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  • 1
    Electronic Resource
    Electronic Resource
    Stellenwert der Staging-Laparoskopie (1999)
    Springer
    Der Onkologe 5 (1999), S. 203-207 
    Details
    ISSN: 1433-0415
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Die einzige kurative Therapieoption beim Pankreaskarzinom besteht in der radikalen Resektion des Tumors. Das z.Z. sensitivste Verfahren zum Nachweis einer intraabdominellen Metastasierung stellt die Staging-Laparoskopie mit laparoskopischer Sonographie dar.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007610050343
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  • 2
    Electronic Resource
    Electronic Resource
    MRI diagnosis and staging of rectal carcinoma (1996)
    Springer
    Abdominal imaging 21 (1996), S. 211-218 
    Details
    ISSN: 1432-0509
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900048
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  • 3
    Electronic Resource
    Electronic Resource
    Three-dimensional endoluminal ultrasound: a new method for the evaluation of gastrointestinal tumors (1999)
    Springer
    Abdominal imaging 24 (1999), S. 445-448 
    Details
    ISSN: 1432-0509
    Keywords: Key words: Endoscopic ultrasound—Three-dimensional imaging—Esophageal cancer—Tumor staging—Colorectal cancer.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The purpose of the present study was to evaluate the feasibility of three-dimensional endoluminal ultrasound of gastrointestinal tumors. Methods: Sixteen patients with esophageal, gastric, or colorectal tumors underwent endoscopic ultrasound. Three-dimensional ultrasound data were obtained from multiple serial images of a miniprobe (360°, 12.5 MHz) and processed on a PC-based 3D workstation. Results: Adequate three-dimensional ultrasound scans were obtained in eight patients with esophageal cancer and five patients with colorectal cancer. Three-dimensional image processing enabled visualization of the data as a multiplanar display or as a life-like three-dimensional view. The availability of arbitrary scan planes improved the assessment of local tumor spread and the spatial relation of the tumor to relevant adjacent structures (e.g., major vessels). Three-dimensional presentations provided realistic views of the anatomy and facilitated the interpretation of the ultrasound images. Conclusions: Three-dimensional display and the ability to review endoluminal ultrasound data interactively may improve the staging of gastrointestinal tumors. These preliminary data encourage further evaluation of this technique.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002619900536
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  • 4
    Electronic Resource
    Electronic Resource
    Three-dimensional endoscopic ultrasound of the esophagus (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 991-994 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endoscopic ultrasound — Three-dimensional imaging — Esophageal cancer — Staging
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The aim of this study was to develop a technique for three-dimensional endoscopic ultrasound of the esophagus based on standard ultrasonic images. Methods: Endoscopic ultrasound was performed in five esophageal cancer patients using a high-resolution miniprobe (360°, 12.5 MHz). For acquisition of three-dimensional data sets, the miniprobe was attached to a stepping motor that enabled ECG-triggered withdrawal of the transducer. Three-dimensional images were reconstructed from serial transverse sections on a PC-based 3D work station. Results: Twelve volume scans were obtained in five patients with esophageal cancer. The system enabled the acquisition of accurate three-dimensional ultrasound data within 30– 50 s. Computed image processing allowed us to display the data in transverse, longitudinal, and oblique sections, or as a 3D reconstruction. Three-dimensional imaging provided accurate visualization of the tumor and surrounding structures in all cases. The tumor stage was determined correctly in four of five patients. Longitudinal scan planes and 3D views improved the assessment of longitudinal tumor infiltration and the spatial relation of the tumor to relevant mediastinal structures. Conclusion: This study shows that three-dimensional endoscopic ultrasound of the esophagus is technically feasible. The technique allows the assessment of local tumor spread in previously unattainable scan planes and 3D views. This promising preliminary experience should encourage further exploration of this method.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900509
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  • 5
    Electronic Resource
    Electronic Resource
    Endoscopic treatment of a choledochocele in a 2-year-old child (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1016-1018 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Choledochocele — ERCP — Sphincterotomy — Biliary drainage — Pediatric
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Choledochocele is an extremely rare congenital lesion of the biliary tree causing abdominal pain, pancreatitis, and obstructive cholestasis. Traditionally the therapy for this malformation has been surgery. Recently endoscopic therapy has been utilized alternatively for the treatment of choledocele in adults. We report the case of a 2-year-old girl with a choledochocele who was treated by endoscopic sphincterotomy and placement of a biliary stent. The prosthesis was removed after 4 months. After a follow-up of 20 months the patient remains free of symptoms. Our experience suggests that endoscopic treatment of congenital biliary disease can be performed accurately. Further studies will be necessary to confirm the value of stent implantation in congenital bile duct stenosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900227
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  • 6
    Electronic Resource
    Electronic Resource
    Endosonography and endosonography-guided biopsy of upper-GI-tract tumors using a curved-array echoendoscope (1996)
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 1205-1209 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endoscopic ultrasound — Curved array — Staging — Endosonography-guided biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The purpose of the present study was to evaluate the accuracy of endoscopic ultrasonography (EUS) with a curved-array transducer and to determine the value of endosonography-guided biopsy. Methods: EUS was performed in 162 consecutive patients for preoperative staging of gastric or esophageal cancer (n= 122) or for EUS-guided biopsy (n= 40). All patients were examined using a flexible echoendoscope (Pentax FG32-UA) equipped with a 7.5-MHz curved-array transducer. A specially designed fine needle was used for EUS-guided biopsy of submucosal or extrinsic lesions. Results: Surgery was performed in 19 of 48 patients with esophageal cancer and 60 of 74 patients with gastric cancer. The accuracy in the assessment of the infiltration depth of esophageal cancer and in the determination of lymph node involvement was 84% and 88%, respectively. In gastric cancer the tumor infiltration depth was assessed correctly in only 65% of the patients. The identification of early gastric cancer proved to be a major problem. The accuracy in the detection of lymph node involvement was 73%. Obstructing tumors were examined in 17 patients with carcinoma of the esophagus or the gastric cardia. The accuracy of EUS in determining the T-stage and the N-stage of stenotic tumors was 88% and 86%, respectively. Endosonography-guided needle biopsy was successfully performed in all 40 patients. Histologic analysis revealed malignancy in 50% of the patients. Only two biopsy specimens contained nonrepresentative material (accuracy: 95%). No complications were observed related to the procedure. Conclusions: EUS with a curved-array transducer provides high accuracy rates in staging of esophageal carcinoma. Evaluation of gastric cancer with this technique appears to be more difficult than with radial transducers. A major advantage of the linear transducer is the ability to perform EUS-guided biopsies of submucosal or extamural lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900280
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  • 7
    Electronic Resource
    Electronic Resource
    Application of rectal stents for palliation of obstructing rectosigmoid cancer (1997)
    Springer
    Surgical endoscopy and other interventional techniques 11 (1997), S. 758 -761 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endoscopic palliation — Rectal cancer — Self-expanding metal stent — Endoprosthesis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The rationale of palliative endoscopic treatment is to avoid a colostomy in patients with advanced disease and limited life expectancy. This study was conducted to evaluate the role of endoscopic stent implantation for palliation of obstructing rectal cancer. Methods: Overall, 19 patients (aged 47–87 years) with nonresectable or metastatic rectal cancer were treated by stent insertion after laser recanalization or dilation. Three types of stents, i.e., plastic tubes (n= 8), self-expanding mesh stents (n= 6), and endocoil stents (n= 5), were used to maintain luminal patency. Results: Endoscopic stent implantation was successfully performed in all 19 patients. Long-term luminal patency and satisfactory bowel function were achieved in 16 of 19 patients (84%). After a median follow-up of 6 months, eight of the patients have died and eight are still alive without evidence of recurrent obstruction. Dislocation of the endoprosthesis occurred in two of eight plastic tubes and one of five mesh stents. Recurrent obstruction due to tumor ingrowth was only observed in patients treated with self-expanding mesh stents (n= 2). In spite of reinsertion and laser therapy a colostomy was required in three of 19 patients. There was no evidence of treatment failure in five patients who received endocoil stents. None of the patients experienced serious complications related to the endoscopic procedure. Conclusions: Endoscopic stent implantation seems to be a safe and efficient palliative approach to selected patients with obstructing rectal cancer. Currently, self-expanding coil stents are superior to other devices because of lower risk of dislocation and tumor ingrowth.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900444
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  • 8
    Electronic Resource
    Electronic Resource
    Video-assisted thoracic surgery (1998)
    Springer
    Surgical endoscopy and other interventional techniques 12 (1998), S. 133-136 
    Details
    ISSN: 1432-2218
    Keywords: Key words: VATS — Staging of extrathoracic tumors — Peripheral pulmonary lesions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: This prospective study was conducted to investigate the value of video-assisted thoracic surgery (VATS) for staging and therapy of thoracic tumors. Methods: VATS was performed in 86 patients presenting peripheral pulmonary nodules. Indications for thoracoscopy included diagnosis of indeterminated pulmonary lesions (n= 55), staging of disseminated disease (n= 24), and therapeutic interventions (n= 7). Previous or simultaneous tumors belonged to gastrointestinal tract (n= 27), sarcoma (n= 19), breast (n= 12), and miscellaneous. VATS was carried out under general anesthesia using double lumen intubation. Results: VATS was successfully performed in 78% of patients. It was converted in 19 patients (22%) because of adhesions (n= 12), technical problems (n= 3), and lesions not to be found (n= 4). VATS revealed malignancy in 81% and benign lesions in 19%. Additional information compared to conventional staging was obtained in 48%, resulting in therapeutic consequences in 34% of the patients. Postoperative complications related to VATS were observed in nine patients. Conclusions: In this study, VATS proved to be a sensitive technique for staging of pulmonary lesions. Thoracoscopic wedge resection may have significant impact on the operative management of carefully selected patients with peripheral pulmonary lesions.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649900613
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  • 9
    Electronic Resource
    Electronic Resource
    Accuracy of endorectal ultrasound after preoperative radiochemotherapy in locally advanced rectal cancer (1999)
    Springer
    Surgical endoscopy and other interventional techniques 13 (1999), S. 980-984 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Rectal cancer — Preoperative staging — Endorectal ultrasound — Preoperative radiochemotherapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: Factors limiting the accuracy of endorectal ultrasound in staging, locally advanced primary rectal cancer after preoperative neoadjuvant radiochemotherapy (RCT) were evaluated. Methods: Patients (n= 84) with initial locally advanced rectal cancer (uT3/uT4) undergoing R0 resection were investigated after preoperative treatment that combined radiotherapy up to 45 Gy with two cycles of chemotherapy (5-FU and leucovorin on d 1–5 and 22–28). At 4 to 6 weeks after completion of RCT and before tumor resection, preoperative endoluminal ultrasound was performed. Results: The accuracy to predict the depth of tumor infiltration (T-category) was found to correlate with downstaging. The T-category was correctly staged before surgery in 15 of the 51 responders (29%) and in 27 of 33 nonresponders (82%), whereas misinterpretation occurred in 36 of the responders (71%) and in 6 of the nonresponders (18%) (p 〈 0.001). Neither tumor distance from anal verge nor tumor location correlated with the staging accuracy. Lymph node involvement was correctly assessed in 48 patients (57%). Wall invasion was correctly ascertained in 42 patients (50%), with under estimation in 11 patients (13%) and overestimation in 31 patients (37%). Conclusions: After radiochemotherapy, endosonography does not provide a satisfactory accuracy for preoperative staging of rectal cancer. New interpretation and diagnostic criteria are needed for the prediction of treatment response.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004649901151
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  • 10
    Electronic Resource
    Electronic Resource
    Prospective comparison of endorectal ultrasound, three-dimensional endorectal ultrasound, and endorectal MRI in the preoperative evaluation of rectal tumorsrid="" (2000)
    Springer
    Surgical endoscopy and other interventional techniques 14 (2000), S. 1005 -1009 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Endorectal ultrasound — Three-dimensional endorectal ultrasound — Rectal cancer — Staging — Endorectal MR imaging — Surface coil — Cancer
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The aim of this study was to compare the value of endorectal ultrasound (EUS), three-dimensional (3D) EUS, and endorectal MRI in the preoperative staging of rectal neoplasms. Methods: Thirty consecutive patients with rectal tumors were assessed by EUS and endorectal MRI. Additionally, three-dimensional ultrasound was performed in a subgroup of 25 patients. EUS data were obtained with a bifocal multiplane transducer (10 MHz) and processed on a 3D ultrasound workstation. MR imaging was carried out with a 1.5 T superconducting unit using an endorectal surface coil. Results: EUS was carried out successfully in all 30 patients, whereas endorectal MRI was not feasible in two patients. Compared with the histopathological classification, EUS and endorectal MRI correctly determined the tumor infiltration depth in 25 of 30 and 28 patients, respectively. The comparative accuracy of EUS, 3D EUS, and endorectal MRI in predicting tumor invasion was 84%, 88%, and 91%, respectively. EUS, three-dimensional EUS, and endorectal MRI enabled us to assess the lymph node status correctly in 25, 25, and 24 patients, respectively. Both three-dimensional EUS and endorectal MRI combined high-resolution imaging and multiplanar display options. Assessment of additional scan planes facilitated the interpretation of the findings and improved the understanding of the three-dimensional anatomy. Conclusion: The accuracy of three-dimensional EUS and endorectal MRI in the assessment of the infiltration depth of rectal cancer is comparable to conventional EUS. One advantage of both methods is the ability to obtain multiplanar images, which may be helpful for the planning of surgery in the future.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004640000345
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