No abstract available.
Dyspepsia* ; Humans

There have been an evolutionary development with respect to the resection modality for the treatment of the gastric neoplasms such as gastric subepithelial tumors (SETs) or early gastric cancers (EGCs). Hybrid natural orifice transluminal endoscopic surgery (hybrid NOTES) played a central role in the process of development. In the earlier period, the non-exposure type hybrid NOTES such as laparoscopy and endoscopy cooperative surgery (LECS), endoscope-assisted wedge resection (EAWR), and laparoscopy-assisted endoscopic full-thickness resection (LAEFTR) has been introduced by several investigators. However, a concern about a spillage of gastric content including the tumor cells has been continuously raised among the clinicians. Accordingly, the non-exposure type hybrid NOTES such as combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (CLEAN-NET), non-exposed endoscopic wall-inversion surgery (NEWS), and hybrid neo-endoscopic full-thickness resection (hybrid neo-EFTR) have been developed to the clinicians. Although most of studies about hybrid NOTES for the treatment of the gastric neoplasms have a small number of patients and require further validations, those are enough to receive our attention. Here, we describe and summarize the development process of the innovative resection methods for gastric neoplasms using hybrid NOTES approach.
Endoscopy ; Humans ; Laparoscopy ; Methods* ; Natural Orifice Endoscopic Surgery* ; Research Personnel ; Stomach Neoplasms*

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.

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.

Perforations or fistulas in the gastrointestinal tract constitute serious emergencies and are associated with high morbidity and mortality rates. Such lesions, occurring in the esophagus, stomach, and duodenum, may arise from noniatrogenic causes (e.g., peptic ulcers, corrosive insults, trauma, malignant tumors) and iatrogenic causes (e.g., endoscopic procedures and surgeries). A prompt diagnosis and an appropriate management strategy are crucial for early recovery before secondary complications occur that may be induced by infection and/or chemical damage from gastric acid or bile. Various endoscopy-based treatment modalities have been developed and play pivotal roles in the management of upper gastrointestinal perforations and fistulas. Through-the-scope clips, self-expanding metallic stents, over-the-scope clips, endoscopic suturing devices, and endoscopic vacuum therapy have significantly improved the success rates associated with treating these types of lesions. However, choosing the optimal modalities that lead to good patient prognoses depends on the lesion characteristics, such as its size, duration, location, and surrounding tissue condition. Thus, gastrointestinal endoscopists have to regularly master and incorporate new endoscopy-based treatment approaches for these complicated conditions.

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.

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.

PURPOSE: To evaluate the value of dacryoscintigraphy in the assessment of patients with a clinical diagnosis of functional nasolacrimal duct obstruction. MATERIALS AND METHODS: Dacryoscintigraphy was performed in symptomatic 35 lacrimal drainage systems in 18 patients (age range: 37~76, 8 males, 10 females) that were patent on syringing. RESULTS: Abnormalities were detected with dacryoscintigraphy in 75.8% of systems. The positive scintigrams were subdivided into those demonstrating prelacrimal sac delay (31.8%), delay at the lacrimal sac/junction (40.9%), or delay within the duct (27%). CONCLUSION: Dacryoscintigraphy is noninvasive useful technique in the assessment of the functional nasolacrimal duct obstruction and very sensitive at detecting abnormalities in patients with lid laxity caused by senile change and facial nerve palsy.
Diagnosis* ; Drainage ; Facial Nerve ; Humans ; Male ; Nasolacrimal Duct* ; Paralysis