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( Tsuyoshi Hamada ),( Hideo Yasunaga ),( Yousuke Nakai ),( Hiroyuki Isayama ),( Hiromasa Horiguchi ),( Shinya Matsuda ),( Kiyohide Fushimi ),( Kazuhiko Koike ) The Editorial Office of Gut and Liver 2014 Gut and Liver Vol.8 No.2
Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful for the pathological diagnosis of pancreatic masses, but patients are susceptible to severe bleeding and perforation. Because the incidence and severity of these complications have not been fully evaluated. Methods: We aimed to evaluate severe bleeding and perforation after EUS-FNA for pancreatic masses using large-scale data derived from a Japanese nationwide admin-istrative database. Results: In total, 3,090 consecutive pa-tients from 212 low- to high-volume hospitals were analyzed. Severe bleeding requiring transfusion or endoscopic treat-ment occurred in seven patients (0.23%), and no perforation was observed. No patient mortality was recorded within 30 days of EUS-FNA. The rate of severe bleeding in low-volume hospitals was significantly higher than that in medium- and high-volume hospitals (0.48% vs 0.10%, p=0.045). Conclu-sions: Severe bleeding and perforation following EUS-FNA for pancreatic masses are rare, and the procedure is safe. (Gut Liver 2014;8:215-218)
Gastrointestinal Endoscopy-Assisted Minimally Invasive Surgery for Superficial Cancer of the Uvula
Hiroyuki Odagiri,Toshiro Iizuka,Daisuke Kikuchi,Mitsuru Kaise,Hidehiko Takeda,Kenichi Ohashi,Hideo Yasunaga 대한소화기내시경학회 2016 Clinical Endoscopy Vol.49 No.3
Previous studies reported that endoscopic resection is effective for the treatment of superficial pharyngeal cancers, as for digestive tract cancers. However, the optimal treatment for superficial cancer of the uvula has not been established because of the rarity of this condition. We present two male patients in their 70s with superficial cancer of the uvula, detected with upper gastrointestinal endoscopy. Both patients underwent surgical resection of the uvula under general anesthesia. The extent of the lesions was determined by means of gastrointestinal endoscopy by using magnifying observation with narrow-band imaging, enabling the performance of minimally invasive surgery. Endoscopic submucosal dissection was performed to achieve en bloc resection of the intramucosal carcinoma that had infiltrated the area adjacent to the uvula. Gastrointestinal endoscopists should carefully examine the laryngopharynx to avoid missing superficial cancers. Our minimally invasive treatment for superficial cancer of the uvula had favorable postoperative outcomes, and prevented postoperative loss of breathing, swallowing, and articulation functions.