Hepato Gastroenterol
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Hepato Gastroenterol · May 2015
ReviewMystery Story about Erythropoietin (Epo) and Erythropoietin Receptor (EpoR) are Disguised?
In this review we would like to focus our attention upon very controversial reports on Erythropoietin (Epo) and Erythropoietin Receptor (EpoR) expression in cancer patients. The effects of Epo on cancerous tissues are poorly understood. Hypoxia results in an increase in the level of the production of both Epo and EpoR via activation of the hypoxia-inducible factor 1 (HIF-1) pathway. ⋯ Macrophages stimulate vessel sprouting via a soluble factor other than VEGF, rather than through direct contact with endothelial cells. The intriguing questions are set about many researches to link Epo/EpoR expression and function in order to establish one of the mechanisms of tumor growth, disease progression of cancer patient. However, it is uncertain role in tumour angiogenesis as promoter and stimulator of tumour growth which should need to be furtherly validated.
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Hepato Gastroenterol · Mar 2015
Review Meta AnalysisThe impact of anesthetic techniques on survival for patients with colorectal cancer: evidence based on six studies.
Epidural-supplemented general anesthesia is perceived as a more beneficial method over general anesthesia since it reduces incidence of side effects, provides better postoperative pain relief and lowers the possibility to use immunosuppressive anesthetics. However, previous prospective and retrospective studies reported conflicting results in the effects of epidural anesthesia on post-operative outcomes of colorectal cancer surgery. Therefore, this study aims to pool available evidence to assess the association between epidural anesthesia and the post- operative outcomes in this group of patients. ⋯ Although epidural anesthesia might not lead to improved recurrence free survival, it had significant benefit in improving overall survival and reducing all-cause of death. It might be a useful anesthetic technique for colorectal cancer patients undergoing surgery. However, prospective studies are required to confirm whether this benefit is causative with epidural anesthesia.
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Hepato Gastroenterol · Mar 2015
ReviewRisk, diagnosis and treatment to postoperative delirium in elderly patients with gastrointestinal cancers.
In recent years, more elderly patients with gastrointestinal cancers have been undergoing surgery. As one of main postoperative complications, postoperative delirium (POD) is harmful and difficult to prevent and treat. ⋯ However, health care providers still have many problems for POD to face in elderly,with gastrointestinal cancers during the clinical care. In this paper, Etiology, damages, prevention, diagnosis and treatment of POD in elderly with gastrointestinal cancer were reviewed, and the prospect of POD was also discussed.
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Hepato Gastroenterol · Sep 2014
Review Meta AnalysisRadiofrequency ablation vs. surgical resection on the treatment of patients with small hepatocellular carcinoma: a system review and meta-analysis of five randomized controlled trials.
To investigate the meta-analysis of randomized controlled trials(RCTs) of the efficacy and safety between radiofrequency ablation (RFA ) and surgical resection (SR) in treating small hepatocellular carcinoma (SHCC). ⋯ SR treatment led to a higher long-term survival rate and a lower long-term recurrence rate, while RFA led to a lower complication rate than SR. However, Further research was needed to investigate the efficacy of RFA because of the inadequate research data and the heterogeneity among the included studies.
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Hepato Gastroenterol · Sep 2014
ReviewEndoscopic ultrasound guided radiofrequency ablation in pancreas.
Radiofrequency ablation of the pancreas represents a more effective tumor-destruction method compared to other ablation techniques. The endoscopic ultrasound guided radiofrequency ablation is indicated for locally advanced, non-metastatic pancreatic adenocarcinoma, without the need of general anesthesia and fast recovery. ⋯ It has been successfully applied on insulinomas and pancreatic adenocarcinoma in humans, with few complications, such as duodenal bleeding or mild abdominal pain. Other side effects as biliary fistula, pancreatic fistula or acute pancreatitis seen in intraoperative settings of radiofrequency ablation, have not been reported in endoscopic ultrasound guided radiofrequency ablation.