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Advances in gastrointestinal surgery

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https://www.readbyqxmd.com/read/29760538/gastrointestinal-stromal-tumors-a-multidisciplinary-challenge
#1
REVIEW
Juan Manuel Sanchez-Hidalgo, Manuel Duran-Martinez, Rafael Molero-Payan, Sebastian Rufian-Peña, Alvaro Arjona-Sanchez, Angela Casado-Adam, Antonio Cosano-Alvarez, Javier Briceño-Delgado
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors located in the alimentary tract. Its usual manifestation is gastrointestinal bleeding. However, small asymptomatic lesions are frequently detected as incidental finding. Characteristically, most GISTs (> 95%) are positive for the KIT protein (CD117) by IHC staining and approximately 80%-90% of GISTs carry a mutation in the c-KIT or PDGFRA genes. Mutational analysis should be performed when planning adjuvant and neoadjuvant therapy, due to its possible resistance to conventional treatment...
May 14, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29730070/exercise-prehabilitation-in-elective-intra-cavity-surgery-a-role-within-the-eras-pathway-a-narrative-review
#2
REVIEW
Samuel T Orange, Matthew J Northgraves, Phil Marshall, Leigh A Madden, Rebecca V Vince
The Enhanced Recovery after Surgery (ERAS) model integrates several elements of perioperative care into a standardised clinical pathway for surgical patients. ERAS programmes aim to reduce the rate of complications, improve surgical recovery, and limit postoperative length of hospital stay (LOHS). One area of growing interest that is not currently included within ERAS protocols is the use of exercise prehabilitation (PREHAB) interventions. PREHAB refers to the systematic process of improving functional capacity of the patient to withstand the upcoming physiological stress of surgery...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29725797/management-and-outcomes-following-surgery-for-gastrointestinal-typhoid-an-international-prospective-multicentre-cohort-study
#3
(no author information available yet)
BACKGROUND: Gastrointestinal perforation is the most serious complication of typhoid fever, with a high disease burden in low-income countries. Reliable, prospective, contemporary surgical outcome data are scarce in these settings. This study aimed to investigate surgical outcomes following surgery for intestinal typhoid. METHODS: Two multicentre, international prospective cohort studies of consecutive patients undergoing surgery for gastrointestinal typhoid perforation were conducted...
May 3, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29701352/two-years-of-experience-in-the-implantation-of-heartmate-iii
#4
Vítor Mendes, Candido Cerca, Monique Crosset, Matthias Kirsh
INTRODUCTION: Left ventricular assist devices as long-term mechanical circulatory support are increasingly used as an option for medically refractory advanced heart failure. Heartmate III is one of the alternative devices for circulatory support in those patients. OBJECTIVES: Analyze a two years Heartmate III implantation Program. METHODS: From November 2015 to August 2017, Heartmate III was implanted in 16 patients with chronic end-stage heart failure, in 81% (n = 13) as a bridge to transplant and 19% (n = 3) as destination therapy...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29694306/totally-laparoscopic-resection-and-extraction-of-specimens-via-transanal-route-in-synchronous-colon-and-gastric-cancer
#5
F Sumer, S Karakas, E Gundogan, T Sahin, C Kayaalp
INTRODUCTION: Synchronous colon and gastric cancer is a rare clinical entity. In the present case, it is aimed to show that in a patient with synchronous colon and gastric cancer, laparoscopic resection can be safely performed and both specimens can be delivered through a natural orifice. In our knowledge, this is the first example showing the delivery of the gastric resection specimen through the anus in a human being. CASE REPORT: Sixty-six years old male patient with an upper gastrointestinal bleeding and obstruction symptoms was admitted to our department and the evaluation revealed an advanced stage gastric and a synchronous colon cancer...
March 2018: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29691094/first-experience-of-the-egyptian-national-cancer-institute-using-the-robot-assisted-laparoscopic-approach-in-radical-hysterectomies-for-cervical-cancer
#6
Ashraf Saad Zaghloul, Ahmed Mahmoud El-Minawi, Mohamed Atef ElKordy, Amr Kamal Younes, Ahmed Mostafa Mahmoud, Waleed Mohamed Fadlalla, Gamal Amira Mohamed
AIM OF WORK: Robotics in surgery led to an improvement of visualization, a better handling of tissues and better suturing. This study aimed to document the first experience of the Egyptian National Cancer Institute (NCI) using the robot-assisted laparoscopic approach in radical hysterectomies for cervical cancer and to highlight observed advantages, disadvantages, morbidity and oncological outcomes. PATIENTS AND METHODS: Data of cases that had either early cervical cancer (stage IB-IIA1 with a tumor ≥2 cm) or locally advanced cervical cancer (Stage IIA2-IIB after chemo-radiotherapy) were collected prospectively...
April 21, 2018: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/29682621/surgery-for-metastatic-gastrointestinal-stromal-tumor-to-whom-and-how-to
#7
REVIEW
Hirotoshi Kikuchi, Yoshihiro Hiramatsu, Kinji Kamiya, Yoshifumi Morita, Takanori Sakaguchi, Hiroyuki Konno, Hiroya Takeuchi
Although imatinib is a standard treatment for metastatic or recurrent gastrointestinal stromal tumors (GISTs), acquired c-kit mutations reportedly cause secondary resistance to imatinib. Sunitinib is a tyrosine kinase inhibitor (TKI) that can be used as second-line therapy in imatinib-resistant or -intolerant GISTs. For sunitinib-resistant or -intolerant GISTs, regorafenib is a standard third-line treatment. Although TKI therapies have revolutionized the treatment of recurrent or metastatic GISTs, they cannot cure GISTs...
2018: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29650858/-a-case-of-unresectable-advanced-gastric-cancer-treated-by-seven-courses-of-chemotherapy-with-docetaxel-cisplatin-and-s-1followed-by-conversion-surgery-achieved-five-year-relapse-free-survival
#8
Tetsushi Nakajima, Haruhiko Cho, Yoichiro Okubo, Kazuki Kano, Yukio Maezawa, Kousuke Ikeda, Takanobu Yamada, Takashi Ogata, Takaki Yoshikawa
The patient is a 51-year-old man.Upper gastrointestinal endoscopy revealed gigantic type 3 gastric cancer.Enhanced abdominal CT demonstrated a gigantic mass of 15×7 cm in the stomach, and a large number of peritoneal dissemination with moderate amount of ascites.The patient was diagnosed with cT4aN3bM1(peritoneal dissemination), Stage IV gastric cancer(JPN ver8)and was treated by chemotherapy with docetaxel(40mg/m / 2 day 1)plus cisplatin(60mg/m2 day 1)plus S-1(80mg/m2 day 1-14).After 7 courses of chemotherapy, peritoneal dissemination was disappeared...
April 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29627055/factors-favoring-and-impairing-healing-of-tracheal-anastomosis
#9
REVIEW
Farid M Shamji
The factors governing successful healing of and impairing of tracheal and bronchial anastomosis are best understood by reviewing the normal histologic changes accompanying healing, governing factors, and biochemical advances made in the last 5 decades. Normal wound healing factors, also relevant to tracheal and bronchial reconstruction, rely on precise handling of tissues without interfering with tissue perfusion, careful selection and placement of sutures, and steps to minimize tension. Impairments of satisfactory healing are well recognized in gastrointestinal surgery and apply to tracheal and carinal resection, and sleeve bronchial resection...
May 2018: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/29620659/individualized-pelvic-lymphadenectomy-should-follow-neoadjuvant-concurrent-chemoradiotherapy-for-locally-advanced-cervical-cancer
#10
Li-Chun Wei, Xin Li, Ying Zhang, Yun-Zhi Dang, Wei-Wei Li, Jian-Ping Li, Li-Na Zhao, Shu-Juan Liu, Xia Li, Mei Shi
To study the outcomes following concurrent chemoradiotherapy (CCRT) and subsequent radical surgery for locally advanced cervical cancer (LACC), analyze the relationship between imaging-diagnosed and postoperative-diagnosed lymph node (LN) involvement, and identify patients who would benefit from individualized pelvic lymphadenectomy.We retrospectively reviewed records of 410 patients who underwent CCRT followed by radical surgery for International Federation of Gynecology and Obstetrics Stage Ib2-IIIb disease...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29618175/foreign-body-ingestion-in-children
#11
Ji Hyuk Lee
Foreign body (FB) ingestion in children is common and most children are observed to be between 6 months and 3 years of age. Although most FBs in the gastrointestinal tract pass spontaneously without complications, endoscopic or surgical removal may be required in a few children. Thus, FB ingestion presents a significant clinical difficulty in pediatric gastroenterological practice. Parameters that need to be considered regarding the timing of endoscopic removal of ingested FBs in children are the children's age or body weight, the clinical presentation, time lapse since ingestion, time of last meal, type as well as size and shape of the FB, and its current location in the gastrointestinal tract...
March 2018: Clinical Endoscopy
https://www.readbyqxmd.com/read/29607052/changing-nationwide-trends-in-endoscopic-medical-and-surgical-admissions-for-inflammatory-bowel-disease-2003-2013
#12
Ahmir Ahmad, Anthony A Laverty, Chris Alexakis, Tom Cowling, Sonia Saxena, Azeem Majeed, Richard C G Pollok
Background and study aims: In the last decade, there have been major advances in inflammatory bowel disease (IBD) management but their impact on hospital admissions requires evaluation. We aim to investigate nationwide trends in IBD surgical/medical elective and emergency admissions, including endoscopy and cytokine inhibitor infusions, between 2003 and 2013. Patients and methods: We used Hospital Episode Statistics and population data from the UK Office for National Statistics...
2018: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29602460/preoperative-gastric-lavage-in-gastric-cancer-patients-undergoing-surgical-endoscopic-or-minimally-invasive-treatment-an-oncological-measure-preventing-peritoneal-spillage-of-intragastric-cancer-cells-and-development-of-related-metastases
#13
Edoardo Virgilio, Genoveffa Balducci, Paolo Mercantini, Enrico Giarnieri, Maria Rosaria Giovagnoli, Monica Montagnini, Antonella Proietti, Rosaria D'Urso, Marco Cavallini
In addition to classical metastatic pathways, recently gastric cancer was described having an alternative route called "endoluminal exfoliation". Provisional analyses demonstrated, in fact, this kind of shedding is associated with several clinico-pathological features indicative of aggressive behavior and resulted to be an independent prognostic factor entailing poor prognosis. Compared with non-sowing counterparts, in fact, patients affected with exfoliating early and advanced gastric carcinomas met with shorter overall survival, disease free survival, progression free survival and time to tumor progression...
May 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29594169/robotic-endoscopy
#14
REVIEW
Zheng Li, Philip Wai-Yan Chiu
Endoscopes extend the eyes of the physician into the patient's body. They are widely used in gastrointestinal (GI) diagnostics and minimally invasive surgery. Endoscopes can be classified into 3 types: rigid, flexible, and capsule endoscopes. Rigid and flexible endoscopes are traditionally held and manipulated by the physician to visualize the region of interest, while capsule endoscopes move passively along with the GI peristalsis. With the advancement of technology, robotic endoscopy has been increasingly developed and accepted...
February 2018: Visceral Medicine
https://www.readbyqxmd.com/read/29594107/effects-of-enteral-immunonutrition-in-esophageal-cancer
#15
REVIEW
Kenji Mimatsu, Nobutada Fukino, Yasuo Ogasawara, Yoko Saino, Takatsugu Oida
Background: Immunonutrition (IN) significantly reduces the incidence of postoperative infectious complications and the length of hospitalization in patients undergoing major elective surgery for gastrointestinal malignances. However, the clinical benefit of IN in patients who have undergone esophagectomy for esophageal cancer is unclear. Moreover, the effect of enteral IN in patients during preoperative adjuvant chemoradiotherapy and in patients treated with concurrent chemoradiotherapy for advanced esophageal cancer is unknown...
February 2018: Gastrointestinal Tumors
https://www.readbyqxmd.com/read/29587683/shorter-survival-in-adolescent-and-young-adult-patients-compared-to-adult-patients-with-stage-iv-colorectal-cancer-in-japan
#16
Dai Shida, Yuka Ahiko, Taro Tanabe, Takefumi Yoshida, Shunsuke Tsukamoto, Hiroki Ochiai, Atsuo Takashima, Narikazu Boku, Yukihide Kanemitsu
BACKGROUND: The incidence of colorectal cancer in adolescent and young adult patients is increasing. However, survival and clinical features of young patients, especially those with stage IV disease, relative to adult patients remain unclear. METHODS: This retrospective single-institution cohort study was conducted at a tertiary care cancer center. Subjects were 861 consecutive patients who were diagnosed with stage IV colorectal cancer at the age of 15 to 74 years and who were referred to the division of surgery or gastrointestinal oncology at the National Cancer Center Hospital from 1999 to 2013...
March 27, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29572794/clinical-correlation-of-the-histoculture-drug-response-assay-in-gastrointestinal-cancer
#17
Robert M Hoffman
The histoculture drug response assay (HDRA) with tumors histocultured on Gelfoam® was tested for clinical correlation for advanced gastric and colorectal cancer patients. In one study, 29 patients were treated with drugs shown to be ineffective in the HDRA, and all 29 cases showed clinical chemoresistance. In nine patients treated with drugs shown to be effective in the HDRA, six showed clinical chemoresponse and three showed arrest of disease progression. In a study of 32 patients with stage III and IV gastric cancer treated with mitomycin C and 5-fluorouracil (5-FU), the survival rate of 10 patients whose tumors were sensitive to either mitomycin C and/or 5-fluorouracil in the HDRA was significantly better than that of 22 patients whose tumors were insensitive to both drugs in the HDRA...
2018: Methods in Molecular Biology
https://www.readbyqxmd.com/read/29570542/caring-for-the-orthopaedic-patient-with-a-history-of-bariatric-surgery
#18
Allyson S Chicoski
Bariatric surgery is performed on the gastrointestinal tract as a solution to obesity, and prevalence of these surgical procedures continues to rise. Bariatric surgery creates restrictive and/or malabsorptive properties, causing nutritional deficits from the physiological changes in absorption and a hypoacidic environment. Although surgery induces sustained weight loss, decreases mortality, and provides resolution or improvement to comorbidities of obesity, it can also come with complications. Common long-term complications of bariatric surgery include malnutrition, anemia, impaired wound healing, and impaired bone health...
March 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29568842/cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-in-gastrointestinal-cancers-fad-or-standard-of-care
#19
Melissa Ching Ching Teo, Grace Hwei Ching Tan
Peritoneal metastases (PM) are the common endpoint for patients with advanced gastrointestinal cancers. PM from these cancers are often managed in a similar fashion to other sites of systemic metastases, but the following must be taken into consideration. (a) PM do not respond to systemic chemotherapy in the same fashion as liver and lung metastases. (b) PM cause local problems, resulting in disruption of chemotherapy. (c) Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) actually work for PM...
March 2018: Singapore Medical Journal
https://www.readbyqxmd.com/read/29564184/how-does-the-tumor-microenvironment-play-a-role-in-hepatobiliary-tumors
#20
REVIEW
Fathima Kamil, Julie H Rowe
The tumor microenvironment (TME) is defined as the structural and dynamic network of cellular and non-cellular interactions between malignant cells and the surrounding non-malignant matrix. Hepatocellular carcinoma (HCC) and pancreatic ductal adenocarcinoma (PDAC) are two of the most challenging gastrointestinal malignancies. Despite clinical advancements in understanding tumor biology and growth of the chemotherapeutic industry, there have been no corresponding improvements in prognosis and overall survival of HCC and PDAC...
February 2018: Journal of Gastrointestinal Oncology
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