Search results for "Esophageal"
showing 10 items of 523 documents
Supra-esophageal manifestations of gastroesophageal reflux, a different diagnostic approach and an indication for laparoscopic Nissen fundoplication:…
2004
24-hour oesophageal pH monitoring with a dual pH probe is considered to be the most sensitive test for diagnosing GORD-related otolaryngological manifestations. In this study we evaluate an initial diagnostic approach with digital videofluorography associated to the water siphon test and primary "ex juvantibus" therapy with proton pump inhibitors for patients with supra-oesophageal symptoms of GORD. The results of Nissen fundoplication surgical treatment are also assessed in some of these patients. Two hundred and thirty patients with suspected GORD-related supra-oesophageal symptoms were referred for videofluorography and the water siphon test. When hiatal hernia and/or reflux were found, …
Efficacy of pneumatic dilatation for the treatment of idiopatic achalasia: a single-center experience
2015
Pneumatic dilatation (PD) and Surgical Miotomy (SM) are presently the best treatments for untreated achalasia, with similar efficacy. There is no information on the relative efficacy of PD in younger compared to older patients. Aim of our study was to compare success rate and safety of PD in patients under fifty years old and in those over fifty years old affected by achalasia. Twenty consecutive symptomatic patients were treated in our Unit with graded PD under fluoroscopic view. Five male and 15 female with a median age of 47 years were treated. Twelve patients were less than fifty years old (group I) while 8 were older (group II). Median dysphagia questionnaire score was 14 and13 ingroup…
Immune checkpoint inhibitors plus chemotherapy versus chemotherapy or immune checkpoint inhibitors for first- or second-line treatment of advanced ga…
2019
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the efficacy and safety of immune checkpoint inhibitors, alone or in combination with chemotherapy, in people with advanced gastric and gastroesophageal junction adenocarcinoma in first and subsequent treatment lines.
Emergency sclerotherapy or band ligation combined with vasoactive drugs for bleeding esophageal varices in cirrhosis
2019
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the efficacy as well as adverse events of emergency sclerotherapy (or band ligation) combined with pharmacological treatments versus sclerotherapy (or band ligation) alone or vasoactive drugs alone for acute variceal bleeding in cirrhotic patients based on the results of randomised clinical trials (RCTs).
Immunohistochemical/histochemical double staining method in the study of the columnar metaplasia of the oesophagus
2014
Intestinal metaplasia in Barrett’s oesophagus (BO) represents an important risk factor for oesophageal adenocarcinoma. Instead, few and controversial data are reported about the progression risk of columnar-lined oesophagus without intestinal metaplasia (CLO), posing an issue about its clinical management. The aim was to evaluate if some immunophenotypic changes were present in CLO independently of the presence of the goblet cells. We studied a series of oesophageal biopsies from patients with endoscopic finding of columnar metaplasia, by performing some immunohistochemical stainings (CK7, p53, AuroraA) combined with histochemistry (Alcian-blue and Alcian/PAS), with the aim of simultaneousl…
Ramucirumab and its use in gastric cancer treatment
2014
Abstract: The inhibition of the mechanisms of tumor neo-angiogenesis represents a milestone that in the last 10 years has seen the advent of numerous molecules to target action against the vascular endothelial growth factor (VEGF). More recently, new molecules have been developed that inhibit tumor spread by the blockade of specific VEGF receptors (VEGFRs), thereby preventing the binding of a ligand to its receptor and the cascade of proliferative events downstream. Ramucirumab is a fully humanized IgG1 monoclonal antibody that performs its action by blocking the isoform 2 of the VEGF receptor (VEGFR-2). Numerous preclinical and clinical studies have demonstrated its activity in several sol…
Persistent and recurrent achalasia after Heller myotomy: analysis of different patterns and long-term results of reoperation.
2007
Hypothesis Two groups of patients with inadequate therapeutic success after surgical treatment for achalasia can be identified, patients with type 1 recurrence (early recurrence after technical failure of myotomy or a scarring process requiring remyotomy) and patients with type 2 recurrence (late recurrence with irreversible progression of the disease and development of megaesophagus requiring esophagectomy). Design Prospective study. Setting University-based tertiary care center. Patients One hundred sixty-three patients undergoing surgery for achalasia during 20.3 years. Interventions Conventional remyotomy for type 1 recurrence (group 1) and esophagectomy (transhiatal or transthoracic) f…
Long-term results of conventional myotomy in patients with achalasia: a prospective 20-year analysis.
2006
Myotomy has proved to be an efficient primary therapy in patients with achalasia, especially in younger patients (<40 years of age). The results of laparoscopic myotomy cannot be finally assessed, on account of the shorter postoperative follow-up. Thus, there are considerable data regarding intermediate-term outcomes after laparoscopic myotomy. The aim of our study was a 20-year analysis of the conventional cardiomyotomy as the underlying basis assessing the results of minimal-invasive surgery. Within 20 years (September 1985 through September 2005), 161 operations for achalasia were performed in our clinic. Enrolled in this study were 108 patients with a conventional, transabdominal myotom…
Effects of pneumatic dilation and myotomy on esophageal function and morphology in patients with achalasia.
2005
Only two treatment modalities–pneumatic dilation and Heller myotomy–promise long-term relief from dysphagia and regurgitation in patients with achalasia. The objective of this study was to determine whether both options differ in their effects on esophageal function, morphology, and improvement in symptoms. Eighty-nine patients diagnosed with achalasia between January 1980 and December 2002 at a single center were enrolled in this study. Sixty-four patients underwent pneumatic dilation and 25 Heller myotomy in combination with an anterior semifundoplication (Dor procedure). Clinical evaluation (Eckardt-Score), esophageal manometry, and barium swallow were performed before and within 6 mont…
Impact of Minimally Invasive Surgery in the Spectrum of Current Achalasia Treatment Options
2011
Minimally invasive Heller myotomy has evolved the “gold standard” procedure for achalasia in the spectrum of current treatment options. The laparoscopic technique has proved superior to the thoracoscopic approach due to improved visualization of the esophagogastric junction. Operative controversies most recently include the length of the myotomy, especially of its fundic part, with respect to the balance between postoperative persistent dysphagia and development of gastroesophageal reflux, as well as the type of the added antireflux procedure. Perioperative mortality should approach 0%, and favorable long-term results can be achieved in > 90%.