Objective To analyze the effect of nasopharyngeal ventilation on the detection rate of colorectal polyps in 200 middle-aged and elderly overweight patients during painless colonoscopy. Methods A total of 100 patients aged 50-75 years, body mass index (BMI) ≥24 or abdominal circumference ≥85 cm in males and ≥82 cm in females, without underlying diseases, who underwent nasopharyngeal ventilation during painless colonoscopy at physical examinations in our hospital from 2019 to 2020, were selected as the observation subjects (n = 100). The control sample area was determined by propensity matching according to the basic information characteristics presented by the observation group. 100 patients received mask oxygen at physical examinations were randomly selected in the control group (n = 100). Results The verification analysis after matching indicated that there were no intraoperative and postoperative adverse reactions, the number of intraoperative limb movements was less than 1, and the intestinal peristalsis intervals were more than 5s in both groups, without atropine intervention. Colonoscopy was performed by senior endoscopists with a withdrawal time of 6-8 min. When the intraoperative SpO2 was lower than 90% but higher than 85%, the patients in the observation group underwent nasopharyngeal ventilation while those in the control group received mask oxygen assisted chin-lift. As a result, the SpO2 was maintained higher than 90%. The detection rate of colorectal polyps was compared between the two groups. Conclusion The detection rate of colorectal polyps in the observation group was higher than that in the control group, with a statistically significant difference. It may result from the reduction of ineffective respiratory movement and intraoperative intestinal peristalsis in middle-aged and elderly overweight patients.
Papillary cystadenoma is a epithelial benign tumor of the salivary gland, most commonly in the oral cavity, head and neck. There was no difference in the sex distribution of patients, and the age of onset was 30-50 years old. The clinical manifestations are: slow growth local mass, long course of disease, some can be as long as decades, most patients have no obvious conscious symptoms, a few patients can appear local pain or distension. However, papillary cystadenoma of the esophagus is very rare, and few cases have been reported. We report a case of papillary cystadenoma of the lower esophagus and its treatment by endoscopy. The patient had no obvious complaint of discomfort. Routine gastroscopy found submucosal protuberant lesions in the lower segment of the esophagus (Figure 1), and endoscopic ultrasonography suggested cystic and solid lesions originating from the muscular layer of the esophageal mucosa, thus mesenchymal tumor was preliminarily diagnosed (Figure 2). After the exclusion of relevant contraindications, preoperative examinations were completed and the tumor was completely removed by esophageal submucosal tumor excision under endoscopy (Figure 3). Postoperative pathology indicated the tumor is papillary cystadenoma, and immunohistochemistry indicated that: CK7(+), CK(+), and basal cells of P63 (+) (Figure 4, 5). Due to the rare case, combined with the process of the diagnosis and treatment of this case, we reviewed the relevant reports on the papillary cystadenoma of the digestive tract in the past 60 years, in order to help clinicians to improve their understanding and treatments of the papillary cystadenoma.