Gastroenterology Research and Practice最新文献

{"title":"Serum Lactate Dehydrogenase Is a Sensitive Predictor of Systemic Complications of Acute Pancreatitis.","authors":"Dong-Ni Huang,&nbsp;Hao-Jie Zhong,&nbsp;Ying-Li Cai,&nbsp;Wen-Rui Xie,&nbsp;Xing-Xiang He","doi":"10.1155/2022/1131235","DOIUrl":"https://doi.org/10.1155/2022/1131235","url":null,"abstract":"<p><strong>Background: </strong>Acute pancreatitis (AP) is a common and potentially life-threatening inflammatory disease that can cause various complications, including systemic inflammatory response syndrome (SIRS), pleural effusion, ascitic fluid, myocardial infarction, and acute kidney injury (AKI). However, there is still a lack of rapid and effective indicators to assess the disease. The aim of this study was to investigate the associations of high serum lactate dehydrogenase (LDH) levels with AP severity and systemic complications.</p><p><strong>Methods: </strong>AP patients treated from July 2014 to December 2020 were retrospectively enrolled. They were divided into elevated (<i>n</i> = 93) and normal (<i>n</i> = 143) LDH groups. Their demographic data, clinical data, hospital duration, and hospital expenses were analyzed. Linear and binary logistic regression analyses were used to determine whether elevated LDH is a risk factor for AP severity and complications after adjusting for confounders.</p><p><strong>Results: </strong>There were significant differences in AP severity scores (Ranson, MODS, BISAP, APACHE II, and CTSI), hospital duration, hospital expenses, and the incidences of complications (SIRS, pleural effusion, ascitic fluid, myocardial infarction, and AKI) between the elevated and normal LDH groups. After adjusting for confounders, elevated LDH was associated with AP severity scores and hospital duration and expenses (based on linear regression analyses) and was a risk factor for the occurrence of AP complications and interventions, that is, diuretic and vasoactive agent use (based on binary logistic regression analyses).</p><p><strong>Conclusions: </strong>Elevated LDH is associated with high AP severity scores and high incidences of complications (SIRS, pleural effusion, ascitic fluid, myocardial infarction, and AKI).</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"1131235"},"PeriodicalIF":2.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40446187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ZNF521 Is Correlated with Tumor Immune Cell Infiltration and Act as a Valuable Prognostic Biomarker in Gastric Cancer.","authors":"Li Li,&nbsp;Zheng-Hui Liu,&nbsp;Hui-Ju Wang,&nbsp;Lei Wang,&nbsp;Guo-Qing Ru,&nbsp;Yuan-Yu Wang","doi":"10.1155/2022/5288075","DOIUrl":"https://doi.org/10.1155/2022/5288075","url":null,"abstract":"<p><strong>Aim: </strong>To explore the correlations between the expression of zinc finger protein 521 (ZNF521) with immune invasion and prognosis of gastric cancer.</p><p><strong>Methods: </strong>Expression of ZNF521 was examined by immunohistochemistry in gastric cancer cases. Kaplan-Meier plotter was used to determine the relationships between ZNF521 and prognosis. TIMER and GEPIA were used to analyze the correlation between ZNF521 expression and gene markers of immune cell infiltration.</p><p><strong>Results: </strong>The expression of ZNF521 was up-regulated in gastric cancer samples. Kaplan-Meier analysis indicated that higher expression of ZNF521 was associated with poor prognosis. The expression of ZNF521 was correlated with infiltrating levels of CD4+ T and CD8+ T cells, macrophages, neutrophils, and dendritic cells in gastric cancer, which also correlated with diverse immune marker sets.</p><p><strong>Conclusions: </strong>ZNF521 is correlated significantly with immune cell infiltration and is a valuable biomarker for prognosis in gastric cancer.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"5288075"},"PeriodicalIF":2.0,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9606838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40443348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Novel Magnetically Controlled Cable Capsule Endoscopy System In Vitro Experiments for Gastric Examination.","authors":"Yaoping Zhang,&nbsp;Lina Qu,&nbsp;Yani Gou,&nbsp;Jinyong Hao,&nbsp;Xiaojun Huang","doi":"10.1155/2022/4313647","DOIUrl":"https://doi.org/10.1155/2022/4313647","url":null,"abstract":"<p><strong>Background: </strong>Magnetically controlled capsule endoscopy has been shown to be feasible for the examination of gastric diseases. However, there may be problems, such as low image quality, incomplete esophageal observation, and capsule retention. We developed a novel magnetically controlled cable capsule endoscopy (MCCCE) system and evaluated its feasibility through in vitro experiments.</p><p><strong>Methods: </strong>Three experienced endoscopists performed MCCCE on the plastic stomach model and the excised porcine stomach model 5 times, respectively. Outcomes included handle ability, examination time, examination completion, and image quality. The examination completion was accessed by other two blinded endoscopists, and the image quality was compared with conventional gastroscopy (Olympus, GIF-290).</p><p><strong>Results: </strong>The performance of MCCCE in vitro experiments is excellent, with a mean operation time of 18.5 minutes in the plastic stomach model and 17.3 minutes in the excised porcine stomach model. The visualization rate of the gastric mucosa is >90% in the plastic stomach model and 75-90% in the excised porcine stomach model. The images of MCCCE are very clear, with good color resolution and no image distortion, which seem to be comparable to conventional gastroscopy.</p><p><strong>Conclusions: </strong>MCCCE system is feasible for gastric examination in vitro experiments, living animal experiments and human trials need to be further conducted.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"4313647"},"PeriodicalIF":2.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9596269/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Jaundice on Presentation Is Associated with Higher In-Patient Mortality and Complications in Patients Admitted for Acute Pancreatitis: A Retrospective Study Based on National Inpatient Sample Database.","authors":"Nishit Patel,&nbsp;Krishna Bodrya,&nbsp;Kirten Patel,&nbsp;Nishi Patel,&nbsp;Dhruvanshu Patel,&nbsp;Ronak Modi,&nbsp;Ayaz Matin","doi":"10.1155/2022/5048061","DOIUrl":"https://doi.org/10.1155/2022/5048061","url":null,"abstract":"<p><p>Pancreatitis usually presents with characteristic abdominal pain, radiological findings, and elevated lipase. The presence of jaundice may hint at a biliary etiology; however, it is not always present. We hypothesized that the presence of jaundice is associated with worse outcomes in patients admitted with pancreatitis. We conducted a retrospective analysis using the National Inpatient Sample, inquiring about patients admitted with pancreatitis with and without jaundice between October 2015 and December 2017. The primary outcome was in-hospital mortality in patients admitted for pancreatitis with and without jaundice. Secondary outcomes were the median length of stay, hospitalization cost, the incidence of ventilator-dependent respiratory failure (VDRF), acute respiratory distress syndrome (ARDS), sepsis, septic shock, dehydration and electrolyte disturbances, and ascites. A total of 1,267,744 patients were admitted with pancreatitis from October 2015 to December 2017. Among them, 8855 (0.7%) had concomitant jaundice on presentation. In-hospital mortality in this group was 4.3%. The patients with pancreatitis and jaundice had higher odds of in-hospital mortality (adjusted odds ratio [aOR]: 1.51, 99% CI 1.35-1.68, <i>p</i> < 0.0001) as compared to those without jaundice. Patients with jaundice showed a significantly higher incidence of sepsis (15.2% vs. 9.6%, <i>p</i> < 0.0001), septic shock (4.1% vs. 2.9%, <i>p</i> < 0.0001), ascites (6.5% vs. 3.1%, <i>p</i> < 0.0001), and dehydration and electrolyte disorders (47.6% vs. 43.8%, <i>p</i> < 0.0001). Patients with jaundice also had higher total hospital costs ($11,412 vs. $7893, <i>p</i> < 0.0001). There was no statistical difference in ARDS, VDRF, and median length of stay. In conclusion, patients admitted for pancreatitis with jaundice had worse outcomes, including in-hospital mortality and complications, compared to those without jaundice.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"5048061"},"PeriodicalIF":2.0,"publicationDate":"2022-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9596271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40651871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Serum Squamous Cell Carcinoma Antigen Level Associated with Remission of Mild/Moderate Dysplasia of the Esophagus: A Nested Case-Control Study.","authors":"Hui Su,&nbsp;Kuiliang Liu,&nbsp;Yanjie Zhao,&nbsp;Feng Shi,&nbsp;Yuchen Li,&nbsp;Jiangping Wu,&nbsp;Qingkun Song","doi":"10.1155/2022/2961337","DOIUrl":"https://doi.org/10.1155/2022/2961337","url":null,"abstract":"<p><strong>Background: </strong>The esophageal epithelial dysplasia is the precancerous lesion. This study aimed to investigate the association between the serum squamous cell carcinoma antigen (SCCA) and the remission of esophageal squamous mild or moderate dysplasia.</p><p><strong>Methods: </strong>We performed a nested case-control study. Patients with mild/moderate dysplasia of the esophageal squamous epithelium were enrolled in this study during the years of 2013-2015 and received a follow-up endoscopy during 2017-2018. With the comparison between baseline and follow-up diagnosis, the patients were divided into regression/stable and progression groups. A predictive model for the outcome of dysplasia was comprised of the variables of SCCA, age, sex, education level, and baseline dysplasia grade. A receiver operating characteristic (ROC) curve was used to estimate the diagnostic efficacy of the regression status of dysplasia under the predictive model.</p><p><strong>Results: </strong>There were 146 patients enrolled in this study. 100 patients experienced a regression or stable status of dysplasia and 46 patients had a progressed status. Increased age, low education level, and moderate dysplasia were the risk factors of progression. With an 0.1 <i>μ</i>g/L increase, SCCA was associated with a 0.90-fold risk (95% CI 0.81, 0.99) of progression. In the predictive model, the area under ROC curve was 0.78. The cut-off values of predictive probability of combined factors for progression, were 0.40 and 0.32 for males and females, respectively.</p><p><strong>Conclusions: </strong>Increased serum SCCA concentration was associated with regressed severity of mild and moderate dysplasia of the esophageal mucosa. Further studies were warranted and SCCA concentration was a potential biomarker for the dysplasia prognosis.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"2961337"},"PeriodicalIF":2.0,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40581408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Normalized Ratio-to-Albumin Ratio as a Novel Marker of Upper Gastrointestinal Bleeding Severity.","authors":"Jeongwoo Choi,&nbsp;Je Seop Lee,&nbsp;Solmoon Lee,&nbsp;Yong Won Kim,&nbsp;Yoonsuk Lee,&nbsp;Tae Youn Kim","doi":"10.1155/2022/1172540","DOIUrl":"https://doi.org/10.1155/2022/1172540","url":null,"abstract":"<p><strong>Introduction: </strong>Upper gastrointestinal bleeding (UGIB) is a potentially life-threatening gastrointestinal emergency, and effective management depends on early risk stratification. The Glasgow-Blatchford and Rockall scores are commonly used prognostic measures for UGIB, although these scoring systems are relatively difficult to apply in early emergency settings. AIMS65 with five items, albumin, international normalized ratio, mental status, systolic blood pressure, and age (>65 years), showed efficacy in predicting long-term hospitalization and mortality. This study aimed to investigate the usefulness of the prothrombin time-international normalized ratio-to-albumin ratio (PTAR) in the emergency room for early UGIB risk stratification.</p><p><strong>Methods: </strong>We retrospectively examined patients who visited a tertiary academic hospital's emergency department (ED) with UGIB as the chief presentation between January 2019 and December 2020. The cutoff values and diagnostic accuracies of the PTAR, Glasgow-Blatchford score, AIMS65 score, pre-endoscopy, and complete Rockall score were analyzed, and the performance of the PTAR was compared with that of other risk stratification methods. In total, 519 patients were enrolled: 163 patients were admitted in the intensive care unit (ICU) and 35 died during admission. Multiple logistic regression analyses confirmed the association of the PTAR with ICU admission and mortality. The adjusted odd ratio (aOR) of the PTAR for ICU admission care was 8.376 (2.722-25.774), and the aOR of the PTAR for mortality was 27.846 (8.701-89.116).</p><p><strong>Conclusions: </strong>The PTAR measured in the ED is an independent factor related to ICU admission and mortality in patients with UGIB. Using ED blood laboratory results, which are reported relatively quickly and are easy to acquire and calculate, the PTAR can be used as a risk stratification marker in the early emergency setting.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"1172540"},"PeriodicalIF":2.0,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40581410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of ASCITIC Paracentesis on Symptomatic Outcomes in Palliative Patients: 3-Year Experience of a Melbourne Inpatient Palliative Care Unit Using Palliative Care Outcomes Collaboration Assessments.","authors":"Kiran Iyer,&nbsp;Lucy Kernick","doi":"10.1155/2022/7300110","DOIUrl":"https://doi.org/10.1155/2022/7300110","url":null,"abstract":"<p><strong>Background: </strong>Ascites formation is a common occurrence in patients receiving palliative care. This is associated with symptoms that may respond to drainage.</p><p><strong>Aim: </strong>To review and quantify ascites-related symptoms pre- and post-paracentesis to evaluate its benefit in an inpatient palliative care setting.</p><p><strong>Methods: </strong>A retrospective audit of patients admitted to an inpatient palliative care unit who underwent paracentesis between November 2016 to June 2020 was performed. The primary outcome was a symptomatic benefit of paracentesis. Secondary outcomes assessed the associated complications as well as the alterations to functional status. Data were analysed using a paired <i>T</i>-test.</p><p><strong>Results: </strong>43 instances of ascitic paracentesis were performed on a total of 26 patients. Three patients were excluded from the study due to the technical failure of their paracentesis procedure. There was a mean 0.16-point reduction in pain (95% confidence interval (CI) -0.33 to 0.65), a mean 0.03-point increase in dyspnoea (95% CI -0.51 to 0.46), and a mean 0.32-point reduction in nausea (95% CI -0.09 to 0.74).</p><p><strong>Conclusions: </strong>Ascitic paracentesis in the palliative setting may demonstrate some benefit in managing symptoms associated with ascites. Although the findings of this study did not achieve statistical significance, these results may be substantiated by future studies with larger sample size.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"7300110"},"PeriodicalIF":2.0,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40581409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Antibiotic Treatment Followed by Prolonged Repeated Faecal Microbiota Transplantation Improves Symptoms and Quality of Life in Patients with Irritable Bowel Syndrome: An Observational Australian Clinical Experience.","authors":"Harrison Hamblin,&nbsp;Anoja W Gunaratne,&nbsp;Annabel Clancy,&nbsp;Denise Pilarinos,&nbsp;Antoinette LeBusque,&nbsp;Marie Vic M Dawson,&nbsp;Thomas J Borody","doi":"10.1155/2022/6083896","DOIUrl":"https://doi.org/10.1155/2022/6083896","url":null,"abstract":"<p><strong>Background: </strong>The use of faecal microbiota transplantation (FMT) in irritable bowel syndrome (IBS) has frequently failed to induce long-term symptomatic improvement. The use of multiple FMT infusions is one proposed mechanism through which the efficacy of FMT can be amplified.</p><p><strong>Aims: </strong>To evaluate the safety and efficacy of a novel six-month FMT treatment protocol in IBS.</p><p><strong>Methods: </strong>Patients diagnosed with IBS confirmed by Rome IV Criteria were recruited for single-centre, single-arm, prospective clinical observational study. Participants received one colonoscopically delivered FMT followed by 36 rectal enemas across a six-month period. Validated abdominal symptoms and Short-Form (SF-36) Quality of Life (QOL) questionnaires were collected at baseline, week-12, week-24, and week-56, respectively. Wilcoxon matched-pairs signed-rank tests were conducted to compare differences in abdominal symptom and SF-36 QOL scores over the follow-up timepoints. Statistical significance was set at 5%.</p><p><strong>Results: </strong>Sixty participants diagnosed with IBS [IBS-constipation (<i>n</i> = 27), IBS-diarrhoea (<i>n</i> = 18), and IBS-mixed (<i>n</i> = 15)] received the six-month FMT treatment. IBS symptom severity reduction was achieved in up to 61% of respondents at week-12, 64% of respondents at week-24, and maintained in up to 75% of respondents at week-52. Long-term reduction in symptom severity was associated with an increase in QOL, achieved in up to 64% of respondents at week-52 when compared to baseline. Adverse events were experienced in 28% of participants, though they were both transient and mild in nature.</p><p><strong>Conclusions: </strong>Six-month sustained FMT appears to be both safe and effective in the short- and long-term alleviation of IBS associated symptoms as well as improving participant QOL.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"6083896"},"PeriodicalIF":2.0,"publicationDate":"2022-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9584708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40581407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alterations of Serum Bile Acid Profile in Patients with Crohn's Disease.","authors":"Rui Sun,&nbsp;Jingjing Jiang,&nbsp;Ling Yang,&nbsp;Lu Chen,&nbsp;Hong Chen","doi":"10.1155/2022/1680008","DOIUrl":"https://doi.org/10.1155/2022/1680008","url":null,"abstract":"<p><strong>Background: </strong>Bile acid (BA) metabolism may be influenced by gut dysbiosis and alterations of intestinal epithelium in patients with Crohn's disease (CD). Here, we aimed at investigating the alterations of serum BA profile in CD patients and analyzing the correlation between BAs and CD disease activity.</p><p><strong>Methods: </strong>A total of 62 CD patients (29 active and 33 remission) and 33 healthy volunteers (HVs) were enrolled in this retrospective study. Serum BA profiles were measured by liquid chromatography-tandem mass spectrometry.</p><p><strong>Results: </strong>Levels of primary BAs components, including cholic acid (CA) and chenodeoxycholic acid (CDCA), showed no significant difference when compared with HVs. Secondary BAs (SBA) were significantly decreased in CD patients compared with HVs. Importantly, the deoxycholic acid (DCA) and glycodeoxycholic acid (GDCA) levels were significantly lower in CD active than in CD remission patients. The DCA/(DCA + CA) ratio was also decreased in CD active patients than in CD remission patients while the LCA/(LCA + CDCA) ratio showed no difference between them. Principal component analysis also indicated a clear separation among the three groups, with a total variance of 93.43%. The correlation analysis showed that the SBA, DCA, GDCA levels, and DCA/(DCA + CA) ratio had an inverse relationship with Crohn's Disease Activity Index.</p><p><strong>Conclusion: </strong>The BA profile exhibits significant alterations in CD patients. The SBA, DCA, GDCA levels, and DCA/(DCA + CA) ratio were significantly decreased in CD active patients. The DCA/(DCA + CA) ratio had an inverse correlation with CD disease activity.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"1680008"},"PeriodicalIF":2.0,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33527724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of the Supine Position with the Right Shoulder Raised versus the Left Lateral Position in Peroral Endoscopic Myotomy for Achalasia: A Large-Sample Retrospective Study.","authors":"Nanjun Wang,&nbsp;Ningli Chai,&nbsp;Longsong Li,&nbsp;Yawei Bi,&nbsp;Shengzhen Liu,&nbsp;Wengang Zhang,&nbsp;Shasha Wang,&nbsp;Enqiang Linghu","doi":"10.1155/2022/3202212","DOIUrl":"https://doi.org/10.1155/2022/3202212","url":null,"abstract":"<p><strong>Background: </strong>The correct surgical position is very important in the treatment of peroral endoscopic myotomy (POEM) for achalasia, which can make the procedure safer and more efficient. Currently, there are two commonly used positions: the supine position with the right shoulder raised and the left lateral position. This study aims to evaluate the differences in the safety and efficacy of these two positions.</p><p><strong>Methods: </strong>We conducted a retrospective study of 702 patients with achalasia undergoing POEM from December 2010 to December 2020. These patients were divided into the supine position with the right shoulder raised group (<i>n</i> = 579) and the left lateral position group (<i>n</i> = 123). The efficacy of POEM and adverse events were analyzed.</p><p><strong>Results: </strong>The clinical characteristics were similar in both groups, and there were no significant differences between the two groups in the Eckardt score change, lower esophageal sphincter (LES) basal pressure or residual pressure after POEM (all <i>p</i> > 0.05). The mean operative time in the supine position with the right shoulder raised group was significantly shorter than that in the left lateral position group (43.5 min vs. 54.6 min, respectively, <i>p</i> < 0.001). In addition, the differences between the two groups in terms of gas-related complications, such as pneumoperitoneum, pneumomediastinum, and subcutaneous emphysema were statistically significant (all <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>The efficacy of POEM was comparable between the two groups. However, the supine position with the right shoulder raised significantly reduced the operative time and the rate of procedure-related adverse events, especially gas-related complications.</p>","PeriodicalId":12597,"journal":{"name":"Gastroenterology Research and Practice","volume":" ","pages":"3202212"},"PeriodicalIF":2.0,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33514623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}