Benign strictures are frequent complications following colorectal surgery, with an incidence of up to 20%. Endoscopic treatment is safe and effective but there is not enough evidence for establishing ...stricture management at that anatomic level.
To determine the risk factors associated with the development of stricture in patients with colorectal cancer and describe endoscopic treatment in those patients.
A retrospective study was conducted on patients with colorectal cancer that underwent surgery and anastomosis, evaluated through colonoscopy, within the time frame of 2014 to 2019.
Of the 213 patients included in the study, 18.3% presented with stricture that was associated with the type of surgery. Intersphincteric resection was a risk factor (OR = 18.81, 95% CI: 3.31-189.40, p < .001). A total of 69.2% patients with stricture had a stoma, identifying it as a risk factor for stricture (OR = 7.07, 95% CI: 3.10-16.57, p < .001). Mechanical anastomotic stapling was performed in 87.4% of the patients that did not present with stricture, identifying it as a protective factor (OR = 0.41, 95% CI: 0.16-1.1, p = .04). Endoscopic treatment was required in 69.2% of the patients and provided favorable results in 83.3%. Only 2.6% of the patients had recurrence. No complications were reported.
Intersphincteric resection and the presence of a stoma were independent risk factors for stricture, and mechanical anastomosis was a protective factor against stricture development. Endoscopic treatment was safe and effective.
Self-expanding metallic stents (SEMS) are the ideal treatment for malignant gastric outlet obstruction (MGOO) in patients with a short life expectancy, but stent dysfunction is frequent. The primary ...aim of our study was to identify the predictive factors of SEMS dysfunction in MGOO and the secondary aim was to determine the technical success, clinical success, and nutritional impact after SEMS placement.
A retrospective, longitudinal study was conducted at the gastrointestinal endoscopy department of the Instituto Nacional de Cancerología in Mexico City. Patients diagnosed with MGOO that underwent SEMS placement within the time frame of January 2015 to May 2018 were included. We utilized the gastric outlet obstruction scoring system (GOOSS) to determine clinical success and SEMS dysfunction.
The study included 43 patients, technical success was 97.7% (n=42), and clinical success was 88.3% (n=38). SEMS dysfunction presented in 30.2% (n=13) of the patients, occurring in<6 months after placement in 53.8% (n=7) of them. In the univariate analysis, the histologic subtype, diffuse gastric adenocarcinoma (p=0.02) and the use of uncovered SEMS (p=0.02) were the variables associated with dysfunction. Albumin levels and body mass index did not increase after SEMS placement. Medical follow-up was a mean 5.8 months (1-24 months).
SEMS demonstrated adequate technical and clinical efficacy in the treatment of MGOO. SEMS dysfunction was frequent and diffuse type gastric cancer and uncovered SEMS appeared to be dysfunction predictors.
Malignant dysphagia is difficulty swallowing resulting from esophageal obstruction due to cancer. The goal of palliative treatment is to reduce the dysphagia and improve oral dietary intake. ...Self-expandable metallic stents are the current treatment of choice, given that they enable the immediate restoration of oral intake. The aim of the present study was to describe the results of using totally covered and partially covered esophageal stents for palliating esophageal cancer.
A retrospective study was conducted on patients with inoperable esophageal cancer treated with self-expandable metallic stents. The 2 groups formed were: group A, which consisted of patients with a fully covered self-expandable stent (SX-ELLA
), and group B, which was made up of patients with a partially covered self-expandable stent (Ultraflex
).
Of the 69-patient total, 50 were included in the study. Group A had 19 men and 2 women and their mean age was 63.6 years (range 41-84). Technical success was achieved in 100% (n=21) of the cases and clinical success in 90.4% (n=19). Group B had 24 men and 5 women and their mean age was 67.5 years (range 43-92). Technical success was achieved in 100% (n=29) of the cases and clinical success in 89.6% (n=26). Complications were similar in both groups (33.3 vs. 51.7%).
There was no difference between the 2 types of stent for the palliative treatment of esophageal cancer with respect to technical success, clinical success, or complications.
Granular cell tumor of the esophagus González-Sánchez, C B; Alonso-Lárraga, J O; Maldonado Vázquez, A ...
Revista de gastroenterología de México,
2018 Jan - Mar, Letnik:
83, Številka:
1
Journal Article
endoscopic evaluation of the ampulla of Vater (AV), although routinely recommended, is not always possible due to its anatomic configuration, which can hide it from the visual field of the ...forward-viewing endoscope. Cap-assisted forward-viewing endoscopy has been proposed as a useful alternative to facilitate the examination of this structure.
to assess the efficacy of cap-assisted forward-viewing endoscopy for the complete evaluation of the AV. Secondary outcomes were to assess AV morphology, search and total procedure times and technique safety.
a prospective, single-arm study. Patients who were selected for elective upper endoscopy were included. Patients with advanced neoplasia, modified anatomy, upper gastrointestinal stenosis or obstructions were excluded.
ninety patients were included, 36 males (40 %) and 54 females (60 %). Fifteen percent had a history of hereditary colon cancer syndrome. Technical success of cap-assisted, forward-viewing endoscopy was 98.8 %. AV was classified as type 1 (classic) in 49.4 %, type 2 (small) in 16.8 %, type 3 (protruding) in 11.2 % and type 4 (ridged) in 22.4 %. The mean search time was 37.7 seconds (s) (SD ± 31.6) and the total procedure time was 487.4 s (SD ± 206.2). No adverse events were reported.
cap-assisted forward-viewing endoscopy is an effective and safe technique for the complete visualization and morphologic characterization of the ampulla of Vater.
Las estenosis benignas son complicaciones frecuentes posterior a la cirugía colorrectal, con una incidencia de hasta el 20%. El tratamiento endoscópico es seguro y efectivo, pero no hay evidencia ...suficiente para establecer el manejo de la estenosis a ese nivel anatómico.
Determinar los factores de riesgo asociados a el desarrollo de estenosis en pacientes con cáncer colorrectal y describir el tratamiento endoscópico en estos pacientes.
Se realizó un estudio retrospectivo en pacientes con cáncer colorrectal sometidos a cirugía y anastomosis, evaluados mediante colonoscopia entre 2014 y 2019.
De los 213 pacientes incluidos en el estudio, el 18.3% presentó una estenosis que fue asociada con el tipo de cirugía. La resección interesfintérica fue un factor de riesgo (OR = 18.81 IC 95%: 3.31-189.40, p < 0.001). El 69.2% de los pacientes con estenosis tenían un estoma, que fue identificado como factor de riesgo para estenosis (OR = 7.07, IC 95%: 3.10-16.57, p < 0.001). Se realizó anastomosis mecánica con engrapadora en el 87,4% de los pacientes que no presentaron estenosis, identificandose como factor de protección (OR = 0.41, IC 95%: 0.16-1.1, p = 0.04).
De los pacientes con estenosis el 69.2% de los pacientes requirieron tratamiento endoscópico con resultados favorables en el 83.3%. Solo el 2.6% de los pacientes tuvieron recurrencia y no se identificaron complicaciones asociadas al procedimiento.
La resección interesfintérica y la presencia de un estoma fueron factores de riesgo independientes para el desarrollo de estenosis; la anastomosis mecánica fue un factor protector contra el desarrollo de estenosis. El tratamiento endoscópico fue seguro y efectivo.
Benign strictures are frequent complications following colorectal surgery, with an incidence of up to 20%. Endoscopic treatment is safe and effective but there is not enough evidence for establishing stricture management at that anatomic level.
To determine the risk factors associated with the development of stricture in patients with colorectal cancer and describe endoscopic treatment in those patients.
A retrospective study was conducted on patients with colorectal cancer that underwent surgery and anastomosis, evaluated through colonoscopy, within the time frame of 2014 to 2019.
Of the 213 patients included in the study, 18.3% presented with stricture that was associated with the type of surgery. Intersphincteric resection was a risk factor (OR = 18.81, 95% CI: 3.31-189.40, p < .001). A total of 69.2% patients with stricture had a stoma, identifying it as a risk factor for stricture (OR = 7.07, 95% CI: 3.10-16.57, p < .001). Mechanical anastomotic stapling was performed in 87.4% of the patients that did not present with stricture, identifying it as a protective factor (OR = 0.41, 95% CI: 0.16-1.1, p = .04). Endoscopic treatment was required in 69.2% of the patients and provided favorable results in 83.3%. Only 2.6% of the patients had recurrence. No complications were reported.
Intersphincteric resection and the presence of a stoma were independent risk factors for stricture, and mechanical anastomosis was a protective factor against stricture development. Endoscopic treatment was safe and effective.
Benign strictures are frequent complications following colorectal surgery, with an incidence of up to 20%. Endoscopic treatment is safe and effective but there is not enough evidence for establishing ...stricture management at that anatomic level.
To determine the risk factors associated with the development of stricture in patients with colorectal cancer and describe endoscopic treatment in those patients.
A retrospective study was conducted on patients with colorectal cancer that underwent surgery and anastomosis, evaluated through colonoscopy, within the time frame of 2014 to 2019.
Of the 213 patients included in the study, 18.3% presented with stricture that was associated with the type of surgery. Intersphincteric resection was a risk factor (OR = 18.81, 95% CI: 3.31-189.40, p < 0.001). A total of 69.2% patients with stricture had a stoma, identifying it as a risk factor for stricture (OR = 7.07, 95% CI: 3.10-16.57, p < 0.001). Mechanical anastomotic stapling was performed in 87.4% of the patients that did not present with stricture, identifying it as a protective factor (OR = 0.41, 95% CI: 0.16-1.1, p = 0.04).
Endoscopic treatment was required in 69.2% of the patients and provided favorable results in 83.3%. Only 2.6% of the patients had recurrence. No complications were reported.
Intersphincteric resection and the presence of a stoma were independent risk factors for stricture, and mechanical anastomosis was a protective factor against stricture development. Endoscopic treatment was safe and effective.
Las estenosis benignas son complicaciones frecuentes posterior a la cirugía colorectal con una incidencia hasta del 20%. El tratamiento endoscópico es seguro y efectivo pero no hay evidencia suficiente para establecer el manejo de las estenosis a este nivel.
Determinar los factores de riesgo asociados al desarrollo de estenosis en pacientes con cáncer y describir el tratamiento endoscópico en estos pacientes
Es un estudio retrospectivo en pacientes con cáncer colorectal sometidos a cirugìa y anastomosis valorados por colonoscopia entre el 2014 y 2019.
Se incluyeron 213 pacientes, 18.3% con estenosis, la cual se asoció con el tipo de cirugía, siendo la RIE un factor de riesgo OR = 18.81 (IC95% 3.31- 189.40, p < 0.001). La presencia de estoma fue de 69.2% en los pacientes con estenosis identificándose como factor de riesgo para estenosis OR = 7.07 (3.10 - 16.57, p < 0.001). Las anastomosis se hicieron de forma mecánica en el 87.4% de los pacientes sin estenosis, siendo identificado como factor protector OR = 0.41 (IC 0.16 - 1.1, p = 0.04).
El 69.2% requirieron tratamiento endoscópico con resultados favorables en el 83.3% y recurrencia en el 2.6% únicamente. No se reportaron complicaciones.
La RIE y la presencia de un estoma son factores de riesgo independiente para estenosis y la conformación mecánica de la anastomosis como un factor protector contra el desarrollo de estenosis. El tratamiento endoscópico es una opción segura y efectiva.
gastric cancer (GC) is a gastrointestinal (GI) neoplasia which often complicates with GI bleeding. It is uncertain if bleeding worsens mortality in this group of patients.
to compare 30- and 90-day ...mortality in patients with unresectable GC (uGC) and tumor bleeding versus patients with the same neoplasia without bleeding.
a retrospective analysis of patients with uGC, with and without tumor bleeding was performed. Survival analysis for 30- and 90-days mortality was performed using Cox regression. Logistic regression was used to identify risk factors associated with mortality and first bleeding episode.
202 patients were included in the analysis (105 cases). Mortality at 90 days was 37.14 % for cases and 20.62 % for controls (p = 0.04). There was a significant difference in hazard ratio (HR) at 90 days for cases compared to controls (HR 1.95, 95 % CI 1.14-3.34, p = 0.02). Cases without palliative chemotherapy had the highest 90-days mortality (HR 5.43, 95 % CI 2.12-13.87, p < 0.01), compared to controls treated with chemotherapy. Predictors for first tumor bleeding were clinical stage IV (OR 2.93, 95 % CI 1.04-8.26, p = 0.04), Helicobacter pylori infection (OR 2.80, 95 % CI 1.35-5.80, p < 0.01) and histologic intestinal-subtype (OR 2.14, 95 % CI 1.07-4.30, p = 0.03).
tumor bleeding increases 90-days mortality in patients with uGC. Prevention of the first bleeding episode might improve outcome in these patients and the recognition of high-risk patients might help decision-making.
The oblique-view echoendoscope is currently the sole tool for ultrasound-guided endoscopic procedures (EUS) in most hospital centers, despite its limitations like a lack of forward vision, issues ...with needle angle, and restricted accessory device size due to channel angulation. However, our study revealed no significant differences between the oblique and frontal endoscopes, except for minor variations in specific regions. For routine diagnostic studies, interchangeability between the devices is feasible. The anticipated advantages of the frontal device may emerge more prominently in future therapeutic procedures. This suggests that, while the oblique-view echoendoscope remains the primary tool, the frontal device holds potential for evolving roles in diagnostic and therapeutic interventions.
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