PubMed Health⌕ Search

Biomedical subjects

W Cwikiel

Publications and source records attributed to W Cwikiel.

At least 37 records · Page 2Linked to original sources
PubMed1996

Simplified percutaneous gastrostomy.

PURPOSE: The aim of this study was to develop a simple radiological method for the creation of percutaneous gastrostomy. MATERIAL AND METHODS: Percutaneous gastrostomy was created in 15 patients. After a blunt dissection of the abdominal wall under local anesthesia, puncture of the stomach was performed. A 6-mm peel-off introducer sheath was used to place the permanent catheter. Immediate use of the catheter was allowed. RESULTS: The procedure was successful in all cases and no procedural complications were seen. CONCLUSION: The method is simple, cost-saving, and may be recommended as an alternative to other methods.

Adult↗
PubMed1996

Palliation of dysphagia in patients with malignant esophageal strictures. Comparison of results of radiotherapy, chemotherapy and esophageal stent treatment.

Dysphagia is the earliest and the most common symptom of malignant disease in the esophagus. The palliative effects on dysphagia of radiotherapy (RT) and chemotherapy (CT) were evaluated retrospectively and compared with the effect of the self-expanding stent, evaluated in the prospective study. After completion of treatment, 78 (56%) of 140 patients treated with RT; 31 (49%) of 63 patients treated with CT; and 53 (81%) of 66 patients treated with stent insertion were free from dysphagia. Stent treatment has a good and prompt effect on dysphagia and can be recommended for palliation of patients with malignant esophageal strictures.

Adenocarcinoma↗
PubMed1995

Percutaneous translumbar central venous catheter in infants and small children.

Vascular occlusion is a common clinical problem in children dependent on prolonged vascular access. As an alternative to conventional central venous catheter placement we report our experience of four children receiving translumbar inferior vena cava catheter on 12 different occasions. All catheter placements were successful. No procedure-related complications occurred. The median catheter patency was 4.8 months (range 1-10 months). The translumbar route for central venous access is safe and reliable and should be considered when prolonged use is anticipated in infants and small children.

Catheterization, Central Venous↗
PubMed1995

The YAG laser and Wallstent endoprosthesis for palliation of cancer in the esophagus or gastric cardia.

The need for frequent retreatment is a disadvantage of using endoscopic laser therapy (ELT) alone for palliative treatment of esophageal carcinoma. In this prospective study, therefore, we investigated the potential and feasibility of combining ELT with a self-expanding metallic stent (Wallstent). Twelve patients received ELT followed by stent placement (stent group) and were compared with 39 patients receiving ELT alone (ELT group). Swallowing ability was similar in the two groups. About one-third of the patients who had a short life expectancy, did not appear to benefit from stenting, whereas the interval between retreatments was prolonged by a factor of 2-4 in the remaining patients. Median survivals were 5.5 (range 1.0-23.5) months in patients with stents, and 4.5 (range 1.2-24.6) months in patients without stents. There were few complications related to stenting. In one patient, technical problems caused stent dislodgement into the stomach. Another stent patient died of hemorrhage from an untreated tumor in the stomach, but it was considered unlikely that the bleeding was caused by the stent. In conclusion, this preliminary trial suggests that a Wallstent endoprosthesis, used in combination with laser treatment, may become a valuable tool for prolonging the dysphagia-free interval in selected patients.

Aged↗
PubMed1994

Immunotherapy in liver tumours: I. Combined administration of recombinant interleukin-2 (IL-2) and interferon-alpha through the subcutaneous transposed spleen prolongs the half-life of IL-2 in vivo and enhances antitumor effects.

Two modifications in this study, including the use of subcutaneous transposed spleen (STS) as a port for administration of recombinant interleukin-2 (IL-2) and interferon-alpha (IFN-alpha), and the mixture of IL-2 and IFN-alpha with degradable starch microspheres (IIM), for the treatment of rat liver tumor are introduced. Group I is the control. Group II received the IIM schedule through the STS. Group III and group IV received IL-2 and IFN-alpha, diluted with normal saline and injected through the STS or a peripheral vein. The comparative studies indicated that the best result was seen in group II where the elevated concentration of IL-2 in portal blood and massive tumor necrosis with lysis were observed. Inhibitions of tumor growth of 33%, 20% and 13% in group II, III, and IV, respectively, were observed. We conclude that administration of the IIM schedule through the STS is an effective method for the treatment of liver tumor in rats.

Animals↗
PubMed1993

Malignant stricture with colovesical fistula: stent insertion in the colon.

The authors describe a 91-year-old man with a malignant stricture of the sigmoid colon complicated with a colovesical fistula, which was successfully managed with insertion of a metallic esophageal stent. The fistula closed, and the stent function was good during the observation time of 1 month. Temporary stent placement for treatment of malignant strictures in the large bowel is proposed.

Aged↗
PubMed1993

Malignant esophageal strictures: treatment with a self-expanding nitinol stent.

A self-expanding esophageal nitinol stent was implanted under fluoroscopic guidance in 40 patients with malignant esophageal strictures and clinically significant dysphagia. The strictures were caused by squamous cell carcinoma (n = 14), adenocarcinoma (n = 12), recurrent anastomotic carcinoma (n = 8), and mediastinal tumors (n = 6). Eight stents were balloon dilated to maximum diameter immediately after insertion. Sixteen stents self-expanded to maximum diameter within 24 hours, and the other stents expanded to maximum diameter during further observation. There were no serious stent-related complications, and the dysphagia was reduced considerably in all patients immediately after stent insertion. Persistent tumor bleeding occurred in two patients, and ingrowth of tumor into the stent was seen in eight patients. Two stents occluded due to tumor ingrowth but were successfully recanalized with endoscopic laser coagulation. At the end of the study, 28 patients were dead with a mean survival of 2.9 months (range, 0.1-7.0 months), and 12 patients were alive with a mean follow-up of 8.8 months (range, 4.0-15.0 months).

Adult↗
PubMed1993

Self-expanding stent in the treatment of benign esophageal strictures: experimental study in pigs and presentation of clinical cases.

The reaction of the normal esophageal wall to inserted self-expanding nitinol stents was studied in pigs. An inflammatory reaction with increasing fibrotic activity and degeneration of the muscular layers in the esophageal wall was demonstrated. Five patients with severe dysphagia secondary to benign esophageal strictures also underwent insertion of self-expanding nitinol stents. All of the stents expanded completely, with subsequent regression of dysphagia. One treated esophagus was resected and showed deep implantation of the stent meshwork in the esophageal wall. Significant stenoses secondary to tissue hyperplasia, located at the edges of the stent, occurred in two patients. These results show that self-expanding nitinol stents may be used for palliation of dysphagia in patients with benign esophageal strictures. Because of the observed reactions in the esophageal wall, such treatment should be restricted to selected patients until more experience has been gained.

Adolescent↗
PubMed1993

Electrolytic stents to inhibit tumor growth. An experimental study in vitro and in rats.

Obstruction of metallic stents used in the management of malignant biliary strictures is common and in several cases due to tumor growth through the stent wall. In an experimental animal model in rats, a tumor was implanted subcutaneously adjacent to different metallic stents. Ingrowth of tumor through the wall of these stents was frequent. A stent generating direct electric current on the basis of electrolysis was developed and tested in vitro and in the experimental model. The study confirms that an "electrolytic" stent can inhibit ingrowth of tumor.

Animals↗
PubMed1992

Experimental transjugular portacaval shunt. Use of a fine-needle puncture device for the implantation of Strecker stents.

A transjugular portacaval intrahepatic stented shunt was created in 16 pigs without induced portal hypertension. A fine needle (OD 0.7 mm) was used for the transjugular puncture of the portal vein. The puncture was done directly from the inferior vena cava in 5 cases and from the right liver vein in 11 cases. The puncture tract was dilated and subsequently supported by a Strecker stent. The stented shunt was patent in all cases immediately after the stent placement, but was obstructed by fibrous tissue in 7 of 8 cases reexamined by angiography and autopsy after 4 weeks. Complications seem to be related to the choice of the puncture site, with fewer complications when the puncture was done via the right hepatic vein.

Animals↗
PubMed1991

Diagnostic difficulties with duodenal malignancies revisited: a new strategy.

Early diagnosis of a duodenal tumor is essential for effective therapy. Five cases of duodenal tumors are presented. The value of various diagnostic imaging methods in the assessment of tumors is also discussed. Modified duodenography is proposed as a method that should improve the diagnostic accuracy.

Adenocarcinoma↗
PubMed1991

Percutaneous duodenostomy--alternative route for enteral nutrition.

Percutaneous translumbar duodenostomy for enteral feeding was performed in one patient with nutritional difficulties. No complication was encountered. The procedure can be an alternative to percutaneous gastrostomy and jejunostomy for enteral feeding in special situations.

Aged↗
PubMedDate not supplied

Disappearance of esophageal carcinoma after stenting combined with endoscopic laser therapy.

A 92-year-old man with dysphagia secondary to squamous cell carcinoma of the esophagus was palliated repeatedly with endoscopic laser therapy and insertion of esophageal stents. During the treatment period of 32 months, the patient could be fed perorally while ingrowth of tumor, development of new stenoses at the edges of the stents, and breakage of one stent were encountered. A tracheosesophageal fistula developed at the upper edge of the first stent. The patient died from aspiration pneumonia. At autopsy, no cancer cells were found in the esophagus. Combined endoscopic laser treatment and stent therapy may keep a patient free from dysphagia during a long period of time and also may result in the complete disappearance of tumor growth in the esophagus.

Aged↗