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Biomedical subjects

V S Swaroop

Publications and source records attributed to V S Swaroop.

At least 19 recordsLinked to original sources
PubMed1992

Cystic neoplasms of the pancreas: a heterogeneous disorder.

Cystic neoplasms of the pancreas are rare tumors with a relatively better prognosis as compared to other pancreatic cancers. They may be mistaken for pseudocysts. Seventeen patients who underwent surgical resection were analyzed. Seventy percent of the patients were females and 76.7% of the tumors were located in the tail of the pancreas. Preoperative diagnosis was made on the basis of ultrasonography and/or computed tomography findings in 60% of patients. Retrospective review of the imaging modalities revealed one or more findings suggestive of cystic neoplasms in 90% of the patients. These included multiloculated cysts, thickened cyst wall, intracystic mass or calcifications, and presence of liver metastasis. All the tumors were completely or partly excised. The final histopathological diagnosis was microcystic adenoma in 2, mucinous cyst adenoma in 1, papillary cystic neoplasm in 3, cystic neuroendocrine tumor in 5, and cystadenocarcinoma in 6. Of the 17 patients, 10 had malignant tumors. Seven patients with benign tumors and 3 patients with malignant tumors are disease free 12-30 months after resection. Cystic neoplasm must always be considered as a possibility when dealing with cystic lesions of the pancreas and a careful evaluation of ultrasonography and computed tomographic scan may give a clue to the diagnosis.

Adolescent↗
PubMed1992

Combination chemotherapy and radiation for palliation of hepatocellular carcinoma.

Twenty seven patients with hepatocellular carcinoma were treated by sequential methotrexate (75 mg/m2) and 5-fluorouracil (5-FU) (750 mg/m2) on day 1 followed on days 8-36 by external beam radiotherapy (total dose 30 cGy). The response was assessed by liver size on clinical examination. One patient had complete response, and six patients had partial response. The overall response to the treatment was 25.9%. More than a 50% reduction in serum alfa-fetoprotein level was noted in 66.6% patients. Seventy-one percent of patients had palliation of pain following therapy. The median survival of responders was 11 months and of nonresponders, 2 months. Radiation was discontinued in two patients who developed radiation hepatitis. Additional trials with different dosages and schedules are needed to fully evaluate this form of therapy.

Adult↗
PubMed1992

Indigenous silicone rubber endoprosthesis for malignant esophago-pulmonary fistula.

Endoscopic placement of an esophageal endoprosthesis is the most rational therapy for relieving the distress of malignant esophago-pulmonary fistula. The commercial prostheses are very expensive for widespread use in India. We have indigenously prepared silicone rubber endoprostheses. The wall of the prosthesis was hardened in a graded manner until the desired resistance to compression with flexibility is achieved. This prosthesis was placed successfully in five patients with malignant esophago-pulmonary fistula. Dysphagia and aspiration were relieved in all the patients. One patient had delayed esophageal perforation and died of massive bleeding 3 weeks after the placement of prosthesis. The indigenous endoprosthesis is cost-effective and safe.

Adult↗
PubMed1992

Role of endoscopic ambulatory laser therapy in palliation of malignant colorectal diseases.

BACKGROUND: Endoscopic laser therapy is widely used in the palliation of advanced malignant colorectal diseases. The role of this therapy in improving the quality of life of these patients needs adequate assessment. METHODS: Nine patients with advanced colorectal cancers and three patients with secondary colorectal involvement by pelvic cancers underwent endoscopic Nd:YAG laser therapy for palliation using non-contact laser guides for tumor bleeding alone (n = 12) or associated with obstruction (n = 7). The therapy was performed on an outpatient basis in 9 of the 12 patients. One patient was lost to follow up. RESULTS: Symptom control was achieved in all the 11 bleeding tumors and in 5 of the 7 obstructive tumors. There were no major complications. Three patients had no improvement in the quality of life in spite of control of symptoms. CONCLUSION: Ambulatory endoscopic laser therapy is a minimally invasive, safe and effective method of palliation for selected patients with non-resectable malignant colorectal tumors.

Adult↗
PubMed1992

Palliative segment III biliary bypass (left cholangio-jejunostomy) in malignant block at porta hepatis.

Segment III cholangio-enteric anastomosis was performed in 17 patients with obstructive jaundice due to unresectable malignancies at the porta hepatis. The operative mortality was 6% (1/17) and morbidity 30% (5/17). More than 50% fall in bilirubin level with symptomatic improvement in pruritus was seen in 13 patients. Three patients had 25%-50% fall in bilirubin level. This procedure is safe and effective in palliation of unresectable hilar obstruction.

Adult↗
PubMed1992

Out-patient esophageal dilation: an experience in 130 patients using Savary-Gilliard dilators.

Experience of outpatient esophageal dilation using Savary-Gilliard dilators in 130 patients during a 17 month period is reported. The strictures were radiation induced (48), tumoral stenoses (40), anastomotic (16) and due to other causes (26). Both fluoroscopy and endoscopy were used in 58%, endoscopy alone in 23% and fluoroscopy alone in 19% of patients for placement of the guide wire. One hundred and twenty six stricture dilations (97%) were technically successful. Eighty one (62%) patients could be dilated to 14 mm or more. One hundred and nineteen (94%) patients were dilated in one or two sessions. Among the 109 patients who followed up, dilation was successful in providing adequate dysphagia relief in 97 patients and facilitated the performance of other therapies in 9 patients. Major complications included severe continuous chest pain (1 case), hematemesis (2), fever (4) and transient stridor (2). The patient with persistent pain and 9 patients undergoing other therapies required hospitalization. There were no perforations or death. We conclude that esophageal dilation with Savary-Gilliard dilators is safe and effective even in tumors and post-radiation strictures. It can be performed on an outpatient basis in a majority of patients.

Adult↗
PubMed1992

A prospective study of radiation induced damage of pancreatic ducts.

To study radiation-induced pancreatic duct damage, endoscopic retrograde pancreatograms of 11 patients with primary gastric lymphoma who had completed chemotherapy and moderate dose external radiation therapy were compared with those of 22 normal subjects. No significant alteration was seen in the length and caliber of the main pancreatic duct and number of side branches. Clubbing of one or two side branches was observed in four patients who had received radiation (p = ns). We conclude that significant structural changes do not develop in the pancreas following moderate dose upper abdominal radiation.

Adult↗
PubMed1992

Outpatient dilation of anastomotic strictures of the upper gastrointestinal tract.

Anastomotic upper gastrointestinal strictures in 32 patients were dilated on an outpatient basis. Strictures had developed following resection-anastomosis of the esophagus in 27, total esophagectomy in two and total/partial gastrectomy in three patients. Patients with benign anastomotic strictures (group A; n = 21) presented within 6 (median 2) months of surgery while those with recurrent tumors at the site of anastomosis (group B; n = 11) presented 7 (median 14) months later. Dilation using Savary-Gilliard (n = 24), through the scope balloon (n = 2) and Eder Puestow (n = 1) dilators or a combination of these (n = 1) was possible in 20 (95%) patients in group A and 8 (73%) patients in group B. All the 28 patients had relief of dysphagia. Median duration of response after first dilation was 4.2 and 1.2 months in groups A and B respectively. Nature of previous surgery, length of the remaining stomach and recurrence of tumor at anastomosis appeared to affect the technique and outcome of dilation. Savary-Gilliard dilators can be used in a majority of patients except those with short stomachs where through the scope balloon dilators may be preferred.

Deglutition Disorders↗
PubMed1991

Familial polyposis coli with villous adenoma of ampulla of Vater.

Adenoma of the ampulla of Vater is one of the extracolonic manifestations of familial polyposis coli (FPC). We report three patients with FPC in whom villous adenoma of the ampulla was detected. An adenoma carcinoma sequence has been suggested in such lesions.

Adenoma↗
PubMed1991

Duodenal diversion of percutaneous biliary drain through a percutaneous endoscopic gastrostomy: report of a case.

Occasionally, percutaneous biliary drainage is the only possible form of treatment in a patient with a malignant obstruction at the porta hepatis. We report on a case of gallbladder carcinoma with a complete block at the porta hepatis, which was palliated with a percutaneous biliary drain. Enteral reinfusion of bile was accomplished through a duodenal tube placed through a percutaneous endoscopic gastrostomy.

Adenoma, Bile Duct↗
PubMed1991

Association of esophageal cancer and esophageal varices.

Of the 312 cases of esophageal cancer seen over 2 years, four patients had associated varices. Three patients gave history of alcohol abuse. All had malnutrition and splenomegaly. Endoscopic biopsies were safe in the presence of varices. External radiation did not have any untoward effect on the varices. Prophylactic sclerotherapy was not required in these patients. The association between esophageal carcinoma and varices could be secondary to alcohol consumption or merely coincidental.

Alcohol Drinking↗