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At least 1,549 records · Page 86Linked to original sources
PubMed1976

The role of upper gastrointestinal endoscopy in patients with cancer.

The last decade has seen considerable advance in the application of fiberoptic endoscopy to the diagnosis and management of patients with cancer. Forward and side-viewing instruments have been developed that have complete tip control, potential for obtaining directed biopsies, brush and lavage cytology, and for aspiration of material for assay of enzymes and tumor-associated antigens. These features have provided a high degree of diagnostic capability in the esophagus, stomach, and duodenum. Accurate histologic diagnoses require multiple biopsies and brush cytology from each lesion. Lavage cytology has been useful in selected patients, especially those with diffusely infiltrating lesions. Brush cytology has been especially helpful in patients with stenotic esophageal cancer. These techniques have also provided a diagnosis in a high percentage of patients with lymphoma involving the stomach. Endoscopy has also been very useful in patients with nongastrointestinal cancer who have major gastrointestinal problems such as bleeding stress ulcers or monilial esophagitis.

Biopsy↗
PubMed1976

Endoscopy and the detection of genitourinary carcinoma.

Endoscopy in the detection of urinary tract cancer is one of the primary tools of the urologist. It is used in the localization of bleeding sites, the systematic follow-up in detecting recurrent malignancies, the pathologic staging of carcinoma of the bladder through transurethral biopsy, and the identification and biopsy of primary transitional cell carcinoma of the prostate. It is also a prime tool in the diagnosis of ureteral and pelvic tumors through retrograde pyelography, brush biopsy, and urine collection for cytology. Nephroscopy is now also possible for the obscure lesions difficult to diagnose otherwise. Urethroscopy is also important in detecting malignant changes. The various sites for urologic cancer, their incidence, and the role of endoscopy in relation to other means of diagnosis and management are discussed.

Age Factors↗
PubMed1993

Radiology and endoscopy in the pretreatment diagnostic management of colorectal cancer.

This paper discusses the imaging methods available for the detection and diagnosis of colon cancer, concentrating on endoscopy and barium radiology. Effective utilization of these two methods may be facilitated by using flexible sigmoidoscopy to direct further investigation. There is a need for educational efforts to enhance the performance of endoscopy and barium radiology so that the high standards achieved in some published series are more generally available to patients. New developments in contrast agents will alter rapidly the roles of ultrasound, CT scanning, and magnetic resonance in the investigation and management of colorectal cancer.

Colonic Neoplasms↗
PubMed1977

Diagnosis and management of post-cholecystectomy symptoms: the place of endoscopy and retrograde choledochopancreatography.

Endoscopic retrograde choledochopancreatography (ERCP) was employed in 52 patients symptomatic after cholecystectomy in whom barium meal studies and intravenous cholangiography had failed to yield a diagnosis. Cannulation of the papilla of Vater was carried out in 50 of the patients in a mean time of 10 min. Diagnostic information demonstrating a pathological lesion or a normal biliary and pancreatic ductal system was obtained by means of endoscopy and ERCP in 48 cases. There were no serious complications. A pathological lesion was demonstrated in all but one of the patients presenting with jaundice, cholangitis or pancreatitis but the diagnostic yield was not as high in patients with vague upper abdominal symptoms. Endoscopy and ERCP are the investigative procedures of first choice in complex post-cholecystectomy cases in whom intravenous cholangiography fails, gives incomplete information or suggests normality in the face of continuing symptoms or clinical evidence of residual biliary disease.

Adult↗
PubMed1980

Spontaneous closure of choledochoduodenostomy: diagnosis by endoscopy and ERCP.

Choledochoduodenostomy has been recommended for the management of benign lower common bile duct obstruction, but opinion on this is still divided. Two cases are presented of recurrent cholangitis following choledochoduodenostomy, in which endoscopy and ERCP demonstrated closure of the choledochoduodenal anastomosis, continuing lower biliary obstruction and retained stones or debris. Persistent of recurrent symptoms following this operation may be due to stoma closure without adequate biliary drainage, and in these circumstances endoscopy with ERCP is proving most useful and in difficult cases may be the investigation of choice.

Aged↗
PubMed1987

Is an anesthesiologist's presence justified during therapeutic laser endoscopy?

Diagnostic endoscopy has generally been done under intravenous sedation. Diazepam and meperidine are the two most frequent drugs used. Even though these drugs produce sedation, analgesia, and amnesia, they do not provide a quiet field. Therapeutic laser endoscopy requires a quiet field. We conclude that an anesthesiologist is needed at the head of the table. Despite the increased cost of the procedure, the anesthesiologist is able to tailor the anesthesia to fit the needs of both the patient and the endoscopist.

Anesthesia↗
PubMed1999

Intracranial endoscopy.

Since 1910, when Lespinasse [73] in Chicago was the first surgeon to use an endoscopic device for the treatment of a neurologic disease, various methods of endoscopy have evolved into accepted diagnostic and therapeutic adjuncts of modern neurosurgery. Nevertheless, until recently technical shortcomings of the available endoscopes have prevented the widespread use of neuroendoscopy. However, now, at the end of the 20th century, endoscopes can be regarded as some of the most important instruments for the development of microneurosurgery into the 3rd millennium. The aim of this review of intracranial endoscopy in neurosurgery, which admittedly might not be completely objective in the authors' personal assessment of various endoscopic techniques, is first to depict the historical evolution of neuroendoscopy, second to describe the technical equipment used in intracranial endoscopic neurosurgery, third to characterize the most frequent endoscopic methods in brain surgery, and fourth to indicate how neuroendoscopy might develop in the near future. It will be shown that this ongoing evolutionary process in neuroendoscopy was only possible with the mutual influence of improved diagnostic techniques, increased microanatomical knowledge, refined neurosurgical instrumentation--especially the introduction of the surgical microscope, and endoscopic diagnostic and therapeutic strategies.

Brain↗
PubMed1992

The postoperative recurrence of Crohn's disease: an analysis of 37 patients with Crohn's disease who underwent endoscopy during initial surgery.

A total 37 patients with Crohn's disease who underwent intraoperative endoscopy during resection of the affected intestine were evaluated in this study. The average age of the patients at surgery was 23.2 years. The residual lesions in the remaining intestine identified by intraoperative endoscopy were classified according to their pathologic profiles into three groups: A, B and C. In group A, comprising patients with longitudinal ulcers and/or a cobblestone appearance, 10 of 12 patients had recurrence. In 5 of these 10, the residual lesions were exacerbated and 2 required a further operation. The remaining 5 patients showed recurrence at the site of previous anastomosis and 2 of these 5 required additional surgery. In group B, comprising patients with small ulcers, aphthoid ulcers, or scars, and group C, comprising patients with no residual lesions, recurrence was observed in 13 of 16, and 3 of 9 patients, respectively. The recurrent lesions were all found proximal to, or at the site of previous anastomosis. Additional operations were performed on 3 of the group B patients. The findings of this study revealed that recurrence requiring additional surgery is more frequent at the site of anastomosis, regardless of the endoscopic appearance of the residual lesions.

Adolescent↗
PubMed1978

Endoscopy in pediatric gastroenterology.

Seventy two endoscopies of the upper gastrointestinal tract and one hundred and fifteen colonoscopies were performed in children aged nine months to seventeen years. The experience gained with different types of endoscopes suggests that endoscopy of the upper gastrointestinal tract should be only performed with pediatric instruments. These are: GIF-P2(1) (max. outer diameter 9 mm) and TX-7(2) (max. outer diameter 10mm). For colonoscopy, the ideal pediatric instrument is not yet available. Sigmoidocoloscopes like the CFMB1 (length 1115 mm) and the F-91-S2 (length 650 mm) are suitable for older children.

Adolescent↗
PubMed1989

Long-term endoscopic injection sclerotherapy of bleeding esophageal varices. A prospective analysis of results by endoscopy, manometry and 24-h pH-monitoring.

From 1 January 1986 to 1 January 1988, 91 consecutive patients who had undergone repeated paravariceal endoscopic injection sclerotherapy (PEIS) for bleeding esophageal varices over a period of up to 10 years were followed up prospectively by endoscopy, manometry and 24-h pH monitoring. In 39% nonfatal complications occurred after two phases of PEIS. The number of complications tended to decrease with increasing phases and was only 12% after five or more phases of PEIS. Endoscopy is undoubtedly the most important method in the follow-up of these patients. Early and long-term complications are mostly diagnosed by direct view and thus can be managed or sometimes even prevented in the follow-up. No significant motility disorders were found. Only 12 patients showed significant gastroesophageal reflux. No correlation was found between the severity of reflux and the number of phases of PEIS. No correlation between clinical symptoms and changes in the manometric and pH metric results could be found. The effects and side effects of PEIS can be closely monitored by manometry and pH monitoring and therapy can be tailored accordingly. Our results suggest that PEIS is a superb method with a low complication rate, both short- and long-term. It has proven to be an effective long-term treatment of bleeding esophageal varices.

Adolescent↗
PubMed1991

The current role of endoscopy in Mallory-Weiss syndrome.

We have carried out a retrospective review of 61 patients with Mallory-Weiss syndrome, 9 of whom underwent hemostatic injection treatment. At emergency endoscopy, 3 patients (5%) were actively bleeding and 6 (10%) had stigmata of recent hemorrhage. Fifty-two patients had a lesion of the cardia which was the suspected source of bleeding in 33 cases (54%). In the remaining 19 cases (31%) this site was not considered responsible because other sites of bleeding were present in the upper gastrointestinal tract. The 9 patients with active bleeding or stigmata of recent hemorrhage underwent injection treatment and the other 52 patients were treated with H2 antagonists. The low rebleed rate and the zero mortality recorded in this series indicate that endoscopy is the optimum method for diagnosis and treatment of patients with Mallory-Weiss syndrome.

Adult↗
PubMedDate not supplied

Diagnostic value of push-type jejunal endoscopy in primary jejunal carcinoma.

Push-type jejunal endoscopy using a long forward-viewing duodenofiberscope was performed in two patients with primary jejunal carcinoma. Patient 1, a 48-year-old female, complained of nausea, vomiting, and weight loss, whereas patient 2, a 65-year-old female, presented epigastric pain. The lesion was located in the upper portion of the jejunum, and diagnosis was made by a double-contrast X-ray study of the small intestine in both patients. Endoscopic examinations revealed a reddish, nodular polypoid lesion with an annular constriction and an irregular central ulceration. Endoscopic biopsy confirmed a diagnosis of adenocarcinoma in both patients. Push-type jejunal endoscopy is valuable for an accurate preoperative diagnosis of primary jejunal carcinoma.

Adenocarcinoma↗
PubMed1988

Electronic imaging in endoscopy.

Endoscopy evolved from a hollow tube view of visually restricted areas into an expansive, distal representation of the anatomy. Rod lens telescopes, improved coherent imaging bundles, superior light sources, and other optical advances enhanced endoscopic observations. Yet complicated endoscopic procedures remained visible to the endoscopist alone, relegating assistance and consultation to verbal description of sophisticated visual observation. Instrumentational advances alone did not promote three crucial elements: participation, cooperation and documentation. The importance of these elements has increased with the need for coordinated assistance in complex operative endoscopic manipulations, as well as in a visual record for improved documentation and consultation. New imaging technologies are supplanting the unwieldy, often daunting equipment once required for photodocumentation. The charged couple device (CCD) 2/3 and 1/2 in. "chip" video camera miniaturization provides nearly weightless TV coobservation. Distal chip placement has created the "video endoscope". Combined with the 8 mm tape format, the chip has created a lightweight, single unit camera, monitor, and recorder. A recent advantage, magnetic disc recording, permits still video storage of up to 25 images. An electronic printer produces a hard color copy (4 x 5), which is inserted in the chart before the patient leaves the endoscopy room. The cost of the equipment can be shared in multidisciplinary institutions.

Costs and Cost Analysis↗
PubMed1975

Paraprosthetic-enteric fistula. Role of Preoperative endoscopy.

A case of paraprosthetic-enteric fistula occurring after aortic aneurysectomy and Dacron graft placement is reported. Two and one-half years after aneurysectomy, the patient presented with the problems of fever of obscure origin, arthralgias, and anemia. The diagnosis of paraprosthetic-enteric fistula was made preoperatively by endoscopy. The role of endoscopy in the evaluation of postaneurysectomy complications is emphasized.

Aorta, Abdominal↗
PubMed1976

Crohn's disease of the colon. Analysis of the diagnostic value of radiology, endoscopy, and histology.

Radiologic, endoscopic, and histologic features were analyzed in 15 patients with Crohn's disease of the colon. Radiologic findings were considered of diagnostic value in only 6 (40%), characteristic endoscopic lesions were found in 13 (87%) and diagnostic histologic features in 11 (73%). Endoscopy combined with biopsy was diagnostic in all 15 cases. The extent of involvement of endoscopy frequently disagreed with the radiologic assessment, particularly in the rectosigmoid area. Studies in 8 patients indicate that sigmoidoscopy and coloscopy with multiple biopsies provide an accurate alternative to radiology to estimate the extent and severity of the lesions and their evolution during corticosteroid and/or azathioprine treatment.

Adolescent↗
PubMed1975

The role of fiberoptic endoscopy in the diagnosis and management of duodenal neoplasms.

This is a study of 11 cases of duodenal tumors encountered in 1200 consecutive duodenoscopic examinations over a 34-month period at The Johns Hopkins Hospital. Of these tumors, 4 were benign and 7 malignant. Endoscopic removal of 2 benign tumors was accomplished without morbidity and obviated the necessity for transabdominal surgery. The 2 other benign tumors were a probable lipoma and a benign polyp, and did not require surgical intervention. In 6 of the 7 patients with malignant lesions, the indication for performing duodenoscopy was an abnormal roentgenographic study. In each case, direct visualization of the abnormal area, together with biopsy and cytologic brushing, provided a definitive diagnosis of malignant disease and helped plan the therapeutic course. In the seventh patient, a primary adenocarcinoma at the duodenojejunal junction was found on endoscopic examination, after all other available diagnostic studies to find the cause of persistent gastrointestinal bleeding had been exhausted. Although duodenal tumors are not common, they were encountered in 1 of every 100 duodenoscopies at a referral center. With increasing use of fiberoptic endoscopy, such tumors will undoubtedly be seen with increasing frequency. In our experience, endoscopy has proved to be a safe and reliable method of distinguishing between benign and malignant duodenal neoplasms and of assistance in planning subsequent management.

Adenocarcinoma↗
PubMed1981

[Surgery in pregnancy from an endoscopy viewpoint].

Gastrointestinal endoscopy with flexible instruments is also a suitable method for pregnant women. Pregnancy is generally not a contraindication for use of the endoscopy, and additional special preparations are usually not necessary. In cases with unclear upper abdominal pain the esophagogastro-duodenoscopy with thin instruments is more suitable than X-ray examination. An indication for the coloscopy can occur in patients with relapsing peranal hemorrhage or diarrhea. For obstructive jaundice ERCP with PTC is the diagnostic method of choice.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMedDate not supplied

Emergency endoscopy: a basis for therapeutic decisions in the treatment of severe gastroduodenal bleeding.

This prospective study compares 3 different consecutive treatment protocols of gastroduodenal hemorrhage. Three hundred sixty-one patients underwent emergency endoscopy as the basis for further treatment. Clinical and endoscopic findings, such as site and type of the bleeding source, bleeding activity and intensity, age, and concomitant diseases of the patient were scored between 0 and 6 points, the higher number indicating a higher risk. The mean values of the total score of the 7 risk factors were comparable in the 3 treatment protocols. In period I (n = 77), a total of 16 patients (20.8%) underwent emergency operations because of severe bleeding, 27 (35%) were operated on after cessation of the bleeding, and 34 (44.2%) were treated conservatively. The mortality was 16.9%. In period II (n = 116), patients with actively bleeding lesions (n = 38) underwent endoscopic sclerotherapy, with a primary rate of hemostasis in 95%. As a result, the rate of emergency surgery could be reduced to 12.9% and the mortality for the entire group was reduced to 9.5%. The problem in this protocol was the rate of recurrent bleeding after primary endoscopic hemostasis: 13/116 (11.2%). Eleven of the 13 rebleeders presented with a lesion either on the back wall of the duodenum or with a visible vessel. In period III (n = 168), a total of 83 patients (50%) underwent endoscopic injection therapy with a primary success in 93%. Sixteen patients (9.5%) with lesions of high rebleeding risk (duodenal ulcer on the posterior wall or visible vessel) were scheduled for urgent elective operation after volume resuscitation within 24 hours of emergency endoscopy (mortality, 6.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

Duodenal Diseases↗