submit url • add directory • Physician Assistant jobs ♦ Nurse Practitioner jobs
Today's News:
Surgical Endoscopy (Browse Results)
Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases)
Sat, 19 May 2012 07:26:10 -0000
Abstract Background The aim of this study was to investigate the management and treatment for complications during and after peroral endoscopic myotomy (POEM) for patients suffering from esophageal achalasia (EA). Methods The data of 119 cases of EA patients who underwent POEM from October 2010 to July 2011 and the complications that arose during the operation, after the operation, and during follow-up were analyzed. Results Complications that occurred during the operation included cutaneous emphysema (22.7 %, 27/119) and pneumothorax (2.5 %, 3/119). Postoperative complications included pneumothorax (25.2 %, 30/119), subcutaneous emphysema (55.5 %, 66/119), mediastinal emphysema (29.4 %, 35/119), delayed hemorrhage (0.8 %, 1/119), pleural effusion (48.7 %, 58/119), minor inflammation or segmental atelectasis of the lungs (49.6 %, 59/119), and gas under diaphragm or aeroperitoneum (39.5 %, 47/119). Complications that occurred during follow-up included one case of difficulty eating caused by the stricture of mucosa and one case of dehiscence at the mouth of the tunnel created during surgery, with food retention. No deaths occurred. All complications were resolved through traditional treatment. No additional surgery was needed. Conclusion Complications arising during and after POEM should be treated quickly and can be resolved by using traditional treatment. POEM can be expected to become the preferred treatment for EA. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-012-2336-yAuthors Zhong Ren, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaYunshi Zhong, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaPinghong Zhou, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaMeidong Xu, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaMingyan Cai, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaLiang Li, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaQiang Shi, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaLiqing Yao, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 China Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Colorectal polyps: when should we tattoo?
Sat, 19 May 2012 07:26:09 -0000
Abstract Background Current guidelines recommend tattooing of suspicious-looking lesions at colonoscopy without a reference to the size of the polyp. However, the endoscopist has to make a judgement as to which lesion may be malignant and require future localisation based on the appearance and size of the polyp. The aim of this study was to determine the relationship between endoscopic polyp size and invasive colorectal cancer so as to inform tattooing practice for patients taking part in the national bowel cancer screening programme (BCSP). Methods Data of BCSP patients who had undergone a polypectomy between October 2008 and October 2010 were collected from a prospectively maintained hospital endoscopic database. Histology data were obtained from electronic patient records. Results A total of 165 patients had undergone 269 polypectomies. Their median age was 66 years and 66 % were men. The mean endoscopic polyp size was 10.7 mm (SD = ±8 mm). Histologically, 81 % were neoplastic with 95 % showing low-grade and 5 % high-grade dysplasia. Eight patients were found to have invasive malignancy within their polyp. The risk of invasive malignancy within a polyp was 0.7 % (1/143) when the endoscopic polyp size was <10 mm; the risk increased to 2.4 % (2/83) when the polyp size was 10–19 mm and 13 % (5/40) when the polyp was >20 mm. This trend was statistically significant (p = 0.001). About 23 % of the patients had the site of their polyp tattooed; the mean size of the tattooed polyps was 21 mm (range = 15–50 mm). Consequently, 25 % of malignant polyps and 63 % of polyps with high-grade dysplasia were not tattooed. Conclusion The risk of polyp cancer among BCSP patients increases significantly when the endoscopic polyp size is ≥10 mm. We recommend that all polyps ≥10 mm be tattooed. Content Type Journal ArticlePages 1-3DOI 10.1007/s00464-012-2335-zAuthors Ali Zafar, Department of General and Colorectal Surgery, Good Hope Hospital, Heart of England NHS Trust, Rectory Road, Sutton Coldfield, West Midlands, B75 7RR UKMohammed Mustafa, Department of General and Colorectal Surgery, Good Hope Hospital, Heart of England NHS Trust, Rectory Road, Sutton Coldfield, West Midlands, B75 7RR UKMark Chapman, Department of General and Colorectal Surgery, Good Hope Hospital, Heart of England NHS Trust, Rectory Road, Sutton Coldfield, West Midlands, B75 7RR UK Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Cryorecanalization: keys to success
Sat, 19 May 2012 07:26:09 -0000
Abstract Background Symptomatic airway obstructions are common with endobronchial exophytic tumors and may result in lethal complications. Recently, a cryorecanalization procedure has emerged that plays a role in the immediate management of airway obstruction. This study was conducted to investigate the value of cryorecanalization for the immediate management of endobronchial obstructive pathology and to determine the factors that affect the success of the procedure. Methods We analyzed 40 patients with symptoms of airway obstruction who were admitted to our hospital from 2006 to 2010. Patients with exophytic stenosis due to primary bronchial or metastatic neoplasms who underwent cryorecanalization procedures were included. Patients were excluded if they had involvement of a major artery near the site of the intervention. The procedure was not performed on patients with coagulation abnormalities or thrombocyte count and aggregation problems. The data were collected retrospectively. Results Successful cryorecanalization was achieved in 72.5 % of patients. We found that the success rate was mainly related to the presence of the distal involvement and the older age of obstruction. Restenosis rate was 12.8 %. The mean survival time after the cryorecanalization procedure was 11 ± 12.7 months. No complications occurred in 14 patients. No severe bleeding was observed for any patients, and moderate hemorrhaging occurred in ten patients, which was stopped with an argon plasma coagulator. We experienced no intraoperative mortality. Conclusions Cryorecanalization is a successful and safe intervention for the immediate management of endobronchial stenosis. Appropriate patient selection and high success rates should be achieved after careful radiological assessments and with early management. Content Type Journal ArticleCategory Endoluminal SurgeryPages 1-6DOI 10.1007/s00464-012-2260-1Authors Aydın Yılmaz, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, TurkeyZafer Aktaş, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, Turkeyİbrahim Onur Alici, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, TurkeyAtalay Çağlar, Department of Econometrics, Pamukkale University, Denizli, TurkeyHilal Sazak, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, TurkeyFatma Ulus, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, Turkey Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Thoracoscopic coaxial cutting needle biopsy for clinically suspected lung cancer: technical details, diagnostic accuracy, and probable complications
Sat, 19 May 2012 07:26:08 -0000
Abstract Background Little has been described regarding the technical details, diagnostic accuracy, and probable complications of thoracoscopic cutting needle biopsy, which seems to be preferable to transthoracic needle biopsy for patients scheduled to undergo surgery for suspected lung cancer. Methods This study was a retrospective analysis of a prospective database of patients who underwent surgical biopsy for suspected lung cancer (n = 176). Sixty-two patients underwent thoracoscopic cutting needle biopsy, which was performed via thoracoport using a 16 gauge coaxial cutting needle; the remaining 114 patients underwent excisional biopsy, followed by curative intent surgery. Results The sensitivity and specificity of diagnosing lung cancer by thoracoscopic needle biopsy were 57/59 (96.6%) and 1/3 (33.3%), respectively. One false-negative result and one undiagnostic result occurred, but both lesions were correctly re-diagnosed by backup excisional biopsy during the same operation. When analysis was restricted to patients with lung lesions predominantly presenting with ground glass opacity, the sensitivity and specificity were 13/14 (92.9%) and 1/1 (100%), respectively. The sensitivity, specificity, and accuracy of diagnosing lung cancer by surgical biopsy in all patients were 164/165 (99.4%), 9/11 (81.8%), and 173/176 (98.3%), respectively. Pleural recurrence was identified in one patient after thoracoscopic needle biopsy whose pleural lavage cytology, performed before biopsy, was negative. Conclusions Thoracoscopic cutting needle biopsy can be effectively applied to patients with an indeterminate lung tumor, especially those patients with lesions possessing ground glass opacity. However, further evaluation is necessary to confirm the risk of pleural dissemination induced by this procedure. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-2115-1Authors Kazuhiro Ueda, Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanToshiki Tanaka, Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanMasataro Hayashi, Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanNobuyuki Tanaka, Division of Radiology, Department of Radiopathology and Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanYoshinobu Hoshii, Department of Surgical Pathology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanKimikazu Hamano, Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Kidney safety during surgical pneumoperitoneum: an experimental study in rats
Sat, 19 May 2012 07:26:06 -0000
Abstract Background Elevations of intraabdominal pressure during laparoscopic procedures may lead to oliguria or anuria in mammals. Despite this, previous research has not been able to confirm an associated kidney injury. This study aimed to investigate the occurrence of an early kidney lesion secondary to surgical pneumoperitoneum in a rat model using the expression of neutrophil gelatinase-associated lipocalin (N-GAL) as a biomarker for early kidney injury. Methods In this study, 20 male Sprague-Dawley rats under general anesthesia and mechanically ventilated were allocated to one of five experimental time-dependent groups: group 1 (1-h control), group 2 (1-h pneumoperitoneum), group 3 (2-h control), group 4 (2-h pneumoperitoneum), and group 5 (positive kidney injury group induced by intravenous administration of cisplatin 7.5 mg/kg). To evaluate the renal expression of N-GAL 24 h after the procedure, all the rats underwent a 2-h urine output evaluation as well as laparotomy and bilateral nephrectomy performed sequentially to investigate the presence of renal injury using immunofluorescence qualification and western blotting. Results Urine output was reduced and N-GAL expression was increased in the animals from the cisplatin group. The animals undergoing 1- or 2-h pneumoperitoneum displayed urine output and N-GAL expression similar to that of the animals from the matching control groups. Conclusions Under the experimental conditions of this study, the animals with normal preoperative renal function did not show any type of acute kidney injury associated with the presence of a stabilized surgical pneumoperitoneum. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-012-2322-4Authors Rogério Fortunato de Barros, Division of Pediatric Surgery, University of Campinas, Campinas, SP, BrazilMárcio Lopes Miranda, Division of Pediatric Surgery, University of Campinas, Campinas, SP, BrazilAmilcar Castro de Mattos, Department of Pathology, University of Campinas, Campinas, SP, BrazilJosé Antonio Rocha Gontijo, Laboratório de Metabolismo Hidro-Salino, Núcleo de Medicina e Cirurgia Experimental, University of Campinas, Campinas, SP, BrazilVinicius Rodrigues Silva, Laboratório de Metabolismo Hidro-Salino, Núcleo de Medicina e Cirurgia Experimental, University of Campinas, Campinas, SP, BrazilBrayner Iorio, Division of Pediatric Surgery, University of Campinas, Campinas, SP, BrazilJoaquim M. Bustorff-Silva, Division of Pediatric Surgery, University of Campinas, Campinas, SP, Brazil Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Outcome and safety of self-expandable metallic stents for malignant colon obstruction: a Korean multicenter randomized prospective study
Sat, 19 May 2012 07:26:04 -0000
Abstract Background Newly developed uncovered stents are designed to have varied radial force and high conformability to improve clinical outcome and safety. This study aimed to determine and compare the clinical outcome and safety of the Taewoong D-type uncovered stent and the Boston Scientific Wallfex stent. Methods Patients with acute malignant colonic obstruction were treated with a colonic stent. For the purpose of palliation, patients were randomly allocated. For the purpose of bridging, the type of stent was determined by the discretion of the individual doctors. Technical and clinical success and complication occurrence were measured as primary outcomes. Results From 12 university hospitals, 123 patients with malignant colonic obstruction were enrolled. Of these 123 patients, 58 were treated with colonic stents for palliative purposes. The technical and clinical success rate was 100 % for both stents in the palliative group. Perforation occurred for one patient (3.6 %) in the Wallflex stent group (n = 28) on day 5 and for no patients in the D-type stent group (n = 30). Two cases of migration occurred: one with the Wallflex stent and one with the D-type stent. Stent restenosis occurred for one patient with the Wallflex stent. Preoperative bridging stents were placed in 65 patients. The median time to surgery was 10 days. The technical success rate was 93.4 %, and clinical success was achieved for 86.2 % of the patients. Perforation occurred for five patients: four with the Wallflex stent and one with the D-type stent. The efficacy and safety of the two stents did not differ statistically. Conclusions The D-type colonic uncovered stent and the Wallflex colonic uncovered stent are effective and safe for both palliative and preoperative bridging therapy used to treat acute malignant colonic obstruction. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-012-2300-xAuthors Dae Young Cheung, The Catholic University of Korea College of Medicine, Seoul, KoreaJin Yong Kim, Sungkyunkwan University School of Medicine, Seoul, KoreaSung Pil Hong, Yonsei University College of Medicine, Seoul, KoreaMin Kyu Jung, Kyungpook National University School of Medicine, Daegu, KoreaByong Duk Ye, University of Ulsan College of Medicine, Seoul, KoreaSang Gyun Kim, Seoul National University College of Medicine, Seoul, KoreaJin Hong Kim, Ajou University School of Medicine, Suwon, KoreaKang Moon Lee, The Catholic University of Korea College of Medicine, Seoul, KoreaKyung Ho Kim, Hallym University College of Medicine, Chuncheon, KoreaGwang Ho Baik, Hallym University College of Medicine, Chuncheon, KoreaHo Gak Kim, Catholic University of Daegu School of Medicine, Daegu, KoreaChang Soo Eun, Hanyang University College of Medicine, Seoul, KoreaTae Il Kim, Yonsei University College of Medicine, Seoul, KoreaSang Woo Kim, The Catholic University of Korea College of Medicine, Seoul, KoreaChang Duck Kim, Korea University College of Medicine, Seoul, KoreaChang Heon Yang, Department of Internal Medicine, Dongguk University College of Medicine, 707 Sukjang-dong, Kyongju, Kyongbuk, 780-714 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Subscribe to Endoscopic RSS feed 
Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases)
Sat, 19 May 2012 07:26:10 -0000
Abstract Background The aim of this study was to investigate the management and treatment for complications during and after peroral endoscopic myotomy (POEM) for patients suffering from esophageal achalasia (EA). Methods The data of 119 cases of EA patients who underwent POEM from October 2010 to July 2011 and the complications that arose during the operation, after the operation, and during follow-up were analyzed. Results Complications that occurred during the operation included cutaneous emphysema (22.7 %, 27/119) and pneumothorax (2.5 %, 3/119). Postoperative complications included pneumothorax (25.2 %, 30/119), subcutaneous emphysema (55.5 %, 66/119), mediastinal emphysema (29.4 %, 35/119), delayed hemorrhage (0.8 %, 1/119), pleural effusion (48.7 %, 58/119), minor inflammation or segmental atelectasis of the lungs (49.6 %, 59/119), and gas under diaphragm or aeroperitoneum (39.5 %, 47/119). Complications that occurred during follow-up included one case of difficulty eating caused by the stricture of mucosa and one case of dehiscence at the mouth of the tunnel created during surgery, with food retention. No deaths occurred. All complications were resolved through traditional treatment. No additional surgery was needed. Conclusion Complications arising during and after POEM should be treated quickly and can be resolved by using traditional treatment. POEM can be expected to become the preferred treatment for EA. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-012-2336-yAuthors Zhong Ren, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaYunshi Zhong, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaPinghong Zhou, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaMeidong Xu, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaMingyan Cai, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaLiang Li, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaQiang Shi, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 ChinaLiqing Yao, Endoscopy Center, Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, 200032 China Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Colorectal polyps: when should we tattoo?
Sat, 19 May 2012 07:26:09 -0000
Abstract Background Current guidelines recommend tattooing of suspicious-looking lesions at colonoscopy without a reference to the size of the polyp. However, the endoscopist has to make a judgement as to which lesion may be malignant and require future localisation based on the appearance and size of the polyp. The aim of this study was to determine the relationship between endoscopic polyp size and invasive colorectal cancer so as to inform tattooing practice for patients taking part in the national bowel cancer screening programme (BCSP). Methods Data of BCSP patients who had undergone a polypectomy between October 2008 and October 2010 were collected from a prospectively maintained hospital endoscopic database. Histology data were obtained from electronic patient records. Results A total of 165 patients had undergone 269 polypectomies. Their median age was 66 years and 66 % were men. The mean endoscopic polyp size was 10.7 mm (SD = ±8 mm). Histologically, 81 % were neoplastic with 95 % showing low-grade and 5 % high-grade dysplasia. Eight patients were found to have invasive malignancy within their polyp. The risk of invasive malignancy within a polyp was 0.7 % (1/143) when the endoscopic polyp size was <10 mm; the risk increased to 2.4 % (2/83) when the polyp size was 10–19 mm and 13 % (5/40) when the polyp was >20 mm. This trend was statistically significant (p = 0.001). About 23 % of the patients had the site of their polyp tattooed; the mean size of the tattooed polyps was 21 mm (range = 15–50 mm). Consequently, 25 % of malignant polyps and 63 % of polyps with high-grade dysplasia were not tattooed. Conclusion The risk of polyp cancer among BCSP patients increases significantly when the endoscopic polyp size is ≥10 mm. We recommend that all polyps ≥10 mm be tattooed. Content Type Journal ArticlePages 1-3DOI 10.1007/s00464-012-2335-zAuthors Ali Zafar, Department of General and Colorectal Surgery, Good Hope Hospital, Heart of England NHS Trust, Rectory Road, Sutton Coldfield, West Midlands, B75 7RR UKMohammed Mustafa, Department of General and Colorectal Surgery, Good Hope Hospital, Heart of England NHS Trust, Rectory Road, Sutton Coldfield, West Midlands, B75 7RR UKMark Chapman, Department of General and Colorectal Surgery, Good Hope Hospital, Heart of England NHS Trust, Rectory Road, Sutton Coldfield, West Midlands, B75 7RR UK Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Cryorecanalization: keys to success
Sat, 19 May 2012 07:26:09 -0000
Abstract Background Symptomatic airway obstructions are common with endobronchial exophytic tumors and may result in lethal complications. Recently, a cryorecanalization procedure has emerged that plays a role in the immediate management of airway obstruction. This study was conducted to investigate the value of cryorecanalization for the immediate management of endobronchial obstructive pathology and to determine the factors that affect the success of the procedure. Methods We analyzed 40 patients with symptoms of airway obstruction who were admitted to our hospital from 2006 to 2010. Patients with exophytic stenosis due to primary bronchial or metastatic neoplasms who underwent cryorecanalization procedures were included. Patients were excluded if they had involvement of a major artery near the site of the intervention. The procedure was not performed on patients with coagulation abnormalities or thrombocyte count and aggregation problems. The data were collected retrospectively. Results Successful cryorecanalization was achieved in 72.5 % of patients. We found that the success rate was mainly related to the presence of the distal involvement and the older age of obstruction. Restenosis rate was 12.8 %. The mean survival time after the cryorecanalization procedure was 11 ± 12.7 months. No complications occurred in 14 patients. No severe bleeding was observed for any patients, and moderate hemorrhaging occurred in ten patients, which was stopped with an argon plasma coagulator. We experienced no intraoperative mortality. Conclusions Cryorecanalization is a successful and safe intervention for the immediate management of endobronchial stenosis. Appropriate patient selection and high success rates should be achieved after careful radiological assessments and with early management. Content Type Journal ArticleCategory Endoluminal SurgeryPages 1-6DOI 10.1007/s00464-012-2260-1Authors Aydın Yılmaz, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, TurkeyZafer Aktaş, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, Turkeyİbrahim Onur Alici, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, TurkeyAtalay Çağlar, Department of Econometrics, Pamukkale University, Denizli, TurkeyHilal Sazak, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, TurkeyFatma Ulus, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, 06280 Ankara, Turkey Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Thoracoscopic coaxial cutting needle biopsy for clinically suspected lung cancer: technical details, diagnostic accuracy, and probable complications
Sat, 19 May 2012 07:26:08 -0000
Abstract Background Little has been described regarding the technical details, diagnostic accuracy, and probable complications of thoracoscopic cutting needle biopsy, which seems to be preferable to transthoracic needle biopsy for patients scheduled to undergo surgery for suspected lung cancer. Methods This study was a retrospective analysis of a prospective database of patients who underwent surgical biopsy for suspected lung cancer (n = 176). Sixty-two patients underwent thoracoscopic cutting needle biopsy, which was performed via thoracoport using a 16 gauge coaxial cutting needle; the remaining 114 patients underwent excisional biopsy, followed by curative intent surgery. Results The sensitivity and specificity of diagnosing lung cancer by thoracoscopic needle biopsy were 57/59 (96.6%) and 1/3 (33.3%), respectively. One false-negative result and one undiagnostic result occurred, but both lesions were correctly re-diagnosed by backup excisional biopsy during the same operation. When analysis was restricted to patients with lung lesions predominantly presenting with ground glass opacity, the sensitivity and specificity were 13/14 (92.9%) and 1/1 (100%), respectively. The sensitivity, specificity, and accuracy of diagnosing lung cancer by surgical biopsy in all patients were 164/165 (99.4%), 9/11 (81.8%), and 173/176 (98.3%), respectively. Pleural recurrence was identified in one patient after thoracoscopic needle biopsy whose pleural lavage cytology, performed before biopsy, was negative. Conclusions Thoracoscopic cutting needle biopsy can be effectively applied to patients with an indeterminate lung tumor, especially those patients with lesions possessing ground glass opacity. However, further evaluation is necessary to confirm the risk of pleural dissemination induced by this procedure. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-2115-1Authors Kazuhiro Ueda, Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanToshiki Tanaka, Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanMasataro Hayashi, Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanNobuyuki Tanaka, Division of Radiology, Department of Radiopathology and Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanYoshinobu Hoshii, Department of Surgical Pathology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, JapanKimikazu Hamano, Division of Chest Surgery, Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi 755-8505, Japan Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Kidney safety during surgical pneumoperitoneum: an experimental study in rats
Sat, 19 May 2012 07:26:06 -0000
Abstract Background Elevations of intraabdominal pressure during laparoscopic procedures may lead to oliguria or anuria in mammals. Despite this, previous research has not been able to confirm an associated kidney injury. This study aimed to investigate the occurrence of an early kidney lesion secondary to surgical pneumoperitoneum in a rat model using the expression of neutrophil gelatinase-associated lipocalin (N-GAL) as a biomarker for early kidney injury. Methods In this study, 20 male Sprague-Dawley rats under general anesthesia and mechanically ventilated were allocated to one of five experimental time-dependent groups: group 1 (1-h control), group 2 (1-h pneumoperitoneum), group 3 (2-h control), group 4 (2-h pneumoperitoneum), and group 5 (positive kidney injury group induced by intravenous administration of cisplatin 7.5 mg/kg). To evaluate the renal expression of N-GAL 24 h after the procedure, all the rats underwent a 2-h urine output evaluation as well as laparotomy and bilateral nephrectomy performed sequentially to investigate the presence of renal injury using immunofluorescence qualification and western blotting. Results Urine output was reduced and N-GAL expression was increased in the animals from the cisplatin group. The animals undergoing 1- or 2-h pneumoperitoneum displayed urine output and N-GAL expression similar to that of the animals from the matching control groups. Conclusions Under the experimental conditions of this study, the animals with normal preoperative renal function did not show any type of acute kidney injury associated with the presence of a stabilized surgical pneumoperitoneum. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-012-2322-4Authors Rogério Fortunato de Barros, Division of Pediatric Surgery, University of Campinas, Campinas, SP, BrazilMárcio Lopes Miranda, Division of Pediatric Surgery, University of Campinas, Campinas, SP, BrazilAmilcar Castro de Mattos, Department of Pathology, University of Campinas, Campinas, SP, BrazilJosé Antonio Rocha Gontijo, Laboratório de Metabolismo Hidro-Salino, Núcleo de Medicina e Cirurgia Experimental, University of Campinas, Campinas, SP, BrazilVinicius Rodrigues Silva, Laboratório de Metabolismo Hidro-Salino, Núcleo de Medicina e Cirurgia Experimental, University of Campinas, Campinas, SP, BrazilBrayner Iorio, Division of Pediatric Surgery, University of Campinas, Campinas, SP, BrazilJoaquim M. Bustorff-Silva, Division of Pediatric Surgery, University of Campinas, Campinas, SP, Brazil Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Outcome and safety of self-expandable metallic stents for malignant colon obstruction: a Korean multicenter randomized prospective study
Sat, 19 May 2012 07:26:04 -0000
Abstract Background Newly developed uncovered stents are designed to have varied radial force and high conformability to improve clinical outcome and safety. This study aimed to determine and compare the clinical outcome and safety of the Taewoong D-type uncovered stent and the Boston Scientific Wallfex stent. Methods Patients with acute malignant colonic obstruction were treated with a colonic stent. For the purpose of palliation, patients were randomly allocated. For the purpose of bridging, the type of stent was determined by the discretion of the individual doctors. Technical and clinical success and complication occurrence were measured as primary outcomes. Results From 12 university hospitals, 123 patients with malignant colonic obstruction were enrolled. Of these 123 patients, 58 were treated with colonic stents for palliative purposes. The technical and clinical success rate was 100 % for both stents in the palliative group. Perforation occurred for one patient (3.6 %) in the Wallflex stent group (n = 28) on day 5 and for no patients in the D-type stent group (n = 30). Two cases of migration occurred: one with the Wallflex stent and one with the D-type stent. Stent restenosis occurred for one patient with the Wallflex stent. Preoperative bridging stents were placed in 65 patients. The median time to surgery was 10 days. The technical success rate was 93.4 %, and clinical success was achieved for 86.2 % of the patients. Perforation occurred for five patients: four with the Wallflex stent and one with the D-type stent. The efficacy and safety of the two stents did not differ statistically. Conclusions The D-type colonic uncovered stent and the Wallflex colonic uncovered stent are effective and safe for both palliative and preoperative bridging therapy used to treat acute malignant colonic obstruction. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-012-2300-xAuthors Dae Young Cheung, The Catholic University of Korea College of Medicine, Seoul, KoreaJin Yong Kim, Sungkyunkwan University School of Medicine, Seoul, KoreaSung Pil Hong, Yonsei University College of Medicine, Seoul, KoreaMin Kyu Jung, Kyungpook National University School of Medicine, Daegu, KoreaByong Duk Ye, University of Ulsan College of Medicine, Seoul, KoreaSang Gyun Kim, Seoul National University College of Medicine, Seoul, KoreaJin Hong Kim, Ajou University School of Medicine, Suwon, KoreaKang Moon Lee, The Catholic University of Korea College of Medicine, Seoul, KoreaKyung Ho Kim, Hallym University College of Medicine, Chuncheon, KoreaGwang Ho Baik, Hallym University College of Medicine, Chuncheon, KoreaHo Gak Kim, Catholic University of Daegu School of Medicine, Daegu, KoreaChang Soo Eun, Hanyang University College of Medicine, Seoul, KoreaTae Il Kim, Yonsei University College of Medicine, Seoul, KoreaSang Woo Kim, The Catholic University of Korea College of Medicine, Seoul, KoreaChang Duck Kim, Korea University College of Medicine, Seoul, KoreaChang Heon Yang, Department of Internal Medicine, Dongguk University College of Medicine, 707 Sukjang-dong, Kyongju, Kyongbuk, 780-714 Korea Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794
Sites:
Carpal Tunnel Syndrome: The Southern California Orthopedic Institute (SCOI) - serving the Los Angeles and San Fernando Valley California in orthopedic surgery, sports medicine, knee and shoulder surgery, joint replacement, MRI, and physical rehabilitation.Duke US Surgical Endosurgery Center: The Center was established for the purpose of improving endosurgical education, advancing endosurgery through research and technical developments, and assessing the appropriate applications of endosurgical techniques.
Endius: endoscopic spinal surgery - Endius Incorporated
Gastrointestinal Endoscopy: Explains how the stomach and intestines can be examined using endoscopes, without surgery.
Laparoscopic Surgery: RSAPC1.com provides information about a broad spectrum of procedures including minimally invasive surgery, colo-rectal , breast and hernia surgery with special interest in advanced laparoscopic procedures including surgical weight loss, esophagus, stomach, liver, gallbladder, colon small intestin...
Laparoscopy Hospital: Laparoscopy Hospital is super specialized institute for laparoscopic treatment training and research
MicroSpine - Minimally Invasive Spinal Surgery Specialists: Endoscopic Laser Spine Surgery
Neurosurgeon and Pain Management Specialist: Dr. Ramsis F. Ghaly is a Neurosurgeon who is uniquely specialized in the latest endoscopic surgical techniques. Dr. Ghaly also specializes in Pain Management by using techniques that alleviate refractory pain sufferers. He also specializes in Anesthesiology and Intensive Care Management.
Plastic Surgery Performed Using Endoscopes: Provides explanations of various procedures (browlifts, facelifts) that can be performed endoscopically. Compares conventional and endoscopic procedures.
San Diego Shoulder Arthroscopy: An on-line library of tips, techniques, and procedures.
Society of American Gastrointestinal Endoscopic Surgeons: The leading professional society and CME meeting, representing more than 5000 board certified surgeons who use endoscopy and laparoscopy as an integral part of their treatment of patients
The Belgian Group for Endoscopic Surgery: An association of endoscopic surgeons in Belgium.
TMJ (Temporomandibular Joint) Disorders: The temporomandibular joint, anatomy, disorders, surgery. Includes a brief discussion of TMJ arthroscopy.
University of Massachusetts EndoSurgery Center: Laparoscopic surgical techniques, online courses and educational resources for minimally invasive and hand-assisted laparoscopic surgery. Watch videos and learn the essentials of laparoscopy, including cholecystectomy, hernia repair, Nissen and Toupet fundoplication for GERD.
