The Experts below are selected from a list of 303 Experts worldwide ranked by ideXlab platform
Eli D Ehrenpreis - One of the best experts on this subject based on the ideXlab platform.
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the Mesentery systemic inflammation and crohn s disease
Inflammatory Bowel Diseases, 2019Co-Authors: Edgardo Rivera D Rivera, J C Coffey, Dara Walsh, Eli D EhrenpreisAbstract:: Initially thought to be a structure that only provided support to the abdominal contents, the Mesentery has now gained special attention in the scientific community. The new approach of studying the Mesentery as an individual organ has highlighted its importance in the development of local and systemic inflammatory diseases and its potential role in Crohn's disease. Its topographical relationship with the intestine in the setting of active inflammation and "creeping fat" is possibly one of the most important arguments for including the Mesentery as an important factor in the pathogenesis of Crohn's disease. In this review, we discuss the importance of the Mesentery from the anatomical and embryological standpoints. We also will summarize data on mesenteric inflammation in patients with Crohn's disease. The significance of the Mesentery in systemic inflammatory syndromes will be discussed, and we provide an overview of primary inflammatory disorders of the Mesentery. Finally, we discuss surgical approaches for patients requiring resection for Crohn's disease that incorporate mesenteric factors, pointing out recent data suggesting that these have the potential for improving outcomes and reducing disease recurrence. : 10.1093/ibd/izy201_video1izy201.video15794169491001.
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The Mesentery, Systemic Inflammation, and Crohn’s Disease
Inflammatory Bowel Diseases, 2018Co-Authors: Edgardo D. Rivera Rivera, John Calvin Coffey, Dara Walsh, Eli D EhrenpreisAbstract:Initially thought to be a structure that only provided support to the abdominal contents, the Mesentery has now gained special attention in the scientific community. The new approach of studying the Mesentery as an individual organ has highlighted its importance in the development of local and systemic inflammatory diseases and its potential role in Crohn's disease. Its topographical relationship with the intestine in the setting of active inflammation and "creeping fat" is possibly one of the most important arguments for including the Mesentery as an important factor in the pathogenesis of Crohn's disease. In this review, we discuss the importance of the Mesentery from the anatomical and embryological standpoints. We also will summarize data on mesenteric inflammation in patients with Crohn's disease. The significance of the Mesentery in systemic inflammatory syndromes will be discussed, and we provide an overview of primary inflammatory disorders of the Mesentery. Finally, we discuss surgical approaches for patients requiring resection for Crohn's disease that incorporate mesenteric factors, pointing out recent data suggesting that these have the potential for improving outcomes and reducing disease recurrence. 10.1093/ibd/izy201_video1izy201.video15794169491001.
Phillip Ruiz - One of the best experts on this subject based on the ideXlab platform.
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partial abdominal evisceration ex vivo resection and intestinal autotransplantation for the treatment of pathologic lesions of the root of the Mesentery
Journal of The American College of Surgeons, 2003Co-Authors: Andreas G Tzakis, P Tryphonopoulos, Werviston De Faria, Tomoaki Kato, Seigo Nishida, D Levi, Juan Madariaga, Debbie Weppler, Naveen K Mittal, Phillip RuizAbstract:Abstract Background Resection of lesions of the root of the Mesentery with established techniques is difficult and at times impossible because of their proximity to the blood supply of the intestine. Damage of the superior mesenteric vessels necessitates resection of the intestine, resulting in short bowel syndrome and intestinal failure. Study design We describe a surgical technique drawn from our experience in intestinal transplantation in which the root of the Mesentery (including the lesion) and the head or the entire pancreas, duodenum, small intestine, and part of the colon are excised en bloc and preserved in a cold solution. Resection of the lesion is performed in a bloodless field ex vivo, and the salvaged intestine is reimplanted in the abdominal cavity. We performed this procedure in four patients, two adult and two pediatric, who had extensive neoplasms of the root of the Mesentery. Their underlying diseases were mesenteric fibroma, vascular dysplasia of the root of the Mesentery, pancreatic cancer, and desmoid tumor. Results Local control of the lesions was achieved in all four cases, preserving at the same time enough small intestine to avoid short bowel syndrome. All patients survived the operation and live on enteral nutrition 6 to 49.5 months after the procedure. Conclusions The procedure of partial abdominal exenteration, ex vivo resection, and autotransplantation is an extension of our experience with intestinal transplantation. In selected cases, this technique may be useful in the treatment of extensive, otherwise unresectable lesions of the root of the Mesentery.
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partial abdominal evisceration ex vivo resection and intestinal autotransplantation for the treatment of pathologic lesions of the root of the Mesentery
Journal of The American College of Surgeons, 2003Co-Authors: Andreas G Tzakis, P Tryphonopoulos, Werviston De Faria, Tomoaki Kato, Seigo Nishida, D Levi, Juan Madariaga, Debbie Weppler, Naveen K Mittal, Phillip RuizAbstract:BACKGROUND: Resection of lesions of the root of the Mesentery with established techniques is difficult and at times impossible because of their proximity to the blood supply of the intestine. Damage of the superior mesenteric vessels necessitates resection of the intestine, resulting in short bowel syndrome and intestinal failure. STUDY DESIGN: We describe a surgical technique drawn from our experience in intestinal transplantation in which the root of the Mesentery (including the lesion) and the head or the entire pancreas, duodenum, small intestine, and part of the colon are excised en bloc and preserved in a cold solution. Resection of the lesion is performed in a bloodless field ex vivo, and the salvaged intestine is reimplanted in the abdominal cavity. We performed this procedure in four patients, two adult and two pediatric, who had extensive neoplasms of the root of the Mesentery. Their underlying diseases were mesenteric fibroma, vascular dysplasia of the root of the Mesentery, pancreatic cancer, and desmoid tumor. RESULTS: Local control of the lesions was achieved in all four cases, preserving at the same time enough small intestine to avoid short bowel syndrome. All patients survived the operation and live on enteral nutrition 6 to 49.5 months after the procedure. CONCLUSIONS: The procedure of partial abdominal exenteration, ex vivo resection, and autotransplantation is an extension of our experience with intestinal transplantation. In selected cases, this technique may be useful in the treatment of extensive, otherwise unresectable lesions of the root of the Mesentery.
J C Coffey - One of the best experts on this subject based on the ideXlab platform.
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Resectional surgery for malignant disease of abdominal digestive organs is not surgery of the organ itself, but also that of the mesenteric organ
Techniques in Coloproctology, 2020Co-Authors: J. Bunni, J C Coffey, M. F. KaladyAbstract:Despite large strides in molecular oncology, surgery remains the bedrock in the management of visceral cancer. The primacy of surgery cannot be understated and a mesenteric (i.e. ontogenetic) approach is particularly beneficial to patients. Heald greatly advanced the management of rectal cancer with his description of the anatomical foundation of total mesorectal excision (TME), dramatically improving outcomes worldwide with this mesenteric-based approach. Moreover, complete mesocolic excision (CME) based on similar principles is becoming popular. Introduced by Hohenberger, CME resembles TME insofar as it emphasises strictly anatomical dissection along embryological planes to detach an intact (i.e. “complete”) Mesentery with peritoneal envelope. CME also incorporates “central” vascular ligation (CVL) which broadly correlates with the “D3 lymphadenectomy” of Eastern literature. As many surgeons already practise anatomical and mesenteric-based surgery, it is unclear how the putative benefits of CME (including CVL) arise. Herein, we argue that these may relate to a more extensive resection of the Mesentery, and thus mesenteric tumour deposits within the connective tissue lattice of the Mesentery, and not necessarily the lymphadenectomy alone. We believe the connective tissue interface between the bowel wall and Mesentery provides an alternative mode of spread of pathogenic elements. Whilst this remains a suggestion only, it would explain the histological independence of tumour deposits and why a greater mesenterectomy could be associated with benefits in survival. If this argument holds, it follows that resectional surgery for digestive organ malignancy is not surgery of the organ itself (or lymphatics only), but also that of the contiguous Mesentery.
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the Mesentery systemic inflammation and crohn s disease
Inflammatory Bowel Diseases, 2019Co-Authors: Edgardo Rivera D Rivera, J C Coffey, Dara Walsh, Eli D EhrenpreisAbstract:: Initially thought to be a structure that only provided support to the abdominal contents, the Mesentery has now gained special attention in the scientific community. The new approach of studying the Mesentery as an individual organ has highlighted its importance in the development of local and systemic inflammatory diseases and its potential role in Crohn's disease. Its topographical relationship with the intestine in the setting of active inflammation and "creeping fat" is possibly one of the most important arguments for including the Mesentery as an important factor in the pathogenesis of Crohn's disease. In this review, we discuss the importance of the Mesentery from the anatomical and embryological standpoints. We also will summarize data on mesenteric inflammation in patients with Crohn's disease. The significance of the Mesentery in systemic inflammatory syndromes will be discussed, and we provide an overview of primary inflammatory disorders of the Mesentery. Finally, we discuss surgical approaches for patients requiring resection for Crohn's disease that incorporate mesenteric factors, pointing out recent data suggesting that these have the potential for improving outcomes and reducing disease recurrence. : 10.1093/ibd/izy201_video1izy201.video15794169491001.
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the Mesentery in crohn s disease friend or foe
Current Opinion in Gastroenterology, 2016Co-Authors: J C Coffey, Donal Peter O Leary, Miranda G Kiernan, Peter N FaulAbstract:Purpose of reviewThis article assesses the role of the Mesentery in Crohn's disease.Recent findingsThe Mesentery is centrally positioned both anatomically and physiologically. Overlapping mesenteric and submucosal mesenchymal contributions are important in the pathobiology of Crohn's disease. Mesent
Andreas G Tzakis - One of the best experts on this subject based on the ideXlab platform.
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partial abdominal evisceration ex vivo resection and intestinal autotransplantation for the treatment of pathologic lesions of the root of the Mesentery
Journal of The American College of Surgeons, 2003Co-Authors: Andreas G Tzakis, P Tryphonopoulos, Werviston De Faria, Tomoaki Kato, Seigo Nishida, D Levi, Juan Madariaga, Debbie Weppler, Naveen K Mittal, Phillip RuizAbstract:Abstract Background Resection of lesions of the root of the Mesentery with established techniques is difficult and at times impossible because of their proximity to the blood supply of the intestine. Damage of the superior mesenteric vessels necessitates resection of the intestine, resulting in short bowel syndrome and intestinal failure. Study design We describe a surgical technique drawn from our experience in intestinal transplantation in which the root of the Mesentery (including the lesion) and the head or the entire pancreas, duodenum, small intestine, and part of the colon are excised en bloc and preserved in a cold solution. Resection of the lesion is performed in a bloodless field ex vivo, and the salvaged intestine is reimplanted in the abdominal cavity. We performed this procedure in four patients, two adult and two pediatric, who had extensive neoplasms of the root of the Mesentery. Their underlying diseases were mesenteric fibroma, vascular dysplasia of the root of the Mesentery, pancreatic cancer, and desmoid tumor. Results Local control of the lesions was achieved in all four cases, preserving at the same time enough small intestine to avoid short bowel syndrome. All patients survived the operation and live on enteral nutrition 6 to 49.5 months after the procedure. Conclusions The procedure of partial abdominal exenteration, ex vivo resection, and autotransplantation is an extension of our experience with intestinal transplantation. In selected cases, this technique may be useful in the treatment of extensive, otherwise unresectable lesions of the root of the Mesentery.
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partial abdominal evisceration ex vivo resection and intestinal autotransplantation for the treatment of pathologic lesions of the root of the Mesentery
Journal of The American College of Surgeons, 2003Co-Authors: Andreas G Tzakis, P Tryphonopoulos, Werviston De Faria, Tomoaki Kato, Seigo Nishida, D Levi, Juan Madariaga, Debbie Weppler, Naveen K Mittal, Phillip RuizAbstract:BACKGROUND: Resection of lesions of the root of the Mesentery with established techniques is difficult and at times impossible because of their proximity to the blood supply of the intestine. Damage of the superior mesenteric vessels necessitates resection of the intestine, resulting in short bowel syndrome and intestinal failure. STUDY DESIGN: We describe a surgical technique drawn from our experience in intestinal transplantation in which the root of the Mesentery (including the lesion) and the head or the entire pancreas, duodenum, small intestine, and part of the colon are excised en bloc and preserved in a cold solution. Resection of the lesion is performed in a bloodless field ex vivo, and the salvaged intestine is reimplanted in the abdominal cavity. We performed this procedure in four patients, two adult and two pediatric, who had extensive neoplasms of the root of the Mesentery. Their underlying diseases were mesenteric fibroma, vascular dysplasia of the root of the Mesentery, pancreatic cancer, and desmoid tumor. RESULTS: Local control of the lesions was achieved in all four cases, preserving at the same time enough small intestine to avoid short bowel syndrome. All patients survived the operation and live on enteral nutrition 6 to 49.5 months after the procedure. CONCLUSIONS: The procedure of partial abdominal exenteration, ex vivo resection, and autotransplantation is an extension of our experience with intestinal transplantation. In selected cases, this technique may be useful in the treatment of extensive, otherwise unresectable lesions of the root of the Mesentery.
Petros Mirilas - One of the best experts on this subject based on the ideXlab platform.
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‘Testis–epididymis dissociation’ in cryptorchidism and hydrocele: the tip of the iceberg of a persistent genital Mesentery
Surgical and Radiologic Anatomy, 2020Co-Authors: Anastasia Mentessidou, Petros MirilasAbstract:Purpose To investigate whether testis–epididymis dissociation encountered in boys with cryptorchidism/hydrocele is related with an abnormal persistence of the fetal Mesentery of testis and associated ducts. Methods We examined the morphology of peritoneal folds of the testis, epididymis, and vas deferens in 25 boys operated for unilateral cryptorchidism [inguinal ( n = 20), intrabdominal ( n = 5)] and 20 boys operated for unilateral communicating hydrocele. Findings were compared with the normally persisting genital Mesentery of rats ( n = 30, both sides), a known animal model of the genital Mesentery of human fetuses, as well as with the normal mature pattern of genital peritoneal folds in adult male cadavers ( n = 12, both sides). Rats before testis descent [aged 18 days ( n = 15)] served for comparison with boys with cryptorchidism, while rats after testis descent [aged 50 ( n = 15)] known to retain patent processi vaginales for comparison with boys with hydrocele. Results A well-developed genital Mesentery, identical to the fetal-type genital Mesentery in the rat, was documented in cryptorchidism and hydrocele. The peritoneum enveloped the testis, epididymis, and vas deferens, and formed wide ligaments between testis–epididymis, epididymis–vas deferens, and vas–posterior wall; processus vaginalis was patent in all cases. The testis–epididymis ligament was related with testis–epididymis distancing, the so-called testis–epididymis dissociation. On the contrary, genital Mesentery had involuted in the adult male cadavers, except for a small portion of testis–epididymis ligament corresponding to the so-called sinus epididymis. Conclusion The testis–epididymis dissociation encountered in cryptorchidism/hydrocele is part of an anomalously persisting fetal-type genital Mesentery.
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testis epididymis dissociation in cryptorchidism and hydrocele the tip of the iceberg of a persistent genital Mesentery
Surgical and Radiologic Anatomy, 2020Co-Authors: Anastasia Mentessidou, Petros MirilasAbstract:To investigate whether testis–epididymis dissociation encountered in boys with cryptorchidism/hydrocele is related with an abnormal persistence of the fetal Mesentery of testis and associated ducts. We examined the morphology of peritoneal folds of the testis, epididymis, and vas deferens in 25 boys operated for unilateral cryptorchidism [inguinal (n = 20), intrabdominal (n = 5)] and 20 boys operated for unilateral communicating hydrocele. Findings were compared with the normally persisting genital Mesentery of rats (n = 30, both sides), a known animal model of the genital Mesentery of human fetuses, as well as with the normal mature pattern of genital peritoneal folds in adult male cadavers (n = 12, both sides). Rats before testis descent [aged 18 days (n = 15)] served for comparison with boys with cryptorchidism, while rats after testis descent [aged 50 (n = 15)] known to retain patent processi vaginales for comparison with boys with hydrocele. A well-developed genital Mesentery, identical to the fetal-type genital Mesentery in the rat, was documented in cryptorchidism and hydrocele. The peritoneum enveloped the testis, epididymis, and vas deferens, and formed wide ligaments between testis–epididymis, epididymis–vas deferens, and vas–posterior wall; processus vaginalis was patent in all cases. The testis–epididymis ligament was related with testis–epididymis distancing, the so-called testis–epididymis dissociation. On the contrary, genital Mesentery had involuted in the adult male cadavers, except for a small portion of testis–epididymis ligament corresponding to the so-called sinus epididymis. The testis–epididymis dissociation encountered in cryptorchidism/hydrocele is part of an anomalously persisting fetal-type genital Mesentery.
