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https://www.readbyqxmd.com/read/29435660/indications-for-total-esophagogastric-dissociation-in-children-with-gastroesophageal-reflux-disease
#1
REVIEW
Yujiro Tanaka, Takahisa Tainaka, Hiroo Uchida
Total esophagogastric dissociation (TED) is used to treat gastroesophageal reflux (GER) after failed fundoplication in neurologically impaired patients. It is now performed for some otherwise healthy patients with severe GER. In this procedure, the gastrointestinal tract is reconstructed in a non-physiological way with a Roux-en-Y esophagojejunal anastomosis and jejuno-jejunostomy. Although TED eliminates almost all GER, some patients experience late complications. In this review, we investigated the long-term outcomes after TED to determine the best indications...
February 12, 2018: Surgery Today
https://www.readbyqxmd.com/read/29430435/esophageal-endoscopic-vacuum-therapy-with-enteral-feeding-using-a-sengstaken-blakemore-tube
#2
So Young Lee, Kun Woo Kim, Jae-Ik Lee, Dong-Kyun Park, Kook-Yang Park, Chul-Hyun Park, Kuk-Hui Son
Early diagnosis followed by primary repair is the best treatment for spontaneous esophageal perforation. However, the appropriate management of esophageal leakage after surgical repair is still controversial. Recently, the successful adaptation of vacuum-assisted closure therapy, which is well established for the treatment of chronic surface wounds, has been demonstrated for esophageal perforation or leakage. Conservative treatment methods require long-term fasting with total parenteral nutrition or enteral feeding through invasive procedures, such as percutaneous endoscopic gastrostomy or a feeding jejunostomy...
February 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29396112/risk-factors-of-exocrine-and-endocrine-pancreatic-insufficiency-after-pancreatic-resection-a-multi-center-prospective-study
#3
A Maignan, M Ouaïssi, O Turrini, N Regenet, A Loundou, G Louis, V Moutardier, L Dahan, N Pirrò, B Sastre, J-R Delpero, I Sielezneff
Management of functional consequences after pancreatic resection has become a new therapeutic challenge. The goal of our study is to evaluate the risk factors for exocrine (ExoPI) and endocrine (EndoPI) pancreatic insufficiency after pancreatic surgery and to establish a predictive model for their onset. PATIENTS AND METHODS: Between January 1, 2014 and June 19, 2015, 91 consecutive patients undergoing pancreatoduodenectomy (PD) or left pancreatectomy (LP) (72% and 28%, respectively) were followed prospectively...
January 26, 2018: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29386758/challenges-in-management-of-pediatric-life-threatening-neck-and-chest-trauma
#4
Shilpa Sharma, Biplab Mishra, Amit Gupta, Kapil Dev Soni, Richa Aggarwal, Subodh Kumar
Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2-10) years were managed...
January 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/29373689/central-line-associated-mucor-velutinosus-bloodstream-infection-in-an-immunocompetent-pediatric-patient
#5
Madan Kumar, Barbara Jantausch, Clarivet Torres, Joseph Campos, Adrian Zelazny
We report here the isolation of Mucor velutinosus from multiple blood cultures performed on samples from Broviac catheters and culture of a Broviac insertion-site wound sample from a 6-year-old boy with a history of intestinal failure secondary to chronic intestinal pseudo-obstruction, parenteral nutrition, and jejunostomy tube dependence. Examination of a slide from the culture revealed the presence of wide nonseptate hyphae with sporangiophores, columella, and chlamydospores. The fungal isolate was sent to the National Institutes of Health for further evaluation and was identified as Mucor velutinosus by matrix-assisted laser desorption ionization-time-of-flight mass spectrometry and genomic sequencing...
January 24, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29372374/cysto-cholecystostomy-a-more-physiological-procedure-for-hepatic-cysts-with-biliary-communications-and-cystic-dilatations-of-main-intrahepatic-ducts
#6
Mei Diao, Long Li, Wei Cheng
OBJECTIVE: Hepatic cysts with biliary communications (HC) and cystic dilatations of main intrahepatic ducts (CIHD) can cause biliary obstruction, cholestasis, stone formation, cholangitis, liver damage and carcinoma. Conventionally, Roux-Y cysto-jejunostomy is employed to manage these conditions. However, it is technically demanding and may be complicated with major biliary disruption and bacteria migration from intestine to intrahepatic duct. We have carried out laparoscopic cysto-cholecystostomies for HC with biliary communication and CIHD and evaluated outcomes...
January 25, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29368029/an-investigation-into-the-nutritional-status-of-patients-receiving-an-enhanced-recovery-after-surgery-eras-protocol-versus-standard-care-following-oesophagectomy
#7
Katie Benton, Iain Thomson, Elisabeth Isenring, B Mark Smithers, Ekta Agarwal
PURPOSE: Enhanced Recovery After Surgery (ERAS) protocols have been effectively expanded to various surgical specialities including oesophagectomy. Despite nutrition being a key component, actual nutrition outcomes and specific guidelines are lacking. This cohort comparison study aims to compare nutritional status and adherence during implementation of a standardised post-operative nutritional support protocol, as part of ERAS, compared to those who received usual care. METHODS: Two groups of patients undergoing resection of oesophageal cancer were studied...
January 24, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29367443/outcomes-among-patients-with-direct-enteral-vs-nasogastric-tube-placement-after-acute-stroke
#8
Raed A Joundi, Gustavo Saposnik, Rosemary Martino, Jiming Fang, Joan Porter, Moira K Kapral
OBJECTIVE: To compare complications, disability, and long-term mortality of patients who received direct enteral tube vs nasogastric tube feeding alone after acute stroke. METHODS: We used the Ontario Stroke Registry to identify patients who received direct enteral tubes (DET; gastrostomy or jejunostomy) or temporary nasogastric tubes (NGT) alone during hospital stay after acute ischemic stroke or intracerebral hemorrhage from July 1, 2003, to March 31, 2013. We used propensity matching to compare groups from discharge and evaluated discharge disability, institutionalization, complications, and mortality, with follow-up over 2 years, and with cumulative incidence functions used to account for competing risks...
January 24, 2018: Neurology
https://www.readbyqxmd.com/read/29341148/outcomes-after-prophylactic-gastrectomy-for-hereditary-diffuse-gastric-cancer
#9
R T van der Kaaij, J P van Kessel, J M van Dieren, P Snaebjornsson, O Balagué, F van Coevorden, L E van der Kolk, K Sikorska, A Cats, J W van Sandick
BACKGROUND: Patients with hereditary diffuse gastric cancer and a CDH1 mutation have a 60-80 per cent lifetime risk of developing diffuse gastric cancer. Total prophylactic gastrectomy eliminates this risk, but is associated with considerable morbidity. The effectiveness (removal of all gastric mucosa) and outcomes of this procedure were evaluated retrospectively. METHODS: All consecutive individuals undergoing a prophylactic gastrectomy for a CDH1 mutation or gastric signet ring cell foci at the authors' institute between 2005 and 2017 were included...
January 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29331883/curative-distal-pancreatectomy-in-patients-with-acinar-cell-carcinoma-of-pancreas-diagnosed-by-endoscopic-aspiration-via-esophago-jejunostomy-a-successful-case-report
#10
Takeomi Hamada, Atsushi Nanashima, Masahide Hiyoshi, Makoto Ikenoue, Naoya Imamura, Koichi Yano, Yoshiro Fujii, Yoshimasa Kubota, Tesshin Ban, Hiroshi Kawakami, Yuichiro Sato
INTRODUCTION: This is a case report on the advances in preoperative endoscopic-guided fine-needle-aspiration (FNA) diagnosis for pancreatic carcinoma to achieve a curative operation even in patients who have a history of total gastrectomy. CASE PRESENTATION: A 65-year-old man, who underwent total gastrectomy for gastric cancer 13 years ago, had discomfort in the left lateral abdomen. A 3-cm hypovascular mass accompanying a large distal pseudocyst in the pancreatic tail was observed on computed tomography...
January 8, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29234613/phlegmonous-esophagitis-treated-with-internal-drainage-and-feeding-jejunostomy
#11
Won Gi Woo, Young Woo Do, Geun Dong Lee, Sung Soo Lee
We report the case of a 67-year-old woman presenting with epigastric pain. Computed tomography identified diffuse phlegmonous esophagitis. Esophagogastroduodenoscopy revealed multiple perforations in the mucosal layer of the esophagus. A large amount of pus was drained internally through the gut. The patient was treated with antibiotics and early jejunostomy feeding. Although phlegmonous esophagitis is a potentially fatal disease, the patient was successfully treated medically with only a minor complication (esophageal stricture)...
December 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29229483/outcomes-of-fundoplication-in-oesophageal-atresia-associated-gastrooesophageal-reflux-disease
#12
Antti I Koivusalo, Risto J Rintala, Mikko P Pakarinen
AIM OF THE STUDY: Conservative management of gastrooesophageal reflux (GORD) in oesophageal atresia (OA) is sometimes inefficient, and fundoplication is required. We assessed the outcomes of fundoplication among OA patients from 1980 to 2016. METHODS: After ethical consent, hospital records of 290 patients, including 22 referred patients, were reviewed. Included were 262 patients with end-to-end repair. Excluded were patients who underwent oesophageal reconstruction (n=23) or no repair (n=5)...
November 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29225893/a-novel-approach-to-glycemic-control-in-type-2-diabetes-mellitus-partial-jejunal-diversion-pre-clinical-to-clinical-pathway
#13
Martin Fried, Karin Dolezalova, Adam P Chambers, Elliott J Fegelman, Robin Scamuffa, Michael L Schwiers, Jason R Waggoner, Martin Haluzik, Randy J Seeley
Objective: To explore partial jejunal diversion (PJD) via a side-to-side jejuno-jejunostomy for improved glycemic control in type 2 diabetes mellitus (T2DM). PJD is an anatomy-sparing, technically simple surgery in comparison to the predominate metabolic procedures, Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). Positive results in a rodent model prompted a human proof-of-concept study. Research design and methods: Pre-clinically, 71 rats were studied in a model of metabolic dysfunction induced by a high-fat diet; 33 animals undergoing one of two lengths of PJD were compared with 18 undergoing sham, 10 RYGB and 10 jejuno-ileal bypass...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/29225081/enteral-nutrition-and-quality-of-life-in-patients-undergoing-chemoradiotherapy-for-esophageal-carcinoma-a-comparison-of-nasogastric-tube-esophageal-stent-and-ostomy-tube-feeding
#14
Fang-Jung Yu, Hsiang-Yao Shih, Chien-Yi Wu, Yun-Shiuan Chuan, Jui-Ying Lee, Hsien-Pin Li, Pen-Tzu Fang, Dong-Lin Tsai, Shah-Hwa Chou, I-Chen Wu
BACKGROUND AND AIMS: This study prospectively recruited esophageal squamous-cell carcinoma patients who received esophageal stent, nasogastric tube (NG) or jejunostomy/gastrostomy feeding to compare the changes in nutritional status and quality of life during chemoradiation therapy (CRT). METHODS: In total, 81 patients were analyzed (stent 7, surgical ostomy 26, NG 19, oral intake 29). NG was inserted when despite medication dysphagia or pain worsened with oral feeding during CRT...
December 7, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29218657/comparison-of-laparoscopic-jejunostomy-tube-to-percutaneous-endoscopic-gastrostomy-tube-with-jejunal-extension-long-term-durability-and-nutritional-outcomes
#15
Ivy N Haskins, Andrew T Strong, Mary Baginsky, Gautam Sharma, Matthew Karafa, Jeffrey L Ponsky, John H Rodriguez, Matthew D Kroh
INTRODUCTION: Enteral access through the jejunum is indicated when patients cannot tolerate oral intake or gastric feeding. While multiple approaches for feeding jejunal access exist, few studies have compared the efficacy of these techniques. The purpose of this study was to investigate the long-term durability, re-intervention rates, and nutritional outcomes following percutaneous endoscopic gastrostomy tubes with jejunal extension tubes (PEG-JET) versus laparoscopic jejunostomy tubes (j-tubes)...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29201780/successful-conservative-management-of-spontaneous-antegrade-migration-of-feeding-jejunostomy
#16
Gautham Krishnamurthy, Narendra Pandit, Harjeet Singh, Rajinder Singh
Successful conservative management of spontaneous antegrade migration of feeding jejunostomy of a patient with dysphagia due to carcinoma of nasopharynx is reported. How to cite this article: Krishnamurthy G, Pandit N, Singh H, Singh R. Successful Conservative Management of Spontaneous Antegrade Migration of Feeding Jejunostomy. Euroasian J Hepato-Gastroenterol 2017;7(1):84-86.
January 2017: Euroasian Journal of Hepato-Gastroenterology
https://www.readbyqxmd.com/read/29198770/preoperative-enteral-access-is-not-necessary-prior-to-multimodality-treatment-of-esophageal-cancer
#17
Thomas K Jenkins, Alexandra N Lopez, George A Sarosi, Kfir Ben-David, Ryan M Thomas
BACKGROUND: Surgical enteral access prior to multimodality treatment for esophageal cancer is controversial as dysphagia is often used for feeding tube referral. We hypothesized that enteral access before neoadjuvant chemoradiation for esophageal cancer provides no benefit compared to that placed during definitive esophagectomy. METHODS: Patients undergoing esophagectomy for esophageal malignancy from 2007 - 2014 were retrospectively identified. Clinicopathologic factors were recorded including preoperative enteral access, weight change, nutritional laboratory works, and perioperative complications...
November 30, 2017: Surgery
https://www.readbyqxmd.com/read/29174926/factors-associated-with-response-to-teduglutide-in-patients-with-short-bowel-syndrome-and-intestinal-failure
#18
Palle Bekker Jeppesen, Simon M Gabe, Douglas L Seidner, Hak-Myung Lee, Clément Olivier
BACKGROUND & AIMS: Clinical studies showed teduglutide to increase urine production and reduce need for parenteral support volume in patients with short bowel syndrome (SBS) with intestinal failure, increasing intestinal wet weight absorption and reducing diarrhea. However, the effects of teduglutide on parenteral support vary among patients. We performed a post-hoc analysis of a phase 3 placebo-controlled study to identify characteristics of patients in whom teduglutide has the largest effects on parenteral support volume response...
November 22, 2017: Gastroenterology
https://www.readbyqxmd.com/read/29154244/nutrition-accesses-among-patients-receiving-enteral-treatment-in-the-home-environment
#19
Janusz Sznajder, Marta Ślefarska-Wasilewska, Piotr Wójcik
Enteral feeding in the home environment is connected with creating access to digestive tract, and thanks to that, this kind of treatment is possible. The gold standard in enteral nutrition is PEG, other types of access are: nasogastric tube, gastronomy and jejunostomy. In the article 851 patients who were treated nutritionally in the home environment, in the nutrition clinic, Nutrimed Górny Śląsk, were analyzed. It was described how, in practice, the schedule of nutrition access looks like in the nutrition clinic at a time of qualifying patients to the treatment (PEG 47,35%, gastronomy 18,91%, nasogastric tube 17,39%,jejunostomy 16,33%) and how it changes among patients treated in the nutrition clinic during specific period of time - to the treatment there were qualified patients with at least three-month period of therapy ( second evaluation: PEG 37,01%, gastrostomy 31,13%, nasogastric tube 16,98%, jejunostomy 15,86%)...
October 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29143474/chronic-intestinal-pseudo-obstruction-progress-in-management
#20
REVIEW
G Di Nardo, T B Karunaratne, S Frediani, R De Giorgio
Chronic intestinal pseudo-obstruction (CIPO) is a severe form of gastrointestinal dysmotility (often due to derangement of the innervation/smooth muscle/interstitial cells of Cajal) with recurrent episodes of intestinal subocclusion mimicking a mechanical obstruction. Because of its complexity and heterogeneity, CIPO is often misdiagnosed or remains unrecognized until advanced stages. Management is a critical aspect in CIPO patient care. So far, most prokinetic drugs have not proven efficacy in restoring intestinal propulsion, thus nutritional support, fluid/electrolyte replacement, and antibiotics are the mainstay of treatment...
December 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
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