KRAS/GNAS-testing by highly sensitive deep targeted next generation sequencing improves the endoscopic ultrasound-guided workup of suspected mucinous neoplasms of the pancreas.

Pancreatic cysts or dilated pancreatic ducts are often found by cross-sectional imaging, but only mucinous lesions can become malignant. Therefore, distinction between mucinous and non-mucinous lesions is crucial for adequate patient management. We performed a prospective study including targeted next generation sequencing (NGS) of cell-free DNA in the diagnostic endoscopic ultrasound (EUS)-guided workup.

[Minimally invasive and robot-assisted surgery for chronic inflammatory bowel disease : Current status and evidence situation].

The majority of cases of inflammatory bowel disease (IBD) can be treated by minimally invasive surgery. The advantages of standard laparoscopic approaches compared to open surgery with respect to short-term and long-term outcome parameters have been adequately proven with evidence level 1 for ileocecal resection in Crohn's disease. For many other indications there are at least several larger registry or case-control studies that have shown advantages for laparoscopy.

Gallbladder Cancer Presenting as Mirizzi Syndrome Complicated by Rapidly Evolving 23 rRNA Gene-Linezolid Resistance with Vancomycin-Resistant Enterococcus Infection Resulting in Fatal Cholangial Sepsis.

We describe the case of a 71-year-old woman who presented with obstructive jaundice and subhilar bile duct stenosis. MRI showed extensive cholecystolithiasis with an impacted bile stone in the cystic duct suggesting Mirizzi syndrome. Delayed enhancement of the thickened gallbladder wall suggested inflammation instead of carcinoma.

Preoperative hypoalbuminemia is an independent risk factor for increased high-grade morbidity after elective rectal cancer resection.

Purpose: This study investigated the association of preoperative hypoalbuminemia and postoperative complications after elective resection for rectal cancer.

Methods: From September 2009 to December 2014, all patients who underwent elective rectal resection for adenocarcinoma of the rectum were identified using a prospective colorectal cancer database. Hypoalbuminemia was defined as a serum albumin < 35 g/L.

Hybrid transgastric appendectomy is feasible but does not offer advantages compared with laparoscopic appendectomy: Results from the transgastric appendectomy study.

Background: Very few transgastric procedures, the original objective of natural orifice translumenal surgery, have been reported in the international Natural Orifice Translumenal Surgery registers. In addition, most cases were controlled mainly by laparoscopy. To show the feasibility of hybrid transgastric appendectomy and to compare results with laparoscopic a prospective, nonrandomized study was conducted.

Analysis of the First 217 Appendectomies of the German NOTES Registry.

Objective: To analyze the feasibility and safety of Natural Orifice Transluminal Endoscopic Surgery (NOTES) appendectomy, and to analyze separately the transvaginal appendectomy (TVAE) and the transgastric appendectomy (TGAE) procedures.

Background: Laparoscopic appendectomy has rare but relevant complications, namely incisional hernias and neuralgia at the trocar sites, which can potentially be avoided by the NOTES techniques.

Methods: The first 217 data sets of the largest NOTES registry worldwide-the German NOTES registry-were analyzed with respect to demographic data, procedural data, and short-term outcomes.

Endoscopic application of polysaccharide powder for hemostasis in anticoagulated pigs (with video).

Background: Acute GI bleeding remains a clinical problem of daily importance. Increasing numbers of patients with compromised coagulation challenge the established methods of endoscopic hemostasis. Therefore, new powders for the treatment of GI bleeding have been developed.

Natural orifice transluminal endoscopic surgery in humans: feasibility and safety of transgastric closure using the OTSC system.

Background: NOTES is a technique in which an operation is performed within the body without a skin incision by using a natural body orifice to provide access. The principal challenge of transgastric NOTES procedures is still the feasibility and safety of access closure. Currently, there are very limited data regarding the closure of transgastric NOTES in humans, and the standard method and device for closure has not been defined.

New methods of magnet-based instrumentation for NOTES.

Introduction: Laparoscopic surgery has displaced open surgery as the standard of care for many clinical conditions. NOTES has been described as the next surgical frontier with the objective of incision-free abdominal surgery. The principal challenge of NOTES procedures is the loss of triangulation and instrument rigidity, which is one of the fundamental concepts of laparoscopic surgery.

Differences in the endoscopic closure of colonic perforation due to diagnostic or therapeutic colonoscopy.

Objective: To describe the experience of a single center regarding the feasibility of endoscopic closure of iatrogenic colonic perforations and to elucidate differences between the efficacy of endoscopic clip closure due to diagnostic or therapeutic colonoscopy.

Material And Methods: A retrospective institutional computer-based search of records of colonoscopic perforation occurring between January 2004 and December 2011 was undertaken. Data on patients undergoing colonoscopy were entered into a clinical database.

Transgastric appendicectomy.

Background: Experimental studies and small anecdotal reports have documented the potential and feasibility of transgastric appendicectomy. This paper reports the results of the new technique in a selected group of patients.

Methods: From April 2010 transgastric appendicectomy was offered to all patients with acute appendicitis, but without generalized peritonitis or local contraindications.

The EURO-NOTES clinical registry for natural orifice transluminal endoscopic surgery: a 2-year activity report.

Background: The EURO-NOTES Clinical Registry (ECR) was established as a European database to allow the monitoring and safe introduction of Natural Orifice Transluminal Endoscopic Surgery (NOTES). The aim of this study was to analyze different techniques applied and relative results during the first 2 years of the ECR.

Methods: The ECR was designed as a voluntary database with online access.

[New ways in the surgery of acute appendicitis?].

Acute appendicitis is still one of the most common abdominal emergencies necessitating operative treatment. For the past century, the conventional management of appendicitis has been open appendectomy. Since the introduction of laparoscopic appendectomy, it has been performed with increased frequency.

Effect of different liver resection methods on liver damage and regeneration factors VEGF and FGF-2 in mice.

Background: Different approaches to study liver regeneration in murine models have been proposed. We investigated the effect of different liver resection models on liver damage and regeneration parameters in mice.

Methods: We compared the technical aspect of the 2 most commonly used techniques of 50% and 70% liver resection.

Imaging EGFR phosphorylation in intact human pancreatic carcinoma cells.

Background/aim: Carcinoma of the pancreatic duct is a highly malignant tumor characterized by aggressive and early metastastatic growth. A high rate of tumor recurrence after surgical resection and the lack of effective chemotherapeutic approaches result in low 5-year survival rates. Overexpression of epidermal growth factor (EGF) and its receptor have been correlated to a higher tumor biological aggressiveness.

Perianal abscess caused by Actinomyces: report of a case.

Most anal abscesses are caused by anal fistula and invasion of the surrounding tissues by a mixed colonic flora. The treatment comprises excision of the abscess and. if appropriate, fistulectomy.

Association between EGF, TGF-beta1, VEGF gene polymorphism and colorectal cancer.

Introduction: Up to the present, EGF 61 A/G, TGF-beta1 -509 T/C, and VEGF 936 T/C gene polymorphisms have been analyzed in other cancer entities than colorectal cancer. We have now investigated the frequency of these gene polymorphisms among colorectal cancer patients.

Material And Methods: A total of 157 colorectal cancer patients and 117 cancer-free healthy people were recruited at the Surgical Department of the Universitätsklinikum Mannheim.

First experiences with A circular stapled gastro-jejunostomy by a new transorally introducible stapler system in laparoscopic Roux-en-Y gastric bypass.

Background: The only effective treatment for patients with morbid obesity is surgery. Laparoscopic bariatric surgery has become quite popular in attempts to decrease the morbidity associated with laparotomy. The aim of this study was to assess the safety and efficiency by using SurgASSIST(R) for performing the gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass (RYGBP).

Endoclipping of iatrogenic colonic perforation to avoid surgery.

Background: Colonoscopy is an established tool for the diagnosis and management of colonic and rectal pathology. Even though colonic perforation is rare after colonoscopy, it is a serious and typical complication. The definitive management remains controversial.

Quantitative imaging of apoptosis commitment in colorectal tumor cells.

We have studied caspase-3 activation by combined DNA damage induction and EGFR kinase inhibition in order to identify potential EGFR-mediated survival signals conferring resistance to apoptosis in human colorectal tumor cells. The onset of apoptosis was microscopically imaged with a newly developed caspase-3 substrate sensor based on EGFP and tHcred1, enabling us to monitor caspase-3 activation in cells by fluorescence lifetime imaging microscopy or fluorescence correlation spectroscopy. Both optical approaches provide parameters quantitatively reporting the ratio between cleaved and uncleaved sensor, thereby facilitating the comparison of caspase-3 activation between different cells.

Ileus secondary to wireless capsule enteroscopy.

Wireless capsule enteroscopy, being a novel, painless investigative technique, is reported to be significantly superior to push enteroscopy in its ability to find bleeding abnormalities in the small intestine. Here we report a case of acute jejunal obstruction following wireless capsule endoscopy. The patient had a 1-month history of gastrointestinal bleeding of unknown source.

Imaging epidermal growth factor receptor phosphorylation in human colorectal cancer cells and human tissues.

In tumor cells, high phosphorylation levels of receptor tyrosine kinases may occur in the absence of exogenous ligands due to autocrine signaling or enhanced tyrosine kinase activity. Here we show that the phosphorylation state of the endogenous epidermal growth factor receptor (EGFR) can be quantitatively imaged in tumor cells and tissues by detecting fluorescence resonance energy transfer between fluorophores conjugated to antibodies against the receptor and phosphotyrosine, respectively. Five different human colorectal cell lines were analyzed for activity and expression of EGFR.