Gastric polyps are commonly detected during upper gastrointestinal endoscopy.They are most often benign and rarely become malignant.Nevertheless,adequate knowledge,diagnostic modalities,and management strategies shoul...Gastric polyps are commonly detected during upper gastrointestinal endoscopy.They are most often benign and rarely become malignant.Nevertheless,adequate knowledge,diagnostic modalities,and management strategies should be the endoscopist’s readily available“weapons”to defeat the potentially malignant“enemies”.This article sheds light on the valuable effort by Costa et al to generate a new classification system of gastric polyps as“good”,“bad”,and“ugly”.This comprehensive overview provides clinicians with a simplified decision-making process.展开更多
With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming a...With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming and may not guide immediate clinical decisions.This paper aims to introduce a novel classification system for GPs based on their potential risk of malignant transformation,categorizing them as"good","bad",and"ugly".A review of the literature and clinical case analysis were conducted to explore the clinical implications,management strategies,and the system's application in endoscopic practice.Good polyps,mainly including fundic gland polyps and inflammatory fibrous polyps,have a low risk of malignancy and typically require minimal or no intervention.Bad polyps,mainly including hyperplastic polyps and adenomas,pose an intermediate risk of malignancy,necessitating closer monitoring or removal.Ugly polyps,mainly including type 3 neuroendocrine tumors and early gastric cancer,indicate a high potential for malignancy and require urgent and comprehensive treatment.The new classification system provides a simplified and practical framework for diagnosing and managing GPs,improving diagnostic accuracy,guiding individualized treatment,and promoting advancements in endoscopic techniques.Despite some challenges,such as the risk of misclassification due to similar endoscopic appearances,this system is essential for the standardized management of GPs.It also lays the foundation for future research into biomarkers and the development of personalized medicine.展开更多
BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double c...BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.展开更多
This editorial,inspired by a recent study published in the World Journal of Gastrointestinal Oncology,covers the research findings on microbiota changes in various diseases.In recurrent colorectal polyps,the abundance...This editorial,inspired by a recent study published in the World Journal of Gastrointestinal Oncology,covers the research findings on microbiota changes in various diseases.In recurrent colorectal polyps,the abundances of Klebsiella,Parvimonas,and Clostridium increase,while those of Bifidobacterium and Lactoba-cillus decrease.This dysbiosis may promote the formation and recurrence of polyps.Similar microbial changes have also been observed in colorectal cancer,inflammatory bowel disease,autism spectrum disorder,and metabolic syndrome,indicating the role of increased pathogens and decreased probiotics in these conditions.Regulating the gut microbiota,particularly by increasing probiotic levels,may help prevent polyp recurrence and promote gut health.This microbial intervention strategy holds promise as an adjunctive treatment for patients with colorectal polyps.展开更多
BACKGROUND The incidence of gastric polyps(GPs)has ranged from 0.30%to 6.8%in various studies.Most GPs include hyperplastic polyps(HPs),fundic gland polyps(FGPs),and adenomatous polyps(APs).Although APs have a high ma...BACKGROUND The incidence of gastric polyps(GPs)has ranged from 0.30%to 6.8%in various studies.Most GPs include hyperplastic polyps(HPs),fundic gland polyps(FGPs),and adenomatous polyps(APs).Although APs have a high malignant potential,HPs have a low risk of potential harm,whereas sporadic FGPs have no malignant potential.It is not enough to determine the type and displacement of a polyp by biopsy alone;therefore,some polyps may require an extensive biopsy or complete resection.AIM To evaluate the detection rate and pathological features of polyps in patients undergoing upper gastrointestinal endoscopy.METHODS This retrospective study included patients with GPs or polyphenic lesions with polyps or malignant histology found in polyps or by gastroscopy at the Department of Gastroenterology at the Shaanxi Provincial Hospital of Traditional Chinese Medicine from 2019 to 2023.RESULTS In a series of 10000 patients who underwent upper gastrointestinal endoscopy,384(3.84%)had GPs.There were 98 males(25.5%)and 286 females(74.5%).The mean age of patients was 62.8±10.4(36-75)years.The frequencies of HPs,APs,and FGPs were 88.5%,5.2%,and 2.1%,respectively.The polyp size of 274 patients(71.3%)was≤1 cm.Polyps were found in 262 cases(68.2%).The most common sites for polyps were the lumen and body of the intestine.Endoscopic polypectomy was performed in 128 patients.Bleeding events were observed and endoscopic treatment was required after endoscopic polypectomy.CONCLUSION The incidence of GPs was low.HPs were the most common types of GPs.Of note,as GPs have the potential to develop into adenocarcinoma or precancerous lesions,we suggest that appropriate GP resection technology(e.g.,biopsy forceps or mesenchymal resection)be applied.展开更多
In pediatric patients,gallbladder polyps(GBPs)are lesions that are usually found incidentally on ultrasonography,which is the first-line modality for diagnosis.Though common in adults,GBPs are rare in children,and the...In pediatric patients,gallbladder polyps(GBPs)are lesions that are usually found incidentally on ultrasonography,which is the first-line modality for diagnosis.Though common in adults,GBPs are rare in children,and their prevalence remains unclear.Most GBPs in children are benign,and although the risk of malignancy is influenced by polyp size,growth rate,and morphology,specific criteria for the pediatric population are lacking.Management,therefore,is based on adult guidelines,with cholecystectomy being recommended only in symptomatic patients and for rapidly enlarging or 10-mm polyps and those with unfavorable morphology to avert the risk of malignant transformation,while surveillance is applied to asymptomatic patients with smaller polyps.Further research is needed to develop pediatric-specific guidelines for the management of GBPs.This review discusses the classification,diagnosis,risk factors,and management of pediatric GBPs.展开更多
Colorectal polyps remain a significant health concern because they can develop into cancer.Therefore,accurate assessment and diagnosis of polyps,along with appropriate treatment decisions,are crucial in preventing com...Colorectal polyps remain a significant health concern because they can develop into cancer.Therefore,accurate assessment and diagnosis of polyps,along with appropriate treatment decisions,are crucial in preventing complications or malignant transformation.Some polyps are classified as complex polyps,which means they fail to elevate due to a scar from a previously removed polyp or can be determined by a scoring system like the size/morphology/site/access score,which considers factors like site,morphology,size,and access.Management of complex colorectal polyps involves various options,including endoscopic and surgical approaches.Endoscopic mucosal resection(EMR)may be challenging in scarred polyps,as inadequate lifting can result in incomplete resection or recurrence.As a more advanced alternative,endoscopic submucosal dissection(ESD)is suitable for larger lesions,enabling en-bloc resection even in complex cases with EMR.However,ESD requires expertise and is more time-consuming than EMR,often necessitating hospitalization due to its complexity.Endoscopic full-thickness resection could be a viable alternative for managing scarred polyps.Endoscopic powered resection,either alone or in combination with other modalities,can also be used to achieve less extensive resection.Managing complications during the procedure or post-procedurally is equally important,as bleeding or perforations can be fatal.Careful patient selection based on individual profiles and risk factors,along with the identification of any signs of malignancy,is crucial before treatment to avoid negative post-treatment outcomes.展开更多
Minimally invasive endoscopic resection techniques are the recommended firstline treatment strategy for the majority of large non-pedunculated colorectal polyps,with endoscopic mucosal resection(EMR)as a predominant r...Minimally invasive endoscopic resection techniques are the recommended firstline treatment strategy for the majority of large non-pedunculated colorectal polyps,with endoscopic mucosal resection(EMR)as a predominant resection modality due to its efficacy,efficiency,safety,and cost-effectiveness.A limitation of EMR is recurrence,which has historically occurred in 15%-20%of lesions.In the past 10 years,a number of effective mitigating strategies have been developed,including margin thermal ablation using snare-tip soft coagulation,argon plasma coagulation(APC),and hybrid-APC,alongside margin marking pre-resection.Moreover,techniques for effective recurrence management have also been developed.Herein,we appraise existing evidence on the frequency of recurrence,reasonings behind recurrence formation,as well as recurrence mitigating strategies and the effectiveness of recurrence management.展开更多
Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data dat...Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data databases were searched to include clinical studies on the effect of EP on pregnancy outcomes in patients with EMs,published before August 31,2020.A meta-analysis was performed using Rev Man 5.3 software after two investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results The meta-analysis included ten studies(651 and 1,040 in the combined EP and uncomplicated EP groups,respectively).The spontaneous pregnancy rate,clinical pregnancy rate,and live birth rate were significantly lower in the group with combined EPs than in the group without combined EPs[Odd’s ratio(OR)=0.63,95%confidence interval(CI):0.50–0.80,P=0.0001;OR=0.63,95%CI:0.48–0.84,P=0.001;OR=0.63,95%CI:0.42–0.96,P=0.03],and the rate of embryonic abortion was significantly higher than that in the uncomplicated EP group[OR=3.10,95%CI:1.52–6.32,P=0.002].Conclusion EP may adversely affect pregnancy outcomes in patients with infertility and EMs.Even after surgical treatment,EP can still reduce natural pregnancy,clinical pregnancy,and live birth rates in infertile women with EMs and increase the risk of embryo arrest in these women.展开更多
Colorectal cancer(CRC)is the third most frequently diagnosed cancer and the second leading cause of cancer death worldwide.In this regard,CRC screening is one of the most important issues in modern preventive medicine...Colorectal cancer(CRC)is the third most frequently diagnosed cancer and the second leading cause of cancer death worldwide.In this regard,CRC screening is one of the most important issues in modern preventive medicine.Colorectal polyps are potential predictors of CRC,and therefore represent one of the leading targets for screening colonoscopy.The difficulty of analyzing the information obtained during colonoscopy,including the size,location,shape,type of polyps,the need to standardize morphological data,determines that recently a number of works have promoted the opinion on the advisability of using various artificial intelligence(AI)methods to improve the effectiveness of endoscopic screening for CRC.At the same time,they point to a number of errors and methodological problems in the use of AI systems for the diagnosis of colorectal polyps.In this regard,the interpretation of the work of Shi et al,devoted to the use of a machine learning-based predictive model for monitoring the results of colorectal polypectomy,is undoubtedly interesting.In our opinion,the prospects for using AI to assess endoscopic screening for CRC look certainly positive,but the road to its widespread use will not be easy.展开更多
OBJECTIVE:To investigate the therapeutic effects of Chinese medicine Weifuchun(WFC,胃复春)on gastric fundic gland polyps(FGPs).METHODS:FGPs organoids were constructed with patients-derived samples.The morphology and s...OBJECTIVE:To investigate the therapeutic effects of Chinese medicine Weifuchun(WFC,胃复春)on gastric fundic gland polyps(FGPs).METHODS:FGPs organoids were constructed with patients-derived samples.The morphology and size of FGPs organoids were detected using bright-field imaging.Effective components and corresponding potential targets of WFC were screened using multiple opensource databases and research on Traditional Chinese Medicine or compound formulas.Core genes were identified through protein-protein interaction networks.Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analyses of the core genes were conducted.The interactions between main components and core targets were analyzed through the Ferr Db database.The expressions of core targets were detected by quantitative real-time polymerase chain reaction(q RT-PCR).RESULTS:After WFC treatment,the number and size of FGPs organoids were significantly reduced.Twenty nine active drug components and 162 candidate targets of WFC for treating FGPs were identified,including 37 targets related to ferroptosis.Quercetin,Glaucocalyxin B,Melissoidesin U,Melissoidesin O,Hesperetin,Glaucocalyxin A,Angustifolin,Melissoidesin M,Di-n-octyl phthalate,and beta-sitosterol were identified as the main active compounds.SRC proto-oncogene,non-receptor tyrosine kinase,signal transducer and activator of transcription 3,phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha,phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta,phosphoinositide-3-kinase regulatory subunit 1,and AKT serine/threonine kinase 1 were identified as the primary targets.KEGG pathways related to carcinogenesis,cell proliferation and metabolism,and oxidative stress.WFC promoted FGPs organoids'death and could be reversed by ferroptosis inhibitor of Erastin.The q RT-PCR results showed that WFC treatment could regulate the m RNA expression levels of solute carrier family 7 member 11,acyl-Co A synthetase long chain family member 4,and arachidonate 15-lipoxygenase,type B.CONCLUSION:WFC may exert its therapeutic effects by inducing ferroptosis in FGPs cells.展开更多
BACKGROUND Colorectal polyps(CPs)are important precursor lesions of colorectal cancer,and endoscopic surgery remains the primary treatment option.However,the shortterm recurrence rate post-surgery is high,and the risk...BACKGROUND Colorectal polyps(CPs)are important precursor lesions of colorectal cancer,and endoscopic surgery remains the primary treatment option.However,the shortterm recurrence rate post-surgery is high,and the risk factors for recurrence remain unknown.AIM To comprehensively explore risk factors for short-term recurrence of CPs after endoscopic surgery and develop a nomogram prediction model.METHODS Overall,362 patients who underwent endoscopic polypectomy between January 2022 and January 2024 at Nanjing Jiangbei Hospital were included.We screened basic demographic data,clinical and polyp characteristics,surgery-related information,and independent risk factors for CPs recurrence using univariate and multivariate logistic regression analyses.The multivariate analysis results were used to construct a nomogram prediction model,internally validated using Bootstrapping,with performance evaluated using area under the curve(AUC),calibration curve,and decision curve analysis.RESULTS CP re-occurred in 166(45.86%)of the 362 patients within 1 year post-surgery.Multivariate logistic regression analysis showed that age(OR=1.04,P=0.002),alcohol consumption(OR=2.07,P=0.012),Helicobacter pylori infection(OR=2.34,P<0.001),polyp number>2(OR=1.98,P=0.005),sessile polyps(OR=2.10,P=0.006),and adenomatous pathological type(OR=3.02,P<0.001)were independent risk factors for post-surgery recurrence.The nomogram prediction model showed good discriminatory(AUC=0.73)and calibrating power,and decision curve analysis showed that the model had good clinical benefit at risk probabilities>20%.CONCLUSION We identified multiple independent risk factors for short-term recurrence after endoscopic surgery.The nomogram prediction model showed a certain degree of differentiation,calibration,and potential clinical applicability.展开更多
BACKGROUND Thyroid nodules(TN)are increasingly diagnosed worldwide;investigating the association between TN and colon polyps could be helpful in early detection and management.To our knowledge no meta-analysis has ass...BACKGROUND Thyroid nodules(TN)are increasingly diagnosed worldwide;investigating the association between TN and colon polyps could be helpful in early detection and management.To our knowledge no meta-analysis has assessed the relationship between TN and adenomatous colonic polyps.AIM To assess the association between adenomatous colonic polyps,thyroid-stimulating hormone,and TN.METHODS We searched PubMed,MEDLINE,Cochrane Library,EBSCO,and the first 100 articles in Google for articles published in English from inception until April 2025.We included prospective cohorts,retrospective studies,case-control studies,and cross-sectional studies.The keywords thyroid nodules,adenomatous colon polyps,thyroid volume,metabolic syndrome,insulin resistance,and thyroid malignancy were used.RESULTS Out of 237 articles,25 full texts were reviewed,and 5 full texts were included in the final meta-analysis.No relationship was found between TN,colonic polyps,and thyroid-stimulating hormone levels[odd ratio(OR):1.78,95%confidence interval(CI):0.55-5.74,P=0.33].Colonic polyps were more common among patients with TN when addressing heterogeneity(OR:0.42,95%CI:0.30-0.52,P<0.001 and OR:0.08,95%CI:0.70-0.86,P=0.85).CONCLUSION TN were similar among patients with and without adenomatous colonic polyps.However,TN was more common among colon polyps when addressing the heterogeneity.Thyroid-stimulating hormone was not different between those with and without TN.Age,sex,adiposity,and smoking effects might explain the higher rate observed by the included studies.Further studies controlling for the same are needed.展开更多
BACKGROUNDColorectal cancer(CRC)typically progresses from benign colorectal polyps,whichrepresent a precursor to malignancy.Identifying the factors influencing thisprogression is crucial for early intervention and pre...BACKGROUNDColorectal cancer(CRC)typically progresses from benign colorectal polyps,whichrepresent a precursor to malignancy.Identifying the factors influencing thisprogression is crucial for early intervention and prevention.Although genetic andenvironmental factors have been widely studied,the role of lifestyle factors suchas physical activity,diet,smoking,sleep,and stress remains underexplored,especially in patients with early stage CRC or polyps.Recent evidence suggeststhat lifestyle behaviors may influence cancer progression by modulating inflammatorypathways,metabolic health,and immune function.For instance,highlevels of physical activity are linked to a reduced risk of CRC development,whereas poor dietary habits,smoking,and inadequate sleep have all beenimplicated in increased cancer risk and progression.Moreover,early-stage CRCpatients,who are often asymptomatic or have minimal symptoms,may particularlybenefit from lifestyle modifications to slow disease progression andimprove overall prognosis.The gap in understanding the specific influence ofthese lifestyle factors on colorectal polyps and early stage cancer progressionunderscores the need for comprehensive studies.By assessing several modifiablelifestyle factors and their association with disease progression,clinicians canidentify practical intervention points.These interventions could ultimately reducethe need for more aggressive treatments and improve the long-term outcomes inaffected patients.AIMTo investigate the association between lifestyle factors and disease progression inpatients with colorectal polyps and early stage cancer.METHODSIn this observational study conducted from January 2022 to December 2023,werecruited 120 patients with colorectal polyps or early stage cancer from Jiangshan People's Hospital.Lifestyle factors,including physical activity,dietary patterns,smoking status,sleep quality,andstress levels,were assessed using validated questionnaires.Disease progression was evaluated using standardizedfollow-up colonoscopies and pathological examinations.Cox proportional hazards models were used to analyzethe association between lifestyle factors and disease progression after adjusting for potential confounders.RESULTSDuring the median follow-up of 18.4 months,42(35.0%)patients experienced disease progression.High levels ofphysical activity were associated with reduced progression risk[adjusted hazard ratio(HR)0.55,95%confidenceinterval(CI):0.38-0.80,P=0.002]compared to low activity levels.High adherence to a healthy dietary patternshowed similar protective effects(adjusted HR 0.62,95%CI:0.43-0.89,P=0.009).Current smoking(adjusted HR1.92,95%CI:1.35-2.73,P<0.001)and poor sleep quality(adjusted HR 1.38,95%CI:1.05-1.82,P=0.021)wereassociated with increased progression risk.The impact of lifestyle factors was particularly pronounced in patientsyounger than 60 years and those with multiple polyps at baseline.CONCLUSIONThis study demonstrated significant associations between lifestyle factors and disease progression in colorectalpolyps and early stage cancer.Physical activity,dietary patterns,smoking status,and sleep quality have emergedas key modifiable factors influencing disease progression.These findings support the integration of lifestyleassessments and modifications in the clinical management of patients with colorectal neoplasia.展开更多
BACKGROUND Cold snare polypectomy(CSP)is comparatively safe and effective for removing polyps less than 10 mm in size with lower rates of postpolypectomy syndrome and delayed postpolypectomy bleeding compared with hot...BACKGROUND Cold snare polypectomy(CSP)is comparatively safe and effective for removing polyps less than 10 mm in size with lower rates of postpolypectomy syndrome and delayed postpolypectomy bleeding compared with hot snare polypectomy(HSP).Recently,CSP is also expanded for removing polyps larger than 10 mm in size.AIM To compare the efficiency and safety of CSP and HSP in the management of 10-19 mm non-pedunculated colorectal polyps.METHODS A total of 1686 inpatients with at least one 10-19 mm non-pedunculated colorectal polyp,who underwent CSP(study group,n=843)or HSP(control group,n=843)at our Digestive Endoscopy Center between February 2020 and February 2024 were enrolled.The outcome measures including complete resection rate,intraoperative bleeding rate,and healthcare expenses such as procedure time and treatment cost were compared between the CSP vs HSP groups.RESULTS No statistically significant intergroup difference was observed in histological complete resection rates(P>0.05).Polyp resection time in the study group(76.5±23.6 seconds)was notably shorter than that in the control group(91.24±32.06 seconds;P<0.05).The immediate intraoperative bleeding rate was significantly higher in the study group than in the control group(12.7%vs 4.9%,P<0.05).No instances of delayed bleeding or perforation were documented in either group.Hospitalization duration was significantly reduced in the study group(2.42±0.61 days)compared to the control group(3.21±1.02 days;P<0.05).CONCLUSION For 10-19 mm non-pedunculated colorectal polyps,CSP demonstrates operational efficiency advantages over HSP in terms of procedure time,treatment cost,and length of hospital stay.Both techniques demonstrate robust safety profiles;however,CSP is associated with a higher intraoperative bleeding rate.Clinical decision-making should incorporate individualized assessment of these factors.展开更多
This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total ...This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.展开更多
BACKGROUND Implementing nursing interventions in patients undergoing endoscopic treatment for intestinal polyps and early stage cancer can serve as a reference for reducing the incidence of complications,accelerating ...BACKGROUND Implementing nursing interventions in patients undergoing endoscopic treatment for intestinal polyps and early stage cancer can serve as a reference for reducing the incidence of complications,accelerating the recovery process,and improving the quality of life.AIM To impact of systematic nursing intervention on recovery,complications prevention,and quality of life after endoscopic surgery for intestinal polyps.METHODS This retrospective study included 157 patients who underwent endoscopic mucosal resection or endoscopic submucosal dissection at our hospital.The patients were divided into intervention and conventional groups,with no significant differences in age,sex,or surgical methods.The intervention group received multidimensional nursing interventions,including preoperative evaluation,intraoperative cooperation,postoperative rehabilitation,psychological support and nutritional management.The conventional group received standardized care.Clinical efficacy,inflammation and infection indicators,complication rates,rehabilitation indicators,and visual analog scale(VAS)scores were compared.RESULTS On the 7th day after surgery,C-reactive protein(CRP)and white blood cell levels were lower in the intervention group than in the conventional group.Complications occurred in 9.33%of the patients in the intervention group and 23.17%in the conventional group,with significant differences in fever and abdominal distension.The intervention group had shorter first exhaust and hospitalization durations than the control group.By day 3 post-surgery,the intervention group showed lower VAS scores and reduced anxiety and depression.High-risk factors included diabetes[relative risk(RR)=2.43,95%CI:1.21-4.86],laparotomy(RR=2.86,95%CI:1.22-6.71),CRP>15 mg/L(RR=3.12,95%CI:1.54-6.33),and procalcitonin>0.5 ng/mL 1 day after surgery(RR=2.91.95%CI:1.31-6.44),while systematic nursing interventions(OR=0.40,95%CI:0.18-0.89)reduced the complication risk by 60%.CONCLUSION Multidimensional nursing interventions have clinical value in endoscopic treatment of intestinal polyps and early stage cancer,reducing complications and hospital stay.This study provides a basis for establishing patientcentered guidelines.展开更多
BACKGROUND Colorectal polypectomy is fundamental to the prevention of colorectal cancer,utilizing several endoscopic techniques.Robust comparative data regarding the efficacy and safety of these modalities in clinical...BACKGROUND Colorectal polypectomy is fundamental to the prevention of colorectal cancer,utilizing several endoscopic techniques.Robust comparative data regarding the efficacy and safety of these modalities in clinical practice are limited.AIM To evaluate and compare the efficacy and safety of three endoscopic polypectomy techniques,namely,high-frequency electroresection(HFE),cold snare polypectomy(CSP),and endoscopic mucosal resection(EMR),for the treatment of colonic polyps.METHODS This single-center retrospective cohort study included adults who underwent endoscopic resection of pathologically confirmed colorectal polyps at Central Hospital Affiliated to Shandong First Medical University between January 2015 and December 2023.Patients were grouped by technique:HFE(n=107),CSP(n=106),and EMR(n=108).Standardized preoperative,intraoperative,and postoperative protocols were applied.Outcome measures included resection status(en bloc,R0,R1,and Rx),adverse events(immediate/delayed bleeding,perforation,and post-polypectomy coagulation syndrome),postoperative pain(visual analog scale at 1,3,and 5 hours),and 12-month recurrence rate.RESULTS Baseline demographics and polyp characteristics,except for polyp diameter,were comparable among groups.CSP achieved the highest en bloc resection rate,whereas HFE had a higher R0 resection rate.Polyp diameter was largest in the EMR group.Procedure duration was shortest with HFE.Adverse reactions were more frequent with HFE,particularly post-polypectomy bleeding and delayed perforation,whereas CSP demonstrated a superior safety profile and the lowest incidence of complications.Postoperative pain diminished in all groups over time but was consistently low for CSP and EMR.Recurrence rates were significantly higher in the EMR group vs CSP group,with HFE showing intermediate recurrence.CONCLUSION CSP offers the best safety profile and lowest recurrence rate among patients undergoing endoscopic resection of colorectal polyps,whereas HFE confers a high R0 resection rate but increased risk of adverse events.EMR remains essential for large polyps despite elevated recurrence.Technique selection should be tailored according to polyp characteristics and patient risk factors to optimize outcomes.展开更多
BACKGROUND The diagnosis of gastric inflammatory fibroid polyps(IFPs)mainly depends on pathological confirmation after endoscopic or surgical treatment.Gastric IFP have typical manifestations under endoscopic ultrason...BACKGROUND The diagnosis of gastric inflammatory fibroid polyps(IFPs)mainly depends on pathological confirmation after endoscopic or surgical treatment.Gastric IFP have typical manifestations under endoscopic ultrasonography(EUS),but atypical EUS features have also been reported.Previous studies have found that atypical features of gastric IFPs observed under EUS have corresponding histological manifestations.At present,there is no study elaborating the EUS manifestations of gastric IFPs at different pathological stages.We hypothesize that gastric IFPs at different pathological stages may have different EUS features.AIM To describe EUS features of gastric IFPs and compare with their pathological characteristics.METHODS Clinical data of 53 inpatients with pathologically diagnosed gastric IFPs after endoscopic treatment were collected.All patients underwent preoperative EUS.We analyzed the EUS characteristics of the lesions and compared with the pathological characteristics and staging of the resected specimens.RESULTS Most gastric IFPs showed medium-low echo(67.9%),homogeneous echo(90.6%),and unclear boundaries(83%),and involved the second and third layers of the gastric wall(69.8%)under EUS.The echogenicity level and echo homogeneity were significantly correlated with the pathological stage of gastric IFP.Gastric IFPs in the nodular stage presented hypoechoic and homogeneous echo.Gastric IFPs in the fibrovascular stage mostly showed medium-low echo and homogeneous echo.Gastric IFPs in the sclerotic stage showed different echogenicity levels and echo homogeneity.The accuracy of EUS in diagnosing gastric IFPs was 66.0%(35/53),and the accuracy in determining the origin layer of gastric IFPs was 73.4%(39/53).CONCLUSION Gastric IFPs at different pathological stages have different EUS features.In order to improve the diagnostic rate,it is necessary to combine EUS with EUS-guided fine-needle aspiration or artificial intelligence.展开更多
Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderl...Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderly GP patients admitted between June 2021 and December 2022 were selected.Patients were randomly divided into two groups:the painless group(50 cases)underwent high-frequency electrosurgical knife surgery guided by PDE,while the conventional group(50 cases)underwent the same surgery guided by traditional digestive endoscopy(DE).The total treatment efficacy,perioperative indicators,gastrointestinal hormone levels,oxidative stress(OS)markers,and complication rates were compared between the two groups.Results:The total treatment efficacy in the painless group was higher than that in the conventional group,and perioperative indicators were superior in the painless group(P<0.05).One week after treatment,the gastrointestinal hormone levels and OS-related markers in the painless group were better than those in the conventional group(P<0.05).The complication rate in the painless group was lower than in the conventional group(P<0.05).Conclusion:High-frequency electrosurgical knife surgery guided by PDE improves the effectiveness of polyp removal in elderly GP patients and accelerates postoperative recovery.It also protects gastrointestinal function,reduces postoperative OS,and ensures higher surgical safety.展开更多
文摘Gastric polyps are commonly detected during upper gastrointestinal endoscopy.They are most often benign and rarely become malignant.Nevertheless,adequate knowledge,diagnostic modalities,and management strategies should be the endoscopist’s readily available“weapons”to defeat the potentially malignant“enemies”.This article sheds light on the valuable effort by Costa et al to generate a new classification system of gastric polyps as“good”,“bad”,and“ugly”.This comprehensive overview provides clinicians with a simplified decision-making process.
文摘With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming and may not guide immediate clinical decisions.This paper aims to introduce a novel classification system for GPs based on their potential risk of malignant transformation,categorizing them as"good","bad",and"ugly".A review of the literature and clinical case analysis were conducted to explore the clinical implications,management strategies,and the system's application in endoscopic practice.Good polyps,mainly including fundic gland polyps and inflammatory fibrous polyps,have a low risk of malignancy and typically require minimal or no intervention.Bad polyps,mainly including hyperplastic polyps and adenomas,pose an intermediate risk of malignancy,necessitating closer monitoring or removal.Ugly polyps,mainly including type 3 neuroendocrine tumors and early gastric cancer,indicate a high potential for malignancy and require urgent and comprehensive treatment.The new classification system provides a simplified and practical framework for diagnosing and managing GPs,improving diagnostic accuracy,guiding individualized treatment,and promoting advancements in endoscopic techniques.Despite some challenges,such as the risk of misclassification due to similar endoscopic appearances,this system is essential for the standardized management of GPs.It also lays the foundation for future research into biomarkers and the development of personalized medicine.
基金Supported by the Health Technology Project of Pudong New District Health Commission,No.PW2020D-12.
文摘BACKGROUND The relationship between autoimmune gastritis(AIG)and gastric polyps(GPs)is not well understood.AIM To explore the clinical characteristics and risk factors of AIG with GPs in patients.METHODS This double center retrospective study included 530 patients diagnosed with AIG from July 2019 to July 2023.We collected clinical,biochemical,serological,and demographic data were of each patient.Logistic regression analyses,both multivariate and univariate,were conducted to pinpoint independent risk factors for GPs in patients with AIG patients.Receiver operating characteristic curves were utilized to establish the optimal cutoff values,sensitivity,and specificity of these risk factors for predicting GPs in patients with AIG.RESULTS Patients with GPs had a higher median age than those without GPs[61(52.25-69)years vs 58(47-66)years,P=0.006].The gastrin-17 levels were significantly elevated in patients with GPs compared with those without GPs[91.9(34.2-138.9)pmol/mL vs 60.9(12.6-98.4)pmol/mL,P<0.001].Additionally,the positive rate of parietal cell antibody(PCA)antibody was higher in these patients than in those without GPs(88.6%vs 73.6%,P<0.001).Multivariate and univariate analyses revealed that PCA positivity[odds ratio(OR)=2.003,P=0.017],pepsinogen II(OR=1.053,P=0.015),and enterochromaffin like cells hyperplasia(OR=3.116,P<0.001)were significant risk factors for GPs,while pepsinogen I was identified as a protective factor.CONCLUSION PCA positivity and enterochromaffin like cells hyperplasia are significant risk factor for the development of GPs in patients with AIG.Elevated gastrin-17 levels may also play a role in this process.These findings suggest potential targets for further research and therapeutic intervention in managing GPs in patients with AIG.
文摘This editorial,inspired by a recent study published in the World Journal of Gastrointestinal Oncology,covers the research findings on microbiota changes in various diseases.In recurrent colorectal polyps,the abundances of Klebsiella,Parvimonas,and Clostridium increase,while those of Bifidobacterium and Lactoba-cillus decrease.This dysbiosis may promote the formation and recurrence of polyps.Similar microbial changes have also been observed in colorectal cancer,inflammatory bowel disease,autism spectrum disorder,and metabolic syndrome,indicating the role of increased pathogens and decreased probiotics in these conditions.Regulating the gut microbiota,particularly by increasing probiotic levels,may help prevent polyp recurrence and promote gut health.This microbial intervention strategy holds promise as an adjunctive treatment for patients with colorectal polyps.
基金Supported by the Shaanxi Province Traditional Chinese Medicine Research and Innovation Talent Plan Project,No.TZKN-CXRC-16Project of Shaanxi Administration of Traditional Chinese Medicine,No.SZYKJCYC-2025-JC-010+2 种基金Shaanxi Province Outstanding TCM Talents Training Project Training Object in 2025Xi’an Science and Technology Plan Project,No.23YXYJ0162Shaanxi Province Key Research and Development Plan Project-Social Development Field,No.S2025-YF-YBSF-0391.
文摘BACKGROUND The incidence of gastric polyps(GPs)has ranged from 0.30%to 6.8%in various studies.Most GPs include hyperplastic polyps(HPs),fundic gland polyps(FGPs),and adenomatous polyps(APs).Although APs have a high malignant potential,HPs have a low risk of potential harm,whereas sporadic FGPs have no malignant potential.It is not enough to determine the type and displacement of a polyp by biopsy alone;therefore,some polyps may require an extensive biopsy or complete resection.AIM To evaluate the detection rate and pathological features of polyps in patients undergoing upper gastrointestinal endoscopy.METHODS This retrospective study included patients with GPs or polyphenic lesions with polyps or malignant histology found in polyps or by gastroscopy at the Department of Gastroenterology at the Shaanxi Provincial Hospital of Traditional Chinese Medicine from 2019 to 2023.RESULTS In a series of 10000 patients who underwent upper gastrointestinal endoscopy,384(3.84%)had GPs.There were 98 males(25.5%)and 286 females(74.5%).The mean age of patients was 62.8±10.4(36-75)years.The frequencies of HPs,APs,and FGPs were 88.5%,5.2%,and 2.1%,respectively.The polyp size of 274 patients(71.3%)was≤1 cm.Polyps were found in 262 cases(68.2%).The most common sites for polyps were the lumen and body of the intestine.Endoscopic polypectomy was performed in 128 patients.Bleeding events were observed and endoscopic treatment was required after endoscopic polypectomy.CONCLUSION The incidence of GPs was low.HPs were the most common types of GPs.Of note,as GPs have the potential to develop into adenocarcinoma or precancerous lesions,we suggest that appropriate GP resection technology(e.g.,biopsy forceps or mesenchymal resection)be applied.
文摘In pediatric patients,gallbladder polyps(GBPs)are lesions that are usually found incidentally on ultrasonography,which is the first-line modality for diagnosis.Though common in adults,GBPs are rare in children,and their prevalence remains unclear.Most GBPs in children are benign,and although the risk of malignancy is influenced by polyp size,growth rate,and morphology,specific criteria for the pediatric population are lacking.Management,therefore,is based on adult guidelines,with cholecystectomy being recommended only in symptomatic patients and for rapidly enlarging or 10-mm polyps and those with unfavorable morphology to avert the risk of malignant transformation,while surveillance is applied to asymptomatic patients with smaller polyps.Further research is needed to develop pediatric-specific guidelines for the management of GBPs.This review discusses the classification,diagnosis,risk factors,and management of pediatric GBPs.
文摘Colorectal polyps remain a significant health concern because they can develop into cancer.Therefore,accurate assessment and diagnosis of polyps,along with appropriate treatment decisions,are crucial in preventing complications or malignant transformation.Some polyps are classified as complex polyps,which means they fail to elevate due to a scar from a previously removed polyp or can be determined by a scoring system like the size/morphology/site/access score,which considers factors like site,morphology,size,and access.Management of complex colorectal polyps involves various options,including endoscopic and surgical approaches.Endoscopic mucosal resection(EMR)may be challenging in scarred polyps,as inadequate lifting can result in incomplete resection or recurrence.As a more advanced alternative,endoscopic submucosal dissection(ESD)is suitable for larger lesions,enabling en-bloc resection even in complex cases with EMR.However,ESD requires expertise and is more time-consuming than EMR,often necessitating hospitalization due to its complexity.Endoscopic full-thickness resection could be a viable alternative for managing scarred polyps.Endoscopic powered resection,either alone or in combination with other modalities,can also be used to achieve less extensive resection.Managing complications during the procedure or post-procedurally is equally important,as bleeding or perforations can be fatal.Careful patient selection based on individual profiles and risk factors,along with the identification of any signs of malignancy,is crucial before treatment to avoid negative post-treatment outcomes.
文摘Minimally invasive endoscopic resection techniques are the recommended firstline treatment strategy for the majority of large non-pedunculated colorectal polyps,with endoscopic mucosal resection(EMR)as a predominant resection modality due to its efficacy,efficiency,safety,and cost-effectiveness.A limitation of EMR is recurrence,which has historically occurred in 15%-20%of lesions.In the past 10 years,a number of effective mitigating strategies have been developed,including margin thermal ablation using snare-tip soft coagulation,argon plasma coagulation(APC),and hybrid-APC,alongside margin marking pre-resection.Moreover,techniques for effective recurrence management have also been developed.Herein,we appraise existing evidence on the frequency of recurrence,reasonings behind recurrence formation,as well as recurrence mitigating strategies and the effectiveness of recurrence management.
文摘Objective To evaluate the impact of endometrial polyps(EP)on postoperative pregnancy outcomes in infertile women with endometriosis(EMs).Methods PubMed,Embase,The Cochrane Library,CNKI,VIP,SinoMed,and WanFang Data databases were searched to include clinical studies on the effect of EP on pregnancy outcomes in patients with EMs,published before August 31,2020.A meta-analysis was performed using Rev Man 5.3 software after two investigators independently screened the literature,extracted information,and evaluated the risk of bias of the included studies.Results The meta-analysis included ten studies(651 and 1,040 in the combined EP and uncomplicated EP groups,respectively).The spontaneous pregnancy rate,clinical pregnancy rate,and live birth rate were significantly lower in the group with combined EPs than in the group without combined EPs[Odd’s ratio(OR)=0.63,95%confidence interval(CI):0.50–0.80,P=0.0001;OR=0.63,95%CI:0.48–0.84,P=0.001;OR=0.63,95%CI:0.42–0.96,P=0.03],and the rate of embryonic abortion was significantly higher than that in the uncomplicated EP group[OR=3.10,95%CI:1.52–6.32,P=0.002].Conclusion EP may adversely affect pregnancy outcomes in patients with infertility and EMs.Even after surgical treatment,EP can still reduce natural pregnancy,clinical pregnancy,and live birth rates in infertile women with EMs and increase the risk of embryo arrest in these women.
文摘Colorectal cancer(CRC)is the third most frequently diagnosed cancer and the second leading cause of cancer death worldwide.In this regard,CRC screening is one of the most important issues in modern preventive medicine.Colorectal polyps are potential predictors of CRC,and therefore represent one of the leading targets for screening colonoscopy.The difficulty of analyzing the information obtained during colonoscopy,including the size,location,shape,type of polyps,the need to standardize morphological data,determines that recently a number of works have promoted the opinion on the advisability of using various artificial intelligence(AI)methods to improve the effectiveness of endoscopic screening for CRC.At the same time,they point to a number of errors and methodological problems in the use of AI systems for the diagnosis of colorectal polyps.In this regard,the interpretation of the work of Shi et al,devoted to the use of a machine learning-based predictive model for monitoring the results of colorectal polypectomy,is undoubtedly interesting.In our opinion,the prospects for using AI to assess endoscopic screening for CRC look certainly positive,but the road to its widespread use will not be easy.
基金the National Administration of Traditional Chinese Medicine Letter([2022]-1)Dongzhimen Hospital Horizontal Project:Exploring the Effects of Weifuchun on Key Mechanisms of Different Types of Gastric Polyps based on Human Organoid Culture Technology(No.HX-DZM-202239)the Qihuang Talent Program for Renowned Physician Cultivation at Beijing University of Chinese Medicine(No.Y2023A06)。
文摘OBJECTIVE:To investigate the therapeutic effects of Chinese medicine Weifuchun(WFC,胃复春)on gastric fundic gland polyps(FGPs).METHODS:FGPs organoids were constructed with patients-derived samples.The morphology and size of FGPs organoids were detected using bright-field imaging.Effective components and corresponding potential targets of WFC were screened using multiple opensource databases and research on Traditional Chinese Medicine or compound formulas.Core genes were identified through protein-protein interaction networks.Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment analyses of the core genes were conducted.The interactions between main components and core targets were analyzed through the Ferr Db database.The expressions of core targets were detected by quantitative real-time polymerase chain reaction(q RT-PCR).RESULTS:After WFC treatment,the number and size of FGPs organoids were significantly reduced.Twenty nine active drug components and 162 candidate targets of WFC for treating FGPs were identified,including 37 targets related to ferroptosis.Quercetin,Glaucocalyxin B,Melissoidesin U,Melissoidesin O,Hesperetin,Glaucocalyxin A,Angustifolin,Melissoidesin M,Di-n-octyl phthalate,and beta-sitosterol were identified as the main active compounds.SRC proto-oncogene,non-receptor tyrosine kinase,signal transducer and activator of transcription 3,phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha,phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit beta,phosphoinositide-3-kinase regulatory subunit 1,and AKT serine/threonine kinase 1 were identified as the primary targets.KEGG pathways related to carcinogenesis,cell proliferation and metabolism,and oxidative stress.WFC promoted FGPs organoids'death and could be reversed by ferroptosis inhibitor of Erastin.The q RT-PCR results showed that WFC treatment could regulate the m RNA expression levels of solute carrier family 7 member 11,acyl-Co A synthetase long chain family member 4,and arachidonate 15-lipoxygenase,type B.CONCLUSION:WFC may exert its therapeutic effects by inducing ferroptosis in FGPs cells.
文摘BACKGROUND Colorectal polyps(CPs)are important precursor lesions of colorectal cancer,and endoscopic surgery remains the primary treatment option.However,the shortterm recurrence rate post-surgery is high,and the risk factors for recurrence remain unknown.AIM To comprehensively explore risk factors for short-term recurrence of CPs after endoscopic surgery and develop a nomogram prediction model.METHODS Overall,362 patients who underwent endoscopic polypectomy between January 2022 and January 2024 at Nanjing Jiangbei Hospital were included.We screened basic demographic data,clinical and polyp characteristics,surgery-related information,and independent risk factors for CPs recurrence using univariate and multivariate logistic regression analyses.The multivariate analysis results were used to construct a nomogram prediction model,internally validated using Bootstrapping,with performance evaluated using area under the curve(AUC),calibration curve,and decision curve analysis.RESULTS CP re-occurred in 166(45.86%)of the 362 patients within 1 year post-surgery.Multivariate logistic regression analysis showed that age(OR=1.04,P=0.002),alcohol consumption(OR=2.07,P=0.012),Helicobacter pylori infection(OR=2.34,P<0.001),polyp number>2(OR=1.98,P=0.005),sessile polyps(OR=2.10,P=0.006),and adenomatous pathological type(OR=3.02,P<0.001)were independent risk factors for post-surgery recurrence.The nomogram prediction model showed good discriminatory(AUC=0.73)and calibrating power,and decision curve analysis showed that the model had good clinical benefit at risk probabilities>20%.CONCLUSION We identified multiple independent risk factors for short-term recurrence after endoscopic surgery.The nomogram prediction model showed a certain degree of differentiation,calibration,and potential clinical applicability.
文摘BACKGROUND Thyroid nodules(TN)are increasingly diagnosed worldwide;investigating the association between TN and colon polyps could be helpful in early detection and management.To our knowledge no meta-analysis has assessed the relationship between TN and adenomatous colonic polyps.AIM To assess the association between adenomatous colonic polyps,thyroid-stimulating hormone,and TN.METHODS We searched PubMed,MEDLINE,Cochrane Library,EBSCO,and the first 100 articles in Google for articles published in English from inception until April 2025.We included prospective cohorts,retrospective studies,case-control studies,and cross-sectional studies.The keywords thyroid nodules,adenomatous colon polyps,thyroid volume,metabolic syndrome,insulin resistance,and thyroid malignancy were used.RESULTS Out of 237 articles,25 full texts were reviewed,and 5 full texts were included in the final meta-analysis.No relationship was found between TN,colonic polyps,and thyroid-stimulating hormone levels[odd ratio(OR):1.78,95%confidence interval(CI):0.55-5.74,P=0.33].Colonic polyps were more common among patients with TN when addressing heterogeneity(OR:0.42,95%CI:0.30-0.52,P<0.001 and OR:0.08,95%CI:0.70-0.86,P=0.85).CONCLUSION TN were similar among patients with and without adenomatous colonic polyps.However,TN was more common among colon polyps when addressing the heterogeneity.Thyroid-stimulating hormone was not different between those with and without TN.Age,sex,adiposity,and smoking effects might explain the higher rate observed by the included studies.Further studies controlling for the same are needed.
文摘BACKGROUNDColorectal cancer(CRC)typically progresses from benign colorectal polyps,whichrepresent a precursor to malignancy.Identifying the factors influencing thisprogression is crucial for early intervention and prevention.Although genetic andenvironmental factors have been widely studied,the role of lifestyle factors suchas physical activity,diet,smoking,sleep,and stress remains underexplored,especially in patients with early stage CRC or polyps.Recent evidence suggeststhat lifestyle behaviors may influence cancer progression by modulating inflammatorypathways,metabolic health,and immune function.For instance,highlevels of physical activity are linked to a reduced risk of CRC development,whereas poor dietary habits,smoking,and inadequate sleep have all beenimplicated in increased cancer risk and progression.Moreover,early-stage CRCpatients,who are often asymptomatic or have minimal symptoms,may particularlybenefit from lifestyle modifications to slow disease progression andimprove overall prognosis.The gap in understanding the specific influence ofthese lifestyle factors on colorectal polyps and early stage cancer progressionunderscores the need for comprehensive studies.By assessing several modifiablelifestyle factors and their association with disease progression,clinicians canidentify practical intervention points.These interventions could ultimately reducethe need for more aggressive treatments and improve the long-term outcomes inaffected patients.AIMTo investigate the association between lifestyle factors and disease progression inpatients with colorectal polyps and early stage cancer.METHODSIn this observational study conducted from January 2022 to December 2023,werecruited 120 patients with colorectal polyps or early stage cancer from Jiangshan People's Hospital.Lifestyle factors,including physical activity,dietary patterns,smoking status,sleep quality,andstress levels,were assessed using validated questionnaires.Disease progression was evaluated using standardizedfollow-up colonoscopies and pathological examinations.Cox proportional hazards models were used to analyzethe association between lifestyle factors and disease progression after adjusting for potential confounders.RESULTSDuring the median follow-up of 18.4 months,42(35.0%)patients experienced disease progression.High levels ofphysical activity were associated with reduced progression risk[adjusted hazard ratio(HR)0.55,95%confidenceinterval(CI):0.38-0.80,P=0.002]compared to low activity levels.High adherence to a healthy dietary patternshowed similar protective effects(adjusted HR 0.62,95%CI:0.43-0.89,P=0.009).Current smoking(adjusted HR1.92,95%CI:1.35-2.73,P<0.001)and poor sleep quality(adjusted HR 1.38,95%CI:1.05-1.82,P=0.021)wereassociated with increased progression risk.The impact of lifestyle factors was particularly pronounced in patientsyounger than 60 years and those with multiple polyps at baseline.CONCLUSIONThis study demonstrated significant associations between lifestyle factors and disease progression in colorectalpolyps and early stage cancer.Physical activity,dietary patterns,smoking status,and sleep quality have emergedas key modifiable factors influencing disease progression.These findings support the integration of lifestyleassessments and modifications in the clinical management of patients with colorectal neoplasia.
文摘BACKGROUND Cold snare polypectomy(CSP)is comparatively safe and effective for removing polyps less than 10 mm in size with lower rates of postpolypectomy syndrome and delayed postpolypectomy bleeding compared with hot snare polypectomy(HSP).Recently,CSP is also expanded for removing polyps larger than 10 mm in size.AIM To compare the efficiency and safety of CSP and HSP in the management of 10-19 mm non-pedunculated colorectal polyps.METHODS A total of 1686 inpatients with at least one 10-19 mm non-pedunculated colorectal polyp,who underwent CSP(study group,n=843)or HSP(control group,n=843)at our Digestive Endoscopy Center between February 2020 and February 2024 were enrolled.The outcome measures including complete resection rate,intraoperative bleeding rate,and healthcare expenses such as procedure time and treatment cost were compared between the CSP vs HSP groups.RESULTS No statistically significant intergroup difference was observed in histological complete resection rates(P>0.05).Polyp resection time in the study group(76.5±23.6 seconds)was notably shorter than that in the control group(91.24±32.06 seconds;P<0.05).The immediate intraoperative bleeding rate was significantly higher in the study group than in the control group(12.7%vs 4.9%,P<0.05).No instances of delayed bleeding or perforation were documented in either group.Hospitalization duration was significantly reduced in the study group(2.42±0.61 days)compared to the control group(3.21±1.02 days;P<0.05).CONCLUSION For 10-19 mm non-pedunculated colorectal polyps,CSP demonstrates operational efficiency advantages over HSP in terms of procedure time,treatment cost,and length of hospital stay.Both techniques demonstrate robust safety profiles;however,CSP is associated with a higher intraoperative bleeding rate.Clinical decision-making should incorporate individualized assessment of these factors.
文摘This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.
文摘BACKGROUND Implementing nursing interventions in patients undergoing endoscopic treatment for intestinal polyps and early stage cancer can serve as a reference for reducing the incidence of complications,accelerating the recovery process,and improving the quality of life.AIM To impact of systematic nursing intervention on recovery,complications prevention,and quality of life after endoscopic surgery for intestinal polyps.METHODS This retrospective study included 157 patients who underwent endoscopic mucosal resection or endoscopic submucosal dissection at our hospital.The patients were divided into intervention and conventional groups,with no significant differences in age,sex,or surgical methods.The intervention group received multidimensional nursing interventions,including preoperative evaluation,intraoperative cooperation,postoperative rehabilitation,psychological support and nutritional management.The conventional group received standardized care.Clinical efficacy,inflammation and infection indicators,complication rates,rehabilitation indicators,and visual analog scale(VAS)scores were compared.RESULTS On the 7th day after surgery,C-reactive protein(CRP)and white blood cell levels were lower in the intervention group than in the conventional group.Complications occurred in 9.33%of the patients in the intervention group and 23.17%in the conventional group,with significant differences in fever and abdominal distension.The intervention group had shorter first exhaust and hospitalization durations than the control group.By day 3 post-surgery,the intervention group showed lower VAS scores and reduced anxiety and depression.High-risk factors included diabetes[relative risk(RR)=2.43,95%CI:1.21-4.86],laparotomy(RR=2.86,95%CI:1.22-6.71),CRP>15 mg/L(RR=3.12,95%CI:1.54-6.33),and procalcitonin>0.5 ng/mL 1 day after surgery(RR=2.91.95%CI:1.31-6.44),while systematic nursing interventions(OR=0.40,95%CI:0.18-0.89)reduced the complication risk by 60%.CONCLUSION Multidimensional nursing interventions have clinical value in endoscopic treatment of intestinal polyps and early stage cancer,reducing complications and hospital stay.This study provides a basis for establishing patientcentered guidelines.
文摘BACKGROUND Colorectal polypectomy is fundamental to the prevention of colorectal cancer,utilizing several endoscopic techniques.Robust comparative data regarding the efficacy and safety of these modalities in clinical practice are limited.AIM To evaluate and compare the efficacy and safety of three endoscopic polypectomy techniques,namely,high-frequency electroresection(HFE),cold snare polypectomy(CSP),and endoscopic mucosal resection(EMR),for the treatment of colonic polyps.METHODS This single-center retrospective cohort study included adults who underwent endoscopic resection of pathologically confirmed colorectal polyps at Central Hospital Affiliated to Shandong First Medical University between January 2015 and December 2023.Patients were grouped by technique:HFE(n=107),CSP(n=106),and EMR(n=108).Standardized preoperative,intraoperative,and postoperative protocols were applied.Outcome measures included resection status(en bloc,R0,R1,and Rx),adverse events(immediate/delayed bleeding,perforation,and post-polypectomy coagulation syndrome),postoperative pain(visual analog scale at 1,3,and 5 hours),and 12-month recurrence rate.RESULTS Baseline demographics and polyp characteristics,except for polyp diameter,were comparable among groups.CSP achieved the highest en bloc resection rate,whereas HFE had a higher R0 resection rate.Polyp diameter was largest in the EMR group.Procedure duration was shortest with HFE.Adverse reactions were more frequent with HFE,particularly post-polypectomy bleeding and delayed perforation,whereas CSP demonstrated a superior safety profile and the lowest incidence of complications.Postoperative pain diminished in all groups over time but was consistently low for CSP and EMR.Recurrence rates were significantly higher in the EMR group vs CSP group,with HFE showing intermediate recurrence.CONCLUSION CSP offers the best safety profile and lowest recurrence rate among patients undergoing endoscopic resection of colorectal polyps,whereas HFE confers a high R0 resection rate but increased risk of adverse events.EMR remains essential for large polyps despite elevated recurrence.Technique selection should be tailored according to polyp characteristics and patient risk factors to optimize outcomes.
文摘BACKGROUND The diagnosis of gastric inflammatory fibroid polyps(IFPs)mainly depends on pathological confirmation after endoscopic or surgical treatment.Gastric IFP have typical manifestations under endoscopic ultrasonography(EUS),but atypical EUS features have also been reported.Previous studies have found that atypical features of gastric IFPs observed under EUS have corresponding histological manifestations.At present,there is no study elaborating the EUS manifestations of gastric IFPs at different pathological stages.We hypothesize that gastric IFPs at different pathological stages may have different EUS features.AIM To describe EUS features of gastric IFPs and compare with their pathological characteristics.METHODS Clinical data of 53 inpatients with pathologically diagnosed gastric IFPs after endoscopic treatment were collected.All patients underwent preoperative EUS.We analyzed the EUS characteristics of the lesions and compared with the pathological characteristics and staging of the resected specimens.RESULTS Most gastric IFPs showed medium-low echo(67.9%),homogeneous echo(90.6%),and unclear boundaries(83%),and involved the second and third layers of the gastric wall(69.8%)under EUS.The echogenicity level and echo homogeneity were significantly correlated with the pathological stage of gastric IFP.Gastric IFPs in the nodular stage presented hypoechoic and homogeneous echo.Gastric IFPs in the fibrovascular stage mostly showed medium-low echo and homogeneous echo.Gastric IFPs in the sclerotic stage showed different echogenicity levels and echo homogeneity.The accuracy of EUS in diagnosing gastric IFPs was 66.0%(35/53),and the accuracy in determining the origin layer of gastric IFPs was 73.4%(39/53).CONCLUSION Gastric IFPs at different pathological stages have different EUS features.In order to improve the diagnostic rate,it is necessary to combine EUS with EUS-guided fine-needle aspiration or artificial intelligence.
文摘Objective:To analyze the therapeutic effect of high-frequency electrosurgical knife surgery guided by painless digestive endoscopy(PDE)in elderly patients with gastrointestinal polyps(GP).Methods:A total of 100 elderly GP patients admitted between June 2021 and December 2022 were selected.Patients were randomly divided into two groups:the painless group(50 cases)underwent high-frequency electrosurgical knife surgery guided by PDE,while the conventional group(50 cases)underwent the same surgery guided by traditional digestive endoscopy(DE).The total treatment efficacy,perioperative indicators,gastrointestinal hormone levels,oxidative stress(OS)markers,and complication rates were compared between the two groups.Results:The total treatment efficacy in the painless group was higher than that in the conventional group,and perioperative indicators were superior in the painless group(P<0.05).One week after treatment,the gastrointestinal hormone levels and OS-related markers in the painless group were better than those in the conventional group(P<0.05).The complication rate in the painless group was lower than in the conventional group(P<0.05).Conclusion:High-frequency electrosurgical knife surgery guided by PDE improves the effectiveness of polyp removal in elderly GP patients and accelerates postoperative recovery.It also protects gastrointestinal function,reduces postoperative OS,and ensures higher surgical safety.
