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RISS 인기검색어
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- 저자 : Iwaya, Akira (검색결과 5 건)
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Accuracy of Endoscopic Diagnosis for Mild Atrophic Gastritis Infected with Helicobacter pylori
Takuma Okamura,Yugo Iwaya,Kei Kitahara,Tomoaki Suga,Eiji Tanaka 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.4
Background/Aims: This study examined the accuracy of endoscopic evaluation for determining the Helicobacter pylori infection statusin patients with mild atrophy who might not exhibit characteristic endoscopic findings. Methods: Forty endoscopists determined the H. pylori infection status of 50 randomly presented H. pylori-positive and H. pylorinegativecases on the basis of a list of established findings. Results: The median clinical endoscopy experience was 7 years (range, 1–35 years), including 22 board-certified endoscopists (55%) of theJapan Gastroenterological Endoscopy Society. The mean accuracy rate of endoscopic diagnosis was 67% and was unrelated to experiencestatus (experienced vs. trainee: 69% vs. 65%, p=0.089) and total years of experience (R2=0.022). The most frequently selected endoscopicfindings were regular arrangement of collecting venules (59%), atrophy (45%), and red streak (22%), which had fair accuracy rates of67%, 65%, and 73%, respectively. By contrast, the accuracy rates of nodularity (89%) and mucosal swelling (77%) were highest. The 20endoscopists who more frequently identified these findings diagnosed H. pylori infection significantly more accurately than did the otherendoscopists (71% vs. 64%, p=0.008). Conclusions: Careful attention to nodularity and mucosal swelling in patients with mild atrophy may enhance diagnosis, enable prompttreatment, and avoid possible long-term carcinogenesis.
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Uehara, Hiroaki,Yamazaki, Toshiyuki,Iwaya, Akira,Kameyama, Hitoshi,Komatsu, Masaru,Hirai, Motoharu 대한대장항문학회 2022 Annals of Coloproctolgy Vol.38 No.3
Purpose: We evaluated the oncological outcomes of bridge to surgery (BTS) using stent compared with surgery alone for obstructive colorectal cancer. Methods: Consecutive patients who underwent curative resection for stages II to III obstructive colorectal cancer at our institution from January 2009 to March 2020, were registered retrospectively and divided into 43 patients in the BTS group and 65 patients in the surgery alone group. We compared the surgical and oncological outcomes between the 2 groups. Results: Stent-related perforation did not occur. One patient in whom the stent placement was unsuccessful underwent emergency surgery with poor decompression (clinical success rate, 97.7%). The pathological characteristics were not significantly different between the groups. The following surgical outcomes in the BTS group were superior to those in the surgery alone group; nonemergency surgery (P<0.001), surgical approach (P=0.006), and length of hospital stay (P=0.020). The median follow-up time was 44.9 months (range, 1.1–126.5 months). The 3-year relapse-free survival rates were 68.4% and 58.2% (P=0.411), and the overall survival rates were 78.3% and 88.2% (P=0.255) in the surgery alone and BTS groups, respectively. The 3-year locoregional recurrence rates were 10.2% and 8.0% (P=0.948), and distant metastatic recurrence rates were 13.3% and 30.4% (P=0.035) in the surgery alone and BTS groups, respectively. Conclusion: This study revealed that BTS with stent may be associated with a higher frequency of distant metastatic recurrence. Stent for stages II to III obstructive colorectal cancer potentially worsens oncological outcomes.
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Infectious peritonitis after endoscopic ultrasound-guided biliary drainage in a patient with ascites
Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Takamichi Kuwahara,Hiromichi Iwaya,Masahiro Tajika,Tsutomu Tanaka,Makoto Ishihara,Yutaka Hirayama,Sachiyo Onishi,Kazuhiro Toriyama,Ayako Ito,Naosuke Kuraoka,Shi 소화기인터벤션의학회 2018 International journal of gastrointestinal interven Vol.7 No.1
Summary of Event Bacterial, mycotic peritonitis and Candida fungemia developed in a patient with moderate ascites who had undergone endoscopic ultrasound-guided biliary drainage (EUS-BD). Antibiotics and antifungal agent were administered and ascites drainage was performed. Although the infection improved, the patient’s general condition gradually deteriorated due to aggravation of the primary cancer and he died. Teaching Point This is the first report to describe infectious peritonitis after EUS-BD. Ascites carries the potential risk of severe complications. As such, in patients with ascites, endoscopic retrograde cholangiopancreatography (ERCP) is typically preferred over EUS-BD or percutaneous drainage to prevent bile leakage. However, ERCP may not be possible in some patients with tumor invasion of the duodenum or with surgically altered anatomy. Thus, in patients with ascites who require EUS-BD, we recommend inserting the drainage tube percutaneously and draining the ascites before and after the intervention in order to prevent severe infection. Summary of Event Bacterial, mycotic peritonitis and Candida fungemia developed in a patient with moderate ascites who had undergone endoscopic ultrasound-guided biliary drainage (EUS-BD). Antibiotics and antifungal agent were administered and ascites drainage was performed. Although the infection improved, the patient’s general condition gradually deteriorated due to aggravation of the primary cancer and he died. Teaching Point This is the first report to describe infectious peritonitis after EUS-BD. Ascites carries the potential risk of severe complications. As such, in patients with ascites, endoscopic retrograde cholangiopancreatography (ERCP) is typically preferred over EUS-BD or percutaneous drainage to prevent bile leakage. However, ERCP may not be possible in some patients with tumor invasion of the duodenum or with surgically altered anatomy. Thus, in patients with ascites who require EUS-BD, we recommend inserting the drainage tube percutaneously and draining the ascites before and after the intervention in order to prevent severe infection.
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Infectious peritonitis after endoscopic ultrasound-guided biliary drainage in a patient with ascites
Nozomi Okuno,Kazuo Hara,Nobumasa Mizuno,Takamichi Kuwahara,Hiromichi Iwaya,Masahiro Tajika,Tsutomu Tanaka,Makoto Ishihara,Yutaka Hirayama,Sachiyo Onishi,Kazuhiro Toriyama,Ayako Ito,Naosuke Kuraoka,Shi 소화기인터벤션의학회 2018 Gastrointestinal Intervention Vol.7 No.1
Summary of Event Bacterial, mycotic peritonitis and Candida fungemia developed in a patient with moderate ascites who had undergone endoscopic ultrasound-guided biliary drainage (EUS-BD). Antibiotics and antifungal agent were administered and ascites drainage was performed. Although the infection improved, the patient’s general condition gradually deteriorated due to aggravation of the primary cancer and he died. Teaching Point This is the first report to describe infectious peritonitis after EUS-BD. Ascites carries the potential risk of severe complications. As such, in patients with ascites, endoscopic retrograde cholangiopancreatography (ERCP) is typically preferred over EUS-BD or percutaneous drainage to prevent bile leakage. However, ERCP may not be possible in some patients with tumor invasion of the duodenum or with surgically altered anatomy. Thus, in patients with ascites who require EUS-BD, we recommend inserting the drainage tube percutaneously and draining the ascites before and after the intervention in order to prevent severe infection.
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