In a period of 4 years between March 1994 and March 1998, 143 patients with gastroesophageal reflux disease (GERD) underwent laparoscopic antireflux surgery. According to manometric studies 76 patients had a short-floppy Nissen fundoplication, patients with impaired motility or paraesophageal hernias received a hemifundoplication (Toupet = 42, Dor/Thal = 25). Recurrent reflux symptoms appeared in 6.3% after mean 16.7 months follow-up (Nissen = 2.6%, Toupet = 2.3%, Dor/Thal = 24%, P < 0.01). Persistent dysphagia with reoperation occurred in 2.1% (Nissen = 2.6%, Toupet = 2.3%, Dor/Thal = 0%, n.s.). The assessment of Visick's score at the latest control showed the following: Visick I = 63.6%, Visick II = 30.1%, Visick III = 6.3%, Visick IV = 0%. The outcome of the operation was rated "excellent" or "good" by 91.6% of the patients.

Purpose Colorectal cancer and its treatment are associated with debilitating side effects. Exercise may improve the physical and psychological wellbeing of cancer patients; however, evidence in colorectal cancer patients undergoing adjuvant chemotherapy is limited. This pilot study aimed to explore the effects of supervised aerobic exercise on cardiorespiratory fitness and patient-reported health outcomes in colorectal cancer patients undergoing adjuvant chemotherapy. Methods Patients who had undergone curative resection for colorectal cancer (stages II–III) and were scheduled to receive adjuvant chemotherapy were enrolled into this non-randomized controlled trial. Patients in the intervention group (IG) took part in a 6-month supervised aerobic exercise program, while the control group (CG) received usual care. Cardiorespiratory fitness (measured by peak oxygen consumption) was assessed at baseline and 6 months. Fatigue, quality of life, and physical activity levels were additionally assessed at 3 months. Results In total, 59 patients (33 in IG vs. 26 in CG) were enrolled into this study. Eighteen patients (9 in IG vs. 9 in CG) dropped out of the study prior to the 6-month follow-up. Significant improvements in cardiorespiratory fitness (p = .002) and selected patient-reported health outcomes, such as reduced motivation (p = .015) and mental fatigue (p = .018), were observed in the IG when compared to the CG. Conclusion To our knowledge, this is the first study to investigate the effects of a supervised aerobic exercise program in colorectal cancer patients undergoing adjuvant chemotherapy. The significant and clinically meaningful improvements in CRF warrant further randomized controlled trials to confirm these findings. Trials registration German Clinical Trials Register Identifier: DRKS00005793, 11/03/2014, retrospectively registered.

The Collis gastroplasty combined with Nissen fundoplication is an effective procedure in patients with shortened esophagus diagnosed intraoperatively during laparoscopic antireflux surgery. Because of neoesophageal acid production proximal to an intact fundoplication coupled with poor esophageal clearance, there was no complete restitution.

The case-study reminds of adenocarcinoma of the small intestine as a rare complication of Crohn's disease. A few more than 100 of these cases have been published. Epidemiological studies concerning small bowel carcinoma showed consumption of sugar and carbohydrates as pathogenetic factors, other conditions like ileostoma, ileumconduit, Crohn's disease and coeliac disease have been identified to some extent. An adenoma-carcinoma sequence as in large intestine carcinoma has been discussed. Immunohistochemical and oncogenetic findings failed to demonstrate any result of practical clinical value. Diagnosis of early stages of adenocarcinoma of the small intestine is very difficult and thus might be impossible to differentiate from exacerbation or progressive stenosis of preexisting Crohn's disease. If non-invasive diagnostic measures (ultrasound, small bowel enema, CT-scan, intestinoscopy, radiography, NMR-Sellink, capsule-endoscopy) fail to clear the situation a diagnostic laparoscopy or even laparotomy should not be delayed. This constitutes the only chance to discover early stages which can possibly be cured in accordance with oncosurgical principles. Otherwise the prognosis remains poor with a high percentage of late stages and a 5-year-survival-rate between 20 and 50 percent.