Frank Heieck - Academia.edu (original) (raw)
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Papers by Frank Heieck
Digestive and Liver Disease, 2011
Background/Aims: Colonoscopy has been proven a valuable tool in preventing colorectal cancer in c... more Background/Aims: Colonoscopy has been proven a valuable tool in preventing colorectal cancer in controlled studies; we conducted a longitudinal confirmation study in everyday clinical practice. Methods: In a retrospective study, we monitored the outcome of patients with a total colonoscopy at our hospital between 1994 and 2007. We analysed the data of in-house follow-up colonoscopies, a national person registry and the morphological tumour registry centralizing all histopathological data at a national level. Patients with a particular colorectal cancer risk were excluded. Results: 8950 patients were included in our study. 2032 (22.7%) patients had at least one colorectal adenoma at index colonoscopy. Adenoma prevalence was significantly higher in men than in women (27.9% vs. 17.4%, p < 0.001) and was increasing with age in both sexes. Patients were followed for a mean of 5.2 years and 19 had invasive colorectal cancer detected over 47,725 person years of follow-up. The incidence rate was 0.40 cases/1000 person years of follow-up (95% confidence interval, 0.25-0.62), and the standardized incidence ratio was 0.37 (95% confidence interval, 0.24-0.58). Conclusion: Incidence rates of colorectal cancer are low in the follow-up of patients having undergone a total colonoscopy in everyday practice. After standard therapy of colorectal adenomas at colonoscopy, there is little evidence for excess colorectal cancer incidence in this subgroup.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2014
Postoperative esophagojejunal fistula induces morbidity and mortality after total gastrectomy and... more Postoperative esophagojejunal fistula induces morbidity and mortality after total gastrectomy and affects the long-term survival rate. Between 2003 and 2011, 38 patients underwent laparoscopic total gastrectomy and 2 developed an esophagojejunal fistula. The diagnosis was established by a computed tomography scan with contrast ingestion. The absence of complete dehiscence and the vitality of the alimentary loop were checked during laparoscopic exploration, associated with effective drainage. During the endoscopy, dehiscence was assessed and a covered stent and nasojejunal tube were inserted for enteral feeding. The leaks healed progressively, oral feeding was resumed and the drains removed within 3 weeks. The stent was removed 6 weeks. Three months later, the patients were able to eat without dysphagia. Early diagnosis allows successful conservative management. The objectives are effective drainage, covering by an endoscopic stent and renutrition. Management by a multidisciplinary team is essential.
Digestive and Liver Disease, 2011
Background/Aims: Colonoscopy has been proven a valuable tool in preventing colorectal cancer in c... more Background/Aims: Colonoscopy has been proven a valuable tool in preventing colorectal cancer in controlled studies; we conducted a longitudinal confirmation study in everyday clinical practice. Methods: In a retrospective study, we monitored the outcome of patients with a total colonoscopy at our hospital between 1994 and 2007. We analysed the data of in-house follow-up colonoscopies, a national person registry and the morphological tumour registry centralizing all histopathological data at a national level. Patients with a particular colorectal cancer risk were excluded. Results: 8950 patients were included in our study. 2032 (22.7%) patients had at least one colorectal adenoma at index colonoscopy. Adenoma prevalence was significantly higher in men than in women (27.9% vs. 17.4%, p < 0.001) and was increasing with age in both sexes. Patients were followed for a mean of 5.2 years and 19 had invasive colorectal cancer detected over 47,725 person years of follow-up. The incidence rate was 0.40 cases/1000 person years of follow-up (95% confidence interval, 0.25-0.62), and the standardized incidence ratio was 0.37 (95% confidence interval, 0.24-0.58). Conclusion: Incidence rates of colorectal cancer are low in the follow-up of patients having undergone a total colonoscopy in everyday practice. After standard therapy of colorectal adenomas at colonoscopy, there is little evidence for excess colorectal cancer incidence in this subgroup.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 2014
Postoperative esophagojejunal fistula induces morbidity and mortality after total gastrectomy and... more Postoperative esophagojejunal fistula induces morbidity and mortality after total gastrectomy and affects the long-term survival rate. Between 2003 and 2011, 38 patients underwent laparoscopic total gastrectomy and 2 developed an esophagojejunal fistula. The diagnosis was established by a computed tomography scan with contrast ingestion. The absence of complete dehiscence and the vitality of the alimentary loop were checked during laparoscopic exploration, associated with effective drainage. During the endoscopy, dehiscence was assessed and a covered stent and nasojejunal tube were inserted for enteral feeding. The leaks healed progressively, oral feeding was resumed and the drains removed within 3 weeks. The stent was removed 6 weeks. Three months later, the patients were able to eat without dysphagia. Early diagnosis allows successful conservative management. The objectives are effective drainage, covering by an endoscopic stent and renutrition. Management by a multidisciplinary team is essential.