic improvement in both patients.Direct endoscopic lavage and OTSC closure are very useful for pararectal abscess lavage and fistula closure,respectively,in elderly patients who are in poor general condition.Our two cases are the first reports of the successful endoscopic closure of fistulae using double OTSCs after endoscopic lavage of the debris and an abscess of the rectum secondary to a GE. | Hirohito Mori Hideki Kobara Shintaro Fujihara Noriko Nishiyama Mitsuyoshi Kobayashi Tsutomu Masaki Kunihiko Izuishi Yasuyuki Suzuki | 2012 | World Journal of Gastroenterology2012，18，24： | 6 |
| 5 | Successful closing of duodenal ulcer after endoscopic submucosal dissection with over‐the‐scope clip to prevent delayed perforation显示文摘 | Hirohito Mori Fujihara Shintaro Hideki Kobara Noriko Nishiyama Kazi Rafiq Mitsuyoshi Kobayashi Toshiaki Nakatsu Noboru Miichi Yasuyuki Suzuki Tsutomu Masaki | 2013 | Digestive Endoscopy2013，，4： | 3 |
| 6 | Outcomes of gastrointestinal defect closure with an overthe-scope clip system in a multicenter experience: An analysis of a successful suction method显示文摘AIM To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method. METHODS This retrospective study at 5 medical centers involved 58 consecutive patients undergoing over-the-scope clips(OTSCs) placement. The overall rates of technical success (TSR), clinical success (CSR), complications, and procedure time were analyzed as major outcomes. Subsequently, 56 patients, excluding two cases that used the Anchor device, were divided into two groups: 14 cases of simple suction (SS-group) and 42 cases using the Twin Grasper (TG-group). Secondary evaluation was performed to clarify the predictors of OTSC success.RESULTS The TSR, CSR, complication rate, and median procedure time were 89.7%, 84.5%, 1.8%, and 8 (range 1-36) min, respectively, demonstrating good outcomes. However, significant differences were observed between the two groups in terms of the mean procedure time (5.9 min vs 14.1 min). The CSR of the SS- and TG-groups among cases with a maximum defect size ≤ 10 mm and immediate or acute refractory bleeding was 100%, which suggests that SS is a better method than TG in terms of time efficacy. The CSR in the SS-group (78.6%), despite the technical success of the SS method (TSR, 100%), tended to decrease due to delayed leakage compared to that in the TG-group (TSR, CSR; 88.1%), indicating that TG may be desirable for leaks and fistulae with defects of the entire layer. CONCLUSION OTSC system is a safe and effective therapeutic option for gastrointestinal defects. Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success. | Hideki Kobara Hirohito Mori Shintaro Fujihara Noriko Nishiyama Taiga Chiyo Takayoshi Yamada Masao Fujiwara Keiichi Okano Yasuyuki Suzuki Masayuki Murota Yoshitaka Ikeda Makoto Oryu Mohamed Abo Ellail Tsutomu Masaki | 2017 | World Journal of Gastroenterology2017，23，9： | 3 |
| 7 | Endoscopic management of a rare granulation polyp in a colonic diverticulum显示文摘There are many case reports on colon diverticula that cause irritable bowel syndrome,constipation,bleeding,diverticulitis,stricture due to multiple recurrences of diverticulitis,and perforation.However,few articles have examined neoplasms that arise from a diverticulum,such as adenoma and adenocarcinoma,and there have been no reports of granulation polyps that arise from a colon diverticulum after recurrent diverticulitis.We observed a rare granulation polyp that arose from a diverticulum as a result of repeated episodes of local diverticulitis.Narrow band imaging magnified colonoscopy was very useful to diagnose the polyp as a granulation polyp because of the absence of a pit pattern on the surface of the polyp.We successfully resected the polyp using endoscopic mucosal resection.We inverted the diverticulum,and the resected stalk of the polyp was used to close the diverticulum with an over-thescope clip.If a granulomatous polyp could arise from a diverticulum,differential diagnosis between a colon neoplasm and a granulomatous polyp would not only be difficult but also necessary for suitable endoscopic treatment. | Hirohito Mori Takaaki Tsushimi Hideki Kobara Noriko Nishiyama Shintaro Fujihara Tae Matsunaga Maki Ayagi Tatsuo Yachida Tsutomu Masaki | 2013 | World Journal of Gastroenterology2013，19，48： | 3 |
| 8 | Feasibility of pure EFTR using an innovative new endoscopic suturing device: the Double-arm-bar Suturing System (with video)显示文摘 | Hirohito Mori Hideki Kobara Shintaro Fujihara Noriko Nishiyama Kazi Rafiq Makoto Oryu Masao Fujiwara Yasuyuki Suzuki Tsutomu Masaki | 2014 | Surgical Endoscopy2014，，2： | 2 |
| 9 | Current Innovations in Endoscopic Therapy for the Management of Colorectal Cancer: From Endoscopic Submucosal Dissection to Endoscopic Full-Thickness Resection显示文摘 | Shintaro Fujihara Hirohito Mori Hideki Kobara Noriko Nishiyama Tae Matsunaga Maki Ayaki Tatsuo Yachida Asahiro Morishita Kunihiko Izuishi Tsutomu Masaki Hirotoshi Kobayashi | 2014 | BioMed Research International2014，，： | 2 |
| 10 | Balloon-Armed Mechanical Counter Traction and Double-Armed Bar Suturing Systems for Pure Endoscopic Full-Thickness Resection显示文摘 | Hirohito Mori Hideki Kobara Rafiq Kazi Shintaro Fujihara Noriko Nishiyama Tsutomu Masaki | 2014 | Gastroenterology2014，，2： | 2 |
| 11 | Novel and safer endoscopic cholecystectomy using only a flexible endoscope via single port显示文摘AIM: To apply the laparoscopic and endoscopic cooperative surgery concept, we investigated whether endoscopic cholecystectomy could be performed more safely and rapidly via only 1 port or not.METHODS: Two dogs(11 and 13-mo-old female Beagle) were used in this study. Only 1 blunt port was created, and a flexible endoscope with a tip attachment was inserted between the fundus of gallbladder and liver. After local injection of saline to the gallbladder bed, resection of the gallbladder bed from the liver was performed. After complete resection of the gallbladder bed, the gallbladder was pulled up to resect its neck using the Ring-shaped thread technique. The neck of the gallbladder was cut using scissor forceps. Resected gallbladder was retrieved using endoscopic net forceps via a port. RESULTS: The operation times from general anesthetizing with sevoflurane to finishing the closure of the blunt port site were about 50 min and 60 min respectively. The resection times of gallbladder bed were about 15 min and 13 min respectively without liver injury and bleeding at all. Feed were given just after next day of operation, and they had a good appetite. Two dogs are in good health now and no complications for 1 mo after endoscopic cholecystectomy using only a flexible endoscope via one port.CONCLUSION: We are sure of great feasibility of endoscopic cholecystectomy via single port for human. | Hirohito Mori Nobuya Kobayashi Hideki Kobara Noriko Nishiyama Shintaro Fujihara Taiga Chiyo Maki Ayaki Takashi Nagase Tsutomu Masaki | 2016 | World Journal of Gastroenterology2016，22，13： | 1 |
| 12 | Antitumor effect of metformin in esophageal cancer: In vitro study显示文摘 | Mitsuyoshi Kobayashi Kiyohito Kato Hisakazu Iwama Shintaro Fujihara Noriko Nishiyama Shima Mimura Yuka Toyota Takako Nomura Kei Nomura Joji Tani Hisaaki Miyoshi Hideki Kobara Hirohito Mori Koji Murao Tsutomu Masaki | 2013 | International Journal of Oncology2013，，2： | 1 |
| 13 | Giant gastric ulcer penetrating into the pancreas显示文摘 | Shintaro Fujihara Hirohito Mori Noriko Nishiyama Hideki Kobara Tsutomu Masaki | 2012 | Arab Journal of Gastroenterology2012，，3： | 1 |
| 14 | Influence of percutaneous local therapy for hepatocellular carcinoma on gastric function显示文摘AIM:To investigate the influence of percutaneous local therapy on gastric myoelectrical activity in patients with hepatocellular carcinomas.METHODS:Forty-four patients with hepatocellular carcinoma(HCC) [27 males and 17 females,ranging in age from 49 to 81 years old(69.7 ± 8.01 years)] who were admitted for percutaneous local therapy were enrolled in this study.We examined clinical abdominal symptoms using the Gastrointestinal Symptom Rating Scale(GSRS) before and 3 d after percutaneous local therapy.We also measured cutaneous fasting and postprandial electrogastrography(EGG) recordings before and 3 d after percutaneous local therapy.RESULTS:We found that the percentage of normogastria in the fasting period was lower in the Child B group than in the Child A group(66.8% ± 8.6% vs 84.0% ± 3.8%).After percutaneous local therapy for HCC,the percentages of normogastria in the fasting period were significantly decreased(81.6% ± 3.5% vs 75.2% ± 4.5%).None of the postprandial EGG parameters changed significantly after percutaneous local therapy for HCC.Percutaneous local therapy for HCC reduced the power ratio(PR).In particular,the PR of tachygastria was significantly decreased after therapy(P < 0.01).However,no significant differences were found in the postprandial EGG parameters.Likewise,no significant differences were found in the calculated GSRS scores obtained from the questionnaire before and after therapy.CONCLUSION:Gastric slow-wave dysrhythmias were induced by percutaneous local therapy in HCC patients,even though the GSRS scores obtained from the questionnaire did not change significantly. | Mitsuyoshi Kobayashi Fumihiko Kinekawa Kazuya Matsuda Shintaro Fujihara Noriko Nishiyama Takako Nomura Joji Tani Hisaaki Miyoshi Hideki Kobara Akihiro Deguchi Hirohito Yoneyama Hirohito Mori Tsutomu Masaki | 2013 | World Journal of Gastroenterology2013，19，10： | 1 |
| 15 | Evaluation of gastric submucosal tumors using endoscopically visualizedfeatures with submucosal endoscopy显示文摘 | Hideki Kobara Hirohito Mori Kazi Rafiq Tae Matsunaga Shintaro Fujihara Noriko Nishiyama Maki Ayaki Tatsuo Yachida Johji Tani Hisaaki Miyoshi Kiyohito Kato Hideki Kamada Hirohito Yoneyama Asahiro Morishita Kunihiko Tsutsui Hisakazu Iwama Reiji Haba Tsutomu | 2014 | Oncology Letters2014，，1： | 1 |
| 16 | The efficacy and safety of prophylactic closure for a large mucosaldefect after colorectal endoscopic submucosal dissection显示文摘 | Shintaro Fujihara Hirohito Mori Hideki Kobara Noriko Nishiyama Mitsuyoshi Kobayashi Kazi Rafiq Tsutomu Masaki | 2013 | Oncology Reports2013，，1： | 1 |
| 17 | Novel method to prevent gastric antral strictures after endoscopic submucosal dissection: Using triamcinolone显示文摘Endoscopic submucosal dissection(ESD) of large gastric lesions often leads to severe gastric strictures, especially in cases of large ESD in the antrum of the stomach. It has recently been reported that balloon dilation, mucosal incision, and local steroid injections can successfully treat gastric strictures. However, there are some complications with existing methods and decreasing the quality of life. We have developed a novel method to prevent severe gastric strictures that does not involve balloon dilation, mucosal incision, or steroid injections after circumferential ESD. Our original method involves the submucosal injection of a mixed solution composed of triamcinolone acetonide and a general solution of glycerol, hyaluronic acid, and a small amount of indigo carmine and epinephrine dur-ing the ESD procedure; this mixture is called a mixed solution of triamcinolone(MST). According to standard ESD procedures, several milliliters of MST are injected into the submucosal layer for the purpose of elevating the submucosa during ESD resulting in prevention of severe strictures. Our method using MST take several advantages such as MST method suppress inflammation in ulcer from initial phase, prevention of stricture without obstructive symptoms, and does not require several ballooning. Therefore, MST method is safe and gentle, shorten the hospitalization duration. Here, we described two cases in which we prevented severe strictures of the gastric antrum after completing a circumferential ESD using MST without any complications. | Noriko Nishiyama Hirohito Mori Hideki Kobara Kazi Rafiq Shintaro Fujihara Tae Matsunaga Maki Ayaki Tatsuo Yachida Makoto Oryu Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，33： | 1 |
| 18 | Suitable closure for post-duodenal endoscopic resection taking medical costs into consideration显示文摘AIM:To compare closure methods,closure times and medical costs between two groups of patients who had post-endoscopic resection(ER) artificial ulcer floor closures.METHODS:Nineteen patients with duodenal adenoma,early duodenal cancer,and subepithelial tumors that received ER between September 2009 and September 2014 at Kagawa University Hospital and Ehime Rosai Hospital,an affiliated hospital of Kagawa University,were included in the study.We retrospectively compared two groups of patients who received postER artificial ulcer floor closure:the conventional clip group vs the over-the-scope clip(OTSC) group.Delayed bleeding,procedure time of closure,delayed perforation,total number of conventional clips and OTSCs and medical costs were analyzed.RESULTS:Although we observed delayed bleeding in three patients in the conventional clip group,we observed no delayed bleeding in the OTSC group(P = 0.049).We did not observe perforation in either group.The mean procedure times for ulcer closure were 33.26 ± 12.57 min and 9.71 ± 2.92 min,respectively(P = 0.0001).The resection diameters were 18.8 ± 1.30 mm and 22.9 ± 1.21 mm for the conventional clip group and the OTSC group,respectively,with significant difference(P = 0.039).As for medical costs,the costs of all conventional clips were USD $1257 and the costs of OTSCs were $7850(P = 0.005).If the post-ER ulcer is under 20 mm in diameter,a conventional clip closure may be more suitable with regard to the prevention of delayed perforation and to medical costs.CONCLUSION:If the post-ER ulcer is over 20 mm,the OTSC closure should be selected with regard to safety and reliable closure even if there are high medical costs. | Hirohito Mori Maki Ayaki Hideki Kobara Shintaro Fujihara Noriko Nishiyama Tae Matsunaga Tatsuo Yachida Tsutomu Masaki | 2015 | World Journal of Gastroenterology2015，21，17： | 1 |
| 19 | Accurate hemostasis with a new endoscopic overtube for emergency endoscopy显示文摘Endoscopic hemostasis performed in the emergency room is difficult due to the presence of blood clots and food residue that makes obtaining a clear view of the bleeding vessel difficult. We experienced the efficacy of a newly developed inverted overtube to shorten the hemostatic time and obtain a clear endoscopic view with upper gastrointestinal bleeding patient who were transferred by ambulance car and required emergency endoscopy. The technique improved the endoscopic views and enabled us to perform the hemostatic procedures from the conventional standing position while freely and easily changing the patient's position. The presence of blood clots and food residue in the gastric fornix or upper gastric body makes identifying a bleeding exposed vessel impossible. This set-up significantly shortened the procedure time. The inverted overtube helped us obtain a clear view in patients who were laid in the right lateral position. Rapid identification of ex-posed vessels resulted in success of hemostasis. | Hirohito Mori Hideki Kobara Shintaro Fujihara Noriko Nishiyama Makoto Oryu Kazi Rafiq Tsutomu Masaki | 2013 | World Journal of Gastroenterology2013，19，17： | 1 |
| 20 | The anti-diabetic drug metformin inhibits pancreatic cancer cell proliferationin vitro and in vivo: Study of the microRNAs associated with the antitumor effectof metformin显示文摘 | Kiyohito Kato Hisakazu Iwama Takuma Yamashita Kiyoyuki Kobayashi Shintaro Fujihara Takayuki Fujimori Hideki Kamada Hideki Kobara Tsutomu Masaki | 2016 | Oncology Reports2016，，3： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员