• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Rectal neuroendocrine tumours and the role of emerging endoscopic techniques

    2023-06-09 11:42:18EoinKeatingGayleBennettMichelleMurraySineadRyanJohnAirdDonalConnorDermotTooleConorLahiff

    Eoin Keating, Gayle Bennett, Michelle A Murray, Sinead Ryan, John Aird, Donal B O'Connor, Dermot O'Toole,Conor Lahiff

    Eoin Keating, Gayle Bennett, Conor Lahiff, Department of Gastroenterology, Mater Misericordiae University Hospital, Dublin 7, Ireland

    Eoin Keating, Gayle Bennett, Michelle A Murray, John Aird, Conor Lahiff, School of Medicine,University College Dublin, Dublin 4, Ireland

    Michelle A Murray, National Lung Transplant Unit, Mater Misericordiae University Hospital,Dublin 7, Ireland

    Sinead Ryan, John Aird, Department of Pathology, Mater Misericordiae University Hospital,Dublin 7, Ireland

    Donal B O'Connor, Department of Surgery, Tallaght University Hospital, Dublin 24, Ireland

    Donal B O'Connor, Dermot O'Toole, School of Medicine, Trinity College Dublin, Dublin 2,Ireland

    Dermot O'Toole, Department of Clinical Medicine and Gastroenterology, St. James Hospital,Dublin 8, Ireland

    Abstract

    Rectal neuroendocrine tumours represent a rare colorectal tumour with a 10 fold increased prevalence due to incidental detection in the era of colorectal screening.Patient outcomes with early diagnosis are excellent. However endoscopic recognition of this lesion is variable and misdiagnosis can result in suboptimal endoscopic resection with subsequent uncertainty in relation to optimal long-term management. Endoscopic techniques have shown particular utility in managing this under-recognized neuroendocrine tumour.

    Key Words: Rectal neuroendocrine tumour; Carcinoid; Endoscopic mucosal resection;Endoscopic submucosal dissection; Knife-assisted snare resection

    INTRODUCTION

    Neuroendocrine tumours (NETs), previously described as carcinoid tumours, describes a classification of neoplastic cells originating from a neuroendocrine cell lineage. NETs can occur in multiple organ systems throughout the body and have a specific classification criteria according to the World Health Organization (WHO)[1]. These criteria include a grading of tumours based on mitotic counts and Ki-67 proliferation index (G1/G2/G3). The gastroenteropancreatic tract is the most common site for NETs(GEP-NETs), accounting for 73.7% of all NETs[2]. Overall, colonic NETs remain a rare occurrence compared to colorectal adenocarcinoma incidence rates, accounting for only 1.5% of all colorectal cancers[3].

    Rectal neuroendocrine tumours (r-NETs) are one of the most frequent sites of GEP-NETs, representing 27% of GEP-NETs and 18% of all NETs[4]. The incidence of r-NETs is estimated to have risen 10 fold over the past 4 decades, attributed to increased incidental detection during colorectal cancer screening[5]. Weinstocket al[6] demonstrated that the majority of r-NETs are asymptomatic, with only a minority reporting symptoms such as altered bowel habit (12.8%), rectal bleeding (6.4%) or unexplained weight loss (2.1%). The carcinoid syndrome of flushing or diarrhoea is rarely associated with r-NETs[7].

    The primary prognostic factor for r-NETs is driven by the disease stage at diagnosis. Five year survival for localised disease is excellent with rates of 94%-100%[8]. Regional and metastatic spread are uncommon as 75%-85% of r-NETs are localised at time of diagnosis[9]. According to the WHO grading criterion, r-NETs are predominantly G1 or G2 due to low proliferative activity.

    The risk factors for nodal involvement or metastatic disease include lymphovascular invasion,muscularis propria involvement and tumour size/grade[8-10]. Pre-resection staging with endoscopic ultrasound (EUS) or magnetic resonance imaging (MRI) is necessary to adequately assess for regional or metastatic disease. Multiple approaches to achieve R0 resection may be utilised, primarily depending on lesion size, such as endoscopic mucosal resection (EMR, band or ligation approach), endoscopic submucosal dissection (ESD), combination approaches [e.g., knife-assisted snare resection (KAR)] or surgical approaches such as transanal resection (e.g., Transanal endoscopic microsurgery) or radical resections.

    The classical described endoscopic appearance of r-NETs is of a small, typically < 20 mm, solitary nodule with a yellow coloration, embedded in the rectal submucosa. However, the correct endoscopic diagnosis of r-NET is not always achieved by the endoscopist, demonstrated by Fineet al[11], to be as low as 18%. As prognosis in r-NETs is dependent on the appropriate resection method, lack of recognition may result in a compromised initial resection, affecting patient prognosis.

    PLANNED RECTAL NEUROENDOCRINE TUMOUR MANAGEMENT

    Endoscopic diagnosis and inspection of r-NETs

    The standard description of an r-NET at endoscopy is of a solitary nodular structure, appearing to be embedded in the normal rectal mucosa, and most often associated with a yellow coloration. r-NETs can be endoscopically differentiated from rectal adenomas by the presence of overlying normal rectal mucosa. The majority of r-NETs are < 20 mm in size[6] and increasing tumour size is also associated with increased risk of metastasis, especially once size exceeds 20 mm[12]. Lesion size is thus a primary consideration in planning excision strategies.

    However, metastatic disease has been confirmed in small r-NETs of < 10 mm diameter[13], indicating that tumour size cannot be used in isolation. Therefore close inspection of the surface mucosa at endoscopy is required as the presence of overlying ulceration, depression or erosions is also associated with tumour metastasis[14].

    Pre-intervention management

    If r-NET is suspected at time of endoscopy, the European Neuroendocrine Tumour Society (ENETS)guidelines, published in 2012 and revised in 2016, recommends completing a pre-intervention workup with a rectal EUS to establish tumour size, tumour depth (including involvement of muscularis propria)and evidence of lymphovascular involvement[5,9,15]. EUS accuracy of tumour depth is high, with rates of 91-100% correlation with post-resection findings reported[16,17]. Accurate, pre-intervention EUS is therefore essential in determining r-NET stage and selection of optimal resection strategy.

    r-NETs of > 10 mm in size are also recommended to undergo MRI pelvis examination to assess for muscularis propria invasion and lymphovascular involvement. If muscularis propria involvement or nodal positivity is confirmed, a surgical approach with anterior resection and total mesenteric excision is recommended[9].

    Beyond a lesion size of 20 mm, the risk of r-NET metastasis is significant and evaluation with CT thorax, abdomen and pelvis, in addition to MRI pelvis is required, prior to surgical management[8,9].

    Endoscopic resection approaches

    As outlined above, resection approach for r-NETs depends on accurate assessment of size, grade (if biopsies completed) and locoregional involvement. Complete excision of r-NETs < 10 mm is considered the gold standard and can be safely achieved using advanced endoscopic techniques[5,8].

    Strategies to excise r-NETs of 10-19 mm in size have not reached consensus acceptance and there are no comparative studies of endoscopic resectionvssurgical outcomes for this size cohort[9,15,18]. The requirement for a general anaesthetic for surgical approaches such as transanal endoscopic microsurgery may favour advanced endoscopic techniques in a selection of patients. A metastatic risk of 10%-15% is quoted for this category[10]. Therefore, a case-by-case strategy may be required for r-NETs 10-19 mm in size, based on patient characteristics (e.g., comorbidities), in addition to the EUS and/or MRI findings predicting potential locoregional spread or metastatic disease.

    The ENETS 2012 guideline stipulates that the only guaranteed curative option is complete resection in a localised lesion[9]. Pathological interpretation of r-NET margin clearance is therefore of primary importance to determine risk of locoregional spread. En-bloc resections are preferential to piecemeal resection to aid pathological assessment. The goal of achieving en-bloc pathology specimens influences the choice of advanced endoscopic technique employed to resect the r-NET (Table 1).

    Table 1 Endoscopic techniques for rectal neuroendocrine tumour resection

    EMR

    EMR is widely used in the safe and successful resection of large non-pedunculated colorectal polyps(LNPCPs) by Western endoscopists[19]. Conventional EMR (C-EMR) en-bloc resection rates in Western centres, across all polyp sizes, approach 35%[20]. En-bloc resections have significantly lower rates of recurrence over piecemeal EMR[21]. In relation to r-NETs therefore, caution must be exercised in lesion assessment, to ensure that an en-bloc resection is feasible.

    C-EMR

    The ENETS guidelines endorse the use of C-EMR for r-NET lesions < 10 mm in size, once muscularis propria involvement has been out ruled with rectal EUS[15]. However, Nakamuraet al[22] demonstrated that C-EMR had complete resection rates of 36.4% and curative resection rates of only 27.3%.

    Modified EMR

    In the same Nakamura study, modified EMR (M-EMR) strategies such as band ligation EMR or cap assisted EMR achieved significantly higher complete resection and curative resection rates, 88.0% and 69.4% respectively. Additionally, M-EMR achieved a 100% en-bloc resection rate. While this study was limited by a small number of EMRs (n= 11), its results are consistent with other studies regarding EMR resection of r-NETs outcomes and support the use of M-EMR over C-EMR for resection of r-NETs < 10 mm.

    With regard to cap-assisted EMR (EMR-C), it is superior to EMR in complete histologic resection rates(94.1%vs76.8%) without significant additional perforation or bleeding risks[23]. Similarly for band ligation EMR, complete resection rates outperform C-EMR, 93.3%vs65.5% respectively, again without additional procedural times or complication rates[24].

    M-EMR is restricted in its use to lesions < 10 mm in size, due to the specifications of the band or cap diameter of the equipment. M-EMR outcomes, for r-NETs < 10 mm in diameter, approach the resection results of ESD[5], and may be more accessible to Western endoscopists who lack suitable ESD exposure.A recent Japanese study demonstrated superior M-EMR complete resection rates and lower recurrence ratesvsESD, but this did not reach significance[25]. Yanget al[23] have also demonstrated that EMR-C histologic resection rates approach those of ESD (94.1%vs93.8%) , but again, this did not reach significance.

    The ENETS 2016 guidelines, factoring the improved en-bloc resection rates, recommend M-EMR, and specifically band ligation EMR, for r-NET resections of lesions < 10 mm[15].

    ESD

    ESD uses an endoscopically deployed thermal-knife to dissect the submucosal plane, facilitating en-bloc resection and aiding pathological interpretation. ESD was pioneered in Japan for the resection of gastric neoplasia and consequently, there are significant differences in the R0 outcomes and exposure to ESD practice between Asian and non-Asian countries[26].

    ESD affords excellent r-NET en-bloc resection rates ranging from 98.2% to 100% and high R0 resection rates (90.38%-90.9%) for lesions < 20 mm[27,28]. Due to these superior outcomes, systematic reviews have recommended ESD over EMR for the resection of r-NETs < 10 mm and for ESD consideration in lesions < 20 mm[27,29].

    Analysing the utility of ESD, there are several limitations to consider. Colonic ESD for LNPCPs is associated with higher complication rates including perforation and post-polypectomy bleeding (PPB)when compared to EMR[30]. Specifically considering r-NETs, there is a non-significant trend towards perforation and PPB but this is limited by small sample sizes[31]. Increased endoscopist experience is associated with a reduction in ESD complication rates[27]. Another consistent limitation of ESD is the increased procedural time requiredvsEMR[29,31].

    Chenet al[27] also highlighted the coagulation or burn effect on normal tissues at time of ESD and potential effects on R0 pathologic interpretation. To counter this phenomenon, Yoshiiet al[32]demonstrated an “underwater” ESD approach which afforded a heat sink effect, successfully limiting burn artefact.

    Hybrid technique-KAR

    ESD requires extensive training and procedural exposure to perform safely and effectively with a significant learning curve[33]. As demonstrated above, ESD outcomes differ between Asian and non-Asian endoscopists. Attempting to accelerate the learning curve of ESD for Western endoscopists has led to the development of a hybrid technique, combining familiar EMR practices with elements of ESD.

    KAR described by Bhattacharyaet alin the resection of LNPCPs incorporates standard submucosal injection, followed by circumferential submucosal dissection[34]. Once a circumferential margin has been established, a snare is deployed to facilitate en-bloc resection. The study achieved a 53% en- bloc resection rate in polyps < 50 mm in size and demonstrated a recurrence rate of 4.3% for en-bloc specimens. The KAR technique was subsequently shown to be effective in the management of scarred polyps with previous EMR[35].

    Lisottiet al[36] applied the KAR technique for two < 5 mm r-NETs in a case series, successfully achieving en-bloc resections and negative resection margins. The following case report from our institution further illustrates the utility of KAR in this context.

    We present the case of a 33-year-old male with a background history of cystic fibrosis, referred for consideration for lung transplantation. During a pre-transplantation screening colonoscopy at a local hospital a 6mm submucosal lesion was identified 3 cm above the anorectal junction (Figure 1A). Reevaluation at our institution included EUS, which confirmed a hypoechoic, homogenous, well circumscribed lesion, arising from the submucosa and consistent with a r-NET (Figure 1B). Submucosal injection (gelofusion and methylene blue) was followed by hybrid KAR to successfully achieve en-bloc resection (Figure 1C and D). Histopathological examination confirmed a grade 1, well-differentiated neuroendocrine tumour, with no evidence of lymphovascular involvement and negative margins(Figure 1F). After multidisciplinary discussion, and corresponding to 2012 ENETs guidelines on subcentimetre r-NETs, surveillance was not considered necessary for this 6mm lesion and the patient has been listed for transplantation.

    Figure 1 Case of a 33-year-old male with a background history of cystic fibrosis, referred for consideration for lung transplantation. A:Endoscopic image of 6mm rectal neuroendocrine tumour (r-NRT) in retroflexion, 3 cm from anal verge; B: Endoscopic ultrasound images of the same 6 mm hypoechoic homogenous lesion, seen at 10 MHz frequency, consistent with a NET; C: Endoscopic image of hybrid Knife assisted snare resection approach; post circumferential submucosal incision; D: Endoscopic image of post en-bloc knife-assisted snare resection site in retroflexion; E: Excised en-bloc r-NET specimen; F:Neuroendocrine tumour composed of neuroendocrine cells arranged in anastomosing trabeculae with overlying rectal mucosa. The tumour is well circumscribed and has been excised (haematoxylin and eosin stain, 20× magnification).

    Surveillance post resection

    ENETS guidelines for surveillance post r-NET resection are determined by size, in addition to mitotic grade[9]. Follow-up modalities recommended include colonoscopy, rectal EUS and cross sectional imaging. G1 or G2 r-NETS, < 10 mm in size, with no evidence of lymphovascular invasion or muscularis propria involvement are not recommended for follow-up at present. All r-NETs 10-20 mm require annual endoscopic follow up. r-NETs > 20 mm require intensive follow-up due to the risk of metastasis.

    The surveillance guidelines have generated debate, particularly for r-NETs of <10mm in diameter.The reported metastatic risk of these small r-NETs has varied from 0% to 10%[16,37,38]. Holingaet al[38], proposed an intensive EUS surveillance programme at 3 mo post resection, in addition to 6 moly EUS for the 3 years post resection.

    MANAGEMENT OF INCIDENTAL OR UNRECOGNISED R-NETS

    Prevalence

    Fineet al[11] confirmed that the real time endoscopic recognition of r-NETs is low at only 18%. Of 284 unsuspected r-NETs in the French study, 190 (67%) underwent attempted resection, primarily by standard polypectomy (n= 148/190, 78%)[11]. The successful R0 resection rate for patients who underwent polypectomy at initial colonoscopy was only 17%. As the prognosis of r-NETs depends on the successful complete excision of the lesion, salvage therapies such as EMR, ESD or trans-anal endoscopic microsurgery were required.

    Surveillance

    The retrospective diagnosis of r-NET poses a challenge in determining appropriate surveillance.Polypectomy or piecemeal EMR are often associated with R1 pathology as well as difficulty assessing for lymphovascular invasion, a key factor in surveillance algorithms. Therefore, appropriate surveillance for these cases is yet to be determined and results in local variation in practice. Such difficulties can largely be avoided by accurate index endoscopic assessment.

    CONCLUSION

    Rectal neuroendocrine tumours represent a rare colorectal tumour, with increasing prevalence due to incidental diagnosis during standard colorectal screening. Accurate endoscopic recognition rates of r-NETs are disappointing and the area requires increased focus in endoscopy training to improve specificity. Endoscopist education on the differentiation of rectal adenomas from r-NETs is a priority in this regard. Management strategies for diagnosed r-NETS are well established. Advanced endoscopic resection techniques have resulted in improved outcomes and can be an effective alternative for surgical resection for intermediate (10-19 mm) r-NETs but further studies are required. Newer techniques such as KAR may be valuable but require further study. International surveillance guidelines are clear but adherence to guidelines is variable and need to be more consistently applied.

    FOOTNOTES

    Author contributions:Keating E designed and drafted the original manuscript and reviewed all subsequent and final drafts. Ryan S and Aird J, curated the pathological specimen and provided pathological comment. Bennett G,Murray. M, O’Connor D and O’Toole D reviewed the draft and final manuscripts. Lahiff C designed and reviewed the original manuscript and all subsequent drafts, including the final draft.

    Conflict-of-interest statement:The authors declare no conflict of interests for this mini-review article.

    Open-Access:This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BYNC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is noncommercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

    Country/Territory of origin:Ireland

    ORCID number:Eoin Keating 0000-0002-1466-8752.

    S-Editor:Zhang H

    L-Editor:A

    P-Editor:Cai YX

    一级黄色大片毛片| 12—13女人毛片做爰片一| 精品国产一区二区久久| 久久女婷五月综合色啪小说| 亚洲精品中文字幕在线视频| 亚洲精品av麻豆狂野| 成人三级做爰电影| 一区在线观看完整版| 久久毛片免费看一区二区三区| 妹子高潮喷水视频| 国产av国产精品国产| 夫妻午夜视频| 纵有疾风起免费观看全集完整版| 久久女婷五月综合色啪小说| 少妇被粗大的猛进出69影院| 精品亚洲乱码少妇综合久久| www日本在线高清视频| 欧美精品人与动牲交sv欧美| 性色av一级| 亚洲av日韩在线播放| 国产又爽黄色视频| 国产高清视频在线播放一区 | avwww免费| 精品亚洲乱码少妇综合久久| 亚洲精品中文字幕在线视频| 老司机在亚洲福利影院| 99久久99久久久精品蜜桃| 亚洲av电影在线观看一区二区三区| 成年女人毛片免费观看观看9 | 国产福利在线免费观看视频| 日本黄色日本黄色录像| 国产又色又爽无遮挡免| 国产精品久久久av美女十八| 飞空精品影院首页| 国产视频一区二区在线看| 美国免费a级毛片| 真人做人爱边吃奶动态| 久久久久久久精品精品| 亚洲国产中文字幕在线视频| 久久这里只有精品19| 两性夫妻黄色片| 麻豆av在线久日| 日韩欧美免费精品| 亚洲精品粉嫩美女一区| 国产免费av片在线观看野外av| 亚洲国产毛片av蜜桃av| 好男人电影高清在线观看| 免费在线观看影片大全网站| 在线 av 中文字幕| 真人做人爱边吃奶动态| 黑人欧美特级aaaaaa片| 夫妻午夜视频| 婷婷丁香在线五月| 日本撒尿小便嘘嘘汇集6| 欧美日韩一级在线毛片| 国产av又大| 亚洲一区二区三区欧美精品| 国产伦人伦偷精品视频| 19禁男女啪啪无遮挡网站| 热99久久久久精品小说推荐| 国产精品麻豆人妻色哟哟久久| 自线自在国产av| 欧美日韩亚洲高清精品| 777久久人妻少妇嫩草av网站| 黄色视频在线播放观看不卡| 不卡av一区二区三区| 99九九在线精品视频| 91精品国产国语对白视频| 天堂8中文在线网| 高清在线国产一区| 国产亚洲午夜精品一区二区久久| 女警被强在线播放| 午夜精品久久久久久毛片777| 大香蕉久久成人网| 丝袜人妻中文字幕| 一级,二级,三级黄色视频| 欧美在线一区亚洲| 国产免费福利视频在线观看| 亚洲九九香蕉| 老司机影院毛片| 女人久久www免费人成看片| 久久久水蜜桃国产精品网| 亚洲成人国产一区在线观看| 久久精品aⅴ一区二区三区四区| 精品国产一区二区三区四区第35| 91成人精品电影| 国产野战对白在线观看| 久久人人97超碰香蕉20202| 国产精品一二三区在线看| 黑人巨大精品欧美一区二区mp4| 老熟妇乱子伦视频在线观看 | 午夜激情av网站| 国产在视频线精品| 大片电影免费在线观看免费| 亚洲五月婷婷丁香| 俄罗斯特黄特色一大片| 午夜福利免费观看在线| 国产精品二区激情视频| 亚洲第一青青草原| 人人妻人人爽人人添夜夜欢视频| 免费在线观看完整版高清| 18禁国产床啪视频网站| 国产伦理片在线播放av一区| 亚洲,欧美精品.| 久久久精品免费免费高清| 午夜免费观看性视频| av欧美777| 午夜福利一区二区在线看| 日韩视频在线欧美| 午夜免费观看性视频| 日韩欧美一区二区三区在线观看 | 国产男女超爽视频在线观看| 国产免费现黄频在线看| 一个人免费在线观看的高清视频 | tocl精华| 欧美精品一区二区免费开放| 日韩有码中文字幕| 亚洲伊人久久精品综合| 99热网站在线观看| av又黄又爽大尺度在线免费看| 嫁个100分男人电影在线观看| 精品少妇黑人巨大在线播放| 一二三四社区在线视频社区8| 国产一区二区三区综合在线观看| 亚洲精品国产精品久久久不卡| 国产三级黄色录像| 日韩,欧美,国产一区二区三区| 19禁男女啪啪无遮挡网站| 成在线人永久免费视频| 国产av精品麻豆| 国产亚洲精品久久久久5区| 国产免费福利视频在线观看| 老鸭窝网址在线观看| 亚洲精品久久久久久婷婷小说| 国产av又大| 亚洲国产av新网站| 爱豆传媒免费全集在线观看| 91麻豆av在线| 丰满人妻熟妇乱又伦精品不卡| 天堂8中文在线网| 精品少妇久久久久久888优播| 美女福利国产在线| 亚洲欧美清纯卡通| 亚洲一区中文字幕在线| 97精品久久久久久久久久精品| 老汉色∧v一级毛片| 99国产极品粉嫩在线观看| 国产日韩欧美亚洲二区| avwww免费| 亚洲av美国av| 国产成人精品在线电影| 亚洲精品中文字幕一二三四区 | 美女脱内裤让男人舔精品视频| 欧美日韩亚洲综合一区二区三区_| 中亚洲国语对白在线视频| 精品乱码久久久久久99久播| 国产欧美日韩精品亚洲av| 成在线人永久免费视频| 男女下面插进去视频免费观看| 国产成人影院久久av| 麻豆国产av国片精品| 极品人妻少妇av视频| 欧美日韩亚洲国产一区二区在线观看 | cao死你这个sao货| 免费看十八禁软件| 最黄视频免费看| 桃花免费在线播放| www.熟女人妻精品国产| 高潮久久久久久久久久久不卡| 99国产精品99久久久久| 曰老女人黄片| 欧美日韩黄片免| 涩涩av久久男人的天堂| 无遮挡黄片免费观看| 久久天堂一区二区三区四区| 99re6热这里在线精品视频| 精品国产乱码久久久久久男人| 大型av网站在线播放| 最黄视频免费看| 桃花免费在线播放| 欧美精品av麻豆av| 91精品国产国语对白视频| 免费日韩欧美在线观看| 一区二区三区激情视频| 91字幕亚洲| 日韩 欧美 亚洲 中文字幕| 高清视频免费观看一区二区| 90打野战视频偷拍视频| 久久久久久久久久久久大奶| 最新的欧美精品一区二区| 99香蕉大伊视频| 一本色道久久久久久精品综合| www.熟女人妻精品国产| 久久 成人 亚洲| 欧美激情久久久久久爽电影 | www.自偷自拍.com| 99国产极品粉嫩在线观看| 日韩欧美一区二区三区在线观看 | 亚洲色图综合在线观看| 精品第一国产精品| 久久精品国产综合久久久| 黄色视频在线播放观看不卡| 伊人久久大香线蕉亚洲五| 巨乳人妻的诱惑在线观看| 99国产精品免费福利视频| 中文字幕人妻丝袜制服| 免费人妻精品一区二区三区视频| 色婷婷av一区二区三区视频| 高清在线国产一区| 精品少妇内射三级| 精品少妇一区二区三区视频日本电影| 女人高潮潮喷娇喘18禁视频| 久久毛片免费看一区二区三区| 亚洲av国产av综合av卡| 午夜激情久久久久久久| 亚洲欧美清纯卡通| 啦啦啦啦在线视频资源| 欧美av亚洲av综合av国产av| 一二三四社区在线视频社区8| 狠狠婷婷综合久久久久久88av| 如日韩欧美国产精品一区二区三区| 少妇人妻久久综合中文| 亚洲av电影在线观看一区二区三区| 9191精品国产免费久久| 在线观看www视频免费| 亚洲国产毛片av蜜桃av| 十八禁网站网址无遮挡| 欧美在线一区亚洲| 国产极品粉嫩免费观看在线| 国产精品 欧美亚洲| 黄色怎么调成土黄色| 老熟妇乱子伦视频在线观看 | 热99久久久久精品小说推荐| 久久中文字幕一级| 两性夫妻黄色片| 成人三级做爰电影| 黄色毛片三级朝国网站| 欧美日韩av久久| 久久久国产欧美日韩av| 亚洲男人天堂网一区| 国产免费福利视频在线观看| 午夜精品久久久久久毛片777| 免费av中文字幕在线| 午夜福利视频精品| 99热全是精品| 美女中出高潮动态图| 亚洲中文av在线| 在线观看免费日韩欧美大片| 日韩制服骚丝袜av| 精品一区二区三区av网在线观看 | 日本撒尿小便嘘嘘汇集6| xxxhd国产人妻xxx| 一级黄色大片毛片| 女人高潮潮喷娇喘18禁视频| 国产欧美日韩精品亚洲av| a级毛片在线看网站| 午夜成年电影在线免费观看| 亚洲精品在线美女| 欧美日韩中文字幕国产精品一区二区三区 | 男人爽女人下面视频在线观看| 国产野战对白在线观看| 高清黄色对白视频在线免费看| 国产人伦9x9x在线观看| 午夜两性在线视频| 国产不卡av网站在线观看| 18在线观看网站| 亚洲精品久久午夜乱码| 欧美 日韩 精品 国产| 国产精品久久久人人做人人爽| 90打野战视频偷拍视频| 中文欧美无线码| 免费久久久久久久精品成人欧美视频| 99久久99久久久精品蜜桃| 免费在线观看影片大全网站| 久久精品国产亚洲av香蕉五月 | 王馨瑶露胸无遮挡在线观看| 亚洲精品成人av观看孕妇| 国产精品久久久av美女十八| 人人妻人人澡人人爽人人夜夜| 美女主播在线视频| 我的亚洲天堂| 久热爱精品视频在线9| 亚洲成人免费av在线播放| av有码第一页| 成人手机av| 正在播放国产对白刺激| 亚洲午夜精品一区,二区,三区| 国产在线一区二区三区精| 国产在线视频一区二区| 汤姆久久久久久久影院中文字幕| 久久久国产一区二区| 色婷婷久久久亚洲欧美| 欧美在线黄色| 久久中文字幕一级| 精品国产一区二区久久| 日日爽夜夜爽网站| 久久久久久免费高清国产稀缺| 欧美黑人精品巨大| 大型av网站在线播放| 久久久久国产一级毛片高清牌| 国产成人精品久久二区二区免费| 999精品在线视频| 欧美黄色片欧美黄色片| 这个男人来自地球电影免费观看| 成人三级做爰电影| 热99国产精品久久久久久7| 97在线人人人人妻| 女人久久www免费人成看片| 亚洲色图 男人天堂 中文字幕| av一本久久久久| 9热在线视频观看99| 国产又爽黄色视频| 久久人妻福利社区极品人妻图片| 精品久久久久久电影网| 他把我摸到了高潮在线观看 | 精品国产一区二区三区久久久樱花| 亚洲欧美成人综合另类久久久| 亚洲第一欧美日韩一区二区三区 | 又大又爽又粗| 亚洲欧洲日产国产| 亚洲欧美一区二区三区久久| 亚洲专区中文字幕在线| 大香蕉久久网| 精品国产一区二区久久| 又黄又粗又硬又大视频| 精品亚洲成a人片在线观看| 成人免费观看视频高清| 18禁黄网站禁片午夜丰满| 91精品国产国语对白视频| 中文字幕制服av| 亚洲男人天堂网一区| tocl精华| 国产av国产精品国产| 免费在线观看影片大全网站| 国产一区二区激情短视频 | 欧美成人午夜精品| 久久精品aⅴ一区二区三区四区| 1024视频免费在线观看| 久久人人爽av亚洲精品天堂| 国产精品一二三区在线看| 老汉色av国产亚洲站长工具| 国产精品成人在线| 国产日韩一区二区三区精品不卡| 12—13女人毛片做爰片一| 国产成人精品在线电影| 夜夜夜夜夜久久久久| 两性午夜刺激爽爽歪歪视频在线观看 | 亚洲av日韩在线播放| 久久久久国产一级毛片高清牌| 岛国在线观看网站| 在线观看免费视频网站a站| 欧美在线一区亚洲| svipshipincom国产片| 少妇 在线观看| 亚洲国产精品999| 麻豆国产av国片精品| 黑人操中国人逼视频| 免费少妇av软件| 亚洲国产欧美一区二区综合| 黄色a级毛片大全视频| 丝袜在线中文字幕| 国产一区二区三区综合在线观看| 免费观看a级毛片全部| 国产成人精品久久二区二区免费| 精品亚洲成a人片在线观看| 国产免费福利视频在线观看| 国产精品免费大片| 久久国产精品影院| 91精品三级在线观看| 人人妻人人澡人人看| 99九九在线精品视频| 女人高潮潮喷娇喘18禁视频| 免费观看人在逋| 欧美中文综合在线视频| 麻豆乱淫一区二区| 99re6热这里在线精品视频| 国产欧美日韩一区二区精品| 亚洲av片天天在线观看| 久久久国产欧美日韩av| 精品福利永久在线观看| 国产成人av激情在线播放| 成人国产一区最新在线观看| 精品国产一区二区三区久久久樱花| 国产成人免费观看mmmm| 色婷婷久久久亚洲欧美| 久久久欧美国产精品| 如日韩欧美国产精品一区二区三区| 亚洲成人手机| 青春草视频在线免费观看| 亚洲一卡2卡3卡4卡5卡精品中文| 男人爽女人下面视频在线观看| 国产一区二区激情短视频 | 亚洲第一av免费看| 女警被强在线播放| 国产精品国产三级国产专区5o| 亚洲欧美精品自产自拍| 脱女人内裤的视频| 日韩精品免费视频一区二区三区| 中亚洲国语对白在线视频| 国产一区二区 视频在线| 亚洲 国产 在线| 永久免费av网站大全| 9色porny在线观看| 99久久人妻综合| 国产福利在线免费观看视频| 成人18禁高潮啪啪吃奶动态图| 纯流量卡能插随身wifi吗| 午夜福利在线免费观看网站| 日韩中文字幕视频在线看片| 亚洲五月色婷婷综合| 久久久水蜜桃国产精品网| 爱豆传媒免费全集在线观看| 亚洲精品成人av观看孕妇| 欧美日韩中文字幕国产精品一区二区三区 | 亚洲伊人久久精品综合| 岛国在线观看网站| 中文字幕人妻丝袜一区二区| 色婷婷av一区二区三区视频| 免费久久久久久久精品成人欧美视频| 免费一级毛片在线播放高清视频 | 欧美另类亚洲清纯唯美| 妹子高潮喷水视频| 美女脱内裤让男人舔精品视频| 国产激情久久老熟女| 在线亚洲精品国产二区图片欧美| 亚洲欧美精品自产自拍| 黄色怎么调成土黄色| 国产日韩欧美在线精品| 中文欧美无线码| 国产免费一区二区三区四区乱码| 国产av一区二区精品久久| 精品熟女少妇八av免费久了| 热99国产精品久久久久久7| 欧美黄色片欧美黄色片| 亚洲国产av新网站| 欧美日韩av久久| 亚洲精品美女久久av网站| 可以免费在线观看a视频的电影网站| 侵犯人妻中文字幕一二三四区| 日韩熟女老妇一区二区性免费视频| 国产男女内射视频| 老熟妇仑乱视频hdxx| 久久99一区二区三区| 精品一区二区三区av网在线观看 | 亚洲中文日韩欧美视频| 亚洲精品久久成人aⅴ小说| 国产av又大| www日本在线高清视频| www.999成人在线观看| 性少妇av在线| 国产日韩欧美视频二区| 叶爱在线成人免费视频播放| 制服人妻中文乱码| 国产亚洲av片在线观看秒播厂| 国产黄频视频在线观看| 国产亚洲精品一区二区www | 欧美少妇被猛烈插入视频| www.自偷自拍.com| 又大又爽又粗| 午夜福利影视在线免费观看| 人人妻人人爽人人添夜夜欢视频| 精品久久蜜臀av无| 飞空精品影院首页| 国产精品久久久久久人妻精品电影 | 狠狠婷婷综合久久久久久88av| 淫妇啪啪啪对白视频 | 性色av乱码一区二区三区2| 国产一区二区 视频在线| 天天影视国产精品| av福利片在线| 亚洲精品一卡2卡三卡4卡5卡 | 国产极品粉嫩免费观看在线| 丝袜脚勾引网站| 欧美日韩中文字幕国产精品一区二区三区 | 亚洲欧洲精品一区二区精品久久久| 十八禁高潮呻吟视频| 亚洲精品日韩在线中文字幕| 精品卡一卡二卡四卡免费| 亚洲成人国产一区在线观看| 国产97色在线日韩免费| 999久久久精品免费观看国产| 在线看a的网站| 免费一级毛片在线播放高清视频 | 两个人看的免费小视频| 免费少妇av软件| 老司机午夜十八禁免费视频| 婷婷色av中文字幕| 母亲3免费完整高清在线观看| 亚洲欧美一区二区三区久久| 亚洲av美国av| 欧美日韩亚洲国产一区二区在线观看 | 狠狠精品人妻久久久久久综合| 亚洲精品自拍成人| 精品久久久精品久久久| 国产在线视频一区二区| 一级毛片电影观看| 精品亚洲成国产av| 欧美日韩一级在线毛片| 欧美成人午夜精品| 大型av网站在线播放| 丝袜美足系列| 亚洲成av片中文字幕在线观看| av在线app专区| 91国产中文字幕| 免费日韩欧美在线观看| 成人亚洲精品一区在线观看| 国产精品一区二区在线不卡| 国产在线观看jvid| 日本vs欧美在线观看视频| 国产成人欧美| 国产精品偷伦视频观看了| 亚洲自偷自拍图片 自拍| 亚洲国产日韩一区二区| 欧美少妇被猛烈插入视频| 国产精品久久久av美女十八| 天天添夜夜摸| 久久精品亚洲av国产电影网| 国产老妇伦熟女老妇高清| 美女高潮喷水抽搐中文字幕| 99精品久久久久人妻精品| 亚洲专区国产一区二区| 午夜老司机福利片| 国产精品久久久久久精品古装| 国产精品久久久久久人妻精品电影 | 1024视频免费在线观看| 亚洲va日本ⅴa欧美va伊人久久 | 午夜精品久久久久久毛片777| 亚洲精品成人av观看孕妇| 国产成人精品无人区| av电影中文网址| 亚洲av日韩精品久久久久久密| 久久久久久久精品精品| 欧美黄色片欧美黄色片| 国产高清videossex| 在线观看一区二区三区激情| 国产成人av教育| 建设人人有责人人尽责人人享有的| 老鸭窝网址在线观看| www日本在线高清视频| 久久人妻福利社区极品人妻图片| 91精品伊人久久大香线蕉| 日本精品一区二区三区蜜桃| 国产精品一区二区在线不卡| 热99久久久久精品小说推荐| www.精华液| 国产xxxxx性猛交| 色婷婷av一区二区三区视频| 日韩欧美国产一区二区入口| 精品熟女少妇八av免费久了| 亚洲国产成人一精品久久久| 午夜精品久久久久久毛片777| 亚洲成国产人片在线观看| 狠狠精品人妻久久久久久综合| 久久香蕉激情| 久久久久久久大尺度免费视频| 欧美日韩视频精品一区| 久久人人爽人人片av| 一级,二级,三级黄色视频| 午夜激情av网站| a级毛片在线看网站| 国产精品免费视频内射| av网站免费在线观看视频| 夜夜骑夜夜射夜夜干| 叶爱在线成人免费视频播放| 在线观看免费高清a一片| 国产在线免费精品| 啦啦啦在线免费观看视频4| 久久久水蜜桃国产精品网| 亚洲精品av麻豆狂野| 91精品三级在线观看| 青青草视频在线视频观看| 1024香蕉在线观看| 丰满人妻熟妇乱又伦精品不卡| 亚洲精品久久成人aⅴ小说| 午夜激情久久久久久久| 国产精品香港三级国产av潘金莲| 99久久精品国产亚洲精品| 亚洲av成人不卡在线观看播放网 | 国产视频一区二区在线看| 视频在线观看一区二区三区| 亚洲精品成人av观看孕妇| 丝袜人妻中文字幕| 欧美成人午夜精品| 久久性视频一级片| 热re99久久精品国产66热6| 欧美日韩视频精品一区| 久久久久久久大尺度免费视频| 国产极品粉嫩免费观看在线| 嫩草影视91久久| av片东京热男人的天堂| av天堂在线播放| 最新在线观看一区二区三区| 欧美av亚洲av综合av国产av| 91麻豆av在线| 午夜福利乱码中文字幕| 熟女少妇亚洲综合色aaa.| 日韩欧美一区二区三区在线观看 | 999久久久精品免费观看国产| 国产av又大| 亚洲精品国产av蜜桃| 极品人妻少妇av视频| 天天躁狠狠躁夜夜躁狠狠躁| av片东京热男人的天堂| 国产一区有黄有色的免费视频| 高清av免费在线| 亚洲精品一二三| 精品国内亚洲2022精品成人 | 国产一区二区在线观看av| tube8黄色片| 免费久久久久久久精品成人欧美视频| 久久毛片免费看一区二区三区| 黄片播放在线免费| 在线精品无人区一区二区三| 黄色毛片三级朝国网站| 国产av精品麻豆|