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  • 1
    In: Gastroenterology Research and Practice, Hindawi Limited, Vol. 2018 ( 2018), p. 1-8
    Abstract: Background . Shape modification has been one of the methods adopted to improve stent patency but has not always translated into positive outcome. The aim of this study was to compare the efficacy of shape-modified partially covered self-expandable metal stent (SEMS) that has enlarged head versus uncovered SEMS for palliation of gastric outlet obstruction (GOO). Methods . A total of 48 patients underwent insertion of either enlarged-head SEMS ( n = 24 ) or uncovered SEMS (uSEMS) ( n = 24 ) for palliation of GOO from July 2009 to July 2016. Patients with inoperable or advanced malignancy were included. Technical feasibility and clinical outcomes were compared. Results . Technical success rate was 100% (24/24) and 95.8% (23/24) for enlarged-head SEMS group and uSEMS group, respectively. Clinical success rate was 87.5% (21/24) and 87.0% (20/23) for enlarged-head SEMS group and uSEMS group, respectively. The gastric outlet obstruction scoring system score significantly improved in both groups ( p 〈 0.001 for both). Mean survival was similar between the groups: enlarged-head SEMS group, 99.3 days (range, 19–358 days) versus uSEMS group, 82.1 days (range, 11–231 days) ( p = 0.418 ). The mean stent patency also showed no difference between the groups: enlarged-head SEMS group, 87.1 days (range, 8–358 days) versus uSEMS group, 60.4 days (range, 2–231 days) ( p = 0.204 ). With enlarged-head SEMS, distal migration did not occur, but proximal migration was observed in four cases. Conclusions . Distal migration was prevented by shaping the SEMS to have an enlarged head, but improvement in stent patency could not be observed.
    Type of Medium: Online Resource
    ISSN: 1687-6121 , 1687-630X
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2018
    detail.hit.zdb_id: 2435460-0
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  • 2
    In: Canadian Journal of Gastroenterology and Hepatology, Hindawi Limited, Vol. 2016 ( 2016), p. 1-9
    Abstract: Background and Aims . Cardiac varices (CVs) in patients with type 1 gastroesophageal varices (GOV1s) usually disappear with treatment for esophageal varices (EVs) by endoscopic injection sclerotherapy (EIS). However, whether this applies to patients treated with endoscopic band ligation (EBL) for EVs remains unclear. We evaluated the effect of EVs eradication by EBL on CVs. Methods . We included cirrhotic patients whose EVs had been eradicated using EBL and excluded those who had been treated using EIS, those who had received endoscopic therapy for CVs, and those who were combined with hepatocellular carcinoma. Results . A total of 123 patients were enrolled. The age was 59.7 ± 11.7 years, and 96 patients (78.0%) were men. Thirty-eight patients (30.9%) had EVs only, while 85 (69.1%) had GOV1s. After EVs eradication, the CVs disappeared in 55 patients (64.7%). EVs recurred in 40 patients, with recurrence rates at 1, 2, and 3 years of 16.0%, 29.6%, and 35.6%, respectively, the recurrence being more frequent in patients who had undergone EBL for secondary prophylaxis and in those with persisting CVs after EVs eradication ( P = 0.003 ). Conclusions . CVs frequently disappeared when EVs were eradicated using EBL in patients with GOV1s. Persistence of CVs after EVs eradication by EBL was associated with EVs recurrence.
    Type of Medium: Online Resource
    ISSN: 2291-2789 , 2291-2797
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2016
    detail.hit.zdb_id: 2762184-4
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  • 3
    Online Resource
    Online Resource
    Hindawi Limited ; 2021
    In:  Canadian Journal of Gastroenterology and Hepatology Vol. 2021 ( 2021-1-4), p. 1-7
    In: Canadian Journal of Gastroenterology and Hepatology, Hindawi Limited, Vol. 2021 ( 2021-1-4), p. 1-7
    Abstract: Background. We sought to analyze the preferred treatment modality by age and liver function in South Korea. Methods. The Korean Liver Cancer Study Group randomly extracted the data of patients with hepatocellular carcinoma (HCC) enrolled in the Korean Central Cancer Registry from 2008 to 2014 from approximately 50 hospitals nationwide. After excluding distant and lymphatic metastases, the treatment preference for patients with a single lesion (excluding PVT (portal vein thrombosis), hepatic vessels, and bile duct invasion) and with PVT was evaluated in 7559 patients. Patients were grouped by age, and baseline liver function was divided based on the Child–Pugh class (CPC) A, B, and C. Results. For a single HCC, the majority of patients selected transarterial therapy as the initial treatment, followed by surgical resection and local ablative therapy. The surgical resection rate decreased significantly with age ( p 〈 0.001 ), and the transarterial therapy rate significantly increased ( p 〈 0.001 ). For CPC C, liver transplantation was significantly increased to 11.5%, and 36.3% of patients received no treatment. In HCC with PVT, the transarterial therapy rate was the highest, followed by the rate of abandonment of treatment. The proportion of no treatment significantly increased with age ( p 〈 0.001 ). In CPC C, transarterial therapy and systemic therapy were attempted in 15.4% and 5.8% of patients, respectively. Conclusions. Age and liver function have a significant impact on the therapeutic decision-making of HCC patients in Korea. In unfavorable conditions, surgical resection was less favored in patients with single tumors, and no treatment was preferred in patients with PVT.
    Type of Medium: Online Resource
    ISSN: 2291-2797 , 2291-2789
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2021
    detail.hit.zdb_id: 2762184-4
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