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Roy Soetikno

Publications and source records attributed to Roy Soetikno.

9 recordsLinked to original sources
PubMed2005

Endoscopic mucosal resection for early cancers of the upper gastrointestinal tract.

The purpose of this literature review is to examine recent advances in technique and technology of endoscopic mucosal resection of superficial early cancers of the upper gastrointestinal tract. Endoscopic mucosal resection (EMR) of superficial early cancers of the upper gastrointestinal tract is standard technique in Japan and is increasingly used in Western countries. Newer techniques of EMR allow removal of larger lesions en-bloc. These minimally invasive techniques, when applied correctly, allow safe and efficacious treatment in situations that would otherwise require major surgery. Through the establishment of long-term outcomes data, standardization of endoscopic and pathologic reporting, and newer EMR technology and techniques, the future treatment of early cancers in the upper gastrointestinal tract may be achieved primarily through the endoscope.

Endoscopy, Gastrointestinal↗
PubMed2005

18-Fluorodeoxyglucose positron emission tomography has limited sensitivity for colonic adenoma and early stage colon cancer.

BACKGROUND: 18-Fluorodeoxyglucose positron emission tomography (PET) is used clinically to detect recurrent colon cancer after surgical resection, but the sensitivity of PET for premalignant colon lesions and early stage colon cancer is not well defined. METHODS: In a prospective study, 45 patients with a total of 58 colonic neoplasms, including premalignant polyps, premalignant, flat lesions, and early stage cancers, were evaluated by PET. RESULTS: The sensitivity of PET for cancer was 62% (8/13). PET detected 100% (7/7) of cancers 2 cm or larger but only 17% (1/6) of cancers smaller than 2 cm. PET detected 23% (3/13) of flat, premalignant lesions; 70% (7/10) of protruded, premalignant lesions 3 cm or larger; 38% (3/8) of protruded, premalignant lesions between 2 and 2.9 cm; and 14% (2/14) of protruded, premalignant lesions between 1 and 1.9 cm. There was no false-positive PET reading. CONCLUSIONS: PET has limited sensitivity for flat, premalignant lesions; protruded, premalignant lesions smaller than 3 cm; and colon cancers smaller than 2 cm.

Adenoma↗
PubMed2005

Aggressive endoscopic therapy for pancreatic necrosis and pancreatic abscess: a new safe and effective treatment algorithm (videos).

BACKGROUND: Pancreatic necrosis and pancreatic abscess are severe complications of acute pancreatitis. Surgery is associated with significant morbidity and mortality in these critically ill patients. Endoscopic therapy has the potential to offer a safer and more effective alternative treatment modality. However, its role needs to be further investigated. METHODS: This is a retrospective study of the outcome of consecutive patients with pancreatic necrosis and pancreatic abscess, all unfit to undergo surgery, who underwent a new aggressive endoscopic approach. The treatment includes (1) synchronous EUS-guided multiple transmural and/or transpapillary drainage procedures followed by balloon dilation of the cystogastrostoma or cystoduodenostoma, (2) daily endoscopic necrosectomy and saline solution lavage, and (3) sealing of pancreatic fistula by N-butyl-2-cyanoacrylate. RESULTS: Pancreatic necrosis and pancreatic abscesses were successfully drained in 13 patients, thus avoiding emergency surgery as an initial treatment. Surgery was completely avoided in 9 patients over a median follow-up of 8.3 months (range 3-81 months). Surgery was combined with endoscopic therapy in one patient because of abscess extension into the right paracolic gutter, which was not manageable by endoscopic drainage. Because of the "disconnected-duct syndrome," two patients later developed recurrent pseudocysts and underwent elective surgery. Complications included minor bleeding after balloon dilation and necrosectomy in 4 cases, which were self limiting or controlled endoscopically. CONCLUSIONS: This aggressive endoscopic approach shows promising results. It expands the potential for endoscopic treatment in patients with pancreatic necrosis and/or pancreatic abscess.

Abscess↗
PubMed2004

Reflectance spectrophotometry for the assessment of mucosal perfusion in the gastrointestinal tract.

Reflectance spectrophotometry (RS) is an optical technology that has been used for nearly three decades in the measurement of tissue hemoglobin oxygen saturation in the gastrointestinal tract. The technology has evolved substantially throughout this period,and commercial devices are now available for use in clinical trials. Numerous studies have used RS to investigate the importance of mucosal perfusion in disorders such as ulcer disease, portal hypertension, and septic shock. More recently, the technique has been applied to measure changes in perfusion in response to infusion of vasoactive medications and maneuvers such as cardiopulmonary bypass. The results of current trials investigating the application of RS in critical care monitoring and vascular interventions will likely determine whether the technique will evolve from predominantly a research tool to a clinically useful device.

Gastric Mucosa↗
PubMed2004

Continuous, noninvasive, and localized microvascular tissue oximetry using visible light spectroscopy.

BACKGROUND: The authors evaluated the ability of visible light spectroscopy (VLS) oximetry to detect hypoxemia and ischemia in human and animal subjects. Unlike near-infrared spectroscopy or pulse oximetry (SpO2), VLS tissue oximetry uses shallow-penetrating visible light to measure microvascular hemoglobin oxygen saturation (StO2) in small, thin tissue volumes. METHODS: In pigs, StO2 was measured in muscle and enteric mucosa during normoxia, hypoxemia (SpO2 = 40-96%), and ischemia (occlusion, arrest). In patients, StO2 was measured in skin, muscle, and oral/enteric mucosa during normoxia, hypoxemia (SpO2 = 60-99%), and ischemia (occlusion, compression, ventricular fibrillation). RESULTS: In pigs, normoxic StO2 was 71 +/- 4% (mean +/- SD), without differences between sites, and decreased during hypoxemia (muscle, 11 +/- 6%; P < 0.001) and ischemia (colon, 31 +/- 11%; P < 0.001). In patients, mean normoxic StO2 ranged from 68 to 77% at different sites (733 measures, 111 subjects); for each noninvasive site except skin, variance between subjects was low (e.g., colon, 69% +/- 4%, 40 subjects; buccal, 77% +/- 3%, 21 subjects). During hypoxemia, StO2 correlated with SpO2 (animals, r2 = 0.98; humans, r2 = 0.87). During ischemia, StO2 initially decreased at -1.3 +/- 0.2%/s and decreased to zero in 3-9 min (r2 = 0.94). Ischemia was distinguished from normoxia and hypoxemia by a widened pulse/VLS saturation difference (Delta < 30% during normoxia or hypoxemia vs. Delta > 35% during ischemia). CONCLUSIONS: VLS oximetry provides a continuous, noninvasive, and localized measurement of the StO2, sensitive to hypoxemia, regional, and global ischemia. The reproducible and narrow StO2 normal range for oral/enteric mucosa supports use of this site as an accessible and reliable reference point for the VLS monitoring of systemic flow.

Animals↗
PubMed2003

Use of a colonoscope instead of a sigmoidoscope to screen asymptomatic adults for colorectal cancer.

BACKGROUND: Colonoscopic screening can detect neoplasms in asymptomatic adults, many of which would not be detected by sigmoidoscopy. However, because of cost and resource factors, many adults still undergo flexible sigmoidoscopy for colorectal cancer screening. In asymptomatic adults over age 50 undergoing unsedated flexible sigmoidoscopy screening, use of a colonoscope instead of a sigmoidoscope was studied to determine the feasibility, safety, tolerability, and yield. METHODS: Over an 18-month period, asymptomatic adults referred for colorectal cancer screening by sigmoidoscopy were enrolled. Two experienced nurses attempted to reach the cecum by using a pediatric colonoscope but stopped if significant discomfort was experienced, if the preparation was suboptimal, or if polyps were found. RESULTS: A total of 672 adults (652 men, 20 women) underwent screening. The colonoscope was advanced beyond the level attainable with a sigmoidoscope (70-cm mark) in 240 cases. The cecum was reached in 110 (16.4%) of these patients, with a mean pain intensity for patients of 2.6 (scale 1-10) and a mean time for completion of the procedure of 17 minutes. Colonoscopy to the cecum was not feasible because of patient discomfort in 280 patients (41.7%), poor preparation in 179 (26.7%), left-sided polyps or cancer in 69, and/or severe diverticulosis and tortuosity in 34 cases. Twenty patients had polyps proximal to the 70-cm mark (65% adenomas, no cancer). There was no complication. CONCLUSIONS: The use of a colonoscope instead of a sigmoidoscope by nurses performing unsedated screening sigmoidoscopy is feasible, safe, and well-tolerated, and may improve the yield for screening by at least 16.4% in patients who would otherwise have had only the left colon examined.

Aged↗
PubMed2003

Measurement of mucosal capillary hemoglobin oxygen saturation in the colon by reflectance spectrophotometry.

BACKGROUND: Advances in optical and computer technology have enabled the development of a device that uses white-light reflectance spectrophotometry to measure capillary hemoglobin saturation in intestinal mucosa during colonoscopy. METHODS: Studies were performed with the colon oximeter in anesthetized animals and patients undergoing colonoscopy. RESULTS: Mean (SD) mucosal hemoglobin saturation in the normal colon was 72% (3.5%). In an animal model, ischemia induced by arterial ligation and hypoxemia via hypoxic ventilation each resulted in a decrease of over 40% in the mucosal saturation. In patients with colon polyps, ischemia induced by epinephrine injection, stalk ligation with a loop, or clipping of the polyp stalk each resulted in a decrease of over 40% in the mucosal saturation (p < 0.02). In contrast, saline solution injection did not decrease the mucosal saturation. CONCLUSIONS: A novel device for measuring capillary hemoglobin saturation in intestinal mucosa during colonoscopy is capable of providing reproducible measurements in normal patients and clearly detects dramatic decreases in saturation with ischemic and hypoxic insults.

Aged↗