Long-Term Follow-Up of Biofragmentable Anastomoses Rings in the Lower Gastrointestinal Tract

Author(s):  
S. Vogel ◽  
R. Engemann ◽  
M. Sailer ◽  
A. Thiede
2015 ◽  
Vol 87 (6) ◽  
Author(s):  
Katarzyna Kuśnierz ◽  
Paweł Lampe

AbstractThe aim of the study was to present the first long-term results on the clinical use of compression anastomosis clips (CAC) in upper and lower gastrointestinal tract anastomoses.Material and methods. The study included 50 patients who underwent anastomosis of the upper (n = 32) or lower GI tract (n = 18) with the use of CAC. In the period of 6‑7 months after the surgery, patients underwent endoscopic examination and computed tomography evaluation of the anastomosis. Each anastomosis was evaluated macro and microscopically. The width of anastomoses was evaluated using a 4-point-scale for grading stenosis.Results. Of the 50 patients who underwent anastomosis with compression anastomosis clip, 28 (56%) patients reported to the follow-up examination within 190‑209 days of the execution of the anastomosis. Among the 22 patients who did not report to the study, 18 (36%) patients died within 91‑154 days from the execution of the anastomosis (mean 122 days), 4 (8%) patients were impossible to contact after discharge from hospital. Two mild stenoses (I0) were diagnosed; 1 of them was found in the gastroenterostomy and 1 in Braun enteroenterostomy. Microscopic changes were diagnosed in 4 anastomoses (3 gastroenterostomies, 1 Braun enteroenterostomy). Anastomoses were well-formed and wide, scars in the line of anastomoses were thin.Conclusions. During the period of 6 months after the anastomoses performed using CAC have been formed, they were evaluated as unobstructed and functioning properly; therefore, they can be safely performed within the upper and lower gastrointestinal tract.


2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Sunil Vitthalrao Jagtap

GISTs (Gastrointestinal Stromal Tumors) are the most frequently encountered mesenchymal tumor of the gastrointestinal tract. Gastrointestinal stromal tumors have been recognized as a biologically distinctive tumor type, different from smooth muscle and neural tumors of the gastrointestinal tract (GIT). GISTs present 0.1%-3.0% of gastrointestinal malignant tumors. The goals in treating patients with GIST are to maximize the chance of cure, minimize recurrence. A multidisciplinary approach to patients with GISTs is necessary to optimize the timing of medical and surgical therapy as they have unpredictable behavior. Also long term follow up is essential for all patients, independent of their benign or malignant characteristics. This review highlight on clinical, diagnostic imaging, histopatholpgical, immunohistochemical ,new markers and management modalities for Gastrointestinal Stromal Tumors (GISTs) and Extragastrointestinal stromal tumors (E-GISTs).


2014 ◽  
Vol 174 (3) ◽  
pp. 853-855 ◽  
Author(s):  
Michael Jeserich ◽  
Manfred Olschewski ◽  
Simone Kimmel ◽  
Christoph Bode ◽  
Annette Geibel

2019 ◽  
Vol 42 ◽  
Author(s):  
John P. A. Ioannidis

AbstractNeurobiology-based interventions for mental diseases and searches for useful biomarkers of treatment response have largely failed. Clinical trials should assess interventions related to environmental and social stressors, with long-term follow-up; social rather than biological endpoints; personalized outcomes; and suitable cluster, adaptive, and n-of-1 designs. Labor, education, financial, and other social/political decisions should be evaluated for their impacts on mental disease.


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