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Biomedical subjects

J S Goff

Publications and source records attributed to J S Goff.

58 records · Page 4Linked to original sources
PubMedDate not supplied

Endoscopic esophageal varix ligation: preliminary clinical experience.

Endoscopic variceal ligation (EVL) was performed in 14 consecutive patients who had recently bled from esophageal varices. None was actively bleeding at initial treatment. Ligations were accomplished using an endoscopic ligating device and an overtube. There were no procedural complications. 132 varix ligations were performed during 44 separate EVL sessions. Two patients were lost to follow-up and two died; neither death resulted from hemorrhage or treatment complications. Variceal rebleeding occurred in 2 noncompliant patients (14.3%) and was successfully controlled with emergent EVL. Ten patients achieved complete variceal eradication with from 1 to 6 (mean, 3.9) EVL sessions. No major complications (perforation, secondary bleeding, deep ulceration) resulted and there were no treatment failures. Follow-up of 10 surviving patients ranged from 240 to 370 (mean, 280) days. Endoscopic observation suggested that varices were obliterated by a process of mechanical strangulation, ischemia, superficial ulceration, and scar formation. Preliminary data indicate that EVL is a safe and effective treatment for esophageal varices.

Esophageal and Gastric Varices↗
PubMedDate not supplied

Endoscopic variceal ligation: an alternative to sclerotherapy.

Endoscopic variceal ligation (EVL) consists of mechanical ligation and thrombosis of varices using elastic "O" rings. This study assessed the efficacy and safety of EVL as definitive therapy for bleeding esophageal varices. During a 16-month period, 68 consecutive patients with bleeding varices had EVL. Fourteen patients died from 3 to 125 (median = 12.5) days after initial EVL. Fifteen (88%) of those actively bleeding at index treatment had bleeding controlled during index hospitalization. Survivors of index hospitalization had a 37% incidence of recurrent bleeding. Thirty-five patients had varices eradicated or reduced to small size with a median of five EVL treatments. No significant treatment-related nonbleeding complications resulted from 265 EVL sessions. EVL appears to control active variceal bleeding and eradicates varices with repeat treatments. EVL results in few nonbleeding complications, and may be employed as a safe alternative to sclerotherapy.

Adolescent↗
PubMedDate not supplied

Endoscopic versus operative gastrostomy: final results of a prospective randomized trial.

This study compared operative gastrostomy (OG) (by surgeons) with endoscopic gastrostomy (PEG) (by physicians) in a prospective randomized fashion to determine whether one technique was superior. PEG (Sachs-Vine) and OG (Stamm) were done using local anesthesia. Patients were assessed for complications, mortality, tube function, and cost. Groups were equally matched for indications and underlying disease. Fifty-seven had OG and 64 had attempted PEG. Complications occurred in 26% of OG patients and 9% died. Complications occurred in 25% of PEG patients and 12% died. Tube feeding was initiated in both groups within a mean of 29 (24 to 72) hours of the gastrostomy placement. OG cost $1675 and PEG $979 to perform. Twenty-one PEG patients required endoscopic tube change which raised their total cost to $1574. We conclude there is no difference between OG (using local anesthesia) and PEG with regard to morbidity, mortality, or tube function. The endoscopic technique does appear to have economic advantage.

Adolescent↗