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| 1 | Role of colonoscopy in the diagnostic work-up of bowel endometriosis显示文摘AIM:To evaluate the accuracy of colonoscopy for the prediction of intestinal involvement in deep pelvic endometriosis.METHODS:This prospective observational study was performed between September 2011 and July 2014.Only women with both a clinical and imaging diagnosis of deep pelvic endometriosis were included.The study was approved by the local ethics committee and written informed consent was obtained in all cases.Both colonoscopy and laparoscopy were performed by expert surgeons with a high level of expertise with these techniques.Laparoscopy was performed within4 wk of colonoscopic examination.All hypothetical colonoscopy findings(eccentric wall thickening with or without surface nodularities and polypoid lesions with or without surface nodularities of endometriosis)were compared with laparoscopic and histological findings.We calculated the sensitivity,specificity,positive predictive value and negative predictive value for the presence of colonoscopic findings of intestinal endometriosis.RESULTS:A total of 174 consecutive women aged between 21-42 years with a diagnosis of deep pelvic endometriosis who underwent colonoscopy andsurgical intervention were included in our analysis.In 76 of the women(43.6%),intestinal endometrial implants were found at surgery and histopathological examination.Specifically,38 of the 76 lesions(50%)were characterized by the presence of serosal bowel nodules;28 of the 76 lesions(36.8%)reached the muscularis layer;8 of the 76 lesions(10.5%)reached the submucosa;and 2 of the 76 lesions(2.6%)reached the mucosa.Colonoscopic findings suggestive of intestinal endometriosis were detected in 7 of the174(4%)examinations.Colonoscopy failed to diagnose intestinal endometriosis in 70 of the 76 women(92.1%).A colonoscopic diagnosis of endometriosis was obtained in all cases of mucosal involvement,in 3of 8 cases(37.5%)of submucosal involvement,in no cases of muscularis layer involvement and in 1 of 38cases(2.6%)of serosa involvement.The sensitivity,specificity,positive predictive and negative predictive values of colonoscopy for the diagnosis of intestinal endometriosis were 7%,98%,85%and 58%,respectively.CONCLUSION:Being an invasive procedure,colonoscopy should not be routinely performed in the diagnostic work-up of bowel endometriosis. | Marco Milone Antonio Mollo Mario Musella Paola Maietta Loredana Maria Sosa Fernandez Olena Shatalova Alessandro Conforti Gianni Barone Giuseppe De Placido Francesco Milone | 2015 | World Journal of Gastroenterology2015，21，16： | 5 |
| 2 | Endovascular management of patients with coronary artery disease and diabetic foot syndrome: A long-term follow-up显示文摘背景将调查糖尿病的脚病人的全球冠、外部的 interventional 治疗的长期的结果。我们回顾地包括了 220 个糖尿病的病人的方法(78.5 +/- 15.8 年, 107 女性,都与 Fontaine III 或 IV 班) 被指我们糖尿病的脚症候群的中心和到 2010 年 12 月的从 2006 年 1 月的严重手足局部缺血。病人们被 interventional 心脏病专家和 diabetologists 的一个队评估以便估计伴随物的存在冠的动脉疾病(CAD ) 和对冠的 revascularization 的最终的需要。压力回响在诊断外部 angiography 前在所有病人被执行。有为冠的 angiography 的指示的病人被提交到联合诊断 angiography 然后到最终的上演外设和冠的干预。Doppler ultrasonography 和在过程前后的 transcutaneous 氧压力(TcPO2 ) 的脚 transcutaneous oximetry 象 stress-echocardiography 一样被执行并且在 1 和 6 个月并且每年联合了 cardiologic 和糖尿病的检查。结果 Stress-echocardiography 在 94/220 病人被执行并且结果在经历了的 56 个病人积极联合了冠、外部的 angiography。在 126 个病人的其余部分,联合了冠、外部的 angiography 在 35 个病人为冠的心疾病的伴随物症状直接被执行。冠的 revascularization 被判定在 85/129 病人必要并且在 13 个病人在 72 个病人并且通过手术在外部干预以后经皮地被执行。为糖尿病的脚干预,比较喜欢的途径是 ipsilateral 在 170/220 病人(77.7%) 和在 40/220 病人(18.8%) 的 contralateral 转线路的大腿骨的 antegrade 并且腿弯部后退 + 在 10/220 病人(4.5%) 的大腿骨的 antegrade。汽球 angioplasty 在 252 条腿被执行(32 个病人有的双边的疾病) :过程与溃疡在 233/252 腿(92.4%) 愈合在 TcPO2 和 ABI 在有 94.8% 的立即的成功率和重要改进的 239/252 腿是成功的。从主要切断的自由在 3.1 汣湩捩污 ? 的吝啬的后续是 82.8%? | Gianluca Rigatelli Paolo Cardaioli Fabio dell'Avvocata Massimo Giordan Giovanna Lisato Francesco Mollo | 2011 | Journal of Geriatric Cardiology2011，8，2： | 1 |
| 3 | Colorectal resection in deep pelvic endometriosis: Surgical technique and post-operative complications显示文摘AIM: To investigate the impact of different surgical techniques on post-operative complications after colorectal resection for endometriosis.METHODS: A multicenter case-controlled study using the prospectively collected data of 90 women(22 with and 68 without post-operative complications) who underwent laparoscopic colorectal resection for endometriosis was designed to evaluate any risk factors of post-operative complications. The prospectively collected data included: gender, age, body mass index, American Society of Anesthesiologists risk class, endometriosis localization(from anal verge), operative time, conversion, intraoperative complications, and post-operative surgical complications such as anastomotic dehiscence, bleeding, infection, and bowel dysfunction.RESULTS: A similar number of complicated cases have been registered for the different surgical techniques evaluated(laparoscopy, single access, flexure mobilization, mesenteric artery ligation, and transvaginal specimen extraction). A multivariate regression analysis showed that, after adjusting for major clinical, demographic, and surgical characteristics, complicated cases were only associated withendometriosis localization from the anal verge(OR = 0.8, 95%CI: 0.74-0.98, P = 0.03). After analyzing the association of post-operative complications and each different surgical technique, we found that only bowel dysfunction after surgery was associated with mesenteric artery ligation(11 out of 44 dysfunctions in the mesenteric artery ligation group vs 2 out of 36 cases in the no mesenteric artery ligation group; P = 0.03).CONCLUSION: Although further randomized clinical trials are needed to give a definitive conclusion, laparoscopic colorectal resection for deep infiltrating endometriosis appears to be both feasible and safe. Surgical technique cannot be considered a risk factor of post-operative complications. | Marco Milone Andrea Vignali Francesco Milone Giusto Pignata Ugo Elmore Mario Musella Giuseppe De Placido Antonio Mollo Loredana Maria Sosa Fernandez Guido Coretti Umberto Bracale Riccardo Rosati | 2015 | World Journal of Gastroenterology2015，21，47： | 0 |
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