Seminars in gastrointestinal disease最新文献_第2页

Early diagnosis of esophageal adenocarcinoma. 食管腺癌的早期诊断。

Seminars in gastrointestinal disease Pub Date : 2003-07-01

Bruno Buecher, Jean Paul Galmiche

{"title":"Early diagnosis of esophageal adenocarcinoma.","authors":"Bruno Buecher, Jean Paul Galmiche","doi":"","DOIUrl":"","url":null,"abstract":"The incidence of esophageal adenocarcinoma has increased dramatically in developed countries during the past 2 decades, and prognosis remains very poor. Gastroesophageal reflux disease is an important risk factor for this cancer that develops in patients with specialized esophageal metaplasia (Barrett's esophagus). Careful periodic endoscopic examinations, with random biopsy sampling of the entire mucosal surface, are usually recommended for the surveillance of these patients. Several innovative techniques have recently been developed to improve the accuracy of diagnosis of intestinal metaplasia, dysplasia, and early adenocarcinoma in Barrett's esophagus. Some of these techniques (eg, chromoendoscopy, magnifying endoscopy, and light-induced fluorescence endoscopy) are intended to identify suspicious areas of the mucosa not visible during conventional endoscopic examination and to perform targeted biopsies toward these areas to avoid sampling errors. Optical coherence tomography and confocal laser scanning microscopy are other powerful techniques that provide real-time cross-sectional tissue images at a resolution close to that of histology. They allow tissue characterization based solely on optical properties and are likely to replace excisional biopsies. Although promising, none of these techniques is currently recommendable for routine surveillance of patients with Barrett's esophagus. Further evaluation is warranted to define the optimal method and standardize the procedures.","PeriodicalId":79377,"journal":{"name":"Seminars in gastrointestinal disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24106410","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}

引用次数: 0

Staging esophageal adenocarcinoma. 食管腺癌分期。

Seminars in gastrointestinal disease Pub Date : 2003-07-01

Ian F Yusoff, Anand V Sahai

{"title":"Staging esophageal adenocarcinoma.","authors":"Ian F Yusoff, Anand V Sahai","doi":"","DOIUrl":"","url":null,"abstract":"The incidence of esophageal adenocarcinoma has increased dramatically in Western societies over the last 20 years. Most patients present with advanced disease. Stage-dependent treatment protocols require the most complete and accurate staging possible. With all esophageal cancers (ie, adenocarcinomas and squamous carcinomas), it is perhaps most important to identify patients who are unlikely to benefit from aggressive treatment. The performance characteristics and clinical utility of CT scanning, endoscopic ultrasound, FDG-PET, and minimally invasive surgery in staging esophageal cancer are reviewed, including issues relating specifically to staging of adenocarcinomas. These investigations are not mutually exclusive and each has its own strengths and shortcomings. Accurate staging often requires the use of multiple modalities. The optimal staging algorithm for a given practice setting (if it exists) will be determined largely by local variables that include patient population, available technology, and local expertise in applying such technology. A lack of consensus on the effectiveness of therapeutic alternatives (particularly surgical v nonsurgical methods) may also affect the perceived value of the various staging modalities and how they are used.","PeriodicalId":79377,"journal":{"name":"Seminars in gastrointestinal disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24106411","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}

引用次数: 0

Emergencies after liver transplantation. 肝移植后紧急情况。

Seminars in gastrointestinal disease Pub Date : 2003-04-01

Carlos E Marroquin, J Elizabeth Tuttle-Newhall, Bradley H Collins, Paul C Kuo, Rebecca A Schroeder

{"title":"Emergencies after liver transplantation.","authors":"Carlos E Marroquin, J Elizabeth Tuttle-Newhall, Bradley H Collins, Paul C Kuo, Rebecca A Schroeder","doi":"","DOIUrl":"","url":null,"abstract":"Liver transplantation has become the procedure of choice for a wide variety of patients with end-stage liver disease. Perioperative morbidity and mortality have decreased dramatically over the past two decades, and superior graft and patient survival rates are now routine. Despite these advances, however, there remain several potentially lethal possibilities that may complicate the immediate postoperative period. Failure of the graft to regain any useful metabolic activity is known as primary nonfunction, and almost uniformly requires retransplantation for any hope of survival. Lesser degrees of immediate dysfunction require experienced clinical judgment as to the probability of sustaining long-term patient viability. Another potentially catastrophic development is thrombosis of the grafted hepatic artery. This is sometimes successfully managed by surgical reconstruction. It may develop immediately, or present insidiously much later. Thrombosis of the portal vein, while not usually fatal, can significantly complicate the immediate course, carrying with it a significant risk of sepsis. Close monitoring of patients in the period following liver transplantation is crucial, as prompt diagnosis and early intervention directly affects the patient's chances of survival.","PeriodicalId":79377,"journal":{"name":"Seminars in gastrointestinal disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22506779","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}

引用次数: 0

Acute gastrointestinal bleeding. 急性消化道出血。

Seminars in gastrointestinal disease Pub Date : 2003-04-01

Bryan T Green, Don C Rockey

{"title":"Acute gastrointestinal bleeding.","authors":"Bryan T Green, Don C Rockey","doi":"","DOIUrl":"","url":null,"abstract":"Acute gastrointestinal bleeding is a common disorder with a wide spectrum of presentations that may encompass multiple clinical scenarios. Initial hemodynamic assessment and resuscitation are critical. Once accomplished, the source of bleeding should be localized, active bleeding should be stopped, the underlying abnormality should be treated, and recurrent bleeding should be prevented. The means to accomplish these goals depends on the specific clinical situation. For most forms of upper gastrointestinal bleeding, early endoscopy is the cornerstone of diagnosis and management. It can predict and improve clinical outcomes. A variety of endoscopic and pharmacologic modalities are effective at achieving and maintaining hemostasis. The optimum means of evaluation and treatment of acute lower gastrointestinal bleeding is less clear and is now evolving. Endoscopy (usually expectant, less often early) is widely used and effective for diagnosis but has unproven therapeutic benefits. Angiography is effective (diagnostically and/or therapeutically) in certain situations. Surgery offers the opportunity for definitive therapy at the cost of higher morbidity. At this time, the approach to evaluation and management should be based on the specific clinical situation and available local expertise.","PeriodicalId":79377,"journal":{"name":"Seminars in gastrointestinal disease","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22506204","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}

引用次数: 0

Acute intestinal ischemia and infarction. 急性肠缺血和梗死。

Seminars in gastrointestinal disease Pub Date : 2003-04-01

David A Tendler

引用次数: 0

Fulminant hepatic failure. 暴发性肝衰竭。

Seminars in gastrointestinal disease Pub Date : 2003-04-01

Michael A Heneghan, Luis Lara

引用次数: 0

Fulminant hepatic failure. 暴发性肝衰竭。

Seminars in gastrointestinal disease Pub Date : 2003-04-01 DOI: 10.1002/9780470751541.CH13

M. Heneghan, L. Lara