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Advances in gastrointestinal surgery

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https://www.readbyqxmd.com/read/27928789/-surgical-management-of-locally-advanced-digestive-tract-neuroendocrine-neoplasm-with-or-without-liver-metastasis
#1
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
#2
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
#3
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...
November 30, 2016: European Journal of Cancer
https://www.readbyqxmd.com/read/27909547/gastrointestinal-tract-access-for-urological-natural-orifice-transluminal-endoscopic-surgery
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/27843428/a-rare-case-of-gastric-variceal-hemorrhage-secondary-to-infiltrative-b-cell-lymphoma
#12
Adrienne Lenhart, Juan Fernandez-Castillo, Keith Mullins, Reena Salgia
Portal hypertension commonly arises in the setting of advanced liver cirrhosis and is the consequence of increased resistance within the portal vasculature. Less commonly, left-sided noncirrhotic portal hypertension can develop in a patient secondary to isolated obstruction of the splenic vein. We present a rare case of left-sided portal hypertension and isolated gastric varices in a patient with large B-cell lymphoma, who was treated with splenic artery embolization. The patient is a 73-year-old male with no previous history of liver disease, who presented with coffee ground emesis and melena...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27833380/indications-and-surgical-options-for-small-bowel-large-bowel-and-perianal-crohn-s-disease
#13
REVIEW
James Wt Toh, Peter Stewart, Matthew Jfx Rickard, Rupert Leong, Nelson Wang, Christopher J Young
Despite advancements in medical therapy of Crohn's disease (CD), majority of patients with CD will eventually require surgical intervention, with at least a third of patients requiring multiple surgeries. It is important to understand the role and timing of surgery, with the goals of therapy to reduce the need for surgery without increasing the odds of emergency surgery and its associated morbidity, as well as to limit surgical recurrence and avoid intestinal failure. The profile of CD patients requiring surgical intervention has changed over the decades with improvements in medical therapy with immunomodulators and biological agents...
October 28, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27830037/goblet-cell-carcinoids-of-the-appendix-tumor-biology-mutations-and-management-strategies
#14
REVIEW
Santosh Shenoy
Malignant neoplasms of the appendix are rare and represent less than 1% of gastrointestinal cancers. Goblet cell carcinoids (GCC) tumors are a distinctive group of heterogeneous appendiceal neoplasm that exhibit unique clinical and pathologic features. This review focuses on the current diagnostic procedures, pathogenesis, possible signaling mechanisms and treatment options for GCC. Perspectives for future research are discussed. The tumor likely arises from pluripotent intestinal epithelial crypt base stem cells...
October 27, 2016: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27818590/preoperative-therapy-in-locally-advanced-esophageal-cancer
#15
REVIEW
Pankaj Kumar Garg, Jyoti Sharma, Ashish Jakhetiya, Aakanksha Goel, Manish Kumar Gaur
Esophageal cancer is an aggressive malignancy associated with dismal treatment outcomes. Presence of two distinct histopathological types distinguishes it from other gastrointestinal tract malignancies. Surgery is the cornerstone of treatment in locally advanced esophageal cancer (T2 or greater or node positive); however, a high rate of disease recurrence (systemic and loco-regional) and poor survival justifies a continued search for optimal therapy. Various combinations of multimodality treatment (preoperative/perioperative, or postoperative; radiotherapy, chemotherapy, or chemoradiotherapy) are being explored to lower disease recurrence and improve survival...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27798009/applied-investigation-of-person-specific-and-context-specific-factors-on-postoperative-recovery-and-clinical-outcomes-of-patients-undergoing-gastrointestinal-cancer-surgery-multicentre-european-study
#16
Sheraz R Markar, Stella Mavroveli, Konstantinos V Petrides, Marco Scarpa, Veronique Christophe, Carlo Castoro, Christophe Mariette, Pernilla Lagergren, George B Hanna
INTRODUCTION: Cancer treatments have greatly advanced over the past two decades causing survival improvements and reduced complications from cancer surgery. However, the cancer diagnosis and the effects of treatment modalities pose a major risk to patients' psychological well-being. Given current interest and emerging evidence about the importance of psychological and social factors on cancer survival and coping with cancer treatments, this study will build and expand research in order to identify key modifiable psychosocial variables that contribute to better physical and mental health following gastrointestinal cancer (GIC) surgery...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27777753/coagulative-safety-of-epidural-catheters-after-major-upper-gastrointestinal-surgery-advanced-and-routine-coagulation-analysis-in-38-patients
#17
Owain Thomas, Hampus Rein, Karin Strandberg, Ulf Schött
BACKGROUND: The risk of spinal haematoma in patients receiving epidural catheters is estimated using routine coagulation tests, but guidelines are inconsistent in their recommendations on what to do when results indicate slight hypocoagulation. Postoperative patients are prone to thrombosis, and thromboelastometry has previously shown hypercoagulation in this setting. We aimed to better understand perioperative haemostasis by comparing results from routine and advanced tests, hypothesizing that patients undergoing major upper gastrointestinal surgery would be deficient in vitamin K-dependent coagulation factors because of malnutrition, or hypocoagulative because of accumulation of low molecular weight heparin (LMWH)...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27761712/3d-vs-2d-imaging-in-laparoscopic-surgery-an-advantage-results-of-standardised-black-box-training-in-laparoscopic-surgery
#18
A Buia, F Stockhausen, N Filmann, E Hanisch
PURPOSE: 3D imaging is an upcoming technology in laparoscopic surgery, and recent studies have shown that the modern 3D technique is superior in an experimental setting. METHODS: All 14 members of the Asklepios Klinik Langen Department of Visceral and Thoracic Surgery, as well as two gynaecologists, were asked to undertake 2D vs. 3D laparoscopic black box skill training. The black box training was adapted to the "fundamentals of laparoscopic surgery" programme provided by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)...
October 19, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27747091/the-promise-of-pd-1-inhibitors-in-gastro-esophageal-cancers-microsatellite-instability-vs-pd-l1
#19
REVIEW
Zhaohui Jin, Harry H Yoon
Preliminary clinical studies of anti-programmed cell death-1 (anti-PD-1) therapy in gastro-esophageal cancers have suggested promising single-agent activity. In patients who received prior treatment for advanced disease, pembrolizumab has been associated with a response rate of 20% in programmed cell death-1 ligand 1 (PD-L1)-positive tumors, and nivolumab with a response rate of 12% in unselected tumors. Both agents yielded a median duration of response lasting ~6-7 months. PD-L1 expression and microsatellite instability (MSI) have emerged as potential predictive markers for PD-1/PD-L1 blockade...
October 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/27744326/is-cancer-history-really-an-exclusion-criterion-for-clinical-trial-of-lung-cancer-influence-of-gastrointestinal-tract-cancer-history-on-the-outcomes-of-lung-cancer-surgery
#20
Keiju Aokage, Morihito Okada, Kenji Suzuki, Shogo Nomura, Shigeki Suzuki, Norifumi Tsubokawa, Takahiro Mimae, Aritoshi Hattori, Tomoyuki Hishida, Junji Yoshida, Masahiro Tsuboi
OBJECTIVE: Exclusion of patients with a history of other cancer treatment except in situ situation has been considered to be inevitable for clinical trials investigating survival outcome. However, there have been few reports confirming these influences on surgical outcome of lung cancer patients ever. METHODS: Multi-institutional, individual data from patients with non-small cell lung cancer resected between 2000 and 2013 were collected. The patients were divided into two groups: those with a history of gastrointestinal tract cancer (GI group) and those without any history (non-GI group)...
October 15, 2016: Japanese Journal of Clinical Oncology
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