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At least 1,153 records · Page 64Linked to original sources
PubMed1999

Endoscopic carpal tunnel release.

BACKGROUND: Endoscopic carpal tunnel release was developed by Okutsu and Chow in 1989. Many reports have indicated that endoscopic carpal tunnel release diminishes postoperative pain and accelerates the recovery time. METHODS: In a series of 1278 carpal tunnel release procedures (in 948 patients), 1214 were performed with a modified Menon endoscopic method and the remaining 64 with an open procedure. The patients with idiopathic carpal tunnel syndrome were followed for at least 3 months. RESULTS: Of the endoscopic release patients, 80.9% recovered grip strength equal to or greater than preoperative levels within 4 weeks, whereas in the open procedure group, the rate was only 59.3%. The difference was statistically significant (p = 0.00011). An immediate complication was one median motor nerve severance. There were 24 conversions to a conventional open procedure during endoscopic release. In the endoscopic group, 81% developed scar tenderness over the thenar crease, 31% developed new sensory disturbance, and 4% developed pillar pain. CONCLUSION: Endoscopic release facilitated the recovery of grip strength and diminished the frequency of scar tenderness. However, neurovascular injury should be carefully prevented.

Adult↗
PubMed1999

Endoscopic ultrasonography in patients with gastrinomas.

Placing the endoscopic ultrasound transducer in the descending duodenum, the duodenal bulb and the stomach, all the pancreas can be imaged. Endoscopic ultrasonography is a sophisticated imaging technique able to accurately diagnose and localize primary endocrine tumours of the pancreas (mostly insulinoma and gastrinoma) which may not be detectable with other imaging modalities. Furthermore, endoscopic ultrasonography-guided fine needle aspiration allows cytology and/or biopsy specimens to be obtained, that are crucial for clinicians in decision making. In the case of extrapancreatic endocrine tumours, which are often localized in the second and third part of the duodenum, endoscopic ultrasonography may have difficulty in localizing small and flat lesions. In this case, the initial step would be identification of duodenal nodules by duodenoscopy and thereafter, a catheter echoprobe can be inserted to identify the extent of submucosal lesion. Then gastroduodenal nodules found by endoscopy and confirmed by endoscopic ultrasonography can be removed endoscopically using the technique of mucosectomy. In the case of large pancreatic lesions, endoscopic tattoo with dye-India ink or methylene blue may become helpful for the surgeon to perform local resection via duodenostomy.

Endosonography↗
PubMed2000

EndoSheath endoscopic system.

To address the problems inherent in reprocessing endoscopes--the time required (about an hour per use), the difficulty of the process, and the adverse consequences of endoscope contamination--Vision Sciences Inc. introduced the EndoSheath endoscopic system. It consists of a disposable sheath that fits over a specially designed reusable fiberoptic endoscope. When an endoscopic procedure is completed, the sheath is discarded, and the endoscope is wiped with alcohol and reused. We evaluated one of the EndoSheath products--a sheathed sigmoidoscope--for its suitability in an endoscopy suite. We examined the unit and surveyed a number of users. We found that, although it would considerably shorten the time between endoscopic procedures, the unit was not well suited for an endoscopy suite because it provided no more protection than would be afforded by a carefully followed reprocessing protocol. However, users informed us that the sigmoidoscope and one other product--a nasopharyngo-laryngoscope--would likely be useful in a doctor's office or a hospital clinic.

Cost-Benefit Analysis↗
PubMed1999

Possibilities and limitations of endoscopic management of nasal and paranasal sinus malignancies.

Over the last decade, the use of rigid endoscopes in surgery of tumorous lesions of the nose, paranasal sinuses, nasopharynx and anterior skull base has extended and diversified. Endoscopic surgical approaches for malignant lesions are very controversially discussed as of today, yet. From 1989-1999 we have treated 43 patients with invasive/destructive tumors of the paranasal sinuses and the anterior skull base strictly endoscopically, transnasally. These included 5 patients with juvenile angiofibromas and 36 patients with various malignant tumors, one with a large invasive macroadenoma of the pituitary and one case of a craniopharyngeoma. The age range was 3 months to 82 years. Whereas the very first patients were approached endoscopically in a palliative intention, we have started endoscopic surgery for selected malignancies with curative intention in the last years. Histologically, patients with various carcinoma differentiation were operated (n = 18), as well as patients with malignant melanoma (n = 5), esthesioneuroblastoma (n = 8), clivus chordoma (n = 3), immature teratoma (n = 1) and leiomyosarcoma (n = 1). Our first results appear to indicate, that outcome is at least equal to standard external approaches, however with excellent functional terms and significantly better overall quality of life. The limitations result from the anatomical spread of the tumor, when extensive infiltration of orbit, dura/brain and other vital structures exist. However, in experienced hands, endoscopic surgery in this region can be rather radical, bone and even dura of the anterior skull base can be resected as can the periorbit, and all structures reconstructed in the same session. Endoscopic techniques lend themselves very well to cooperation with neighbouring specialities like neurosurgery. In individual cases, gamma-knife therapy has proven an extremely helpful adjunctive. With this combined approach, all 8 patients with esthesioneuroblastoma are alive and free of disease with a mean observation time of 37.2 months. We will therefore continue to use this procedure in selected cases as a reliable alternative to external approaches in the future. However we recommend, that these techniques are only applied at centers, where all other surgical approaches can be performed, should need for this arise.

Endoscopy↗
PubMedDate not supplied

[Endoscopic fenestration of median supratentorial cerebrospinal fluid cysts].

Mid-supratentorial liquor cysts are a relatively rare and generally congenital abnormality of the cerebral ventricles and subdural spaces. The data and views available in the literature on rational surgical policy is contradictory. The authors' experience in treating 16 patients was used to consider whether endoscopic techniques can be employed for invasive fenestration of the cysts. The goal of surgery was to remove the masses caused by cystic malformations and their local compression of the brain via fenestration of the walls of the cysts and via communication of their cavities with the ventricles and cisterns. There were solitary cysts in all cases (arachnoidal cysts of the interpedicular cistern and the third ventricle in 9; cysts of the ventricular septum in 4, ependicular cysts of the lateral ventricle in 2, and cysts of the celiac plexus of the third ventricle in other 2 cases, in 1 cases a liquor cyst was located in the midbrain thickness). The clinical picture was characterized by a combination of hypertensive, hydrocephalic and focal symptoms of damages to the hypothalamic and thalamic structures and the adjacent formations of the brain (pyramidal and extrapyramidal disorders, ataxia, chiasmal syndrome, metabolic and endocrine disorders, etc.). In 6 cases these symptoms were persistent despite preimplanted VP anastomosis. Rigid Storz endoscopes (Germany) with an external coat, 6 mm in diameter, and a Codman fibroendoscope (USA), 4 mm in diameter, were employed. Cystic ventriculostomy and cystic ventriculocisternostomies were made in 11 and 6 patients, respectively; one patient underwent endoscopic resection of the walls of an ependymal cyst. In one patient with signs of decreased liquor resorption, endoscopic fenestration was concurrently developed into a ventricle-peritoneal anastomosis. In other 4 anastomosis-dependent patients, the preimplanted mechanically consistent bypass system was left at its site. In 2 of these cases, cystic ventriculostomy was supplemented by ventricular septal fenestration and third-ventricular bottom perforation. Twelve patients were followed up for 6 to 36.5 months (mean 15 months). There has been no information about 6 patients since their discharge. In 12 (66.5%) surgery yielded expected results and the fenestration of cystic walls was followed by their retraction and a steady-state regression of local and/or hypertensive symptoms. In 5 (28%) patients, the complaints and clinical data remained unchanged despite although incomplete but objective cystic relaxation. This was most frequently noted in patients (n = 4) with arachnoidal cysts of the interpedicular cistern and the third ventricle who had endocrine disorders. In one case the operation was stopped due to bleeding. Totally, 5 patients were found to have complications (hemorrhage, ventriculitis). None patient died. Some aspects of indications for endoscopy and surgical techniques are considered. It is concluded that endoscopic internal bypass surgery in patients wit median cystic liquor malformations is the treatment of choice. When equipment is adjusted, fenestration of the membranous walls of these cysts by using an endoscope is reliable and safe. Such patients may be recommended endoscopic technology used as the method of choice.

Adolescent↗
PubMed1997

[Endoscopic and CT evaluation of three types of intranasal ethmoidectomies].

To evaluate the curative effects and complications of conventional, microscopic and endoscopic intranasal ethmoidectomuies, 130 cases of sinusitis and polys (stage II) were operated on with intranasal ethmoidectomies. There were 40 conventional, 40 microscopic, and 50 endoscopic ethmoidectomies, followed-up with endoscopy and CT scanning. The results showed that 1. the relieve of symptoms in the endoscopic group(94.0%) was obviously better than the conventional (60.0%) and the microscopic groups (70.0%, P < 0.01): 2. the clinical cure rate in the endoscopic group (86.0%) was obviously higher than the conventional (40.0%) and the microscopic groups (52.5%, P < 0.01); the CT scans showed a normal ratio in the endoscopic group(82.0%) obviously higher than those in the conventional (22.5%) and microscopic groups (37.5%, P < 0.01); 3. the complication ratio in the endoscopic group(12.0%) was slightly higher than those in the conventional(5.0%) and the microscopic groups (2.5%, P > 0.05). The intranasal endoscopic ethmoidectomy was more successful than the conventional and microscopic ethmoidectomies, but attention should be paid to the possibility of complications.

Adult↗
PubMed2000

[Endoscopic sympathectomy for palmar and plantar hyperhidrosis: results in 107 patients].

INTRODUCTION: Transthoracic endoscopic sympathectomy for palmar hyperhidrosis is a safe and effective method. However, no radical and definite treatment exists for plantar hyperhidrosis. We report our experience, immediate post-operative and mid-term results after transthoracic and lumbar endoscopic sympathectomy for palmar and plantar hyperhidrosis. PATIENTS AND METHODS: One hundred and seven of 117 patients cured between January 94 and December 98, answered a questionnaire regarding their past history, the early post-operative results, side effects and complications caused by the operation and mid-term results with particular emphasis on patient satisfaction. RESULTS: Seventy-eight thoracic and lumbar endoscopic sympathectomies and 125 thoracic endoscopic sympathectomies were performed. The patients were 30 men (median age 30 years) and 77 women (median age 26 years). Only women underwent lumbar endoscopic sympathectomy because of risk of retrograde ejaculation. No severe complications were noted. The success rate was 96 p. 100 for palmar hyperhidrosis and 98,5 p. 100 for plantar hyperhidrosis. No recurrences were noted in 97 p. 100 of the patients with median follow-up of 28 months. The main side effect was compensatory sweating which was the reason for dissatisfaction for 5 p. 100 of the patients. Cutaneous dryness and gustatory sweating were also described. However, 95 p. 100 of the patients were "satisfied" or "very satisfied". CONCLUSION: Our experience proved that lumbar endoscopic sympathectomy is as safe and effective for treatment of plantar hyperhidrosis, as thoracic endoscopic sympathectomy for palmar hyperhidrosis.

Adolescent↗
PubMed2001

[Endoscopic treatment of bleeding gastroduodenal ulcers].

INTRODUCTION: The aim of this study was to assess the extent to which GI endoscopic treatment of bleeding gastroduodenal ulcers is effective and whether it could reduce the need for surgery. METHODS: A retrospective evaluation was carried out. Over a period of three years (1995-1997), 122 patients with bleeding caused by a gastroduodenal ulcer, defined as fresh haematemesis with or without melaena, old haematemesis with melaena or melaena accompanied by a systolic blood pressure below 80 mmHg, underwent emergency GI endoscopy. Endoscopic therapy consisted of either injection therapy or electrocoagulation. RESULTS: Altogether 72 patients received endoscopic treatment. Primary haemostasis was achieved in 94%. Definitive haemostasis after one endoscopic treatment with either injection therapy or electrocoagulation was achieved in 63% and 62%, respectively. Including repeated endoscopic treatment, definitive haemostasis was achieved in 79%. No direct complications of the treatment were observed. DISCUSSION: Endoscopic treatment of bleeding gastroduodenal ulcers is the only alternative to an operation. Endoscopic treatment can reduce the need for surgery, as it was effective in about 80% of the patients.

Adult↗
PubMed2001

Effectiveness of endoscopic and open surgical management in benign ureteral strictures.

OBJECTIVE: To assess the effectiveness of different treatment modalities for benign ureteric strictures. SETTING: Department of Urology, Al-Emiri Hospital, Kuwait. PATIENTS AND METHODS: Twenty four cases (19 unilateral and 5 bilateral) of ureteral strictures were reviewed. Retrograde endoscopic dilatation was tried, initially for all of the strictures. Technical failure was observed in 8/29 (27.5%) strictures. Three of them were negotiated through antegrade endoscopic dilatation, while in 5 of the strictures open surgical repair was required. Both the balloon and fascial dilator were used for endoscopic dilatation; ureteroneocystostomy with or without Boari's bladder flap were the procedures employed for open repair. RESULTS: Of the 29 strictures the majority were secondary to Bilharzial cystitis (66.6%). Twenty-four (82.7%) strictures underwent endoscopic manipulation and 5 (17.2%) had open repair. Among the 24 strictures that had endoscopic dilatation, 21 (87.5%) were managed in retrograde fashion while in 3 (12.5%) technical failures were due to the inability to canulate the strictured ureter with a guide wire in retrograde fashion. All these patients were treated successfully by antegrade stenting. Among 24 strictures that were initially managed with dilatation and stenting, recurrence was found in 9 (37.5%) patients. The group had open repair, no recurrence was found during the follow up. There was no serious intraoperative or postoperative complications of both the procedures. Patients were followed up with intravenous urography. CONCLUSION: Endoscopic dilatation is an effective treatment modality for partial benign ureteric strictures. However, open ureteroneocystostomy with or without Boari's flap or Psoas hitch should be reserved for complete or recurrent ureteric strictures. Bilharzial strictures are amenable to endoscopic dilation but recurrence rate is high and re-implantation is frequently required.

Adolescent↗
PubMedDate not supplied

Diabetes insipidus after pituitary surgery: incidence after traditional versus endoscopic transsphenoidal approaches.

The endoscopic transnasal approach is gaining increasing popularity as the surgical method of choice for treatment of pituitary lesions. Previous studies have shown advantages such as quicker recovery and fewer cosmetic, dental, and nasal complications. However, no study has compared the rate of diabetes insipidus (DI) between the traditional and endoscopic approaches. This study will examine the incidence of short- and long-term postoperative DI after transnasal pituitary surgery and compare it with the incidence after traditional transseptal surgery. Eighty-one patients underwent transnasal surgery for the management of pituitary lesions. Fifty-five had the traditional sublabial, transseptal, transsphenoidal surgery and 26 patients had the direct transnasal, transsphenoidal endoscopic procedure. The incidence of immediate postoperative DI was 36% in the traditional group and 15% in the endoscopic group. Short-term (>2 weeks) DI that required treatment occurred in 11 patients (20%) in the traditional group and 2 patients (7.6%) in the endoscopic group. Long-term (>6 months) incidence of DI was 7.2% in the traditional group and 3.8% in the endoscopic group. We found a decreased incidence of immediate DI after transnasal endoscopic pituitary surgery as compared with the traditional sublabial transseptal approach. However, the incidence of long-term DI was not significantly different in the two groups.

Adenoma↗
PubMed2001

An alternative arterial conduit for totally endoscopic multivessel coronary artery bypass.

BACKGROUND: The ultimate goal of coronary artery bypass grafting (CABG) is the performance of a totally endoscopic procedure using multiple arterial conduits. At our center we have been routinely performing endoscopic robotic harvesting of internal thoracic arteries (ITAs) for use in minimally invasive CABG. The right gastroepiploic artery (RGEA) has been shown to be a reliable and versatile arterial conduit for bypass to coronary vessels not easily accessible by an ITA. The RGEA has already been harvested less invasively through a small laparotomy. This procedure could be made even less invasive by harvesting the RGEA laparoscopically, but this procedure has not yet been reported. The purpose of this study was to develop an endoscopic technique for harvesting the RGEA and demonstrate the safety and efficacy of this less invasive approach. METHODS: Twenty Duroc X Hampshire swine were administered general anesthesia and intubated. Ten mm and 5 mm trocars were then inserted. A 10 mm, 30-degree endoscope was adapted to a voice-activated robotic arm (AESOP), and the RGEA was harvested totally endoscopically using 5 mm harmonic scalpel shears. Intraoperative events and RGEA harvest times were recorded, and RGEA flows were measured after harvest. RGEA was delivered into the pericardial sac endoscopically. RESULTS: All RGEAs were successfully harvested without injury. Harvest time averaged 29.9+/- 10.9 min. The harvested conduits averaged 24.7+/- 2.37 cm in length. Flows were excellent in all harvested conduits, averaging 81.1+/- 31.8 cc/min. The harmonic scalpel controlled all RGEA branches with excellent hemostasis. CONCLUSION: The RGEA can be harvested safely through port access with robotic assistance. This conduit is of sufficient length to be used as an alternative arterial conduit for totally endoscopic multivessel coronary artery bypass.

Animals↗
PubMed2002

[Value of endoscopic ultrasonography and somatostatin receptor scintigraphy in the preoperative localization of insulinomas and gastrinomas. Experience of 54 cases].

AIM: The classic morphological techniques for the localization of insulinomas and gastrinomas are of limited value. Endoscopic ultrasonography and somatostatin receptor scintigraphy have shown high sensitivity for the detection of gastroenteropancreatic endocrine tumors. The aim of the study was to evaluate the sensitivity of endoscopic ultrasonography and that of somatostatin receptor scintigraphy in the localization of insulinomas and gastrinomas. PATIENTS AND METHODS: This retrospective study concerned 54 patients with insulinoma (n=29) or gastrinoma (n=26) operated on between March 1991 and March 2000 and who had at least one among the two tested examinations. Forty-two patients had scintigraphy (17 with insulinoma, 25 with gastrinoma), 47 had endoscopic ultrasonography (28 with insulinoma, 17 with gastrinoma). One of the ten patients with MEN 1 had both tumors. All diagnosis were confirmed by histologic examination. RESULTS: The sensitivity of scintigraphy for the localization of insulinomas was 47%. There was one false positive. Sensitivity of endoscopic ultrasonography for insulinomas was 85%. The sensitivity of scintigraphy in the detection of gastrinomas was 65% for the tumors in the duodenopancreatic area, 20% for the tumors in the pancreatic tail and 71% for metastasis. The sensitivity of endoscopic ultrasonography was 46% for duodenal tumors, 75% for pancreatic tumors and 57% for lymph node metastasis. The combination of both localization studies increased sensitivity to 94%. CONCLUSION: Endoscopic ultrasonography and somatostatin receptor scintigraphy are the gold standard for localization of gastrinomas. Association of both examinations increases the sensitivity. Scintigraphy for the detection of insulinomas should be performed when endoscopic ultrasonography is negative.

Adolescent↗
PubMed1999

[Endoscopic treatment of sphenoidal and ethmoidal mucoceles].

OBJECTIVE: To evaluate endoscopic surgery for sphenoidal and ethmoidal mucoceles. METHOD: Seventeen patients diagnosed as having paranasal sinus mucoceles underwent attempted endoscopic marsupialization between 1989 and 1995. Ten of the mucoceles were in the sphenoid sinus, seven in the ethmoid sinus. Postoperative endoscopic follow-up period varied from 3 to 9 years. RESULT: All the sphenoidal and ethmoidal mucoceles were satisfactorily approached endoscopically. Postoperative endoscopic examination manifested all the operating cavity was satisfactorily marsupialized. The symptoms were improved or relieved in 15 patients. None of the patients undergoing endoscopic surgery had significant complications. CONCLUSION: Our results show that endoscopic surgery seems to be a safe, valuable way for management of sphenoidal and ethmoidal mucoceles.

Adult↗
PubMedDate not supplied

[Acute hemorrhage caused by duodenal ulcer. Results of endoscopic treatment of the first bleeding episode and of recurrences].

BACKGROUND: The aim of this study was to evaluate the impact of immediate endoscopic treatment of bleeding and rebleeding on the clinical outcome of patients with duodenal ulcer hemorrhage. MATERIALS AND METHODS: Between January 1995 and December 1998, 445 patients with bleeding duodenal ulcers were observed in the First Division of General Surgery--University of Verona. All patients, except two who died for hemorrhage before the endoscopic examination, underwent emergency endoscopy within 2 hours from the admission and ulcers with active or sign of recent bleeding were submitted to injection therapy. History, clinical and endoscopic findings, recurrent bleeding and outcome were prospectively collected and analyzed. Recurrent bleeding underwent immediate endoscopic retreatment as first attempt. RESULTS: Endoscopic therapy was performed in 277 patients with active bleeding and hemostasis was initially obtained in all patients except one. Rebleeding occurred in 62 patients (14%) and endoscopic treatment was successful in 85% of first rebleeding and in 58% of the cases with 2 or more rebleeding. Multivariate analysis showed that systolic blood pressure at admission, ulcer size and Forrest classification influenced independently the recurrence rate. The 30 days mortality was 12.2% in the whole series: 35 deaths (9.2%) in the group without recurrence and 19 (30.6%) deaths in the rebleeding group (p = 0.001). Only 22 patients (5%) underwent surgical treatment with a higher mortality compared to not operated patients (36.4% versus 10.9%). CONCLUSIONS: Endoscopic treatment was associated with reductions of the risk of recurrent bleeding and surgery without increasing mortality rate.

Acute Disease↗
PubMedDate not supplied

Superselective transcatheter embolization for acute lower gastrointestinal hemorrhage after endoscopic mucosal resection: a report of 3 cases.

One of the most common complications related to endoscopic mucosal resection is hemorrhage; in almost every case, the bleeding is endoscopically managed, but some cases are unresponsive to the treatment. We have encountered three cases of endoscopically uncontrollable lower gastrointestinal hemorrhage after endoscopic mucosal resection in the colon which we successfully treated by urgent superselective transcatheter embolization. In our three cases, massive hemorrhage occurred immediately after endoscopic mucosal resection of a sessile polyp 25-40 mm in diameter, two cases in the ascending colon and one in the rectum. Although hemoclip placement was attempted in every case, hemostasis was not achieved. Emergency angiography disclosed massive extravasation of the contrast material in the colon. Hemostasis was achieved immediately after superselective transcatheter arterial embolizations with microcoils, with no observable ischemic complications and without the need of transfusions. In conclusion, superselective transcatheter embolization with microcoils should be considered a safe and efficient treatment option for endoscopically uncontrollable lower gastrointestinal hemorrhage occurring after endoscopic mucosal resection.

Aged↗
PubMed2003

[Symptomatic vesicoureteral reflux in kidney transplantation: results of endoscopic injections of teflon and predictive factors for success].

OBJECTIVES: Evaluation of the results of endoscopic Teflon injections for the treatment of symptomatic vesicoureteric reflux in renal transplant recipients and identification of prognostic factors. POPULATION AND METHODS: Between June 1997 and January 2002, out of a series of 408 renal transplant recipients, 15 patients (8 males, 7 females) with a mean age of 41.9 years were treated for symptomatic vesicoureteric reflux on the transplanted kidney by endoscopic Teflon injection. This treatment was indicated due to the presence of febrile or afebrile infections, possibly associated with deterioration of renal function. Reflux was demonstrated by retrograde cystography. The results of endoscopic treatment were evaluated by cystography at 3 months, and by clinical and laboratory examinations thereafter. RESULTS: The mean interval between renal transplantation and endoscopic treatment was 64.2 +/- 64.7 months. With a mean follow-up of 25 +/- 16.7 months, we observed a 53.3% success rate (8 patients), 13.3% of patients (2 patients) were improved and 33.3% of procedures were considered to be failures (5 patients). A lower number of preoperative infections, reflux < or = grade III and the absence of impaired renal function are predictive factors for the success of endoscopic treatment. The only complication was one case of renal colic due to meatal stenosis at 3 months, which responded favourably to endoscopic treatment alone. CONCLUSION: Endoscopic treatment of symptomatic vesicoureteric reflux on a transplanted kidney by Teflon injection is effective in two-thirds of cases. Due to the low morbidity of this minimally invasive procedure, this treatment should be proposed as first-line management for all cases of symptomatic vesicoureteric reflux on a transplanted kidney.

Adult↗
PubMedDate not supplied

Endoscopic findings in a biennial follow-up program in patients with pernicious anemia.

BACKGROUND/AIMS: It is known that patients with pernicious anemia have a higher risk of gastric neoplasms. However, the optimal endoscopic follow-up in these patients has not been properly defined. This study was aimed to assess the usefulness of an endoscopic follow-up program. METHODOLOGY: We analyzed the endoscopic and histological findings of the first endoscopy performed in a group of 128 patients with the diagnosis of pernicious anemia who were referred to the Endoscopic Unit, and we evaluated the results of the biannual follow-up endoscopies made to 68 of them. RESULTS: The initial endoscopy did not provide evidence of any lesions in 107 patients (83.5%), and polypoid lesions were found in 12 cases (9.4%). The histological results showed gastric dysplasia in 3 patients (2.3%) and carcinoid tumor in 2 cases (1.6%). No cases of gastric carcinoma were found. During the endoscopic follow-up of 68 patients, in 52 of them (76.8%) there were no endoscopic findings, and raised lesions were detected in 8 patients (11.8%). Three cases of gastric dysplasia were found. No cases of gastric carcinoma or carcinoid were detected during the follow-up. CONCLUSIONS: We suggest that a biannual endoscopic follow-up in not useful for the early detection of gastric neoplasms in patients with pernicious anemia.

Adenocarcinoma↗
PubMed2004

[Review of 209 cases of foreign bodies in the upper gastrointestinal tract and clinical factors for successful endoscopic removal].

BACKGROUND/AIMS: Most of ingested foreign bodies pass through the gastrointestinal tract spontaneously, but some of them (about 20%) need endoscopic or surgical removal. The aims of this study were to characterize the clinical features associated with foreign bodies in the upper gastrointestinal tract and to determine the clinical factors for their successful removal by endoscopic techniques. METHODS: We analyzed retrospectively 209 cases of foreign bodies in the upper gastrointestinal tract at Chonnam National University Hospital between May 1998 and May 2003. RESULTS: Foreign bodies were found in 97.1% (203/209) of the cases during endoscopic procedure. The types were chiefly fish bones (21.2%), coins (14.8%), meats (11.3%), and bezoars (8.9%). The locations were upper esophagus (49.8%), stomach (26.6%), lower esophagus (11.3%), and mid-esophagus (7.4%). Endoscopic removal was successful in 93.1% (189/203) of the cases, and surgical removal was successful in 8/203 (3.9%) of the cases. Age (p=0.015) and short duration of impaction (p=0.015) were the independent factors to predict the successful removal of the foreign bodies by endoscopic techniques. CONCLUSIONS: Endoscopic removal of foreign bodies in the upper gastrointestinal tract is an effective and safe procedure. Foreign bodies are more successfully removed by endoscopic techniques in children or in cases of short duration of impaction.

Adult↗