China
Africa
Explore chapters and articles related to this topic
Regional Therapy of Liver Metastases: A Surgeon’s View
Published in Neville Willmott, John Daly, Microspheres and Regional Cancer Therapy, 2020
Patients are followed up with serial visits every 2 weeks when their pump is filled and they are asked about symptoms or side effects of therapy, such as weakness and abdominal pain. Liver function tests and complete blood counts are performed at each visit and plasma CEA levels are taken at alternate visits. An abdominal CT scan is performed at 2 months and thereafter as necessary. Esophagogastroduodenoscopy is performed for patients who describe epigastric pain, fullness, or vomiting.
Familial Adenomatous Polyposis
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Mariann Unhjem Wiik, Bente A. Talseth-Palmer
Surveillance is done by esophagogastroduodenoscopy, and the frequency is determined by the severity of the polyps [13]. There is no consensus regarding the initiation of surveillance, but the EHTG recommends starting between 25–30 years of age, as duodenal cancer before 30 years of age has shown to be extremely rare [2]. The surveillance can also be adjusted according to changes in the Spigelman classification within the individual patient and necessary treatment initiated. A side-viewing endoscope should be used to get proper visualization of the papilla and a tissue biopsy of the papilla if it is enlarged, even if no polyps are detected [2]. In addition, endoscopic retrograde cholangiopancreatography may be necessary for the surveillance of adenomas of the common bile duct [13]. Routine small bowel screening distal to the duodenum is not recommended, as cancer rarely develops here [121].
Electrocoagulation Of Vascular Abnormalities Of The Large Bowel
Published in John P. Papp, Endoscopie Control of Gastrointestinal Hemorrhage, 2019
In the clinical setting of lower gastrointestinal blood loss of obscure source in elderly patients, mucosal vascular abnormality of the cecal area should be included in the differential diagnosis, especially if hypertension, diabetes mellitus or cardiac, vascular, or pulmonary disease is also present. Colonoscopy is usually the easiest method for demonstrating the lesion in the living patient. When properly performed, electrocoagulation with biopsy during endoscopy is safe and effective. In addition, histologic confirmation of the vascular nature of the lesion is obtained. If endoscopic therapy has eradicated all abnormal vascular tissue from the large bowel, and if blood loss persists, then a bleeding point higher in the gastrointestinal tract should be suspected. An attempt at examining the distal terminal ileum with the colonoscope should be made. Esophagogastroduodenoscopy should be performed in anticipation of demonstrating a mucosal vascular abnormality in the upper GI tract, where electrocoagulation can also be performed. If both upper and lower endoscopy are negative, selective angiography of the superior mesenteric artery should be recommended. Angiography is also recommended if the colonoscopist fails to reach the cecum. Surgical therapy is recommended for all lesions demonstrated angiographically which are beyond the reach of the endoscopist. However, at exploration, the surgeon would be wise to seek other causes which may explain the patient’s blood loss.
Association of Candida esophagitis with acute esophageal necrosis
Published in Baylor University Medical Center Proceedings, 2022
Muhammad Sheharyar Warraich, Bashar Attar, Shazaq Khalid, Muhammad Ali Khaqan
AEN is exceedingly rare, with an incidence of 0.01% to 0.28%.3 It was first described in 1914 by Brekke et al but did not get its current name until 1990.2,4 Some commonly described risk factors associated with this condition include renal insufficiency, diabetes mellitus, hypertension, atherosclerotic vascular disease, sepsis, and hypothermia.5 Mucosal barrier dysfunction seems to be the common endpoint of the different theories that have attempted to explain the pathogenesis of AEN. AEN typically occurs in critically ill patients who have multiple chronic conditions. It usually presents with upper gastrointestinal bleeding, but patients may display other symptoms like nausea, vomiting, dysphagia, and abdominal pain. Diagnosis is made on direct visualization during esophagogastroduodenoscopy. Biopsy is associated with a small risk of perforation and is supportive but not required for the diagnosis. It can help rule out infections and some other similar-appearing conditions like melanosis, melanoma, and acanthosis nigricans. Treatment is mostly supportive and includes aggressive hydration, proton pump inhibitors, and antimicrobials for cases that have a histologically confirmed infection. Total parenteral nutrition is a consideration for such patients due to the risk of perforation associated with the use of enteral tubes. Surgical management is necessary for the subset of patients whose disease is complicated by perforation or mediastinal disease. AEN is known to have a high mortality rate, with one study suggesting a rate up to 28%.6
Assessing the Prognostic Value of Extranodal Extension in Esophageal Cancer from the Pathological Staging Perspective
Published in Journal of Investigative Surgery, 2022
Masato Hayashi, Makoto Abe, Takeshi Fujita, Hisayuki Matsushita
The included patients had been treated according to the current guidelines for esophageal cancer [19,20]. Although neoadjuvant chemotherapy is currently a standard treatment for resectable advanced esophageal cancer in Japan, some patients did not receive that treatment because they were treated before this strategy became standard or because primary surgery was preferred for patients who found oral intake difficult. Postoperative surveillance was performed using esophagogastroduodenoscopy every year and computed tomography every 6 months for ≥5 years after surgery. Overall survival (OS) and disease-free survival (DFS) were calculated from the day after surgery to the day of death or recurrence. The analyses also considered grade III or higher complications based on the Clavien–Dindo classification system [21,22].
Appropriate endoscopic treatment selection and surveillance for superficial non-ampullary duodenal epithelial tumors
Published in Scandinavian Journal of Gastroenterology, 2021
Kingo Hirasawa, Yuichiro Ozeki, Atsushi Sawada, Chiko Sato, Ryosuke Ikeda, Masafumi Nishio, Takehide Fukuchi, Ryosuke Kobayashi, Makomo Makazu, Masataka Taguri, Shin Maeda
No deaths were attributed to mucosal neoplasms. In our study, 185 of the 189 enrolled patients underwent a scheduled esophagogastroduodenoscopy. Our results demonstrated that no cases that underwent complete resection experienced local recurrence across all the ER modalities. Local recurrence only occurred in cases of incomplete resections. Besides, all cases with local recurrence were handled with repeat ER. Importantly, given that the time from the day of ER to local recurrence ranged from 385 to 1727 days, a minimum of 3 years of endoscopic surveillance is advised. Although this study excluded patients with familial polyposis syndrome, three patients with a metachronous incidence of small bowel neoplasms were noted. Notably, one case had an advanced ileal carcinoma 5 years after the initial endoscopic treatment of a submucosal invasive duodenal carcinoma triggered by an increase in serum CEA level. Because there have been no reports dealing with the significance of the whole intestine examination for patients with duodenal neoplasms, further studies using video capsule endoscopy may be needed.