Search results for "Digestive System"
showing 10 items of 1747 documents
Esophageal abnormalities in morbidly obese adult patients.
2015
Abstract Background An increase in body mass index has been found to be associated with an increase in the prevalence of gastroesophageal reflux disease (GERD) symptoms, esophageal mucosal injury, and GERD complications. Few systematic studies with objective tests have evaluated esophageal disorders in the morbidly obese population. Objectives To define more precisely in morbidly obese people the incidence of esophageal symptoms and characterize the esophageal disorders using objective data. Setting University Hospital, Spain. Methods Two hundred twenty-four presurgical morbidly obese patients were submitted to a protocol including a clinical history and objective tests (endoscopy, stationa…
Long-term followup of the intussuscepted ileal nipple and the in situ, submucosally embedded appendix as continence mechanisms of continent urinary d…
2006
We analyzed stoma related complications and continence rates in patients who underwent continent urinary diversion with the cutaneous ileocecal pouch (Mainz pouch I). We compared the intussuscepted ileal nipple and in situ, submucosally embedded appendix as continence mechanisms.A total of 401 patients were included in a retrospective followup study. Continence mechanisms were the intussuscepted ileal nipple in 205 patients and the in situ, submucosally embedded appendix in 196.A total of 144 patients (36%) required intervention for a stomal complication. Of patients who received an intussuscepted ileal nipple 34 (17%) had stomal stenosis at a mean time to first stenosis of 43.8 months, 41 …
Small-Bowel Diagnosis in Patients with Familial Adenomatous Polyposis: Comparison of Push Enteroscopy, Capsule Endoscopy, Ileoscopy, and Enteroclysis
2009
BACKGROUND: Conventional upper endoscopy (EGD), EGD with side-view endoscope and ileoscopy are established procedures for endoscopic evaluation of patients with familial adenomatous polyposis (FAP). However, we still have little data on the frequency and relevance of adenomas in those parts of the small bowel which are not accessible to EGD and ileoscopy. Adenomas distal to the duodenum are found more often in FAP patients with known duodenal adenomas. The question is, whether these patients can benefit from additional endoscopic and/or radiographic examinations. METHODS: Between July 2001 and August 2006 we performed comparative small bowel studies with push enteroscopy (PE), capsule endos…
Advancement flap in the management of chronic anal fissure: A prospective study
2012
Lateral internal sphincterotomy is the surgical treatment of choice of chronic anal fissure after failure of conservative measures. Several randomized trials identified an overall risk of incontinence of 10 % mostly for flatus. Fissurectomy is the most commonly used procedure to preserve the integrity of the anal sphincters. However, a possible complication is keyhole defect that may lead to faecal soiling. In this study, chronic anal fissure (CAF) was treated by fissurectomy and anal advancement flap to preserve the anatomo-functional integrity of sphincters and to reduce healing time and the risk of anal stenosis. In patients with hypertonia, surgical treatment was combined with chemical …
Accuracy of magnetic resonance enterography in the preoperative assessment of patients with Crohn's disease of the small bowel
2016
Aim to assess the accuracy of magnetic resonance-enterography in predicting the extension, location and characteristics of the small bowel segments affected by Crohn's disease. Method This is a prospective study including a consecutive series of 38 patients with small bowel Crohn's disease who underwent surgery at a specialized colorectal unit of a tertiary hospital. Preoperative magnetic resonance enterography was performed in all patients, following a homogeneous protocol, within the three months prior to surgery. A thorough exploration of the small bowel was performed during the surgical procedure, using calibration spheres, according to the discretion of the surgeon. The accuracy of mag…
Metabolic and psychosocial effects of minimal invasive gastric banding for morbid obesity
2003
Obesity is considered a primary risk factor for cardiovascular disease and related mortality. The current study aimed to investigate the efficacy of minimal invasive gastric banding (GB) surgery for reducing caloric intake in morbid obesity, and to analyze the effects of weight loss on body composition and metabolic and psychosocial outcomes. Twenty-six adult severely obese patients (mean body mass index [BMI], 48.1 kg/m(2); range, 42 to 56) underwent adjustable silicone laparoscopic GB. Nine additional obese patients who declined surgery were treated with metformin (2 g daily) and served as a small additional group (BMI, 50.5 kg/m(2); range, 41 to 68). Presurgery and 17 +/- 2.2 months post…
Role of the GALAD and BALAD-2 Serologic Models in Diagnosis of Hepatocellular Carcinoma and Prediction of Survival in Patients.
2016
Background & Aims GALAD and BALAD-2 are statistical models for estimating the likelihood of the presence of hepatocellular carcinoma (HCC) in individual patients with chronic liver disease and the survival of patients with HCC, respectively. Both models use objective measures, particularly the serum markers α-fetoprotein (AFP), AFP-L3, and des-γ-carboxyprothrombin. We aimed to validate these models in an international cohort of patients with HCC and assess their clinical performance. Methods We collected data on cancer diagnosis and outcomes of 6834 patients (2430 with HCC and 4404 with chronic liver disease) recruited from Germany, Japan, and Hong Kong. We also collected data from 229 pati…
An endoscopic approach to the management of surgical bile duct injuries: nine years’ experience
2003
Abstract Background. The evaluation of the endoscopic treatment of surgical bile duct injuries, especially in the management of post-operative strictures, remains controversial. Aim. The aim of this study was to evaluate the feasibility of using endoscopic management from a study of the clinical reports of two of the main endoscopy units in Sicily. Patients and methods. A total of 137 consecutive patients were selected. There were 85 simple biliary fistulas: 64 from the cystic duct stump; 19 from the gall bladder bed; and two from intra-hepatic bile ducts. There were 52 biliary lesions: 15 complete transections; 12 incomplete lesions of the common bile duct with six associated strictures; f…
Prospective randomized comparison of short-access mother-baby cholangioscopy versus direct cholangioscopy with ultraslim gastroscopes
2012
Mother-baby technologies, the criterion standard for cholangioscopy, have several limitations. A novel, short-access, mother-baby (SAMBA) system may improve this technique. Direct cholangioscopy (DC) was recently developed as an alternative to mother-baby cholangioscopy.Comparison of success rates with SAMBA and DC.Single-center, randomized, controlled trial.Academic tertiary-care referral center.Sixty patients with suspected cholangiopathies randomized to either SAMBA (n = 30) or DC (n = 30).Cholangioscopy under deep sedation.Technical success rate of diagnostic or therapeutic procedure.A total of 24 and 21 diagnostic procedures were performed in the SAMBA and DC groups, respectively. Ther…
Hepatocellular carcinoma (HCC) vs. non-HCC: accuracy and reliability of Liver Imaging Reporting and Data System v2018
2019
PURPOSE: The Liver Imaging Reporting and Data System (LI-RADS) was created to standardize the diagnostic criteria for hepatocellular carcinoma (HCC), and has undergone multiple revisions including a recent update in 2018 (v2018). The primary aim of this study was to determine the diagnostic performance and interrater reliability (IRR) of LI-RADS v2018 for distinguishing HCC from non-HCC primary hepatic malignancy in patients ‘at-risk’ for HCC. A secondary aim was to assess the impact of changes introduced in the v2018 diagnostic algorithm. METHODS: This retrospective study combined a 10-year experience of pathologically-proven primary liver malignancies from two large liver transplant cente…