Hepato Gastroenterol
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Hepato Gastroenterol · Jan 2004
Spleen-preserving distal pancreatectomy for intraductal papillary-mucinous tumor (IPMT).
Recently, the significance of preserving the spleen has received a lot of attention. Since our first trial and success of spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein for chronic pancreatitis, this procedure has been more frequently performed and reported. In this study, we introduce the technique and indications for the procedure for intraductal papillary mucinous tumor of the pancreas. ⋯ Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein is easy and safe, and should be performed for some of the patients with intraductal papillary mucinous tumor of the pancreas.
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Hepato Gastroenterol · Dec 2003
Alteration of hypothalamus-pituitary-adrenal glands axis in colorectal cancer patients.
in advanced cancer patients a cell-mediated immunological impairment, both at baseline and during postoperative period (surgical trauma response) is often found and is associated with poor prognosis. Furthermore it is well known that cortisol is strictly involved in the response to major surgical stress, has an important immunosuppression activity and causes a redistribution of immunological population cells in different tissues. The aim of the study was to verify serum levels and circadian rhythm of cortisol and ACTH in patients with colorectal cancer at baseline before surgery and in the postoperative period, and relate it to the immune status. ⋯ it is known that lymphocytopenia, both at baseline and in the postoperative period, is associated with a poor prognosis in cancer patients and that cortisol plays an important role in the immune response. Our data show that lymphocytopenia often present in cancer patients, poor prognostic factor, seems not to be associated with ACTH and cortisol level and circadian rhythm alteration, both at baseline and after surgical stress. Otherwise even if paraneoplastic syndromes seems not to be related to colorectal cancer and no patient showed adrenocortical metastasis, an impairment of circadian rhythm of cortisol and ACTH was found at baseline in 28% and 44% respectively. It was significantly associated with the presence of metastatic disease. These preliminary results suggest further investigations on relation between cancer and endocrine system.
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Hepato Gastroenterol · Dec 2003
Randomized Controlled Trial Clinical TrialRemifentanil/midazolam versus tramadol/midazolam use for colonoscopy.
One of the most commonly performed outpatient procedure is colonoscopy. The pain and anxiety is frequently associated with colonoscopy. The aim of this study was to compare the effectiveness of remifentanil/midazolam, and tramadol/midazolam for iv sedation and analgesia during colonoscopy. ⋯ The patients in group T had higher pain scores. Gastroenterologist satisfaction and patient satisfaction were similar in both groups. Our results suggests that, sedoanalgesia with midazolam/remifentanil may be an alternative to sedoanalgesia with midazolam/tramadol for colonoscopy.
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Hepato Gastroenterol · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialCoronary artery disease and upper abdominal surgery: impact of anesthesia on perioperative myocardial ischemia.
Some papers claim that epidural anesthesia and analgesia lowers the incidence of perioperative ischemic events and may have a favorable effect on perioperative cardiac morbidity and mortality. We studied the effect of epidural anesthesia and analgesia on perioperative myocardial ischemia, in a group of patients with known coronary artery disease, who underwent upper abdominal surgery. ⋯ Epidural anesthesia and analgesia reduces intraoperative and early postoperative ischemia in patients with known coronary artery disease undergoing upper abdominal surgery.
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Hepato Gastroenterol · Nov 2003
Randomized Controlled Trial Clinical TrialTranscatheter arterial chemoembolization for hepatocellular carcinoma in patients with cirrhosis: evaluation of two kinds of dosages of anticancer drugs and analysis of prognostic factors.
To evaluate the efficacy of TACE (transcatheter arterial chemoembolization) with use of low-dose versus conventional-dose anticancer drugs in hepatocellular carcinoma patients with cirrhosis and to analyze their prognostic factors. ⋯ TACE with use of large-dose anticancer drugs does not significantly enhance the anticancer effects and survival compared that with lowdose anticancer drugs. The therapeutic effect of TACE was mainly attributed to embolization of the artery rather than to anticancer drugs.