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Therapeutic endoscopy

Álvaro Brotons, Angels Vilella, Cristina Sánchez-Montes, Catalina Garau, Albert Vila, Vicente Pons Beltrán, Carlos Dolz Abadía
Digestive endoscopy is the most effective tool available for the diagnosis of multiple gastrointestinal (GI) tract conditions, and it represents a key aspect in the training of gastroenterology residents according to the Spanish MIR (médico interno residente) program. The Sociedad Española de Endoscopia Digestiva (SEED), aware of all the technical advances that have emerged during the past few years, deems it necessary to define a program of the skills specialists-in-training in gastroenterology should acquire during their residency...
June 14, 2018: Revista Española de Enfermedades Digestivas
Rena Yadlapati, Eric S Hungness, John E Pandolfino
Antireflux surgery anatomically restores the antireflux barrier and is a therapeutic option for proton pump inhibitor (PPI)-refractory gastroesophageal reflux disease or PPI intolerance. Laparoscopic fundoplication is the standard antireflux surgery, though its popularity has declined due to concerns regarding wrap durability and adverse events. As the esophagogastric junction is an anatomically complex and dynamic area subject to mechanical stress, wraps are susceptible to disruption, herniation or slippage...
June 14, 2018: American Journal of Gastroenterology
Sara Ebrahimi, Gholamreza Khademi, Seyed Ali Jafari, Nona Zaboli Nejad, Abdolreza Norouzy, Bahareh Imani
Very-early-onset inflammatory bowel disease (VEO-IBD) has a distinct phenotype and should be considered a specific entity. VEO-IBD presents with very severe clinical pictures and is frequently known by an indeterminate colitis whose clinical remission is unmanageable. This study examines the case of a neonate with VEO-IBD, not responding to medical and surgical treatment. A 7-day-old Iranian female neonate presented with severe bloody diarrhea, poor feeding, abdominal distention, and dehydration suggesting severe proctocolitis due to an allergy to the protein in cow's milk...
May 2018: Iranian Journal of Medical Sciences
Jan Bruensing, Lukas Buendgens, Christoph Jochum, Ulf Herbers, Ali Canbay, Georg Braun, Christian Trautwein, Wolfgang Huber, Alexander Koch, Frank Tacke
BACKGROUND:  Clostridium difficile associated colitis is a frequent cause of nosocomial diarrhea at the intensive care unit (ICU) and is associated with poor prognosis in critically ill patients. Few studies have evaluated the efficacy of treatment options or adherence to guideline recommendations of Clostridium difficile infections at the ICU. METHODS:  Therefore, on behalf of the Gastroenterology Intensive Care Medicine working group of the DGVS, we have conducted an online-based survey among leading intensivists in Germany...
June 2018: Zeitschrift Für Gastroenterologie
Camille A Kezer, Neil Gupta
PURPOSE OF REVIEW: This article aims to review current therapeutic endoscopic treatments available for the management of gastrointestinal bleeding related to cirrhosis. RECENT FINDINGS: Endoscopic band ligation is an effective treatment for primary prophylaxis, acute bleeding, and secondary prophylaxis of esophageal varices as well as for acute bleeding and secondary prophylaxis of select gastric varices. Sclerotherapy is a treatment option for acute bleeding and secondary prophylaxis of esophageal varices when band ligation is technically difficult...
June 9, 2018: Current Gastroenterology Reports
Eliza R C Hagens, Maarten C J Anderegg, Mark I van Berge Henegouwen, Suzanne S Gisbertz
BACKGROUND: Anastomotic leakage is one of the most severe complications following esophageal surgery, leading to significant morbidity, prolonged hospital stay, considerable costs, decreased quality of life and increased mortality. Management of anastomotic leakage is complicated and has currently not been standardized. The objective of this research is to gain insight into the different opinions on anastomotic leakage management among upper gastrointestinal surgeons and to verify the need for diagnostic and treatment guidelines...
June 5, 2018: Annals of Thoracic Surgery
Sung Hyun Lee, Youngdeuk Kim, Tae Young Lim
Background When intranasal contact points are the cause of headache and facial pain, opinions regarding whether to remove intranasal contact points when they are believed to be the cause of headache and facial pain are divided. Clinical Presentation A 46-year-old woman visited the authors' pain clinic with complaints of right nasal pain accompanied by frontotemporal headache. She first met an Otorhinolaryngologist and a neurologist. Based on nasal endoscopy and pain pattern, they presumed that her pain was a nasal mucosal headache rather than migraine...
June 8, 2018: Cranio: the Journal of Craniomandibular Practice
J M Gonzalez, D Lorenzo, T Guilbaud, T Bège, M Barthet
Background and study aims : Management of post-sleeve gastrectomy fistulas (PSGF) recently has evolved, resulting in prioritization of internal endoscopic drainage (IED). We report our experience with the technique in a tertiary center. Patients and methods:  This was a single-center, retrospective study of 44 patients whose PSGF was managed with IED, comparing two periods: after 2013 (Group 1; n = 22) when IED was used in first line and before 2013 (Group 2; n = 22) when IED was applied in second line...
June 2018: Endoscopy International Open
Jiao Li, Wai K Leung
Colon capsule endoscopy (CCE) is designed for direct visualization of the colonic mucosa through passive propulsion. The role of CCE on detection of colonic polyps has been extensively evaluated. As mucosal healing has emerged as a pivotal target for treatment of inflammatory bowel disease (IBD), there is increasing data to suggest that CCE can also be used in the monitoring of mucosal inflammation in patients with active IBD, particularly in ulcerative colitis (UC) and also in Crohn's disease (CD). Despite advantages such as its non-invasive nature, patient's comfort, safety, and access to anatomical regions not easily reached by conventional endoscopy, CE has limitations including the lack of ability to obtain biopsies or therapeutic capabilities and no control over movement...
June 4, 2018: Journal of Digestive Diseases
Zhenguo Qiao, Xin Ling, Jianhong Zhu, Guojian Ying, Lihua Xu, Hong Zhu, Jinhai Tang
The present study was performed to evaluate the therapeutic safety and feasibility of purse-string sutures with nylon loops and metal clips under single-channel endoscopy to repair gastrointestinal wall defects that had previously developed during endoscopic full-thickness resection (EFR). A multicenter prospective cohort study of 42 patients who had developed defects of the gastrointestinal wall during EFR was conducted from April 2012 to October 2016. All lesions were endoscopically repaired with either a single-channel gastroscope (research group, n=18) or double-channel gastroscope (control group, n=24)...
May 2018: Experimental and Therapeutic Medicine
Thomas Lindebo Holm, Ditte Tornehave, Henrik Søndergaard, Peter Helding Kvist, Bodil-Cecilie Sondergaard, Lene Hansen, Mette Brunsgaard Hermit, Kristine Holgersen, Sandra Vergo, Klaus Stensgaard Frederiksen, Claus Haase, Dorthe Lundsgaard
Background and Aim: Interleukin-21 (IL-21) is primarily a T cell-derived cytokine; it is upregulated in patients with Crohn's Disease (CD) and could be a potential new therapeutic target in CD. Methods: In human material, IL-21 and IL-21R expression was investigated by in situ hybridization (ISH) and immunohistochemistry (IHC) in noninflammatory bowel disease (non-IBD) controls and patients with CD. The pathologic role of IL-21 was examined in murine models of T cell-dependent and T cell-independent colitis, either with a neutralizing monoclonal antibody against IL-21 or with the transfer of CD4+ CD45RBhigh IL-21R-/- T cells...
2018: Gastroenterology Research and Practice
Reena Khanna, Neeraj Narula, Brian G Feagan
Clinical trials require valid outcome measures to assess the therapeutic benefit of investigational agents. Recently, regulatory authorities have mandated the use of patient-reported outcomes in combination with an objective measure of disease activity as primary outcome measures in inflammatory bowel disease trials. Endoscopy has commonly fulfilled the latter role; however, due to the costs and complexity of these assessments, interest has emerged in the use of noninvasive biomarkers. The role of C-reactive protein, fecal calprotectin, and fecal lactoferrin in clinical research is discussed...
May 28, 2018: Inflammatory Bowel Diseases
Wojciech Latos, Aleksander Sieroń, Grzegorz Cieślar, Aleksandra Kawczyk-Krupka
INTRODUCTION: The search for new diagnostic and therapeutic procedures is an essential task in contemporary oncology. The purpose of our study was the evaluation of the practical usefulness of autofluorescence endoscopy (AFE) using the Onco-LIFE system, compared with the use of white light endoscopy (WLE), and the estimation of the correlation between the histopathological evaluation with the degree of lesions' Numerical Color Value (NCV index) and the method's sensitivity and specificity valuation...
May 25, 2018: Photodiagnosis and Photodynamic Therapy
Juan Antonio Chirinos Vega, César García Delgado, Alfonso Delgado Vergara
The endoscopic sumucosal disection (ESD) is an advanced endoscopic technique that achieves the curative resection of superficial neoplasms of the gastrointestinal tract, getting block exeresis with margins free of neoplasia avoiding surgery. However, tumors located in the esophagogastric junction, or pylorus, are technically more complex to resect by ESD. When a neoplasm settles in the pylorus, the anatomical characteristics of this region can affect the adequate assessment of the margins and the performance of the procedure...
January 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Diego Soares Coca, Carolina Manna Santos, Osmar Silvio Garcia de Oliveira, Dayse Aparício Pereira, Carlos Jr Kiyoshi Furuya, Everson L A Artifon
OBJECTIVE: To present and discuss the endoscopic and histological results, as well as the incidence of Helicobacter pylori and other diseases, indications and characteristics of upper digestive endoscopies performed in children. MATERIAL AND METHODS: Twenty-five endoscopies were performed in children aged six months to 11 years (mean 7.69 years), from February 2013 to January 2016. In 200 patients, endoscopies were diagnostic and serial biopsies were performed (esophagus, stomach and duodenum), in 120 of them...
January 2018: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Patricia García-Cabo, Laura Fernández-Vañes, Daniel Pedregal, Marta Menéndez Del Castro, Eduardo Murias, Pedro Vega, José Luis Llorente, Juan Pablo Rodrigo, Fernando López
OBJECTIVE: The objective was to determine the results of the treatment of severe and/or refractory epistaxis requiring hospital admission. In addition, the results of arterial ligation versus embolization were compared. MATERIAL AND METHOD: Sixty-three patients with severe and/or refractory epistaxis requiring hospital admission between August 2014 and December 2016 were included prospectively. RESULTS: Eleven patients (17%) underwent embolization, 5 (8%) endoscopy ligation and the remaining 47 (75%) underwent conservative treatment with tamponade...
May 18, 2018: Acta Otorrinolaringológica Española
Carol H Yan, Navarat Tangbumrungtham, Ximena A Maul, Yifei Ma, Jayakar V Nayak, Peter H Hwang, Zara M Patel
BACKGROUND: Acute exacerbations in patients with chronic rhinosinusitis (CRS) are often treated with courses of systemic antibiotics. Poor correlation between microbiologic culture results and the sinus microbiome in CRS has caused increased debate as to the relevance of culture-directed antibiotics. There is currently sparse data comparing outcomes of culture-directed antibiotics vs non-culture-directed antibiotics for treatment of CRS. METHODS: This work reports a retrospective review...
May 21, 2018: International Forum of Allergy & Rhinology
Shishira Bharadwaj, Neeraj Narula, Parul Tandon, Mohammad Yaghoobi
Crohn's disease (CD) and ulcerative colitis (UC) constitute the two most common phenotypes of inflammatory bowel disease (IBD). Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of IBD. Differential diagnosis of CD and UC is important, as their medical and surgical treatment modalities and prognoses can be different. However, approximately 15% of patients with IBD are misdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or UC. Recently, there has been increased recognition of the role of the therapeutic endoscopist in the field of IBD...
May 2018: Gastroenterology Report
Masanari Sekine, Hiroyuki Miyatani, Keita Matsumoto, Hitomi Kashima, Yudai Koito, Takaya Miura, Yuko Takahashi, Rumiko Tsuboi, Takehiro Ishii, Junichi Fujiwara, Takeshi Uehara, Shunsuke Urayoshi, Kazuhito Yuhashi, Takeharu Asano, Noriyoshi Sagihara, Satohiro Matsumoto, Hirosato Mashima
The patient was a "73" -year-old woman who visited our hospital with the chief complaint of weight loss. Upper gastrointestinal endoscopy revealed an enlarged ampulla of Vater, and a biopsy led to a diagnosis of Group "4" gastric carcinoma; suspicious of adenocarcinoma. There were no findings suggesting invasion into the muscle layer of duodenum, despite tumor mass formation being observed in the sphincter of Oddi. We performed endoscopic papillectomy for both diagnostic and therapeutic purposes...
May 18, 2018: Internal Medicine
Heechan Kang, Mo Hameed Thoufeeq
Background an study aims:  Polypectomy and endoscopic mucosal resection (EMR) are effective and safe ways of removing polyps from the colon at endoscopy. Guidelines exist for advising the time allocation for diagnostic endoscopy but not for polypectomy and EMR. The aim of this study was to identify if time allocated for polypectomy and EMR at planned therapeutic lists in our endoscopy unit is sufficient for procedures to be carried out. We also wanted to identify factors that might be associated with procedures taking longer than the allocated time and to identify factors that might predict duration of these procedures...
May 2018: Endoscopy International Open
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