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https://www.readbyqxmd.com/read/27895081/malignant-melanoma-of-cervix
#1
Mayank Gupta
A 68-year-old woman presented with symptoms of bleeding per vaginum. On examination, a growth was seen in the cervix, clinically considered to be squamous cell carcinoma. The growth was confined to the cervix and did not involve the parametria. However, on biopsy it was diagnosed as malignant melanoma. She underwent surgery elsewhere and was advised chemotherapy as these tumours are aggressive; however, she refused chemotherapy. She has been on regular follow-up and has an ongoing survival and disease-free period of more than 5 years...
November 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27888864/oesophageal-disease-gastroesophageal-reflux-disease-barrett-s-oesophagus-achalasia-and-eosinophilic-oesophagitis
#2
Xavier Calvet
The most interesting conclusions and/or advances presented at Digestive Disease Week 2016 were the following: a) gastroesophageal reflux disease: proton pump inhibitor-refractory reflux disease is frequently associated with poor treatment adherence, psychiatric comorbidities and functional gastrointestinal disorders. These possible entities should be investigated in all cases of proton pump inhibitor-refractory reflux disease; b) Barrett's oesophagus: the efficacy of screening remains unclear; however, new minimally-invasive techniques such as the cytosponge allow more effective detection, both of Barrett's oesophagus and Barrett's oesophagus-associated dysplasia or neoplasia; c) achalasia: evidence indicates that peroral endoscopic myotomy is as effective as surgery and is a safer alternative; d) eosinophilic oesophagitis: high-dose proton pump inhibitors are required to rule out proton pump inhibitor-responsive eosinophilic oesophagitis; montelukast is not clearly effective in the treatment of eosinophilic oesophagitis, although moderate efficacy cannot be ruled out...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27888219/long-term-intestinal-bleeding-in-a-child-a-rare-case-of-heterotopic-gastric-mucosa-in-the-jejunum
#3
Stella Leng, Marco Ghionzoli, Chiara Caporalini, Anna Maria Buccoliero
We report a rare case of heterotopic gastric mucosa presenting in a jejunal polyp of a 9-year-old girl, diagnosed with capsule endoscopy and laparoscopic exploration, after a 15-month history of lower gastrointestinal bleeding and anaemia. During surgery, the jejunal segment containing the polyp was resected and pathological examination revealed a polyp with gastric heterotopia. Heterotopic gastric mucosa is a rare pathology characterised by the presence of gastric mucosa outside of the stomach. Heterotopic gastric mucosa usually occurs in the oesophagus, duodenum, Meckel's diverticulum and enteric duplication cysts...
November 25, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27811857/phase-ii-study-of-chemoselection-with-docetaxel-plus-cisplatin-and-5-fluorouracil-induction-chemotherapy-and-subsequent-conversion-surgery-for-locally-advanced-unresectable-oesophageal-cancer
#4
Tomoya Yokota, Ken Kato, Yasuo Hamamoto, Yasuhiro Tsubosa, Hirofumi Ogawa, Yoshinori Ito, Hiroki Hara, Takashi Ura, Takashi Kojima, Keisho Chin, Shuichi Hironaka, Takayuki Kii, Yasushi Kojima, Yasunori Akutsu, Hisayuki Matsushita, Kentaro Kawakami, Keita Mori, Yushi Nagai, Chika Asami, Yuko Kitagawa
BACKGROUND: The standard treatment for locally advanced unresectable squamous cell carcinoma (SCC) of the oesophagus is chemoradiation with cisplatin and 5-fluorouracil (CF-RT). This multicentre phase II trial assessed the safety and efficacy of chemoselection with docetaxel plus cisplatin and 5-fluorouracil (DCF) induction chemotherapy (ICT) and subsequent conversion surgery (CS) for initially unresectable locally advanced SCC of the oesophagus. METHODS: Patients with clinical T4 and/or unresectable supraclavicular lymph node metastasis were eligible...
November 22, 2016: British Journal of Cancer
https://www.readbyqxmd.com/read/27780192/pathogenesis-and-progression-of-oesophageal-adenocarcinoma-varies-by-prior-diagnosis-of-barrett-s-oesophagus
#5
Michael B Cook, Jennifer Drahos, Shannon Wood, Lindsey Enewold, Ruth Parsons, Neal D Freedman, Philip R Taylor, Winnie Ricker, Christian C Abnet
BACKGROUND: The absolute risk of oesophageal adenocarcinoma (EA) among individuals with Barrett's oesophagus (BE) is low and a majority of EA cases are diagnosed among individuals with no prior BE diagnosis. To ensure that insights from EA case-control studies are transferable to clinical management of BE populations, we conducted a case-case study to compare the clinical presentation, medical history and survival of EA cases with and without a prior BE diagnosis in the Surveillance, Epidemiology and End Results Medicare database...
November 22, 2016: British Journal of Cancer
https://www.readbyqxmd.com/read/27761232/monitoring-the-premalignant-potential-of-barrett-s-oesophagus
#6
David Graham, Gideon Lipman, Vinay Sehgal, Laurence B Lovat
The landscape for patients with Barrett's oesophagus (BE) has changed significantly in the last decade. Research and new guidelines have helped gastroenterologists to better identify those patients with BE who are particularly at risk of developing oesophageal adenocarcinoma. In parallel, developments in endoscopic image enhancement technology and optical biopsy techniques have improved our ability to detect high-risk lesions. Once these lesions have been identified, the improvements in minimally invasive endoscopic therapies has meant that these patients can potentially be cured of early cancer and high-risk dysplastic lesions without the need for surgery, which still has a significant morbidity and mortality...
October 2016: Frontline Gastroenterology
https://www.readbyqxmd.com/read/27730779/abdominal-tuberculosis
#7
Pravin Rathi, Pravir Gambhire
Abdomen is involved in 11% of patients with extra-pulmonary tuberculosis; The most common site of involvement is the ileocaecal region, other locations of involvement, in order of descending frequency, are the ascending colon, jejunum, appendix, duodenum, stomach, oesophagus, sigmoid colon, and rectum. Apart from the basic work up, Investigations like CT scan, EUS, Capsule endoscopy, Balloon enteroscopy, Ascitic fluid ADA, TB-PCR, GeneXpert, Laproscopy are being increasingly used to diagnose tuberculosis.Therapy with standard antituberculous drugs is usually highly effective for intestinal TB...
February 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27696382/prognostic-impact-of-extracapsular-lymph-node-involvement-after-neoadjuvant-therapy-and-oesophagectomy
#8
S M Lagarde, M Navidi, S S Gisbertz, H W M van Laarhoven, K Sumpter, S L Meijer, B Disep, A Immanuel, S M Griffin, M I van Berge Henegouwen
BACKGROUND: The significance of extracapsular lymph node involvement (LNI) is unclear in patients with oesophageal cancer who have undergone neoadjuvant treatment followed by oesophagectomy. The aim of this study was to assess the incidence and prognostic significance of extracapsular LNI in a large multicentre series of consecutive patients with oesophageal cancer treated by neoadjuvant chemotherapy or chemoradiotherapy and surgery. METHODS: Data from a consecutive series of patients treated at two European centres were analysed...
November 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27689845/outcome-of-neoadjuvant-therapies-for-cancer-of-the-oesophagus-or-gastro-oesophageal-junction-based-on-a-national-data-registry
#9
F Klevebro, M Lindblad, J Johansson, L Lundell, M Nilsson
BACKGROUND: Randomized trials have shown that neoadjuvant treatment improves survival in the curative treatment of oesophageal and gastro-oesophageal junction cancer. Results from population-based observational studies are, however, sparse and ambiguous. METHODS: This prospective population-based cohort study included all patients who had oesophagectomy for cancer in Sweden, excluding clinical T1 N0, recorded in the National Register for Oesophageal and Gastric Cancer, 2006-2014...
December 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27644904/chemoradiotherapy-in-tumours-of-the-oesophagus-and-gastro-oesophageal-junction
#10
M C C M Hulshof, H W M van Laarhoven
Oesophageal cancer remains a malignancy with a poor prognosis. However, in the recent 10-15 years relevant progress has been made by the introduction of chemoradiotherapy (CRT) for tumours of the oesophagus or gastro-oesophageal junction. The addition of neo-adjuvant CRT to surgery has significantly improved survival and locoregional control, for both adenocarcinoma and squamous cell carcinoma. For irresectable or medically inoperable patients, definitive CRT has changed the treatment intent from palliative to curative...
August 2016: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/27639666/-total-en-bloc-spondylectomy-for-spinal-tumours-technical-aspects-and-surgical-details
#11
Pedro David Delgado-López, Antonio Rodríguez-Salazar, Vicente Martín-Velasco, José Manuel Castilla-Díez, Javier Martín-Alonso, Ana Galacho-Harriero, Cecilia Gil-Polo, Elena Araus-Galdós
OBJECTIVE: To describe the specific surgical details and report the lessons learned with a series of patients suffering from spinal tumours that underwent total en bloc spondylectomy (TES). METHODS: A retrospective case series review is presented, together with an analysis of the clinical and technical variables, as well as the outcomes. RESULTS: A total of 10 patients underwent TES (2000-2016) for primary (osteosarcoma, chondrosarcoma, fibrosarcoma and chordoma) and secondary spinal tumours (lung, breast, thyroid, oesophagus, and meningioma metastases)...
September 14, 2016: Neurocirugía
https://www.readbyqxmd.com/read/27593706/effects-of-omeprazole-or-anti-reflux-surgery-on-lower-oesophageal-sphincter-characteristics-and-oesophageal-acid-exposure-over-10-years
#12
Birgitte-Elise G Emken, Lars R Lundell, Lene Wallin, Helge E Myrvold, Cecilia Engström, Madeleine Montgomery, Anders R Malm, Tore Lind, Jan G Hatlebakk
OBJECTIVE: To compare the effect of anti-reflux surgery (ARS) versus proton pump inhibitor therapy on lower oesophageal sphincter (LOS) function and oesophageal acid exposure in patients with chronic gastro-oesophageal reflux disease (GORD) over a decade of follow-up. MATERIAL AND METHODS: In this randomised, prospective, multicentre study we compared LOS pressure profiles, as well as oesophageal exposure to acid, at baseline and at 1 and 10 years after randomisation to either open ARS (n = 137) or long-term treatment with omeprazole (OME) 20-60 mg daily (n = 108)...
September 3, 2016: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/27585079/physical-and-virtual-modelling-of-the-head-and-neck-for-surgical-simulation-and-training
#13
Steven Dirven, Jacqui E Allen
PURPOSE OF REVIEW: Investigation and surgical manipulation of the larynx, pharynx, and oesophagus suffer from inherent challenges with access to the sites of interest. To reduce trauma and external scarring, visualization and minimally invasive interventions by the transnasal or transoral routes have become more prevalent. This article discusses engineering methods used to understand and overcome the mechanical constraints inside the airway and upper gastrointestinal tract, and examines the role that robotics and engineering are beginning to play in modelling of surgical interventions in this region...
December 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27551905/vascular-ring-presenting-as-dysphagia-in-an-adult-woman-a-case-report
#14
B L Powell
A 48-year-old woman was seen in a surgical outpatient clinic with a 2 year history of progressive dysphagia with occasional regurgitation, partially controlled with a proton pump inhibitor. Primary investigations of pH testing and gastroscopy were normal, although a barium swallow study revealed significant hold-up at the aortic arch impression and a posterior right-sided oesophageal impression suggestive of a right-sided aortic arch. A follow-up computed tomography angiogram discovered a vascular ring encircling the trachea and oesophagus, formed by a right-sided aortic arch with aberrant aortic branches, and a Kommerell's diverticulum...
August 23, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27550526/role-of-omentectomy-as-part-of-radical-surgery-for-gastric-cancer
#15
E J Jongerius, D Boerma, K A Seldenrijk, S L Meijer, J J G Scheepers, F Smedts, S M Lagarde, O Balague Ponz, M I van Berge Henegouwen, J W van Sandick, S S Gisbertz
BACKGROUND: A complete omentectomy is recommended as part of radical (sub)total gastrectomy for gastric cancer, but there is little evidence to suggest any survival benefit. The aim of this study was to evaluate the incidence of, and risk factors for, metastases in the greater omentum in patients undergoing gastrectomy for gastric cancer. METHODS: This was a multicentre prospective cohort study (OMEGA trial) of consecutive patients with gastric cancer undergoing (sub)total gastrectomy with complete en bloc omentectomy and modified D2 lymphadenectomy...
October 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27545978/co-morbidity-after-oesophageal-cancer-surgery-and-recovery-of-health-related-quality-of-life
#16
L Backemar, A Wikman, T Djärv, A Johar, P Lagergren
BACKGROUND: Although health-related quality of life (HRQoL) recovers after surgery for oesophageal cancer in most long-term survivors, one in seven patients experiences a deterioration in HRQoL for reasons yet unknown. The aim of this study was to assess whether co-morbidities diagnosed after surgery influence recovery of HRQoL. METHODS: Patients who underwent surgery for cancer of the oesophagus or gastro-oesophageal junction in Sweden between 2001 and 2005 were included...
November 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27543651/surgical-management-without-resection-of-the-oesophagus-for-aorto-oesophageal-fistula-secondary-to-aortic-arch-aneurysm-rupture
#17
Atsushi Omura, Masato Yoshida, Yojiro Koda, Nobuhiko Mukohara
A 79-year-old moderately frail man with a history of graft replacement for descending thoracic aortic aneurysm and chronic kidney disease presented with the onset of haemoptysis. Computed tomography demonstrated aorto-oesophageal fistula secondary to aortic arch aneurysm rupture. Emergency surgery was performed through a median sternotomy. Cardiopulmonary bypass was established via femoral artery inflow and bicaval venous drainage. After establishing circulatory arrest, the aortic arch was excised. Resection of the aortic aneurysm and debridement were performed during antegrade cerebral perfusion and lower body perfusion from femoral artery inflow using balloon occlusion of the previous graft...
August 19, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27523409/-radiotherapy-in-cancers-of-the-oesophagus-the-gastric-cardia-and-the-stomach
#18
G Créhange, F Huguet, L Quero, T V N'Guyen, X Mirabel, T Lacornerie
Localized oesophageal and gastric cancers have a poor prognosis. In oesophageal cancer, external radiotherapy combined with concomitant chemotherapy is accepted as part of the therapeutic armamentarium in a curative intent in the preoperative setting for resectable tumours; or without surgery in inoperable patients or non-resectable tumours due to wide local and/or regional extension. Data from the literature show conflicting results with no clinical evidence in favour of either a unique dose protocol or consensual target volume definition in the setting of exclusive chemoradiation...
September 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/27516782/iatrogenic-injuries-to-the-trachea-and-main-bronchi
#19
Tomasz Gil, Janusz Warmus, Janusz Włodarczyk, Zbigniew Grochowski, Krzysztof Bederski, Piotr Kocoń, Piotr Talar, Jarosław Kużdżał
INTRODUCTION: Iatrogenic tracheobronchial injuries are rare. AIM: To analyse the mechanism of injury, symptoms and treatment of these patients. MATERIAL AND METHODS: Retrospective analysis of hospital records of all patients treated for main airway injuries between 1990 and 2012 was performed. RESULTS: There were 24 patients, including 21 women and 3 men. Mean time between injury and initiation of treatment was 12 hours (range: 2-48)...
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/27507031/-therapeutic-management-of-poorly-differentiated-neuroendocrine-lung-tumors-and-neuroendocrine-carcinomas-of-the-digestive-system
#20
Anna Pellat, Marie Wislez, Magali Svrcek, Pascal Hammel, Pauline Afchain, Thierry André
Poorly differentiated neuroendocrine tumors are rare but their incidence is rising. High-grade neuroendocrine lung tumors, including small-cell lung cancer, are part of this group. Outside of the lung, they most often arise within the gastrointestinal tract (oesophagus, guts and pancreas) and are called neuroendocrine carcinomas. Due to their rarity, very little is known about neuroendocrine carcinomas of the pancreas and the gastrointestinal tract and few studies have been done. Therefore, most therapeutic recommendations are issued from studies on small-cell lung cancers...
August 6, 2016: Bulletin du Cancer
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