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ABSTRACT: Patients with familial adenomatous polyposis (FAP) are at increased risk of developing duodenal and jejunal adenocarcinomas. The aim of this study was to assess the usefulness of double-balloon enteroscopy- (DBE-) assisted chromoendoscopy for the detection and characterization of small-bowel polyps in patients with FAP.
We performed a prospective evaluation of patients with clinically and genetically proved FAP who were enrolled in an endoscopic surveillance program. DBE was performed using a Fujinon intestinoscope (FN 450P 5/20; Fujinon Corp., Omiya, Japan), and chromoendoscopy was performed using indigo carmine. The severity of small bowel polyposis was based on the Spigelman-Saurin classification.
Nine patients underwent DBE-assisted chromoendoscopy. Small-bowel polyps (including papillary adenomas) were detected in seven patients (88 %). The mean depth of small-bowel insertion was 180 cm (range 120-320 cm). The mean Spigelman-Saurin score was 4.6 (range 0-8). Jejunal polyps were detected in six patients (67 %). Chromoendoscopy aided in the detection of additional polyps in two patients. In one patient the polyps were flat and only visible with chromoendoscopy (biopsy confirmed these to be adenomas). Jejunal polyps and advanced neoplasms were more frequent in patients with APC gene mutations in exon 15. The following endoscopic therapies were performed: polypectomy (n = 1), duodenal mucosectomy (n = 1), and ablation therapy with argon plasma coagulation (n = 2).
DBE was found to be a helpful method for the evaluation of small-bowel polyps in patients with FAP. DBE-assisted chromoendoscopy was of further assistance for the detection of jejunal polyps.
Endoscopy 02/2007; 39(1):52-7. · 5.21 Impact Factor
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ABSTRACT: The interesting pathophysiological interaction between Helicobacter pylori infection, type of gastritis, acid secretion and GORD complicated by weakness of study designs with small numbers of patients
should not lead to confusion. The risk of gastric carcinogenesis and peptic ulcer formation against the need for possible
higher doses of acid suppressive therapy for symptom control after eradication should be balanced carefully and can only lead
us to one conclusion: there are more reasons that favour Helicobacter pylori eradication than to leave the bug in the stomach of your patients.
05/2006: pages 73-80;
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ABSTRACT: Obesity is a severe health problem in Europe and in the USA. There are many different methods to reduce patients' weight. We report a new method: gastric pacing. Gastric pacing is intended to induce early satiety through electrical stimulation of the gastric wall. We report the operative technique and the complications.
Der Chirurg 08/2002; 73(7):700-3. · 0.70 Impact Factor
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ABSTRACT: Living conditions (e. g. domestic crowding) may influence the infection rate. Some studies suggested that the reappearance of H. pylori in H. pylori positive patients after successful eradication therapy might be a result of transmission by H. pylori positive spouses. Therefore this study has been performed to evaluate the effect of the H. pylori status of family members on the reinfection rate of H. pylori positive patients after successful eradication therapy.
108 H. pylori positive patients (64 male, 44 female, aged 48.7 years, range 18-76 years) who presented with dyspeptic symptoms for upper GI-endoscopy have been included into this study. H. pylori status has been defined by culture and/or histology, rapid urease test and serology. For eradication therapy patients received omeprazole 20 mg bd, clarithromycine 250 mg bd and metronidazole 400 mg bd. H. pylori status was controlled by (13)C-urea breath test 28 days (n = 96), 6 (n = 35), 12 (n = 28) and 24 months (n = 25) after eradication therapy. Additionally H. pylori status of 170 family members (82 spouses, 68 children, 20 siblings/parents, aged 3-83 years) was defined by (13)C-urea breath test (n = 167), upper GI-endoscopy (n = 2) or serology (n = 1).
The eradication rate was 98 % (94/96). H. pylori prevalence in all family members was 40 % (56 % in spouses, 20 % in children). No reinfection has been found in successful eradicated patients within the two-years follow-up.
These results suggest that reinfection is not dependent on the H. pylori prevalence in family members and that H. pylori reinfection after successful eradication therapy is an unlikely event.
Zeitschrift für Gastroenterologie 07/2002; 40(6):383-7. · 0.90 Impact Factor
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ABSTRACT: Übergewicht ist heute in Europa und den USA ein gesundheitliches und soziales Problem. Neben den konservativen Therapiemaßnahmen Übergewicht ist heute in Europa und den USA ein gesundheitliches und soziales Problem. Neben den konservativen Therapiemaßnahmen
gibt es zahlreiche Verfahren zur operativen Therapie bei Adipositas. Wir berichten über eine neue laparoskopische Operationstechnik: gibt es zahlreiche Verfahren zur operativen Therapie bei Adipositas. Wir berichten über eine neue laparoskopische Operationstechnik:
das Gastric pacing. Neu ist hierbei, dass über eine elektrische Stimulation des Magens beim Patienten ein Sättigungsgefühl das Gastric pacing. Neu ist hierbei, dass über eine elektrische Stimulation des Magens beim Patienten ein Sättigungsgefühl
ausgelöst wird. Der Eingriff wird hier in seiner Technik und im Hinblick auf mögliche Komplikationen beschrieben. ausgelöst wird. Der Eingriff wird hier in seiner Technik und im Hinblick auf mögliche Komplikationen beschrieben.
Obesity is a severe health problem in Europe and in the USA. There are many different methods to reduce patients' weight. Obesity is a severe health problem in Europe and in the USA. There are many different methods to reduce patients' weight.
We report a new method: gastric pacing. Gastric pacing is intended to induce early satiety through electrical stimulationgh electrical stimulation
of the gastric wall. We report the operative technique and the complications. of the gastric wall. We report the operative technique and the complications.
Der Chirurg 06/2002; 73(7):700-703. · 0.70 Impact Factor
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ABSTRACT: Functional gastrointestinal disorders are a common problem. Different noninvasive and invasive strategies have been carried out in recent years to study the role of impaired myoelectrical activity, tone, compliance, transit and perception of the gastrointestinal tract. Esophageal barostat examination and impedance measurements have been added to standard clinical methods like manometry and pH-metry for the esophagus. Bilirubin measurement allows the evaluation of duodenogastroesophageal reflux and perception can be studied by gastric barostat. Electrogastrography and tenostat test are still research tools. Rectal or sigmoid barostat examination is a new research tool to study visceral sensitivity in the lower gastrointestinal tract. New methods--like functional MRI and SPECT--are promising features for the future.
Digestive Diseases 02/2001; 19(3):232-9. · 2.37 Impact Factor
