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Biomedical subjects

M Hünerbein

Publications and source records attributed to M Hünerbein.

82 records · Page 5Linked to original sources
PubMed1995

[Laparoscopy and laparoscopic endosonography as staging examination of tumors of the upper gastrointestinal tract].

UNLABELLED: Accurate staging of gastric and oesophageal cancer is of major importance for the therapeutic strategy. However conventional imaging procedures are often not sensitive enough for precise assessment of resectability and curability. In this study laparoscopy and laparoscopic ultrasound were evaluated for preoperative staging. PATIENTS AND METHODS: Laparoscopy was performed on 21 patients for staging of intraabdominal malignancy using a standard equipment. Laparoscopic ultrasound was done with a flexible echoendoscope equipped with a curved array transducer (5/7,5 MHz). The ultrasound probe was introduced via a 15 mm trocar. RESULTS: By laparoscopy and laparoscopic ultrasound additional informations compared to conventional staging were obtained and revealed a disseminated disease in 15 out of 21 (71%) patients. These informations induced a change of the initially planned treatment concept in 14 of these patients (67%). A definitive palliative treatment was performed in 5 patients after diagnosis of incurable disease. Laparoscopic ultrasound proved to be useful for the detection of small non superficial lesions followed by biopsy and can improve laparoscopic staging of intraabdominal tumor spread.

Esophageal Neoplasms↗
PubMed1994

[Thoracoscopic localization of intraparenchymal pulmonary coin lesion using intraoperative ultrasound].

Generally, thoracoscopic resection of peripheral round lesions of the lung is a viable alternative to open surgery. However, due to the lack of tactile sensitivity intraparenchymal lesions often escape thoracoscopic detection and therefore this approach is limited to superficial lesions. The use of thoracoscopic endosonography may be valuable to localize intraparenchymal lesions which are not visible and enable subsequent thoracoscopic wedge resection.

Diagnosis, Differential↗
PubMed1994

[Laparoscopic sonography with an ultrasound endoscope].

Abdominal ultrasound is one of the major diagnostic tools for preoperative staging of malignancies. However this technique is limited by meteorismus and other physical factors (adipositas, ribs). Intraabdominal laparoscopic ultrasound is a valuable technique to overcome these limitations. A flexible echoendoscope was evaluated for this purpose. Being flexible the echoendoscope can be directed easily even to regions that are usually not accessible. Therefore this minimally invasive technique provides the chance to obtain precise tissue diagnosis by ultrasound guided biopsies through the biopsy channel while contemporary visualisation is possible.

Biopsy, Needle↗
PubMed1994

Cancer of unknown primary site.

Cancer of unknown primary is a clinical challenge that occurs in about 10% of the cancer patients. The major goal is to identify curable patients, while unnecessary efforts and discomfort should be avoided in intreatable patients. Extensive radiological examinations and serum tumour markers have turned out to be unsatisfactory means to establish the origin of the metastasis in patients with cancer of unknown origin. The crucial step for precise diagnosis is histopathological examination of the malignant tissue. Transmission electron microscopy and immunocytochemistry and genetic analysis are being increasingly used in the diagnostic evaluation of patients with cancer of unknown primary. Once a diagnosis is strongly suggested, specific treatment can be administered according to treatment in advanced known cancer. While regional disease is amenable to surgery and/or radiation therapy, multimodality treatment should be considered in treatable disseminated disease. Subsets of patients with a favourable prognosis include non-Hodgkin's and Hodgkin's lymphoma, germ cell tumours and thyroid cancer. A fair response to combination therapy can be expected in breast, ovarian and prostate cancer, while metastatic gastrointestinal or urogenital tumours remain difficult to treat. If it is not possible to identify the primary, empiric chemotherapy may provide a chance for cure in about 5% of the cases. The most common regimen employs 5-fluorouracil, adriblastin and mitomycin C. All in all, the prognosis of patients with the CUP-syndrome remains poor--the median survival in somewhat less than six months.

Combined Modality Therapy↗
PubMed1993

[Modified presentation of a lung embolism by a rare variant of pulmonary vein anomalous connection].

Partial anomalous pulmonary venous return of the left lung is an extremely rare cardiovascular abnormality. Mostly, this rare entity is found incidentally when patients undergo angiography of the pulmonary artery because of suspected pulmonary embolism. In this case hemodynamic data obtained by a swan ganz catheter suggested a cardiovascular abnormality presenting as left-right shunt. Surgical therapy of anomalous venous return of the left lung is only required if volume overload of the left ventricle occurs.

Aged↗
PubMedDate not supplied

Anal cancer: multimodal therapy.

Anal cancer is a rare clinical entity which represents 1-2% of all gastrointestinal tract cancers. Due to the paucity of this malignancy it has been difficult to establish generally accepted guidelines for treatment, although various therapy modalities have been evaluated. For a long time radical surgery was the primary treatment for anal cancer and still about 30% of the patients undergo abdominoperineal rectotomy. However, recurrence rates of 20-40% have been observed after this mutilating procedure. Therefore, other treatment options, including external or interstitial radiotherapy and chemotherapy, are used increasingly with the intention to preserve sphincter function. In the last years much interest has been addressed to multimodal therapy with radiation (50 Gy) and chemotherapy (5-fluorouracil and mitomycin C). Presently radiochemotherapy appears to be the most efficient therapy in advanced anal cancer. Locoregional tumor control is obtained in 60-80% of the patients and there is evidence that radiochemotherapy can improve disease-free survival. Despite considerable toxicity, radiochemotherapy should be recommended as primary therapy to most patients.

Anus Neoplasms↗
PubMedDate not supplied

Three-dimensional endoluminal ultrasound: a new method for the evaluation of gastrointestinal tumors.

BACKGROUND: The purpose of the present study was to evaluate the feasibility of three-dimensional endoluminal ultrasound of gastrointestinal tumors. METHODS: Sixteen patients with esophageal, gastric, or colorectal tumors underwent endoscopic ultrasound. Three-dimensional ultrasound data were obtained from multiple serial images of a miniprobe (360 degrees, 12.5 MHz) and processed on a PC-based 3D workstation. RESULTS: Adequate three-dimensional ultrasound scans were obtained in eight patients with esophageal cancer and five patients with colorectal cancer. Three-dimensional image processing enabled visualization of the data as a multiplanar display or as a life-like three-dimensional view. The availability of arbitrary scan planes improved the assessment of local tumor spread and the spatial relation of the tumor to relevant adjacent structures (e.g., major vessels). Three-dimensional presentations provided realistic views of the anatomy and facilitated the interpretation of the ultrasound images. CONCLUSIONS: Three-dimensional display and the ability to review endoluminal ultrasound data interactively may improve the staging of gastrointestinal tumors. These preliminary data encourage further evaluation of this technique.

Artifacts↗
PubMedDate not supplied

A rare malformation of the pancreaticobiliary junction long common channel choledochal cyst and pancreas divisum in a patient with pancreatic cancer.

Congenital variants of the pancreaticobiliary junction are rare anomalies that are usually diagnosed in childhood because of recurrent abdominal pain and jaundice. These lesions are associated with several pancreaticobiliary diseases including pancreatitis and malignancy. We observed a rare anomaly of the pancreaticobiliary tract with a combination of several ductal malformations, i.e., choledochal cyst, long common channel and incomplete pancreas divisum in a patient with pancreatic cancer.

Adenocarcinoma↗