No abstract available.

No abstract available.
Humans ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn

No abstract available.
Humans ; Infant, Newborn*

Endoscopic full-thickness resection (EFTR) is a natural orifice transluminal endoscopic surgery (NOTES) that was developed to overcome the limitations of laparoscopic resection and conventional endoscopic resection methods (endoscopic mucosal resection and endoscopic submucosal dissection). EFTR can be performed with endoscopy only or combined with a laparoscopic approach. During EFTR, the lesions can be exposed to peritoneum or not. Laparoscopic and endoscopic cooperative surgery (LECS) is a well-known procedure in which the lesion is exposed to peritoneum. Non-exposed endoscopic wall-inversion surgery (NEWS) and simple non-exposure EFTR were developed to escape the exposure of the lesions to peritoneum. Submucosal tunneling method may be a good candidate for treatment of subepithelial tumors at the esophagogasric junction and gastric cardia. This review will give an overview about current EFTR techniques to treat subepithelial tumors and adenocarcinoma of stomach.
Adenocarcinoma ; Cardia ; Endoscopy ; Natural Orifice Endoscopic Surgery ; Peritoneum ; Stomach ; United Nations

Since the first transgastric natural orifice transluminal endoscopic surgery was described, various applications and modified procedures have been investigated. Transgastric natural orifice transluminal endoscopic surgery for periotoneoscopy, cholecystectomy, and appendectomy all seem viable in humans, but additional studies are required to demonstrate their benefits and roles in clinical practice. The submucosal tunneling method enhances the safety of peritoneal access and gastric closure and minimizes the risk of intraperitoneal leakage of gastric air and juice. Submucosal tunneling involves submucosal tumor resection and peroral endoscopic myotomy. Peroral endoscopic myotomy is a safe and effective treatment option for achalasia, and the most promising natural orifice transluminal endoscopic surgery procedure. Endoscopic full-thickness resection is a rapidly developing natural orifice transluminal endoscopic surgery procedure for the upper gastrointestinal tract and can be performed with a hybrid natural orifice transluminal endoscopic surgery technique (combining a laparoscopic approach) to overcome some limitations of pure natural orifice transluminal endoscopic surgery. Studies to identify the most appropriate role of endoscopic full-thickness resection are anticipated. In this article, I review the procedures of natural orifice transluminal endoscopic surgery associated with the upper gastrointestinal tract.
Appendectomy ; Cholecystectomy ; Esophageal Achalasia ; Humans ; Natural Orifice Endoscopic Surgery* ; Upper Gastrointestinal Tract*

Helicobacter pylori has been considered as the possible etiology in many extragastric disease. Hematologic diseases such as immune thrombocytopenic purpura (ITP) and iron-deficiency anemia have been proposed to associate with H. pylori infection, although the hypothesis of an etiological role has not yet been fully investigated. Systematic reviews and meta-analysis have shown a significant increase of platelet counts in ITP patients in whom eradiation was successful compared with untreated, failed eradication or H. pylori-negative patients. H. pylori infection has emerged as a one of causes of refractory iron-deficiency anemia which is unresponsiveness to oral iron therapy. A link between H. pylori infection and iron- deficiency anemia was shown in recent meta-analyses and H. pylori eradication increased hemoglobin levels in these patients. The effect of H. pylori on iron stores may be greatest in those with marginal dietary iron intake or other stressors of iron stores. The guideline of Korean College of Helicobacter and Upper Gastrointestinal Research (2009) and other guidelines of western and Japan recommend that H. pylori should be sought and eradicated in the patients with ITP and unexplained iron-deficiency anemia.
Aluminum Hydroxide ; Anemia ; Anemia, Iron-Deficiency ; Carbonates ; Helicobacter ; Helicobacter pylori ; Hematologic Diseases ; Hemoglobins ; Humans ; Iron ; Iron, Dietary ; Japan ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic

Endoscopic forceps biopsy is essential before planning an endoscopic resection of upper gastrointestinal epithelial tumors. However, forceps biopsy is limited by its superficiality and frequency of sampling errors. Histologic discrepancies between endoscopic forceps biopsies and resected specimens are frequent. Factors associated with such histologic discrepancies are tumor size, macroscopic type, surface color, and the type of medical facility. Precise targeting of biopsies is recommended to achieve an accurate diagnosis, curative endoscopic resection, and a satisfactory oncologic outcome. Multiple deep forceps biopsies can induce mucosal ulceration in early gastric cancer. Endoscopic resection for early gastric cancer with ulcerative findings is associated with piecemeal resection, incomplete resection, and a risk for procedure-related complications such as bleeding and perforation. Such active ulcers caused by forceps biopsy and following submucosal fibrosis might also be mistaken as an indication for more aggressive procedures, such as gastrectomy with D2 lymph node dissection. Proton pump inhibitors might be prescribed to facilitate the healing of biopsy-induced ulcers if an active ulcer is predicted after deep biopsy. It is unknown which time interval from biopsy to endoscopic resection is appropriate for a safe procedure and a good oncologic outcome. Further investigations are needed to conclude the appropriate time interval.
Biopsy ; Fibrosis ; Gastrectomy ; Hemorrhage ; Lymph Node Excision ; Proton Pump Inhibitors ; Selection Bias ; Stomach Neoplasms ; Surgical Instruments ; Ulcer

Malignant gastric outlet obstruction (GOO) is a condition characterized by blockage or narrowing where the stomach empties its contents into the small intestine due to primary malignant tumors or metastatic diseases. This condition leads to various symptoms such as nausea, vomiting, abdominal pain, and weight loss. To manage malignant GOO, different treatment options have been employed, including surgical gastrojejunostomy (SGJ), gastroduodenal stenting (GDS) using self-expandable metallic stent (SEMS), and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ). This review focuses on comparing the clinical outcomes of endoscopic stenting (GDS and EUS-GJ) with SGJ for malignant GOO. Studies have shown that GDS with SEMS provides comparable clinical outcomes and safety for the palliation of obstructive symptoms. The choice between covered and uncovered SEMS remains controversial, as different studies have reported varying results. EUS-GJ, performed via endoscopic ultrasound guidance, has shown promising efficacy and safety in managing malignant GOO, but further studies are needed to establish it as the primary treatment option. Comparative analyses suggest that GDS has higher recurrence and reintervention rates compared to EUS-GJ and SGJ, with similar overall procedural complications. However, bleeding rates were lower with GDS than with SGJ. Randomized controlled trials are required to determine the optimal treatment approach for malignant GOO.

Most gastric subepithelial tumors (SETs) are asymptomatic and are often incidentally discovered during endoscopic procedures conducted for unrelated reasons. Although surveillance is sufficient for the majority of gastric SETs, certain cases necessitate proactive management. Laparoscopic wedge resection, although a viable treatment option, has its limitations, particularly in cases where SETs (especially those with intraluminal growth) are not visualized on the peritoneal side. Recent advances in endoscopic instruments and technology have paved the way for the feasibility of endoscopic resection of SETs. Several promising endoscopic techniques have emerged for gastric SET resection, including submucosal tunneling endoscopic resection, endoscopic full-thickness resection (EFTR), laparoscopic and endoscopic cooperative surgery (LECS), and non-exposure EFTR (nonexposed endoscopic wall-inversion surgery and non-exposure simple suturing EFTR). This study aimed to discuss the indications, methods, and outcomes of endoscopic therapy for gastric SETs. In addition, a simplified diagram of the category of SETs according to the therapeutic indications and an algorithm for the endoscopic management of SET is suggested.

Malignant gastric outlet obstruction (GOO) is a condition characterized by blockage or narrowing where the stomach empties its contents into the small intestine due to primary malignant tumors or metastatic diseases. This condition leads to various symptoms such as nausea, vomiting, abdominal pain, and weight loss. To manage malignant GOO, different treatment options have been employed, including surgical gastrojejunostomy (SGJ), gastroduodenal stenting (GDS) using self-expandable metallic stent (SEMS), and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ). This review focuses on comparing the clinical outcomes of endoscopic stenting (GDS and EUS-GJ) with SGJ for malignant GOO. Studies have shown that GDS with SEMS provides comparable clinical outcomes and safety for the palliation of obstructive symptoms. The choice between covered and uncovered SEMS remains controversial, as different studies have reported varying results. EUS-GJ, performed via endoscopic ultrasound guidance, has shown promising efficacy and safety in managing malignant GOO, but further studies are needed to establish it as the primary treatment option. Comparative analyses suggest that GDS has higher recurrence and reintervention rates compared to EUS-GJ and SGJ, with similar overall procedural complications. However, bleeding rates were lower with GDS than with SGJ. Randomized controlled trials are required to determine the optimal treatment approach for malignant GOO.