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At least 235 records · Page 13Linked to original sources
PubMed2001

Gastroentological investigations.

In this fourth article in the Concepts in Anatomy series, Anne-Marie Ramsay joins John Clancy and Andrew McVicar in examining the upper and lower gastrointestinal tract and identifies some common homeostatic imbalances. Diagnostic tests for detecting abnormalities are described, highlighting the importance of the nurse's role in caring for the patient throughout these procedures. This series is based on Physiology and Anatomy, a homeostatic approach, 2nd ed, John Clancy and Andrew McVicar (eds), Edward Arnold, London, 1995, currently in print.

Digestive System Diseases↗
PubMed2006

EUS-guided mucosectomy for gastrointestinal cancer.

INTRODUCTION: the only way of improving prognosis and survival in gastrointestinal cancer is early diagnosis, with intramucosal localization as confirmed by endoscopic ultrasonography (EUS) or 20-MHz miniprobes (MPs) (T1) being most appropriate. Endoscopic mucosal resection (EMR) has proven effective in the treatment of this sort of lesions. PATIENTS AND METHOD: in a group (18 cases) with 15 cases of superficial gastrointestinal cancer and 3 cases of severe gastric dysplasia, 9 cases (3 esophageal, 4 gastric, 2 rectal) underwent a classic EMR following EUS or a 7.5- and 20-MHz miniprobe exploration. RESULTS: ultrasonographic studies showed a T1 in all but one esophageal case (Tis), and in both gastric dysplasias, with no changed layer structure being demonstrated in the latter (T0). No complications arose with classic EMR, and all 9 patients are alive and free from local or metastatic recurrence, except for one esophageal case, which recurred distally to the esophageal lesion (metachronous). CONCLUSIONS: echoendoscopically-assisted EMR is a safe, effective technique in the endoscopic management of superficial gastrointestinal (esophageal, gastric, colorectal) cancer. Recurrence most likely depends upon cancer multiplicity.

Aged↗
PubMedDate not supplied

Prospective study of the functional results of transanal endoscopic microsurgery.

BACKGROUND/AIMS: Most clinical research addresses the technological advances and oncological outcomes of transanal endoscopic microsurgery. Our aim was to examine the functional results. METHODOLOGY: From August 1999 to November 2000, 22 Taiwanese patients (14 men, 8 women; median age, 68 years) undergoing transanal endoscopic microsurgery were prospectively examined. Functional questionnaires and anorectal manometry were assessed before surgery and at 2 weeks, 6 weeks, 3 months, and 1 year. RESULTS: The median distance from the anal verge to the tumor was 10 cm. The median tumor diameter was 2.0 cm. The median duration of surgery was 120 minutes. No surgical mortality or morbidity and no local recurrence occurred during a median follow-up of 23 months. The mean stool frequency and consistency were significantly better at 3 months after surgery than before surgery. The maximal resting pressure significantly decreased after surgery. The maximal contraction pressure and maximal tolerated volume were significantly lower at 2 and 6 weeks than before surgery; these values recovered at 1 year. CONCLUSIONS: Transanal endoscopic microsurgery is safe for the cure of benign tumors and the palliative excision of malignant tumors in middle and upper rectum. Anorectal function was preserved and improved, though some anorectal manometric parameters changed over time.

Adenocarcinoma↗
PubMed2003

Diagnosis and treatment of mucobilia: report of 8 cases.

OBJECTIVE: To better understand mucobilia as well as its diagnosis and treatment. METHODS: The etiological factors, diagnosis, and treatment of 8 patients with mucobilia were discussed. RESULTS: Mucobilia characterized by copious mucin secretion in the extrahepatic bile duct resulted in obstructive jaundice and cholangitis. Four patients receiving curative resection of primary lesions were free from jaundice and cholangitis while the other 4 who had had palliative biliary drainage showed persistent symptoms. CONCLUSIONS: Mucobilia is attributable to biliary mucous metaplasia, and benign or malignant biliary tumors. Cholangioscopy and biopsy can offer precise information about the location and extension of the primary lesion. The best choice of treatment is curative resection of the primary lesion.

Adult↗
PubMed2004

Surgical and endoscopic palliation for pancreatic cancer.

Patients with pancreatic cancer often present with locally advanced or metastatic disease and are deemed not to be candidates for a curative resection. Palliation in these patients focuses on relief of biliary obstruction, gastroduodenal obstruction and pain. Palliative treatment modalities include both surgical and nonsurgical approaches. Biliary obstruction is often initially treated with endoscopic biliary stenting. Two major types of biliary stents are used, plastic and metallic stents. Both of these provide similar initial relief of biliary obstruction, however, plastic stents have a greater propensity for occlusion and should primarily be used in patients with anticipated short survival duration. Metallic stents have a greater initial cost, but provide an overall cost-saving in patients with expected survival duration of over 6 months. Surgical palliation for biliary obstruction should be primarily considered in patients who fail endoscopic biliary decompression or who develop clinical evidence of gastroduodenal obstruction. In these patients, surgical palliation should consist of biliary decompression with a choledochojejunostomy when ever feasible, a gastroduodenal bypass and a chemical splanchnicectomy for pain relief. An initial prophylactic gastroenterostomy at the time of endoscopic biliary decompression is rarely indicated. The role of palliative pancreaticoduodenectomy remains controversial and to date there are no prospective randomized data to support its role in palliation of locally advanced pancreatic cancer. This review examines the available data from prospective trials for surgical and nonsurgical palliation of locally advanced and metastatic pancreatic cancer.

Choledochostomy↗
PubMed2004

[Clinical signs, diagnostics and treatment of the benign mesenchymal (submucosal) tumors of the gastrointestinal tract].

Benign mesenhimal tumors (submucosal) of the gastrointestinal tract are rarely found. They develop in the submucosa of the digestive tract. The tumors are covered by normal mucosa, have slow growth and tendency to ulcerations and bleeding. The clinical manifestations are not characteristic and depend on tumors size localization and complications, which often lead to diagnostic difficulties. The three cases of benign mesenchimal tumors localized in the stomach, colon and rectum, surgically removed during 2001/2002 year are represented. Typical clinical symptoms include abdominal pain, gastrointestinal bleeding and anaemia. The presented clinical cases are of great interest, because of the very low grade of incidence, non-specific clinical manifestations and different diagnosis. Expressive intraoperative histological confirmation of the diagnosis is absolutely necessary. Recurrences are not found in the treated patients.

Adult↗
PubMed2005

[Thromboembolic risk and prevention of deep venous thrombosis in open and laparoscopic surgery].

Deep Vein Thrombosis (DVT) and pulmonary embolism are the dangerous and serious complications in patients undergoing surgery. It is known that prognosis is strictly linked to timely recognition of the pathogenetic-clinical phase of the thromboembolic disease and that prevention, therefore, plays the leading role in patients at risk. The most recent series show that, in absence of prophylaxis, the frequency of DVT, diagnosed by objective tests, is still significant in abdominal surgery. Modern diagnostic tools make possible to identify relatively silent clinical thrombosis, also with laboratory tests (i.e., D-dimer plasma levels). The Authors report a study on thromboembolic episodes in patients who underwent pneumoperitoneum with CO2 during laparoscopic abdominal surgery, compared to a control group submitted to open surgery. They underline the importance of a careful preoperative evaluation of the venous system, by Doppler study, in order to identify, patients at risk of DVT and establish a suitable anti-thrombotic prophylaxis.

Anticoagulants↗
PubMed1991

[Digestive tuberculosis].

On a experience of 123 patients with intestinal and/or peritoneal TBC, the author do a complete review of the epidemiological and environmental factors and about the anatomo-pathological types of the disease. The review remarks the value of the clinical picture evaluation, the diagnostic methods and therapeutic schemes of medical treatment and the complications management.

Age Factors↗
PubMed1994

Endoscopic techniques in gastrointestinal oncology.

Gastrointestinal endoscopy continues to play a significant role in gastroenterologic oncology. As a diagnostic tool, it has largely replaced radiology in diseases of the gastrointestinal tract because of its capability to provide a tissue diagnosis by endoscopic biopsy. The still-expanding therapeutic potential of gastrointestinal endoscopy represents the prototype of minimal invasive therapy. This review deals with relevant papers on diagnostic and therapeutic gastrointestinal endoscopy during the past 2 years. The abundance of studies renders a detailed discussion of all or even most of them impossible; therefore, only trends are shown. The reader is referred to the annotations in the reference list for more detailed information.

Adult↗
PubMed1995

Endoscopic ultrasonography of the gastrointestinal tract.

Endoscopic ultrasonography (EUS) combines the advantages of conventional endoscopy with the capabilities of ultrasonography. EUS allows clinicians to see through the wall of the gastrointestinal tract. The close proximity allows the use of relatively high frequencies with the resulting increase in tissue contrast and resolution. Despite some limitations, this new modality does open new horizons in the diagnosis and characterization of upper gastrointestinal diseases.

Digestive System↗