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Endoscopic interventions

Brain D Sindelar, Vimal Patel, Shakeel Chowdhry, Julian E Bailes
Intracerebral hemorrhage (ICH) with or without intraventricular hemorrhage (IVH) is a highly morbid disease process due to the mass effect and secondary injury that occurs upon the surrounding brain. Historically, surgical evacuation has failed to demonstrate improved outcomes in comparison to standard medical therapy likely due to the significant brain trauma when accessing the clot. Recent minimally invasive techniques have proposed a way to improve outcomes by reducing this injury. We report here a 62-year-old male with ICH and IVH with acute neurological deterioration due to hydrocephalus was found to have no improvement following external ventricular drainage...
July 13, 2018: Curēus
Emanuele Sinagra, Dario Raimondo, Domenico Albano, Valentina Guarnotta, Melania Blasco, Sergio Testai, Marta Marasà, Vincenzo Mastrella, Valerio Alaimo, Valentina Bova, Giovanni Albano, Dario Sorrentino, Giovanni Tomasello, Francesco Cappello, Angelo Leone, Francesca Rossi, Massimo Galia, Roberto Lagalla, Federico Midiri, Gaetano Cristian Morreale, Georgios Amvrosiadis, Guido Martorana, Marcello Giuseppe Spampinato, Vittorio Virgilio, Massimo Midiri
Background: The superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods: This study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to confirm the diagnosis...
2018: Gastroenterology Research and Practice
Lyvia Y Leigh, Jonathan M Spergel
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic allergic, immune-mediated disease associated with increased risk of comorbid atopic conditions. OBJECTIVE: We aim to perform an in-depth characterization of a large cohort of manually verified adult EoE patients including evaluation of less studied associations such as pollen food allergy syndrome, anaphylaxis, autoimmunity and psychiatric comorbidities. METHODS: We performed manual retrospective electronic medical record review of 1,218 patients with EoE identified by ICD-9 and 10 codes from the University of Pennsylvania Health Systems (UPHS)...
September 14, 2018: Annals of Allergy, Asthma & Immunology
Przemysław Pyda, Aleksander Sowier, Sebastian Sowier, Anna-Maria Borucka, Joanna Kapturzak, Jacek Białecki, Stanisław Wójtowicz
INTRODUCTION: Obesity is becoming one of the major public health problems. Bariatric procedures are considered the most effective methods of treating this condition but they are costly and entail a high risk of complications. Thus, there is a need to look for better bariatric treatment solutions. One of the newest, highly promising bariatric methods is endoscopic sleeve gastroplasty (ESG), which is comparably effective to other bariatric procedures in terms of weight loss but at the same time it is much less invasive...
June 13, 2018: Polski Przeglad Chirurgiczny
Roos E Pouw, Torsten Beyna, Kamar Belghazi, Arjun D Koch, Erik J Schoon, Rehan Haidry, Bas L Weusten, Raf Bisschops, Nicholas J Shaheen, Michael B Wallace, Norman Marcon, Rachel Heise-Ginsburg, Anniek W Gotink, Kenneth K Wang, Cadman L Leggett, Jacobo Ortiz-Fernández-Sordo, Krish Ragunath, Massimiliano DiPietro, Oliver Pech, Horst Neuhaus, Jacques J Bergman
BACKGROUND AND AIMS: Early neoplasia in Barrett's esophagus (BE) can be effectively and safely removed by endoscopic resection (ER) using multiband mucosectomy (MBM). This study aimed to document performance of a novel MBM device designed for improved visualization, easier passage of accessories, and better suction power compared with other marketed MBM devices. METHODS: This international, single-arm, prospective registry in 14 referral centers (Europe, 10; United States, 3; Canada, 1) included patients with early BE neoplasia scheduled for ER...
October 2018: Gastrointestinal Endoscopy
Zhao Xiaobing, Li Xingchen, Zhou Honggang, Cao Xiaoqiang, Yuan Qidong, Ma Haijun, Yang Hejun, Wang Bisheng
PURPOSES: To describe the rationale, surgical technique, and short-term follow-up results of a new minimally invasive treatment for thoracic spinal stenosis (TSS) caused by herniation, ossification of the ligamentum flavum (OLF), and/or ossification of the posterior longitudinal ligament (OPLL) with a "U" route transforaminal percutaneous endoscopic thoracic discectomy (PETD). METHODS: Fourteen patients, including seven males and seven females, underwent "U" route PETD...
September 15, 2018: International Orthopaedics
Gabriel-Cristian Inaraja-Pérez, María Júlvez-Blancas
OBJECTIVE: Our primary objective was to test if the C-D-C is also applicable for the assessment of carotid surgery and how well it correlates with patient prognosis in the mid-term follow-up. METHODS: From January 2011 to March 2014, a total of 248 consecutive open surgical carotid revascularization procedures were performed at one academic institution. All patients, symptomatic and asymptomatic, had a high-grade (>70%) stenosis and were operated on under general anesthesia...
September 11, 2018: Annals of Vascular Surgery
Jia Rui Kwan, Keith Sheng Hng Low, Rahul Lohan, Vishal G Shelat
Percutaneous transhepatic biliary drainage (PTBD) is safe treatment for biliary decompression given certain indications. However, this is temporary until definitive drainage is established. We report on a 76-year-old lady with recurrent pyogenic cholangitis and PTBD catheter fracture. She had hepatitis B virus-related Child-Pugh class A liver cirrhosis, hypothyroidism, hyperlipidaemia, and previous atrial fibrillation with a background of mild mitral, tricuspid and aortic valvular regurgitation. She had history of laparoscopic cholecystectomy in the past...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Wafaa S Hamza, Mona F Salama, Samar S Morsi, Naglaa M Abdo, Mariam A Al-Fadhli
Purpose: To measure surgical site infection (SSI) rates among gastrointestinal surgeries and to identify the associated risk factors. Patients and methods: We conducted a multicenter, retrospective, surveillance-based study of adults undergoing gastric, colon, and small bowel (SB) procedures from January to December 2016. Univariate and multivariate analyses were conducted to determine the predictive variables in each surgery. Results: In total, 71 of 2,099 patients developed SSI - 0...
2018: Infection and Drug Resistance
Max Ward, Naveed Kamal, Neil Majmundar, Ada Baisre-De Leon, Jean Anderson Eloy, James K Liu
We present a rare case of a 63-year-old male who developed pituitary apoplexy (PA) after sustaining a closed head injury from assault with a metal pole. The patient had a known pituitary tumor for which he had previously declined surgical resection. On initial CT scan, there was no traumatic intracerebral hemorrhage or subarachnoid hemorrhage. There was sellar expansion but no obvious sellar hemorrhage. Within 48 hours of admission the patient was presumed septic after developing altered mental status, fevers, hypotension and tachycardia...
September 10, 2018: World Neurosurgery
Mike Thomson
Acute upper gastrointestinal bleeding in children is possibly the last medical emergency which continues to lead to the death of a child due to the lack of competency/clinical judgement of the doctor, as opposed to the disease itself, leading to mortality despite optimum medical intervention. This is unacceptable in any circumstances in 2018. It occurs due to a number of conspiring factors including lack of appreciation of the clinical presentation requiring urgent endoscopic intervention; misapprehension of the urgency of timing required of such an intervention predicated on the severity of the gastrointestinal (GI) bleed; lack of application of a paediatric-specific validated score predicting for such endoscopic intervention; lack of skill in endo-haemostatic intervention techniques by paediatric endoscopists; poor training in such techniques among paediatric endoscopists; paucity of cases with lack of exposure of the paediatric endoscopist regularly to enable skills to be maintained, once acquired; reluctance of adult endoscopists in many centres to support paediatric GI bleeding services...
September 11, 2018: Journal of Pediatric Gastroenterology and Nutrition
Maxime E S Bronzwaer, Barbara A J Bastiaansen, Lianne Koens, Evelien Dekker, Paul Fockens
Background and study aims  Colorectal polyps involving the appendiceal orifice (AO) are difficult to resect with conventional polypectomy techniques and therefore often require surgical intervention. These appendiceal polyps could potentially be removed with endoscopic full-thickness resection (eFTR) performed with a full-thickness resection device (FTRD). The aim of this prospective observational case study was to evaluate feasibility, technical success and safety of eFTR procedures involving the AO. Patients and methods  This study was performed between November 2016 and December 2017 in a tertiary referral center by two experienced endoscopists...
September 2018: Endoscopy International Open
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Masahiro Katsuda, Keiji Hayata, Toshiaki Tsuji, Shimpei Maruoka, Hiroki Yamaue
Background and study aims  Interventional endoscopic treatments including the application of glue are becoming more frequently used for the treatment of esophageal fistulas. However, there are no prospective studies of endoscopic treatment for esophageal fistulas. This prospective study aims to investigate the efficacy and safety of endoscopic injection of alpha-cyanoacrylate monomer for intractable esophageal fistulas. Patients and methods  This single-center prospective phase II trial included patients with more than 1 wk of conservative medical treatment for intractable esophageal fistulas after esophagectomy...
September 2018: Endoscopy International Open
Shunya Hanakita, Moujahed Labidi, Kentaro Watanabe, Sebastien Froelich
Objective  While the endoscopic endonasal approach (EEA) has gained widespread acceptance for the resection of clivus chordomas, conventional transcranial approaches still have a crucial role in craniocervical junction (CCJ) chordoma surgery. In repeat surgery, a carefully planned treatment strategy is needed. We present a surgical treatment plan combining an EEA and a far-lateral craniotomy with endoscopic assistance (EA) in the salvage surgery of a recurrent CCJ chordoma. Case Presentation  A 37-year-old woman who had undergone partial resection of a chordoma extending from the mid-clivus to the CCJ...
October 2018: Journal of Neurological Surgery. Part B, Skull Base
Ali Kord Valeshabad, Jennifer Acostamadiedo, Lekui Xiao, Winnie Mar, Karen L Xie
A 49-year-old male with history of chronic alcohol-induced pancreatitis presented with one month of worsening left pleuritic chest pain and shortness of breath. Chest radiograph demonstrated bilateral pleural effusions. Thoracentesis revealed increased amylase in the pleural fluid. Computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) showed a fistula tract between the left pleural cavity and pancreas which was confirmed on endoscopic retrograde cholangiopancreatography (ERCP). Patient was treated with placement of a pancreatic stent with complete resolution of the fistula tract approximately in 9 weeks...
2018: Case Reports in Gastrointestinal Medicine
Kaid Darwiche, Clemens Aigner
Following the evaluation of surgical lung volume reduction (LVR) in the National Emphysema Treatment (NETT) trial, different endoscopic LVR procedures have been developed for severe emphysema. Among those, endobronchial valve placement is the best evaluated method. All these therapies aim at reducing hyperinflation and at improving respiratory mechanics. It has been shown that these procedures can improve quality of life, lung function and exercise capacity in a significant and clinically meaningful way in suitable patients...
August 2018: Journal of Thoracic Disease
Katharina Martini, Thomas Frauenfelder
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. One of the main findings is pulmonary emphysema in association with chronic bronchitis. Clinical signs, pulmonary function tests and imaging are the current used methods to diagnose and stage emphysema. Lung volume reduction (LVR) and endoscopic lung volume reduction (ELVR) are the current therapeutic options beside lung transplantation in cases of severe emphysema. Nowadays imaging is one of the key factors for the success of these therapies...
August 2018: Journal of Thoracic Disease
Ali Siddiqui, Rastislav Kunda, Amy Tyberg, Mustafa A Arain, Arish Noor, Tayebah Mumtaz, Usama Iqbal, David E Loren, Thomas E Kowalski, Douglas G Adler, Monica Saumoy, Monica Gaidhane, Shawn Mallery, Eric M Christiansen, Jose Nieto, Michel Kahaleh
BACKGROUND: Percutaneous cholecystostomy tube (PTGBD), endoscopic retrograde cholangiopancreatography with transpapillary gallbladder drainage (TP), and endoscopic ultrasound-guided transmural gallbladder drainage (EGBD) using lumen-apposing metal stents (LAMS) have been offered for gallbladder decompression for acute cholecystitis in high-risk surgical patients. Yet, there are limited data comparing these therapies. Our aim was to compare the safety and efficacy of EGBD to TP and PTGBD for gallbladder drainage...
September 12, 2018: Surgical Endoscopy
Karen Head, Steve Sharp, Lee-Yee Chong, Claire Hopkins, Carl Philpott
BACKGROUND: This review adds to a series of reviews looking at primary medical management options for patients with chronic rhinosinusitis.Chronic rhinosinusitis is common and characterised by inflammation of the lining of the nose and paranasal sinuses leading to nasal blockage, nasal discharge, facial pressure/pain and loss of sense of smell. The condition can occur with or without nasal polyps. Antifungals have been suggested as a treatment for chronic rhinosinusitis. OBJECTIVES: To assess the effects of systemic and topical antifungal agents in patients with chronic rhinosinusitis, including those with allergic fungal rhinosinusitis (AFRS) and, if possible, AFRS exclusively...
September 10, 2018: Cochrane Database of Systematic Reviews
Yu A Shelygin, M A Nagudov, A A Ponomarenko, M V Alekseev, E G Rybakov, M A Tarasov, S I Achkasov
AIM: To identify the most effective management of colorectal anastomosis failure via analysis of available literature sources. RESULTS: Systematic review included 20 original trials. Effectiveness of redo interventions for colorectal anastomosis failure including open, laparoscopic, minimally invasive techniques (transanal drainage, endoscopic vacuum therapy, endoscopic drainage) was described. Anastomotic failure rate was 6.5%. Medication was effective in 57% (95% CI 34-77%) of cases...
2018: Khirurgiia
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