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https://www.readbyqxmd.com/read/28103500/thoracoscopic-surgery-in-the-prone-position-for-esophageal-cancer-in-patients-with-situs-inversus-totalis-a-report-of-two-cases
#1
Toru Nakano, Takashi Kamei, Yu Onodera, Naoto Ujiie, Noriaki Ohuchi
INTRODUCTION: Situs inversus totalis (SIT) is a rare congenital condition characterized by a complete transposition of thoracic and abdominal organs. Here, we present two successful cases of left thoracoscopic esophagectomy in the prone position for SIT-associated esophageal cancer. PRESENTATION OF CASE: Our first case was of an 82-year-old man who underwent a left thoracoscopic esophagectomy in the prone position, followed by hand-assisted laparoscopic gastric mobilization...
January 6, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28078131/a-novel-management-of-post-oesophagectomy-gastro-pleural-fistula
#2
Javaid Ishtiaq, Jonathan Sutton, Waqar Ahmed
Oesophageal anastomotic leak and fistula are major and life-threatening complications of oesophagectomy with resultant increased mortality. Non-operative approach of such cases should be the initial strategy. Re-operative surgery and/or stent insertion are considered if conservative measures failed. Although oesophageal stenting is a safe option for the leaks, stent migration and failure to completely cover large anastomotic leaks are the main complications and pitfalls of the procedure. These can be overcome by using multiple or larger stents...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28047956/tu-ab-bra-10-treatment-of-gastric-malt-lymphoma-utilizing-a-magnetic-resonance-image-guided-radiation-therapy-mr-igrt-system-evaluation-of-gating-feasibility
#3
T Mazur, H Gach, A Chundury, B Fischer-Valuck, J Huang, M Thomas, O Green
PURPOSE: To evaluate the feasibility of real-time, real-anatomy tracking and gating for gastric lymphoma patients treated with magnetic resonance image-guided radiation therapy (MR-IGRT) METHODS: Over the last 2 years, 8 patients with gastric lymphoma were treated with 0.3-T, Co-60 MR-IGRT. Post-treatment analysis of real-time cine imaging in the sagittal plane during each patient's treatment revealed significant motion of the stomach. While this motion was accounted for with generous PTV margins, the system's capability for real-time, real-anatomy tracking could be used to reduce treatment margins by gating...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047134/th-cd-202-11-implications-for-online-adaptive-and-non-adaptive-radiotherapy-of-gastic-and-gastroesophageal-junction-cancers-using-mri-guided-radiotherapy
#4
K Mittauer, M Geurts, R Toya, M Bassetti, P Harari, B Paliwal, J Bayouth
PURPOSE: Radiotherapy for gastric and gastroesophageal junction (GEJ) tumors commonly requires large margins due to deformation, motion and variable changes of the stomach anatomy, at the risk of increased normal tissue toxicities. This work quantifies the interfraction variation of stomach deformation from daily MRI-guided radiotherapy to allow for a more targeted determination of margin expansion in the treatment of gastric and GEJ tumors. METHODS: Five patients treated for gastric (n=3) and gastroesophageal junction (n=2) cancers with conventionally fractionated radiotherapy underwent daily MR imaging on a clinical MR-IGRT system...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/27980124/right-to-left-shunt-has-modest-effects-on-co2-delivery-to-the-gut-during-digestion-but-compromises-oxygen-delivery
#5
Christian Lind Malte, Hans Malte, Lærke Rønlev Reinholdt, Anders Findsen, James W Hicks, Tobias Wang
By virtue of their cardiovascular anatomy, reptiles and amphibians can shunt blood away from the pulmonary or systemic circuits, but the functional role of this characteristic trait remains unclear. It has been suggested that right-to-left (R-L) shunt (recirculation of systemic blood within the body) fuels the gastric mucosa with acidified and CO2-rich blood to facilitate gastric acid secretion during digestion. However, in addition to elevating PCO2, R-L shunt also reduces arterial O2 levels and would compromise O2 delivery during the increased metabolic state of digestion...
December 15, 2016: Journal of Experimental Biology
https://www.readbyqxmd.com/read/27943376/oral-contrast-enhanced-gastric-ultrasonography-in-the-assessment-of-gastric-lesions-a-large-scale-multicenter-study
#6
Xiao-Zhi Zheng, Li-Juan Zhang, Xin-Ping Wu, Wen-Ming Lu, Jing Wu, Xu-Yan Tan
OBJECTIVE: To determine the diagnostic efficiency of oral contrast-enhanced gastric ultrasonography in the evaluation of gastric lesions, based on large-scale multicenter study. METHODS: The study enrolled 383,945 patients with suspect gastric lesions who underwent complete oral contrast-enhanced gastric ultrasonography and endoscopic evaluation. Two operators, unaware of the results of other diagnostic procedures, performed each examination independently. The accuracies of conventional ultrasonography, oral contrast-enhanced gastric ultrasonography, and upper gastrointestinal endoscopy were determined...
December 1, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27920863/balloon-occluded-retrograde-transvenous-obliteration-for-treatment-of-bleeding-gastric-varices-case-report-and-review-of-literature
#7
Sana Basseri, Christopher B Lightfoot
Gastric variceal bleeding is a major complication of portal hypertension and is associated with high morbidity and mortality. While esophageal varices are more common, gastric varices are often more challenging to treat. Balloon-Occluded Retrograde Transvenous Obliteration is an interventional procedure whereby the portosystemic gastrorenal shunt is accessed via the left renal vein and the gastric varix outflow tract obliterated using direct sclerotherapy. Herein, we present a case of a 68-year-old female patient with cirrhosis who presented with bleeding gastric varices and successfully treated...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27844255/a-vertically-placed-clip-for-weight-loss-a-39-month-pilot-study
#8
Moises Jacobs, Natan Zundel, Gustavo Plasencia, Prospero Rodriguez-Pumarol, Eddie Gomez, James Leithead
BACKGROUND: Morbid obesity remains one of society's significant medical dilemmas. It is rapidly worsening and expected to affect 35% of the US population by the year 2020. Common current bariatric procedures exist and include, but not limited to, the adjustable gastric band, gastric bypass, and the sleeve gastrectomy. Although beneficial to morbidly obese patients, they also alter the patient's anatomy and involve resections, or require maintenance. The goal of the trial is to show a new minimally invasive vertical gastric clip technique that produces significant weight loss but requires no resection, no change in anatomy, and is reversible...
November 14, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27829412/gastric-bypass-surgery-reveals-independency-of-obesity-and-diabetes-melitus-type-2
#9
Mogens Fenger, Dorte Lindqvist Hansen, Dorte Worm, Lisbeth Hvolris, Viggo B Kristiansen, Elin Rebecka Carlsson, Sten Madsbad
BACKGROUND: Roux-en-Y gastric bypass surgery is widely applied to ameliorate morbid obesity, including diabetes in people with type 2 diabetes. The latter vanish a few days after surgery for many, but not in all patients before any weight reduction has occurred. The explanation for this change in metabolic status is poorly understood, but the observation may suggest that the fate obesity and diabetes is only partly linked after surgery. METHODS: The trajectories of weight reduction measured as reduced body mass index (BMI) in 741obese subjects with and without diabetes were evaluated...
November 9, 2016: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/27812408/comparative-internal-anatomy-of-staurozoa-cnidaria-with-functional-and-evolutionary-inferences
#10
Lucília S Miranda, Allen G Collins, Yayoi M Hirano, Claudia E Mills, Antonio C Marques
Comparative efforts to understand the body plan evolution of stalked jellyfishes are scarce. Most characters, and particularly internal anatomy, have neither been explored for the class Staurozoa, nor broadly applied in its taxonomy and classification. Recently, a molecular phylogenetic hypothesis was derived for Staurozoa, allowing for the first broad histological comparative study of staurozoan taxa. This study uses comparative histology to describe the body plans of nine staurozoan species, inferring functional and evolutionary aspects of internal morphology based on the current phylogeny of Staurozoa...
2016: PeerJ
https://www.readbyqxmd.com/read/27808040/endobarrier-gastrointestinal-liner-delineation-of-underlying-mechanisms-and-clinical-effects
#11
Ulrich Rohde
Bariatric surgery (e.g. Roux-en-Y gastric bypass (RYGB)) has proven the most effective way of achieving sustainable weight losses and remission of type 2 diabetes (T2D). Studies indicate that the effectiveness of RYGB is mediated by an altered gastrointestinal tract anatomy, which in particular favours release of the gut incretin hormone glucagon-like peptide-1 (GLP-1). The EndoBarrier gastrointestinal liner or duodenal-jejunal bypass sleeve (DJBS) is an endoscopic deployable minimally invasive and fully reversible technique designed to mimic the bypass component of the RYGB...
November 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27738969/one-anastomosis-jejunal-interposition-with-gastric-remnant-resection-branco-zorron-switch-for-severe-recurrent-hyperinsulinemic-hypoglycemia-after-gastric-bypass-for-morbid-obesity
#12
Ricardo Zorron, Alcides Branco, Jose Sampaio, Claudia Bothe, Tido Junghans, Gyurdzhan Rasim, Johann Pratschke, Safak Guel-Klein
BACKGROUND: The anatomical and physiological changes after Roux-en-Y gastric bypass for morbid obesity can lead to severe hyperinsulinemic hypoglycemia with neuroglycopenia in a small percentage of patients. The exact physiologic mechanism is not completely understood. Surgical reversal to the original anatomy and distal or total pancreatectomy are current therapeutic options to reverse the hypoglycemic effect, with substantial associated morbidity. Our group reports a pilot clinical series of a novel surgical technique using one-anastomosis jejunal interposition with gastric remnant resection (Branco-Zorron Switch)...
October 13, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27716860/safety-and-effectiveness-of-a-long-partially-covered-metal-stent-for-endoscopic-ultrasound-guided-hepaticogastrostomy-in-patients-with-malignant-biliary-obstruction
#13
Yousuke Nakai, Hiroyuki Isayama, Natsuyo Yamamoto, Saburo Matsubara, Yukiko Ito, Naoki Sasahira, Ryunosuke Hakuta, Gyotane Umefune, Naminatsu Takahara, Tsuyoshi Hamada, Suguru Mizuno, Hirofumi Kogure, Minoru Tada, Kazuhiko Koike
Background and study aims: Endoscopic ultrasound (EUS)-guided biliary drainage (EUS-BD) is potentially complicated by bile leak and stent migration. The aim of this study was to evaluate the safety and effectiveness of a long (≥ 10 cm), partially covered metal stent (LP-CMS) for EUS-guided hepaticogastrostomy (EUS-HGS) for malignant biliary obstruction. Both the stent length and the uncovered portion at the proximal end of the LP-CMS are designed to prevent stent migration. Patients and methods: A total of 33 patients undergoing EUS-HGS using an LP-CMS in four centers were retrospectively studied...
December 2016: Endoscopy
https://www.readbyqxmd.com/read/27697984/multimodality-therapy-of-localized-gastric-adenocarcinoma
#14
REVIEW
Brian Badgwell
Surgical resection is the primary method of obtaining a potential cure for patients with gastric adenocarcinoma. However, chemotherapy or chemoradiotherapy offer significant improvement in survival over surgery alone. Much of the difficulty in deciding the optimal treatment strategy is choosing between perioperative chemotherapy or adjuvant chemoradiotherapy. Adding to the complexity is the potential for incorporating treatment strategies based on clinical trials performed in Asia. There is likely a difference in tumor biology between Eastern and Western patients with gastric adenocarcinoma, in addition to the clear differences in screening, pathologic assessment, and surgical technique...
October 2016: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/27683794/from-complex-evolving-to-simple-current-revisional-and-endoscopic-procedures-following-bariatric-surgery
#15
Ricardo Zorron, Manoel Passos Galvão-Neto, Josemberg Campos, Alcides José Branco, José Sampaio, Tido Junghans, Claudia Bothe, Christian Benzing, Felix Krenzien
Background: Roux-en-Y gastric bypass (RYGB) is a standard therapy in bariatric surgery. Sleeve gastrectomy and gastric banding, although with good results in the literature, are showing higher rates of treatment failure to reduce obesity-associated morbidity and body weight. Other problems after bariatric may occur, as band erosion, gastroesophageal reflux disease and might be refractory to medication. Therefore, a laparoscopic conversion to a RYGB can be an effective alternative, as long as specific indications for revision are fulfilled...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27683770/intestinal-malrotation-in-patients-undergoing-bariatric-surgery
#16
Eduardo Arevalo Vidal, Francisco Abarca Rendon, Trino Andrade Zambrano, Yudoco Andrade García, Mario Ferrin Viteri, Josemberg Marins Campos, Manoela Galvão Ramos, Almino Cardoso Ramos
Background: Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. Aim: To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Methods: Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27659179/determination-of-porto-azygos-shunt-anatomy-in-dogs-by-computed-tomography-angiography
#17
Matan Or, Kumiko Ishigaki, Hilde de Rooster, Kenji Kutara, Kazushi Asano
OBJECTIVE: To describe the morphology of porto-azygos shunts in a large series of dogs using computed tomography (CT) angiography. STUDY DESIGN: Retrospective study. ANIMALS: Dogs (n=36) with porto-azygos shunts. METHODS: CT angiography was performed in dogs subsequently proven to have a porto-azygos shunt. The origin and insertion of the shunts were assessed on native images. The diameter of the porto-azygos shunt and the portal vein, cranial and caudal to the shunt origin, were measured...
September 23, 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27651917/case-report-of-eus-guided-endoscopic-transduodenal-necrosectomy-in-a-patient-with-sleeve-gastrectomy
#18
Avik Sarkar, Ragui Sadek, Matthew Lissauer, Swati Pawa
BACKGROUND: After an acute attack of pancreatitis, walled-off pancreatic fluid collections (PFC) occur in approximately 10 % of cases. Drainage of the cavity is recommended when specific indications are met. Endoscopic drainage has been adopted as the main intervention for symptomatic walled-off PFC. Altered gastric anatomy in these patients poses an interesting challenge. We present the first case of a patient with sleeve gastrectomy who underwent successful endoscopic transduodenal necrosectomy (TDN)...
2016: BMC Obesity
https://www.readbyqxmd.com/read/27614616/laparoscopy-assisted-trans-gastric-rendez-vous-for-the-treatment-of-common-bile-duct-stones-in-patients-with-prior-roux-en-y-gastric-bypass
#19
Ricardo Mejía, Pablo Achurra, Mauricio Gabrielli, Eduardo Briceño, Rolando Rebolledo, Alberto Torres, Allan Sharp, Fernando Pimentel, Fernando Crovari
BACKGROUND: Common bile duct (CBD) stones in a Roux-en-Y gastric bypass (RYGB) represent a major challenge for ERCP due to long-limb anatomy. Trans-gastric approach has been proposed but entails high ERCP-related risks. Laparoscopy assisted trans-gastric rendez-vous (LATG-RV) is a one-step procedure that may lower the risks of these patients. METHODS: We describe our initial experience in four patients with past history of RYGB and CBD stones. RESULTS: All patients underwent LATG-RV and had successful CBD stone clearance...
November 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27597144/the-dynamic-gastric-environment-and-its-impact-on-drug-and-formulation-behaviour
#20
REVIEW
Jens Van Den Abeele, Jari Rubbens, Joachim Brouwers, Patrick Augustijns
Before being absorbed in the small intestine and/or colon, orally administered drugs inevitably need to pass through the stomach. Hence, it seems reasonable that the residence of a dosage form in the gastric environment, however brief it may be, may influence drug disposition further down the gastrointestinal tract and may potentially impact systemic exposure to a drug of interest. However, research efforts in the past mainly focused on drug disposition at the level of the intestine, i.e. the main site of absorption, hereby disregarding or oversimplifying the stomach's contribution to gastrointestinal drug disposition...
January 1, 2017: European Journal of Pharmaceutical Sciences
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