Retrieval anchor-assisted endoscopic ultrasound-guided gastroenterostomy for gastric outlet obstruction

OBJECTIVES

Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is an emerging procedure for gastric outlet obstruction (GOO) as an alternative to endoscopic stent placement in the duodenum or surgery; however, it is technically challenging. This study aimed to evaluate the safety, success rate, and adverse events rate associated with retrieval anchor-assisted EUS-GE.

METHODS

Data from patients who underwent retrieval anchor-assisted EUS-GE for malignant and benign GOO were retrospectively analyzed. Patients' clinical and demographic characteristics, procedure time, and success and adverse event rates were recorded.

RESULTS

A total of 10 patients (6 females; mean age 63.2 ± 5.8 years) were included in our study. Nine cases were malignant and one case was benign GOO. Nine patients received retrievable anchor-assisted EUS-GE for GOO. One patient received retrievable anchor-assisted EUS-GE and concurrent EUS-guided hepatogastrostomy due to the biliary obstruction. There were no complications during any of the procedures. The rate of technical and clinical success was 100%.

CONCLUSIONS

EUS-GE is a safe and effective procedure for GOO. The retrieval anchor can make EUS-GE easier to perform successfully.

[Video endosopic inguinal lymphadenectomy for penile cancer]

Inguinal lymph node metastasis is one of the important factors affecting the prognosis of penile cancer. Conventional open inguinal lymphadenectomy, with a high rate of complications, seriously affects the effect of surgery and the patient's quality of life, and therefore is rarely employed nowadays as a treatment option. Video endosopic inguinal lymphadenectomy (VEIL), however, can significantly reduce the incidence rate of surgery-related complications, achieve a desirable control of the tumor, and markedly improve the prognosis. This review focuses on the application, development, indications, effectiveness and complications of VEIL in the treatment of penile cancer.

[Anatomic characterization of the seminal vesicle and its guiding significance in seminal vesiculoscopy]

OBJECTIVE

To gain a deeper insight into the local anatomic structures of the seminal vesicle and ejaculatory duct and provide some anatomic guidance in seminal vesiculoscopy.

METHODS

We analyzed the clinical data on 48 cases of seminal vesiculoscopy and recorded the surgical approaches to the seminal vesicle and clinical effects after operation. At the same time, we made an anatomic study of the seminal vesicle, ejaculatory duct and prostatic utricle and simulated the surgical approaches in 12 adult pelvis specimens.

RESULTS

The anatomical results accorded well with the surgical findings. The ejaculatory ducts failed to be revealed for 52.1%（25/48）, but 93.8%(45/48) of the operations were completed through different approaches into the seminal vesicle.

CONCLUSIONS

Transurethral seminal vesiculoscopy can be applied in the treatment of seminal tract and seminal vesicle diseases, but has its obvious limitations and has to be used with other strategies to achieve better results.