Comparison between minimally invasive and open surgical treatment in necrotizing pancreatitis.

Background: Minimal access techniques have gained popularity for the management of necrotizing pancreatitis, but only a few studies compared open necrosectomy with a less invasive treatment. The aim of this study was to evaluate the outcomes of minimally invasive treatment for necrotizing pancreatitis in comparison with open necrosectomy.

Materials And Methods: This retrospective study included 70 patients who underwent minimally invasive intervention or open surgical debridement for necrotizing pancreatitis between January 2007 and December 2014.

Colorectal cancer tumour markers and biomarkers: Recent therapeutic advances.

Colorectal cancer (CRC) is the second most commonly diagnosed cancer among females and third among males worldwide. It also contributes significantly to cancer-related deaths, despite the continuous progress in diagnostic and therapeutic methods. Biomarkers currently play an important role in the detection and treatment of patients with colorectal cancer.

Parenchyma-Sparing Pancreatic Resections: With or Without a Pancreaticojejunostomy?

Background/aim: Parenchyma-sparing pancreatic resections are used in low-grade malignant tumors, but result in a high incidence of pancreatic fistula. Pancreaticojejunostomy to the site of resection might decrease the risk of pancreatic fistula. The purpose of this study was to evaluate the influence of pancreaticojejunostomy on the outcomes of parenchyma-sparing resections.

Giant gastrointestinal stromal tumour of rare sarcomatoid epithelioid subtype: case study and literature review.

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract, but they represent less than 3% of all gastrointestinal tract malignancies. This is a detailed case study of a 52-year-old male patient treated for very uncommon histological subtype of gastric GIST with atypical clinical presentation, asymptomatic progress and late diagnosis. The resected tumour, giant in diameters, was confirmed to represent the most rare histopathologic subtype of GISTs - sarcomatoid epithelioid GIST.

Minimally invasive treatment of infected pancreatic necrosis.

Infected pancreatic necrosis is a challenging complication that worsens prognosis in acute pancreatitis. For years, open necrosectomy has been the mainstay treatment option in infected pancreatic necrosis, although surgical debridement still results in high morbidity and mortality rates. Recently, many reports on minimally invasive treatment in infected pancreatic necrosis have been published.

Walled-off necrosis: safety of watchful waiting.

Background: Asymptomatic pancreatic necrosis should be managed conservatively, regardless of its extent. However, late sequelae and safety of non-interventional management in patients with asymptomatic walled-off necrosis remain unclear.

Aims: The purpose of this study was to report the clinical outcome of outpatient expectant management in a cohort of patients with walled-off necrosis who were discharged asymptomatic after an episode of acute pancreatitis.

Combined minimally invasive management of infected pancreatic necrosis: a case report.

Infected necrosis is a potentially fatal complication of necrotizing pancreatitis. Open surgical debridement is the mainstay management of infected pancreatic necrosis. Over the last decade minimally invasive techniques have been increasingly used for the treatment of infected pancreatic necrosis and their results are encouraging.

Sister Mary Joseph nodule: a tip of an iceberg.

A Sister Mary Joseph nodule represents a cutaneous metastasis into the umbilicus. This clinical sign of intra-abdominal malignancy is frequently overlooked or misinterpreted by both patients and their physicians. We report 4 patients with a Sister Mary Joseph nodule.

Ultrasound-guided percutaneous drainage of infected pancreatic necrosis.

Background: The role of percutaneous drainage in the management of infected pancreatic necrosis remains controversial, and ultrasound-guided technique is rarely used for this indication. The purpose of this study was to evaluate the safety and efficacy of sonographically guided percutaneous catheter drainage for infected pancreatic necrosis.

Methods: The patient group consisted of 16 men and 2 women.

Zenker's diverticulum: aetiopathogenesis, symptoms and diagnosis. Comparison of operative methods.

Zenker's diverticulum is an alimentary tract pouch localized in the area of the upper esophageal sphincter. Treatment procedure complications and coexisting diseases constitute a serious diagnostic and therapeutic problem. Characteristic symptoms and signs facilitate differential diagnosis, simultaneously being real patient maladies.

Retroperitoneal minimally invasive pancreatic necrosectomy using single-port access.

Infected pancreatic necrosis is a life-threatening complication of acute pancreatitis that has been traditionally managed with open surgical debridement. Over the last decade, minimally invasive techniques have been increasingly used for the treatment of infected pancreatic necrosis and their results are encouraging. Percutaneous retroperitoneal pancreatic necrosectomy is one of the minimally invasive approaches used for debridement of pancreatic necrosis.

Optimizing management of pancreaticopleural fistulas.

Aim: To evaluate the management of pancreaticopleural fistulas involving early endoscopic instrumentation of the pancreatic duct.

Methods: Eight patients with a spontaneous pancreaticopleural fistula underwent endoscopic retrograde cholangiopancreatography (ERCP) with an intention to stent the site of a ductal disruption as the primary treatment. Imaging features and management were evaluated retrospectively and compared with outcome.

Implementation of the fast track surgery in patients undergoing the colonic resection: own experience.

A perioperative care in the colorectal surgery has been considerably changed recently. The fast track surgery decreases complications rate, shortens length of stay, improves quality of life and leads to cost reduction. It is achieved by: resignation of a mechanical bowel preparation before and a nasogastric tube insertion after operation, optimal pain and intravenous fluid management, an early rehabilitation, enteral nutrition and removal of a vesical catheter and abdominal drain if used.

Necrotizing fasciitis: early sonographic diagnosis.

Necrotizing fasciitis is a rare, but potentially fatal bacterial infection of the soft tissues. Establishing the diagnosis at the early stages of the disease remains the greatest challenge. We report a case of necrotizing fasciitis involving the upper extremity.

Mesenteric fibromatosis with intestinal involvement mimicking a gastrointestinal stromal tumour.

Introduction: Mesenteric fibromatosis or intra-abdominal desmoid tumour is a rare proliferative disease affecting the mesentery. It is a locally aggressive tumour that lacks metastatic potential, but the local recurrence is common. Mesenteric fibromatosis with the intestinal involvement can be easily confused with other primary gastrointestinal tumours, especially with that of the mesenchymal origin.

[Hemobilia of neoplastic origin].

Haemobilia is a rare and difficult to diagnose cause of gastrointestinal tract bleeding. Actually the most frequent causes of haemobilia are iatrogenic traumas, due to development of different diagnostic and therapeutic procedures performed endoscopically or laparoscopically. On the other hand cancer disease is the rarest reason of haemobilia.

Sonographic findings in groove pancreatitis.

Groove pancreatitis is a rare form of chronic pancreatitis involving the anatomic plane between the pancreatic head and duodenum. The radiographic diagnosis remains challenging, and most patients undergo exploratory laparotomy on suspicion of a periampullary malignancy. The appearance of groove pancreatitis on transabdominal and intraoperative sonography has rarely been reported in the literature.

Aberrant repair of etheno-DNA adducts in leukocytes and colon tissue of colon cancer patients.

To assess the role of lipid peroxidation-induced DNA damage and repair in colon carcinogenesis, the excision rates and levels of 1,N(6)-etheno-2'-deoxyadenosine (epsilondA), 3,N(4)-etheno-2'-deoxycytidine (epsilondC), and 1,N(2)-etheno-2'-deoxyguanosine (1,N(2)-epsilondG) were analyzed in polymorphic blood leukocytes (PBL) and resected colon tissues of 54 colorectal carcinoma (CRC) patients and PBL of 56 healthy individuals. In PBL the excision rates of 1,N(6)-ethenoadenine (epsilonAde) and 3,N(4)-ethenocytosine (epsilonCyt), measured by the nicking of oligodeoxynucleotide duplexes with single lesions, and unexpectedly also the levels of epsilondA and 1,N(2)-epsilondG, measured by LC/MS/MS, were lower in CRC patients than in controls. In contrast the mRNA levels of repair enzymes, alkylpurine- and thymine-DNA glycosylases and abasic site endonuclease (APE1), were higher in PBL of CRC patients than in those of controls, as measured by QPCR.

Anal endosonographic findings in women after vaginal delivery.

Objective: To estimate a frequency of obstetric anal sphincters defects in women after vaginal delivery.

Methods: The study included 102 women, aged from 16 to 40 years (mean age 28.6 years).

Gastrointestinal stromal tumors: ultrasonographic spectrum of the disease.

Objective: The purpose of this series was to determine the spectrum of findings on gray scale trans-abdominal ultrasonography (TAUS) in pathologically proven cases of primary gastrointestinal stromal tumors (GISTs) and correlate them with gross morphologic and pathologic findings.

Methods: The series included 18 patients with a primary GIST tumor detected on preoperative TAUS. The ultrasonographic findings were evaluated for features such as tumor size, shape, margin, echogenicity, and presence of fluid components, and the features were compared with morphologic and pathologic findings.

Small bowel transplantation--harvesting technique and graft preparation in pigs.

Background: In more and more frequently occurring short bowel syndrome, requiring total parenteral nutrition therapy, the complications of the latter not seldom prevent its use. The idea of treating these patients with small bowel transplantation pushed the authors to start the program aiming at development of small bowel harvesting, preservation and transplantation technique in experimental settings. Additionally, an attempt to find which, if any, and to what extent, histological changes of the preserved bowel may be of prognostic value for the early transplant failure.

Synchronous occurrence of gastrointestinal stromal tumors and other primary gastrointestinal neoplasms.

Aim: To review clinical and pathologic features of Gastrointestinal stromal tumors (GISTs) occurring synchronously with other primary gastrointestinal neoplasms.

Methods: Twenty-eight patients with primary GIST were treated at our institution between 1989 and 2005. Clinical and pathologic records were reviewed.

[Late malignant melanoma metastases within the abdominal cavity imitating clinically and pathologically a gastrointestinal stromal tumor].

Melanoma is a malignant skin neoplasm that often metastasizes within the abdominal cavity. Melanoma metastases can develop even many years after the primary treatment. Clinical course, microscopic histology, and immunohistochemical profile of melanoma may imitate a gastrointestinal stromal tumor (GIST).