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  • 1
    In: Digestion, S. Karger AG, Vol. 104, No. 3 ( 2023), p. 174-186
    Abstract: 〈 b 〉 〈 i 〉 Background and Aim: 〈 /i 〉 〈 /b 〉 Small gastric subepithelial lesions (SELs) are sometimes encountered in daily esophagogastroduodenoscopy (EGD) practice, but whether once-annual or twice-annual endoscopy can provide sufficient follow-up remains unclear. Because follow-up based on small-SEL characteristics is important, this study clarified the natural history of gastric SELs less than 20 mm. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This retrospective multicenter observation study conducted at 24 Japanese hospitals during April 2000 to March 2020 examined small gastric SELs of ≤20 mm diameter. The primary outcome was the rate of size increase of those SELs detected using EGD, with growth times assessed irrespective of SEL pathological diagnoses. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 We examined 824 cases with tumors of 1–5 mm diameter in 298 (36.2%) cases, 6–10 mm in 344 (41.7%) cases, 11–15 mm in 112 (13.6%) cases, and 16–20 mm in 70 (8.50%) cases. An increase of small gastric SELs was observed in 70/824 patients (8.5%). The SELs larger than 6 mm increased, even after 10 years. No-change and increasing groups had no significantly different malignant findings at diagnosis. In cases of gastrointestinal stromal tumors (GISTs), internal cystic change in endoscopic ultrasound (EUS) is a risk factor for an increased tumor size. The predictive tumor growth cutoff size at initial diagnosis was 13.5 mm. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Small gastric SELs less than 20 mm have an approximately 8.5% chance of increase. Predictive markers for GIST growth are tumor size ≥13.5 mm and internal cystic change in EUS.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    RVK:
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1482218-0
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  • 2
    In: Digestion, S. Karger AG, Vol. 103, No. 6 ( 2022), p. 404-410
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Hematochezia is observed frequently in daily practice. However, natural hemostasis often prevents identification of the bleeding source during observations. This study was conducted to clarify risk factors related to rebleeding in hematochezia patients without an identified cause of bleeding. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We analyzed patients who were admitted to Dokkyo Medical University Hospital during April 1, 2009, through March 31, 2015, with the chief complaint of hematochezia. Main outcome measures included the rebleeding rate and the period until rebleeding in hematochezia patients without an identified bleeding source. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 We selected 159 patients for analyses. Rebleeding was observed in 46 (28.9%) of 159 patients. The median period until first rebleeding was 166 days (2–3,046 days). Univariate analysis indicated that risk factors for rebleeding were male gender ( 〈 i 〉 p 〈 /i 〉 = 0.029), higher age ( 〈 i 〉 p 〈 /i 〉 = 0.023), antithrombotic medicines ( 〈 i 〉 p 〈 /i 〉 = 0.047), lower hemoglobin on admission ( 〈 i 〉 p 〈 /i 〉 = 0.024), and the presence of diverticula ( 〈 i 〉 p 〈 /i 〉 = 0.002). Multivariate analysis indicated the presence of diverticula ( 〈 i 〉 p 〈 /i 〉 = 0.023) and male gender ( 〈 i 〉 p 〈 /i 〉 = 0.043) as rebleeding risk factors. 〈 b 〉 〈 i 〉 Discussion/Conclusion: 〈 /i 〉 〈 /b 〉 In patients with hematochezia of unknown origin, risk factors for rebleeding indicated in this study, especially the presence of diverticula and male gender, should be given particular attention by physicians.
    Type of Medium: Online Resource
    ISSN: 0012-2823 , 1421-9867
    RVK:
    RVK:
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1482218-0
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
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