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Endoscopic dilation

Ben H Chew, Dirk Lange
Open ureterolithotomy and pyelolithotomy used to be first line therapy for treating kidney and ureteral stones. With the advent of shockwave lithotripsy, open stone surgery became less prevalent, but once ureteroscopy became more prevalent, open stone surgery became all but extinct. Advances in smaller, more flexible endoscopes and improvements in intracorporeal lithotripters, ureteroscopy has become a mainstay of therapy for kidney stones. The holmium:YAG laser can be utilized through flexible instruments and fragments any stone no matter what it is composed of...
October 19, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Lava Y Patel, Brittany Lapin, Craig S Brown, Thomas Stringer, Matthew E Gitelis, John G Linn, Woody E Denham, Elizabeth Farwell, Stephen Haggerty, Michael B Ujiki
BACKGROUND: Approximately 20-30 % of morbidly obese patients undergoing Roux-en-Y gastric bypass (RYGB) will experience significant weight regain in the years following surgery. Endoscopic gastrojejunal revision (EGJR) has been shown to be a safe, effective and less invasive alternative to revisional surgery, with promising weight loss outcomes. However, minimal data exist regarding how to perform the procedure most effectively and what factors may predict good outcomes. We compared weight loss outcomes between patients undergoing endoscopic stoma revision by one of two full-thickness suturing techniques...
October 17, 2016: Surgical Endoscopy
Yusuke Tonai, Ryu Ishihara, Yasushi Yamasaki, Takashi Kanesaka, Sachiko Yamamoto, Tomofumi Akasaka, Noboru Hanaoka, Yoji Takeuchi, Koji Higashino, Noriya Uedo, Yasuhiko Tomita, Hiroyasu Iishi
Background and study aims: Better endoscopic diagnosis in case of Barrett's esophagus is still needed. White globe appearance (WGA) is a novel endoscopic marker for gastric adenocarcinoma, with high sensitivity for differentiating between gastric cancer/high-grade dysplasia and other lesions. We report 2 cases of esophageal adenocarcinoma with WGA. In Case 1, esophagogastroduodenoscopy (EGD) revealed a 10-mm esophageal adenocarcinoma in a 48-year-old Japanese woman with short-segment Barrett's esophagus. A small (< 1 mm) white globular lesion, typical of WGA, was observed under the epithelium by magnifying narrow-band imaging...
October 2016: Endoscopy International Open
Felix Blasl, Wolfgang H Rösch, Mark Koen, Mircia-Aurel Ardelean, Anne-Karoline Ebert
OBJECTIVE AND INTRODUCTION: Cowper's syringocele is a cystic dilation of the bulbourethral gland duct, initially defined by Maizels et al. in 1983. Although obstructive and non-obstructive types of this rare anomaly are described, clinical symptoms are highly unspecific. Therefore, we report 12 cases of children and young adults diagnosed with Cowper's syringocele to further clarify clinical course, comorbidity and treatment strategies. STUDY DESIGN: We retrospectively collected clinical data of 12 children and young adults from birth to 18...
October 8, 2016: Journal of Pediatric Urology
Frank Zerbib
Eosinophilic esophagitis is a major cause of dysphagia and esophageal food impaction in young adults, although the diagnostic can be made in older patients. The diagnosis of eosinophilic esophagitis is suspected on endoscopic abnormalities of esophageal mucosa and confirmed by esophageal biopsy samples. Approximately 50% of patients with eosinophilic esophagitis do respond to proton pump inhibitors therapy. The first line therapy for eosinophilic esophagitis is proton pump inhibitor therapy. Ingested topical steroids represent a second-line therapy...
October 10, 2016: La Presse Médicale
Seiji Kaino, Manabu Sen-Yo, Shuhei Shinoda, Michitaka Kawano, Hirofumi Harima, Shigeyuki Suenaga, Isao Sakaida
Postoperative biliary strictures are usually complications of cholecystectomy. Endoscopic plastic stent prosthesis is generally undertaken for treating benign biliary strictures. Recently, fully covered metal stents have been shown to be effective for treating benign distal biliary strictures. We present the case of a 53-year-old woman with liver injury in which imaging studies showed a common hepatic duct stricture. Endoscopic retrograde cholangiopancreatography also confirmed the presence of a common hepatic duct stricture...
October 15, 2016: Clinical Journal of Gastroenterology
Mordechai Duvdevani
Endoscopic treatment is currently the mainstay of management for urolithiasis. The high effectiveness of PCNL is well documented in the literature, as are its complications. Bleeding during PCNL is directly related to the size of the dilatation.(1) Several minimally invasive refinements in percutaneous surgery have been made to reduce access related complications and bleeding rates.(2) This was achieved mainly by reducing tract diameter, but the advantage over standard PCNL has yet to be proven.(3) The effectiveness of RIRS is decreasing with increasing stone burden...
October 12, 2016: Journal of Endourology
Shinjiro Kobayashi, Horoyuki Hoshino, Kouhei Segami, Satoshi Koizumi, Nobuyuki Ooike, Takehito Otsubo
The patient was a 56-year-old woman who had experienced epigastralgia and dorsal pain several times over the last 20 years. She was admitted for a diagnosis of acute cholecystitis, and severe intra- and extrahepatic bile duct dilatation with inner air density was noted. No papilla of Vater was present in the descending duodenum, and 2 small holes were present in the pyloric ring. Bile excretion from one of the small holes was observed under forward-viewing endoscope. It was considered that the pancreatic and bile ducts separately opened into the pyloric ring...
May 2016: Case Reports in Gastroenterology
Katherine N Adams, Rupali N Shah, Robert A Buckmire
OBJECTIVES/HYPOTHESIS: Complete pharyngoesophageal strictures may be encountered by the otolaryngologist as a consequence of radiation/chemoradiotherapy therapies for head and neck cancer. A combined anterograde and retrograde dilation procedure (rendezvous procedure) has proven to be a useful surgical intervention in these cases. We assess the long-term swallowing outcomes of this patient cohort including gastrostomy tube (G-tube) reliance, swallowing quality of life, and variables that contribute to improved swallowing outcomes...
September 26, 2016: Laryngoscope
Stanisław Pieczarkowski, Marek Woynarowski, Piotr Landowski, Robert Wilk, Adam Daukszewicz, Ewa Toporowska-Kowalska, Piotr Albrecht, Iwona Ignys, Elżbieta Czkwianianc, Elżbieta Jarocka-Cyrta, Bartosz Korczowski
INTRODUCTION: Oesophageal strictures are rare in children but may require endoscopic dilation. AIM: To gather information on centres performing endoscopic oesophageal dilation in Poland. MATERIAL AND METHODS: The data were obtained from questionnaires concerning the relevant data mailed to 22 paediatric endoscopy centres. Completed questionnaires were received from 11 centres. RESULTS: In 2010 the 11 Polish paediatric endoscopy centres performed a total of 10,650 endoscopic procedures...
2016: Przegla̜d Gastroenterologiczny
Yong-Hyun Hwang, Hee-Chun Lee, Jae-Hoon Lee
OBJECTIVE: To examine the technical feasibility of percutaneous endoscopic pediculectomy using a lateral approach and to evaluate its use for decompression and examination of the thoracic and lumbar spinal canals in small dogs. STUDY DESIGN: Experimental study. ANIMALS: Clinically normal adult dogs (n=10). METHODS: After optimizing the technique in cadavers, percutaneous endoscopic pediculectomy was performed using a lateral approach to the thoracic (T12) or lumbar (L2) vertebrae in 5 dogs each...
October 6, 2016: Veterinary Surgery: VS
Stefano Paolo Zanetti, Luca Boeri, Michele Catellani, Andrea Gallioli, Alberto Trinchieri, Kemal Sarica, Emanuele Montanari
OBJECTIVE: A wide selection of both anterograde and retrograde mini-invasive procedures exist for stones' treatment. The 2016 European Association of Urology (EAU) guidelines still don't univocally define a best option. Our purpose is to give an overview on some European Stone Centers' customs and to compare real life clinical practice with statements of opinion leaders and Guidelines. MATERIALS AND METHODS: In 2015 we performed a survey in 3 step about the spread of retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) techniques among EAU Section of Urolithiasis (EULIS) members...
October 5, 2016: Archivio Italiano di Urologia, Andrologia
Luiz Gustavo de Quadros, Roberto Luiz Kaiser, Manoel Dos Passos Galvão, Josemberg Marins Campos, Marcelo Falcão de Santana, Alvaro Antonio Bandeira Ferraz
Background: A multitude of endoscopic findings post-gastric bypass procedures have been previously reported in the literature, but to our knowledge, no present rules exist that could guide clinicians regarding which findings should be actively sought, once an initial finding is identified. Objective: To identify co-occurrence patterns among endoscopic findings of patients having undergone past gastric bypass procedure. Methods: Our registry involves all consecutive patients undergoing an upper endoscopic evaluation after a gastric bypass procedure...
October 2016: Arquivos de Gastroenterologia
Kim Tong, Chick Weisse, Allyson C Berent
OBJECTIVE To describe the technique and outcome for male dogs undergoing rigid urethrocystoscopy via a novel percutaneous, fluoroscopic-assisted perineal approach. DESIGN Retrospective case series. ANIMALS 19 client-owned male dogs. PROCEDURES Medical records of male dogs that underwent urethrocystoscopy via a percutaneous perineal approach for treatment of a variety of conditions from 2005 through 2014 were reviewed. Signalment, history, pertinent diagnostic imaging results, endourologic and postprocedure details, duration of hospitalization, complications, and outcome (short-term, < 1 month; long-term, ≥ 1 month) were recorded...
October 15, 2016: Journal of the American Veterinary Medical Association
Nisha A Shah, Dustin M Albert, Noah M Hall, Fouad J Moawad
Eosinophilic esophagitis (EoE) is a chronic and progressive immune-mediated condition defined by symptoms of esophageal dysfunction and dense eosinophilic infiltration of the esophageal mucosa. Therapies consist of anti-eosinophilic medications and specialized diets aimed to decrease the progression of EoE and alleviate its symptoms, namely, dysphagia and food impaction. Assessing response to therapy remains challenging, as treatment end points are not well defined and currently consist of clinical, histologic, and endoscopic features...
2016: Clinical and Experimental Gastroenterology
Kosuke Minaga, Masayuki Kitano, Chimyon Gon, Kentaro Yamao, Hajime Imai, Takeshi Miyata, Ken Kamata, Shunsuke Omoto, Mamoru Takenaka, Masatoshi Kudo
BACKGROUND AND AIMS: Endoscopic ultrasonography (EUS)-guided choledochoduodenostomy (EUS-CDS) is increasingly utilized in the treatment of malignant distal biliary obstruction. Standardized use of this technique requires improvements in instruments, including more convenient and safer devices. This study was designed to evaluate the resistance force to migration (RFM) of a newly designed laser-cut metal stent and the feasibility of EUS-CDS using this stent. METHODS: This experimental study utilized a porcine model of biliary dilatation involving five male pigs...
September 28, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
E Ray-Offor, S N Elenwo, P O Igwe, C Ngeribara
BACKGROUND: The cystic dilatation of the biliary tract is an uncommon anomaly. Choledochocele, a cystic dilatation of the distal common bile duct, rarely presents clinically as massive gastrointestinal bleeding. AIM: This is to report a very rare disease condition and highlight minimal access options in surgical care. CASE SUMMARY: A 13 year-old boy was referred with a day history of sudden onset of passage of bright red blood per rectum with a fainting episode...
September 13, 2016: International Journal of Surgery Case Reports
Kuang-Chun Hu, Cheng-Hsin Chu, Horng-Yuan Wang, Wen-Hsiung Chang, Shee-Chan Lin, Chuan-Chuan Liu, Wei-Chih Liao, Chun-Jen Liu, Ming-Shiang Wu, Shou-Chuan Shih
Common bile duct (CBD) stones are common in elderly adults, but the effect of aging on the presentation of CBD stones remains to be evaluated. Recent studies have demonstrated that the clinical presentation of CBD stones may vary with age. Younger adults may present with classical biliary colic symptoms, whereas elderly adults may have no unapparent clinical features. Younger adults with CBD stones were significantly more likely to have abnormal liver function tests than those without. The sensitivity and accuracy of transabdominal ultrasound scans in screening for CBD stones increases with age...
September 27, 2016: Journal of the American Geriatrics Society
Mohammad S Khuroo, Ajaz A Rather, Naira S Khuroo, Mehnaaz S Khuroo
Portal biliopathy refers to cholangiographic abnormalities which occur in patients with portal cavernoma. These changes occur as a result of pressure on bile ducts from bridging tortuous paracholedochal, epicholedochal and cholecystic veins. Bile duct ischemia may occur due prolonged venous pressure effect or result from insufficient blood supply. In addition, encasement of ducts may occur due fibrotic cavernoma. Majority of patients are asymptomatic. Portal biliopathy is a progressive disease and patients who have long standing disease and more severe bile duct abnormalities present with recurrent episodes of biliary pain, cholangitis and cholestasis...
September 21, 2016: World Journal of Gastroenterology: WJG
Han-Yu Deng, Wen-Ping Wang, Yi-Dan Lin, Long-Qi Chen
A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was 'Can mitomycin facilitate endoscopic dilatation treatment of benign esophageal stricture (mainly including caustic and anastomotic esophageal stricture)?' Altogether, 115 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question, which included 1 randomized controlled trial, 1 systematic review and 4 cohort studies. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
September 23, 2016: Interactive Cardiovascular and Thoracic Surgery
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