By Giuseppe Galloro
Owing to the adjustments in visceral anatomy, many endoscopists, and particularly trainees, adventure problems whilst acting endoscopic surveys or strategies in sufferers who've formerly gone through surgical procedure to the digestive tract. during this richly illustrated e-book, a professional within the box offers a close evaluate of endoscopic follow-up of gastrointestinal (esophageal, gastric, and colorectal) anastomosis. either general appearances and pathological stipulations concerning problems are absolutely lined. The method, timing, protocols, and position of diagnostic endoscopy are first mentioned. Endoscopic remedies for the answer of alternative medical difficulties on the topic of recurrences, stenoses, dehiscences, and fistulas are then evaluated step-by-step via fine quality photos. despite point of expertise, endoscopists and gastroenterologists will locate Endoscopic Follow-up of Digestive Anastomosis to be a useful resource of knowledge and relief to remedy during this very important quarter, which too frequently gets insufficiently distinct attention.
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Additional resources for Endoscopic Follow-up of Digestive Anastomosis
Consequently, the number of cured patients has increased and some of these patients are at risk of acquiring a second primary cancer in the remnant stomach. This implies that more cases of GSC will be encountered in the future . Surveillance systems for early detection and curative treatment of GSC with periodic endoscopic examinations of the gastric remnant are mandatory. 8 years, respectively . In the study of Komatsu et al. , the follow-up interval was significantly associated with the stage of progression in remnant gastric cancer: an early detection of GSC required less-invasive curative treatment (endoscopic submucosal dissection) and a better prognosis (Fig.
1 Preventing Postsurgical Complications The most common complication of intestinal anastomosis is the development of ulcers . 1 years. Reaction to foreign body (Fig. 2) has been postulated as the main cause for the ulceration ; 43 Fig. 2 Retained postsurgical suture at CE; arrows indicate the suture stitch however, the majority of patients who have their anastomosis either with hand-sewn sutures or stapled do not develop ulcers. The local ischemia, secondary to scar formation, as well as abnormal motility and local intussusceptions, has also been advocated as mechanisms contributing to ulcer formation .
On the contrary, in another study by Kayani et al.  examining 47 published articles, no clear evidence was found concerning a higher incidence for cervical anastomoses, but the studies comparing the two types of anastomoses are few, with a low number of cases, and they are not standardized concerning surgery approaches, anastomosis techniques, and the neo-adjuvant therapy. 05)) compared to the whole viscera . 685). 8 %). 9 % over the last decade. 7 % (P = NS)). 7 % (12/255: 8 slight 4 serious).