Scandinavian Journal of Gastroenterology最新文献_第2页

Effectiveness of treatment with budesonide orodispersible tablets in 76 patients with eosinophilic oesophagitis - real-life experience from the population-based DanEoE cohort. 布地奈德口崩片剂治疗 76 例嗜酸性粒细胞食管炎患者的疗效--基于人群的 DanEoE 队列的实际经验。

IF 1.6 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-10-01 Epub Date: 2024-09-12 DOI: 10.1080/00365521.2024.2395865

Line Tegtmeier Frandsen, Dorte Melgaard, Stine Kjærsgaard Hansen, Kasper Mørk, Anne Lund Krarup

{"title":"Effectiveness of treatment with budesonide orodispersible tablets in 76 patients with eosinophilic oesophagitis - real-life experience from the population-based DanEoE cohort.","authors":"Line Tegtmeier Frandsen, Dorte Melgaard, Stine Kjærsgaard Hansen, Kasper Mørk, Anne Lund Krarup","doi":"10.1080/00365521.2024.2395865","DOIUrl":"10.1080/00365521.2024.2395865","url":null,"abstract":"Background: Eosinophilic oesophagitis (EoE) is a chronic immune-mediated disease. In Denmark, the budesonide orodispersible tablet (BOT) is recommended as a second-line treatment for proton pump inhibitor-refractory EoE patients.Aims: To evaluate the effectiveness of treatment with BOT in adult EoE patients in a population-based setting in Denmark.Methods: This was a retrospective, registry-based, DanEoE cohort study of all 76 adult EoE patients treated with BOT and diagnosed between 2007 and 2021 in the North Denmark Region. After medical record revision, the EoE diagnosis was defined according to the AGREE consensus. Symptomatic response was based on the information found in the patients' medical reports and histologic remission was defined as <15 eosinophils per high-power field (eos/hpf).Results: Histologic remission was achieved in 89% of the patients treated with BOT who underwent histologic evaluation. Clinicohistologic remission was achieved in 71% of the patients who underwent both symptomatic and histologic evaluation. Despite histologic remission, 18% of patients still experienced symptoms. Non-responders were found in 7% of the patients. Complications were rare, with dilation of strictures performed in 7% and food bolus obstruction (FBO) occurring in 3%. Discontinuation of the treatment due to unacceptable side effects was observed in 11% of the treated patients.Conclusions: Treatment with BOT effectively induced histologic remission in most of the EoE patients. Despite achieving histologic remission, approximately 1/5 of the patients were still symptomatic. Complications were rare. In non-responders and those with unacceptable side effects, alternative treatment options such as biologic agents might be needed.","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Collagenous and lymphocytic gastritis in pediatric patients. A single-center experience observing an increase in diagnosis in recent years. 小儿胶原性和淋巴细胞性胃炎。单中心经验观察近年来诊断率的上升。

IF 1.6 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-10-01 Epub Date: 2024-08-29 DOI: 10.1080/00365521.2024.2395858

Mariana Pinis, Nadya Ziv-Sokolovskaya, Michal Kori

{"title":"Collagenous and lymphocytic gastritis in pediatric patients. A single-center experience observing an increase in diagnosis in recent years.","authors":"Mariana Pinis, Nadya Ziv-Sokolovskaya, Michal Kori","doi":"10.1080/00365521.2024.2395858","DOIUrl":"10.1080/00365521.2024.2395858","url":null,"abstract":"Background: Collagenous gastritis (CG) and Lymphocytic gastritis (LG) are rare types of gastritis. Thick sub-epithelial collagen bands characterize CG. Numerous lymphocytes in the surface and foveolar epithelium characterize LG. We aimed to characterize these disorders in our pediatric unit.Methods: A retrospective review of children diagnosed with CG and LG between 2000 and 2023. Baseline data; demographics, anthropometric, symptoms, laboratory data, macroscopic and histopathologic findings. Follow-up data; treatment, improvement of symptoms and laboratory parameters.Results: We identified 31 children, 11 (35.5%) had CG and 20 (64.5%) LG, mean age 9.07 ± 5.04 years. Seven (22.6%) children were diagnosed between 2000 and 2016 and 24 (77.4%) between 2017 and 2023. Baseline characteristics included gastrointestinal symptoms in 16 (51.6%), iron deficiency anemia in 22 (71%), with a mean hemoglobin level of 8.8 ± 2.5 gr/dl. Gastric endoscopic findings were normal in 12 (38.7%), demonstrated nodularity in 14 (45.2%) and an inflamed mucosa without nodularity in 5 (16.1%). Helicobacter pylori was positive in 3 (9.7%) children, celiac disease was diagnosed in 7 (22.6%). Treatment included iron supplementation in 24 (77.4%), proton pump inhibitors in 16 (51.6%) and a gluten free diet in seven. Mean follow-up was 2.9 ± 2.2 years. Hemoglobin levels normalized in 21/22; however, 9 (29%) patients required repeat iron supplementation. Eight patients had a repeat endoscopy (6 CG and 2 LG) without changes in their gastric histopathology.Conclusions: CG and LG are not rare in pediatric patients. Physicians and pathologist should be aware of these types of gastritis.","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142111557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of anal incontinence: psychosocial and sexual consequences and factors associated with QoL in a Norwegian outpatient population. 肛门失禁的影响：挪威门诊患者的社会心理和性后果以及与 QoL 相关的因素。

IF 1.6 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-10-01 Epub Date: 2024-08-20 DOI: 10.1080/00365521.2024.2392707

Susan Saga, Turid Follestad, Lene Elisabeth Blekken

{"title":"The impact of anal incontinence: psychosocial and sexual consequences and factors associated with QoL in a Norwegian outpatient population.","authors":"Susan Saga, Turid Follestad, Lene Elisabeth Blekken","doi":"10.1080/00365521.2024.2392707","DOIUrl":"10.1080/00365521.2024.2392707","url":null,"abstract":"Objectives: Anal incontinence (AI) is a distressing condition with grave impact on many aspects of life, including quality of life (QoL), social life and sexual activities. This study explored how AI and bowel symptoms impact QoL in a Norwegian population by (1) describing the psychosocial and sexual consequences of AI, and (2) investigating factors most often associated with AI-specific QoL.Materials and methods: A cross-sectional study among patients with AI referred to hospital outpatient clinics was conducted. A Norwegian version of ICIQ-B was used to measure bowel control, bowel symptoms, sexual impact, and impact on QoL.Results: A total of 208 persons with AI completed the questionnaire. The results demonstrated that these patients are overall embarrassed, make plans according to the bowels, ensure the presence of a nearby toilet, and many abstain from sexual activities. After adjusting for other variables included in a multivariable model, we found that having bowel accidents on one's mind had the greatest relative impact on QoL, followed by lower bowel control, using more medications to stop bowels, having more pain/soreness around the back passage, lower age, and more straining to open the bowels.Conclusions: AI has substantial consequences for the psychosocial function and sexual activities of persons with AI. This study indicates that worrying about potential faecal accidents and the social stigma associated with this have greater impact on QoL than actual bowel leakages. Future studies should therefore focus on the emotional burden, patient coping, and health education related to bowel function and AI.","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Obstructive sleep apnoea is independently associated with non-alcoholic fatty pancreatic disease. 阻塞性睡眠呼吸暂停与非酒精性脂肪性胰腺疾病密切相关。

IF 1.6 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-09-26 DOI: 10.1080/00365521.2024.2406559

Jiaojiao Lin, Han Wang, Xiaoyang Chen, Lina Han, Zhibin Huang, Guorong Lyu, Shilin Li

{"title":"Obstructive sleep apnoea is independently associated with non-alcoholic fatty pancreatic disease.","authors":"Jiaojiao Lin, Han Wang, Xiaoyang Chen, Lina Han, Zhibin Huang, Guorong Lyu, Shilin Li","doi":"10.1080/00365521.2024.2406559","DOIUrl":"https://doi.org/10.1080/00365521.2024.2406559","url":null,"abstract":"Purpose: This study investigated the prevalence of non-alcoholic fatty pancreatic disease (NAFPD) in patients with obstructive sleep apnoea (OSA) and analysed the correlation between them.Materials and methods: Patients who underwent polysomnography and modified abdominal ultrasound examinations were continuously enrolled and divided into OSA and control groups. The OSA group was further divided into NAFPD and non-NAFPD groups. Differences in various indicators were compared. Binary logistic regression analyses were conducted to identify factors influencing NAFPD.Results: A total of 210 participants were included in the study, including 178 in the OSA group and 32 in the control group. The prevalence of NAFPD, weight, body mass index (BMI), and other indicators were significantly higher in the OSA group than that in the control group (p < 0.05). The above indices, prevalence of hypertension and metabolic associated steatotic liver disease (MASLD), and severity of sleep apnoea were higher in the NAFPD group than that in the non-NAFPD group (p < 0.05). Binary logistic regression analysis showed a 4.4% increased risk of NAFPD for each unit increase in apnea-hypopnea index (AHI) after adjusting for BMI and hypertension.Conclusion: The prevalence of NAFPD was higher in the OSA group than that in the control group, and chronic intermittent hypoxia was strongly associated with pancreatic fat infiltration; AHI, BMI, and hypertension were independent risk factors for NAFPD. The NAFPD group had a higher prevalence of obesity and some other diseases.","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142353059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Eradication rate and safety of vonoprazan-amoxicillin dual therapy for helicobacter pylori eradication: a randomized controlled trial. 根除幽门螺旋杆菌的沃诺普拉赞-阿莫西林双重疗法的根除率和安全性：随机对照试验。

IF 1.6 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-09-22 DOI: 10.1080/00365521.2024.2407898

Guoping Jiang, Mengzhao Luo, Peifen Zheng, Yanqun Cong, Yuliang Feng, Feng Zhou

{"title":"Eradication rate and safety of vonoprazan-amoxicillin dual therapy for helicobacter pylori eradication: a randomized controlled trial.","authors":"Guoping Jiang, Mengzhao Luo, Peifen Zheng, Yanqun Cong, Yuliang Feng, Feng Zhou","doi":"10.1080/00365521.2024.2407898","DOIUrl":"https://doi.org/10.1080/00365521.2024.2407898","url":null,"abstract":"Background: Helicobacter pylori (H. pylori), prevalent in developing regions, is a key factor in gastrointestinal diseases. Despite the common use of bismuth-based quadruple therapy, its drawbacks have prompted the search for alternatives. Recently, vonoprazan, a novel acid suppressant, has shown promise in combination with antibiotics as a dual therapy for H. pylori eradication. This study aimed to assess the therapeutic outcomes and adverse events of vonoprazan-amoxicillin dual therapy compared to quadruple therapy.Methods: A randomized controlled trial (RCT) enrolled H. pylori-infected patients at Zhejiang Hospital. Participants were randomly assigned to dual and quadruple therapy groups. The primary endpoints were H. pylori eradication and adverse events.Results: Of the 400 patients studied from April 2022 to June 2023, In the intention-to-treat (ITT) analysis, the eradication rates of H. pylori in vonoprazan-amoxicillin dual therapy group and quadruple therapy group were 94.0% and 87.0%, respectively, p = 0.017. In the per-protocol (PP) analysis were 97.9% and 93.0%, p = 0.022. Additionally, the dual therapy group had a significantly lower incidence of adverse events (19%) compared to the quadruple therapy group (53%) (p < 0.001).Conclusion: Vonoprazan-amoxicillin dual therapy demonstrates superior eradication efficacy and reduced adverse events compared to quadruple therapy in H. pylori-infected patients, suggesting its potential for clinical application and promotion.","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correlation of gastrointestinal symptom rating scale and frequency scale for the symptoms of gastroesophageal reflux disease with endoscopic findings. 胃食管反流病症状的胃肠道症状评分量表和频率量表与内窥镜检查结果的相关性。

IF 1.6 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-09-20 DOI: 10.1080/00365521.2024.2406537

Kazuhiko Uchiyama, Takashi Ando, Etsuko Kishimoto, Tomoko Nishimura, Eiko Imamoto, Tomohisa Takagi, Takeshi Ishikawa, Yuji Naito, Yoshito Itoh

{"title":"Correlation of gastrointestinal symptom rating scale and frequency scale for the symptoms of gastroesophageal reflux disease with endoscopic findings.","authors":"Kazuhiko Uchiyama, Takashi Ando, Etsuko Kishimoto, Tomoko Nishimura, Eiko Imamoto, Tomohisa Takagi, Takeshi Ishikawa, Yuji Naito, Yoshito Itoh","doi":"10.1080/00365521.2024.2406537","DOIUrl":"https://doi.org/10.1080/00365521.2024.2406537","url":null,"abstract":"Background: Gastroesophageal Reflux Disease (GERD) is caused by the reflux of gastric contents into the esophagus and has a 13% global prevalence that is increasing. GERD symptoms negatively impact physical, social, and emotional quality of life. The Frequency Scale for the Symptoms of GERD (FSSG) and the Gastrointestinal Symptom Rating Scale (GSRS) determine the efficacy of treatment but may not correlate with endoscopically estimated esophageal mucosal injury severity. We aimed to probe the correlation between FSSG, GSRS, and esophageal injury severity to evaluate whether these scores can predict GERD severity.Methods: A total of 2962 patients who underwent physical examinations, including upper gastrointestinal endoscopy, at the Kyoto Kuramaguchi Medical Center, Japan, were enrolled in this study. Upper gastrointestinal endoscopy was used to diagnose fundic mucosal atrophy, reflux esophagitis based on the Los Angeles (LA) classification, gastroesophageal flap value function (GEFV) based on Hill's classification, and Barrett's esophagus. Endoscopic diagnoses were examined for correlations with FSSG and GSRS scores.Results: In reflux esophagitis, FSSG and GSRS scores correlated with LA-B and LA-C endoscopic diagnosis but not with LA-M and LA-A endoscopic findings. Multiple regression analysis results were similar. FSSG scores reflected advanced fundic gland mucosal atrophy, while GSRS scores associated with high grade of GEFV.Conclusions: This is the first report to examine the correlation between FSSG and GSRS scores and endoscopic findings in a relatively large patient population. Our findings suggest that these scores can diagnose the severity of reflux esophagitis.","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

UI-EWD hemostatic powder in the management of refractory lower gastrointestinal bleeding: a multicenter study UI-EWD 止血粉在治疗难治性下消化道出血中的应用：一项多中心研究

IF 1.9 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-09-12 DOI: 10.1080/00365521.2024.2403120

Gyeol Seong, Boram Cha, Jongbeom Shin, Sung Min Kong, Ji Taek Hong, Kye Sook Kwon

引用次数: 0

New insights into predictors of autoimmune pancreatitis relapse after steroid therapy. 类固醇治疗后自身免疫性胰腺炎复发预测因素的新见解。

IF 1.9 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-09-11 DOI: 10.1080/00365521.2024.2398771

Wataru Ujita,Terumi Kamisawa,Kazuro Chiba,Jun Nakahodo,Hiroki Tabata,Keigo Setoguchi,Yoshinori Igarashi,Takahisa Matsuda

{"title":"New insights into predictors of autoimmune pancreatitis relapse after steroid therapy.","authors":"Wataru Ujita,Terumi Kamisawa,Kazuro Chiba,Jun Nakahodo,Hiroki Tabata,Keigo Setoguchi,Yoshinori Igarashi,Takahisa Matsuda","doi":"10.1080/00365521.2024.2398771","DOIUrl":"https://doi.org/10.1080/00365521.2024.2398771","url":null,"abstract":"OBJECTIVESWhile autoimmune pancreatitis (AIP) responds well to steroid therapy, the high relapse rate in type 1 AIP remains a critical problem. The present study examined predictors of relapse of type 1 AIP following steroid therapy.MATERIALS AND METHODSNine factors potentially predictive of relapse were analyzed in 81 AIP patients receiving steroid therapy with follow-up ≥ 12 months. The rate of serum IgG4 decrease following steroid therapy was calculated by dividing the difference between serum IgG4 values before and at two months after the start of steroid by the IgG4 value before steroid.RESULTSA relapse occurred in 11 patients (13.5%) during a median of 38 months. Multivariate analysis revealed that the presence of IgG4-related retroperitoneal fibrosis (HR: 5.59; 95% CI: 1.42-22.0; p = 0.014) and the low rate of serum IgG4 decrease after steroid therapy (HR: 0.048; 95% CI: 0.005-0.46; p = 0.008) were significant, independent predictors of AIP relapse. The cut-off value based on receiver operating characteristic curve data for the rate of serum IgG4 decrease before and at two months after steroid therapy distinguishing patients with and without a relapse was 0.65. Using this cut-off value, the area under the curve, sensitivity, and specificity were found to be 0.63, 0.73, and 0.60, respectively.CONCLUSIONThe low rate of serum IgG4 decrease after the start of steroid therapy and the presence of IgG4-related retroperitoneal fibrosis were predictive of type 1 AIP relapse. Cautious, gradual tapering of steroid dosage and longer maintenance therapy are recommended for patients with these factors.","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142200072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy of CalliSpheres^® drug-loaded microspheres combined with doxorubicin in hepatocellular carcinoma. CalliSpheres®载药微球与多柔比星联合治疗肝细胞癌的疗效。

IF 1.6 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-09-01 Epub Date: 2024-08-18 DOI: 10.1080/00365521.2024.2390025

Boxun Jin, Yanmei Gu, Shuangmei Xi, Xin Liu, Xiulian Wu, Xin Wang, Guangming Li

{"title":"Efficacy of CalliSpheres® drug-loaded microspheres combined with doxorubicin in hepatocellular carcinoma.","authors":"Boxun Jin, Yanmei Gu, Shuangmei Xi, Xin Liu, Xiulian Wu, Xin Wang, Guangming Li","doi":"10.1080/00365521.2024.2390025","DOIUrl":"10.1080/00365521.2024.2390025","url":null,"abstract":"Objective: This study compared the efficacy and safety of the transarterial chemoembolization with CalliSpheres® drug-eluting beads loading with doxorubicin (DEB-TACE) versus conventional lipiodol (cTACE) in patients with unresectable hepatocellular carcinoma (HCC).Methods: A randomized controlled trial (RCT) was conducted with 144 patients, who were randomly assigned to receive either DEB-TACE with doxorubicin-loaded CalliSpheres® microspheres or cTACE with doxorubicin-lipiodol emulsion. Patients were followed up for 12 months, with assessments at 3 and 12 months posttreatment. The primary endpoint was the clinical response rate (CR), and the secondary endpoints were the overall survival (OS), the progression-free survival (PFS), and the safety profile of the two treatments.Results: The results showed that DEB-TACE was superior to cTACE in terms of CR (50.0% vs 30.6% at 3 months, p = 0.03; 43.1% vs 25.0% at 12 months, p = 0.04), OS (18.2 months vs 14.6 months, p < 0.05), and PFS (7.4 months vs 4.8 months, p < 0.05), and that the safety profile of the two treatments was similar (p > 0.05 for all comparisons). However, the efficacy of DEB-TACE and cTACE varied according to the tumor morphology. DEB-TACE showed better CR rates in patients with nodular tumors, while no significant difference in CR between the two groups in patients with infiltrative tumors.Conclusion: DEB-TACE showed superior efficacy to cTACE in terms of CR, OS, and PFS, particularly in patients with nodular tumors, while maintaining a similar safety profile. These findings suggest that tumor morphology could inform treatment decisions for TACE in HCC patients.","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Local recurrence after endoscopic submucosal dissection of gastric neoplastic lesions: special attention should be given also to safety margins. 内镜黏膜下胃癌切除术后的局部复发：还应特别注意安全边缘。

IF 1.6 4区医学

Scandinavian Journal of Gastroenterology Pub Date : 2024-09-01 Epub Date: 2024-07-21 DOI: 10.1080/00365521.2024.2381130

Marta Rodríguez-Carrasco, Diogo Libânio, João Santos-Antunes, Miguel Martins, Rui Morais, João Vaz Silva, Luís Pedro Fernandes Afonso, Rui Henrique, Mário Dinis-Ribeiro

{"title":"Local recurrence after endoscopic submucosal dissection of gastric neoplastic lesions: special attention should be given also to safety margins.","authors":"Marta Rodríguez-Carrasco, Diogo Libânio, João Santos-Antunes, Miguel Martins, Rui Morais, João Vaz Silva, Luís Pedro Fernandes Afonso, Rui Henrique, Mário Dinis-Ribeiro","doi":"10.1080/00365521.2024.2381130","DOIUrl":"10.1080/00365521.2024.2381130","url":null,"abstract":"Introduction: The incidence of local recurrence following gastric endoscopic submucosal dissection (ESD) remains a clinical concern. We aimed to evaluate the impact of narrow safety margin (< 1 mm) on the recurrence rate.Methods: A retrospective cohort study was conducted across two centers. Cases of R0-ESD with subsequent recurrence were compared to matched controls in a 1:2 ratio in a case-cohort analysis.Results: Over a median period of 25 months (IQR 14-43), a recurrence rate of 3% (95%CI 1.7-4.3) was observed, predominantly (13/21) following R0 resections with favourable histology. Endoscopic retreatment was feasible in 18 of 21 recurrences. The proportion of R0-cases where the safety margin in both horizontal (HM) and vertical (VM) margin exceeded 1 mm was similarly distributed in the recurrence and non-recurrence group, representing nearly 20% of cases. However, cases with HM less than 1 mm, despite VM greater than 1 mm, nearly doubled in the recurrence group (7.7% vs. 3.9%), and tripled when both margins were under 1 mm (23.1% vs. 7.7%). Despite this trend, statistical significance was not achieved (p = 0.05). In the overall cohort, the only independent risk factor significantly associated with local recurrence was the presence of residual tumor at the HM (HM1) or not assessable HM (HMx) (OR 16.5 (95%CI 4.4-61.7), and OR 11.7 (95%CI 1.1-124.1), respectively).Conclusions: While not common or typically challenging to manage, recurrence post-ESD warrants attention and justifies rigorous post-procedural surveillance, especially in patients with HM1, HMx, and probably also in those with R0 resections but narrow safety margin.","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0