ESD for colorectal neoplasia was started in our hospital in 2010. The clinical data from our hospital will be reviewed to assess the efficacy and safety of endoscopic submucosal dissection of colonic neoplasms. Methods: From July 2010 to March 2013, 39 consecutive patients with early colorectal neoplasms were treated by ESD at Yuan’s General Hospital. Size of the colonic neoplasms, en-bloc resection rate, and complication rates were compared to several published data.

In addition, lesion sizes, type of lesions, complication, and procedure time were compared between the rectal vs non-rectal lesions in our study. Results: The mean age of the patients was 65.07 ± 9.50 years, and the male-female ratio PKC412 molecular weight was 1.05 : 1. The mean tumor size was 32.5 ± 13.2 mm. The en-bloc resection rate was 87.8%, which is comparable to other studies performed in other centers. ZD1839 price Perforations during ESD occurred in 2

patients (4.87%), which is slightly higher. However this could be a skewed data due to small sample size. Postoperative bleeding occurred in 1 patient (2.43%), and no delayed perforation recorded. There were no procedure-related morbidities or mortalities. Merely half (52.17%) of the LST in non-rectal neoplasms were non-granular type. All the LST in rectum were granular type in our study. Among all the lesions occurred in rectum, 61.10% turned out to be malignant; whereas only 21.7% were malignant in the non-rectal lesions. Rectal lesions required longer procedure time for removal; 73.28+/−61.76 minutes compared with 64+/−26.37 minutes for non-rectal lesion. This could be explained by the richer vasculatures in rectum that creates difficulties technically.

Conclusion: ESD is an effective method for en-bloc resection of large early colorectal neoplasms. Even though, our center commenced to perform ESD not so long ago, we have achieved comparable colonic ESD results to in terms of efficacy and safety compared to many other centers in Asia. Key Word(s): 1. ESD; 2. Colon; Presenting Author: YAN LIU Additional Authors: YANG SHI, WEIXIANG MENG Corresponding Author: YAN LIU Affiliations: Jilin University First Hospital Gastroenterology & Endoscopy Objective: Hirschprung disease is a digestive tract malformations, the basic pathogenesis of it is the lack of ganglia cell in the large bowel wall. The absence of these ganglia cell paralyzes the involved segment leading to cramps, narrow and intestinal contents through with difficulty. Almost patients are diagnosed when there are babies and operated upon in their first year. Hirschprung’s disease is a rare condition in the adult. Methods: A 58-year-old female came to the hospital because of bellyache and abdominal distension of 4 years duration, aggravating for 4 months, accompanied by constipation, vomit and the weight is reduced about 10 Kg in one month.

[113, 114] In terms of duration of treatment, there have been contradictory reports whether the eradication rate was significantly different between

the 7-day and 14-day regimens of bismuth-containing quadruple therapy. Statement 19. A secondary regimen including two or more antibiotics that were not used in the primary regimen is recommended for H. pylori eradication in cases of eradication failure with initial bismuth-containing quadruple therapy (Fig. 3). Level of evidence C, Grade of recommendation 1 Experts’ opinions: completely agree (37.0%), mostly agree (55.6%), partially agree (7.4%), mostly disagree (0%), completely disagree (0%), not sure (0%) H. pylori eradication failure is associated with antibiotics resistance, patient compliance, H. pylori density, CagA status, and smoking. A secondary regimen must contain new antibiotics that have not been used in the primary regimen because of the possibility of resistance. https://www.selleckchem.com/products/Adriamycin.html One study showed that the expression of multidrug-resistant H. pylori increased after GSK2126458 manufacturer primary eradication.[115] Various combinations of antibiotics have been proposed

as secondary regimens.[15, 26, 39, 97] Potential combinations included sequential therapy, concomitant therapy, and triple therapy with a PPI and amoxicillin. However, sequential or concomitant therapy has limitations as a secondary regimen because studies have mostly focused on using these therapies as primary treatment. Even with such limitations, cAMP sequential or concomitant therapy is recommended as a secondary regimen because it is very difficult to create a secondary regimen in cases of H. pylori eradication failure when the primary treatment included both clarithromycin and nitroimidazole. Sequential therapy is composed of 5 days of treatment with PPI and amoxicillin, followed by another 5days of treatment with PPI, clarithromycin, and nitroimidazole (metronidazole or tinidazole). In one retrospective and six prospective randomized studies

conducted in Korea, sequential therapy had an eradication rate of 77.8–85.9% in intention-to-treat analysis, and was more effective than clarithromycin-containing triple therapy, which reported an eradication rate of 62.2–75.0%.[116-120] There are several reasons why sequential therapy has a higher eradication rate than triple therapy. First, clarithromycin-containing triple therapy has a higher eradication rate when H. pylori density is low (inoculum effect). Therefore, initial dual therapy with PPI and amoxicillin lowers H. pylori density, and likely increases the effect of subsequent triple therapy, which is composed of PPI, clarithromycin and nitroimidazole.[121] Second, H. pylori moves antibiotics outside of itself to create an efflux channel of clarithromycin and prevents antibiotics from binding to ribosomes.