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Sara Kammerer, Tobias Meister, Heiner Wolters, Matthias Lessing, Anna Hüsing, Dirk Domagk, Martin Floer, Christian Wilms, Hartmut Schmidt, Norbert Senninger, Gabriele Köhler, Hauke Sebastian Heinzow
Background: Perihilar cholangiocarcinomas are often considered incurable. Late diagnosis is common. Advanced disease therefore frequently causes questioning of curative surgical outcome. Aim: This study aimed to develop a prediction model of curative surgery in patients suffering from perihilar cholangiocarcinomas based on preoperative endosonography and computer tomography. Methods: A cohort of 81 patients (median age 67 (54-75) years, 62% male) with perihilar cholangiocarcinoma was retrospectively analyzed...
March 2018: United European Gastroenterology Journal
Daniel da Costa, Cristián Montenegro, Patricio Palavecino, Germán Lobos, Tomás Cermenati, Jaime Poniachik
Management of gastrointestinal bleeding caused by fundal varices is particularly difficult to manage. The options are: transjugular intrahepatic portosystemic shunt (TIPS), endoscopic injection of cyanoacrylate or balloon-occluded retrograde transvenous obliteration (BRTO). We report a 63 year-old male with a cirrhosis caused by hepatitis C and a 66 year-old female with a cirrhosis caused by a non-alcoholic steatohepatitis. Both patients had a gastrointestinal bleeding caused by fundal varices and were treated with sclerotherapy with cyanoacrylate assisted with BRTO...
October 2017: Revista Médica de Chile
Giovanni Marchegiani, Stefano Andrianello, Alex Borin, Chiara Dal Borgo, Giampaolo Perri, Tommaso Pollini, Giorgia Romanò, Mirko D'Onofrio, Armando Gabbrielli, Aldo Scarpa, Giuseppe Malleo, Claudio Bassi, Roberto Salvia
BACKGROUND: Mural nodules (MNs) have a predominant role in the 2016 revision of the international guidelines on intraductal papillary mucinous neoplasms (IPMN) of the pancreas. The aim of this study was to evaluate MNs as predictors of invasive cancer (iCa) or high-grade dysplasia (HGD) in IPMNs and to investigate the role of MN size in risk prediction. METHODS: A PRISMA-compliant systematic review of the literature and meta-analysis on selected studies were conducted...
February 14, 2018: Surgery
Ahmad Hashim, Yen-I Chen, David Valenti, Peter Metrakos, Sheryl White, Alan Barkun, Ali Bessissow
No abstract text is available yet for this article.
February 16, 2018: Endoscopy
Bo Jan Noordman, Bas P L Wijnhoven, Sjoerd M Lagarde, Jurjen J Boonstra, Peter Paul L O Coene, Jan Willem T Dekker, Michael Doukas, Ate van der Gaast, Joos Heisterkamp, Ewout A Kouwenhoven, Grard A P Nieuwenhuijzen, Jean-Pierre E N Pierie, Camiel Rosman, Johanna W van Sandick, Maurice J C van der Sangen, Meindert N Sosef, Manon C W Spaander, Roelf Valkema, Edwin S van der Zaag, Ewout W Steyerberg, J Jan B van Lanschot
BACKGROUND: Neoadjuvant chemoradiotherapy (nCRT) plus surgery is a standard treatment for locally advanced oesophageal cancer. With this treatment, 29% of patients have a pathologically complete response in the resection specimen. This provides the rationale for investigating an active surveillance approach. The aim of this study is to assess the (cost-)effectiveness of active surveillance vs. standard oesophagectomy after nCRT for oesophageal cancer. METHODS: This is a phase-III multi-centre, stepped-wedge cluster randomised controlled trial...
February 6, 2018: BMC Cancer
Raj A Shah, Jose J Vempilly, Shaikh M Noor Ul Husnain, Pravachan Hegde
Coccidioidomycosis causes significant morbidity in endemic areas. In the absence of sensitive diagnostic serologic testing, clinicians have increasingly relied on lung and lymph node biopsies for diagnosis. Recently, endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has been shown to be an excellent sampling method for the diagnosis and staging of lung cancers, especially when combined with endoscopic ultrasound guided fine needle aspiration (EUS-FNA). We present 13 consecutive cases where EBUS-TBNA and/or EUS-FNA of pulmonary lymph nodes were performed as part of the workup for pulmonary coccidioidomycosis...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
En-Qi Qiu, Wen Guo, Tian-Ming Cheng, Yong-Li Yao, Wei Zhu, Si-De Liu, Fa-Chao Zhi
AIM: To establish a classification method for differential diagnosis of colorectal ulcerative diseases, especially Crohn's disease (CD), primary intestinal lymphoma (PIL) and intestinal tuberculosis (ITB). METHODS: We searched the in-patient medical record database for confirmed cases of CD, PIL and ITB from 2008 to 2015 at our center, collected data on endoscopic ultrasound (EUS) from randomly-chosen patients who formed the training set, conducted univariate logistic regression analysis to summarize EUS features of CD, PIL and ITB, and created a diagnostic classification method...
December 14, 2017: World Journal of Gastroenterology: WJG
Gurhan Sisman, Lara Karaaslan, Nurdan Tözün
Ascites can pose a difficult problem in diagnosis of peritoneal tuberculosis, and diagnostic laparoscopy or laparotomy is eventually required in some patients. Herein, we reported the diagnosis of peritoneal tuberculosis in a patient with ascites by using endosonography (EUS) assisted through the needle biopsy forceps (TTNB). The patient was immediately started on the tuberculosis treatment. This article is protected by copyright. All rights reserved.
December 30, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Michael Hocke, Barbara Braden, Christian Jenssen, Christoph F Dietrich
Endoscopic ultrasound has become an essential tool in modern gastroenterology and abdominal surgery. Compared with all other endoscopic methods, it has the most potential for innovation and its future looks bright. Thus, we compiled this summary of established and novel applications of endoscopic ultrasound methods to inform the reader about what is already possible and where future developments will lead in improving patient care further. This review is structured in four parts. The first section reports on developments in diagnostic endoscopic ultrasound, the second looks at semi-invasive endoscopic ultrasound, and the third discusses advances in therapeutic endoscopic ultrasound...
November 23, 2017: Korean Journal of Internal Medicine
Elroy Patrick Weledji
The majority of patients with neuropathic incontinence and other pelvic floor conditions associated with straining at stool have damage to the pudendal nerves distal to the ischial spine. Sacral nerve stimulation appears to be a promising innovation and has been widely adopted and currently considered the standard of care for adults with moderate to severe fecal incontinence and following failed sphincter repair. From a decision-to-treat perspective, the short-term efficacy is good (70%-80%), but the long-term efficacy of sacral nerve stimulation is around 50%...
October 2017: Annals of Coloproctology
Julia Masomi-Bornwasser, Philipp Winter, Hendrik Müller-Werkmeister, Susanne Strand, Jochem König, Oliver Kempski, Florian Ringel, Sven R Kantelhardt, Naureen Keric
BACKGROUND: Catheter-based lysis with recombinant tissue plasminogen activator (rtPA) is a well-established therapy for spontaneous intracerebral hemorrhage (ICH). The effectiveness of this therapy can be increased with ultrasound, but the optimal conditions are not yet clearly established. Using a novel in vitro system of blood clots previously developed by our group, we investigated various parameters of intralesional sonothrombolysis using an endosonography catheter in combination with rtPA...
2017: PloS One
Ufuk Ateş, Gönül Küçük, Kubilay Çınar, Berktuğ Bahadır, Mehmet Bektaş, Gülnur Göllü, Meltem Bingöl Koloğlu
An 11-year-old morbidly obese boy was diagnosed with pancreatic pseudocyst. Following fine needle aspiration, the cyst recurred in 1-month follow-up. Therefore, endoscopic drainage and cystoduodenostomy was performed following endosonography. Control ultrasonography (USG) revealed a completely shrunken cyst. During the 3 years of follow-up, the patient was asymptomatic with no evidence of cyst on computerized tomography scans. Endoscopic drainage and cystoduodenostomy is a minimally invasive, effective, and safe approach in the management of pancreatic pseudocysts in children...
November 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Rocco Trisolini, Filippo Natali, Marco Ferrari, Vanina Livi, Daniela Paioli, Micaela Romagnoli, Alessandra Cancellieri
INTRODUCTION AND OBJECTIVES: Endosonography has become standard of care in the diagnostic work-up of mediastinal lymphadenopathy and peribronchial lung lesions, but its success rate in some specific settings/conditions may be hampered by limited needle flexibility and size. We report on our initial experience with the 19G Flex needle, characterized by larger size and greater flexibility as compared with the currently available cytology needles. METHODS: Retrospective review of prospectively collected data on the first 13 consecutive patients submitted to endosonography with the 19G Flex needle...
November 4, 2017: Clinical Respiratory Journal
M Ortenzi, R Ghiselli, A Paolucci, M Guerrieri
BACKGROUND: The success of transanal endoscopic microsurgery (TEM) for early rectal cancer depends on proper indications and strict patient selection. When unfavorable pathologic features are identified after TEM operation, total mesorectal excision is recommended to minimize the risk of recurrence. In this study, data were collected in a retrospective series of patients to determine the results of laparoscopic reoperation after TEM. METHODS: All patients underwent an accurate rectal-digital examination and clinical tumor staging by transanal endosonography, CT, and/or MRI...
October 19, 2017: Surgical Endoscopy
Satomi Hashimoto, Seiji Futagami, Hiroshi Yamawaki, Keiko Kaneko, Yasuhiro Kodaka, Mako Wakabayashi, Noriko Sakasegawa, Shuhei Agawa, Kazutoshi Higuchi, Teppei Akimoto, Nobue Ueki, Tetsuro Kawagoe, Hitomi Sato, Katsuhisa Nakatsuka, Kaya Gudis, Chiaki Kawamoto, Takashi Akamizu, Choitsu Sakamoto, Katsuhiko Iwakiri
There was not available data about the overlap between functional dyspepsia (FD) and pancreatic diseases. We aimed to determine whether epigastric pain syndrome (EPS) accompanying with pancreatic enzyme abnormalities were associated with early chronic pancreatitis proposed by Japan Pancreas Society (JPS) using endosonography. We enrolled 99 consecutive patients presenting with typical symptoms of FD, including patients with postprandial distress syndrome (PDS) (n = 59), EPS with pancreatic enzyme abnormalities (n = 41) and EPS without pancreatic enzyme abnormalities (n = 42) based on Rome III criteria...
September 2017: Journal of Clinical Biochemistry and Nutrition
Saurabh Mukewar, Venkataraman Raman Muthusamy
Therapeutic endosonography (EUS) may play an important role in the management of cancers. EUS-guided fiducial placement has a high success rate and can aid in stereotactic radiotherapy. EUS-guided tumor ablation therapies can help in palliation of locally advanced tumors. EUS-guided antitumor injection seems to be feasible and safe in animals; initial human studies suffer from small sample size and lack of controls. Randomized, controlled trials have not shown benefit over conventional therapy. EUS celiac plexus neurolysis has gained popularity and is performed by interventional endosonographers...
October 2017: Gastrointestinal Endoscopy Clinics of North America
Anjali A Roeth, Ioana Slabu, Martin Baumann, Patrick H Alizai, Maximilian Schmeding, Gernot Guentherodt, Thomas Schmitz-Rode, Ulf P Neumann
Superparamagnetic iron oxide nanoparticles (SPION) may be used for local tumor treatment by coupling them to a drug and accumulating them locally with magnetic field traps, that is, a combination of permanent magnets and coils. Thereafter, an alternating magnetic field generates heat which may be used to release the thermosensitively bound drug and for hyperthermia. Until today, only superficial tumors can be treated with this method. Our aim was to transfer this method into an endoscopic setting to also reach the majority of tumors located inside the body...
2017: International Journal of Nanomedicine
W Bohle, M Kasper, W G Zoller
The objective of this study is the feasibility of sequential endoscopic and endosonographic measurement of locoregional tumor load for the prediction of tumor recurrence in patients after neoadjuvant or definitive chemoradiotherapy, treated in curative intent for locally advanced esophageal carcinoma. In 67 patients with esophageal cancer, serial endoscopic ultrasound was performed before and after neoadjuvant (25) or definitive (42) chemoradiotherapy. Rate of complete endoscopic and endosonographic tumor response, reduction in tumor length or circumferential tumorous extension, maximal tumor thickness, lymph node size, and endosonographic uT- and uN-stage shift was measured...
October 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Jung Bin Yoon, Bong Eun Lee, Dae Hwan Kim, Do Youn Park, Hye Kyung Jeon, Dong Hoon Baek, Gwang Ha Kim, Geun Am Song
Heterotopic pancreas in the stomach is usually asymptomatic and benign. Here, we presented a rare case of an early gastric cancer overlying a heterotopic pancreas. A 48-year-old woman underwent esophagogastroduodenoscopy, which revealed a subepithelial mass measuring 2.0×1.5 cm on the gastric antrum with a 1-cm erosive erythematous discoloration on the surface. A biopsy specimen showed moderately differentiated tubular adenocarcinoma. Endosonography showed a heterogeneous hypoechoic mass measuring 1.3×0.6 cm, with indistinct margins in the second and third layers of the gastric wall; anechoic tubular structures within the mass were suggestive of heterotopic pancreas...
August 31, 2017: Clinical Endoscopy
G O Ceyhan, F Scheufele, H Friess
The incidence of cystic pancreatic lesions is steadily increasing due to the technical advances in imaging. Within the group of cystic pancreatic lesions intraductal papillary mucinous neoplasms (IPMNs) depict an important entity. Due to a possible progression to malignancy the clinical strategy has to be well chosen. For primary diagnostic work-up imaging by magnetic resonance imaging (MRI) with MR cholangiopancreatography (MRCP) and computed tomography (CT) scanning is recommended. Additional information can be gained by endosonography and a biopsy of the cystic lesion, allowing analysis of biomarkers, such as GNAS and KRAS mutation as wells as NLR...
November 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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