Gastroenterologie a Hepatologie最新文献

{"title":"Pelvic floor disorders of women from the point of coloproctologist‘s view","authors":"A. Berková, P. Vlček, V. Červeňák, J. Dolina, T. Vystrčilová, B. Hemmelová, Z. Chovanec","doi":"10.48095/ccgh2022319","DOIUrl":"https://doi.org/10.48095/ccgh2022319","url":null,"abstract":"Summary: Disorders of the pelvic floor and anorectal dysfunction are a major cause of discomfort for many women. As a result of shyness and embarrassment, women come for medical examination after a longer period of difficulties, mostly for progressive disorder of defecation and continence. Despite the low morbidity, anorectal dysfunctions have a very significant impact on patient’s quality of life and therefore dia­gnosis and subsequent treatment should be aimed at every possible cause. Gastroenterological examination can play an important part In primary detection, but also in the multidisciplinary dia­gnostic process of pelvic floor pathology. Likewise, coloproctology is an integral part of the dia­gnostic-therapeutic algorithm of pelvic dysfunctions. The aim of the article is to provide information on the pathophysiology, dia­gnosis and treatment of anorectal disorders from the perspective of coloproctology. Anorectal dysfunctions are a multidisciplinary problem, therefore, to achieve good treatment results, the cooperation of different specializations is essential. Key words: anorectal dysfunction – defecation – prolapse – rectocele – incontinence – rectopexy","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88057302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic therapy of gastroesophageal reflux disease using radiofrequency energy (Stretta procedure) – treatment of the first patients in the Czech Republic","authors":"K. Košťálová, S. Suchanek, Lucie Zdrhova, J. Koželuhová, M. Zavoral, P. Urbánek, K. Balihar","doi":"10.48095/ccgh2022228","DOIUrl":"https://doi.org/10.48095/ccgh2022228","url":null,"abstract":"Gastroesophageal reflux disease (GERD) is the most common disease of the gastrointestinal tract, affecting approximately a quarter of the European population with an increasing incidence. Some patients with GERD do not get full relief with conservative approach with proton pump inhibitors (PPI), while surgical solution is burdened with a significant percentage of complications and its effectiveness decreases over time. Endoscopic therapy of GERD currently includes five different methods, none of which have, to the knowledge of the authors, been more widely available and performed in the Czech Republic. The methods of electrical oesophageal stimulation, endoscopic fundoplication and Stretta have the potential to be used in practice. The latter method consists in the application of a low-frequency radiofrequency energy to the oesophagogastric junction (EGJ). According to the data published so far, it is probably a less effective alternative to laparoscopic fundoplication for patients with hiatal hernia ≤ 2 cm and failed conservative treatment, but its favourable safety profile, absence of EGJ anatomy alteration, repeatability and long-time effect in most patients are its undeniable advantages. On the other hand, the need to select suitable patients for the procedure and higher costs are among its disadvantages. Despite its limitations, Stretta offers an alternative option in the future for selected patients who would like to avoid the risks associated with long-term PPIs and are concerned about the risks of laparoscopic fundoplication. Keywords gastroesophageal reflux disease, endoscopic therapy, radiofrequency energy, Stretta","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75257109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term and long-term results of pneumatic dilation in the treatment of patients with esophageal achalasia: 16 years of experience","authors":"E. Veseliny, M. Janíčko, M. Zakuciová, P. Jarčuška","doi":"10.48095/ccgh2022236","DOIUrl":"https://doi.org/10.48095/ccgh2022236","url":null,"abstract":"Background: Pneumatic dilation (PD) is still a common treatment of oesophageal achalasia. This retrospective analysis informs about 16 years of experience with pneumatic dilation in the treatment of patients with achalasia. Patients and methods: Consecutive patients with achalasia treated with endoscopic balloon dilation therapy were analysed retrospectively. The success of endoscopic pneumatic dilation was defined as no treatment other than pneumatic dilation and the overall clinical Eckardt score ≤ 3 (and at the same time each individual item <2). Results: From January 2004 to December 2019, 140 patients with achalasia consecutively underwent pneumatic dilation (67 males [47.9%], mean age 54.9 ±16.2 years). The median follow-up since the first dilation was 125 months (range 6–263 months). Satisfactory results were observed in 130 patients (92.9%). Out of the remaining ten patients, two (1.4%) had periprocedural oesophageal perforation and in 8 (5.7%) patients the treatment effect was insufficient. Out of all patients, 107/140 (76.4%) had only one PD, 22/140 (15.7%) had two PDs, three PDs were performed in 8/140 (5.7%) and four PDs in 3/140 (2.1%). Treatment failure was more common in patients who had more pneumatic dilations (1 PD 37.5%, 2 and more PDs 62.5%; P = 0.019). Conclusions: Endoscopic balloon dilation, starting with a 35 mm balloon, is an effective treatment for achalasia in the short and long term, with minimal morbidity. The possible incomplete effect of dilation therapy is more often manifested in an earlier period after the initial dilation therapy. Keywords achalasia, pneumatic dilation, long-term results, complications","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88959149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Some notes on mesalazine treatment in patients with ulcerative colitis and Crohn‘s disease","authors":"M. Lukáš","doi":"10.48095/ccgh2022248","DOIUrl":"https://doi.org/10.48095/ccgh2022248","url":null,"abstract":"","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88548155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sub-squamous neoplasia after radiofrequency ablation of Barrett’s oesophagus","authors":"Peter Slodička, P. Vaněk, T. Tichý, O. Urban","doi":"10.48095/ccgh2022218","DOIUrl":"https://doi.org/10.48095/ccgh2022218","url":null,"abstract":"The term sub-squamous neoplasia or “buried carcinoma” refers to neoplastic processes developing in intestinal metaplasia lesions localised in the lamina propria below the squamous epithelium of the oesophagus. Sub-squamous intestinal metaplasia are located in the transition area between Barrett and squamous epithelium and also beneath neo-squamous epithelium that develops post endoscopic ablation. To date, less than 20 cases of sub squamous neoplasia following successful radiofrequency ablation of Barrett’s oesophagus have been reported in the MedLine database. Knowledge of these conditions is important for adequate follow-up and timely dia gnosis of this potentially fatal complication. Keywords: radiofrequency ablation – buried carcinoma – Barrett’s oesophagus – oesophageal adenocarcinoma","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76298575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastroscopy – quality standards of the Czech Society of Gastroenterology","authors":"J. Cyrany, K. Balihar, P. Falt, D. Kohoutová, R. Kroupa, J. Martínek, Ivana Mikoviny-Kajzrlíková, Hana Klusáková, R. Procházka, M. Štěpán, T. Van̆ásek, S. Rejchrt","doi":"10.48095/ccgh2022194","DOIUrl":"https://doi.org/10.48095/ccgh2022194","url":null,"abstract":"","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86238793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare cause of biliary obstruction – a case study","authors":"Ivo Chrobok, M. Loveček, Dominika Fritzová, M. Sedlacek, P. Vítek","doi":"10.48095/ccgh2022223","DOIUrl":"https://doi.org/10.48095/ccgh2022223","url":null,"abstract":"We present a case study of a 47-year-old woman with cholecystolithiasis, in whom a diagnostic examination showed a solid-cystic lesion in the subhepatic region, oppressing the biliary tract. After completing examinations with imaging techniques (ultrasound, CT, MR) and endoscopic retrograde cholangiopancreatography (ERCP) with biliary drainage through a duodeno-biliary stent, the patient was directly indicated for a resection. Mucinous neoplasia of the biliary tract or cystic anomalies were considered as possible diagnoses prior to the surgery. The lesion was resected together with the adjacent gallbladder and biliary ducts. Surprisingly, the histological examination of the resected tissue showed a non-tumorous affection – adenomyomatosis of extrahepatic biliary ducts. Keywords: benign biliary obstruction – adenomyomatosis of gallbladder and biliary ducts","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80751149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of pancreatic fistula in laparoscopic left-sided pancreatectomies","authors":"P. Moravčík, Z. Kala, J. Hlavsa, V. Procházka, Tomáš Pavlík, L. Kunovský","doi":"10.48095/ccgh2022212","DOIUrl":"https://doi.org/10.48095/ccgh2022212","url":null,"abstract":"ntroduction: Postoperative pancreatic fistula (POPF) is one of the most serious complications in pancreatobiliary surgery. The management of clinically relevant grade B and C fistulas requires interventional management or reoperation. POPF is accompanied with high mortality rate. Prevention of fistula formation is a possible solution of the problem. Methods: A retrospective observational study of patients with pathology of pancreatic body or tail, who underwent laparoscopic distal pancreatectomy or splenopancreatectomy (LDP) a tour instution between 2016 and 2021. From 2020, a set of perioperative precautions to reduce POPF has been standardised. Primary objective was to determine the total number of POPFs, the number of POPF-associated bleeds, and POPF-associated mortality in the 2016–2021 cohort. Secondary objective was to compare the outcomes of the group of patients with standardised preventive measures operated on in 2020–2021 with the group of patients without standardised measures operated on in 2016–2019. Results: In 2016–2021, we performed a total of 67 laparoscopic distal pancreatectomies. Of these, 10 patients (14.9%) had clinically relevant POPF (CR-POPF) grade B or C and we observed biochemical leakage in 22 cases (32.8%). There was no POPF associated bleeding or POPF associated mortality. In the 2020–2021 group of 20 patients treated with the standardised precautions, we observed no CR-POPF, and biochemical leakage occurred in 7 patients (35%). In contrast, in the group of patients without any standardisation of treatment (47 patients), operated on in 2016–2019, CR-POPF occurred in 10 patients (21.3%) and biochemical leakage in 15 patients (31.9%). Conclusion: The results of our entire cohort of patients confirm high numbers of POPFs after LDP. The results of the subgroup of patients with standardised perioperative procedures aimed at reducing POPFs showed a significant reduction in CR-POPFs, suggesting good rates of efficacy of the preventive measures introduced. Keywords: surgery – Pancreas – postoperative complications – pancreatic fistula – distal pancreatectomy","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"26 8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82706382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remsima SC 120 mg – a new generation of biosimilar drugs","authors":"M. Lukáš","doi":"10.48095/ccgh202257","DOIUrl":"https://doi.org/10.48095/ccgh202257","url":null,"abstract":"","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77393049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of vedolizumab and ustekinumab in the treatment of pregnant women with inflammatory bowel disease – a multicentre retrospective-prospective observational study","authors":"B. Pipek, D. Ďuricová, K. Mitrová, M. Bortlík, L. Bouchner, J. Březina, T. Douda, Tomáš Drašar, P. Drastich, P. Falt, P. Klvaňa, P. Kohout, V. Leksa, A. Novotný, P. Svoboda, Jan Škorpík, J. Ulbrych, Marek Veinfurt, Blanka Zbořilová, M. Lukáš","doi":"10.48095/ccgh202246","DOIUrl":"https://doi.org/10.48095/ccgh202246","url":null,"abstract":"Background: Inflammatory bowel disease (IBD) is mostly diagnosed in young women of fertile age, and a significant number of patients become pregnant while they have the disease. The remission of the illness, which is often achieved by intensive anti inflammatory treatment, has been found to be the most important factor of a successful pregnancy. Vedolizumab (VDZ) and ustekinumab (UST) are newer types of monoclonal antibodies with different mechanisms of effect when compared to anti-TNF treatment. VDZ is a monoclonal antibody against the α4ß7 integrin receptor, and UST against interleukin 12/23; both have expanded the spectrum of the biological treatment of IBD in recent years. Aims: To present the results of a multicentre observational study. The primary aim was to assess the safety of vedolizumab and ustekinumab for pregnancy, foetal development and the neonatal outcome. The secondary aim was to measure the drug concentration in maternal and cord blood at the time of delivery. Methods: It was a multicentre, retrospective-prospective observational study. Data on patients’ demographics, clinical characteristics and pregnancy were collected by the treating physician using a predefined questionnaire, data on newborn outcome were obtained from medical documentation. The ELISA method was used to measure the VDZ and UST concentrations. Results: The study took place in 15 IBD clinical centres in the Czech Republic. 79 women with 85 completed pregnancies were included in the study, and they were exposed to VDZ or UST during pregnancy. 36 women were treated with vedolizumab (median age 32 years) and 49 with ustekinumab (median age 30.5 years). In the group with VDZ, live births occurred with 32 women (88.9%), and there were two early spontaneous abortions up to the eighth week of gestation in addition to two instrumentally aborted pregnancies (4, 11.1%). 31 children (93.9%) in the group with VDZ were born at term with a median birth weight of 3,097.5 grams. In the ustekinumab group, 39 women (79.6%) had live births, there were nine early abortions and one instrumentally aborted pregnancy (10, 20.4%). 38 (97.4%) children were born at term with a median birth weight of 3,265 grams. The drug levels of VDZ and UST at birth were measured in 44 neonate-mother pairs (21 VDZ, 23 UST). The median level of VDZ in maternal venous blood was 7.2 mg/l, and in cord blood it was 4.7 mg/l (infant / maternal ratio 0.66). With UST, the median maternal level was 4.7 mg/l, and in neonates it was 7.9 mg/l (infant / maternal ratio 1.65). Conclusion: The results found in a group of women that were being treated for IBD and were exposed to at least one dose of biologic treatment with UST or VDZ during pregnancy are consistent with previously published evidence showing no adverse events, and they confirm the safety profile of new biologics in pregnancy. Due to the still limited number of enrolled patients, further studies are needed on the outcomes of pregnancies with new biologic","PeriodicalId":38577,"journal":{"name":"Gastroenterologie a Hepatologie","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86973484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}