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https://www.readbyqxmd.com/read/28616223/clinical-outcomes-of-self-expandable-metal-stent-sems-placement-as-palliative-treatment-for-malignant-colorectal-obstruction-a-single-center-study-from-japan
#1
Toshikatsu Nitta, Jun Kataoka, Masato Ohta, Kensuke Fujii, Tomo Tominaga, Yoshihiro Inoue, Hiroshi Kawasaki, Takashi Ishibashi
OBJECTIVES: We aimed to assess the efficacy of self-expanding metal stent (SEMS) implantation as palliative treatment for malignant colorectal obstruction. METHODS: We retrospectively reviewed the records of patients with malignant colorectal obstruction who underwent SEMS insertion as palliative treatment in our hospital between March 2013 and December 2016. We analyzed demographic, clinical, and operative characteristics. RESULTS: A total of 13 patients (8 males, 5 females; median age, 80...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28598830/tetrahydrobiopterin-improves-microcirculation-in-experimental-sepsis
#2
Tristan Dumbarton
BACKGROUND: Tetrahydrobiopterin (BH4), an endogenous nucleic acid derivative, acts as an important cofactor for several enzymes found within the vascular endothelium, which is deranged in sepsis. OBJECTIVE: We hypothesized that BH4 would improve capillary density and decrease inflammation within the intestinal microcirculation of septic rats. METHODS: We conducted a randomized, controlled trial using two previously validated models of sepsis in rats: 1) A fecal peritonitis model using a stent perforating the ascending colon, and 2) An endotoxemia model using lipopolysaccharide (LPS) toxin from E...
June 8, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28593006/ultrasound-detection-of-aortoenteric-fistula-in-a-patient-with-sepsis
#3
Tiziano Perrone, Chiara Pagani, Elisa Eleonora Mossolani
We report a case of an 81-year-old man, hospitalized for sepsis unresponsive to targeted antibiotic therapy, who underwent abdominal aortic aneurysmectomy with stent placement before 12 years. Point-of-care ultrasound examination showed the presence of a voluminous and inhomogeneous lesion adjacent to the anterior wall of aortic bifurcation with pulsatile flow from the aorta into the lesion, highlighted by Color-Doppler, and peripheral (closely with intestinal loops) floating hyperechoic spots marked by posterior comet tail artifact, suggestive for the presence of air bubbles...
June 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28591040/an-uncommon-cause-of-gastric-outlet-obstruction-a-case-report
#4
Manjusha Bandireddy, Noemi Baffy
RATIONALE: Metastatic involvement of the gastrointestinal tract is an uncommon scenario encountered in the clinical practice. Our case represents a gastric outlet obstruction (GOO) as a consequence of distant Transitional cell carcinoma (TCC) metastasis without any lymph node involvement in association with inflammatory stranding leading to extrinsic duodenal obstruction. PATIENT CONCERNS: We report an unusual case of a 73-year-old male presented with a five-week history of nausea, vomiting and abdominal pain due to the metastatic extension from TCC that had been considered in remission...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28580350/colon-perforation-due-to-embolization-coil-for-internal-iliac-aneurysm
#5
Ho Kyun Lee, Hong Sung Jung, Sang Young Chung, Soo Jin Na Choi
Coil migration is an extremely rare but hazardous complication of aneurysmal coil embolization. Only 1 case report has described coil migration following endovascular exclusion to gastrointestinal (GI) tract. We report the experience of a case of colon penetration caused by embolization coil placed for internal iliac aneurysm. A 66-year-old man visited the Emergency Department for hematochezia that had persisted for 3 months. Stent insertion and coil embolization of left internal iliac artery aneurysm had been performed on the patient 18 months ago...
June 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28579348/ten-year-survival-after-endoscopic-stenting-as-a-bridge-to-surgery-in-obstructing-colon-cancer
#6
Bram Verstockt, Annelien Van Driessche, Marc De Man, Pieter van der Spek, Koen Hendrickx, Veerle Casneuf, Pieter Dobbels, Yves Van Molhem, Jo Vandervoort
BACKGROUND AND AIMS: Self-expandable metallic stents are increasingly used in the treatment of obstructing colorectal cancer (CRC). Although endoscopic colonic stenting is widely accepted in palliation, disagreement exists about its role in a curative setting. This study aims to describe long-term survival data in a large patient group, treated with colonic stenting as a bridge to surgery (BTS) for CRC. PATIENTS AND METHODS: This prospective study included 97 patients who presented in a Belgian hospital between 1998 and 2013 with an obstructing, though potentially curable, CRC...
June 1, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28569279/safety-and-efficacy-of-self-expandable-metal-stents-for-obstructive-proximal-and-distal-large-bowel-cancer
#7
V Mitra, M Hu, D Majumdar, V Krishnan, B Chaudhury, J Hancock, D Dwarakanath
Self-expandable metal stents are often used to treat obstructive large bowel cancers. This study assessed the safety and efficacy of colonic stent insertion carried out in a district general hospital. Methods A retrospective review was carried out between 1 January 2007 and 28 February 2014 to identify patients who underwent stent insertion for malignant colorectal obstruction. Results Seventy-five patients (median age 75.2 years, 70.6% male) with primary colorectal cancer underwent stent insertion - 53 underwent semi-elective self-expanded metal stent insertion (for subacute bowel obstruction) and 22 had emergency stent inserted (for acute bowel obstruction)...
March 2017: Journal of the Royal College of Physicians of Edinburgh
https://www.readbyqxmd.com/read/28567379/colonic-obstruction-caused-by-video-capsule-entrapment-in-a-metal-stent
#8
Ervin Toth, Lars Marthinsen, Maria Bergström, Per-Ola Park, Peter Månsson, Artur Nemeth, Gabriele Wurm Johansson, Henrik Thorlacius
Video capsule endoscopy (VCE) has become the method of choice for visualizing the small bowel mucosa and is generally considered to be a safe method. Although uncommon, the most feared complication of VCE is capsule retention that can potentially lead to life-threatening bowel obstruction. Herein, we present for the first time a case of capsule retention in a colonic stent. The patient had known Crohn's disease with colonic involvement and underwent an uneventful but incomplete small bowel VCE for assessment of disease activity and extension for optimizing medical treatment...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28538086/sphingosine-1-phosphate-receptor-1-agonist-sew2871-causes-severe-cardiac-side-effects-and-does-not-improve-microvascular-barrier-breakdown-in-sepsis
#9
Sven Flemming, Natalie Burkard, Michael Meir, Martin Alexander Schick, Christoph-Thomas Germer, Nicolas Schlegel
BACKGROUND: Endothelial barrier dysfunction is a hallmark in the pathogenesis of sepsis. Sphingosine-1-phosphate (S1P) has been proposed to be critically involved in the maintenance of endothelial barrier function predominately by activating S1P receptor-1 (S1P1). Previous studies have shown that the specific S1P1 agonist SEW2871 improves endothelial barrier function under inflammatory conditions. However, the effectiveness of SEW2871 and potential side effects remained largely unexplored in a clinically relevant model of sepsis...
May 23, 2017: Shock
https://www.readbyqxmd.com/read/28522945/current-status-of-endoscopic-balloon-dilation-for-crohn-s-disease
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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