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Malignant obstruction

Xiao Zheng, Zhi Yuan Bo, Wei Wan, Ye Chen Wu, Tian Tian Wang, Jun Wu, Dao Jian Gao, Bing Hu
AIM: Endoscopic biliary radiofrequency ablation (RFA) has been increasingly used for unresectable malignant biliary obstruction (MBO). However, its efficacy and safety remain unclear. METHODS: A comprehensive search of Cochrane Library, PubMed and EMBASE was conducted to collect studies to evaluate endoscopic biliary RFA in the management of MBO. Meta-analysis was performed by extracting the data from included studies with regards to the technical effectiveness, overall survival, adverse events and mortality of endoscopic RFA...
October 21, 2016: Journal of Digestive Diseases
K Möller, N Kohles, D Eßer
Salivary gland surgery is a common procedure in otorhinolaryngology. Parotidectomy and submandibulectomy represent the treatment of choice in benign and malignant tumors of the salivary glands. However, as to this point there are no guidelines are concerning diagnostic and therapeutic approaches of benign and malignant tumors of the salivary gland. Since the introduction of sialendoscopy there are new diagnostic and therapeutic procedures available in treating obstructive sialadenitis. The present article provides an overview of anatomical principles, diagnostic approaches and the most important salivary gland surgeries for future otorhinolaryngologists under specialist training...
October 2016: Laryngo- Rhino- Otologie
Steffen T Simon, Irene J Higginson, Sara Booth, Richard Harding, Vera Weingärtner, Claudia Bausewein
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 1, 2010, on 'Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults'. Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. At the time of the previously published Cochrane review, there was no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in people with advanced cancer and chronic obstructive pulmonary disease (COPD)...
October 20, 2016: Cochrane Database of Systematic Reviews
Zoran Koturović, Miroslav Knežević, Dejan M Rašić
The main purpose of this paper is to provide the information about the incidence and types of pathology of secondary acquired obstructions of the lacrimal excretory outflow system caused by primary lacrimal sac non-neoplastic and neoplastic lesions. After a thorough literature search, 17 case-control studies were found and selected, data were extracted and categorized, to evaluate specific lacrimal sac pathology mimicking inflammation. A total of 3865 histopathologically examined lacrimal sac wall biopsy specimens from 3662 patients, taken during dacryocystorhinostomy for clinically presumed primary chronic dacryocystitis, were analyzed...
October 18, 2016: Bosnian Journal of Basic Medical Sciences
Hanna Vihervaara, Juha M Grönroos, Saija Hurme, Risto Gullichsen, Paulina Salminen
OBJECTIVE: Endoscopic stents are used to relieve obstructive jaundice. The purpose of this prospective randomized study was to compare the patency of antireflux and conventional plastic biliary stent in relieving distal malignant biliary obstruction. MATERIALS AND METHODS: All jaundiced patients admitted to hospital with suspected unresectable malignant distal biliary stricture between October 2009 and September 2010 were evaluated for the study. Eligible patients were randomized either to antireflux or conventional plastic stent arms...
October 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Takashi Oide, Kazuhiro Yasufuku, Kiyoshi Shibuya, Ichiro Yoshino, Yukio Nakatani, Kenzo Hiroshima
We report a 38-year-old woman with a left lung tumor presenting as obstructive pneumonia. Bronchoscopic examination revealed a polypoid tumor filling the left main bronchus. The tumor was partially resected by a snaring procedure for diagnostic purposes. Microscopic examination revealed a submucosal tumor located underneath normal bronchial epithelium. The tumor was composed of sheets of uniform oval to cuboidal cells encompassing numerous blood vessels. Immunohistochemically, the tumor cells exhibited smooth muscle markers, but were negative for neuroendocrine markers...
2016: Respiratory Medicine Case Reports
Mahzad Akbarpour, Abdelnaby Khalyfa, Zhuanghong Qiao, Alex Gileles-Hillel, Isaac Almendros, Ramon Farré, David Gozal
STUDY OBJECTIVE: The presence of obstructive sleep apnea (OSA) in patients with cancer appears to be accompanied by poorer outcomes. However, the mechanisms underlying such association are unknown. Tumor infiltrating lymphocytes (TILs), including CD8+ T cells, function as cytotoxic T lymphocytes (CTLs), and mount immune responses to cancer by the release of cytolytic enzymes, including granzyme B (GzmB), perforin (Prf) and cytokines such as interferon (IFN)-γ. METHODS: Using established in vivo mouse models, we investigated CD8+ T cells and cancer stem cells (CSC) in intermittent hypoxia (IH) and sleep fragmentation (SF) in the context of tumor environment...
October 10, 2016: Sleep
Tian-Tian Wu, Wei-Min Li, Hu-Cheng Li, Guo-Kun Ao, Fang Zheng, Hu Lin
PURPOSE: The clinical efficacy of intraductal radiofrequency ablation (RFA) with Habib™ EndoHPB catheter, a newly developed intervention for malignant extrahepatic biliary obstruction, remains uncertain. The aim of this study was to investigate the clinical efficacy of intraductal RFA. METHODS: Data from 71 patients with extrahepatic distal cholangiocarcinoma were retrospectively analyzed. The study patients were divided into RFA and control groups. The RFA group had undergone percutaneous transhepatic intraductal RFA with a Habib™ EndoHPB catheter, followed by placement of covered or uncovered biliary self-expandable metallic stents (SEMs) whereas the control group had undergone percutaneous transhepatic covered or uncovered SEMs placement...
October 14, 2016: Cardiovascular and Interventional Radiology
Daisy Walter, Petra G A van Boeckel, Marcel J M Groenen, Bas L A M Weusten, Ben J Witteman, Gi Tan, Menno A Brink, Jan Nicolai, Adriaan C Tan, Joyce Alderliesten, Niels G Venneman, Wim Laleman, Jeroen M Jansen, Alexander Bodelier, Frank L Wolters, Laurens A van der Waaij, Ronald Breumelhof, Frans T M Peters, Robbert C H Scheffer, Ewout W Steyerberg, Anne M May, Max Leenders, Meike M C Hirdes, Frank P Vleggaar, Peter D Siersema
OBJECTIVE: For palliation of extrahepatic bile duct obstruction, self-expandable metal stents (SEMS) are superior to plastic stents in terms of stent patency and occurrence of stent dysfunction. We assessed health-related quality of life (HRQoL) after stent placement to investigate whether this also results in a difference in HRQoL between patients treated with a plastic stent or SEMS. PATIENTS AND METHODS: This randomized multicenter trial included 219 patients who were randomized to receive plastic stent (n=73) or SEMS [uncovered (n=75) and covered (n=71); n=146] placement...
October 12, 2016: European Journal of Gastroenterology & Hepatology
Myong Kim, Bumsik Hong, Hyung Keun Park
PURPOSE: To evaluate the long-term clinical efficacy and safety of double-layered polytetrafluoroethylene membrane-covered self-expandable segmental metallic stents (Uventa) in patients with chronic ureteral obstruction. MATERIALS AND METHODS: In a retrospective study, a total of 50 ureter units (44 patients) with chronic obstructions were included from July 2010 to May 2015. Indications for Uventa placement were primary stenting for malignant ureteral obstruction, failed conventional polymeric Double-J stent (PS) or percutaneous nephrostomy (PCN) technique, with comorbidities or fears limiting PS/PCN changes, or with irritation or pain due to PS/PCN...
October 13, 2016: Journal of Endourology
Wei Ge, Song-Song Jiang, Wang Qi, Hao Chen, Li-Ming Zheng, Gang Chen
GOAL: To share our experience of extra-levator abdominoperineal excision (ELAPE) for low rectal cancer, focusing on perineal repair with biological mesh. METHODS: We retrospectively analyzed medical records of all patients with low rectal cancer who underwent the ELAPE procedure using biological mesh for perineal repair at the Gastrointestinal Surgery of Nanjing Drum Power Hospital between January 2013 and September 2015. All patients were closely followed up to now...
October 6, 2016: Oncotarget
María-Victoria Alvarez-Sánchez, Bertrand Napoléon
Most pancreatic cancers and extrahepatic cholangiocarcinomas are unresectable at the time of diagnosis, and even in case of a resectable cancer, for elderly or patients with coexistent comorbidities, surgery is not an option. Current treatment alternatives in these scenarios are very limited. Biliary stenting with self-expanding metal stents (SEMS) is the mainstay palliative treatment of biliary obstruction due to unresectable pancreatic cancer or cholangiocarcinoma. Nevertheless, more than 50% of SEMS become occluded after 6 mo due to tumour over- and ingrowth, leading to hospital readmissions and reinterventions that significantly impair quality of life...
October 7, 2016: World Journal of Gastroenterology: WJG
Hiroyasu Iwasaki, Takashi Mizushima, Yuta Suzuki, Shigeki Fukusada, Kenta Kachi, Takanori Ozeki, Kaiki Anbe, Hironobu Tsukamoto, Fumihiro Okumura, Takashi Joh, Hitoshi Sano
Background/Aims: Self-expandable metallic stent (SEMS) placement is effective for dysphagia that results from malignant obstruction of the esophagus or gastric cardia; however, stent-related complications may be life-threatening. Thus, the goal of this study was to identify risk factors associated with complications following esophageal stenting. Methods: Of the 71 patients who underwent SEMS placement for dysphagia as a result of malignant stricture of the esophagus or gastric cardia, 53 patients with squamous cell carcinoma or adenocarcinoma, without previous SEMS placement, without a fistula, and without recurrent tumor after surgery were retrospectively identified...
October 13, 2016: Gut and Liver
Jean-Frédéric LeBlanc, Myriam Martel, Alan N Barkun
Introduction. Data are conflicting when assessing indications for colorectal self-expandable metallic stents (SEMS) in managing acute malignant large bowel obstruction (MLO). In November 2014, European and American Societies published guidelines to aid in understanding which patients might benefit from colorectal stenting. Yet, there remain marked disparities in clinical practice. Methods. A web-based survey was sent to Gastroenterologists and Surgical Specialists across Quebec to assess physicians' knowledge and adherence to the indications for colonic SEMS placement in the management of MLO using eight clinical scenarios...
2016: Canadian Journal of Gastroenterology & Hepatology
Z Bahouth, G Meyer, G Yildiz, O Nativ, B Moskovitz
Urethral stents were first introduced in 1988, and since then, they have undergone significant improvements. However, they did not gain a wide popularity and their use is limited to a small number of centers around the world. Urethral stents can be used in the entire urethra and for various and diverse indications. In the anterior urethra, it can be used to treat urethral strictures. In the prostatic urethra, they can be used for the treatment of prostatic obstruction, including benign, malignant and iatrogenic prostatic obstruction...
October 2016: Archivos Españoles de Urología
E Morcillo, I Fernández, M Pamplona, F M Sánchez-Margallo, F Soria
The management of ureteral obstruction of malignant origin or complicated benign obstruction continues to be a challenge for the urological community. In this sense, the use of metallic stents could be considered a useful alternative to the conventional drainage techniques, because it accomplishes the resolution of obstruction in a single procedure, without external diversions and without the adverse effects of current diversions. Another important advantage they offer is that they do not need replacement as frequently as double J catheters or nephrostomy tubes require...
October 2016: Archivos Españoles de Urología
J H Jaunarena, C Cristallo, M S González, F P Daels, J De la Rosette, M P Laguna
OBJECTIVE: To describe the different therapeutic alternatives in malignant ureteral obstruction (MUO), and to analyze short and long-term results. METHODS: We conducted a bibliographic search about MUO in Spanish and English languages in PubMed and Google Scholar. We examined the most relevant reviews, original manuscripts and their respective citations. Last search was on April 2016. RESULTS: Polymeric double J stent is the cheapest and most accessible internal urinary diversion, but has also the shortest duration...
October 2016: Archivos Españoles de Urología
Abdurrahman Kadayifci, Mustafa Atar, David G Forcione, Brenna W Casey, Peter B Kelsey, William R Brugge
Background and study aim: Obstruction of biliary self-expandable metal stents (SEMSs) is seen frequently. Radiofrequency ablation (RFA) causes tissue necrosis. This study aimed to assess the efficacy of RFA for management of occluded SEMS. Patients and methods: Patients with biliary malignancy and treated for an occluded SEMS were retrospectively reviewed. The study group comprised patients treated with RFA using an Habib endoprobe inside the SEMS. The control group comprised patients treated only with insertion of a plastic stent into an occluded SEMS...
October 7, 2016: Endoscopy
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...
October 7, 2016: Endoscopy
Junichiro Kawamura, Masaki Tani, Kimiaki Sumida, Takefumi Yazawa, Junya Kawasoe, Michihiro Yamamoto, Hideki Harada, Hidekazu Yamamoto, Masazumi Zaima
PURPOSE: Cancerous involvement of a ureter is sometimes encountered in pelvic surgery for malignancy. We usually perform transureteroureterostomy (TUU) in cases of unilateral lower ureteral cancerous involvement. We report the outcomes in patients treated with TUU in our institute. METHODS: We retrospectively reviewed the medical records of 11 patients who underwent TUU between June 2006 and September 2015. RESULTS: The primary disease was colon cancer in five patients, rectal cancer in four, and uterine cervical cancer and ovarian cancer in one patient each...
October 6, 2016: International Journal of Colorectal Disease
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