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Upper GI surgery

Seung Jae Paek, Ji Yong Yoo, Jang Won Lee, Won-Jong Park, Young Deok Chee, Moon Gi Choi, Eun Joo Choi, Kyung-Hwan Kwon
BACKGROUND: The aims of this study are to evaluate the lip morphology and change of lip commissure after mandibular setback surgery (MSS) for class III patients and analyze association between the amount of mandibular setback and change of lip morphology. METHODS: The samples consisted of 14 class III patients treated with MSS using bilateral sagittal split ramus osteotomy. Lateral cephalogram and cone-beam CT were taken before and about 6 months after MSS. Changes in landmarks and variables were measured with 3D software program Ondemand™...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
Mike G Laukoetter, Rudolf Mennigen, Philipp A Neumann, Sameer Dhayat, Gabriele Horst, Daniel Palmes, Norbert Senninger, Thorsten Vowinkel
BACKGROUND: Perforations and anastomotic leakages of the upper gastrointestinal (GI) tract cause a high morbidity and mortality rate. Only limited data exist for endoscopic vacuum therapy (EVT) in the upper GI tract. METHODS: Fifty-two patients (37 men and 15 women, ages 41-94 years) were treated (12/2011-12/2015) with EVT for anastomotic insufficiency secondary to esophagectomy or gastrectomy (n = 39), iatrogenic esophageal perforation (n = 9) and Boerhaave syndrome (n = 4)...
October 5, 2016: Surgical Endoscopy
Adam Bobkiewicz, Adam Studniarek, Lukasz Krokowicz, Krzysztof Szmyt, Maciej Borejsza-Wysocki, Jacek Szmeja, Ryszard Marciniak, Michal Drews, Tomasz Banasiewicz
PURPOSE: Biofragmentable anastomosis ring (BAR) is an alternative to manual and stapled anastomoses performed within the upper and lower gastrointestinal (GI) tract. The aim of this study was to evaluate the effectiveness of BAR utility for bowel anastomoses based on our own material. METHODS: A retrospective analysis was performed to a total of 203 patients who underwent bowel surgery with the use of BAR anastomosis within upper and lower gastrointestinal tract between 2004 and 2014...
September 30, 2016: International Journal of Colorectal Disease
Shin Hwang, Jong-Woo Choi, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung
BACKGROUNDS/AIMS: Open surgery for choledochal cyst has a disadvantage of skin incision scar from operative wound, which can be a definite disadvantage especially in young female patients. This study focused on the cosmetic aspect of skin incision for resection of choledochal cyst in young female patients. METHODS: During a 2-year study period, 11 adult female patients aged less than 40 years underwent primary resection of choledochal cyst by a single surgeon. The cosmetic effect of two types of skin incision was evaluated...
August 2016: Korean Journal of Hepato-biliary-pancreatic Surgery
Mary Tao, Eran Shlomovitz, Gail Darling, Graham Roche-Nagle
Thoracic endovascular aortic repair for thoracic aortic aneurysms is an accepted alternative to open surgery, especially in patients with significant comorbidities. The procedure itself has a low risk of complications and fistulas to surrounding organs are rarely reported. An 86-year-old patient was admitted to our hospital with gastro intestinal (GI) bleeding and a suspected aortoesophageal fistula. Eight months prior, the patient had undergone a stent graft repair of a mycotic thoracic aneurysm. Computerized tomography angiography and upper GI endoscopy confirmed an aortoesophageal fistula, which was treated by esophageal stenting...
August 16, 2016: World Journal of Clinical Cases
Jan C Prei, Christian Barmeyer, Nataly Bürgel, Severin Daum, Hans-Jörg Epple, Ute Günther, Jochen Maul, Britta Siegmund, Michael Schumann, Hanno Tröger, Andrea Stroux, Andreas Adler, Winfried Veltzke-Schlieker, Christian Jürgensen, Robert Wentrup, Bertram Wiedenmann, Jana Binkau, Dirk Hartmann, Ellen Nötzel, Dirk Domagk, Wolfram Wacke, Ulrich Wahnschaffe, Christian Bojarski
BACKGROUND AND STUDY AIMS: Hemostatic powders have been introduced to improve the management of gastrointestinal (GI) bleeding and to extend the variety of tools available for emergency endoscopy. The aim of the present pilot study was to evaluate the indication profiles and the short-term outcome of EndoClot. PATIENTS, MATERIALS AND METHODS: In a prospective observational pilot study patients with acute nonvariceal GI bleeding were included. Primary or secondary application of EndoClot was assessed...
November 2016: Journal of Clinical Gastroenterology
Mawaddah Alrajraji, Abrar Nawawi, Reda Jamjoom, Yousef Qari, Murad Aljiffry
BACKGROUND: Hepatic artery pseudoaneurysm as a complication of laparoscopic cholecystectomy is considered a rare, potentially life threatening condition. CASE PRESENTATION: We report a case of late onset hemobilia presenting 8 months following elective laparoscopic cholecystectomy with complex biliary and vascular injury. The patient was treated surgically with primary repair of the aneurysm and hepaticojujenostomy. CONCLUSION: A high index of suspicion should be raised when encountering a patient with massive upper GI bleeding and a previous history of hepatobiliary manipulation or surgery regardless of postoperative period...
2016: BMC Surgery
Kathryn Oakland, Richard Guy, Raman Uberoi, Frances Seeney, Gary Collins, John Grant-Casey, Neil Mortensen, Mike Murphy, Vipul Jairath
INTRODUCTION: Acute lower gastrointestinal bleeding (LGIB) is a common indication for emergency hospitalisation worldwide. In contrast to upper GIB, patient characteristics, modes of investigation, transfusion, treatment and outcomes are poorly described. There are minimal clinical guidelines to inform care pathways and the use of endoscopy, including (diagnostic and therapeutic yields), interventional radiology and surgery are poorly defined. As a result, there is potential for wide variation in practice and clinical outcomes...
August 4, 2016: BMJ Open
Michael McFarlane, John Lin Hieng Wong, Shankara Paneesha, Zbigniew Rudzki, Ramesh Arasaradnam, Chuka Nwokolo
Mucosa-associated lymphoid tissue lymphoma (MALToma) is a subtype of B-cell non-Hodgkin's lymphoma, comprising ∼17% of all gastrointestinal (GI) tract lymphomas. It is associated with chronic inflammation and autoimmunity, for example Helicobacter pylori gastritis and Sjogren's syndrome, respectively. Approximately 50% of GI MALTomas occur in the stomach, with small bowel and colonic lesions being less frequent. Synchronous upper and lower GI MALTomas occur rarely, with few cases reported. We present the case of a 73-year-old patient who presented with change in bowel habit and was found to have synchronous multifocal upper and lower GI MALTomas, which did not respond to H...
May 2016: Case Reports in Gastroenterology
Lorraine S Young, Pham Thi Thu Huong, Nguyen Thi Lam, Nghiem Nguyet Thu, Ha Thi Van, Nguyen Lien Hanh, Le Danh Tuyen, Dinh Thi Kim Lien, Tran Hieu Hoc, Chu Thi Tuyet, Nguyen Quoc Anh, Elizabeth G Henry, Carine M Lenders, Kathleen M Gura, Sherman J Bigornia, Caroline M Apovian, Thomas R Ziegler
BACKGROUND AND OBJECTIVES: The nutritional status and hospital feeding practices of surgical patients in Vietnam are not well documented. Based on a cross-sectional study at Bach Mai Hospital (BMH), the prevalence of malnutrition was found to be 33% in the surgical ward using a body mass index (BMI<18.5 kg/m(2). We conducted an observational study over a three month period to evaluate the feeding practices in the gastrointestinal (GI) surgery ward at Bach Mai Hospital (BMH) in Hanoi, Vietnam...
2016: Asia Pacific Journal of Clinical Nutrition
Koichi Suda, Masaya Nakauchi, Kazuki Inaba, Yoshinori Ishida, Ichiro Uyama
Robotic surgery with the da Vinci Surgical System has been increasingly applied in a wide range of surgical specialties, especially in urology and gynecology; however, that in the field of upper GI tract has yet to be standard due to the lack of clear benefits in comparison with conventional minimally invasive surgery. We have been performing robotic gastrectomy and esophagectomy for operable patients with resectable upper GI malignancies since 2009, and demonstrated the potential advantage that use of the robot may reduce postoperative local complications including pancreatic fistula following gastrectomy and recurrent laryngeal nerve palsy after esophagectomy, even though there have been a couple of issues to be solved including longer duration of operation and higher cost...
July 12, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Francisco J Medina, Andrés Miranda-Merchak, Alonso Martínez, Felipe Sánchez, Sebastián Bravo, Juan Eduardo Contreras, Isabel Alliende, Andrea Canals
BACKGROUND: Postoperative leaks are the most undesirable complication of bariatric surgery and upper gastrointestinal (GI) series are routinely ordered to rule them out. Despite the published literature recommending against its routine use, it is still being customarily used in Chile. AIM: To examine the usefulness of routine upper GI series using water-soluble iodinated contrast media for the detection of early postoperative leaks in patients undergoing bariatric surgery...
April 2016: Revista Médica de Chile
Cecilia Gavazzi, Silvia Colatruglio, Filippo Valoriani, Vincenzo Mazzaferro, Annarita Sabbatini, Roberto Biffi, Luigi Mariani, Rosalba Miceli
BACKGROUND: Weight loss is frequent in patients with gastrointestinal (GI) cancer. Nutritional status deteriorates throughout anti-cancer treatment, mostly after major surgery, increasing complications, reducing tolerance and worsening the final prognosis. Enteral nutrition is safe and effective in malnourished patients undergoing major GI surgery. Randomised trials aimed at investigating the effects of home enteral nutrition (HEN) in post-surgical patients with GI cancer are lacking...
September 2016: European Journal of Cancer
Liang-Liang Xu, Xiao-Qin Zhou, Peng-Sheng Yi, Ming Zhang, Jing Li, Ming-Qing Xu
BACKGROUND: To assess the efficacy and safety of alvimopan in conjunction with enhanced recovery strategy, compared with this strategy alone, in management of postoperative ileus in patients undergoing open abdominal surgery. METHODS: Electronic databases were comprehensively searched for relevant randomized controlled trials. We were interested in doses of 6 and 12 mg. The efficacy end points included the time to recovery of full gastrointestinal (GI) function (a composite end point measured by the time to first toleration of solid food [SF] and the time to first passage of stool, GI-2), the recovery of upper (SF) or the lower (the time to first bowel movement, BM) GI function, and the length of hospital stay (the time to discharge order written)...
June 1, 2016: Journal of Surgical Research
Fnu Asad-Ur-Rahman, Aamer Abbass, Umair Majeed, Udayakumar Navaneethan
Symptomatic gastrointestinal (GI) involvement of melanoma is rare, however, it is a frequent autopsy finding in patients with primary cutaneous melanoma. We present a case of metastatic cutaneous melanoma with initial asymptomatic jejunal involvement as found on a positron emission tomography (PET) scan, with subsequent duodenal perforation. A 69-year-old man presented to the hospital with a three-week history of worsening headache, dizziness, and vomiting with a history of Clark level III malignant melanoma that was completely excised from the right flank three years ago at the hospital...
2016: Curēus
Britt-Marie Iresjö, Cecilia Engström, Kent Lundholm
Loss of muscle mass is associated with increased risk of morbidity and mortality in hospitalized patients. Uncertainties of treatment efficiency by short-term artificial nutrition remain, specifically improvement of protein balance in skeletal muscles. In this study, algorithmic microarray analysis was applied to map cellular changes related to muscle protein metabolism in human skeletal muscle tissue during provision of overnight preoperative total parenteral nutrition (TPN). Twenty-two patients (11/group) scheduled for upper GI surgery due to malignant or benign disease received a continuous peripheral all-in-one TPN infusion (30 kcal/kg/day, 0...
June 2016: Physiological Reports
Jiro Omata, Katsuyuki Utsunomiya, Yoshiki Kajiwara, Risa Takahata, Nobuo Miyasaka, Hidekazu Sugasawa, Naoko Sakamoto, Yoji Yamagishi, Makiko Fukumura, Daiki Kitagawa, Mitsuhiko Konno, Yasushi Okusa, Michinori Murayama
A 43-year-old female was referred to our hospital for sudden onset of abdominal pain, fullness, and vomiting. Physical examination revealed abdominal distension with mild epigastric tenderness. Abdominal radiography showed massive gastric distension and plain computed tomography (CT) a markedly enlarged stomach filled with gas and fluid. A large volume of gastric contents was suctioned out via a nasogastric (NG) tube. Contrast-enhanced CT showed a grossly distended stomach with displacement of the antrum above the gastroesophageal junction, and the spleen was dislocated inferiorly...
December 2016: Surgical Case Reports
Koichi Suda, Masaya Nakauchi, Kazuki Inaba, Yoshinori Ishida, Ichiro Uyama
Minimally invasive surgery (MIS) for upper gastrointestinal (GI) cancer, characterized by minimal access, has been increasingly performed worldwide. It not only results in better cosmetic outcomes, but also reduces intraoperative blood loss and postoperative pain, leading to faster recovery; however, endoscopically enhanced anatomy and improved hemostasis via positive intracorporeal pressure generated by CO2 insufflation have not contributed to reduction in early postoperative complications or improvement in long-term outcomes...
May 21, 2016: World Journal of Gastroenterology: WJG
Weon Jin Ko, Joo Young Cho
Most gastrointestinal stromal tumors (GISTs) arise from the proper muscle layer of the upper gastrointestinal (GI) tract and have a low malignant potential. They are sometimes accompanied by symptoms, but in most cases are detected by chance. Endoscopic surgery of subepithelial tumors in the upper GI tract has been actively performed, and its merits include the need for fewer medical devices compared with other surgical procedures and post-resection organ preservation. However, because endoscopic procedures are still limited to small or pilot studies, a multidisciplinary approach combining laparoscopy and endoscopy is needed for more effective and pathologically acceptable management of GISTs...
May 2016: Clinical Endoscopy
Masahiro Hotta, Kazuhito Yamamoto, Kazumitsu Cho, Yoshimune Takao, Takeshi Fukuoka, Eiji Uchida
Arteriovenous malformations of the stomach are an uncommon cause of upper GI bleeding. We report a case of stomach arteriovenous malformation in an 85-year-old Asian man who presented with massive hematemesis. Initial esophagogastroduodenoscopy did not detect this lesion, but contrast multi-detector CT confirmed GI bleeding. Multi-detector CT revealed a mass of blood vessels underlying the submucosa that arose from the right gastroepiploic artery. Repeat esophagogastroduodenoscopy showed that the lesion was a submucosal tumor with erosion and without active bleeding in the lower body of the stomach on the greater curvature...
May 2016: Asian Journal of Endoscopic Surgery
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