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Background and objective Upper gastrointestinal tract endoscopy (UGIE) is widely performed under propofol sedation, which is considered as a safe sedation agent and alleviates the sympathetic response to the procedure. However, retching and gag reflex still disturb ~29% of those patients despite being under propofol sedation. Patients and methods A total of 120 adult patients scheduled for elective UGIE were randomly allocated into three equal groups (40 patients each): group C was given propofol 50 mg group D was given propofol 50 mg+dexmedetomidine 0.5 µg/kg and group L was given propofol 50 mg+15 g palatable lidocaine gel. The outcome measures included incidence of gag reflex propofol consumption recovery time intraoperative hemodynamics and patients' and endoscopist's satisfaction. Results The incidence of gag reflex was statistically significantly reduced in groups L and D compared with group C; however the reduction was more in group L but with no significant difference when compared with group D group. Propofol consumption was statistically significantly lower in groups L and D compared with group C as well as recovery time was significantly shorter in groups L and D compared with group C. Group L showed the least hemodynamic changes among the three groups and the endoscopist as well as the patients were statistically significant more satisfied in both groups L and D when compared with group C. Conclusion Using palatable lidocaine gel in addition to propofol in patients undergoing UGIE was safe and effectively reduced the incidence of gag reflex and the dose of intravenous propofol with its subsequent complications shortening recovery time and improving patient and endoscopist satisfaction. [ABSTRACT FROM AUTHOR]

Purpose: Presently, there is no scientific evidence supporting a definite role for follow-up after gastrectomy for cancer, and clinical practices are quite different around the globe. The aim of this consensus conference was to present an ideal prototype of follow-up after gastrectomy for cancer, based on shared experiences and taking into account the need to rationalize the diagnostic course without losing the possibility of detecting local recurrence at a potentially curable stage. Methods: On June 19-22, 2013 in Verona (Italy), during the 10th International Gastric Cancer Congress (IGCC) of the International Gastric Cancer Association, a consensus meeting was held, concluding a 6-month, Web-based, consensus conference entitled 'Rationale of oncological follow-up after gastrectomy for cancer.' Results: Forty-eight experts, with a geographical distribution reflecting different health cultures worldwide, participated in the consensus conference, and 39 attended the consensus meeting. Six statements were finally approved, displayed in a plenary session and signed by the vast majority of the 10th IGCC participants. These statements are attached as an annex to the Charter Scaligero on Gastric Cancer. Conclusion: After gastrectomy for cancer, oncological follow-up should be offered to patients; it should be tailored to the stage of the disease, mainly based on cross-sectional imaging, and should be discontinued after 5 years. [ABSTRACT FROM AUTHOR]

Background. Myofibroblastic inflammatory tumor is a benign, unusual tumor and very difficult to diagnose. Symptoms may vary; and some patients may be asymptomatic. The most common location is in the lungs. Gastric myofibroblastic inflammatory tumors are exceptional in children. Case report. An eight year-old boy presented with an epigastric tumor, measuring 4 x 4 cm by examination and anemia. Based on radiographic studies, ultrasound and CT scan of the abdomen, a tentative diagnose of lymphoma was made. A fine needle aspiration biopsy was performed but the material obtained was inadequate for a histopathologic diagnosis. A laparotomy was performed. An epigastric, white and infiltrating tumor was found, which measure was bigger than the one found at examination, 8 x 10 cm. An incisional biopsy was performed. The histopathological diagnosis was myofibroblastic inflammatory tumor. An upper digestive tract endoscopy was done, which showed gastric mucosa invasion by the tumor. A second laparotomy was done an a total resection of the tumor was obtained by means of a partial gastrectomy (30% of the stomach). Seven years later the patient is asymptomatic and the abdominal ultrasound is normal. Conclusions. Having in mind this type of tumor may avoid unnecessary radical surgical procedures as well as the needless chemo and/or radiotherapy. In most patients, conservative surgery is an adequate treatment. [ABSTRACT FROM AUTHOR]

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