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Advances in gastrointestinal surgery

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https://www.readbyqxmd.com/read/28070329/mastering-minimally-invasive-esophagectomy-requires-a-mentor-experience-of-a-personal-mentorship
#1
Miguel A Cuesta, Nicole van der Wielen, Jennifer Straatman, Donald L van der Peet
Since the first laparoscopic procedure, there has been an steady increase in advanced minimally invasive surgery. These procedures include oncological colorectal, hepatobiliary and upper gastrointestinal surgery. Implementation of these procedures requires different and new skills for the surgeons who wish to perform these procedures. To accomplish this surgical teaching program, a mentorship seems the most ideal method to teach the apprentice surgeon these specific skills. At the VU medical center a teaching program for a minimally-invasive esophagectomy for esophageal cancer started in 2009...
January 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28052273/current-status-of-exposed-endoscopic-full-thickness-resection-and-further-development-of-non-exposed-endoscopic-full-thickness-resection
#2
Hirohito Mori, Asadur Rahman, Hideki Kobara, Shintaro Fujihara, Noriko Nishiyama, Maki Ayaki, Tae Matsunaga, Masanori Murakami, Tsumomu Masaki
Endoscopic full-thickness resection (EFTR) is a procedure that makes it possible to access the lesions that are on the wall of the digestive tract via the shortest distance through the mouth. Because of the ultra-minimal invasive nature of the treatment, pure EFTR is a highly promising surgical procedure that allows the radical excision of full-thickness layers of digestive tract tumors using only a flexible endoscope. There are 2 types of EFTR methods: exposed and non-exposed. Considering the risks of contracting infection and intraperitoneal dissemination of tumor cells, non-exposed EFTR is an ideal method...
2017: Digestion
https://www.readbyqxmd.com/read/28028281/-sequential-post-operative-nutrition-care-at-home-for-patients-receiving-surgical-treatment-for-esophageal-cancer
#3
Mio Matsuoka, Shohei Iijima
OBJECTIVE AND METHODS: We evaluated the outcomes of sequential nutrition care provided at home to patients who had undergone surgery for esophageal cancer. For 44 such patients, we investigated caloric intake(kcal), percentage of preoperative body weight(%), and requests and complains related to home nutrition care every 3 months for 1 year after surgery. RESULTS: Duringthe observation period, the mean postoperative caloric intake decreased to a minimum level at 1 month, but nearly recovered to the baseline at 12 months...
December 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28002507/narrow-band-imaging-endoscopy-for-detection-of-precancerous-lesions-of-upper-gastrointestinal-tract
#4
Dan Nicolae Florescu, Elena Tatiana Ivan, Adriana Mihaela Ciocâlteu, Ioana Andreea Gheonea, Diana Rodica Tudoraşcu, Tudorel Ciurea, Dan IonuŢ Gheonea
Gastric cancer (GC) is an important health problem despite the advances in surgery and chemotherapy and although the incidence is decreasing, GC is still considered the second most common cause of deceases produced by cancer. Survival rates in gastric cancer are low, mainly because most patients are often diagnosed in late stages. The current interest in the diagnostic of GC is the detection of early gastric cancer. Advances in high-resolution endoscopic techniques such as narrow band imaging (NBI) allow the detection of early precancerous lesions like polyps or metaplastic mucosa...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27999735/identification-of-immunotherapeutic-targets-by-genomic-profiling-of-rectal-net-metastases
#5
Zeynep Koşaloğlu, Inka Zörnig, Niels Halama, Iris Kaiser, Ivo Buchhalter, Niels Grabe, Roland Eils, Matthias Schlesner, Andrea Califano, Dirk Jäger
Neuroendocrine tumors (NETs) of the gastrointestinal tract are a rare and heterogeneous group of neoplasms with unique tumor biology and clinical management issues. While surgery is the only curative treatment option in patients with early stage NETs, the optimal management strategy for patients with advanced metastatic NETs is unknown. Based on the tremendous success of immunotherapeutic approaches, we sought to investigate such approaches in a case of metastatic rectal NET. Here, we apply an integrative approach using various computational and experimental methods to explore several aspects of the tumor-host immune interactions for immunotherapeutic options...
2016: Oncoimmunology
https://www.readbyqxmd.com/read/27995468/alpha-fetoprotein-producing-esophageal-adenocarcinoma-a-mimicker-of-hepatocellular-carcinoma
#6
Jeremy Wang, Wendy Liu, Keyur Parikh, Anthony Benjamin Post
Alpha-fetoprotein (AFP)-producing esophageal adenocarcinoma (EAC) is a rare occurrence. Elevation of serum AFP is commonly associated with hepatocellular carcinoma and yolk sac tumors, but rarely with esophageal carcinoma. Here, we report a rare case of AFP-producing EAC. A 51-year-old man presented with two weeks of acid reflux and a 35-lb weight loss. Laboratory data were notable for transaminitis and AFP was 2524 ng/mL. Computed tomography of the abdomen revealed abnormal thickening of the esophagus and multiple metastatic masses throughout the liver...
December 19, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27958619/evaluation-of-urgent-multivisceral-resections-due-to-complications-resulting-from-an-advanced-ovarian-cancer
#7
Tomasz Miłek, Witold Woźniak, Piotr Porzycki, Alkalayla Habib, Agnieszka Timorek, Piotr Ciostek, Włodzimierz Sawicki, Krzysztof Cendrowski
BACKGROUND: Unlike other solid tumors (i.e. pancreas, gallbladder, stomach), an ovarian cancer is responsive to a systemic treatment with platinum derivates in 80% of patients. This apparent chemosensitivity justifies a broader surgical approach. A cytoreductive, "tumor-debulking" surgery is defined as an attempt to remove in a maximum degree all visible and detect-able lesions. Despite treatment, the advancement of the disease very often leads to complications defined as "surgical" and life-threatening...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27955634/transdifferentiation-of-pancreatic-stromal-tumor-into-leiomyosarcoma-with-metastases-to-liver-and-peritoneum-a-case-report
#8
Chao Lin, Liping Wang, Jiyao Sheng, Dan Zhang, Lianyue Guan, Kai Zhao, Xuewen Zhang
BACKGROUND: Primary pancreatic leiomyosarcoma is a rare pancreatic malignancy; the clinical presentation and treatment is not well-characterized. Further, the molecular mechanisms underlying its pathogenesis are not known. We report a patient with pancreatic stromal tumor that progressed to primary pancreatic leiomyosarcoma with hepatic and peritoneal metastases. CASE PRESENTATION: A 54-year-old woman was found to have pancreatic and hepatic tumor masses on routine health checkup...
December 13, 2016: BMC Cancer
https://www.readbyqxmd.com/read/27938988/incidence-and-risk-factors-for-surgical-site-infection-post-hysterectomy-in-a-tertiary-care-center
#9
Aurora Pop-Vicas, Jackson S Musuuza, Michelle Schmitz, Ahmed Al-Niaimi, Nasia Safdar
BACKGROUND: Preoperative antibiotic prophylaxis and surgical technological advances have greatly reduced, but not totally eliminated surgical site infection (SSI) posthysterectomy. We aimed to identify risk factors for SSI posthysterectomy among women with a high prevalence of gynecologic malignancies, in a tertiary care setting where compliance with the Joint Commission's Surgical Care Improvement Project core measures is excellent. METHODS: The study was a matched case-control, 2 controls per case, matched on date of surgery...
December 9, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/27928789/-surgical-management-of-locally-advanced-digestive-tract-neuroendocrine-neoplasm-with-or-without-liver-metastasis
#10
Xiaosong Wang, Jiangfeng Qiu, Zhiyong Wu
Neuroendocrine tumors in the digestive tract are rare, however their incidences increased obviously for the past few years. The purpose of this paper is to elucidate the surgical management of locally advanced digestive tract neuroendocrine neoplasms(NENs) with or without liver metastasis and to discuss the present classification of gastrointestinal NENs in order to provide reference for clinicians. WHO re-classified the gastroenteropancreatic NENs in 2010, but this classification remains many questions and needs further clinical trials to answer...
November 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27928787/-lancet-in-the-era-of-targeted-drug-therapy-the-role-of-surgery-in-the-management-of-advanced-gastrointestinal-stromal-tumor
#11
Hui Cao, Ming Wang
Gastrointestinal stromal tumor(GIST) is the most common mesenchymal tumor in the gastrointestinal tract. Due to the occult onset, GIST may present as local advanced or with metastatic disease at diagnosis. Imatinib mesylate (IM) has effectively improved the prognosis of GIST patients and has been established as principle therapy in metastatic GIST. The role of IM as an adjunction to surgery in the management of high-risk and local advanced GIST is also highly regarded. The role of surgery in metastatic or recurrent GIST is still a controversial clinic problem...
November 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27914243/efficacy-and-safety-of-bevacizumab-containing-neoadjuvant-therapy-followed-by-interval-debulking-surgery-in-advanced-ovarian-cancer-results-from-the-anthalya-trial
#12
Roman Rouzier, Sébastien Gouy, Frédéric Selle, Eric Lambaudie, Anne Floquet, Virginie Fourchotte, Christophe Pomel, Pierre-Emmanuel Colombo, Elsa Kalbacher, Sandrine Martin-Francoise, Raffaele Fauvet, Philippe Follana, Anne Lesoin, Fabrice Lecuru, Youssef Ghazi, Julien Dupin, Elisabeth Chereau, Sarah Zohar, Paul Cottu, Florence Joly
AIM: To investigate whether adding bevacizumab to neoadjuvant carboplatin-paclitaxel (CP) helps achieve optimal debulking, measured by complete resection rate (CRR) at interval debulking surgery (IDS), in patients with initially unresectable International Federation of Gynecology and Obstetrics stage IIIC/IV ovarian, tubal or peritoneal adenocarcinoma. METHODS: Multicentre, open-label, non-comparative phase II study. Ninety-five patients randomised (2:1) to receive four cycles of neoadjuvant CP ±3 concomitant cycles of bevacizumab 15 mg/kg (BCP) followed by IDS...
January 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/27909547/gastrointestinal-tract-access-for-urological-natural-orifice-transluminal-endoscopic-surgery
#13
REVIEW
Olga Miakicheva, Zachary Hamilton, Alp T Beksac, Sean W Berquist, Abd-Elrahman Hassan, Marc Holden, Ithaar H Derweesh
We conducted a literature review of natural orifice transluminal endoscopic surgery (NOTES), focusing on urologic procedures with gastrointestinal tract access, to update on the development of this novel surgical approach. As part of the methods, a comprehensive electronic literature search for NOTES was conducted using PubMed and Cochrane Library from March 2002 to February 2016 for papers reporting urologic procedures performed utilizing gastrointestinal tract access. A total of 11 peer-reviewed studies examining utility of gastrointestinal access for NOTES urologic procedures were noted, with the first report in 2007...
November 16, 2016: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27890494/neuroendocrine-tumors-of-the-lung-current-challenges-and-advances-in-the-diagnosis-and-management-of-well-differentiated-disease
#14
REVIEW
Andrew E Hendifar, Alberto M Marchevsky, Richard Tuli
Neuroendocrine tumors (NET) comprise a heterogeneous group of malignancies that arise from neuroendocrine cells throughout the body, most commonly originating from the lungs and gastrointestinal tract. Lung NET can be classified as well-differentiated (low-grade typical carcinoids [TC] and intermediate-grade atypical carcinoids [AC]) and poorly differentiated (high-grade large cell neuroendocrine carcinoma or small cell lung carcinoma). The incidence of these tumors is increasing, but disease awareness remains low among thoracic specialists who are often involved in the diagnosis and early treatment for these patients...
November 23, 2016: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/27889785/overcoming-cost-implications-of-mutational-analysis-in-patients-with-gastrointestinal-stromal-tumors-a-pragmatic-approach
#15
Patrick Schöffski, Agnieszka Wozniak, Oliver Schöffski, Liesbet van Eycken, Maria Debiec-Rychter
BACKGROUND: Genetic analysis of tissue derived from patients with advanced gastrointestinal stromal tumors (GISTs) is not uniformly applied on a national and international level, even though mutational data can provide clinically relevant prognostic and predictive information, especially in patients qualifying for treatment with expensive targeted agents. METHODS: The current article describes the rationale for genetic testing of GIST tissue, looks at financial implications associated with such analysis and speculates on potential cost savings introduced by routine mutational testing and tailored use of tyrosine kinase inhibitors based on genotyping...
2016: Oncology Research and Treatment
https://www.readbyqxmd.com/read/27888864/oesophageal-disease-gastroesophageal-reflux-disease-barrett-s-oesophagus-achalasia-and-eosinophilic-oesophagitis
#16
Xavier Calvet
The most interesting conclusions and/or advances presented at Digestive Disease Week 2016 were the following: a) gastroesophageal reflux disease: proton pump inhibitor-refractory reflux disease is frequently associated with poor treatment adherence, psychiatric comorbidities and functional gastrointestinal disorders. These possible entities should be investigated in all cases of proton pump inhibitor-refractory reflux disease; b) Barrett's oesophagus: the efficacy of screening remains unclear; however, new minimally-invasive techniques such as the cytosponge allow more effective detection, both of Barrett's oesophagus and Barrett's oesophagus-associated dysplasia or neoplasia; c) achalasia: evidence indicates that peroral endoscopic myotomy is as effective as surgery and is a safer alternative; d) eosinophilic oesophagitis: high-dose proton pump inhibitors are required to rule out proton pump inhibitor-responsive eosinophilic oesophagitis; montelukast is not clearly effective in the treatment of eosinophilic oesophagitis, although moderate efficacy cannot be ruled out...
September 2016: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/27885876/predictors-and-survival-for-pathologic-tumor-response-grade-in-borderline-resectable-and-locally-advanced-pancreatic-cancer-treated-with-induction-chemotherapy-and-neoadjuvant-stereotactic-body-radiotherapy
#17
Eric A Mellon, William H Jin, Jessica M Frakes, Barbara A Centeno, Tobin J Strom, Gregory M Springett, Mokenge P Malafa, Ravi Shridhar, Pamela J Hodul, Sarah E Hoffe
BACKGROUND: Neoadjuvant therapy response correlates with survival in multiple gastrointestinal malignancies. To potentially augment neoadjuvant response for pancreas adenocarcinoma, we intensified treatment with stereotactic body radiotherapy (SBRT) following multi-agent chemotherapy. Using this regimen, we analyzed whether the College of American Pathology (CAP) tumor regression grade (TRG) at pancreatectomy correlated with established response biomarkers and survival. MATERIALS AND METHODS: We identified borderline resectable (BRPC) and locally advanced (LAPC) pancreatic cancer patients treated according to our institutional clinical pathway who underwent surgical resection with reported TRG (n = 81, median follow-up after surgery 24...
November 25, 2016: Acta Oncologica
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#18
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m(2)) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27872531/positive-peritoneal-lavage-cytology-implications-for-staging-and-management-of-gastric-cancer
#19
Suman B Koganti, Satish Boddepalli, Muralidhar Nambada, Venu Madhav Thumma, Bheerappa Nagari, R A Sastry
The survival rates of gastric cancer patients with cytology-positive peritoneal lavage fluid without macroscopic dissemination (CY+/P-) is the same as that of patients with overt peritoneal metastasis.The 5-year survival rate of such patients is only 2%. The current study aims to highlight its significance in the staging of gastrointestinal malignancies and its implications for patient care. Prospective nonrandom analysis of peritoneal wash cytology in patients with gastrointestinal malignancies was conducted in the department of Surgical Gastroenterology, Nizams Institute of Medical Sciences, Hyderabad from January 2012 to June 2013...
December 2016: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27869490/congenital-diaphragmatic-hernia-causing-cardiac-arrest-in-a-30-year-old-woman
#20
H J Manson, Y M Goh, P Goldsmith, P Scott, P Turner
Congenital diaphragmatic hernia (CDH) usually presents in infancy with respiratory failure requiring urgent surgical correction. Mortality in this group of patients remains poor and persistent pulmonary hypertension is a significant contributor. It is therefore rare for patients to reach adulthood undiagnosed. CDH is often identified incidentally in adults but when symptoms arise, they relate to the organ involved, and include gastrointestinal symptoms of dyspepsia and obstruction, as well as respiratory complaints such as dyspnoea...
November 21, 2016: Annals of the Royal College of Surgeons of England
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