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https://www.readbyqxmd.com/read/28522945/current-status-of-endoscopic-balloon-dilation-for-crohn-s-disease
#1
REVIEW
Fumihito Hirai
The therapeutic target in Crohn's disease (CD) has been raised to the achievement of mucosal healing. Although effective treatments that target cytokines and other molecules has been widely used for CD, intestinal strictures are still a major cause of surgery. Endoscopic balloon dilation (EBD) is known to be an effective and safe intervention for intestinal strictures in CD. Since frequent intestinal resection often results in short bowel syndrome and can decrease the quality of life, EBD can help avoid surgery...
April 2017: Intestinal Research
https://www.readbyqxmd.com/read/28502887/open-surgical-treatment-of-secondary-aorto-esophageal-and-aortobronchial-fistula-after-thoracic-endovascular-aortic-repair-and-esophagocoloplasty-in-a-second-procedure
#2
Milos Sladojevic, Milos Bjelovic, Nikola Ilic, Perica Mutavdzic, Igor Koncar, Marko Dragas, Lazar Davidovic
INTRODUCTION: Aorto-esophageal (AEF) and aortobronchial fistula (ABF) after TEVAR are rare complications with catastrophic consequences without treatment. In this case report we presented a patient with AEF and ABF after TEVAR successfully treated with endograft explantation and replaced by Dacron graft followed by esophagectomy and left principal bronchus repairing. CASE REPORT: We report a patient with AEF and ABF after TEVAR who was evaluated due to dysphagia and chest pain followed by hematemesis and hemoptysis...
May 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28501253/resection-of-the-primary-tumor-in-stage-iv-colorectal-cancer-when-is-it-necessary
#3
REVIEW
Leandro Feo, Michael Polcino, Garrett M Nash
Management of metastatic colorectal cancer requires accurate staging and multidisciplinary evaluation, leading to a consensus treatment plan with the ultimate goal of increasing survival and improving the quality of life, while taking into consideration the patient's performance status, disease burden, and goals of care. Since the introduction of multidrug chemotherapeutic regimens, survival of patients with metastatic colorectal cancer has improved. Many patients with unresectable disease are undergoing surgery for asymptomatic primary tumors despite evidence that it is usually a futile intervention...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28501245/emergency-presentations-of-colorectal-cancer
#4
REVIEW
Canaan Baer, Raman Menon, Sarah Bastawrous, Amir Bastawrous
Many colorectal carcinomas will present emergently with issues such as obstruction, perforation, and bleeding. Emergency surgery is associated with poor short- and long-term outcomes. For abnormality localizing to the colon proximal to the splenic flexure, surgical management with hemicolectomy is often a safe and appropriate approach. Obstructions are more common in the distal colon, however, where there is an evolving spectrum of surgical and nonsurgical options, most notably by the development of endoluminal stents...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28451412/observational-study-of-colonoscopy-techniques-used-for-acute-colorectal-obstruction-a-single-center-experience
#5
Qian Chen, Qin Yu, Jing-Jing Yu, Mei Liu, Hua-Ping Xie, Bin Cheng, Qiao-Zhen Guao, Guang-Quan Liao, Hua Qin
The prevalence of acute colorectal obstruction at the hospital setting is high. There is need for improvement in the quality of colonoscopy for relieving obstruction. A retrospective, uncontrolled, open-label study was conducted, with the aim of documenting the causes of acute colorectal obstruction and the quality of colonoscopy practice in managing obstruction at a university hospital in China. A total of 61 adult patients with acute colorectal obstruction treated with urgent colonoscopy between February, 2011 and January, 2016 were identified at the Endoscopic Unit of Tongji Hospital (Wuhan, China)...
March 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28409374/self-expandable-metal-stent-placement-versus-emergency-resection-for-malignant-proximal-colon-obstructions
#6
Femke Julie Amelung, Werner Adriaan Draaisma, Esther Catharina Josephina Consten, Peter Derk Siersema, Frank Ter Borg
BACKGROUND: Traditionally, all patients with a malignant obstruction of the proximal colon (MOPC) are treated with emergency resection. However, recent data suggest that Self-expandable metallic stent (SEMS) placement could lower mortality and morbidity rates. This study therefore aimed to compare SEMS placement with emergency resection as treatment options for MOPC. METHODS: All consecutive patients that underwent SEMS placement for MOPC in the period 2004-2015 at our institution were identified...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28400026/malignant-colonic-obstruction-to-stent-or-not-to-stent
#7
EDITORIAL
Alberto Arezzo
No abstract text is available yet for this article.
March 2017: Cirugía Española
https://www.readbyqxmd.com/read/28392363/stent-as-bridge-to-surgery-for-left-sided-malignant-colonic-obstruction-reduces-adverse-events-and-stoma-rate-compared-with-emergency-surgery-results-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
REVIEW
Alberto Arezzo, Roberto Passera, Giacomo Lo Secco, Mauro Verra, Marco Augusto Bonino, Eduardo Targarona, Mario Morino
BACKGROUND AND AIMS: Twenty years after the first description of the technique, the debate is still open on role of self-expandable metallic stent (SEMS) placement as a bridge to elective surgery for symptomatic left-sided malignant colonic obstruction. The aim was to compare morbidity rates after colonic stenting bridge to surgery (SBTS) versus emergency surgery (ES) for left-sided malignant obstruction. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) on SBTS or ES for acute symptomatic malignant left-sided large bowel obstruction...
April 6, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28372449/enteral-stent-for-the-treatment-of-a-urinary-fistula-associated-with-a-biological-mesh-following-a-bricker-type-procedure
#9
Raquel Díaz Ruiz, Marta Castillo Pradillo, Óscar Nogales Rincón, Cecilia González Asanza
Postoperative fistula results in increased morbidity and a longer hospital stay. While surgery is the most common treatment, the endoscopic approach is an increasingly used alternative. A 57-year-old woman underwent surgery for colonic adenocarcinoma, which relapsed as peritoneal carcinomatosis and was managed with chemotherapy and surgery, a biological Permacol™ mesh was used for abdominal wall closure.
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28367495/long-term-outcomes-of-palliative-colonic-stenting-versus-emergency-surgery-for-acute-proximal-malignant-colonic-obstruction-a-multicenter-trial
#10
Ali Siddiqui, Natalie Cosgrove, Linda H Yan, Daniel Brandt, Raymond Janowski, Ankush Kalra, Tingting Zhan, Todd H Baron, Allesandro Repici, Linda Jo Taylor, Douglas G Adler
Background and study aims Long-term data are limited regarding clinical outcomes of self-expanding metal stents as an alternative for surgery in the treatment of acute proximal MBO. The aim of this study was to compare the long-term outcomes of stenting to surgery for palliation in patients with incurable obstructive CRC for lesions proximal to the splenic flexure. Patients and methods Retrospective multicenter cohort study of obstructing proximal CRC patients with who underwent insertion of a SEMS (n = 69) or surgery (n = 36) from 1999 to 2014...
April 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28365542/a-methodology-for-the-customized-design-of-colonic-stents-based-on-a-parametric-model
#11
S Puértolas, D Navallas, A Herrera, E López, J Millastre, E Ibarz, S Gabarre, J A Puértolas, L Gracia
The choice of necessary stent properties depends mainly on the length of the stenosis and degree of occlusion. So a stent design with variable radial stiffness along its longitudinal axis would be a good option. The design proposed corresponds to a tube-based stent with closed diamond-shaped cells made from a NiTi alloy. By acting independently on different geometric factors, variable geometries can be obtained with different radial force reactions. A design adjustment according to specific requirements, in order to get a better fit to ill-duct and reduces complications, is possible...
March 27, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28340803/evaluation-of-ureteral-stent-colonization-in-live-donor-renal-transplant-recipients
#12
M Sarier, M Demir, I Duman, Y Yuksel, A Demirbas
BACKGROUND: Ureteral stent insertion during kidney transplantation is a matter of debate. Stenting has been proven to reduce the risk of surgical complications. In addition, it has been reported to increase risks such as urinary tract infections especially after operation. Ureteral stent colonization (USC) is known to play a role in the pathogenesis of stent related-infections. The aim of this study was (1) to assess the frequency of USC and values of urine cultures in identifying colonizing bacteria; (2) to assess the importance of indwelling time for USC in live-donor renal transplant recipients; and (3) to evaluate the biomarker role of neutrophil-to-lymphocyte ratio (NLR) on USC...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28336185/self-expanding-metallic-stent-as-a-bridge-to-surgery-in-the-treatment-of-left-colon-cancer-obstruction-cost-benefit-analysis-and-oncologic-results
#13
Blas Flor-Lorente, Gloria Báguena, Matteo Frasson, Alvaro García-Granero, Andrés Cervantes, Vicente Sanchiz, Andres Peña, Alejandro Espí, Pedro Esclapez, Eduardo García-Granero
INTRODUCTION: The use of a self-expanding metallic stent as a bridge to surgery in acute malignant left colonic obstruction has been suggested as an alternative treatment to emergency surgery. The aim of the present study was to compare the morbi-mortality, cost-benefit and long-term oncological outcomes of both therapeutic options. METHODS: This is a prospective, comparative, controlled, non-randomized study (2005-2010) performed in a specialized unit. The study included 82 patients with left colon cancer obstruction treated by stent as a bridge to surgery (n=27) or emergency surgery (n=55) operated with local curative intention...
March 2017: Cirugía Española
https://www.readbyqxmd.com/read/28325090/using-stents-in-the-management-of-malignant-bowel-obstruction-the-current-situation-and-future-progress
#14
Alessandro Fugazza, Piera Alessia Galtieri, Alessandro Repici
The use of self-expanding metal stents (SEMS) has been considered an effective and safe alternative to emergency surgery as bridge to surgery or for palliation in advanced colorectal cancer even though more recent data have raised concerns on both early and long-term outcomes when patients are treated with bridge to surgery indications. Areas covered: A comprehensive literature review of articles on endoscopic management of malignant bowel obstruction was performed. Indication, technique, outcomes, benefits and risks of these treatments in acute malignant colonic obstruction were reviewed...
March 24, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28299628/management-of-colon-stents-based-on-bernoulli-s-principle
#15
Yoshiharu Uno
BACKGROUND AND AIMS: The colonic self-expanding metal stent (SEMS) has been widely used for "bridge to surgery" and palliative therapy. However, if the spread of SEMS is insufficient, not only can a decompression effect not be obtained but also perforation and obstructive colitis can occur. The mechanism of occurrence of obstructive colitis and perforation was investigated by flow dynamics. METHODS: Bernoulli's principle was applied, assuming that the cause of inflammation and perforation represented the pressure difference in the proximal lumen and stent...
March 2017: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/28289273/metastatic-colonic-adenocarcinoma-to-the-extrahepatic-common-bile-duct-the-critical-role-of-the-pathologist-and-immunohistochemistry-in-guiding-patient-care-decisions
#16
Kurt J Knowles, Shoujun Chen, Gillermo A Herrera
BACKGROUND Adenocarcinoma of the colon frequently invades adjacent organs, spreads intraperitoneal, and metastasizes to intestinal lymph nodes, lungs, and the liver. Metastasis solely to the extrahepatic bile duct is extremely rare and has only been previously reported on 15 occasions. The accurate determination that an extrahepatic common bile duct lesion is of colonic origin has critical therapeutic implications. CASE REPORT The patient was a 50-year-old male with a history of colon cancer S/P surgical resection in September 2014...
March 14, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28251123/lighted-ureteral-stents-in-laparoscopic-colorectal-surgery-a-five-year-experience
#17
William P Boyan, Daniel Lavy, Anthony Dinallo, Javier Otero, Annelie Roding, Dustin Hanos, Roy Dressner, Michael Arvanitis
BACKGROUND: Ureteral injuries during colorectal surgery are a rare event, ranging in the literature from 0.28-7.6%. Debate surrounds the use of prophylactic lighted ureteral stents to help protect the ureter during laparoscopic surgery. It has been suggested that they help to identify injuries but do not prevent them. The authors look to challenge this. METHODS: Over 66 months, every laparoscopic or colectomy involving ureteral stents was recorded. Researchers documented any injury to the ureter intraoperatively...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28207528/idiopathic-retroperitoneal-fibrosis-causing-unilateral-ureteral-and-sigmoid-colon-obstruction-a-case-report
#18
Ting Yan, Yujuan Wang, Zhijun Liu, Xiaolei Zhang, Qian Wu, Mingrong Xi
OBJECTIVE: The present report aimed to present a unique case of idiopathic retroperitoneal fibrosis (RPF) presenting features of unilateral ureteral and sigmoid colon obstruction. RPF is a rare disorder with unclear etiology. CASE REPORT: A 43-year-old female had a 10-day history of lower right abdominal and lumbar pain. Gynecological examination, ultrasound, and computed tomography (CT) were all suggestive of right ovarian tumor. An enhanced CT showed right-sided hydronephrosis...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28157254/using-our-own-developed-stent-in-the-palliative-treatment-of-obstruction-in-the-left-half-of-the-colon-due-to-ovarian-cancer
#19
Tomasz Miłek, Konrad Pasek, Piotr Ciostek, Habib Alkalaya, Agnieszka Timorek, Włodzimierz Sawicki, Krzysztof Cendrowski
OBJECTIVES: An assessment of implantation efficacy and safety of self-developed self-expanding stent in patients with an ovarian cancer induced by intestinal obstruction. MATERIAL AND METHODS: The study of the stenting efficacy and safety was realized prospectively. The group consisted of 13 patients with left half colon obstruction due to an inoperable metastatic ovarian carcinoma. All the patients had a histopathologically diagnosed ovarian carcinoma and were treated in the past both surgically and systemically...
2017: Ginekologia Polska
https://www.readbyqxmd.com/read/28147351/unmet-therapeutic-needs-focus-on-intestinal-fibrosis-surgical-approach-resection-strictureplasty-and-others
#20
REVIEW
Diane Mege, Yves Panis
BACKGROUND: In patients with ileo-colonic Crohn's disease (CD), the main consequence of the development of intestinal fibrosis is the occurrence of a localized symptomatic stenosis for which treatment is mandatory. Besides medical treatment, which is still considered to be ineffective against non-inflammatory fibrotic intestinal stenosis due to CD, there are 2 options for the treatment of such stenosis: endoscopic and surgical approaches. Key Messages: Endoscopic treatment includes balloon dilatation and stenting, and can be performed only on selected patients with very short stenosis...
2017: Digestive Diseases
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