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https://www.readbyqxmd.com/read/28447199/a-novel-reconstruction-technique-during-pancreaticoduodenectomy-after-roux-en-y-gastric-bypass-how-i-do-it
#1
George Younan, Susan Tsai, Douglas B Evans, Kathleen K Christians
The altered anatomy in patients after bariatric surgery who have undergone a Roux-en-Y gastric bypass may pose a technical challenge for surgical removal of the pancreatic head. We treat patients with pancreas cancer with multimodality therapy in a neoadjuvant fashion followed by pancreaticoduodenectomy (PD). In patients with Roux-en-Y gastric bypass anatomy, the gastric remnant is preserved and used for pancreaticogastrostomy reconstruction and subsequently drained by the same jejunal limb used for the hepaticojejunostomy...
April 26, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28447058/development-of-lymph-node-dissection-in-laparoscopic-gastrectomy-safety-and-technical-tips
#2
REVIEW
Ru-Hong Tu, Ping Li, Jian-Wei Xie, Jia-Bin Wang, Jian-Xian Lin, Jun Lu, Qi-Yue Chen, Long-Long Cao, Mi Lin, Chang-Ming Huang, Chao-Hui Zheng
With the accumulation of experience in laparoscopic radical gastrectomy and the progress in surgical instruments, the laparoscopic technique has been widely applied in gastric cancer. Combining previous reports with data from our center, we believe that laparoscopic surgery for gastric cancer is safe and feasible, and its surgery-related complications have an incidence that is not higher, and perhaps even lower, than that of traditional laparotomy. However, the stomach has many anatomical levels and an abundant blood supply; additionally, laparoscopic surgery is relatively difficult...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28447049/surgical-anatomy-of-gastric-lymphatic-drainage
#3
REVIEW
Maria Carmen Lirosi, Alberto Biondi, Riccardo Ricci
The lymphatic system of the stomach is a multidirectional and complex network composed of lymphatic nodes and vessels. Lymph node metastasis is the most important prognostic factor in curable gastric cancer and lymph node dissection is one of the main areas of surgical research in gastric cancer. Therefore the anatomical classification and embryological development of the gastric lymphatic system have been well described in the literature. The current description of the gastric lymphatic system of the stomach has a surgical orientation and follows the recommendations of the Japanese Gastric Cancer Association...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28440517/-efficacy-and-future-of-endoscopic-bariatric-surgery-in-the-treatment-of-obesity-and-metabolic-diseases
#4
Shangjia Huang, Junchang Zhang, Zhiyong Dong, Cunchuan Wang
The emerging endoscopic technologies are proved to be effective treatments for obesity in selected patients and to offer the potential advantages of reduced invasiveness, reversibility and repeatability. From the view of operation principle, endoscopic technologies can be classified as restrictive procedure, malabsorption procedure and endoscopic revision of gastric bypass. Restrictive procedures include intragastric balloon, aspiration therapy, endoscopic sleeve gastroplasty (ESG) and transoral gastroplasty...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28404159/a-microbiota-centric-view-of-diseases-of-the-upper-gastrointestinal-tract
#5
REVIEW
Gerardo Nardone, Debora Compare, Alba Rocco
The distinctive anatomy and physiology of the upper gastrointestinal tract and the difficulty of obtaining samples led to the theory that it was bacteria free. However, multiomics studies are indicating otherwise. Although influenced by both oral and gastric bacteria, the resident microbial ecosystem in the oesophagus is dominated by Streptococcus. A shift from Gram-positive to Gram-negative bacteria occurs in oesophagitis and Barrett's oesophagus, and this shift might be involved in the pathogenesis of oesophageal adenocarcinoma...
April 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28377138/daily-ct-guidance-improves-target-coverage-during-definitive-radiation-therapy-for-gastric-malt-lymphoma
#6
He Wang, Sarah A Milgrom, Bouthaina S Dabaja, Grace L Smith, Mary Martel, Chelsea C Pinnix
PURPOSE: Radiation therapy (RT) for gastric mucosa-associated lymphoid tissue (MALT) lymphoma is challenging because of variation in the stomach's position, size, and shape. We investigated the interfractional changes in stomach location, consequent dosimetric effects, and impact of daily computed tomography image guidance RT (CT-IGRT). METHODS AND MATERIALS: Twelve patients treated for gastric MALT lymphoma with intensity modulated radiation therapy, using a breath-hold technique and restriction of oral intake, were studied retrospectively...
March 6, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28372456/paraesophageal-hernia-and-gastric-volvulus-an-uncommon-etiology-of-vomiting-and-upper-gastrointestinal-bleeding
#7
Gonçalo Nunes, Marta Patita, Vítor Fernandes, Jorge Fonseca
The authors report the case of a 75 year-old woman admitted to the emergency room with abdominal pain and coffee ground vomiting. Marked epigastric distension with tenderness and signs of severe dehydration were present. Upper GI endoscopy showed a black esophagus covered by a large amount of dark fluid, diffuse hyperaemia and superficial erosions. Marked distortion of gastric anatomy caused by stomach rotation and a large paraesophageal hernia was observed and the pylorus was not identified. Chest X-ray and CT scan confirmed the presence of an organoaxial gastric volvulus with antero superior rotation and incarceration of the gastric antrum, which was located above the diaphragm...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28351472/-the-missing-linx-for-gastroesophageal-reflux-disease-operative-techniques-video-for-the-linx-magnetic-sphincter-augmentation-procedure
#8
John P Kuckelman, Morgan R Barron, Matthew J Martin
In 2012 the FDA approved a magnetic sphincter augmentation (MSA) device (LINX, Torax Medical, Inc) for placement around the lower esophageal sphincter as an alternative approach to fundoplication for gastroesophageal reflux disease (GERD). This is a relatively new procedure and there is not widespread familiarization with the standard indications and techniques of device placement. We present two operative videos to highlight the standard surgical technique and technical points needed for successful LINX placement...
March 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28350490/single-center-experience-on-anatomy-and-histopathology-based-gastric-cancer-molecular-classification
#9
Karol Polom, Daniele Marrelli, Giandomenico Roviello, Costantino Voglino, Carla Vindigni, Daniele Generali, Franco Roviello
We analyzed the clinical utility of molecular classification based on anatomical and histological background. The study was conducted on 457 patients treated for gastric cancer with additional information about microsatellite instability status. We divided the patients in three groups of molecular classification based on anatomical and histological background: proximal non-diffused, diffused, and distal non-diffused groups. These groups varied in terms of clinical and pathological factors as well as survival rates...
March 28, 2017: Cancer Investigation
https://www.readbyqxmd.com/read/28336200/systematic-review-of-transgastric-ercp-in-roux-en-y-gastric-bypass-patients
#10
Nikhil Banerjee, Mayur Parepally, T Karl Byrne, Rana C Pullatt, Gregory A Coté, B Joseph Elmunzer
Balloon-assisted endoscopic retrograde cholangiopancreatoscopy (ERCP) in Roux-en-Y gastric bypass (RYGB) patients is technically challenging due to anatomic and accessory constraints, thus success rates are modest. Transgastric ERCP (TG-ERCP) offers a viable alternative. We aimed to systematically review the literature on TG-ERCP in RYGB patients to better define the technical approaches, success rates, and adverse events of this procedure. A computer-assisted search of the Embase and PubMed databases was performed to identify studies that focused on the techniques and clinical outcomes of TG-ERCP...
February 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28303507/laparoscopic-conversion-of-one-anastomosis-gastric-bypass-to-a-standard-roux-en-y-gastric-bypass
#11
Imed Ben Amor, Niccolo Petrucciani, Radwan Kassir, Abdullah Al Munifi, Thierry Piche, Tarek Debs, Jean Gugenheim
INTRODUCTION: One anastomosis gastric bypass (OAGB) demonstrated results similar to traditional Roux-en-Y procedures [1-3], in terms of weight loss and resolution of obesity-related comorbidities. The main controversy regarding OAGB is the concern for an association between biliary alkaline gastritis and esophageal or gastric cancer raised by some studies [4]. METHODS: We present the case of a 51-year-old woman with a BMI of 41 kg/m2 who underwent a laparoscopic OAGB in 2014...
March 16, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28287530/open-tracheostomy-gastric-acid-aspiration-murine-model-of-acute-lung-injury-results-in-maximal-acute-nonlethal-lung-injury
#12
Ravi Alluri, Hilliard L Kutscher, Barbara A Mullan, Bruce A Davidson, Paul R Knight
Acid pneumonitis is a major cause of sterile acute lung injury (ALI) in humans. Acid pneumonitis spans the clinical spectrum from asymptomatic to acute respiratory distress syndrome (ARDS), characterized by neutrophilic alveolitis, and injury to both alveolar epithelium and vascular endothelium. Clinically, ARDS is defined by acute onset of hypoxemia, bilateral patchy pulmonary infiltrates and non-cardiogenic pulmonary edema. Human studies have provided us with valuable information about the physiological and inflammatory changes in the lung caused by ARDS, which has led to various hypotheses about the underling mechanisms...
February 26, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28281726/anastomotic-loop-between-common-hepatic-artery-and-gastroduodenal-artery-in-coexistence-with-an-aberrant-right-hepatic-artery
#13
Konstantinos Natsis, Maria Piagkou, Theodosis Stamatopoulos, Ioannis Spyridakis, Stylianos Apostolidis
Anatomical variations of the hepatic arteries are not uncommon. The anomalous hepatic arterial supply is of paramount importance in hepatobiliary, pancreatic or liver transplantation and in laparoscopic surgery. We describe an unusual case of a 66-year-old Greek male cadaver, where a rare anastomosis (in the form of an enlarged arterial loop, 4.84 mm in diameter) between the common hepatic artery (6.42 mm) and the gastroduodenal artery (GDA) (4.82 mm) coexisted with an aberrant right hepatic artery (ARHA) (6...
March 10, 2017: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/28276285/gastric-conduit-obstruction-due-to-gastroduodenal-compression-a-new-complication-post-ivor-lewis-oesophagectomy
#14
Victoria A Perkins, Samuel McFerran, Ali Kordzadeh, Elias Sdralis, Bruno Lorenzi, Alexandros Charalabopoulos
INTRODUCTION: Oesophagectomy for oesophageal carcinoma carries a high risk of significant morbidity and mortality. Delayed gastric emptying is a relatively common complication following this procedure. A variety of medical, surgical and endoscopic strategies have been described to manage it. The vast majority of cases are related to post-operative pyloric dysfunction and are amenable to conventional management strategies. PATIENTS AND METHODS: We present a new case of a patient with a duodenal hiatus hernia resulting in extrinsic gastroduodenal compression by the massively distended gastric conduit as a cause of gastric outlet obstruction following laparoscopic-assisted Ivor-Lewis oesophagectomy 2 years previously...
March 9, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28271378/vertical-gastric-bypass-with-fundectomy-feasibility-and-2-year-follow-up-in-a-series-of-morbidly-obese-patients
#15
Marco Antonio Zappa, Alberto Aiolfi, Cinzia Musolino, Maria Paola Giusti, Giovanni Lesti, Andrea Porta
BACKGROUND: Roux-en-Y gastric bypass (RYGB) is the gold standard procedure for morbid obesity and its results are well known and largely discussed. The major limitation of the procedure is the difficult exploration of the excluded gastric pouch and duodenum. The vertical gastric bypass with fundectomy was recently introduced in attempt to overcome these limitations. To date, its effectiveness is debated and outcomes still unclear. The purposes of this study were to describe the vertical gastric bypass with fundectomy and to analyse its outcomes in term of weight loss, complications, and comorbid resolutions...
March 7, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28243128/the-superiority-of-256-slice-spiral-computed-tomography-angiography-for-preoperative-evaluation-of-surrounding-arteries-in-patients-with-gastric-cancer
#16
Deqing Wu, Linyong Zhao, Ying Liu, Junjiang Wang, Weixian Hu, Xingyu Feng, Zejian Lv, Yong Li, Xueqing Yao
OBJECTIVE: To evaluate the utilization of 256-slice spiral computed tomography (CT) angiography in preoperative assessment of perigastric vascular anatomy in patients with gastric cancer. METHODS: In this study, 80 gastric cancer patients were included. The medical procedure of 256-slice spiral CT angiography was performed on each of these patients consecutively. Thereafter, these patients were subjected to surgical treatment in our hospital. The techniques of volume rendering (VR) and maximum intensity projection (MIP) were used to image reconstruction of arteries around the stomach...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28203176/a-case-of-gastric-cancer-with-situs-inversus-totalis
#17
Byoung Jo Suh
Situs inversus totalis (SIT) is a rare congenital anomaly that refers to a completely reversed location of the abdominal and thoracic organs. We report the case of 50-year-old man with gastric cancer and SIT who was diagnosed during a screening esophagogastroduodenoscopy. A chest X-ray, abdominopelvic computed tomography, and (18)F-fluoro2-deoxyglucose-D-glucose-positron emission tomography scans revealed SIT. We performed a radical subtotal gastrectomy with D2 lymph node dissection. Advanced surgical skill is required to perform a precise lymphadenectomy in a patient with SIT by visualizing the exact mirror image of the anatomy during the operation...
January 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/28182300/endoscopic-double-stenting-for-gastrojejunostomy-anastomotic-and-biliary-obstruction-in-a-patient-with-roux-en-y-reconstruction
#18
Tadahisa Inoue, Kiyoaki Ito, Masashi Yoneda
Although it has been reported that endoscopic double stenting using a self-expandable metallic stent (SEMS) for gastroduodenal and biliary obstruction is useful [1-2], the efficacy and safety of performing double stenting using balloon enteroscopy is uncertain in patients with surgically altered anatomy. We describe a patient who had undergone gastrectomy and then underwent endoscopic double stenting for gastrojejunostomy anastomotic and biliary obstruction. A man in his 50s with a history of having undergone distal gastrectomy with Roux-en-Y reconstruction because of gastric cancer developed gastrojejunostomy anastomotic obstruction due to local anastomotic recurrence and peritoneal dissemination (Fig...
February 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28173792/microscopic-identification-and-in-vitro-activity-of-agastache-rugosa-fisch-et-mey-from-xinjiang-china
#19
Haiyan Gong, Shaoyu Li, Lijuan He, Rena Kasimu
BACKGROUND: Agastache rugosa is well-known as a common traditional Chinese medicine, which have relieving summer-heat, analgesic and antipyretic effects, have long been used as folkloristic remedy in the treatment of several infectious diseases, anti-inflammatory, and for its antibacterial properties. Considering the lack of available data on the morphology, anatomy and in vitro activity of A. rugosa, the goal of the present study was to carry out the microscopic identification of its aerial parts and in vitro activity research as a contribution to the quality control and reasonable utilization involving A...
February 7, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28139103/-intestinal-duplication-a-single-experiencie-center
#20
M A Cárdenas Elias, F Vázaquez Rueda, J E Betancourth-Alvarenga, M Centeno Haro, F J Murcia Pascual, R M Paredes Esteban
PURPOUSE: Intestinal duplications (DI) are rare congenital anomalies (1/10.000 new born). We analyze the clinical characteristics, management and treatment of intestinal duplications in our center. MATERIALS AND METHODS: We perform a retrospectively descriptive analysis review by the DI confirmed by histological studies since 1993-2014 in our center. The variables analyzed are: age, sex, clinical presentation, localization, anatomical type, associated diseases, heterotopic tissue, treatment and complications...
April 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
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