논문 상세보기

대한소화기학회> Gut and Liver> Optimal Management of Gastric Outlet Obstruction in Unresectable Malignancies

KCI등재

Optimal Management of Gastric Outlet Obstruction in Unresectable Malignancies

Stephanie Lok Hang Cheung , Anthony Yuen Bun Teoh
  • : 대한소화기학회
  • : Gut and Liver 16권2호
  • : 연속간행물
  • : 2022년 03월
  • : 190-197(8pages)
Gut and Liver

DOI


목차

INTRODUCTION
SURGICAL GASTROJEJUNOSTOMY
DUODENAL STENT
ENDOSCOPIC ULTRASONOGRAPHYGUIDED GASTROENTEROSTOMY
OUTCOMES
CONCLUSION
CONFLICTS OF INTEREST
ORICD
REFERENCES

키워드 보기


초록 보기

The aim of this article is to review the different treatment options for malignant gastric outlet obstruction (GOO) and compare their safety and efficacy. We describe the history and evolution of gastrojejunostomy (GJ), endoscopic stenting and endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) and analyze the current evidence regarding these three methods available in the literature, comparing their applicability, safety, complications and cost when used for the treatment of malignant GOO. We conclude that given the benefits of endoscopic techniques and the ability to place a stent away from the tumor, EUS-GE is a promising technique that may yield an efficacy similar to that of surgical GJ and duodenal stenting, with lower reintervention rates and fewer adverse events. (Gut Liver 2022;16:190-197)

UCI(KEPA)

간행물정보

  • : 의약학분야  > 내과학
  • : KCI등재
  • :
  • : 격월
  • : 1976-2283
  • : 2005-1212
  • : 학술지
  • : 연속간행물
  • : 2007-2022
  • : 1466


저작권 안내

한국학술정보㈜의 모든 학술 자료는 각 학회 및 기관과 저작권 계약을 통해 제공하고 있습니다.

이에 본 자료를 상업적 이용, 무단 배포 등 불법적으로 이용할 시에는 저작권법 및 관계법령에 따른 책임을 질 수 있습니다.

16권3호(2022년 05월) 수록논문
최근 권호 논문
| | | |

KCI등재

1Ulcerative Colitis and Patient's Quality of Life, Especially in Early Stage

저자 : Jung Won Lee

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 317-318 (2 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재

2Waiting for Multi-Stakeholders' Consensus Position Statement on New Nonalcoholic Fatty Liver Disease Nomenclature

저자 : Eileen L. Yoon , Dae Won Jun

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 319-320 (2 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재

3Advancements in the Diagnosis of Gastric Subepithelial Tumors

저자 : Osamu Goto , Mitsuru Kaise , Katsuhiko Iwakiri

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 321-330 (10 pages)

다운로드

(기관인증 필요)

초록보기

A diagnosis of subepithelial tumors (SETs) is sometimes difficult due to the existence of overlying mucosa on the lesions, which hampers optical diagnosis by conventional endoscopy and tissue sampling with standard biopsy forceps. Imaging modalities, by using computed tomography and endoscopic ultrasonography (EUS) are mandatory to noninvasively collect the target's information and to opt candidates for further evaluation. Particularly, EUS is an indispensable diagnostic modality for assessing the lesions precisely and evaluating the possibility of malignancy. The diagnostic ability of EUS appears increased by the combined use of contrast-enhancement or elastography. Histology is the gold standard for obtaining the final diagnosis. Tissue sampling requires special techniques to break the mucosal barrier. Although EUS-guided fine-needle aspiration (EUS-FNA) is commonly applied, mucosal cutting biopsy and mucosal incision-assisted biopsy are comparable methods to definitively obtain tissues from the exposed surface of lesions and seem more useful than EUS-FNA for small SETs. Recent advancements in artificial intelligence (AI) have a potential to drastically change the diagnostic strategy for SETs. Development and establishment of noninvasive methods including AI-assisted diagnosis are expected to provide an alternative to invasive, histological diagnosis. (Gut Liver 2022;16:321-330)

KCI등재

4Postinfection Irritable Bowel Syndrome

저자 : Uday C Ghoshal

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 331-340 (10 pages)

다운로드

(기관인증 필요)

초록보기

Following acute gastroenteritis (AGE) due to bacteria, viruses, or protozoa, a subset of patients develop new onset Rome criteria positive irritable bowel syndrome (IBS), called postinfection IBS (PI-IBS). The pooled prevalence of PI-IBS following AGE was 11.5%. PI-IBS is the best natural model that suggests that a subset of patients with IBS may have an organic basis. Several factors are associated with a greater risk of development of PI-IBS following AGE including female sex, younger age, smoking, severity of AGE, abdominal pain, bleeding per rectum, treatment with antibiotics, anxiety, depression, somatization, neuroticism, recent adverse life events, hypochondriasis, extroversion, negative illness beliefs, history of stress, sleep disturbance, and family history of functional gastrointestinal disorders (FGIDs), currently called disorder of gut-brain interaction. Most patients with PI-IBS present with either diarrhea-predominant IBS or the mixed subtype of IBS, and overlap with other FGIDs, such as functional dyspepsia is common. The drugs used to treat non-constipation IBS may also be useful in PI-IBS treatment. Since randomized controlled trials on the efficacy of drugs to treat PI-IBS are rare, more studies are needed on this issue. (Gut Liver 2022;16:331-340)

KCI등재

52021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation

저자 : Hong Jun Park , Byung-wook Kim , Jun Kyu Lee , Yehyun Park , Jin Myung Park , Jun Yong Bae , Seung Young Seo , Jae Min Lee , Jee Hyun Lee , Hyung Ku Chon , Jun-won Chung , Hyun Ho Choi , Myung Ha Kim ,

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 341-356 (16 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Such cardiopulmonary complications are usually temporary, and most patients recover without sequelae. However, these events may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk. (Gut Liver 2022;16:341-356)

KCI등재

6Type 2 Autoimmune Pancreatitis: Consensus and Controversies

저자 : Yoh Zen

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 357-365 (9 pages)

다운로드

(기관인증 필요)

초록보기

Autoimmune pancreatitis (AIP) has attracted much attention in the last two decades, and due to the diagnostic value of immunoglobulin G4 (IgG4), the number of cases diagnosed in clinical practice has markedly increased. However, in contrast to prototypic IgG4-related type 1 AIP, a minor subtype of AIP, referred to as type 2 AIP, is less widely known and has thus not yet been characterized in detail. Type 2 AIP is unrelated to IgG4 and is a completely distinct entity from type 1 AIP. One confusing factor is that the two types of AIP share patterns of clinical presentation (e.g., acute pancreatitis and painless jaundice) and imaging abnormalities (e.g., diffuse or segmental enlargement). Since there are currently no established serum markers, the diagnosis of type 2 AIP is highly challenging and requires the tissue confirmation of neutrophilic injury to the pancreatic ducts, a finding designated as a granulocytic epithelial lesion. Approximately one-third of cases are associated with inflammatory bowel disease, particularly ulcerative colitis; however, the pathological relationship between these two conditions has not yet been clarified. Unanswered questions relate to its pathophysiology, the potential development of a similar granulocytic injury in other organs, and the characteristics of pediatric cases. This review summarizes consensus and controversies surrounding type 2 AIP, with the aim of increasing awareness and highlighting the unmet needs of this underrecognized condition. (Gut Liver 2022;16:357-365)

KCI등재

7The Incidence and Risk Factors for Metachronous Gastric Cancer in the Remnant Stomach after Gastric Cancer Surgery

저자 : Yonghoon Choi , Nayoung Kim , Hyuk Yoon , Cheol Min Shin , Young Soo Park , Dong Ho Lee , Young Suk Park , Sang-hoon Ahn , Yun-suhk Suh , Do Joong Park , Hyung Ho Kim

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 366-374 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Less invasive surgical treatment is performed in East Asia to preserve postoperative digestive function and reduce complications such as postgastrectomy syndromes, but there is an issue of metachronous gastric cancer (GC) in the remaining stomach. This study aimed to analyze the incidence of metachronous GC and its risk factors in patients who had undergone partial gastrectomy.
Methods: A total of 3,045 GC patients who had undergone curative gastric partial resection at Seoul National University Bundang Hospital were enrolled and analyzed retrospectively for risk factors, including age, sex, smoking, alcohol, Helicobacter pylori status, family history of GC, histological type, and surgical method.
Results: Metachronous GC in the remaining stomach occurred in 35 of the 3,045 patients (1.1%): 23 in the distal gastrectomy group (18 with Billroth-I anastomosis, five with Billroth-II anastomosis), seven in the proximal gastrectomy (PG) group, and five in the pylorus-preserving gastrectomy (PPG) group. Univariate and multivariate Cox regression analyses showed that age ≥60 years (p=0.005) and surgical method used (PG or PPG, p<0.001) were related risk factors for metachronous GC, while male sex and intestinal type histology were potential risk factors.
Conclusions: Metachronous GC was shown to be related to older age and the surgical method used (PG or PPG). Regular and careful follow-up with endoscopy should be performed in the case of gastric partial resection, especially in patients with male sex and intestinal type histology as well as those aged ≥60 years undergoing the PG or PPG surgical method. (Gut Liver 2022;16:366-374)

KCI등재

8Seronegative Celiac Disease in Patients with Isolated Refractory Dyspepsia and Gastroesophageal Reflux Disease

저자 : Salih Tokmak , Baris Boral , Yuksel Gumurdulu

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 375-383 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: To investigate the presence of seronegative celiac disease in patients with isolated refractory dyspepsia and gastroesophageal reflux disease (GERD)-related complaints.
Methods: This was a single-center, prospective study performed at a tertiary care referral hospital. Among 968 consecutive patients, 129 seronegative patients with tissue damage consistent with Marsh IIIa classification or above were included. The patients were divided into two groups: dyspepsia (n=78) and GERD (n=51). Biopsies were taken from the duodenum regardless of endoscopic appearance, and patients with Marsh IIIa or above damage were advised to consume a gluten-free diet. The Glasgow Dyspepsia Severity (GDS) score, Reflux Symptom Index (RSI), and Biagi score were calculated at baseline and every 3 months. Control endoscopy was performed every 6 months during follow-up.
Results: The median follow-up time was 19.9 months (range, 6 to 24 months) in the dyspepsia group and 19.2 months (range, 6 to 24 months) in the GERD group. All the patients were positive for the HLA-DQ2 and DQ8 haplotypes. The differences between the mean GDS scores (14.3±2.1 vs 1.1±0.2, respectively, p<0.05), RSI scores (6.3±0.8 vs 0.7±0.1, respectively, p<0.05), and Biagi scores (3.1±0.4 vs 0.7±0.3 in the dyspepsia group and 2.5±0.4 vs 0.5±0.2 in GERD group) before and after implementation of the gluten-free diet were statistically significant. The decreases in the scores were consistent with improvements in the histological findings. There was no significant correlation between endoscopic appearance and histological examination results (p=0.487).
Conclusions: Seronegative celiac disease may be considered in this group of patients. Even if a patient is seronegative and has normal endoscopic findings, duodenal biopsy should be considered. (Gut Liver 2022;16:375-383)

KCI등재

9Quality of Life in Newly Diagnosed Moderate-to-Severe Ulcerative Colitis: Changes in the MOSAIK Cohort Over 1 Year

저자 : Ik Hyun Jo , Kang-moon Lee , Dae Bum Kim , Ji Won Kim , Jun Lee , Yoon Tae Jeen , Tae-oh Kim , Joo Sung Kim , Jae Jun Park , Sung Noh Hong , Dong Il Park , Hyun-soo Kim , Yoo Jin Lee , Youngdoe Kim

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 384-395 (12 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Improving quality of life has been gaining importance in ulcerative colitis (UC) management. The aim of this study was to investigate changes in health-related quality of life (HRQL) and related factors in patients with moderate-to-severe UC.
Methods: A multicenter, hospital-based, prospective study was performed using a Moderateto- Severe Ulcerative Colitis Cohort in Korea (the MOSAIK). Changes in HRQL, evaluated using the 12-Item Short Form Health Survey (SF-12) and Inflammatory Bowel Disease Questionnaire (IBDQ), were analyzed at the time of diagnosis and 1 year later.
Results: In a sample of 276 patients, the mean age was 38.4 years, and the majority of patients were male (59.8%). HRQL tended to increase in both the IBDQ and SF-12 1 year after diagnosis. A higher partial Mayo score was significantly related to poorer HRQL on the IBDQ and SF-12 in a linear mixed model (p<0.01). Inflammatory markers such as C-reactive protein (CRP) or erythrocyte sedimentation rate also showed a negative correlation on HRQL (p<0.05). Patients whose IBDQ score improved by 16 or more (71.2%) in 1 year were younger, tended to be nonsmokers, and had a lower partial Mayo score and CRP than those whose IBDQ score did not. There was no significant association between HRQL and disease extent, treatments at diagnosis, or the highest treatment step during the 1-year period.
Conclusions: Optimally controlled disease status improves HRQL in patients with moderate-tosevere UC. The partial Mayo score and inflammatory markers may be potential indicators reflecting the influence of UC on patient`s daily lives. (Gut Liver 2022;16:384-395)

KCI등재

10Clinical Course of Hepatitis B Viral Infection in Patients Undergoing Anti-Tumor Necrosis Factor α Therapy for Inflammatory Bowel Disease

저자 : Ji Min Lee , Shu-chen Wei , Kang-moon Lee , Byong Duk Ye , Ren Mao , Hyun-soo Kim , Soo Jung Park , Sang Hyoung Park , Eun Hye Oh , Jong Pil Im , Byung Ik Jang , Dae Bum Kim , Ken Takeuchi

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 3호 발행 연도 : 2022 페이지 : pp. 396-403 (8 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Little is known about the clinical course of hepatitis B virus (HBV)-infected patients undergoing anti-tumor necrosis factor α (TNF-α) therapy for inflammatory bowel disease (IBD). We aimed to investigate the clinical course of HBV infection and IBD and to analyze liver dysfunction risks in patients undergoing anti-TNF-α therapy.
Methods: This retrospective multinational study involved multiple centers in Korea, China, Taiwan, and Japan. We enrolled IBD patients with chronic or resolved HBV infection, who received anti-TNF-α therapy. The patients' medical records were reviewed, and data were collected using a web-based case report form.
Results: Overall, 191 patients (77 ulcerative colitis and 114 Crohn's disease) were included, 28.3% of whom received prophylactic antivirals. During a median follow-up duration of 32.4 months, 7.3% of patients experienced liver dysfunction due to HBV reactivation. Among patients with chronic HBV infection, the proportion experiencing liver dysfunction was significantly higher in the non-prophylaxis group (26% vs 8%, p=0.02). Liver dysfunction occurred in one patient with resolved HBV infection. Antiviral prophylaxis was independently associated with an 84% reduction in liver dysfunction risk in patients with chronic HBV infection (odds ratio, 0.16; 95% confidence interval, 0.04 to 0.66; p=0.01). The clinical course of IBD was not associated with liver dysfunction or the administration of antiviral prophylaxis.
Conclusions: Liver dysfunction due to HBV reactivation can occur in HBV-infected IBD patients treated with anti-TNF-α agents. Careful monitoring is needed in these patients, and antivirals should be administered, especially to those with chronic HBV infection. (Gut Liver 2022;16:396- 403)

123
권호별 보기
같은 권호 다른 논문
| | | | 다운로드

KCI등재

1Management of Antithrombotics before Endoscopy-Balancing the Risks

저자 : Joon Sung Kim , Byung-wook Kim

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 141-142 (2 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재

2Diagnostic Performance of a Comprehensive Risk Model for Posthepatectomy Liver Failure

저자 : Yong Eun Chung

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 143-144 (2 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재

3Biliary Complications after Living Donor Liver Transplantation Differ from Those after Deceased Donor Liver Transplantation

저자 : Sung Ill Jang , Dong Ki Lee

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 145-146 (2 pages)

다운로드

(기관인증 필요)

키워드 보기
초록보기

KCI등재

4Chemopreventive Effect of Metformin on Gastric Cancer Development

저자 : Ka Shing Cheung , Kit Lam Chung , Wai K. Leung

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 147-156 (10 pages)

다운로드

(기관인증 필요)

초록보기

Although Helicobacter pylori infection is the most important causative factor for gastric cancer (GC), H. pylori eradication alone does not completely eliminate the GC risk. In addition to H. pylori eradication, other risk factors for GC should be identified and targeted. Diabetes mellitus (DM) confers a 20% increased risk of GC, which could be mediated via several biological mechanisms including the stimulation of cell proliferation via hyperinsulinemia and increased insulin-growth factor production, the promotion of angiogenesis, and DNA damage. With a current global prevalence of 9.3% and a predicted rise to 10.2% by 2030, DM could contribute substantially to the burden of GC cases worldwide. Emerging evidence showed that metformin possesses chemopreventive effects via both direct (e.g., adenosine monophosphate-activated protein kinase activation and subsequent inhibition of the mammalian target of rapamycin pathway) and indirect (e.g., modulation of the interaction between tumor cells and their microenvironment and gut microbiota) pathways. A recent meta-analysis of observational studies showed that metformin use was associated with 24% lower GC risk. However, many available observational studies related to metformin effects suffered from biases including the failure to adjust for the H. pylori infection status and serial glycemic control and time-related biases. Future prospective studies addressing these pitfalls are needed. (Gut Liver 2022;16:147-156)

KCI등재

5Long-term Disease Course of Crohn's Disease: Changes in Disease Location, Phenotype, Activities, and Predictive Factors

저자 : Choong Wui Cho , Myung-won You , Chi Hyuk Oh , Chang Kyun Lee , Sung Kyoung Moon

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 157-170 (14 pages)

다운로드

(기관인증 필요)

초록보기

Crohn's disease (CD) is a chronic destructive inflammatory bowel disease that affects young people and is associated with significant morbidity. The clinical spectrum and disease course of CD are heterogeneous and often difficult to predict based on the initial presentation. In this article, changes in the disease location, behavior, clinical course during long-term follow-up, and predictive factors are reviewed. Generally, four different patterns of clinical course are discussed: remission, stable disease, chronic relapsing disease, and chronic refractory disease. Understanding the long-term disease course of CD is mandatory to reveal the underlying pathophysiology of the disease and to move toward a more optimistic disease course, such as remission or stability, and less adverse outcomes or devastating sequelae. (Gut Liver 2022;16:157-170)

KCI등재

6Multidimensional Biomarker Analysis Including Mitochondrial Stress Indicators for Nonalcoholic Fatty Liver Disease

저자 : Eunha Chang , Jae Seung Chang , In Deok Kong , Soon Koo Baik , Moon Young Kim , Kyu-sang Park

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 171-189 (19 pages)

다운로드

(기관인증 필요)

초록보기

Nonalcoholic fatty liver disease (NAFLD) is accompanied by a complex and multifactorial pathogenesis with sequential progressions from inflammation to fibrosis and then to cancer. This heterogeneity interferes with the development of precise diagnostic and prognostic strategies for NAFLD. The current approach for the diagnosis of simple steatosis, steatohepatitis, and cirrhosis mainly consists of ultrasonography, magnetic resonance imaging, elastography, and various serological analyses. However, individual dry and wet biomarkers have limitations demanding an integrative approach for the assessment of disease progression. Here, we review diagnostic strategies for simple steatosis, steatohepatitis and hepatic fibrosis, followed by potential biomarkers associated with fat accumulation and mitochondrial stress. For mitochondrial stress indicators, we focused on fibroblast growth factor 21 (FGF21), growth differentiation factor 15 (GDF15), angiopoietin-related growth factor and mitochondrial-derived peptides. Each biomarker may not strongly indicate the severity of steatosis or steatohepatitis. Instead, multidimensional analysis of different groups of biomarkers based on pathogenic mechanisms may provide decisive diagnostic/ prognostic information to develop a therapeutic plan for patients with NAFLD. For this purpose, mitochondrial stress indicators, such as FGF21 or GDF15, could be an important component in the multiplexed and contextual interpretation of NAFLD. Further validation of the integrative evaluation of mitochondrial stress indicators combined with other biomarkers is needed in the diagnosis/prognosis of NAFLD. (Gut Liver 2022;16:171-189)

KCI등재

7Optimal Management of Gastric Outlet Obstruction in Unresectable Malignancies

저자 : Stephanie Lok Hang Cheung , Anthony Yuen Bun Teoh

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 190-197 (8 pages)

다운로드

(기관인증 필요)

초록보기

The aim of this article is to review the different treatment options for malignant gastric outlet obstruction (GOO) and compare their safety and efficacy. We describe the history and evolution of gastrojejunostomy (GJ), endoscopic stenting and endoscopic ultrasonography-guided gastroenterostomy (EUS-GE) and analyze the current evidence regarding these three methods available in the literature, comparing their applicability, safety, complications and cost when used for the treatment of malignant GOO. We conclude that given the benefits of endoscopic techniques and the ability to place a stent away from the tumor, EUS-GE is a promising technique that may yield an efficacy similar to that of surgical GJ and duodenal stenting, with lower reintervention rates and fewer adverse events. (Gut Liver 2022;16:190-197)

KCI등재

8Effect of Antithrombotic Therapy on Bleeding after Argon Plasma Coagulation for Gastric Neoplasms

저자 : Seol So , Jin Hee Noh , Ji Yong Ahn , Hee Kyong Na , Kee Wook Jung , Jeong Hoon Lee , Do Hoon Kim , Kee Don Choi , Ho June Song , Gin Hyug Lee , Hwoon-yong Jung

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 198-206 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Postprocedural bleeding is known to be relatively low after argon plasma coagulation (APC) for gastric neoplasms; however, there are few studies proving the effect of antithrombotic agents. This study aimed to analyze the incidence of delayed bleeding (DB) based on antithrombotic agents administered and to identify the risk factors for DB in APC for gastric tumors.
Methods: A total of 785 patients with 824 lesions underwent APC for single gastric neoplasm between January 2011 and January 2018. After exclusion, 719 and 102 lesions were classified as belonging to the non-antithrombotics (non-AT) and AT groups, respectively. The clinical outcomes were compared between the two groups, and we determined the risk factors for DB in gastric APC.
Results: Of the total 821 cases, DB occurred in 20 cases (2.4%): 17 cases in the non-AT group and three cases in the AT group (2.4% vs 2.9%, p=0.728). Multivariate analysis of the risk factors for DB confirmed the following significant, independent risk factors: male sex (odds ratio, 7.66; 95% confidence interval, 1.02 to 57.69; p=0.048) and chronic kidney disease (odds ratio, 4.51; 95% confidence interval, 1.57 to 13.02; p=0.005). Thromboembolic events and perforation were not observed in all patients regardless of whether they took AT agents.
Conclusions: AT therapy is acceptably safe in gastric APC because it does not significantly increase the incidence of DB. However, patients with chronic kidney disease or male sex need to receive careful follow-up on the incidence of post-APC bleeding. (Gut Liver 2022;16:198-206)

KCI등재

9Primary Gastrointestinal Follicular Lymphomas: A Prospective Study of 31 Patients with Long-term Follow-up Registered in the French Gastrointestinal Lymphoma Study Group (GELD) of the French Federation of Digestive Oncology (FFCD)

저자 : Tamara Matysiak-budnik , Philippe Jamet , Nicolas Chapelle , Bettina Fabiani , Paul Coppo , Agnès Ruskoné-fourmestraux

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 207-215 (9 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: Primary gastrointestinal follicular lymphomas (PGFL) are very rare. Our aim was to analyze the clinical features, management, and long-term outcomes in a prospective series of patients diagnosed with PGFL.
Methods: All adult patients with PGFL, consecutively enrolled into the multicenter French study between 1990 and 2017, were evaluated and followed up prospectively after undergoing a complete work-up. Clinical, pathological and endoscopic features, as well as treatment outcomes, were analyzed.
Results: Thirty-one patients (16 men, median age 62 years, range 33 to 79 years) with PGFL were included. The median follow-up was 92 months (range, 6 to 218 months). In the majority of patients (n=14), lymphoma was incidentally diagnosed during endoscopy. Otherwise, the most frequent circumstances of diagnosis were abdominal pain (n=7) and dyspepsia (n=5). The duodenum was the most common site of involvement (n=19) and multifocal localizations were seen in seven patients (22%). The most frequent first line strategy was surveillance applied in 22 patients (71%), of whom nine reached spontaneous, complete remission and 11 had stable disease. Seven patients (23%) received chemotherapy as first line treatment, and two underwent resection. Of seven patients who received chemotherapy, four achieved complete remission. In three patients, transformation into a high-grade lymphoma occurred.
Conclusions: The diagnosis of PGFL is frequently fortuitous. The most common localization is in the duodenum. The disease has an indolent course and a good prognosis, however, rare cases of transformation into aggressive high-grade lymphoma may occur. An appropriate characterization and follow-up of these lymphomas is mandatory for their optimal management. (Gut Liver 2022;16:207-215)

KCI등재

10Changes in the Long-term Prognosis of Crohn's Disease between 1986 and 2015: The Population-Based Songpa-Kangdong Inflammatory Bowel Disease Cohort Study

저자 : Byong Duk Ye , Sung Noh Hong , Seung In Seo , Ye-jee Kim , Jae Myung Cha , Kyoung Hoon Rhee , Hyuk Yoon , Young-ho Kim , Kyung Ho Kim , Sun Yong Park , Seung Kyu Jeong , Ji Hyun Lee , Hyunju Park , Joo

발행기관 : 대한소화기학회 간행물 : Gut and Liver 16권 2호 발행 연도 : 2022 페이지 : pp. 216-227 (12 pages)

다운로드

(기관인증 필요)

초록보기

Background/Aims: The long-term course of Crohn's disease (CD) has never been evaluated in non-Caucasian population-based cohorts. The aim of the present study was to evaluate the long-term prognosis of Korean CD patients in the well-defined population-based Songpa-Kangdong inflammatory bowel disease cohort.
Methods: Outcomes of disease and their predictors were evaluated for 418 patients diagnosed with CD between 1986 and 2015.
Results: During a median of 123 months, systemic corticosteroids, thiopurines, and anti-tumor necrosis factor (TNF) agents were administered to 58.6%, 81.3%, and 37.1% of patients, respectively. Over time, the cumulative probability of starting corticosteroids significantly decreased (p=0.001), whereas that of starting thiopurines and anti-TNFs significantly increased (both p<0.001). The cumulative probability of behavioral progression was 54.5% at 20 years, and it significantly decreased during the anti-TNF era. Intestinal resection was required for 113 patients (27.0%). The cumulative probabilities of intestinal resection at 1, 5, 10, 20, and 25 years after CD diagnosis were 12.7%, 16.5%, 23.8%, 45.1%, and 51.2%, respectively. Multivariable Cox regression analysis identified stricturing behavior at diagnosis (adjusted hazard ratio [aHR], 2.70; 95% confidence interval [CI], 1.55 to 4.71), penetrating behavior at diagnosis (aHR, 11.15; 95% CI, 6.91 to 17.97), and diagnosis of CD during the anti-TNF era (aHR, 0.51; 95% CI, 0.35 to 0.76) as independently associated with intestinal resection. The standardized mortality ratio among CD patients was 1.36 (95% CI, 0.59 to 2.68).
Conclusions: The long-term prognosis of Korean patients with CD is at least as good as that of Western CD patients, as indicated by the low intestinal resection rate. Moreover, behavioral progression and intestinal resection rates have decreased over the past 3 decades. (Gut Liver 2022;16:216-227)

12
발행기관 최신논문
자료제공: 네이버학술정보
발행기관 최신논문
자료제공: 네이버학술정보

내가 찾은 최근 검색어

최근 열람 자료

맞춤 논문

보관함

내 보관함
공유한 보관함

1:1문의

닫기