scholarly journals Examine the Availability and Safety of Mucosal Cutting Biopsy Technique for Diagnosis of Gastric Submucosal Tumor

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Kazuhiro Mizukami ◽  
Osamu Matsunari ◽  
Ryo Ogawa ◽  
Yuka Hirashita ◽  
Kazuhisa Okamoto ◽  
...  
Keyword(s):  
Diagnostic Yield ◽  
Submucosal Tumor ◽  
Postoperative Bleeding ◽  
Case Series ◽  
Pathological Diagnosis ◽  
Maximum Diameter ◽  
Tumor Diameter ◽  
Safe Procedure ◽  
Submucosal Tumors ◽  
Case Series Study

Objectives. Differentiating gastrointestinal stromal tumor (GIST) from other submucosal tumors (SMTs) is important in diagnosing SMT. GIST is an immunohistological diagnosis that cannot be made from images alone. Tissue sampling of tumor sites is thus becoming increasingly important. In this study, the utility and associated complications of mucosal cutting biopsy (MCB) for gastric SMTs were investigated. Methods. This was a case series study. The subjects were patients aged ≥20 years old in whom an SMT was seen on esophagogastroduodenography and who underwent MCB between January 2012 and December 2016. Patient information, endoscopy findings, gastric SMT size, pathological diagnosis, and other information were gathered from medical records. The SMT size was the maximum diameter that could be visualized on EUS. The pathological diagnosis was made with hematoxylin-eosin staining, with immunostaining added to diagnose GIST. The endpoint was the histopathological diagnostic yield. Risk assessment using the Miettinen classification and modified Fletcher classification was also done for GISTs treated with surgery. Results. The mean tumor diameter was 15.4 mm. The tumor diameter was ≥20 mm in seven patients and <20 mm in 23 patients. The tissue-acquiring rate was 93.3%. A histological diagnosis could not be made in two patients. The only complication was that bleeding required endoscopic hemostasis during the procedure in one patient, but no subsequent bleeding or no postoperative bleeding was seen. Conclusions. MCB is an appropriate and safe procedure in the diagnosis of gastric SMTs. Many hospitals will be able to perform MCB if they have the environment, including skills and equipment, to perform endoscopic submucosal dissection.

scholarly journals Cryoprobe biopsy for the diagnosis of acute hypoxemic respiratory failure of undetermined origin

2019 ◽  
Vol 21 (2) ◽  
pp. 119-123
Author(s):  
Marcos J Las Heras ◽  
Jose Dianti ◽  
Manuel Tisminetzky ◽  
Graciela Svetliza ◽  
Sergio E Giannasi ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Diagnostic Yield ◽  
Specific Treatment ◽  
Case Series ◽  
Safe Procedure ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Select Group ◽  
Lung Sample ◽  
Appropriate Treatment

Rationale Acute hypoxemic respiratory failure is a condition that comprises a wide array of entities. Obtaining a histological lung sample might help reach a diagnosis and direct an appropriate treatment in a select group of patients. Objective To describe our experience in the use of cryobiopsy for the diagnosis of acute hypoxemic respiratory failure of undetermined origin. Methods Retrospective analysis of case series of patients with acute hypoxemic respiratory failure who underwent lung cryobiopsy at the Intensive Care Unit of the Hospital Italiano de Buenos Aires, Argentina. Results Cryobiopsy yielded a histological diagnosis in all patients ( n = 10, 100%). This led to either a change in therapy or continuation of a specific treatment in eight of these patients. Cryobiopsy was found to be contributive in all the patients who did not meet Berlin criteria for acute respiratory distress syndrome. No major complications were associated with the procedure. Conclusions Cryobiopsy is a safe procedure with a high diagnostic yield in a selected group of patients.

Clinical outcomes of transoral robot-assisted supraglottic laryngectomy: An experience of a French cooperative evaluation group of transoral robotic surgery.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6053-6053
Author(s):  
Philippe Ceruse ◽  
Benjamin Lallemant ◽  
Karine Aubry ◽  
Sylvain Morinieres ◽  
Sebastien Vergez ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Functional Outcomes ◽  
Postoperative Bleeding ◽  
Case Series ◽  
Adjuvant Radiation ◽  
Safe Procedure ◽  
Robot Assisted ◽  
Multicentric Study ◽  
Percutaneous Gastrostomy ◽  
Supraglottic Laryngectomy

6053 Background: Transoral, minimally invasive organ preservation surgeries are being increasingly used for laryngopharyngeal carcinomas to avoid the toxicities of combined chemotherapy and radiation therapy regimens. This study investigates the efficiency, safety, and functional outcomes of transoral robot assisted surgery (TORAS) for supraglottic laryngectomy. Methods: Experience of TORA supraglottic laryngectomy for patients with supraglottic carcinomas is presented in a multicentric study of a case series with planned data collection between 2009 and 2012. Results: Eighty-six of 262 patients underwent TORA supraglottic laryngectomy for supraglottic carcinomas. Thirty-three percent of patients were started an oral diet within 24 hours. For 77% of the other patients, the median use of a feeding tube was 8 days (0-10 months). Nine percent of them had a definitive percutaneous gastrostomy feeding. For 87% of patients no tracheotomy was performed, for 23% of the others patients, the median use of tracheotomy was 8 days, 3% of them had a definitive tracheotomy. Aspiration was observed in 22% of the patients in the postoperative course and was responsible for the death of one patient. Sixteen percent of the patients had a postoperative bleeding. Fifty percent of the patients received adjuvant radiation therapy based on pathology results. Conclusions: TORA supraglottic laryngectomy is a safe procedure with good functional outcomes and fast recovery but adverse events are possible. Consequently this technique needs a good selection of the patients to reduce the risk of postoperative complications.

scholarly journals Endoscopic transcecal appendectomy: a new endotherapy for appendiceal orifice lesions

Endoscopy ◽  
2021 ◽  
Author(s):  
Linjie Guo ◽  
Liansong Ye ◽  
Yilong Feng ◽  
Johannes Bethge ◽  
Juliana Yang ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Postoperative Bleeding ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Lesion Size ◽  
Complete Resection ◽  
Technical Success ◽  
Case Series Study ◽  
Submucosal Lesions

Background Endoscopic transcecal appendectomy (ETA) has been reported as a minimally invasive alternative procedure for lesions involving the appendiceal orifice. The aim of this case series study was to evaluate the feasibility, safety, and effectiveness of ETA for lesions at the appendiceal orifice. Methods This retrospective study included consecutive patients with appendiceal orifice lesions who underwent ETA between December 2018 and March 2021. The primary outcome was technical success. The secondary outcomes included postoperative adverse events, postoperative hospital stay, and recurrence. Results 13 patients with appendiceal orifice lesions underwent ETA during the study period. The median lesion size was 20 mm (range 8–50). Lesions morphologies were polypoid lesions (n = 5), laterally spreading tumors (n = 4), and submucosal lesions (n = 4). Technical success with complete resection was achieved in all 13 cases. There were no postoperative bleeding, perforation, or intra-abdominal abscess. The median length of hospital stay after ETA was 8 days (range 6–18). There was no tumor recurrence during a median follow-up of 17 months (range 1–28). Conclusions ETA is feasible, safe, and effective for complete resection of appendiceal orifice lesions. Larger, multicenter, prospective studies are needed to further assess this technique.

scholarly journals Single-incision intragastric resection for upper and mid gastric submucosal tumors: a case-series study

2014 ◽  
Vol 87 (6) ◽  
pp. 304 ◽  
Author(s):  
Chang In Choi ◽  
Si Hak Lee ◽  
Sun Hwi Hwang ◽  
Dae Hwan Kim ◽  
Tae Yong Jeon ◽  
...  
Keyword(s):  
Single Incision ◽  
Case Series ◽  
Submucosal Tumors ◽  
Gastric Submucosal Tumors ◽  
Case Series Study ◽  
Series Study

scholarly journals Complex Modes of Inheritance in Hereditary Red Blood Cell Disorders: A Case Series Study of 155 Patients

Genes ◽  
2021 ◽  
Vol 12 (7) ◽  
pp. 958
Author(s):  
Immacolata Andolfo ◽  
Stefania Martone ◽  
Barbara Eleni Rosato ◽  
Roberta Marra ◽  
Antonella Gambale ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Hereditary Spherocytosis ◽  
Diagnostic Yield ◽  
Case Series ◽  
Targeted Next Generation Sequencing ◽  
Complex Modes ◽  
Case Series Study ◽  
Molecular Bases ◽  
Dual Inheritance

Hereditary erythrocytes disorders include a large group of conditions with heterogeneous molecular bases and phenotypes. We analyzed here a case series of 155 consecutive patients with clinical suspicion of hereditary erythrocyte defects referred to the Medical Genetics Unit from 2018 to 2020. All of the cases followed a diagnostic workflow based on a targeted next-generation sequencing panel of 86 genes causative of hereditary red blood cell defects. We obtained an overall diagnostic yield of 84% of the tested patients. Monogenic inheritance was seen for 69% (107/155), and multi-locus inheritance for 15% (23/155). PIEZO1 and SPTA1 were the most mutated loci. Accordingly, 16/23 patients with multi-locus inheritance showed dual molecular diagnosis of dehydrated hereditary stomatocytosis/xerocytosis and hereditary spherocytosis. These dual inheritance cases were fully characterized and were clinically indistinguishable from patients with hereditary spherocytosis. Additionally, their ektacytometry curves highlighted alterations of dual inheritance patients compared to both dehydrated hereditary stomatocytosis and hereditary spherocytosis. Our findings expand the genotypic spectrum of red blood cell disorders and indicate that multi-locus inheritance should be considered for analysis and counseling of these patients. Of note, the genetic testing was crucial for diagnosis of patients with a complex mode of inheritance.

scholarly journals Cryobiopsy In Flexi-Rigid Pleuroscopy in a Region with Low Mesothelioma Prevalence

2020 ◽  
Author(s):  
Larry Nyanti
Keyword(s):  
Pleural Effusion ◽  
Tissue Sample ◽  
Diagnostic Yield ◽  
Case Series ◽  
Early Experience ◽  
Small Cell ◽  
Definitive Diagnosis ◽  
Safe Procedure ◽  
Large Prospective Study ◽  
High Diagnostic Yield

Background: The use of conventional flexible forceps during flex-rigid pleuroscopy can be challenging when sampling hard and thickened pleura. Pleuroscopic cryobiopsy is an emerging field, with various early studies demonstrating good yield and minimal complications. Objectives: To review the authors’ early experience of pleuroscopic cryobiopsy in their centre and highlight its utility in the diagnosis of mesothelioma. Method: Six cases of undiagnosed pleural effusion that underwent pleuroscopic cryobiopsy via flexi-rigid pleuroscopy between July 2017 and June 2019 were retrospectively analysed. Results: The cohort had a median age of 59 years, consisting of two females and four males with a median age of 57 years. Mean (aggregate) tissue sample diameter was 9.2±1.9 mm. Cryobiopsy established a definitive diagnosis in all six cases: one case of malignant mesothelioma, one pleural tuberculosis, two small cell carcinomas, and two adenocarcinomas. Immunohistochemical staining was performed in all five of the malignant samples (100%). There were no major complications reported. Conclusions: Based on the case series, pleuroscopic cryobiopsy is a feasible adjunct to conventional forceps biopsy, a safe procedure in the authors’ setting, gives high diagnostic yield, and enables differentiation between the different causes of exudative pleural effusion. A large, prospective study is required to validate this retrospective series.

scholarly journals Endoscopic submucosal dissection for rectal neoplastic lesions: experience from a European center.

2021 ◽  
Author(s):  
Michał Spychalski ◽  
Marcin Włodarczyk ◽  
Jakub Włodarczyk ◽  
Igor Dąbrowski ◽  
Piotr Bednarski ◽  
...  
Keyword(s):  
Endoscopic Submucosal Dissection ◽  
Case Series ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
R0 Resection ◽  
Safe Procedure ◽  
Rectal Tumors ◽  
En Bloc ◽  
Submucosal Dissection ◽  
Case Series Study

IntroductionNowadays, various endoscopic resections including polypectomy, endoscopic mucosal resection (EMR), and endoscopic submucosal dissection (ESD) are well known first-line approaches for early neoplastic rectal tumors.Material and methodsIn this case series study, we analyzed 320 ESD procedures performed in a high-volume colorectal center in Poland, Europe. The aim of this study was to retrospectively evaluate ESD procedure in cases of rectal carcinoma performed by a single trained operator in a referral center provided with endoscopy.ResultsOverall, en bloc resection was observed in 92.5% of patients (296/320). The en bloc resection rate was at a similar level in those lesions with involved anal sphincters versus tumors without involvement (93.85% vs. 92.16%; p=0.644). R0 resection was noted in 89.4% of patients (286/320). The overall curative ESD rate was 85.94% (n=275). The curative ESD rate in the invasive cancer group reached 52.6% (n=20). We observed ESD-related adverse events, such as bleeding and perforation, in 3.4 % of patients (n=11).ConclusionsWe have demonstrated that ESD in rectal tumors is an efficient and safe procedure with a high curative rate, even in difficult lesions. Anal sphincter localization and recurrent character of the lesion have no impact on the final outcomes. The ESD approach should have been considered for all rectal tumors, especially those lesions suspected of superficial mucosal invasion, as it can serve as a staging method and may have been curative for adenomas and cancers limited to mucosa.

scholarly journals Laryngeal injury and dysphonia after endotracheal intubation

2021 ◽  
Vol 14 (3) ◽  
pp. 355-360
Author(s):  
Ali Ahmad Al Saeg ◽  
◽  
Haitham Alnori ◽  
◽  
Keyword(s):  
Endotracheal Intubation ◽  
Rare Complication ◽  
Case Series ◽  
Preoperative Assessment ◽  
Safe Procedure ◽  
Laryngeal Injury ◽  
Case Series Study ◽  
Prospective Case Series ◽  
The Voice

We carried out a prospective case series study in order to evaluate the laryngeal complications of the endotracheal tube. Two hundred patients aged 15 years and above who were subjected to endotracheal intubation for less than 5 hours were enrolled in the study. The data were collected from the Al-Salam Teaching Hospital in Mosul, Iraq. A preoperative assessment was accomplished clinically using 70º and/or 90º Hopkins rods or fiber optic laryngoscopy. As part of the assessment, the patients' voices were recorded as well. Five to seven days after the procedure, the same assessment was repeated and compared to the preoperative data. If the postoperative examination and the voices were similar to the preoperative data, no follow-up was performed. If any abnormality was found in the larynx, the examination was repeated once weekly for one month or until the voice was recovered. In our study, five patients (2.5%) had intubation-related laryngeal injuries. The intubation period, changes in the position of the head or body of the patient during anesthesia, and the difficulty of intubation raised the possibility of laryngeal injuries. In general, intubation is a safe procedure; however, a laryngeal injury may appear as a rare complication. We found that there is a relation between the intubation period, changing the position of the patient during intubation, and difficulty of intubation with the occurrence of laryngeal injury.

scholarly journals Hole Diameter Ratio for Prediction of Anatomical Outcomes in Stage III or IV Idiopathic Macular Holes 

2020 ◽  
Author(s):  
Yue Qi ◽  
Yanping Yu ◽  
Qisheng You ◽  
Zengyi Wang ◽  
Jing Wang ◽  
...  
Keyword(s):  
Case Series ◽  
Diameter Ratio ◽  
Hole Diameter ◽  
Stage Iii ◽  
Maximum Diameter ◽  
Type I ◽  
Closure Rate ◽  
Macular Holes ◽  
Case Series Study ◽  
Idiopathic Macular Holes

Abstract Purpose: To determine whether preoperative hole diameter ratio (HDR) is a predictive factor for postoperative anatomical outome for stage III or IV idiopathic macular holes (IMHs).Methods: One-hundred and one eyes with stage III or IV IMH were included in this retrospective case series study.
All cases were treated with vitrectomy combined with internal limiting membrane (ILM) peeling and room air tamponade. The macular hole (MH) minimum and maximum diameter was measured on preoperative optical coherence tomography (OCT) images. The HDR was defined as the minimum to maximum diameter ratio. Results: Eighty-one eyes (80.2%) got a Type I closure after surgery (group A). Postoperative unclosed MHs were found in 20 eyes (19.8%) (group B). The preoperative minimal diameter (703.6±116.1mm vs. 597.6±120.1mm, P<0.01) and HDR (0.6±0.1 vs. 0.5±0.1, P=0.01) were both significantly smaller in postoperative closed eyes. The closure rate of IMHs with HDR<0.6 was significantly higher than those with HDR³0.6 (90.2% vs. 65.0%P=0.002) .Conclusions: Preoperative HDR<0.6 is predictive for a good postoperative anatomical outcome in stage III or IV IMHs.

scholarly journals Laparoscopic and endoscopic cooperative surgery (LECS) to overcome the limitations of endoscopic resection for colorectal tumors

2018 ◽  
Vol 06 (12) ◽  
pp. E1477-E1485 ◽  
Author(s):  
Yoshiro Tamegai ◽  
Yosuke Fukunaga ◽  
Shinsuke Suzuki ◽  
Dennis Lim ◽  
Akiko Chino ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Submucosal Tumor ◽  
Anastomotic Stricture ◽  
Invasive Procedure ◽  
Tumor Diameter ◽  
Colorectal Tumors ◽  
Conversion To Open Surgery ◽  
Submucosal Tumors ◽  
Intramucosal Cancer ◽  
Severe Fibrosis

Abstract Background and study aims We developed a laparoscopy endoscopy cooperative surgery (LECS) to overcome the limitations of endoscopic resection for colorectal tumors. The aim of this study was to evaluate the feasibility of LECS, which combines endoscopic submucosal dissection (ESD) and laparoscopic partial colectomy. Patients and methods We performed LECS for 17 colorectal tumors in 17 patients (male:female 10:7; mean age, 66.5 years). The clinicopathological outcomes of these 17 cases and the feasibility of LECS were evaluated retrospectively. Indications for LECS were as follows: 1) intramucosal cancer and adenoma accompanied by wide and severe fibrosis; 2) intramucosal cancer and adenoma involving the diverticulum or appendix; and 3) submucosal tumors. Results We successfully performed LECS procedures in 17 cases (intramucosal cancer [n = 6], adenoma [n = 9], schwannoma [n = 1], and gastro-intestinal stromal tumour [GIST] [n = 1]. Mean tumor diameter was 22.4 mm (range, 8 – 41 mm). LECS was successfully performed in all 17 cases without conversion to open surgery; the R0 rate was 100 %. LECS was applied to the following situations: involving the appendix (n = 6), tumor accompanied by severe fibrosis (n = 5), involving the diverticulum (n = 3), submucosal tumor (n = 2), and poor endoscopic operability (n = 1). We experienced no adverse events (e. g., leakage or anastomotic stricture) and the median hospital stay was 6.4 dayus (range, 4 to 12). All 17 patients who were followed for ≥ 3 months (median, 30.8 months; range, 3 – 72 months) showed no residual/local recurrence. Conclusion LECS was a safe, feasible, minimally invasive procedure that achieved full-thickness resection of colorectal tumors and showed excellent clinical outcomes.

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