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https://www.readbyqxmd.com/read/28723285/case-244-systemic-amyloidosis-a-complication-of-waldenstr%C3%A3-m-macroglobulinemia
#1
Maja Hrabak-Paar, Marko Kralik
History A 68-year-old man was admitted to the hospital for work-up because of generalized fatigue, anorexia, chronic diarrhea, and weight loss. Laboratory work-up revealed an erythrocyte sedimentation rate of 58 mm/h (reference range, 3-23 mm/h), a hemoglobin level of 14.1 g/dL (reference range, 13.8-17.5 g/dL), a leukocyte count of 8.1 × 10(9)/L (reference range, [3.4-9.7] × 10(9)/L), a platelet count of 223 × 10(9)/L (reference range, [158-424] × 10(9)/L), an alkaline phosphatase level of 85 U/L (1.42 μkat/L) (normal level, <142 U/L [2...
August 2017: Radiology
https://www.readbyqxmd.com/read/28722090/-evaluation-of-a-new-closure-technique-of-large-defects-after-endoscopic-full-thickness-resection
#2
Xiao Liu, Lizhou Dou, Yong Liu, Shun He, Yueming Zhang, Xinying Yu, Yan Ke, Xudong Liu, Ruigang Wang, Guiqi Wang
OBJECTIVE: To investigate the security and efficacy of a new endoscopic closure method of large defects after endoscopic full-thickness resection (EFTR) double purse-string suture using two endoloops and metallic clips via single-channel endoscopy. METHODS: Clinical data of 23 cases with submucosal tumors (SMT) who received endoscopic resection from June 2015 to July 2016 in our National Cancer Center were collected. For gastric and esophageal SMTs or the mucosa layer injured during submucosal tunneling endoscopic resection (STER), double purse-string suture was conducted after EFTR...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28720474/nitrous-oxide-cryotherapy-for-treatment-of-esophageal-squamous-cell-neoplasia-initial-multicenter-international-experience-with-a-novel-portable-cryoballoon-ablation-system-with-video
#3
Marcia Irene Canto, Julian Abrams, Hannah Kunzli, Bas Weusten, Yoshihiro Komatsu, Blair Jobe, Charles J Lightdale
BACKGROUND AND AIMS: Early esophageal squamous cell neoplasia (ESCN) can be successfully treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or radiofrequency ablation (RFA). A new portable, battery-powered cryotherapy system using nitrous oxide (cryoballoon focal ablation system (CbFAS) has been used for Barrett's esophagus. It consists of a small hand-held device containing liquid nitrous oxide, which converts to gas within a low-pressure-compliant through-the-scope balloon and freezes targeted mucosa in contact with the balloon...
July 15, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28713066/approaches-for-stricture-prevention-after-esophageal-endoscopic-resection
#4
REVIEW
Seiichiro Abe, Prasad G Iyer, Ichiro Oda, Nobuo Kanai, Yutaka Saito
BACKGROUND AND AIMS: Endoscopic resection of extensive esophageal lesions has become more common as endoscopic resection techniques and equipment has developed. However, extensive esophageal endoscopic resections can cause postoperative esophageal strictures, which have a negative impact on the quality of life of patients. We aimed to review current treatments and innovative approaches to prevent esophageal strictures after widespread endoscopic resection of esophageal lesions. METHODS: We performed a comprehensive literature search using predetermined search terms from 2000 to 2016 to identify relevant articles and summarized their results as a narrative review...
July 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28706423/risk-factors-for-metachronous-gastric-carcinoma-development-after-endoscopic-resection-of-gastric-dysplasia-retrospective-single-center-study
#5
Hee Seok Moon, Gee Young Yun, Ju Seok Kim, Hyuk Soo Eun, Sun Hyung Kang, Jae Kyu Sung, Hyun Yong Jeong, Kyu-Sang Song
AIM: To determine the gastric adenocarcinoma (GAC) occurrence rate and related factors, we evaluated the follow-up results of patients confirmed to have gastric dysplasia after endoscopic resection (ER). METHODS: We retrospectively analyzed the medical records, endoscopic examination records, endoscopic procedure records, and histological records of 667 cases from 641 patients who were followed-up for at least 12 mo, from among 1273 patients who were conformed to have gastric dysplasia after Endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) of gastric mucosal lesions between January 2007 and August 2013 at the Chungnam National University Hospital...
June 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28704212/endoscopic-mucosal-resection-and-endoscopic-submucosal-dissection-technique-and-new-directions
#6
Toshihiro Nishizawa, Naohisa Yahagi
PURPOSE OF REVIEW: Most of small tumours in gastrointestinal tract are easily removed by endoscopic mucosal resection (EMR). However, EMR are sometimes not reliable to ensure the complete resection for large tumours. Although endoscopic submucosal dissection (ESD) was developed, it had a higher risk for complications such as perforation and bleeding. The techniques and clinical outcomes of EMR and ESD are reviewed. RECENT FINDINGS: ESD is more effective for early gastric and oesophageal cancer with higher en-bloc resection rate and lower local recurrence in comparison to EMR...
July 12, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28698849/clinical-characteristics-treatment-and-outcome-of-primary-rectal-lymphoma-a-single-center-experience-of-16-patients
#7
Jae Ho Jeong, Shin Kim, Jeong Eun Kim, Dok Hyun Yoon, Sang-Wook Lee, Jooryung Huh, Cheolwon Suh
BACKGROUND: The rectum is a relatively uncommon site for lymphoma compared with other gastrointestinal sites; no consensus regarding management of primary rectal lymphoma (PRL) has been formed due to its limited frequency. We aimed to investigate clinical characteristics and treatment outcomes in patients with PRL in a single center patient cohort. METHODS: We retrospectively analyzed the results of 16 consecutive patients with PRL, identified and treated at the Asan Medical Center, Seoul, Korea between January 1993 and December 2014...
June 2017: Blood Research
https://www.readbyqxmd.com/read/28682002/laparoscopic-low-anterior-resection-for-rectal-cancer-after-whitehead-s-hemorrhoidectomy-a-case-report
#8
Yoshihiro Takemoto, Eijiro Harada, Yuriko Takeuchi, Daichi Kawamura, Yuuki Suehiro, Naruji Kugimiya, Kimikazu Hamano
A 65-year-old man presented with bloody stool. Colonoscopy revealed a raised tumor in the rectum, above the peritoneal reflection. He underwent endoscopic mucosal resection, but the pathological findings suggested the possibility of residual cancer. We performed laparoscopic low anterior resection using a circular stapling instrument for additional curative surgery. However, we could not insert the shaft of the endoscopic circular stapler from the anus because of anal stenosis due to Whitehead's hemorrhoidectomy the patient had undergone 20 years earlier...
July 6, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28664661/randomized-controlled-trial-comparing-submucosal-endoscopy-with-mucosal-resection-semr-and-endoscopic-submucosal-dissection-esd-in-the-esophagus-and-stomach-an-animal-study
#9
Kohei Takizawa, Mary A Knipschield, Christopher J Gostout
OBJECTIVES: In Western countries ESD (Endoscopic Submucosal Dissection) has not prevailed due to training issues and a target patient population. We reported a hybrid ESD technique, SEMR (submucosal endoscopy with mucosal resection), in which the submucosal dissection is performed chiefly by blunt balloon dissection. We have reported successful application in the porcine colon. In this study we compared the safety and efficacy between SEMR with ESD in the porcine esophagus and stomach...
June 30, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28664442/safe-and-successful-resection-of-difficult-gi-lesions-using-a-novel-single-step-full-thickness-resection-device-ftrd-%C3%A2
#10
P V Valli, J Mertens, P Bauerfeind
BACKGROUND AND STUDY AIMS: Classic endoscopic resection techniques (EMR and ESD) are limited to mucosal lesions. In the case of deeper growth into the gut wall and anatomic sites prone to perforation, the novel full-thickness resection device (FTRD(®)) opens a new dimension of possibilities for endoscopic resection. PATIENTS AND METHODS: Sixty patients underwent endoscopic full-thickness resection (eFTR) at our institution. Safety, learning curve, R0 resection rate, and clinical outcome were studied...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28664426/laparoscopic-and-endoscopic-cooperative-surgery-is-a-feasible-treatment-procedure-for-intraluminal-gastric-gastrointestinal-stromal-tumors-compared-to-endoscopic-intragastric-surgery
#11
Toshiyasu Ojima, Masaki Nakamura, Mikihito Nakamori, Katsunari Takifuji, Keiji Hayata, Masahiro Katsuda, Yoh Takei, Hiroki Yamaue
BACKGROUND: Laparoscopic wedge resection of the stomach is an ideal procedure if the gastric gastrointestinal stromal tumors (GISTs) are located in the extraluminal stomach. When the tumor is located in the intraluminal stomach, two minimally invasive surgical procedures involving laparoscopic and endoscopic cooperative surgery (LECS) or endoscopic intragastric surgery (EIGS) are frequently performed. To date, there have been no comparative studies of LECS and EIGS in patients with intraluminal gastric GISTs regarding short-term and long-term outcomes...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28664383/the-slow-progressive-nature-of-duodenal-neuroendocrine-tumor-a-case-report-of-long-term-observation-over-14%C3%A2-years
#12
Kiichi Takahashi, Waku Hatta, Tomoyuki Koike, Takeshi Kanno, Nobuyuki Ara, Kiyotaka Asanuma, Naoki Asano, Akira Imatani, Fumiyoshi Fujishima, Hironobu Sasano, Tooru Shimosegawa
The number of duodenal neuroendocrine tumors has recently increased, but their natural history has not been well characterized. Here we report the case of a 59-year-old female undergoing complete resection by endoscopic mucosal resection after monitoring endoscopic morphologic changes and the size increment of a duodenal neuroendocrine tumor over the longest follow-up duration. An elevated lesion was initially detected on the duodenal bulb. Endoscopic biopsy from this lesion was performed three times during the follow-up, but all of the specimens simply demonstrated the presence of gastric metaplasia...
June 29, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28659349/randomised-controlled-trial-of-transanal-endoscopic-microsurgery-versus-endoscopic-mucosal-resection-for-large-rectal-adenomas-trend-study
#13
Renée M Barendse, Gijsbert D Musters, Eelco J R de Graaf, Frank J C van den Broek, Esther C J Consten, Pascal G Doornebosch, James C Hardwick, Ignace H J T de Hingh, Chrisiaan Hoff, Jeroen M Jansen, A W Marc van Milligen de Wit, George P van der Schelling, Erik J Schoon, Matthijs P Schwartz, Bas L A M Weusten, Marcel G Dijkgraaf, Paul Fockens, Willem A Bemelman, Evelien Dekker
OBJECTIVE: Non-randomised studies suggest that endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM), but EMR might be more cost-effective and safer. This trial compares the clinical outcome and cost-effectiveness of TEM and EMR for large rectal adenomas. DESIGN: Patients with rectal adenomas ≥3 cm, without malignant features, were randomised (1:1) to EMR or TEM, allowing endoscopic removal of residual adenoma at 3 months...
June 28, 2017: Gut
https://www.readbyqxmd.com/read/28657837/mckittrick-wheelock-syndrome-treated-by-transanal-minimally-invasive-surgery-a-single-center-experience-and-review-of-the-literature
#14
Anne Elisabeth Maria van der Pool, Eelco Jan Rade de Graaf, Maarten Vermaas, Renée Martine Barendse, Pascal Gabriël Doornebosch
INTRODUCTION: McKittrick Wheelock Syndrome (MKWS) is a rare syndrome characterized by secretory diarrhea, dehydration, prerenal acute kidney injury, and severe electrolyte abnormalities caused by a large hypersecretory villous adenoma located in the rectum or rectosigmoid junction. Transabdominal (laparoscopic) procedures are the most described procedures in the treatment of MKWS. We report an alternative surgical approach, transanal minimally invasive surgery (TAMIS), to solve this syndrome...
June 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28656340/safety-and-efficacy-of-endoscopic-submucosal-dissection-using-it-knife-nano-with-clip-traction-method-for-early-esophageal-squamous-cell-carcinoma
#15
Yoshiyasu Kitagawa, Takuto Suzuki, Taro Hara, Taketo Yamaguchi
BACKGROUND: Although endoscopic submucosal dissection (ESD) is an accepted and established treatment for early esophageal squamous cell carcinoma (EESCC), it is technically difficult, time consuming, and less safe than endoscopic mucosal resection. To perform ESD safely and more efficiently, we proposed a new technique of esophageal ESD using an IT knife nano with the clip traction method. This study aimed to evaluate the efficacy and safety of ESD using this new technique. METHODS: We retrospectively reviewed all consecutive cases of esophageal ESD performed using an IT knife nano with the clip traction method at our hospital between March 2013 and January 2017...
June 27, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28648577/impact-of-cap-assisted-colonoscopy-on-learning-curve-and-quality-in-colonoscopy-a-randomized-controlled-trial
#16
Zhouwen Tang, Daniel S Zhang, Aaron P Thrift, Kalpesh K Patel
BACKGROUND AND AIMS: Colonoscopy competency assessment in trainees have traditionally been informal. Comprehensive metrics such as the Assessment of Competency in Endoscopy (ACE) tool suggest competency thresholds are higher than assumed. cap-assisted colonoscopy (CAC) may improve competency but data in novice trainees are lacking. We compare CAC versus standard colonoscopy (SC) among novice trainees in a randomized controlled trial. METHODS: All colonoscopies performed by 3 gastroenterology fellows without prior experience were eligible for enrollment...
June 22, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28647136/polypectomy-for-the-complete-endoscopic-resection-of-small-colorectal-polyps
#17
Qisheng Zhang, Peng Gao, Bin Han, Jianhua Xu, Yucui Shen
BACKGROUND AND AIMS: Small colorectal polyps are frequently encountered and may be incompletely removed during colonoscopy. The optimal technique for removal of small colorectal polyps is uncertain. The aim of this study was to compare the incomplete resection rate (IRR) using endoscopic mucosal resection (EMR) or cold snare polypectomy (CSP) for the removal of small adenomatous polyps. METHODS: This was a prospective randomized controlled study from a tertiary referral center...
June 21, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28637063/exploring-diagnostic-and-therapeutic-implications-of-endoscopic-mucosal-resection-in-eus-staged-t2-esophageal-adenocarcinoma
#18
Annieke W Gotink, Manon C W Spaander, Michael Doukas, Thjon J Tang, Paul Didden, Bas P L Wijnhoven, Marco J Bruno, Arjun D Koch
Background and study aims Treatment strategies for clinical (c)T2N0M0 esophageal adenocarcinoma (EAC) are subject to debate owing to the relative inaccuracy of tumor staging by endoscopic ultrasound (EUS), with profound implications in overstaged patients. We aimed to evaluate the final histological diagnosis of patients initially staged as having a cT2 tumor by EUS, and to assess the value of endoscopic reassessment by an interventional endoscopist, followed by an endoscopic resection when deemed feasible...
June 21, 2017: Endoscopy
https://www.readbyqxmd.com/read/28626372/acute-appendicitis-caused-by-previous-endoscopic-submucosal-dissection-for-an-adenoma-adjacent-to-the-appendiceal-orifice
#19
Ryo Kato, Keita Harada, Kei Harada, Daisuke Takei, Yuusaku Sugihara, Shiho Takashima, Toshihiro Inokuchi, Masahiro Takahara, Sakiko Hiraoka, Yasushi Omura, Wakako Oda, Hiroyuki Okada
Endoscopic submucosal dissection (ESD) is a groundbreaking treatment for tumors adjacent to the appendiceal orifice that are difficult to remove by conventional endoscopic mucosal resection, and successful cases are increasingly reported. However, little is known about the subsequent complications, especially long-term complications. A female in her early 70s with a 15-mm cecal tumor adjacent to the appendiceal orifice - discovered incidentally during a screening colonoscopy - underwent hybrid ESD of the lesion...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28621294/endoscopic-ultrasound-with-tissue-sampling-is-accurate-in-the-diagnosis-and-subclassification-of-gastrointestinal-spindle-cell-neoplasms
#20
Dalbir Singh Sandhu, Adrian N Holm, Rami El-Abiad, Carolyn Rysgaard, Chris Jensen, Henning Gerke
BACKGROUND AND OBJECTIVES: Mesenchymal (spindle cell) neoplasms (SCN) of the gastrointestinal (GI) tract are an important subtype of subepithelial lesions that need subclassification to assess their malignant potential. Reported success rates of accurate subclassification with endoscopic ultrasound (EUS)-guided biopsies are variable. Our goal was to analyze our experience using EUS-guided TruCut biopsy (EUS-TCB) in the majority of patients. METHODS: Retrospective analysis in patients who underwent EUS with biopsies for suspected SCN at our tertiary referral center between 2004 and 2013...
May 2017: Endoscopic Ultrasound
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