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Jiang Y, Bu BL, Yang W, Zhi Y, Ye HY. Humanistic and graded psychological nursing care for patients undergoing endoscopic submucosal dissection of gastrointestinal tumors. World J Gastrointest Surg 2025; 17:100322. [DOI: 10.4240/wjgs.v17.i2.100322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 10/13/2024] [Accepted: 10/28/2024] [Indexed: 01/22/2025] Open
Abstract
BACKGROUND Endoscopic submucosal dissection (ESD) has become a widely accepted, minimally invasive treatment for gastrointestinal submucosal tumors. It has been reported that humanistic nursing care with graded psychological interventions can effectively enhance patients’ physical activity in patients, reduce postoperative complications, and improve their postoperative quality of life.
AIM To investigate the effects of combining humanistic care with graded psychological support on nursing satisfaction and quality of life in patients undergoing ESD for gastrointestinal submucosal tumors.
METHODS A retrospective analysis was conducted on the clinical data of 180 patients who underwent ESD surgery for gastrointestinal submucosal tumors at our hospital between March 2021 and February 2023. Patients were allocated into groups based on the nursing care they received: The control group, which received routine care (n = 90), and the observation group, which was subjected to humanistic nursing care in combination with graded psychological support (n = 90). Patient anxiety and depression were assessed using the self-rating anxiety scale (SAS) and self-rating depression scale (SDS). Quality of life was evaluated using the short-form 36 health survey, and additional indications such as time to first food intake, surgery duration, length of hospital stay, nursing satisfaction, and adverse reactions were also recorded. Data was analyzed using SPSS22.0, with t-tests employed for continuous variables and χ2 tests for categorical data.
RESULTS Patients in the observation group experienced significantly shorter times to first postoperative meal, surgery, and hospital stay compared to the control group. After the intervention, the SAS score of the observation group was 43.17 ± 5.68, and the SDS score was 41.57 ± 6.52, both significantly lower than those of the control group, with SAS score of 52.38 ± 5.21 and SDS score of 51.23 ± 8.25. In addition, the observation group scored significantly higher in daily living, physical function, psychological well-being, and social functioning (80.01 ± 6.39, 83.59 ± 6.89, 81.69 ± 5.34, and 85.23 ± 6.05, respectively). Moreover, the observation group also exhibited higher satisfaction and self-efficacy scores and a lower incidence of adverse reactions compared to the control group (P < 0.05).
CONCLUSION For patients undergoing ESD for gastrointestinal submucosal tumors, humanistic nursing care in combination with graded psychological nursing care significantly shorten the times to first postoperative meal, surgery, and hospital stay, effectively alleviates anxiety and depression, improves quality of life and nursing satisfaction, and mitigate the incidence of adverse reactions.
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Affiliation(s)
- Ying Jiang
- Department of Endoscopy, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua 321000, Zhejiang Province, China
| | - Bao-Lian Bu
- Department of Gastroenterology, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua 321000, Zhejiang Province, China
| | - Wei Yang
- Department of General Surgery, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua 321000, Zhejiang Province, China
| | - Yuan Zhi
- Department of Endoscopy, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua 321000, Zhejiang Province, China
| | - Hong-Yan Ye
- Department of Endoscopy, Zhejiang Jinhua Guangfu Tumor Hospital, Jinhua 321000, Zhejiang Province, China
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Zhang H, Huang Z, Zhong Y, Su S. Clinical efficacy analysis of endoscopic band electrocision ligation surgical method in the treatment of small submucosal tumors of the gastric fundus. MINIM INVASIV THER 2024:1-9. [PMID: 39392255 DOI: 10.1080/13645706.2024.2413113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 09/22/2024] [Indexed: 10/12/2024]
Abstract
BACKGROUND The aim of this study was to compare and analyze the clinical effects of endoscopic submucosal dissection (ESD) and endoscopic band electrocision ligation (EEL) in the removal of gastric submucosal tumors (SMTs). METHOD We analyzed the clinical data of 130 patients with gastrointestinal SMTs (diameter ≤10 mm) who underwent endoscopic resection, including 62 cases in the EEL group and 68 in the ESD group, and compared indicators such as surgical time, intraoperative and postoperative complications, postoperative hospital stay, and surgical cost, between the EEL and ESD group. RESULTS EEL surgery time (8.9 ± 1.1 min) was significantly shorter than the ESD group (62.3 ± 2.8 min) (p < .05), EEL surgery cost (5126.8 ± 26.5 yuan) was significantly lower than the ESD group (15721.3 ± 39.6 yuan) (p < .05), and intraoperative blood loss was also markedly lower in the EEL group (5.6 ± 1.7 ml) compared to the ESD group (42.3 ± 3.5 ml) (p < .05). There was no statistically significant difference in postoperative hospitalization time or postoperative complication incidence between the two groups (p > .05). CONCLUSIONS In treating gastric muscular, mucosal, or submucosal tumors with a diameter of less than 10 mm, the EEL surgical method was superior to the ESD surgical method in terms of surgical time, intraoperative blood loss, and cost. There was no difference in hospital stay and postoperative complication rate between the two methods, which was worthy of clinical application.
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Affiliation(s)
- Hui Zhang
- Department of Gastroenterology, The Affiliated Hexian Memorial Hospital of Southern Medical University, Guangzhou, China
| | - Zhisheng Huang
- Department of Gastroenterology, The Affiliated Hexian Memorial Hospital of Southern Medical University, Guangzhou, China
| | - Yingyun Zhong
- Department of Gastroenterology, The Affiliated Hexian Memorial Hospital of Southern Medical University, Guangzhou, China
| | - Shuguang Su
- Department of Pathology, The Affiliated Hexian Memorial Hospital of Southern Medical University, Guangzhou, China
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Tribl B. Zufallsbefunde: submuköser Tumor bei der Gastroskopie. JOURNAL FÜR GASTROENTEROLOGISCHE UND HEPATOLOGISCHE ERKRANKUNGEN 2024; 22:82-88. [DOI: 10.1007/s41971-024-00194-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/06/2024] [Indexed: 01/06/2025]
Abstract
ZusammenfassungSubmuköse Tumoren sind meist asymptomatisch und sind in der Regel ein Zufallsbefund bei der Gastroskopie. Submuköse Tumoren können aber auch symptomatisch werden im Rahmen einer gastrointestinalen Blutung bzw. durch eine Eisenmangelanämie oder aber durch Schmerzen infolge einer Obstruktion – bevorzugt an anatomischen Engstellen wie an der Cardia ventriculi oder dem Pylorus. Nur ein Teil der submukösen Tumoren benötigt eine Resektion bzw. eine Surveillance. Die Endosonographie mit der Option der Gewebegewinnung ist ein wesentlicher Bestandteil der Diagnostik und soll häufiger zur Diagnosesicherung eingesetzt werden. Es besteht die Empfehlung, nur Läsionen zu resezieren, die ein malignes Risiko haben oder Symptome verursachen.
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Li CY, Wang YF, Luo LK, Yang XJ. Present situation of minimally invasive surgical treatment for early gastric cancer. World J Gastrointest Oncol 2024; 16:1154-1165. [PMID: 38660633 PMCID: PMC11037069 DOI: 10.4251/wjgo.v16.i4.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/05/2023] [Accepted: 02/02/2024] [Indexed: 04/10/2024] Open
Abstract
Minimally invasive surgery is a kind of surgical operation, which is performed by using professional surgical instruments and equipment to inactivate, resect, repair or reconstruct the pathological changes, deformities and wounds in human body through micro-trauma or micro-approach, in order to achieve the goal of treatment, its surgical effect is equivalent to the traditional open surgery, while avoiding the morbidity of conventional surgical wounds. In addition, it also has the advantages of less trauma, less blood loss during operation, less psychological burden and quick recovery on patients, and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients. Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer (EGC): endoscopic mucosal resection (EMR), underwater EMR (UEMR), endoscopic submucosal dissection (ESD), endoscopic full-thickness resection (EFTR), endoscopic submucosal excavation (ESE), submucosal tunnel endoscopic resection), laparoscopic and endoscopic cooperative surgery (LECS); Among them, EMR, EFTR and LECS technologies have a wide range of applications and different modifications have been derived from their respective surgical operations, such as band-assisted EMR (BA-EMR), conventional EMR (CEMR), over-the-scope clip-assisted EFTR, no-touch EFTR, the inverted LECS, closed LECS, and so on. These new and improved minimally invasive surgeries are more precise, specific and effective in treating different types of EGC.
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Affiliation(s)
- Chun-Yan Li
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Yi-Feng Wang
- The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
| | - Li-Kang Luo
- The First Clinical Medicine College, Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
| | - Xiao-Jun Yang
- The First Clinical Medical School, Lanzhou University, Lanzhou 730000, Gansu Province, China
- General Surgery Clinical Centre, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
- The Second Department of General Surgery, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
- Lanzhou University People's Clinical Hospital, Lanzhou 730000, Gansu Province, China
- Gansu Research Center of Prevention and Control Project for Digestive Oncology, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
- Gansu Key Laboratory of Molecular Diagnostics and Precision Medicine for Surgical Oncology, Gansu Provincial Hospital, Lanzhou 730000, Gansu Province, China
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Wen XP, Wan QQ. Nomogram to predict gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions: Clinical significance. World J Gastrointest Endosc 2024; 16:5-10. [PMID: 38313461 PMCID: PMC10835473 DOI: 10.4253/wjge.v16.i1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/13/2023] [Accepted: 12/29/2023] [Indexed: 01/15/2024] Open
Abstract
Transoral endoscopic resections in treating upper gastrointestinal submucosal lesions have the advantages of maintaining the integrity of the gastrointestinal lumen, avoiding perforation and reducing gastrointestinal fistulae. They are becoming more widely used in clinical practice, but, they may also present a variety of complications. Gas-related complications are one of the most common, which can be left untreated if the symptoms are mild, but in severe cases, they can lead to rapid changes in the respiratory and circulatory systems in a short period, which can be life-threatening. Therefore, it is important to predict the occurrence of gas-related complications early and take preventive measures actively. Based on the authors' results in the prepublication of the article "Nomogram to predict gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions," and in conjunction with our evaluation and additions to the relevant content, radiographs may help screen patients at high risk for gas-related complications. Controlling blood glucose levels, shortening the duration of surgery, and choosing the most appropriate surgical resection may positively impact the prognosis of patients at high risk for gas-related complications during transoral endoscopic resection of upper gastrointestinal submucosal lesions.
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Affiliation(s)
- Xu-Peng Wen
- Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai 200030, China
| | - Qi-Quan Wan
- Department of Transplant Surgery, The Third Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
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Chang WJ, Tsao LC, Yen HH, Yang CW, Chang HC, Kor CT, Wu SC, Lin KH. Goldilocks principle of minimally invasive surgery for gastric subepithelial tumors. World J Gastrointest Surg 2023; 15:1629-1640. [PMID: 37701681 PMCID: PMC10494604 DOI: 10.4240/wjgs.v15.i8.1629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/06/2023] [Accepted: 07/04/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Minimally invasive surgery had been tailored to individual cases of gastric subepithelial tumors (SETs) after comparing the clinical outcomes of endoscopic resection (ER), laparoscopic resection (LR), and hybrid methods. AIM To study the use of Goldilocks principle to determine the best form of minimally invasive surgery for gastric SETs. METHODS In this retrospective study, 194 patients of gastric SETs with high probability of surgical intervention were included. All patients underwent tumor resection in the operating theater between January 2013 and December 2021. The patients were divided into two groups, ER or LR, according to the tumor characteristics and the initial intent of intervention. Few patients in the ER group required further backup laparoscopic surgery after an incomplete ER. The patients who had converted open surgery were excluded. A logistic regression model was used to assess the associations between patient characteristics and the likelihood of a treatment strategy. The area under the curve was used to assess the discriminative ability of tumor size and Youden's index to determine the optimal cut-off tumor size. RESULTS One-hundred ninety-four patients (100 in the ER group and 94 in the LR group) underwent tumor resection in the operating theater. In the ER group, 27 patients required backup laparoscopic surgery after an incomplete ER. The patients in the ER group had small tumor sizes and shorter procedure durations while the patients in the LR group had large tumor sizes, exophytic growth, malignancy, and tumors that were more often located in the middle or lower third of the stomach. Both groups had similar durations of hospital stays and a similar rate of major postoperative complications. The patients in the ER group who underwent backup surgery required longer procedures (56.4 min) and prolonged stays (2 d) compared to the patients in the LR group without the increased rate of major postoperative complications. The optimal cut-off point for the tumor size for laparoscopic surgery was 2.15 cm. CONCLUSION Multidisciplinary teamwork leads to the adoption of different strategies to yield efficient clinical outcomes according to the tumor characteristics.
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Affiliation(s)
- Wei-Jung Chang
- Department of General Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Lien-Cheng Tsao
- Department of General Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Hsu-Heng Yen
- Department of Gastroenterology, Changhua Christian Hospital, Changhua 50006, Taiwan
- General Education Center, Chienkuo Technology University, Changhua 50006, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Chia-Wei Yang
- Department of Gastroenterology, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Hung-Chi Chang
- Department of General Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Chew-Teng Kor
- Big Data Center, Changhua Christian Hospital, Changhua 50006, Taiwan
- Graduate Institute of Statistics and Information Science, National Changhua University of Education, Changhua 50007, Taiwan
| | - Szu-Chia Wu
- Transplant Medicine & Surgery Research Center, Changhua Christian Hospital, Changhua 50006, Taiwan
| | - Kuo-Hua Lin
- Department of General Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan
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Li DF, Wu BH, Wang LS. Abnormal submucosal artery mimicking submucosal tumor in the stomach: the invisible threat that lies within. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 114:61-62. [PMID: 34470454 DOI: 10.17235/reed.2021.8235/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 74-year-old male patient, who complained of abdominal distension for 1 year without previous disease history, was admitted to our hospital. Esophagogastroduodenoscopy (EGD) revealed a submucosal tumor (SMT) in the gastric body.
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Affiliation(s)
- De-Feng Li
- Gastroenterology, Shenzhen People's Hospital
| | - Ben-Hua Wu
- Gastroenterology, Shenzhen People's Hospital
| | - Li-Sheng Wang
- Gastroenterology, Shenzhen People's Hospital , China
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Sanahuja A, Segura MJ, Azorín MC, Merino V, Fernández C, Moles JR, Peña A. Endoscopic submucosal dissection with SB Knife® for treatment of a subcardial gastric leiomyoma. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2021; 113:794-796. [PMID: 33947190 DOI: 10.17235/reed.2021.7998/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Surgery has been considered the main treatment for submucosal tumors (SMTs); however, endoscopic resection is currently accepted for gastric SMTs smaller than 3cm. Endoscopic submucosal dissection (ESD) is considered the technique of choice and submucosal tunneling endoscopic resection shows successful results with low complication rate in the recent meta-analysis by Cao et al. The major limitation of these methods is the technical difficulty to be applied in certain anatomic locations.
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Affiliation(s)
- Ana Sanahuja
- Digestive Medicine, Hospital Clínico Universitario de Valencia
| | | | | | - Víctor Merino
- Digestive Medicine, Hospital Clínico Universitario de Valencia
| | | | | | - Andrés Peña
- Digestive Medicine, Hospital Clínico Universitario de Valencia
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