The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Nib Soehendra - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic closure of a perforation using metallic clips after Snare excision of a gastric leiomyoma
Gastrointestinal Endoscopy, 2008Co-Authors: Kenneth F Binmoeller, Horst Grimm, Nib SoehendraAbstract:A 63-year-old man presented with melena and iron-deficiency anemia. He had a 3-year history of ulcerative colitis involving the rectum and sigmoid colon, for which he was on maintenance Azulfidine therapy. Rectosigmoidoscopy was performed and revealed inactive inflammatory bowel disease. On UGI endoscopy he was found to have a firm, rounded, protruding submucosal tumor, measuring 4 cm, in the fundus (Fig. lA). The tumor had a thick, short stalk and was mobile. No evidence for active gastrointestinal bleeding was observed. Endosonography was performed and revealed a well-circumscribed 3.7 X 3.4 cm submucosal tumor originating from the muscle layer compatible with leiomyoma (Fig. 2). No vascular structures were seen within or in the vicinity of the tumor. No enlarged or pathologic lymph nodes were noted. The tumor was diagnosed as a leiomyoma. Informed consent was obtained for endoscopic removal of the submucosal tumor. Epinephrine (1:20,000, approximately 2 cc) was injected at the base area of attachment as a prophylactic measure to reduce the risk of bleeding. A standard Polypectomy Snare was used to excise the tumor. After the Snare was applied to the base of the tumor, the tumor was transected by applying several seconds of blended current while gradually tightening the Snare. The stalk was kept under constant tension by lifting the tumor away from
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Endoscopic Snare excision of benign adenomas of the papilla of Vater
Gastrointestinal Endoscopy, 2008Co-Authors: Kenneth F Binmoeller, Suraia Boaventura, Kerstin Ramsperger, Nib SoehendraAbstract:Over a 5-year period (1985 to 1990), 25 patients (11 men and 14 women, median age 68) with adenomatous tumors of the papilla of Vater judged to be benign by endoscopic appearance and forceps biopsy were included in this study. All patients had de novo tumors except for two patients who had recurrent adenomas after local surgical excision. Presenting symptoms included pain (19 patients), jaundice (9 patients), and pancreatitis (4 patients). ERCP showed bile and pancreatic duct dilation in 20 patients (6 with stones) and 2 patients, respectively. The adenoma and the papilla of Vater were excised using a standard Polypectomy Snare (Snare papillectomy). Procedure-related complications included bleeding in two patients and acute pancreatitis in three patients. No deaths occurred. Histologic analysis showed benign adenoma with mild to moderate dysplasia in 18 patients and severe dysplasia in 1 patient. Two patients with evidence for intraductal tumor extension on ERCP were referred for surgery. Six patients had recurrences at a median follow-up of 37 months (range, 7 to 79 months), of whom one had intraductal tumor spread and underwent pancreatoduodenectomy. Five patients were re-treated endoscopically: one ultimately required surgery.
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endoscopic Snare mucosectomy in the esophagus without any additional equipment a simple technique for resection of flat early cancer
Endoscopy, 1997Co-Authors: Nib Soehendra, Kenneth F Binmoeller, S Bohnacker, U Seitz, B Brand, F Thonke, G GurakuqiAbstract:Background and Study Aims: Endoscopic mucosal resection of early esophageal cancer has increasingly proved to be an effective treatment modality, especially if the tumor has not invaded the muscularis mucosae. Different techniques have been introduced, using an overtube, double-channel endoscope, or suction cap. We have not found that these devices are required for Snare resection in the esophagus. Patients and Methods: Over a period of two years (1994-1996), seven patients (five men and two women, age range 59-88) with early esophageal cancer defined by endosonography (3 cm or less in size, limited to the submucosal layer) were treated using a simplified technique of endoscopic Snare resection using a monopolar diathermic Polypectomy Snare made of monofilament steel wire. The Snare was positioned around the lesion, and then closed while pressing the Snare against the mucosa and applying suction to draw the lesion into the Snare. Pure coagulation current was used for resection. If necessary, a piecemeal technique was used to achieve complete removal. Results: Complete removal was achieved in one session in all seven cases. No complications were observed. Two patients underwent radical surgery with no tumor remnant or metastatic lymph node in the resected specimen. All patients have remained free of recurrence during a median follow-up period of seven months (range 3-22 months). Two patients died of cardiovascular disease four and eight months after endoscopic mucosal resection. Conclusion: Small early esophageal cancer can be safely removed with a simplified method of endoscopic Snare resection using a standard monofilament Polypectomy Snare.
David Y Graham - One of the best experts on this subject based on the ideXlab platform.
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prospective randomized comparison of 2 methods of cold Snare Polypectomy for small colorectal polyps
Gastrointestinal Endoscopy, 2015Co-Authors: Akira Horiuchi, Kenji Hosoi, Masashi Kajiyama, Naoki Tanaka, Kenji Sano, David Y GrahamAbstract:Background Both cold-only Snare and hot Polypectomy Snare are used for the removal of small colorectal polyps. Objective To compare the outcome of cold Snare Polypectomy of small colorectal polyps with a Snare exclusively designed as a cold Snare versus cold Snare Polypectomy by using a traditional Polypectomy Snare. Design Prospective, randomized, controlled study. Setting Municipal hospital in Japan. Interventions Patients with colorectal polyps 10 mm or smaller in diameter were randomized to dedicated cold Snare (dedicated cold Snare group) or traditional cold Snare (traditional cold Snare group). The primary outcome measure was complete resection rates by cold snaring based on pathological examination. Secondary outcomes included bleeding within 2 weeks after Polypectomy and identification of submucosal arteries and injured arteries in the resected specimens. Results Seventy-six patients having 210 eligible polyps were randomized: dedicated cold Snare group, N = 37 (98 polyps) and traditional cold Snare group, N = 39 (112 polyps). Patient demographic characteristics including the number, size, and shape of the polyps removed were similar in the 2 groups. The complete resection rate was significantly greater with the dedicated cold than with the traditional cold Snare (91% [89/98] vs 79% [88/112], P = .015), with a marked difference with 8- to 10-mm polyps, both flat and pedunculated. Immediate bleeding and hematochezia rates were similar (19% vs 21%, P = .86; 5.4% vs 7.7%, P = .69). No delayed bleeding occurred. Histology demonstrated a similar prevalence of arteries and injured arteries in the submucosa (33% [32/96] vs 30% [31/104], P = .59; 3.1% [3/96] vs 6.7% [7/104], P = .24). Limitations Small sample size, single-center study. Conclusion Polypectomy by using a dedicated cold Snare resulted in complete polyp removal more often than did cold snaring with a traditional Snare, especially polyps 8 to 10 mm in diameter, whether flat or pedunculated. (Clinical trial registration number: NCT02036047.)
Mohammed Amine Benatta - One of the best experts on this subject based on the ideXlab platform.
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endoscopic retrieval of gastric trichobezoar after fragmentation with electrocautery using Polypectomy Snare and argon plasma coagulation in a pediatric patient
Gastroenterology Report, 2016Co-Authors: Mohammed Amine BenattaAbstract:: Trichobezoars are rare, composed of hair and more common in female pediatric patients with psychiatric disorders. Open surgical extraction is the most common removal method. Only two endoscopic removals after fragmentation have been reported in the English literature. We report herein a third case of a trichobezoar that was successfully retrieved after endoscopic fragmentation with Snare Polypectomy and argon plasma coagulation in a six-year-old female patient. The trichobezoar mass was completely removed in 10 pieces after 15 passes. The patient's course was uneventful. Nine months later, she is doing well. This endoscopic removal was effective, minimally invasive and time saving.
J. L. Vázquez Iglesias - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic resection of gastrointestinal submucosal tumors assisted by endoscopic ultrasonography
Surgical Endoscopy And Other Interventional Techniques, 2005Co-Authors: D. Martínez-ares, M. J. Varas Lorenzo, J. Souto-ruzo, J. C. Espinós Pérez, J. Yánez López, R. A. Belando, J. Durana Vilas, J. M. Miquel Colell, J. L. Vázquez IglesiasAbstract:Background The resection and histologic examination of the lesions is generally considered the treatment of choice in order to achieve diagnosis in gastointestinal submucosal tumors. Moreover, the degree of malignancy of the tumor depends on certain features that can only be studied on the entire resected piece. Methods We revised the cases of patients who underwent endoscopic resection of gastrointestinal submucosal tumors in the period from 1997 through 2002. Results Fifty submucosal lesions were resected in 45 patients (64.4% men). Patient mean age was 55.31 years. Of the lesions, 52% were gastric tumors and 88% were located in the second layer. Mean size was 12.34 mm, and 54% were smaller than 10 mm. Resection with submucosal injection of saline solution and diluted adrenaline was performed on 46% of the lesions, and standard resection using Polypectomy Snare on 48%. Ligation was used in three cases. Resection was successful in 98% and major complications were observed in 4% (two cases of bleeding, endoscopically resolved). Conclusions The endoscopic resection of submucosal tumors is a safe and efficient technique: It has few associated complications and allows diagnosis in all the cases and cure of the lesion in the great majority of cases.
Viviane Rossi Figueiredo - One of the best experts on this subject based on the ideXlab platform.
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Minimally invasive bronchoscopic resection of benign tumors of the bronchi* , ** Ressecção minimamente invasiva por broncoscopia de tumores brônquicos benignos
2020Co-Authors: Ascedio Jose Rodrigues, David Coelho, Sérvulo Azevedo, Dias Júnior, Márcia Jacomelli, Paulo Rogério Scordamaglio, Viviane Rossi FigueiredoAbstract:Objective: Primary benign tumors of the trachea and main bronchi are uncommon. Interventional bronchoscopy allows the diagnosis and the treatment of some of these lesions. Methods: We reviewed four cases endoscopically treated at our institution. Results: Two patients had hamartoma, and two patients had endobronchial lipoma. In all of the cases, the interventional technique for the resection was the use of a Polypectomy Snare and electrocautery. The only complication reported was one episode of bronchospasm. Conclusions: Minimally invasive bronchoscopic resection is a safe, effective method for treating selected benign tumors of the main airway and has a low complication rate.
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Ressecção minimamente invasiva por broncoscopia de tumores brônquicos benignos* Minimally invasive bronchoscopic resection of benign tumors of the bronchi
2020Co-Authors: Ascedio Jose Rodrigues, David Coelho, Sérvulo Azevedo, Dias Júnior, Márcia Jacomelli, Paulo Rogério Scordamaglio, Viviane Rossi FigueiredoAbstract:Abstract Objective: Primary benign tumors of the trachea and main bronchi are uncommon. Interventional bronchoscopy allows the diagnosis and the treatment of some of these lesions. Methods: We reviewed four cases endoscopically treated at our institution. Results: Two patients had hamartoma, and two patients had endobronchial lipoma. In all of the cases, the interventional technique for the resection was the use of a Polypectomy Snare and electrocautery. The only complication reported was one episode of bronchospasm. Conclusions: Minimally invasive bronchoscopic resection is a safe, effective method for treating selected benign tumors of the main airway and has a low complication rate. Keywords: Bronchoscopy; Bronchial neoplasms; Hamartoma; Lipoma. * Trabalho realizado no Servico de Endoscopia Respiratoria, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo (SP) Brasil.Endereco para correspondencia: Ascedio Jose Rodrigues. Servico de Endoscopia Respiratoria, HC-FMUSP, Predio dos Ambulatorios, 6o Andar, Bloco 03, Avenida Dr. Eneas de Carvalho Aguiar, 255, Cerqueira Cesar, CEP 05017-000, Sao Paulo, SP, Brasil.Apoio financeiro: Nenhum.Recebido para publicacao em 18/7/2011. Aprovado, apos revisao em 6/9/2011.
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Minimally invasive bronchoscopic resection of benign tumors of the bronchi.
Jornal Brasileiro De Pneumologia, 2011Co-Authors: Ascedio Jose Rodrigues, David Coelho, Márcia Jacomelli, Paulo Rogério Scordamaglio, Sérvulo Azevedo Dias Júnior, Viviane Rossi FigueiredoAbstract:OBJECTIVE: Primary benign tumors of the trachea and main bronchi are uncommon. Interventional bronchoscopy allows the diagnosis and the treatment of some of these lesions. METHODS: We reviewed four cases endoscopically treated at our institution. RESULTS: Two patients had hamartoma, and two patients had endobronchial lipoma. In all of the cases, the interventional technique for the resection was the use of a Polypectomy Snare and electrocautery. The only complication reported was one episode of bronchospasm. CONCLUSIONS: Minimally invasive bronchoscopic resection is a safe, effective method for treating selected benign tumors of the main airway and has a low complication rate.