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3.
Medicine (Baltimore) ; 99(8): e19343, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080155

RESUMO

RATIONALE: Foreign body (FB) ingestion is a relatively common clinical situation in the emergency department. However, multiple sharply pointed foreign bodies located in different organs are rare conditions and no definite treatment guidelines has been established. PATIENT CONCERNS: A 31-year-old amateur magician visited the outpatient clinic with a chief complaint of epigastric discomfort. He might have accidentally swallowed some needles while practicing a magic trick 2 days before. DIAGNOSIS: Imaging tests revealed 1 needle was stuck in the left liver lobe through the stomach wall, 1 was in the third portion of the duodenum, 3 were in the ascending colon, and 2 were in the transverse colon. INTERVENTIONS: A needle in the duodenum and 5 in the colon were removed by endoscopy. The needle stuck in the liver from the stomach was not visible inside the stomach and was successfully removed by laparoscopy a few days later. OUTCOMES: The patient was able to tolerate an oral diet and was discharged on postoperative day 4 without any complications. LESSONS: Developing a treatment plan in cases of multiple sharp FB may be difficult. A multidisciplinary team of endoscopists and surgeons is needed to determine the best possible treatment plan. This experience illustrates the importance of the planning of the sequence and method of removal of multiple foreign bodies from the gastrointestinal tract.


Assuntos
Endoscopia do Sistema Digestório , Corpos Estranhos/cirurgia , Laparoscopia , Agulhas , Acidentes , Adulto , Colo/diagnóstico por imagem , Colo/cirurgia , Duodeno/diagnóstico por imagem , Duodeno/cirurgia , Humanos , Fígado/diagnóstico por imagem , Fígado/cirurgia , Magia , Masculino , Radiografia , Estômago/diagnóstico por imagem , Estômago/cirurgia
5.
Int J Cancer ; 146(5): 1268-1280, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31463974

RESUMO

Gastric cancer (GC) is the third leading cause of cancer deaths and the fourth most prevalent malignancy worldwide. The high incidence and mortality rates of gastric cancer result from multiple factors such as ineffective screening, diagnosis, and limited treatment options. In our study, we sought to systematically identify predictive molecular networks and key regulators to elucidate complex interacting signaling pathways in GC. We performed an integrative network analysis of the transcriptomic data in The Cancer Genome Atlas (TCGA) gastric cancer cohort and then comprehensively characterized the predictive subnetworks and key regulators by the matched genetic and epigenetic data. We identified 221 gene subnetworks (modules) in GC. The most prognostic subnetworks captured multiple aspects of the tumor microenvironment in GC involving interactions among stromal, epithelial and immune cells. We revealed the genetic and epigenetic underpinnings of those subnetworks and their key transcriptional regulators. We computationally predicted and experimentally validated specific mechanisms of anticancer effects of GKN2 in gastric cancer proliferation and invasion in vitro. The network models and the key regulators of the tumor microenvironment in GC identified here pave a way for developing novel therapeutic strategies for GC.


Assuntos
Proteínas de Transporte/genética , Regulação Neoplásica da Expressão Gênica , Redes Reguladoras de Genes , Neoplasias Gástricas/genética , Microambiente Tumoral/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Linhagem Celular Tumoral , Proliferação de Células/genética , Estudos de Coortes , Biologia Computacional , Conjuntos de Dados como Assunto , Intervalo Livre de Doença , Epigênese Genética , Feminino , Gastrectomia , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica/genética , Prognóstico , Estômago/patologia , Estômago/cirurgia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Adulto Jovem
6.
J Surg Res ; 245: 552-563, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31472311

RESUMO

BACKGROUND: It is elusive which subtypes of immune cells are pivotal in cancer progression and prognosis in gastric cancer (GC). The aim of this study is to clarify clinical impact of immature myeloid-derived immune cells in patients with GC who underwent curative gastrectomy with curative lymphadenectomy and treated with S-1 (tegafur/gimeracil/oteracil) postoperatively. METHODS: The prognostic impact of recruited CD33+ immature myeloid-derived cells were clinicopathologically analyzed in curatively resected stage II and III GC. Correlation of preoperative peripheral leukocyte fractions with recruited CD33+ immature cells was also assessed. RESULTS: Patients with high CD33+ cell counts in primary tumor showed dramatically worse prognosis (5-y recurrence-free survival 29.0%) than that of the counterparts (79.4%). High CD33+ cell counts independently predicted poor prognosis in stage II/III (hazard ratio, 4.34; P < 0.001). In analyses of each stage, high CD33+ cell count was pivotally associated with poor prognosis in both stages. There was no significant correlation of each peripheral leukocyte fraction with CD33+ cell recruitment. Of note, high CD33+ cell count was significantly correlated with hematogenous recurrence. CONCLUSIONS: Recruitment of CD33+ immature myeloid cells critically predict hematogenous recurrences in curatively resected advanced GC. These results give rational to focusing on CD33+ myeloid-derived cells as a novel approach to tackle advanced GC.


Assuntos
Células Supressoras Mieloides/imunologia , Recidiva Local de Neoplasia/diagnóstico , Lectina 3 Semelhante a Ig de Ligação ao Ácido Siálico/metabolismo , Neoplasias Gástricas/terapia , Estômago/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Quimioterapia Adjuvante/métodos , Intervalo Livre de Doença , Combinação de Medicamentos , Feminino , Gastrectomia , Humanos , Excisão de Linfonodo , Masculino , Pessoa de Meia-Idade , Células Supressoras Mieloides/metabolismo , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/imunologia , Estadiamento de Neoplasias , Ácido Oxônico/administração & dosagem , Prognóstico , Estômago/citologia , Estômago/cirurgia , Neoplasias Gástricas/imunologia , Neoplasias Gástricas/patologia , Tegafur/administração & dosagem
7.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 54(11): 837-842, 2019 Nov 07.
Artigo em Chinês | MEDLINE | ID: mdl-31795545

RESUMO

Objective: To investigate the potential risk factors for the death of patients underwent gastric pull-up reconstruction following total pharyngoesophagectomy during perioperative periods. Methods: A total of 71 patients, including 64 males and 7 females, aged from 35 to 72 years old, with hypopharyngeal or cervical esophageal carcinoma, who underwent gastric pull-up reconstruction after pharyngoesophagectomy between October 2008 and October 2017, were reviewed retrospectively. Seventeen factors which may have potential influence on the mortality of patients during perioperative periods were evaluated by single factor Logistic regression analysis, and then those factors with obvious difference in statistics were further analyzed by multi-factor Logistic regression. Results: The rate of perioperative mortality was 9.9% (7/71). Single factor Logistic regression analysis indicated that the age of patients, abnormal electrocardiogram, TNM stages, alanine aminotransferase and D-Dimer changes, postoperative bleeding were risk factors for the death of patients(P values were 0.023, 0.004, 0.026, 0.021, 0.015 and 0.002, respectively). Multi-factor Logistic regression showed that postoperative bleeding and D-Dimer changes were 2 independent risk factors for perioperative death(P=0.021 and 0.047, respectively). Conclusions: Many potential factors may affect the perioperative mortality of patients underwent gastric pull-up reconstruction following total pharyngoesophagectomy. Postoperative bleeding and significantly elevated D-Dimer level were independent risk factors for the death of patients, indicating poor prognosis.


Assuntos
Neoplasias Esofágicas/cirurgia , Esofagectomia/mortalidade , Esôfago/cirurgia , Faringectomia/mortalidade , Faringe/cirurgia , Estômago/cirurgia , Adulto , Idoso , Anastomose Cirúrgica/mortalidade , Neoplasias Esofágicas/sangue , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Humanos , Masculino , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/sangue , Hemorragia Pós-Operatória/etiologia , Hemorragia Pós-Operatória/mortalidade , Procedimentos Cirúrgicos Reconstrutivos/mortalidade , Estudos Retrospectivos , Fatores de Risco
8.
Medicine (Baltimore) ; 98(50): e18373, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852147

RESUMO

RATIONALE: Foreign body ingestion is a common clinical event, but serious complication such as perforation is uncommon. Here we present a case of gastrointestinal perforation caused by fish bone, which was treated effectively and successfully by totally laparoscopic management. PATIENT CONCERNS: A 63-year-old man who was admitted to our hospital with epigastric pain for 1 month. Computed tomography of the abdomen at the local hospital revealed a linear, hyperdense, foreign body in the lesser curvature of gastric antrum that had penetrated through the posterior wall of the gastric antrum. DIAGNOSIS: The laparoscopic exploration found that a 2.5 cm × 0.3 cm fish bone had penetrated through the posterior wall of the gastric antrum. INTERVENTIONS: A totally laparoscopic surgery was performed to remove the foreign body and repair the perforation eventually. OUTCOMES: After surgery, the patient underwent uneventful recovery and was discharged on postoperative day 7. During the 3 months of follow-up visit, the patient appeared healthy and did not report abdominal symptoms. LESSONS: In this case, the advantages of laparoscopic techniques in the diagnosis and treatment of gastrointestinal perforation caused by foreign body was confirmed, and which may be considered as the primary choice in similar cases.


Assuntos
Corpos Estranhos/cirurgia , Laparoscopia/métodos , Estômago/cirurgia , Animais , Osso e Ossos , Peixes , Corpos Estranhos/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Estômago/lesões , Tomografia Computadorizada por Raios X
9.
World J Gastroenterol ; 25(38): 5814-5825, 2019 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-31636474

RESUMO

BACKGROUND: Wnt1-inducible signaling pathway protein 1 (WISP1) is upregulated in several types of human cancer, and has been implicated in cancer progression. However, its clinical implications in gastric cancer (GC) remain unclear. AIM: To explore the expression pattern and clinical significance of WISP1 in GC. METHODS: Public data portals, including Oncomine, The Cancer Genome Atlas database, Coexpedia, and Kaplan-Meier plotter, were analyzed for the expression and clinical significance of WISP1 mRNA levels in GC. One hundred and fifty patients who underwent surgery for GC between February 2010 and October 2012 at the Affiliated Hospital of Jiangnan University were selected for validation study. WISP1 levels were measured at both the mRNA and protein levels by RT-qPCR, Western blot analysis, and immunohistochemistry (IHC). In addition, the in situ expression of WISP1 in the GC tissues was determined by IHC, and the patients were accordingly classified into high- and low-expression groups. The correlation of WISP1 expression status with patient prognosis was then determined by univariate and multivariate Cox regression analyses. WISP1 was knocked down by RNA interference. The 50% inhibitory concentration of oxaliplatin was detected by CellTiter-Blue assay. RESULTS: WISP1 levels at both the mRNA and protein levels were remarkably upregulated in GC tissues compared to normal tissues. Moreover, IHC revealed that WISP1 expression was associated with T stage and chemotherapy outcome, but not with lymph node metastasis, age, gender, histological grade, or histological type. GC patients with high WISP1 expression showed a poor overall survival. Multivariate survival analysis indicated that WISP1 was an important prognostic factor for GC patients. Mechanistically, knock-down of WISP1 expression enhanced sensitivity to oxaliplatin by reducing DNA repair and enhancing DNA damage. CONCLUSION: Significantly upregulated WISP1 expression is associated with cancer progression, chemotherapy outcome, and prognosis in GC. Mechanistically, knock-down of WISP1 expression enhances oxaliplatin sensitivity by reducing DNA repair and enhancing DNA damage. WISP1 may be a potential therapeutic target for GC treatment or a potential biomarker for diagnosis and prognosis.


Assuntos
Antineoplásicos/farmacologia , Biomarcadores Tumorais/metabolismo , Proteínas de Sinalização Intercelular CCN/metabolismo , Reparo do DNA , Resistencia a Medicamentos Antineoplásicos/genética , Proteínas Proto-Oncogênicas/metabolismo , Neoplasias Gástricas/terapia , Antineoplásicos/uso terapêutico , Proteínas de Sinalização Intercelular CCN/genética , Linhagem Celular Tumoral , Quimioterapia Adjuvante/métodos , Feminino , Gastrectomia , Regulação Neoplásica da Expressão Gênica , Técnicas de Silenciamento de Genes , Humanos , Concentração Inibidora 50 , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Oxaliplatina/farmacologia , Oxaliplatina/uso terapêutico , Prognóstico , Proteínas Proto-Oncogênicas/genética , Estômago/patologia , Estômago/cirurgia , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Resultado do Tratamento , Regulação para Cima
10.
Medicine (Baltimore) ; 98(41): e17497, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593116

RESUMO

BACKGROUND: This study will systematically evaluate the psychological effects of advanced care (AC) on patients who received endoscopic gastric cancer resection (EGCR). METHODS: This study will search the following databases of Cochrane Library, Pubmed, EMBASE, Web of Science, WANGFANG, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure from inception to the present with no language limitation. All randomized controlled trials on assessing the psychological effects of AC for patients with EGCR will be included. RESULTS: This study will explore the psychological effects of AC on EGCR by assessing depression, anxiety, health-related quality of life, and adverse events. CONCLUSION: This study will summarize recent evidence for the psychological effects of AC on EGCR. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019139868.


Assuntos
Endoscopia/métodos , Gastrectomia/psicologia , Neoplasias Gástricas/cirurgia , Estômago/cirurgia , Ansiedade/epidemiologia , Ansiedade/psicologia , China/epidemiologia , Depressão/epidemiologia , Depressão/psicologia , Gastrectomia/efeitos adversos , Humanos , Qualidade de Vida/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto
11.
Arq Bras Cir Dig ; 32(3): e1452, 2019.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31644672

RESUMO

BACKGROUND: In high-income countries, morbid obesity is a growing health problem that has already reached epidemic proportions. When performing a laparoscopic gastric bypass several operative methods exist. AIM: To describe the institutional experience using a knotless unidirectional barbed suture (V-Loc 180/Covidien, Mansfield, MA) to create a hand-sewn gastrojejunostomy (GJ) and jejunojejunostomy (JJ) during bariatric surgery. METHODS: Evaluation of a case series of 87 morbidly obese patients who underwent laparoscopic gastric bypass with a hand-sewn gastrojejunostomy (GJA) and jejunojejunostomy (JJA) between 01/2015 and 06/2017. The patients were divided into two groups: in group I, GJA und JJA sutures were performed using the knotless unidirectional barbed suture; in group II, GJA and JJA were sutured with resorbable multifilament thread (Vicryl® 3/0 Ethicon, Livingstone, UK). The recorded data on gender, age, BMI, ASA score, operative time, postoperative morbidity, length of hospital stay, and reoperation, were analyzed and compared. RESULTS: All procedures were completed laparoscopically with no mortality. The mean operative time was 123.23 (±30.631) in group I and 127.57 (±42.772) in group II (p<0.05). The postoperative complications did not differ significantly between the two groups. Early complications were observed for two patients (0.9%) in the barbed suture group and for one patient (0.42%) in the multifilament suture group (p<0.05). In group I two patients (0.9%) required reoperation: on the basis of jejunojejunal stenosis in one patient, and local abscess near the gastrojejunostomy, without a leakage, in the other. In group II one patient (0.42%) required reoperation due to stenosis of the GJA. The duration of hospital admission was similar for both groups: 3.36 (±0.743) days in group I vs. 3.38 (±1.058) days in group II (p<0.05). CONCLUSION: The novel anastomotic technique is a safe and effective method and can be applied to gastrojejunal anastomosis and jejunojejunal anastomosis in laparoscopic gastric bypass.


Assuntos
Cirurgia Bariátrica/instrumentação , Segurança de Equipamentos/instrumentação , Obesidade Mórbida/cirurgia , Técnicas de Sutura/instrumentação , Adulto , Anastomose Cirúrgica/instrumentação , Anastomose Cirúrgica/métodos , Cirurgia Bariátrica/métodos , Feminino , Derivação Gástrica/instrumentação , Derivação Gástrica/métodos , Humanos , Jejunostomia/instrumentação , Jejunostomia/métodos , Jejuno/cirurgia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Poliglactina 910 , Complicações Pós-Operatórias , Estudos Prospectivos , Estômago/cirurgia , Resultado do Tratamento , Técnicas de Fechamento de Ferimentos/instrumentação
12.
Orv Hetil ; 160(43): 1714-1718, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31630550

RESUMO

Bariatric surgery is more effective in the management of morbid obesity and related comorbidities than conservative therapy. There are two main groups, restrictive and malabsorptive procedures. Laparoscopic gastric plication with pylorus-preserving loop duodenoileal bypass is classified into the latter group. It should be considered as the modernized variant of the classical Scopinaro procedure. In this article, the method is presented by a case report. Orv Hetil. 2019; 160(43): 1714-1718.


Assuntos
Cirurgia Bariátrica/métodos , Derivação Gástrica/métodos , Gastroplastia/métodos , Laparoscopia/métodos , Obesidade Mórbida/cirurgia , Estômago/cirurgia , Adulto , Cirurgia Bariátrica/efeitos adversos , Feminino , Derivação Gástrica/efeitos adversos , Gastroplastia/efeitos adversos , Humanos , Laparoscopia/efeitos adversos , Obesidade Mórbida/diagnóstico , Piloro , Resultado do Tratamento
13.
Cir Cir ; 87(S1): 73-76, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31501622

RESUMO

Gastric duplication cyst is a very rare congenital anomaly accounting up to 4-9% of all gastrointestinal tract duplications. It is a quite rare anomaly in adults, the majority of cases are diagnosed in the neonatal period. Gastric duplication cysts are usually asymptomatic in the adult. They are usually discovered incidentally in TAC or RMN, although the best specificity diagnostic test is the echoendoscopy. The best election treatment is the surgical complete extirpation. We describe a case of an adult patient who is diagnosed of the incidentally gastric cyst duplication.


Assuntos
Cistos/congênito , Estômago/anormalidades , Tomografia Computadorizada por Raios X , Abscesso Abdominal/diagnóstico por imagem , Abscesso Abdominal/etiologia , Colecistectomia , Colelitíase/complicações , Colelitíase/diagnóstico por imagem , Cistos/diagnóstico por imagem , Cistos/cirurgia , Diagnóstico Diferencial , Endossonografia , Feminino , Humanos , Achados Incidentais , Pessoa de Meia-Idade , Recidiva , Espaço Retroperitoneal , Estômago/diagnóstico por imagem , Estômago/cirurgia , Neoplasias Gástricas/diagnóstico , Infecção da Ferida Cirúrgica/diagnóstico por imagem , Infecção da Ferida Cirúrgica/etiologia , Infecções Urinárias/complicações
14.
J Ayub Med Coll Abbottabad ; 31(3): 466-468, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31535531

RESUMO

Gastrointestinal duplication cyst is a rare congenital anomaly with a reported incidence of 1 in 4500 live births. Any part of gastrointestinal tract from mouth to anus can be affected with this anomaly. Among gastrointestinal tract duplications, gastric duplication cyst is extremely rare (2- 9%). We are presenting a case of the stomach duplication in a four (04) day old male child who presented in our Emergency Department with complaints of non-bilious, non-projectile vomiting and visible bulge in upper abdomen since birth. Workup showed enteric duplication cyst which was excised. Complete surgical resection is the treatment of choice in gastric duplication cyst.


Assuntos
Obstrução da Saída Gástrica/etiologia , Estômago/anormalidades , Anormalidades Congênitas/cirurgia , Humanos , Recém-Nascido , Masculino , Estômago/cirurgia
15.
World J Gastroenterol ; 25(32): 4673-4681, 2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31528093

RESUMO

Zollinger-Ellison syndrome (ZES) is characterized by gastric acid hypersecretion causing severe recurrent acid-related peptic disease. Excessive secretion of gastrin can now be effectively controlled with powerful proton pump inhibitors, but surgical management to control gastrinoma itself remains controversial. Based on a thorough literature review, we design a surgical algorithm for ZES and list some significant consensus findings and recommendations: (1) For sporadic ZES, surgery should be routinely undertaken as early as possible not only for patients with a precisely localized diagnosis but also for those with negative imaging findings. The surgical approach for sporadic ZES depends on the lesion location (including the duodenum, pancreas, lymph nodes, hepatobiliary tract, stomach, and some extremely rare sites such as the ovaries, heart, omentum, and jejunum). Intraoperative liver exploration and lymphadenectomy should be routinely performed; (2) For multiple endocrine neoplasia type 1-related ZES (MEN1/ZES), surgery should not be performed routinely except for lesions > 2 cm. An attempt to perform radical resection (pancreaticoduodenectomy followed by lymphadenectomy) can be made. The ameliorating effect of parathyroid surgery should be considered, and parathyroidectomy should be performed first before any abdominal surgery for ZES; and (3) For hepatic metastatic disease, hepatic resection should be routinely performed. Currently, liver transplantation is still considered an investigational therapeutic approach for ZES. Well-designed prospective studies are desperately needed to further verify and modify the current considerations.


Assuntos
Gastroenterologia/normas , Oncologia/normas , Guias de Prática Clínica como Assunto , Síndrome de Zollinger-Ellison/cirurgia , Duodeno/citologia , Duodeno/patologia , Duodeno/cirurgia , Células Secretoras de Gastrina/patologia , Gastrinas/metabolismo , Gastroenterologia/métodos , Hepatectomia , Humanos , Fígado/citologia , Fígado/patologia , Fígado/cirurgia , Excisão de Linfonodo , Oncologia/métodos , Pâncreas/citologia , Pâncreas/patologia , Pâncreas/cirurgia , Pancreaticoduodenectomia , Paratireoidectomia , Estômago/citologia , Estômago/patologia , Estômago/cirurgia , Fatores de Tempo , Síndrome de Zollinger-Ellison/patologia
16.
Medicina (Kaunas) ; 55(8)2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31416274

RESUMO

Background and Objectives: Nowadays, with the increasing laparoscopic expertise and accessibility to modern surgical tools, laparoscopic assisted ERCP (LAERCP) has become an effective approach for the management of bile stone disease in patients with modified gastrointestinal anatomy. In contrast to patients with gastric bypass in whom a transgastric LAERCP approach is usually performed, the resultant anatomy of Roux-en-Y hepaticojejunostomy precludes a gastric approach as the newly formed bilioenteric anastomosis is not reachable through the stomach. Therefore, a transjejunal approach has been described as an alternative LAERCP technique. To the best of our knowledge this is the tenth case of transjejunal LAERCP reported worldwide. Materials and Methods: We present the case of a 50-year-old female with history of biliary injury during a cholecystectomy corrected with Roux-en-Y hepaticojejunostomy who presented to our center with manifestations of acute abdomen. After laboratory and image analysis, diagnosis of intrahepatic lithiasis was confirmed. The decision to perform a transjejunal LAERCP was made due to the complex anatomy in this patient. No complications were found during surgery and in the follow up period. Conclusions: Transjejunal LAERCP is an effective approach for endoscopic management of biliary complications in patients with Roux-en-Y hepaticojejunostomy and other modified gastrointestinal anatomy. Previous recommendations by more experienced teams have been reported, nonetheless, there are too few cases reported to make definitive recommendations and conclusions. In limited settings, such as ours, some of these recommendations may not be applicable. We are certain that, with the increasing expertise and innovations in laparoscopy surgery for the management of complications that cannot be addressed by endoscopic or noninvasive measures, more cases will be reported.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Colecistectomia Laparoscópica , Jejunostomia , Feminino , Derivação Gástrica , Humanos , Pessoa de Meia-Idade , Estômago/cirurgia
17.
Anticancer Res ; 39(8): 4243-4248, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366512

RESUMO

BACKGROUND/AIM: This study aimed to clarify the benefits and disadvantages of percutaneous endoscopic gastrostomy (PEG) for patients with esophageal cancer (EC) during preoperative therapy. MATERIALS AND METHODS: We retrospectively reviewed 92 patients who underwent esophagectomy for EC after preoperative therapy. Patients were divided into the PEG group (n=14) and the control group (n=78) and compared regarding patient characteristics, nutritional status, operative variables, and postoperative complications. RESULTS: In the PEG group first nutritional status and tumor stage were significantly worse, but changes of nutritional status from first visit to operation were significantly better. According to the intraoperative thermal imaging, there was no patient with blood flow disturbance in the gastric conduit due to PEG. Short-term surgical outcomes did not significantly differ. CONCLUSION: PEG has less adverse effects on gastric tube production in esophagectomy and may be considered in highly selective patients during preoperative therapy.


Assuntos
Endoscopia/métodos , Neoplasias Esofágicas/cirurgia , Gastrostomia/métodos , Estômago/cirurgia , Adulto , Idoso , Neoplasias Esofágicas/patologia , Esofagectomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Complicações Pós-Operatórias/patologia , Período Pré-Operatório , Estudos Retrospectivos , Estômago/patologia , Resultado do Tratamento
18.
Khirurgiia (Mosk) ; (8): 91-94, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31464282

RESUMO

A successful administration of NPWT-therapy combined with Reamberin infusion for gastroenterostomy failure after stomach resection is reported in the article. It was noted that antioxidant/antihypoxic drug Reamberin combined with NPWT-therapy has a positive metabolic effect and results more active and rapid healing of the wounds. The absence of adverse effects of the drug allows us to recommend its inclusion into complex treatment of patients with this pathology.


Assuntos
Antioxidantes/uso terapêutico , Gastrectomia/métodos , Gastroenterostomia/efeitos adversos , Fármacos Gastrointestinais/uso terapêutico , Meglumina/análogos & derivados , Tratamento de Ferimentos com Pressão Negativa , Estômago/cirurgia , Succinatos/uso terapêutico , Gastrectomia/efeitos adversos , Humanos , Meglumina/uso terapêutico , Cicatrização/efeitos dos fármacos
19.
Radiol Med ; 124(12): 1253-1261, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31428958

RESUMO

PURPOSE: We aimed to determine the safety, feasibility and efficacy of interventional radiology method for the management of esophagogastric anastomotic leakage. METHODS: We retrospectively assessed the medical records of 23 consecutive patients with esophagogastric anastomotic leakage treated using intervention protocol. Patients received three-tube method (abscess drainage tube, gastrointestinal decompression tube and jejunal feeding tube) with or without temporary covered esophageal stent placement. Abscess drainage, anti-inflammatory treatment and nutritional support were performed thereafter. The esophageal stents and three tubes were removed after leakage healing. RESULTS: All patient received three-tube method and eight patients received covered stent placement. All operations were technically successful. After a median of 2.4 months, the stents were successfully removed from five patients. No death, esophageal rupture or massive hemorrhage occurred during procedures. The abscess cavity had markedly decreased in seven patients or disappeared in 16 cases. During follow-up, four patients died of cancer recurrence, one died of heart dysfunction and one died of pulmonary infection. The 1-, 3-, 5-year survival rates were 86.4%, 52.3% and 52.3%, respectively. CONCLUSION: Interventional radiology protocol is safe, feasible and efficacious for treatment for esophagogastric anastomotic leakage.


Assuntos
Fístula Anastomótica/diagnóstico por imagem , Fístula Anastomótica/terapia , Radiologia Intervencionista/métodos , Abscesso/terapia , Idoso , Anastomose Cirúrgica , Descompressão Cirúrgica/instrumentação , Remoção de Dispositivo , Drenagem/instrumentação , Nutrição Enteral/instrumentação , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/terapia , Esofagectomia/efeitos adversos , Esôfago/cirurgia , Estudos de Viabilidade , Feminino , Fístula/diagnóstico por imagem , Fístula/terapia , Humanos , Masculino , Doenças do Mediastino/diagnóstico por imagem , Doenças do Mediastino/terapia , Pessoa de Meia-Idade , Estudos Retrospectivos , Stents , Estômago/cirurgia , Taxa de Sobrevida
20.
BMJ Case Rep ; 12(8)2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31466982

RESUMO

Bouveret syndrome is a rare complication of biliary lithiasis. This sequela is caused by the passage of the gallstone via a bilioenteric fistula, resulting in an impacted gallstone in the duodenum or stomach. The common presentation of non-specific symptoms contributes to the diagnostic uncertainty and delay, which is strongly associated with adverse outcomes. We report an uncomplicated stone extraction via open gastrotomy in an elderly man afflicted with bowel obstruction and biliary vomit secondary to Bouveret syndrome.


Assuntos
Sistema Biliar/patologia , Obstrução Duodenal/etiologia , Obstrução da Saída Gástrica/etiologia , Estômago/cirurgia , Vômito/etiologia , Idoso , Fístula Biliar/complicações , Obstrução Duodenal/diagnóstico por imagem , Duodeno/diagnóstico por imagem , Endoscopia do Sistema Digestório/métodos , Cálculos Biliares/complicações , Cálculos Biliares/cirurgia , Obstrução da Saída Gástrica/cirurgia , Humanos , Laparotomia/métodos , Masculino , Estômago/patologia , Síndrome , Resultado do Tratamento
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