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Results for “Endoscopy, Digestive System”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 181 records · Page 10Linked to original sources
PubMed2006

Current aspects of surgical management of GERD.

Gastroesophageal reflux disease (GERD) is one of the most common pathologies treated by primary care physicians. Despite advances in antacid pharmacological treatments, many patients remain refractory to maximal medical therapy. In addition, many others are either unable to tolerate the side effects of the drugs or simply are unwilling to receive life-long daily medications. Laparoscopic Nissen fundoplication has evolved as the surgical procedure of choice for patients with GERD. Although the durability of surgical management has been questioned, experienced surgeons achieve long-term reflux cure rates of about 85% to 95%. Barrett's esophagus has recently been considered an additional indication for surgical therapy of reflux due to evidence of dysplasia regression following a 360 degrees fundoplication. However, the timing of surgical intervention and the exact procedure for patients with both short- and long-segment Barrett's esophagus remains debatable. Esophageal dysmotility in surgical patients with GERD has traditionally been approached by "tailoring" the degree of fundoplication. Recent evidence suggests that partial fundoplication may not be effective and that full fundoplication should still be employed. The degree of dysmotility prohibitive to a full 360 degrees fundoplication remains controversial and should be addressed with future randomized trials. Finally, patients with failed fundoplication represent a formidable diagnostic dilemma and a technical challenge. In experienced hands, these patients can still benefit from minimally-invasive restorative or "re-do" fundoplications with minimal perioperative morbidity and good long-term results.

Clinical Trials as Topic↗
PubMed1991

Endoscopy update.

Explore the source record for details and available documents.

Endoscopy, Digestive System↗
PubMed1991

[Endoscopic laser therapy. Indications, effectiveness and cost analysis in a medical department].

Between June 1985 and December 1988, 297 endoscopic laser procedures were performed in 130 patients. The indications comprised hemostasis, coagulation of potentially bleeding lesions, palliative tumor therapy in the upper and lower gastrointestinal tract and in the tracheobronchial tree, eradication of adenomas after incomplete snare resection, and recanalization of benign esophageal/cardiac strictures and postoperative colonic stenoses. In addition, an endoscopically introduced biliary endoprosthesis was shortened. Treatment was highly effective, and the complication rate less than 1%. The average operating cost of the laser equipment was DM 80 per application, increasing to 430 DM when account was taken of the high purchasing price of the laser.

Cost-Benefit Analysis↗
PubMed1991

[Endoscopic ultrasonography of the digestive tract].

Endoscopic ultrasonography of the digestive tract provides for a precise ultrasonic study of the accessible gastrointestinal walls (oesophagus, stomach, duodenum, rectum) and, through these walls, of the adjacent organs (lymph node clusters, posterior mediastinum, pancreas, extrahepatic biliary ducts and perirectal environment). This method is better than computerized tomography to evaluate the local and regional extension of oesophageal and cardial carcinomas producing little or no stenosis and of gastric and rectum carcinomas and lymphomas. It is the examination of choice to detect a peri-anastomotic recurrence of these cancers and to evaluate submucosal tumors of the digestive tract. This method, without morbidity is better than computerized tomography or ultrasonography in the aetiological diagnosis of obstacles in the biliary tract and in the diagnosis and pretherapeutic assessment of pancreatic cancers or endocrine tumors.

Biliary Tract Diseases↗
PubMedDate not supplied

[The diagnosis and treatment of benign tumors of the subdiaphragmatic digestive tract].

One hundred twenty-two benign tumors of subdiaphragmatic digestive tract admitted in the interval 1975-1988 at the III-rd Surgical Clinic of Iaşi are reported. Out of these patients 120 required surgical treatment, the remainder of 2 being treated conservatively (diffuse intestinal angiomatosis, Peutz-Jeghers' syndrome). The clinical evolution being atypical, the surgical intervention was required, in most of the cases, due to hemorrhagic and occlusive complications. Histologically, the polyps and schwannomas were prevalent. The diagnostic difficulties, especially in the cases with jejuno-ileal localization, are mentioned.

Diaphragm↗
PubMed1993

Endoscopic magnetic cholecystodigestive anastomoses: personal technique for palliative treatment of distal bile duct obstruction.

A new type of endoscopic surgery (magnetic cholecystodigestive anastomoses) is presented as an alternative to conventional palliative treatment of mechanical obstruction with icterus located below the bile duct inlet. By means of endoscopic technique, two clinically usable methods of creating delayed magnetic cholecystogastric anastomoses and one modality of implanting cholecystoenteric and enteroenteric anastomosis have been worked out in the experiment conducted on 50 mongrels with mechanical icterus. Ring-shaped or rectangular magnets were implanted in the gallbladder through laparoscopic cholecystostomy. Implantation into the stomach was accompanied by simultaneous gastroscopy. In clinical conditions, four endoscopic cholecystogastric anastomoses and one cholecystoduodenal anastomosis have been performed on patients suffering from malignant obstruction of distal bile duct due to cancer of the head of the pancreas, making any radical surgery pointless. The preliminary results indicate that endoscopic magnetic cholecystodigestive anastomoses can serve as a form of palliative treatment of distal bile duct malignant obstructions.

Aged↗
PubMedDate not supplied

Endoscopic ultrasound-guided fine-needle aspiration.

Thirty-eight consecutive patients underwent endoscopic ultrasound-guided fine-needle aspiration. Of 46 lesions, 34 were extraluminal (12 pancreatic masses, 8 periesophageal nodes, 6 celiac nodes, 2 pericolonic masses, 1 mediastinal mass, 1 perigastric mass, 1 liver, 1 periduodenal node, 1 perirectal mass, 1 perirectal node) and 12 were submucosal (8 gastric, 3 duodenal, 1 esophageal). One hundred sixty-three passes were made, with an average of 3.5 passes per lesion and 4.3 passes per patient (range, 1 to 8). Adequate specimens were obtained from 91% of targeted lesions. The overall diagnostic accuracy was 87%. In patients with malignant lesions, sensitivity was 91% and specificity 100%. Celiac nodes were successfully sampled and diagnostic in 5 of 6 (83%) patients. No complications occurred. Using this technique, an initial tissue diagnosis of malignancy was made in 66% of cancer patients without a previous diagnosis and the preoperative stage was changed in 44% of cancer patients. The additional information gained by this modality directly influenced the decision not to perform surgery in 26% of patients with a primary malignancy. Endoscopic ultrasound-guided fine-needle aspiration is feasible and can be safely used to evaluate submucosal and extraluminal lesions in both the upper and lower gastrointestinal tract with a high degree of diagnostic accuracy.

Adult↗
PubMed1994

Acute abdominal pain: a diagnostic approach.

The author presents a diagnostic approach to the problem of acute abdominal pain in adults. The typical pain patterns for the various causes are outlined with the aid of illustrations. A systematic method is necessary to make reasonably accurate provisional diagnoses. A summary of possible investigations is included for each condition.

Abdominal Pain↗
PubMed1994

Role of endoscopic ultrasonography in diagnosis, staging, and outcome of gastrointestinal diseases.

Using endoscopic ultrasound imaging, highly accurate gastrointestinal tumor characterization and staging is now possible without surgery. Precise endosonographic preoperative staging allows use of the TNM pathological staging system to stratify treatment for esophageal, gastric, rectal, and pancreatobiliary tumors. Endoscopic ultrasonography often establishes a diagnosis in malignant and, in certain patients, benign disease; accurately evaluates anastomoses for recurrent tumor; and characterizes submucosal masses. When histology is required, endoscopic ultrasonography has a critical role in defining an abnormal area for deep submucosal biopsy from the gastrointestinal lumen. Endoscopic ultrasonography is unsurpassed in determining resectability of gastrointestinal neoplasms. It can be used to monitor treatment of downstaged tumors prior to attempted resection. Using endoscopic ultrasonography for earlier diagnosis and precise staging will significantly improve the clinical outcome of patients with gastrointestinal disease as significant advances both in surgical techniques and in combined chemotherapy and radiotherapy continue to be made and applied selectively.

Digestive System Diseases↗
PubMedDate not supplied

[2-year pioneer experience with endoscopic ultrasonography, linear transducer].

Endoscopic ultrasonography has been applied in gastro enterology for more than 10 years in large medical centers as a special diagnostic tool. Such a technique has applications in tumoral and inflammatory processes and gives important information of the superior gastrointestinal tract. The objective of this study is to show a 2-year experience with linear echoendoscope in 200 operated patients. The equipment is a Toshiba 250 model with a Machida endoscope 7.5 MHz, electronic linear transducer. Endoscopic ultrasonography is successful in obtaining accurate diagnostic images, mainly of submucosal lesions, precise staging of a variety of gastrointestinal tumors, and detection small pancreatic masses and choledochal calculi.

Digestive System Diseases↗
PubMed1994

Introduction to pediatric esophagogastroduodenoscopy and enteroscopy.

Pediatric esophagogastroduodenoscopy is now an integral part of the practice of pediatric gastroenterology. Children are not just small adults. The differing clinical indications, approaches to patient preparation, sedation, and complications are discussed in this article.

Anesthesia↗
PubMed1994

Mucosal biopsy.

Intestinal mucosal biopsy has become an invaluable tool for the evaluation of children with abdominal complaints. Multiple techniques and biopsy instruments have each been developed with advantages and limitations. Physicians caring for infants and children must be familiar with indications for tissue sampling, timing of the biopsies, and interpretations of biopsy specimens.

Adolescent↗
PubMed1993

[Endoscopic ultrasonography of malignant tumors in the upper abdomen].

Endoscopic ultrasonography (EUS) of the upper gastrointestinal tract is a newly developed, non-invasive investigational method. It combines the direct optical picture of the endoscope with a simultaneous ultrasonographic image of the whole wall of the oesophagus, stomach and duodenum as well as organs and other structures with anatomical relations to the upper gastrointestinal tract. EUS is evaluated for its capacity with respect to cancer of the oesophagus, stomach, pancreas, biliary tree and neuroendocrine tumours, the emphasis being laid on TNM-classification, assessment of resectability and comparison with other imaging techniques. It is concluded that EUS is well-suited for assessing tumour infiltration and thereby also the resectability of these cancer types. Judging whether lymph nodes visualized by EUS are malignant or not is difficult when operating solely from endosonographic and quantitative criteria, and while the sensitivity of EUS for detecting lymph node metastases is in most situations superior to other investigational methods, the specificity and ability to visualize distant metastases is poor. For these purposes the optimal solution appears to be a combination of EUS with CT and/or ultrasound scanning. Future possibility of EUS-guided biopsy will strengthen the method's position in the diagnostic armoury concerning malignant disease in the upper gastrointestinal tract.

Digestive System Neoplasms↗