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At least 289 records · Page 16Linked to original sources
PubMed1999

[Histologic comparison between endoscopic axillary lymphadenectomy after lipo-suction and classical surgical technique].

Suzanne recently described a new technique of axillary lymphadenectomy in breast cancer to reduce post surgical morbidity. It combines liposuction and endoscopic dissection. To determine whether this technique induces lymph node alterations, we examined retrospectively 111 lymphadenectomies done by this new method and compared them to 41 lymphadenectomies performed by conventional surgery. The percentage of altered lymph nodes, with or without metastasis, was approximately the same with both techniques (about 19%). Lymph nodes removed by conventional surgical lymphadenectomy had a detached capsule more frequently. Cellular crush was more frequent after liposuction and endoscopic dissection. Liposuction altered more frequently large lymph nodes, which represented, however, the minority of the lymph nodes removed by this technique. No specific alteration was detected in relation to either of the two technics.

Axilla↗
PubMed2005

Enteroscopy.

Wireless capsule endoscopy and double-balloon endoscopy are new methods of enteroscopy that have been introduced in recent years. Wireless capsule endoscopy is an epoch-making examination method that makes possible an endoscopic imaging examination of the entire small intestine without discomfort and without confining patients to a medical facility. Although it is expected to be useful as an initial examination for finding diseases of the small intestine, it cannot be used for biopsy or treatment. One risk associated with the capsule endoscopy technique is entrapment by strictures. Double-balloon endoscopy is based on a new insertion technique in which two balloons, one at the distal end of the endoscope and the other at the distal end of an overtube, are operated in combination, and the endoscope is inserted while simultaneously shortening the intestine. It can be inserted through either the mouth or the anus, allowing the observation of the entire gastrointestinal tract. It features excellent maneuverability even in the distal small intestine, and enables back-and-forth observation, biopsy, and endoscopic treatment at any given site. These two new enteroscopy techniques are expected to lead to innovations in how diseases of the small intestine are approached.

Endoscopes, Gastrointestinal↗
PubMed1985

[Preclinical study of endoscopic laser coagulation of human ovaries].

The hemostatic potential of YAG laser irradiation was investigated in 21 hysterectomy and adnexectomy patients of childbearing age. Endoscopic forceps were used to induce hemorrhaging in the ovarian capsule. The hemorrhage was then irradiated from a distance of 2cm using a series of 1-sec. irradiations at either 30W or 50W until complete hemostasis occurred. In the 30W group, hemostasis was achieved after a total irradiation of 4.1 +/- 1.6 sec. while a significantly shorter time of 2.5 +/- 0.8 sec. was required in the 50W group (p less than 0.01). The irradiation energy in the 30W and 50W groups was 107 +/- 45 J and 109 +/- 35 J, respectively. Tissue temperature was measured during laser irradiation at 5mm and 10mm from the center of irradiation at a tissue depth of 5mm. In the 30W group, the tissue temperature at the 5mm and 10mm points increased 6.6 +/- 2.0 and 2.5 +/- 1.1 degrees C, respectively, while the temperature in the 50W group increased 8.5 +/- 3.5 and 3.1 +/- 0.9 degrees C respectively. No remarkable histological changes were noted in either group following irradiation. YAG laser irradiation during endoscopy is therefore considered to be a highly effective hemostasis for minor hemorrhages caused by instrument manipulation during endoscopic surgery.

Endoscopy↗
PubMed1992

Naproxen-associated gastroduodenal toxicity: enteric coated granules versus plain tablets.

Two naproxen formulations were compared with regard to gastroduodenal endoscopic findings. Using a dose of 500 mg bid for one week, plain tablets were compared to enteric coated granules in a gelatine capsule in a randomized, cross over, double-blind, double dummy study in 16 healthy, male volunteers. Endoscopic evaluation revealed no difference between the two formulations. Since previous studies with enteric coated naproxen tablets indicated a favourable side effect profile compared to plain tablets, the present data indicates that enteric coated formulations are not all alike, and should be studied individually.

Adult↗
PubMed2004

Endoscopic therapy for upper gastrointestinal bleeding.

Upper gastrointestinal bleeding (UGIB) is one of the most common medical emergencies and remains a major cause of morbidity and mortality among patients. Although initially employed diagnostically, endoscopy has steadily replaced surgery as a first-line treatment in all but the haemodynamically unstable patient. A vast selection of techniques and devices are now available to the dedicated therapeutic endoscopist, including injection therapy, electrical or thermal coagulation and mechanical banding or clipping. The use of endoscopic ultrasound for targeting treatment is increasing and the development of new technologies, such as capsule endoscopy, is likely to play an important role in future protocols. However, despite numerous randomized controlled trials and meta-analyses comparing the efficacy of different endoscopic interventions, the implementation of obtained results into treatment regimes has so far failed to impact significantly on overall UGIB mortality, which remains stubbornly at 10-14%. Reducing this continues to be one of the main challenges facing the therapeutic endoscopist.

Clinical Trials as Topic↗
PubMed2002

Small-bowel endoscopy.

During the last year, promising results with the first clinical applications of capsule endoscopy have been reported; this is a new, revolutionary diagnostic method for endoscopic study of the small bowel. The method has chiefly been used in patients with obscure gastrointestinal bleeding, and in some cases has allowed additional diagnoses to be made in comparison with push enteroscopy, with a positive influence on patient management. New therapeutic possibilities have also been developed in push enteroscopy, emphasizing the role of this technique as an essential component of gastrointestinal endoscopy. Important innovations in enteroscopy technique have been described, aimed at increasing the depth of examination, and these will probably make it possible to extend endoscopic treatments to include the entire small bowel. Finally, numerous articles are still being published concerning intraoperative enteroscopy. It is to be hoped that, in future, the use of this invasive procedure will be based on data acquired by capsule endoscopy.

Angiodysplasia↗
PubMed2005

Capsule endoscopy.

Video capsule endoscopy is a major innovation that provides high-resolution imaging of the entire small intestine in its entirety. In the 4 years since its introduction, capsule endoscopy has demonstrated its viability as a first-line investigation in patients with obscure gastrointestinal bleeding after a negative esophagogastroduodenoscopy and colonoscopy, and it has a positive impact on the outcome. Video capsule endoscopy is also useful in the evaluation of inflammatory and neoplastic disorders of the small bowel. Its role in children and in the evaluation of esophageal disorders is currently being explored and defined.

Capsules↗
PubMed2003

Capsule endoscopy versus push enteroscopy in patients with occult gastrointestinal bleeding.

BACKGROUND: Wireless capsule endoscopy is a new method enabling non-invasive diagnostic endoscopy of the entire small intestine. In this study we prospectively examined the diagnostic precision of capsule endoscopy compared with push enteroscopy in patients with occult gastrointestinal bleeding. METHODS: Between July 2001 and October 2002 we examined 48 patients with suspected disorders of the small intestine using capsule endoscopy. 33 patients with obscure bleeding (19 men, 14 women, mean age 58 +/- 23 years) were prospectively examined using capsule endoscopy and push enteroscopy. RESULTS: On average, the patients had been suffering from chronic gastrointestinal bleeding for 30 +/- 36 (1-120) months. The lowest haemoglobin level was 6.5 +/- 1.6 g/dl (2.3-9.6) and on average 9 +/- 10 (0-50) blood units were transfused. Each patient underwent 4 +/- 2 (1-10) hospitalisations, with a mean 9 +/- 4 (5-17) diagnostic procedures before capsule endoscopy was used. Definitive bleeding sites were diagnosed by push enteroscopy in 7 patients (angiodysplasia [n = 5], ulcers [n = 1], multiple jejunal diverticula [n = 1]). Capsule endoscopy showed a bleeding source in 25 cases (76 %) (angiodysplasias [n = 15], Meckel's diverticulum [n = 1], ulcers [n = 7], ileum diverticulosis [n = 1], B-cell lymphoma [n = 1]). Push enteroscopy localised an additional bleeding source in comparison with capsule endoscopy (multiple jejunal diverticula) in one patient. Both methods of examination were safe and showed no complications. DISCUSSION: The present study shows that capsule endoscopy had the highest diagnostic yield and was superior to push enteroscopy in patients with chronic gastrointestinal bleeding. By using the capsule at an early stage the subsequent therapeutic procedure could be considerably shortened and diagnostic processes could possibly be optimised.

Adolescent↗
PubMed1988

[Visible control of peritoneal perforation in surgical pelviscopy].

From the inception of laparoscopy, the primary blind incision has presented an as yet unresolved risk. In "open laparoscopy", the abdomen is opened in the classic manner as though a "mini-laparotomy" were being performed. This is time-consuming, cosmetically unsatisfactory, and restricted locally. Using a newly tried-out technique, and adhering to the classic transumbilical Z-incision technique, both the muscle layer and the peritoneum beneath it are punctured under endoscopic sight. Here, the elliptically ground end of a trocar capsule slides along the epiperitoneum, until light shining through allows a growth-free site to be diagnosed. The preceding inflation of the pneuperitoneum is performed without risk by use of aspiration tests, vacuum tests, and sound tests, and simultaneous measurement of insufflation and static pressure (Semm monofil bivalent system).

Female↗
PubMedDate not supplied

The effects of five potassium chloride preparations on the upper gastrointestinal mucosa in healthy subjects receiving glycopyrrolate.

The effects on the upper gastrointestinal tract of five different preparations of KCl were compared in 90 healthy subjects treated with glycopyrrolate. The KCl preparations studied were wax-matrix KCl, microencapsulated KCl, liquid KCl, experimental extended-release capsules, experimental extended-release tablets,and placebo. The subjects were endoscoped prior to and after seven days of dosing. Upper gastrointestinal mucosal pathology was seen with all of the potassium preparations as well as with placebo. No statistically significant differences between the various KCl groups or between KCl groups and placebo were seen. All of the lesions were superficial, except for one ulcer seen with the microencapsulated KCl. None of the subjects developed occult gastrointestinal bleeding. There were no differences in the incidence of abdominal symptoms.

Adolescent↗
PubMed2006

PillCam colon capsule endoscopy compared with colonoscopy for colorectal tumor diagnosis: a prospective pilot study.

BACKGROUND AND AIMS: Colonoscopy is regarded as the gold standard for colorectal cancer (CRC) screening. PillCam capsule endoscopy could be an alternative approach for screening large populations. We report a pilot evaluation in humans of the safety, feasibility, and performance of colon capsule endoscopy compared with colonoscopy. PATIENTS AND METHODS: Patients included in this single-center comparative study had presented for screening colonoscopy or there was suspicion of polyps or CRC. The capsule was ingested in the morning. After excretion, colonoscopy was performed. Significant findings were defined either as polyps > 6 mm, or three or more polyps of any size. Colonoscopy and colon capsule endoscopy (CCE) review were performed by independent physicians. RESULTS: 41 patients (26 women), mean age 56 years (range 26 - 75) were included, and all had complete colonoscopies. Four patients were excluded due to technical problems and one could not swallow the capsule; thus, 36 patients were considered in the analysis. In six the capsule had not been expelled at 10 hours and was retrieved endoscopically. CCE identified 19 of the 25 patients (76 %) with positive findings and 10 of the 13 (77 %) with significant lesions detected by colonoscopy. CCE detected seven lesions not seen at colonoscopy and two tumors were detected by both examinations. Overall sensitivity of CCE to detect significant lesions was 77 %, specificity was 70 %, positive predictive value was 59 %, and negative predictive value was 84 %. No adverse events occurred. CONCLUSION: CCE showed promising accuracy compared with colonoscopy. This new noninvasive technique deserves further evaluation as a potential CRC screening tool.

Adult↗
PubMed1997

Clarification of the link between polyunsaturated fatty acids and Helicobacter pylori-associated duodenal ulcer disease: a dietary intervention study.

Epidemiological evidence has suggested that the declining prevalence of duodenal ulcer disease may be attributable to rising consumption of polyunsaturated fatty acids, a hypothesis supported by in vitro evidence of toxicity of such substances to Helicobacter pylori. The objective of the present study was to establish whether this association is causal. Forty patients with proven infection with H. pylori and endoscopic evidence of past or present duodenal ulcer disease were randomized to receive either polyunsaturated fatty acids (PUFA group), in the form of capsules and margarine, or a placebo (control). Both groups received concurrent H2 antagonist therapy. Efficacy of therapy was determined endoscopically by assessment of ulcer healing while H. pylori status was determined by antral biopsy, urease (EC 3.5.1.5) culture and histological assessment of the severity of H. pylori infection. Antral levels of prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) were quantified. Compliance was monitored. Before treatment, both groups were comparable for severity of H. pylori infection, smoking status and levels of LTB4 and PGE2. Despite a significant difference in consumption of linoleic acid (19.9 (SE 1.6) g for PUFA group v. 6.7 (SE 0.8) g for controls (P < 0.01) and linolenic acid (2.6 (SE 0.2) g v. 0.6 (SE 0.03) g (P < 0.01) there was no significant change in either the severity of H. pylori infection or prostaglandin levels in either group at 6 weeks. Consumption of a considerable amount of PUFA does not inhibit the colonization of the stomach by H. pylori nor does this alter the inflammatory changes characteristic of H. pylori gastritis. We conclude that the association between duodenal ulceration and a low level of dietary PUFA is likely to be spurious, probably reflecting the effect of confounding factors such as affluence, social class or smoking.

Combined Modality Therapy↗