Japanese journal of gastroenterology and hepatology最新文献

{"title":"Proximal Esophageal Anchored Stent: A Successful Endoscopic Approach in A “Troublesome” Location","authors":"A. Granata, M. Amata, Monteiro Ld, D. Ligresti, M. Traina, A. Bertani","doi":"10.47829/JJGH.2020.5705","DOIUrl":"https://doi.org/10.47829/JJGH.2020.5705","url":null,"abstract":"1. Case Report A 71-year-old woman was admitted for the surgical treatment of a pulmonary adenocarcinoma of the right upper lobe. During anesthesia induction, a left Robertshaw endotracheal tube (ETT) was inadvertently placed in the esophagus. After successful bronchoscopic ETT repositioning, the patient underwent an uneventful VATS (Video-Assisted Thoracoscopic Surgery) right upper lobectomy and lymphadenectomy. High-flow (>1liter) output of particulate white fluid through the chest tube was noted on first post-operative day (POD). In the suspicion of chylothorax, an exploratory esophagogastroduodenoscopy and VATS were performed and a 4-cm longitudinal tear of the posterior wall of the esophagus was found just below the thoracic inlet. The lesion was repaired with a double layer, interrupted 4-0 polydioxanone suture and the chest drained. On POD#7, a barium swallow showed adequate resolution of the fistula. Nevertheless, after initiation of oral intake, the patient developed fever and dysphagia. Endoscopy showed a minimal, 2-mm residual esophageal dehiscence located 2 cm under the cricopharyngeal sphincter, and a CT-scan (Figure 1) showed a residual upper mediastinal collection. Immediate endoscopic clipping of the fistula was attempted but failed due to inadequate margin apposition. After multidisciplinary discussion and despite the very proximal location of the lesion, a fully-covered self-expandable metal stent (FCSEMS, 80x20 mm; Niti-S, Taewoong Medical, South Korea) was deployed in the esophagus and centered on the fistula. In order to avoid distal migration, the proximal end of the stent was sutured to the esophageal wall, just below the cricopharyngeus, using the OverStitch Endoscopic Suturing System (Apollo Endo-surgery, Austin, Texas) (Video). The FC-SEMS was left in place for two months and allowed complete resolution of the fistula. It was then removed endoscopically using a novel cutting device (Ensizor Flex, Austin, Texas) (Figure 2). The final examination revealed definitive healing of the esophageal wall (Figure 3). The patient is alive and well at 11-months follow-up. Esophageal perforation is a rare life-threatening complication of orotracheal intubation, occurring more frequently after difficult cases and double-lumen tube placement, which is a stiffer and sharper device than a standard, single-lumen tube [1, 2]. Endoscopic management of esophageal perforations allows avoiding repeated surgical revisions in patients who are often infected and debilitated. Esophageal lesions located in the proximal esophagus may be very difficult to approach with endoscopic techniques. Endoscopic stenting and anchoring with endo suturing systems may overcome these limitations and may be a further important tool for the interventional endoscopist.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70926302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Drug Monitoring of Thiopurine Therapy in Patients with Inflammatory Bowel Disease","authors":"Zalizko P, J. I., Pukitis A","doi":"10.35665/2435-1210.2019.1017","DOIUrl":"https://doi.org/10.35665/2435-1210.2019.1017","url":null,"abstract":"The aim of this study and review was to make a comparative TPMT enzyme activity analysis using TPMT enzyme expression determination method in IBD patients who are already taking azathioprine drug therapy, with patients who have not yet begun this therapy. The longterm aim is to decrease overall expenses using azathioprine, that could be done if patients would be tested for TPMT expression level before starting therapy with azathioprine, thereby excluding this therapy for patients with higher risk of adverse side effects, reducing medical expenses treating these side effects.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"175 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41287005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophil Cationic Protein Can Monitoring Efficacy of Specific Immunoterapy in Eosinophilic Esophagitis","authors":"Á. Hernández, A. A. Medina, S. M. Armentia, B. Armentia, A. S. M. Rodríguez, M. González-Sagrado, C. Esteban, I. I. Peinado, A. Almaraz","doi":"10.1016/J.CCA.2019.03.538","DOIUrl":"https://doi.org/10.1016/J.CCA.2019.03.538","url":null,"abstract":"","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/J.CCA.2019.03.538","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43195145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Role of Transient Elastography in Assessing Patients with Primary Budd Chiari Syndrome","authors":"W. M, Shibolet O, L. Y., M. Y, Katchman H, P. A., K. Y, Steinberg Dm, Salomon O","doi":"10.47829/jjgh.2020.5101","DOIUrl":"https://doi.org/10.47829/jjgh.2020.5101","url":null,"abstract":"","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70925603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Soluble Programmed Death Ligand 1 is Correlated with HBsAg Level and Nucleos(t)ide Analogue Therapy in Chronic Hepatitis B","authors":"Kerr Rm, Dong Wx, Ouyang Lj, Li Wf, Huang Mx, Peng Xm","doi":"10.47829/jjgh.2021.6302","DOIUrl":"https://doi.org/10.47829/jjgh.2021.6302","url":null,"abstract":"The restoration of immune responses is thought as a complementary approach to the nucleos(t)ide analogue (NUC) therapy of chronic HBV infection. The antiviral immunity is negatively regulated by the programmed cell death-1/programmed death ligand-1 (PD-1/PD-L1) axis. Here, the soluble form of PD-L1 (sPD-L1) that represents the amount of PD-L1 expression cells was used as an indicator to investigate the involvement of this axis in chronic HBV infection, especially in the setting of NUC therapy. increased in NUC-treated patients. These results may be helpful in seeking for new therapeutic approaches to chronic HBV infection in the future.","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70926544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diaphragmatic Disruption Ahead of Herniation Following Hepatic Radiofrequency Ablation","authors":"Hung- Ning T, Yi- Chung H, Shih- Chiang H, Hsiang- Sheng W, Yu- Hsiu C, Kwai- Fong N, Tse- Ching C","doi":"10.47829/jjgh.2021.7601","DOIUrl":"https://doi.org/10.47829/jjgh.2021.7601","url":null,"abstract":"","PeriodicalId":73535,"journal":{"name":"Japanese journal of gastroenterology and hepatology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70927281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}