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Biomedical subjects

N Soehendra

Publications and source records attributed to N Soehendra.

At least 145 records · Page 8Linked to original sources
PubMed1988

Transnasal fixation of the esophageal prosthesis.

We present a simple technique for the fixation of esophageal tubes. The endoprosthesis is anchored to a thin polyethylene catheter which is passed transnasally and attached to the ear. This method of treatment effectively prevents dislodgement. It is also suitable for placing a tube into the esophagus when the stenosis essential for anchorage is absent, for example in large fistulae, perforations, or suture dehiscence.

Esophagus↗
PubMed1988

[Surgical therapy of cancer of the hepatic duct bifurcation].

We report about the diagnostic and therapeutic approaches in 62 cases of Klatskin tumors operated during the last 5 years. In most patients the definite treatment consisted either of primary endoscopic drainage of the bile ducts or of a secondary endoscopic drainage after explorative laparotomy. Only one third of the patients could be operated in curative intention. Operative procedures included local tumor resections as well as a central bile duct resection combined with hemihepatectomy. The main problem in these operations is to avoid a biliodigestive anastomosis with tumor infiltrated bile ducts, because these patients would have been better treated endoscopically. After extended preoperative diagnostic procedures including CT-scan, ultrasound, ERCP and angiography in most cases the criteria for irresectability can be defined and unnecessary operative interventions can be avoided.

Bile Duct Neoplasms↗
PubMed1988

[The surgical treatment concept in acute intestinal hemorrhage].

A clinically developed and prospectively verified therapeutic concept for acute intestinal bleeding is presented in this paper. Emphasis is laid on orthograde lavage likely to enable sooner and more effective use of diagnostic means and to provide optimal conditions for surgical therapy. Prognosis can be further improved by differentiated use of therapeutic endoscopy and early elective surgery. The effectiveness of this new therapeutic concept has been successfully verified on 81 patients, between 1975 and 1986. Lethality amounted to five per cent.

Colectomy↗
PubMed1988

[Colorectal carcinoma--endoscopic diagnosis and therapy].

Endoscopic diagnosis and therapy of colorectal carcinomas comprise their early and late forms. In adenomas with invasive carcinoma, polypectomy is at the same time a complete therapy if the site of removal is histologically free from any tumour. In case of established invasion of the submucous lymphatic vessels and a low degree of differentiation subsequent segmental resection is generally recommended. Advanced carcinomas do not present any special problem in respect of identification by endoscopy. Biopsy can also be performed at the same time. In case of inoperable tumours, endoscopy offers by means of the YAG laser an additional palliative treatment method for extending the lumen or haemostasis.

Colonic Neoplasms↗
PubMed1987

N-butyl-2-cyanoacrylate: a supplement to endoscopic sclerotherapy.

We report on our two years' experience with the tissue adhesive n-butyl-2-cyanoacrylate. During this period 202 patients suffering from esophagogastric varices were treated endoscopically. With the aid of the tissue adhesive the conventional sclerotherapy with Polidocanol 1% has been clearly improved. Problems concerning early recurrent bleeding and fundic varices are satisfactorily solved. The endoscopic hemostasis of severe variceal bleedings has become safer and surer. The overall hospital mortality of these patients has sunk from 31.5 to 17.5%. Cyanoacrylate is a very useful substance for obliterating large esophagogastric varices. However, the complete elimination of esophageal varices, which is the guarantee for a long-term freedom from recurrent bleeding, can only be achieved by using a genuine sclerosing agent.

Enbucrilate↗
PubMed1986

[Endoscopic transpapillary drainage of Wirsung's duct in chronic pancreatitis].

Endoscopic transpapillary drainage of the main pancreatic duct is a novel, non-surgical method for the treatment of chronic pancreatitis. It seems to be particularly suited for the obstructive form characterized by dilatation of the duct system due to stenoses. Up to now drainages could be successfully performed in five out of six patients. In three cases a divided pancreas was present. The preliminary results are favourable: pain was almost completely eliminated and the patients gained weight. Complications due to the intervention have not been registered as yet. There was no obstruction or dislocation of catheters over an observation period of up to 18 weeks.

Adult↗
PubMed1986

Prophylactic sclerosing of esophageal varices--results of a prospective controlled study.

Of 60 patients suffering from various stages of esophageal varices with no previously recorded bleeding, 30 underwent combined peri- and intravascular fiberscopic sclerotherapy in a prospective controlled study. Each of the two groups consisted of 22 men and 8 women with an average age of 49 years. The cause of portal hypertension in 58 patients was a morphologically proven cirrhosis of the liver, due mainly to alcoholism. Portal vein thrombosis was present in two patients. The severity of the liver disease was first evaluated in accordance with the PUGH modification of the CHILD classification. 53% of the patients in the control, and 56% in the treatment, group belonged to the prognostically favourable CHILD A category. The period of observation was at least 26 months, with a mean of 36 months. Sclerotherapy lowered the risk of bleeding to 13.3%; in the control group it was 30%. The mortality rate during the overall observation period was lowered significantly (p less than 0.05) by sclerotherapy to 5.9% in the CHILD A group as compared with 25% in the control group. The mortality rate of CHILD B and C patients was over 40% in the control group and an unequally large 70% in the treatment group. The most frequent cause of death was bleeding from esophageal varices in the control group and liver failure in the treatment group. Complications were seen in 20% and paralleled the severity of the esophageal varices. All complications responded to conservative treatment and no fatality was seen.

Esophageal and Gastric Varices↗
PubMed1986

Endoscopic dilatation and papillotomy of the accessory papilla and internal drainage in pancreas divisum.

In the case of pancreas divisum the minute orifice of the minor papilla has offered a special challenge to endoscopic diagnosis and therapy. Here we describe a method for easy cannulation of the minor papilla and drainage of the pancreatic duct. By means of a flexible guide wire and a dilator, the tiny papilla can be simply dilated, enabling papillotomy to be successfully accomplished. This method has been used in six cases without any major complications, and should pave the way for diagnosis and therapy of pancreas divisum.

Adult↗
PubMed1985

Injection of nonvariceal bleeding lesions of the upper gastrointestinal tract.

In a prospective series 102 non-variceal upper GI bleeders were studied. An indication for endoscopic injection therapy was seen in 63 patients. In accordance with bleeding intensity, 27 patients were grouped as Forrest Ia, 37 as Forrest Ib, 8 as Forrest II with a "visible vessel" and 13 as Forrest II without one. Definitive hemostasis was achieved in almost 100% of the cases. Within the Forrest Ia group mortality was lowered to 11% as compared with 20% within the emergency surgery group. More than 80% of patients had at least one severe coexistent illness. The aim of endoscopic injection is to avoid surgery in high-risk patients.

Adolescent↗
PubMed1985

Monoclonal antibody defines CA 19-9 in pancreatic juices and sera.

In a retrospective study pancreatic juice samples (n = 213) and corresponding serum samples (n = 110) were assayed for their concentration of monoclonal antibody defined CA 19-9/GICA (gastrointestinal cancer associated antigen). Serum CA 19-9 values were found to be good diagnostic and discriminating markers for pancreatic disorders and were raised (greater than 50 u/ml) in more than 80% of the pancreatic cancer patients compared to 8.5% of the pancreatitis group and none of the control group. In contrast pancreatic juice CA 19-9 values showed a considerable overlap between groups. On the basis of recent molecular data on the monoclonal antibody 19-9 defined antigen(s)--that is, monosialoganglioside, mucin--it is proposed that the discrepancies between serum and pancreatic juice findings are due to a specific undirected endocrine release of the mucin into sera in pancreatic tumour patients while in pancreatic juices of all diagnostic groups high CA 19-9 activities are either owing to coexistence of glycolipid and mucin or that the latter is a physiologically exocrine product.

Antibodies, Monoclonal↗
PubMed1985

Multiparametric tumor marker (CA 19-9, CEA, AFP, POA) analyses of pancreatic juices and sera in pancreatic diseases.

With respect to their diagnostic utility CA 19-9, CEA, AFP and POA were determined in pancreatic secretions and serum of patients suffering from pancreatic cancer (n = 76/55) or chronic pancreatitis (n = 79/45) and of controls (n = 81/42), respectively. While the determination of AFP and POA both in pancreatic secretions and serum does not permit a differential diagnosis, serum CEA (greater than 10 ng/ml) and CA 19-9 (greater than 50 U/ml) levels were indicative of pancreatic cancer in 30% and 83%, respectively, with a rate of false positive results of 5% and 8.5% confined to the chronic pancreatitis patients. A combination of tumor marker analyses, that is, serum CA 19-9 (greater than 50 U/ml) and pancreatic secretion CEA (greater than 70 ng/ml), proved to be positive in 92.9% of tumor patients with a maximum of 10.5% false positives. Likewise, values of serum CA 19-9 (greater than 50 U/ml) and serum CEA (greater than 10 ng/ml) were found in 85.8% of the pancreatic cancer patients with only 8.8% false positives, which were confined to the chronic pancreatitis patients. These results indicate the superiority of multiparametric tumor marker analyses for the diagnosis of pancreatic cancer, especially when including new monoclonal antibody defined tumor markers.

Antigens, Neoplasm↗