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Self-Expandable Stents in the Gastrointestinal Tract
July 2013
PRINT AND DIGITAL MEDIA REVIEWS 251
Histopathology of Chronic Constipation, 2nd edition, William A. Meier-Ruge and Elisabeth Bruder, editors. 54 pp. $93.00. Basel, Switzerland, Karger, 2012. ISBN: 978-3-318-02174-5. Web address for ordering: www.karger.com
REVIEWER RATING Coverage of relevant topics
+++++
Improvement over previously available media
+++++
Style of presentation and formatting
+++++
Quality of figures
+++++
Overall
+++++
Stars: +: poor; ++: adequate; +++: fair; ++++: good; +++++: excellent.
Intestinal peristalsis is the result of a complex process involving all components of bowel wall: the enteric nervous system (ENS), the tendinous collagenous tissue of muscularis propria, and muscularis layer itself. A malfunction of any of these parts leads to constipation and abnormal peristalsis. One of the best textbooks on this subject is this new monograph, which has a hard cover and includes 54 pages, as well as 105 figures (93 in color), 6 tables, and schematic drawings of high quality. Editors William A. Meier-Ruge and Elisabeth Bruder of the Institut für Pathologie der Universit ät Basel are experts in this field. They present a systematic classification on constipation and intestinal motility disorders with the aim to obtain a multidisciplinary clinical and diagnostic approach to these disorders, and a possible identification of diagnostic protocols focusing attention on the type of surgical biopsies, technical factors for optimal laboratory results, and criteria for pathologic diagnosis. The principle and fundamental message of the textbook is that enzyme histochemistry is more than a morphologic technique, because it can give functional information on the ENS. It offers orthotopic localization of a particular enzyme in ganglion cells and nerve fibers. Enzyme histochemistry reflects the metabolic rate of a particular cell by enzymes of the critic cycles, owing to enzyme histochemical pathologic diagnosis of the ENS disorders and in particular of Hirschsprung’s disease, total aganglionosis of the colon, intestinal neuronal dysplasia, and hypoganglionosis of the colon. For example, the increase of acetylcholinesterase activity in nerve fibers of the rectum can be as a reliable indicator of aganglionosis of Hirschsprung’s disease. The authors clearly explain the indicators of every ENS disorder, and describe the innervation
pattern of the different colon diseases, with the useful support of superb color histological figures. This goal is very important, because the topic is complex. The authors complete the textbook discussing 2 other intestinal motility problems: intestinal desmosis and leiomiopathy. The chapter on desmosis coli is important and represents an original treatise inside the textbook, discussing a subject of recent interest in the field of constipation, severe intestinal abnormal motility, and intestinal pseudo-obstruction. The authors indicate specific techniques as diagnostic approaches, like picrosirius red staining, that can show the missing connective tissue structures in the muscularis propria. Bottom Line: It is not possible to compare Histopathology of Chronic Constipation with any other book, because it is the only one to include a complete laboratory guide to the histopathologic diagnosis of intestinal motility disorders. This final section describes the most important technical factors step by step. GIUSEPPE MARTUCCIELLO DINOGMI - Gaslini, Department of Pediatric Surgery University of Genova Genova, Italy Self-Expandable Stents in the Gastrointestinal Tract. Richard Kozarek, Todd Baron, and HoYoung Song, editors. 310 pp. Price: $209.00. New York, New York, Springer, 2013. ISBN: 978-14614-3746-8. Web address for ordering: www.springer.com
REVIEWER RATING Coverage of relevant topics
+++++
Improvement over previously available media
++++
Style of presentation and formatting
+++
Quality of figures
+++++
Overall
++++
Stars: +: poor; ++: adequate; +++: fair; ++++: good; +++++: excellent.
Self-Expandable Stents in the Gastrointestinal Tract, edited by Richard Kozarek, Todd Baron, and Ho-Young Song, reviews for the reader the current state of the art of endoscopic stenting in all regions of the gastrointestinal tract. The book includes separate chapters on stenting in the esophagus, gastroduodenum, colon, and biliary tree,
252
PRINT AND DIGITAL MEDIA REVIEWS
and is illustrated by many black-and-white and color images of high quality. The index is detailed and seems to be complete. The title is somewhat of a misnomer; that rigid prostheses of both the esophagus and bile ducts are given separate chapters and discussed thoroughly, so the book does in fact cover more than self-expandable stents. The book has a very international flair to it, with many key chapters being contributed by European and Asian authors. Many of these names may be unfamiliar to readers in the United States, but the quality of the chapters is uniformly strong throughout the entire book. The book is broken into several distinct sections including historical aspects of stenting, available prostheses, placement, complications, and a final chapter on the future. Consistent with the international nature of the book, devices from around the world are highlighted for the reader throughout the chapters, including many devices not currently available in the United States. As someone who is himself passionate about stents and stent-related technology, I found the historical chapters to be among the very best in the entire volume. Descriptions of the development of the first rigid esophageal stents in the 1800s with accompanying drawings, and an almost year-by-year description of the key developments in esophageal stenting over the intervening hundred-plus years, were extremely interesting to read. Similarly, the chapter on the history of bile duct stenting focusing on rigid prostheses was also like reading a brief history of endoscopic retrograde cholangiopancreatography, because biliary stent technology developed hand-in-hand with modern endoscopic retrograde cholangiopancreatography techniques. Sections dealing with stent shape and configuration as well as materials provide the reader with much detailed information they might not have been previously aware of, and these sections extend even to plastic biliary stent technology (eg, “Why Cotton-Leung Stents Are Made of Polyethylene”). Finally, the chapter detailing the history of the development of self-expanding metal stents reviews the technological challenges and advances that took place to allow current endoscopists to
GASTROENTEROLOGY Vol. 145, No. 1
use modern, fourth-generation stents throughout the entire gastrointestinal tract. Equally novel and interesting are sections detailing the manufacture of current commercially available stents. Foreshortening versus non-foreshortening stent manufacturing processes are reviewed as are the braiding or laser cutting of stents; these sections help readers to understand some of the differences in the clinical utility of different stent types in different situations, and also serve to give insight into why stents occasionally fail (both during and after deployment). My favorite image in the entire book is a very nice photo of a woven colonic stent being hand-loaded onto its delivery catheter. I have been saying for years that stent technology is often a marriage of the high-tech and the primitive, and this image illustrates this sentiment exactly: The $2000 stent made through a complex process still needs real human fingers to manually place it onto the plastic catheter that allows it to work! Much of the remainder of the book is devoted to the use of self-expanding stents in all manner of clinical situations, as well as complications and their management. There is some repetition of information in these chapters, but this is difficult to avoid in a book of this kind. Some of the later chapters also detail devices that are no longer in current use, but this is a relatively rare occurrence. The final chapter details the potential future role of transluminal stenting, which is only now in its infancy. The chapter focuses on the use of current self-expanding stents in an off-label manner as well as some dedicated devices for the transluminal drainage of pseudocysts and the gallbladder. Bottom Line: Overall, this is a highly valuable and useful book that emphasizes a unique historical perspective throughout, and will likely teach even the most experienced endoscopist some new tricks and techniques. DOUGLAS G. ADLER University of Utah School of Medicine Salt Lake City, Utah
PRINT AND DIGITAL MEDIA REVIEWS 251
Histopathology of Chronic Constipation, 2nd edition, William A. Meier-Ruge and Elisabeth Bruder, editors. 54 pp. $93.00. Basel, Switzerland, Karger, 2012. ISBN: 978-3-318-02174-5. Web address for ordering: www.karger.com
REVIEWER RATING Coverage of relevant topics
+++++
Improvement over previously available media
+++++
Style of presentation and formatting
+++++
Quality of figures
+++++
Overall
+++++
Stars: +: poor; ++: adequate; +++: fair; ++++: good; +++++: excellent.
Intestinal peristalsis is the result of a complex process involving all components of bowel wall: the enteric nervous system (ENS), the tendinous collagenous tissue of muscularis propria, and muscularis layer itself. A malfunction of any of these parts leads to constipation and abnormal peristalsis. One of the best textbooks on this subject is this new monograph, which has a hard cover and includes 54 pages, as well as 105 figures (93 in color), 6 tables, and schematic drawings of high quality. Editors William A. Meier-Ruge and Elisabeth Bruder of the Institut für Pathologie der Universit ät Basel are experts in this field. They present a systematic classification on constipation and intestinal motility disorders with the aim to obtain a multidisciplinary clinical and diagnostic approach to these disorders, and a possible identification of diagnostic protocols focusing attention on the type of surgical biopsies, technical factors for optimal laboratory results, and criteria for pathologic diagnosis. The principle and fundamental message of the textbook is that enzyme histochemistry is more than a morphologic technique, because it can give functional information on the ENS. It offers orthotopic localization of a particular enzyme in ganglion cells and nerve fibers. Enzyme histochemistry reflects the metabolic rate of a particular cell by enzymes of the critic cycles, owing to enzyme histochemical pathologic diagnosis of the ENS disorders and in particular of Hirschsprung’s disease, total aganglionosis of the colon, intestinal neuronal dysplasia, and hypoganglionosis of the colon. For example, the increase of acetylcholinesterase activity in nerve fibers of the rectum can be as a reliable indicator of aganglionosis of Hirschsprung’s disease. The authors clearly explain the indicators of every ENS disorder, and describe the innervation
pattern of the different colon diseases, with the useful support of superb color histological figures. This goal is very important, because the topic is complex. The authors complete the textbook discussing 2 other intestinal motility problems: intestinal desmosis and leiomiopathy. The chapter on desmosis coli is important and represents an original treatise inside the textbook, discussing a subject of recent interest in the field of constipation, severe intestinal abnormal motility, and intestinal pseudo-obstruction. The authors indicate specific techniques as diagnostic approaches, like picrosirius red staining, that can show the missing connective tissue structures in the muscularis propria. Bottom Line: It is not possible to compare Histopathology of Chronic Constipation with any other book, because it is the only one to include a complete laboratory guide to the histopathologic diagnosis of intestinal motility disorders. This final section describes the most important technical factors step by step. GIUSEPPE MARTUCCIELLO DINOGMI - Gaslini, Department of Pediatric Surgery University of Genova Genova, Italy Self-Expandable Stents in the Gastrointestinal Tract. Richard Kozarek, Todd Baron, and HoYoung Song, editors. 310 pp. Price: $209.00. New York, New York, Springer, 2013. ISBN: 978-14614-3746-8. Web address for ordering: www.springer.com
REVIEWER RATING Coverage of relevant topics
+++++
Improvement over previously available media
++++
Style of presentation and formatting
+++
Quality of figures
+++++
Overall
++++
Stars: +: poor; ++: adequate; +++: fair; ++++: good; +++++: excellent.
Self-Expandable Stents in the Gastrointestinal Tract, edited by Richard Kozarek, Todd Baron, and Ho-Young Song, reviews for the reader the current state of the art of endoscopic stenting in all regions of the gastrointestinal tract. The book includes separate chapters on stenting in the esophagus, gastroduodenum, colon, and biliary tree,
252
PRINT AND DIGITAL MEDIA REVIEWS
and is illustrated by many black-and-white and color images of high quality. The index is detailed and seems to be complete. The title is somewhat of a misnomer; that rigid prostheses of both the esophagus and bile ducts are given separate chapters and discussed thoroughly, so the book does in fact cover more than self-expandable stents. The book has a very international flair to it, with many key chapters being contributed by European and Asian authors. Many of these names may be unfamiliar to readers in the United States, but the quality of the chapters is uniformly strong throughout the entire book. The book is broken into several distinct sections including historical aspects of stenting, available prostheses, placement, complications, and a final chapter on the future. Consistent with the international nature of the book, devices from around the world are highlighted for the reader throughout the chapters, including many devices not currently available in the United States. As someone who is himself passionate about stents and stent-related technology, I found the historical chapters to be among the very best in the entire volume. Descriptions of the development of the first rigid esophageal stents in the 1800s with accompanying drawings, and an almost year-by-year description of the key developments in esophageal stenting over the intervening hundred-plus years, were extremely interesting to read. Similarly, the chapter on the history of bile duct stenting focusing on rigid prostheses was also like reading a brief history of endoscopic retrograde cholangiopancreatography, because biliary stent technology developed hand-in-hand with modern endoscopic retrograde cholangiopancreatography techniques. Sections dealing with stent shape and configuration as well as materials provide the reader with much detailed information they might not have been previously aware of, and these sections extend even to plastic biliary stent technology (eg, “Why Cotton-Leung Stents Are Made of Polyethylene”). Finally, the chapter detailing the history of the development of self-expanding metal stents reviews the technological challenges and advances that took place to allow current endoscopists to
GASTROENTEROLOGY Vol. 145, No. 1
use modern, fourth-generation stents throughout the entire gastrointestinal tract. Equally novel and interesting are sections detailing the manufacture of current commercially available stents. Foreshortening versus non-foreshortening stent manufacturing processes are reviewed as are the braiding or laser cutting of stents; these sections help readers to understand some of the differences in the clinical utility of different stent types in different situations, and also serve to give insight into why stents occasionally fail (both during and after deployment). My favorite image in the entire book is a very nice photo of a woven colonic stent being hand-loaded onto its delivery catheter. I have been saying for years that stent technology is often a marriage of the high-tech and the primitive, and this image illustrates this sentiment exactly: The $2000 stent made through a complex process still needs real human fingers to manually place it onto the plastic catheter that allows it to work! Much of the remainder of the book is devoted to the use of self-expanding stents in all manner of clinical situations, as well as complications and their management. There is some repetition of information in these chapters, but this is difficult to avoid in a book of this kind. Some of the later chapters also detail devices that are no longer in current use, but this is a relatively rare occurrence. The final chapter details the potential future role of transluminal stenting, which is only now in its infancy. The chapter focuses on the use of current self-expanding stents in an off-label manner as well as some dedicated devices for the transluminal drainage of pseudocysts and the gallbladder. Bottom Line: Overall, this is a highly valuable and useful book that emphasizes a unique historical perspective throughout, and will likely teach even the most experienced endoscopist some new tricks and techniques. DOUGLAS G. ADLER University of Utah School of Medicine Salt Lake City, Utah