Therapeutic Advances in Gastrointestinal Endoscopy最新文献

{"title":"The impact of radiomics in diagnosis and staging of pancreatic cancer","authors":"C. Casà, A. Piras, A. D’Aviero, F. Preziosi, S. Mariani, D. Cusumano, A. Romano, I. Boškoski, J. Lenkowicz, N. Dinapoli, F. Cellini, M. Gambacorta, V. Valentini, G. Mattiucci, Luca Boldrini","doi":"10.1177/26317745221081596","DOIUrl":"https://doi.org/10.1177/26317745221081596","url":null,"abstract":"Introduction: Pancreatic cancer (PC) is one of the most aggressive tumours, and better risk stratification among patients is required to provide tailored treatment. The meaning of radiomics and texture analysis as predictive techniques are not already systematically assessed. The aim of this study is to assess the role of radiomics in PC. Methods: A PubMed/MEDLINE and Embase systematic review was conducted to assess the role of radiomics in PC. The search strategy was ‘radiomics [All Fields] AND (“pancreas” [MeSH Terms] OR “pancreas” [All Fields] OR “pancreatic” [All Fields])’ and only original articles referred to PC in humans in the English language were considered. Results: A total of 123 studies and 183 studies were obtained using the mentioned search strategy on PubMed and Embase, respectively. After the complete selection process, a total of 56 papers were considered eligible for the analysis of the results. Radiomics methods were applied in PC for assessment technical feasibility and reproducibility aspects analysis, risk stratification, biologic or genomic status prediction and treatment response prediction. Discussion: Radiomics seems to be a promising approach to evaluate PC from diagnosis to treatment response prediction. Further and larger studies are required to confirm the role and allowed to include radiomics parameter in a comprehensive decision support system.","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"15 1","pages":""},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45415177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic mucosal resection using a ligation device for duodenal neuroendocrine tumors: a simple method","authors":"Y. Inokuchi, K. Hayashi, Y. Kaneta, Y. Okubo, M. Watanabe, M. Furuta, N. Machida, S. Maeda","doi":"10.1177/26317745221103735","DOIUrl":"https://doi.org/10.1177/26317745221103735","url":null,"abstract":"Introduction: Duodenal neuroendocrine tumors (DNETs) smaller than 1 cm in diameter, without invasion to the muscularis propria, have a low risk of metastasis. Therefore, DNETs are frequently resected endoscopically. However, among the various procedures, the best fit for DNET in terms of feasibility, effectiveness, and simplicity is unclear. Methods: Patients with DNET who underwent endoscopic submucosal resection using a ligation device (ESMR-L) at Kanagawa Cancer Center between May 2003 and December 2020 were studied retrospectively to evaluate clinical characteristics and short-term and long-term outcomes. Results: Eleven consecutive patients with 12 lesions were treated with 12 sessions of ESMR-L. Lesions were discovered in patients at a median age of 68 (range, 50–83) years. One patient had two lesions at the time of the initial ESMR-L session. Eleven of the 12 lesions (91.7%) existed in the duodenal bulb, of which 10 (83.3%) were in the anterior wall, and the remaining one (8.3%) existed in the descending part of the duodenum. The en bloc and R0 resection rates were 100% and 75%, respectively. The rates of bleeding and perforation were both 0%. Among the four patients who had non-curative resections, two patients underwent additional surgery after ESMR-L. One patient had a local remnant tumor, and the other had lymph node metastasis. In cases of local remnant tumors, the vertical margin was positive in the ESMR-L specimen. In that case, ligation by the O-ring was insufficient, retrospectively. All patients had no recurrence during the median follow-up period of 5.7 years. Discussion: ESMR-L was the best fit for DNET within the indications for endoscopic resection. It is a simple procedure that enables easy and complete resection of DNETs without complications.","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47908943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of different electrocautery modes for endoscopic sphincterotomy: a Bayesian network meta-analysis.","authors":"Abdellah Hedjoudje,&nbsp;Chérifa Cheurfa,&nbsp;Jad Farha,&nbsp;Bénédicte Jaïs,&nbsp;Alain Aubert,&nbsp;Diane Lorenzo,&nbsp;Frédérique Maire,&nbsp;Dilhana Badurdeen,&nbsp;Vivek Kumbhari,&nbsp;Frédéric Prat","doi":"10.1177/26317745211062983","DOIUrl":"https://doi.org/10.1177/26317745211062983","url":null,"abstract":"<p><strong>Background and aims: </strong>Post-endoscopic retrograde cholangiopancreatography acute pancreatitis (PAP) and post-sphincterotomy hemorrhage are known adverse events of post-endoscopic retrograde cholangiopancreatography. Various electrosurgical currents can be used for endoscopic sphincterotomy. The extent to which this influences adverse events remains unclear. We assessed the comparative safety of different electrosurgical currents, through a Bayesian network meta-analysis of published studies merging direct and indirect comparison of trials.</p><p><strong>Methods: </strong>We performed a Bayesian random-effects network meta-analysis of randomized controlled trials that compared the safety of different electrocautery modes for endoscopic sphincterotomy.</p><p><strong>Results: </strong>Nine studies comparing four electrocautery modes (blended cut, pure cut, endocut, and pure cut followed by blended cut) with a combined enrollment of 1615 patients were included. The pooled results of the network meta-analysis did not show a significant difference in preventing post-sphincterotomy pancreatitis when comparing electrocautery modes. However, pure cut was associated with a statistically significant increased risk of bleeding compared with endocut [relative risk = 4.30; 95% confidence interval (1.53-12.87)]. On the other hand, the pooled results of the network meta-analysis showed no significant difference in prevention of bleeding when comparing blended cut <i>versus</i> endocut, pure cut followed by blended cut <i>versus</i> endocut, pure cut followed by blended cut <i>versus</i> blended cut, pure cut <i>versus</i> blended cut, and pure cut <i>versus</i> pure cut followed by blended cut. The results of rank probability found that endocut was most likely to be ranked the best.</p><p><strong>Conclusion: </strong>No electrocautery mode was superior to another with regard to preventing PAP. Endocut was superior with respect to preventing bleeding. Therefore, we suggest performing endoscopic sphincterotomy with endocut.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"14 ","pages":"26317745211062983"},"PeriodicalIF":2.6,"publicationDate":"2021-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d8/d3/10.1177_26317745211062983.PMC8725216.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39905411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of endoscopic therapy for Barrett's esophagus.","authors":"Ashwinee Condon,&nbsp;V Raman Muthusamy","doi":"10.1177/26317745211051834","DOIUrl":"https://doi.org/10.1177/26317745211051834","url":null,"abstract":"<p><p>Barrett's esophagus is the condition in which a metaplastic columnar epithelium replaces the stratified squamous epithelium that normally lines the distal esophagus. The condition develops as a consequence of chronic gastroesophageal reflux disease and predisposes the patient to the development of esophageal adenocarcinoma. The diagnosis and management of Barrett's esophagus have undergone dramatic changes over the years and continue to evolve today. Endoscopic eradication therapy has revolutionized the management of dysplastic Barrett's esophagus and early esophageal adenocarcinoma by significantly reducing the morbidity and mortality associated with the prior gold standard of therapy, esophagectomy. The purpose of this review is to highlight current principles in the management and endoscopic treatment of this disease.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"14 ","pages":"26317745211051834"},"PeriodicalIF":2.6,"publicationDate":"2021-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/36/10.1177_26317745211051834.PMC8543722.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39564552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of ablation in the treatment of dysplastic Barrett's esophagus.","authors":"Rebecca Sullivan,&nbsp;Ramzi Mulki,&nbsp;Shajan Peter","doi":"10.1177/26317745211049967","DOIUrl":"https://doi.org/10.1177/26317745211049967","url":null,"abstract":"<p><p>Endoscopic eradication therapy for Barrett's esophagus has been established as an effective management strategy for patients with Barrett's esophagus with dysplasia and early esophageal cancer. Among the endoscopic therapies, ablation techniques such as radiofrequency ablation and cryoablation are effective primary treatment interventions with acceptable low complication rates forming the spectrum of a multimodal approach. Appropriate selection of patients, high-definition endoscopic evaluation, and dedicated histological assessment are important cornerstones to help navigate to the best effective treatment method. Carefully structured surveillance programs and preventive measures will be needed to provide long-term durability for maintaining complete remission.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"14 ","pages":"26317745211049967"},"PeriodicalIF":2.6,"publicationDate":"2021-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/39/ec/10.1177_26317745211049967.PMC8544766.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39564548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Artificial intelligence in Barrett's Esophagus'.","authors":"Nour Hamade,&nbsp;Prateek Sharma","doi":"10.1177/26317745211049964","DOIUrl":"https://doi.org/10.1177/26317745211049964","url":null,"abstract":"<p><p>Despite advances in endoscopic imaging modalities, there are still significant miss rates of dysplasia and cancer in Barrett's esophagus. Artificial intelligence (AI) is a promising tool that may potentially be a useful adjunct to the endoscopist in detecting subtle dysplasia and cancer. Studies have shown AI systems have a sensitivity of more than 90% and specificity of more than 80% in detecting Barrett's related dysplasia and cancer. Beyond visual detection and diagnosis, AI may also prove to be useful in quality control, streamlining clinical work, documentation, and lessening the administrative load on physicians. Research in this area is advancing at a rapid rate, and as the field expands, regulations and guidelines will need to be put into place to better regulate the growth and use of AI. This review provides an overview of the present and future role of AI in Barrett's esophagus.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"14 ","pages":"26317745211049964"},"PeriodicalIF":2.6,"publicationDate":"2021-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/3c/10.1177_26317745211049964.PMC8521738.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39537205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving management of colorectal polyps.","authors":"Yervant Ichkhanian,&nbsp;Tobias Zuchelli,&nbsp;Andrew Watson,&nbsp;Cyrus Piraka","doi":"10.1177/26317745211047010","DOIUrl":"https://doi.org/10.1177/26317745211047010","url":null,"abstract":"<p><p>Advances in endoscopic technology have led to increased success in colorectal cancer (CRC) screening and polyp management, with reduction of CRC incidence and mortality. Despite these advances, CRC is still one of the leading causes of cancer deaths, and half of all CRC develops from lesions that were missed during colonoscopy while one-fifth of CRC arise from prior incomplete resection. Techniques to improve polyp detection are needed, along with optimization of complete resection of any abnormal lesions that are found. This article will review the currently available endoscopic resection techniques and will discuss where they fit in the management of polyps of different sizes and types, such as pedunculated <i>versus</i> nonpedunculated, and those with or without suspected invasion.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"14 ","pages":"26317745211047010"},"PeriodicalIF":2.6,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/82/89/10.1177_26317745211047010.PMC8485258.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39482901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyloric stent insertion in malignant gastric outlet obstruction: moving beyond palliation.","authors":"Saad Muhammad Saeed,&nbsp;Sundus Bilal,&nbsp;Muhammad Zeeshan Siddique,&nbsp;Muhammad Saqib,&nbsp;Shahana Shahid,&nbsp;Azhar Noor Ghumman,&nbsp;Muhammed Aasim Yusuf","doi":"10.1177/26317745211047012","DOIUrl":"https://doi.org/10.1177/26317745211047012","url":null,"abstract":"<p><strong>Background: </strong>Self-expandable metallic stents have not only largely replaced surgical gastrojejunostomy for unresectable gastric cancers, but their role as bridging therapy for resectable obstructing tumours is also evolving.</p><p><strong>Objective: </strong>To evaluate the efficacy and safety of pyloric stents in gastric outlet obstruction in patients with gastric cancer and assess survival in patients with resectable obstructing gastric tumours in whom stents were inserted as a bridge to surgery.</p><p><strong>Methods: </strong>We retrospectively reviewed the electronic medical records of patients who underwent self-expandable metallic stent insertion for gastric outlet obstruction due to gastric cancer from January 2014 to March 2019.</p><p><strong>Results: </strong>Out of 161 patients, clinical improvement was observed in 159 (99%) and 156 (97%) at 1 and 12 weeks of stent placement, respectively. None of these patients experienced serious complications, such as perforation or aspiration pneumonia. Of these 161 patients, enteral stents were placed as bridging therapy prior to surgery in 40 (24.8%). Among these, 35 (87.5%) of 40 underwent neo-adjuvant chemotherapy followed by curative surgery. Of the 35 patients, 3 failed to follow-up. One-year survival following curative surgery was 87.5%. Stent helped to reduce vomiting and improve nutrition, measured by the body mass index (<i>p</i> = 0.36) and serum albumin (<i>p</i> = 0.05), over a 4-week period following stent insertion.</p><p><strong>Conclusion: </strong>Pyloric stents are useful in relieving malignant gastric outlet obstruction, maintaining nutrition during neo-adjuvant treatment and improving survival without additional risk of postoperative complications. They have traditionally been used for palliation, but should also be considered as bridging therapy for obstructing resectable gastric tumours during neo-adjuvant treatment.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"14 ","pages":"26317745211047012"},"PeriodicalIF":2.6,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f9/21/10.1177_26317745211047012.PMC8477674.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39476140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary endoscopic bile duct stone removal for severe acute cholangitis: a retrospective study.","authors":"Yu Ishii,&nbsp;Akihiro Nakayama,&nbsp;Kei Nakatani,&nbsp;Shigetoshi Nishihara,&nbsp;Shu Oikawa,&nbsp;Tomono Usami,&nbsp;Toshihiro Noguchi,&nbsp;Yuta Mitsui,&nbsp;Hitoshi Yoshida","doi":"10.1177/26317745211044009","DOIUrl":"10.1177/26317745211044009","url":null,"abstract":"<p><strong>Introduction: </strong>While the Tokyo Guidelines 2018 suggest primary stone removal for mild to moderate cholangitis, a guideline for severe acute cholangitis is not mentioned. We, therefore, investigated the clinical outcomes of patients with severe acute cholangitis to confirm the usefulness and safety of primary stone removal.</p><p><strong>Method: </strong>This study included 104 severe acute cholangitis patients without gallstone pancreatitis diagnosed at our institution between January 2014 and December 2020. Patients with percutaneous transhepatic biliary drainage as the primary drainage, bile duct stenosis, and endoscopically unidentified bile duct stones were excluded from this study. The clinical results of 14 patients with primary stone removal (primary group) and 23 patients with elective stone removal (elective group) were then retrospectively examined (excluding abnormal values due to underlying diseases).</p><p><strong>Results: </strong>Upon comparing the patient characteristics between groups, the elective group had significantly higher cardiovascular dysfunction (57% vs 7%; <i>p</i> = 0.004), septic shock (39% vs 0%; <i>p</i> = 0.006), disseminated intravascular coagulation treatment (57% vs 14%; <i>p</i> = 0.016), and positive blood cultures (91% vs 43%; <i>p</i> = 0.006) than those in the primary group. Endoscopic sphincterotomy for naïve papilla (90% vs 21%; <i>p</i> = 0.01) and endoscopic nasobiliary drainage (50% vs 9%; <i>p</i> = 0.014) were higher in the primary group, while endoscopic biliary stenting (7% vs 87%; <i>p</i> < 0.001) was lower than that in the elective group.</p><p><strong>Discussion: </strong>There were no significant differences in adverse events or complete stone removal rates between the two groups. In the primary group, the period from the first endoscopic retrograde cholangiopancreatography to stone removal (0 days vs 12 days; <i>p</i> < 0.001) and hospitalization period (12 days vs 26 days; <i>p</i> = 0.012) were significantly shorter and the hospitalization cost ($7731 vs $18758; <i>p</i> < 0.001) was significantly lower than those in the elective group.</p><p><strong>Conclusion: </strong>If patients are appropriately selected, bile duct stones may be safely removed for the treatment of severe acute cholangitis.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"14 ","pages":"26317745211044009"},"PeriodicalIF":2.6,"publicationDate":"2021-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/fb/10.1177_26317745211044009.PMC8477704.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39476141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of pancreatic cysts and guidelines: what the gastroenterologist needs to know.","authors":"Ross C D Buerlein,&nbsp;Vanessa M Shami","doi":"10.1177/26317745211045769","DOIUrl":"https://doi.org/10.1177/26317745211045769","url":null,"abstract":"<p><p>The prevalence of pancreatic cysts has increased significantly over the last decade, partly secondary to increased quality and frequency of cross-sectional imaging. While the majority never progress to cancer, a small number will and need to be followed. The management of pancreatic cysts can be both confusing and intimidating due to the multiple guidelines with varying recommendations. Despite the differences in the specifics of the guidelines, they all agree on several high-risk features that should get the attention of any clinician when assessing a pancreatic cyst: presence of a mural nodule or solid component, dilation of the main pancreatic duct (or presence of main duct intraductal papillary mucinous neoplasm), pancreatic cyst size ⩾3-4 cm, or positive cytology on pancreatic cyst fluid aspiration. Other important criteria to consider include rapid cyst growth (⩾5 mm/year), elevated serum carbohydrate antigen 19-9 levels, new-onset diabetes mellitus, or acute pancreatitis thought to be related to the cystic lesion.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"14 ","pages":"26317745211045769"},"PeriodicalIF":2.6,"publicationDate":"2021-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/c8/10.1177_26317745211045769.PMC8474323.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39472728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}