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Upper gastrointestinal surgery

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https://www.readbyqxmd.com/read/28804920/thiopurines-prevented-surgical-recurrence-in-patients-with-crohn-s-disease-after-intestinal-resection-strategy-based-on-risk-stratification
#1
Jing Guo, Bai-Li Chen, Zhi-Hui Chen, Xia-Peng Luo, Yun Qiu, Sheng-Hong Zhang, Rui Feng, Yao He, Zhi-Rong Zeng, Xin-Ming Song, Shomron Ben-Horin, Ren Mao, Min-Hu Chen
BACKGROUND: Thiopurines (TPs) are effective in reducing risk of clinical and endoscopic recurrence in postoperative patients with Crohn's disease (CD). However, whether TPs could prevent surgical recurrence (SR) remains unknown. AIM: To explore whether TPs could prevent SR and identify risk factors associated with SR in postoperative CD patients. METHODS: This was a retrospective cohort study of 246 postoperative patients with CD. Cox proportional hazard model was used to identify risk factors for SR...
August 14, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28803550/palliative-end-ileostomy-and-gastrojejunostomy-for-a-metastatic-distal-transverse-colonic-malignancy-complicated-by-a-proximal-duodenocolic-fistula-a-case-report
#2
Gnanaselvam Pamathy, Umesh Jayarajah, Yapa Hamillage Hemantha Gunathilaka, Sivasuriya Sivaganesh
BACKGROUND: Fistulae between the colon and upper gastrointestinal tract are distressing and uncommon complications of malignancies involving this region. We report a case of a middle-aged man with a locally advanced and metastatic distal transverse colon malignancy who presented with a duodenocolic fistula proximal to the primary tumor and underwent palliative surgery. CASE PRESENTATION: A 50-year-old Sri Lankan man presented to our hospital with a history of feculent vomiting of 1 week's duration preceded by worsening constipation and abdominal fullness of 2 months' duration...
August 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28798284/the-clinical-characteristics-and-prognosis-of-crohn-s-disease-in-korean-patients-showing-proximal-small-bowel-involvement-results-from-the-connect-study
#3
One Zoong Kim, Dong Soo Han, Chan Hyuk Park, Chang Soo Eun, You Sun Kim, Young-Ho Kim, Jae Hee Cheon, Byong Duk Ye, Joo Sung Kim
Background/Aims: We aimed to evaluate the clinical characteristics and prognosis of Crohn's disease (CD) in patients who showed proximal small bowel involvement using a nationwide Korean CD cohort. Methods: We reviewed the data from a cohort of patients diagnosed with CD. The clinical outcomes of patients were evaluated according to the presence of proximal small bowel involvement. Results: Among 1,329 patients with CD for whom complete disease location data were available, 222 patients (16...
August 14, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28790839/isolated-thoracic-perfusion-with-chemofiltration-for-progressive-malignant-pleural-mesothelioma
#4
Karl Reinhard Aigner, Emir Selak, Sabine Gailhofer
INTRODUCTION: Therapy of malignant pleural mesothelioma and especially the adequate role of surgery in this context remain the subject of controversial discussions. Radical surgery in particular, which is associated with substantial morbidity, failed to translate into a definite survival advantage. We report on interim results of an ongoing Phase II study of regional chemotherapy in terms of isolated thoracic perfusion with chemofiltration (ITP-F). PATIENTS AND METHODS: Twenty-eight patients (25 male, 3 female, mean age 63...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28780610/pancreatic-leaks-and-fistulae-an-endoscopy-oriented-classification
#5
REVIEW
Massimiliano Mutignani, Stefanos Dokas, Alberto Tringali, Edoardo Forti, Francesco Pugliese, Marcello Cintolo, Raffaele Manta, Lorenzo Dioscoridi
BACKGROUND: Pancreatic leaks occur as a complication of upper gastrointestinal surgery, acute pancreatitis, or abdominal trauma. Pancreatic fistulas and leaks are primarily managed conservatively. Overall, conservative measures are successful in more than half of cases. Whenever conservative treatment is not efficient, surgery is usually considered the treatment of choice. Nowadays however, endoscopic treatment is being increasingly considered and employed in many cases, as a surgery sparing intervention...
August 5, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28776354/multidisciplinary-approach-to-refractory-upper-gastrointestinal-bleeding-case-series-of-angiographic-embolization
#6
Ko Eun Lee, Ki Nam Shim, Chung Hyun Tae, Min Sun Ryu, Sun Young Choi, Chang Mo Moon, Seong Eun Kim, Hey Kyung Jung, Sung Ae Jung
Although medical and endoscopic hemostasis is now considered as the first-line therapy for nonvariceal upper gastrointestinal (UGI) bleeding, refractory bleeding still occurs in 5%-10% of the patients. In these patients, transcatheter arterial embolization (TAE) or surgery is required, but research on embolization for unmanageable UGI bleeding in Korea is scanty. We reviewed the medical records of 518 patients who underwent endoscopic hemostasis during 4 years. Among these subjects, 8 patients who required embolization due to failure of endoscopic hemostasis were enrolled...
September 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28770120/laparoscopic-repair-of-a-large-paraesophageal-hernia-with-migration-of-the-stomach-into-the-mediastinum-creating-an-upside-down-stomach
#7
Nasser Sakran, Hadar Nevo, Ron Dar, Asnat Raziel, Dan Hershko
Upside-down stomach is a relatively rare type of a large paraesophageal hernia characterized by the migration of the stomach into the posterior mediastinum. Upside-down stomach is prone to severe complications and therefore surgery is recommended even in asymptomatic patients. A 62-year-old male presented with frequent abdominal pain with nausea and vomiting that persisted for one year. The patient was obese with fatty liver and was treated medically for gastroesophageal reflux disease (GERD) for 4 years. On upper gastrointestinal CT study a level-IV paraesophageal hernia was detected with upside-down stomach, and he was referred for elective surgery...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28764844/biliopancreatic-diversion-with-duodenal-switch-leads-to-better-postprandial-glucose-level-and-beta-cell-function-than-sleeve-gastrectomy-in-individuals-with-type-2-diabetes-very-early-after-surgery
#8
Andréanne Michaud, Thomas Grenier-Larouche, Dominique Caron-Dorval, Simon Marceau, Laurent Biertho, Serge Simard, Denis Richard, André Tchernof, André C Carpentier
OBJECTIVE: The aim of this study was to compare the short-term effect of sleeve gastrectomy (SG) and biliopancreatic diversion with duodenal switch (DS) in order to determine if exclusion of the upper gastrointestinal tract confers greater metabolic improvement, independent of weight loss. METHODS: Standard meals were administered before and on day 3 and 4 after SG to assess insulin sensitivity, β-cell function and gastrointestinal hormone responses in matched normoglycemic (NG) and type 2 diabetes (T2D) participants...
September 2017: Metabolism: Clinical and Experimental
https://www.readbyqxmd.com/read/28759483/alarm-limits-for-intraoperative-drug-infusions-a-report-from-the-multicenter-perioperative-outcomes-group
#9
Mitchell F Berman, Nikhil Iyer, Leon Freudzon, Shuang Wang, Robert E Freundlich, Michelle Housey, Sachin Kheterpal
BACKGROUND: Continuous medication infusions are commonly used during surgical procedures. Alarm settings for infusion pumps are considered important for patient safety, but limits are not created in a standardized manner from actual usage data. We estimated 90th and 95th percentile infusion rates from a national database for potential use as upper limit alarm settings. METHODS: We extracted infusion rate data from 17 major hospitals using intraoperative records provided by Multicenter Perioperative Outcomes Group for adult surgery between 2008 and 2014...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28755160/successful-video-assisted-thoracoscopic-surgery-in-prone-position-in-patients-with-esophageal-cancer-and-aberrant-right-subclavian-artery-report-of-three-cases
#10
Koji Shindo, Eishi Nagai, Toshinaga Nabae, Toru Eguchi, Taiki Moriyama, Kenoki Ohuchida, Tatsuya Manabe, Takao Ohtsuka, Yoshinao Oda, Makoto Hashizume, Masafumi Nakamura
BACKGROUND: An aberrant right subclavian artery (ARSA) with an associated nonrecurrent right inferior laryngeal nerve (NRILN) is a relatively rare anomaly that occurs at a frequency of 0.3 to 2.0% of the general population. NRILN has been mainly documented in the head and neck region; it has been rarely described in patients with esophageal cancer, especially those undergoing thoracoscopic surgery. Video-assisted thoracoscopic surgery for esophageal cancer (VATS-E) is becoming more widespread as a reliable minimally invasive surgical procedure associated with reduced perioperative complications...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28742708/postoperative-outcomes-of-minimally-invasive-gastrectomy-versus-open-gastrectomy-during-the-early-introduction-of-minimally-invasive-gastrectomy-in-the-netherlands-a-population-based-cohort-study
#11
Hylke J F Brenkman, Suzanne S Gisbertz, Annelijn E Slaman, Lucas Goense, Jelle P Ruurda, Mark I van Berge Henegouwen, Richard van Hillegersberg
OBJECTIVE: To compare postoperative outcomes of minimally invasive gastrectomy (MIG) to open gastrectomy (OG) for cancer during the introduction of MIG in the Netherlands. BACKGROUND: Between 2011 and 2015, the use of MIG increased from 4% to 53% in the Netherlands. METHODS: This population-based cohort study included all patients with curable gastric adenocarcinoma that underwent gastrectomy between 2011 and 2015, registered in the Dutch Upper GI Cancer Audit...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28732535/case-report-rare-skeletal-manifestations-in-a-child-with-primary-hyperparathyroidism
#12
Maulee Hiromi Arambewela, Kamani Danushka Liyanarachchi, Noel P Somasundaram, Aruna S Pallewatte, Gamini L Punchihewa
BACKGROUND: Primary hyperparathyroidism (PHPT) is uncommon among children with an incidence of 1:300,000. This diagnosis is often missed in children in contrast to adults where it is detected at a pre symptomatic stage due to routine blood investigations. Etiology of PHPT can be due to adenoma, hyperplasia or rarely carcinoma. CASE PRESENTATION: A 12 year old Sri Lankan girl presented with progressive difficulty in walking since 1 year. On examination she had bilateral genu valgum...
July 21, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28725302/the-trend-of-tranexamic-use-in-upper-gastrointestinal-bleeding-ulcers
#13
Stefan Redeen
BACKGROUND: Bleeding ulcer is a common condition, especially among the elderly population. Tranexamic acid (TXA) has been successfully used for many bleeding conditions. Its use in patients with bleeding ulcer is inclusive yet. The aim of this study was to provide an overview of the prescription of TXA. METHODS: This retrospective cohort study was performed as a review of medical records at the Surgery Department, University Hospital in Linkoping. Patients with complete esophagogastroduodenoscopy and ulcer disease were included and divided on the basis of treatment with TXA or not...
June 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28724308/eus-guided-recanalization-of-complete-gastrointestinal-strictures
#14
Miguel Martínez-Guillén, Joan B Gornals, Claudia F Consiglieri, Josep M Castellvi, Carme Loras
BACKGROUND AND AIM: Complete gastrointestinal strictures are a technically demanding problem. In this setting, an anterograde technique is associated with a high risk of complications and a combined anterograde-retrograde technique requires a prior ostomy. Our aim was to assess the outcome of a first case series for the management of complete gastrointestinal strictures using endoscopic ultrasound (EUS)-guided puncture as a novel endoscopic approach. PATIENTS AND METHODS: This retrospective case-series describes four cases that were referred for treatment of complete benign gastrointestinal strictures, three upper and one lower...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28721219/two-rare-manifestations-of-primary-hyperparathyroidism-paralysis-and-peptic-ulcer-bleeding
#15
Maryam Heidarpour, Mehdi Karami, Pegah Hedayat, Ashraf Aminorroaya
Primary hyperparathyroidism revealed by thoracic spine brown tumor and peptic ulcer bleeding is rare. We presented a case of 33-year-old male patient who was admitted with paraplegia. Thoracic spine magnetic resonance imaging (MRI) showed extradural lesion at T4 level. He underwent surgical decompression in T4. According to histopathologic finding and elevated serum parathormone (PTH) and hypercalcemia (total serum calcium 12.1 mg/dL), the diagnosis of brown tumor was down. Ultrasonography of his neck showed a well-defined lesion of 26 × 14 × 6 mm...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28718261/modern-management-of-duodenal-variceal-bleeding
#16
Amer Rehman Farooqi, Lawrence Sunderraj
Duodenal variceal bleeding is an uncommon cause of gastrointestinal bleeding. Treatment strategies are reliant on case reports and case series with new developments in interventional treatment modalities including endoscopic therapy, radiological intervention, and surgery. Endoscopic treatment includes injection sclerotherapy using various agents, banding of varices and clipping of varices. Interventional radiological procedures include Transjugular Intrahepatic porto-systemic shunt (TIPSS), and Balloon- Occluded Retrograde Transvenous Obliteration (BRTO)...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28715900/gangliocytic-paraganglioma-an-unusual-cause-of-upper-gastrointestinal-bleeding
#17
Yolanda Sánchez Torrijos, Rafael León Montañés, María Ángeles Mejías Manzano
Gangliocytic paraganglioma is an uncommon tumor, which is usually located in the ampulla of Vater, and may get confused in the differential diagnosis with ampuloma or GIST. Here we present a case of a patient with upper gastrointestinal bleeding as a predominant symptom, objectified by endoscopy an ulcerative polypoid mass at the juxtapilar level, with histological result of gangliocítica paraganglioma after multiple biopsies, and finally surgical resection. The interest of this case is the difficulty for diagnosing, the different treatments and prognosis that this implies, especially for the tumor location, as surgery can lead to great complications...
July 18, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28704230/effect-of-esophageal-cancer-surgeon-volume-on-management-and-mortality-from-emergency-upper-gastrointestinal-conditions-population-based-cohort-study
#18
Sheraz R Markar, Hugh Mackenzie, Alan Askari, Omar Faiz, George B Hanna
OBJECTIVE: To study the influence of esophageal cancer surgeon volume upon mortality from upper gastrointestinal emergencies. BACKGROUND: Volume-outcome relationships led to the centralization of esophageal cancer surgery. METHODS: Hospital Episode Statistics data were used to identify patients admitted to hospitals within England (1997-2012). The influence of esophageal high-volume (HV) cancer surgeon status (≥5 resections per year) upon 30-day and 90-day mortality from esophageal perforation (EP), paraesophageal hernia causing obstruction or gangrene (PEH) and perforated peptic ulcer (PPU) was analyzed, independent of HV esophageal cancer center status and patient and disease-specific confounding factors...
July 12, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28699175/long-term-health-outcomes-of-adults-with-mccune-albright-syndrome
#19
S C Wong, M Zacharin
CONTEXT: McCune Albright Syndrome (MAS) is associated with numerous health problems. Comprehensive long term health problems of adults with MAS are less well defined in the literature. OBJECTIVE: Our objective is to report comprehensive health outcomes of adults with MAS (> 18 years). DESIGN: Retrospective case note review of 16 adults with MAS managed by one clinician. Results expressed as median (range) RESULTS: The study included 16 adults (7 males) with MAS...
July 12, 2017: Clinical Endocrinology
https://www.readbyqxmd.com/read/28698419/-aortoesophageal-fistula-due-to-aortic-aneurysm-report-of-a-case
#20
Satoshi Yuhara, Takuya Kimura, Hideyuki Okawa, Hiroki Hasegawa, Jun Yokote, Yukifusa Yokoyama, Syuji Tamaki
A 77-year-old woman presented with general fatigue, was found to have anemia, and was referred to our hospital. Upper gastrointestinal endoscopy revealed a submucosal elevated lesion with a bleeding site and debris at the middle thoracic esophagus. Enhanced computed tomography demonstrated a thoracic aortic aneurysm compressing the esophagus. She was diagnosed with an aorto-esophageal fistula due to the thoracic aortic aneurysm. Graft replacement was performed under partial extracorporeal circulation. Because the perforation of the esophagus was small, omental flap transposition was performed without esophagectomy...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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