Gastrointestinal Disorders最新文献_第4页

Developing a Core Outcome Set for Cytoreductive Surgery for Colorectal Cancer with Peritoneal Metastases: A Mixed-Method Study Protocol 为腹膜转移的结直肠癌细胞切除手术制定核心结果集：混合方法研究方案

Gastrointestinal Disorders Pub Date : 2024-01-18 DOI: 10.3390/gidisord6010010

Pratik Raichurkar, K. Brown, N. Ansari, Cherry Koh, Nima Ahmadi, Michael J. Solomon, Brendan Moran, Daniel Steffens

{"title":"Developing a Core Outcome Set for Cytoreductive Surgery for Colorectal Cancer with Peritoneal Metastases: A Mixed-Method Study Protocol","authors":"Pratik Raichurkar, K. Brown, N. Ansari, Cherry Koh, Nima Ahmadi, Michael J. Solomon, Brendan Moran, Daniel Steffens","doi":"10.3390/gidisord6010010","DOIUrl":"https://doi.org/10.3390/gidisord6010010","url":null,"abstract":"As the number of centres offering cytoreductive surgery (CRS) for colorectal cancer with peritoneal metastases (CPMs) is increasing worldwide, research is focused on establishing better patient selection and ensuring that new techniques have positive impacts on survival. However, high-impact comparative research in this field is limited by the heterogeneity of outcome measurement and reporting. Additionally, as there are comparatively few randomised controlled trials reporting comprehensive patient-reported outcomes, it is possible that key stakeholders such as patients and carers are underrepresented in the current literature. A core outcome set (COS) for CRS with or without intraperitoneal chemotherapy for the treatment of CPMs, supported by clinicians and patients, will promote homogenous comparison across trials and optimise the utility of research findings. We have established a comprehensive protocol based on the Core Outcome Measures in Effectiveness Trials (COMETs) method to facilitate this. A systematic review will identify all the outcomes reported in the literature, whereas a semi-structured interview will identify outcomes considered important by patients and carers. The identified outcomes will populate an international Delhi survey, distributed to patients, carers, surgeons, oncologists, nurses, and allied health clinicians. Outcomes reaching international consensus of importance will be further discussed in a face-to-face workshop between patients, carers, and clinicians. This process will inform the development of a final COS for CRS for patients with CPMs.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139614711","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}

引用次数: 0

Probiotic Interventions in Coeliac Disease: A Systematic Review with a Focus on Cardiovascular Risk 乳糜泻的益生菌干预：以心血管风险为重点的系统性综述

Gastrointestinal Disorders Pub Date : 2024-01-10 DOI: 10.3390/gidisord6010008

L. Fagbemi, Carlo Soldaini, Adele Costabile, Sofia Kolida, C. Ciacci, Y. Jeanes

{"title":"Probiotic Interventions in Coeliac Disease: A Systematic Review with a Focus on Cardiovascular Risk","authors":"L. Fagbemi, Carlo Soldaini, Adele Costabile, Sofia Kolida, C. Ciacci, Y. Jeanes","doi":"10.3390/gidisord6010008","DOIUrl":"https://doi.org/10.3390/gidisord6010008","url":null,"abstract":"People with coeliac disease (CD) have a higher risk of developing cardiovascular disease (CVD), potentially due to inflammation. Probiotics can influence CVD risk through several mechanisms including modifying inflammation. We performed a systematic review of probiotic interventions in people with CD. In total, 4 databases were systematically searched for studies published up to March 2023. All outcomes, inclusive of any cardiovascular risk factors, were collated and reported. We screened 8084 articles and 11 publications reporting on 7 RCTs and 2 non-RCTs met the inclusion criteria for qualitative analysis. In total, 1 RCT and both non-RCTs were considered to have a high risk of bias. There was large heterogeneity between the studies and adherence to a gluten-free diet was only measured in two studies. No specific outcomes related to cardiovascular risk were reported. Two studies reported a significant reduction on serum TNF-α in children over time after probiotic supplementation. One study reported no significant change in intestinal permeability over a 3-week intervention. Currently there is insufficient evidence to advocate a positive impact of probiotics on inflammation in CD, due, in part, to the limited data on adherence to the gluten-free diet and active disease.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139439964","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}

引用次数: 0

In the Driving Seat with High-Resolution Ano-Rectal Manometry 通过高分辨率肛门直肠测压掌握主动权

Gastrointestinal Disorders Pub Date : 2024-01-10 DOI: 10.3390/gidisord6010007

M. Nwaezeigwe, Julie O’Neill, Lucy Quinlivan, Lorraine Nolan, John O’Grady, Martin Buckley

{"title":"In the Driving Seat with High-Resolution Ano-Rectal Manometry","authors":"M. Nwaezeigwe, Julie O’Neill, Lucy Quinlivan, Lorraine Nolan, John O’Grady, Martin Buckley","doi":"10.3390/gidisord6010007","DOIUrl":"https://doi.org/10.3390/gidisord6010007","url":null,"abstract":"Introduction: High-resolution ano-rectal manometry (HRAM), part of the investigative process to diagnose disorders of recto-anal co-ordination, is currently performed in the left-lateral position (LLP). This may seem unnatural for patients and recent data suggest that the seated, squatted position (SP) may improve rectal drive and recto-anal pressure gradients, raising the question as to whether defaecatory dyssenergia (DD) is over-diagnosed when the test is carried out in the LLP. Aim/method: A single centre study was carried out in patients with faecal incontinence and/or constipation to evaluate the effect of SP versus LLP on HRAM analysis and resultant manometric diagnosis of DD. Positioning was consecutive and the order was randomised for each patient. The HRAM protocol was carried out in accordance with the manufacturer’s guidelines (Manoscan). Data analysis and interpretation were blinded with a consensus reached for each test position. Data (mean ± SEM) were analysed using an unpaired t-test and Chi-square test. Results: In total, 40 patients completed the study, including 33 females with a median age of 56 (IQR 48–63). The mean rectal drive was significantly higher in the SP vs. LLP (82.6 ± 5.3 mmHg vs. 44.1 ± 3.9 mmHg, respectively, p < 0.0001). No difference in the anal sphincter relaxation pressure (66.7 ± 5.7 mmHg vs. 70.9 ± 5.5 mmHg, p = 0.9535) was detected. The manometric diagnoses of abnormal ano-rectal co-ordination were significantly higher in the LLP, when p = 0.013. Patients reported a significant preference for the seated position, when p = 0.0001. Conclusion: These data show that HRAM in the seated position improves rectal drive, which reduces manometric diagnoses of abnormal ano-rectal coordination. These findings may have important implications for practice and may inform future guidelines.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139440210","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}

引用次数: 0

The Diagnostic Accuracy of Abdominal X-ray in Childhood Constipation: A Systematic Review of the Literature 腹部 X 光对儿童便秘的诊断准确性：文献系统回顾

Gastrointestinal Disorders Pub Date : 2024-01-09 DOI: 10.3390/gidisord6010006

David Avelar Rodriguez, G. Dahlwi, Michelle Gould, Margaret Marcon, Marc Benninga

{"title":"The Diagnostic Accuracy of Abdominal X-ray in Childhood Constipation: A Systematic Review of the Literature","authors":"David Avelar Rodriguez, G. Dahlwi, Michelle Gould, Margaret Marcon, Marc Benninga","doi":"10.3390/gidisord6010006","DOIUrl":"https://doi.org/10.3390/gidisord6010006","url":null,"abstract":"Background: Previous systematic reviews have found insufficient and conflicting evidence for an association between the clinical and radiographic diagnosis of functional constipation. Abdominal X-ray is frequently used for the diagnosis of functional constipation in clinical practice. The objective of this study was to evaluate the diagnostic accuracy of abdominal X-ray for the evaluation of functional constipation in children. Results: Three studies were included in the final qualitative analysis. They were heterogeneous in their study design, definition of constipation, and radiologic parameters used to evaluate the abdominal X-rays. Sensitivities ranged from 73–92%, specificities ranged from 26–92%, and diagnostic accuracies ranged from 78–90%. Methods: This study involved a systematic review of English literature published between 2012 and 2022 covering children 2–18 years of age with a diagnosis of functional constipation in whom abdominal X-ray was performed. The databases searched include Medline, Embase, and Scopus. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) guidelines were followed. PROSPERO ID: CRD42022301833. Conclusions: There is insufficient evidence to support the use of abdominal X-ray as part of the diagnostic workup of functional constipation. More methodologically rigorous studies are needed to determine the utility of abdominal X-ray in the evaluation of functional constipation. The diagnosis of functional constipation should be based on history and clinical findings.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139444461","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}

引用次数: 0

Insights into Personal Perceptions and Experiences of Colonoscopy after Positive FIT in the Flemish Colorectal Cancer Screening Program 对弗拉芒大肠癌筛查计划中 FIT 阳性后进行结肠镜检查的个人看法和经历的深入了解

Gastrointestinal Disorders Pub Date : 2024-01-08 DOI: 10.3390/gidisord6010004

S. Hoeck, T. Tran

{"title":"Insights into Personal Perceptions and Experiences of Colonoscopy after Positive FIT in the Flemish Colorectal Cancer Screening Program","authors":"S. Hoeck, T. Tran","doi":"10.3390/gidisord6010004","DOIUrl":"https://doi.org/10.3390/gidisord6010004","url":null,"abstract":"Background: A timely diagnostic colonoscopy (DC) after a positive FIT result is crucial for effective colorectal cancer (CRC) screening. In the Flemish CRC screening program (CRC-SP), 17% of FIT-positive participants had no DC in 2020. This study explores self-reported barriers, experiences, and perceptions about DC in FIT-positive participants. Methods: An online survey combining qualitative and quantitative approaches was sent by email to FIT-positive participants (November 2019–September 2020). Results: Out of 5134 invitees, 1597 respondents (31.1%) completed the survey. Among them, 77.5% had undergone/planned a DC, while 22.5% were unwilling to undergo a DC. DC perceptions, expectations, and experiences differed among groups; 57% of the ‘DC-performed’ group reported better-than-expected experiences. A substantial portion of the ‘DC-naïve’ group anticipated pain (42%) and embarrassment (30%), while the actual experience in the ‘DC-performed’ group was much lower (6.4% and 3.2%, respectively). GP advice, support from close contacts, and colonoscopy experiencers trigger DC planning, whereas lack of symptoms, false-positive perception, fears, and embarrassment were identified as barriers to DC. Conclusions: The study reveals barriers/facilitators for a DC in the Flemish CRC-SP. The findings inform targeted interventions for improved DC completion and its impact, including patient navigation and testimonial videos of ‘colonoscopy experiencers’ to address DC misperceptions.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446047","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}

引用次数: 0

Viral Liver Disease and Intestinal Gut–Liver Axis 病毒性肝病与肠道-肝轴

Gastrointestinal Disorders Pub Date : 2024-01-08 DOI: 10.3390/gidisord6010005

E. Kouroumalis, Ioannis Tsomidis, A. Voumvouraki

{"title":"Viral Liver Disease and Intestinal Gut–Liver Axis","authors":"E. Kouroumalis, Ioannis Tsomidis, A. Voumvouraki","doi":"10.3390/gidisord6010005","DOIUrl":"https://doi.org/10.3390/gidisord6010005","url":null,"abstract":"The intestinal microbiota is closely related to liver diseases via the intestinal barrier and bile secretion to the gut. Impairment of the barrier can translocate microbes or their components to the liver where they can contribute to liver damage and fibrosis. The components of the barrier are discussed in this review along with the other elements of the so-called gut–liver axis. This bidirectional relation has been widely studied in alcoholic and non-alcoholic liver disease. However, the involvement of microbiota in the pathogenesis and treatment of viral liver diseases have not been extensively studied, and controversial data have been published. Therefore, we reviewed data regarding the integrity and function of the intestinal barrier and the changes of the intestinal microbioma that contribute to progression of Hepatitis B (HBV) and Hepatitis C (HCV) infection. Their consequences, such as cirrhosis and hepatic encephalopathy, were also discussed in connection with therapeutic interventions such as the effects of antiviral eradication and the use of probiotics that may influence the outcome of liver disease. Profound alterations of the microbioma with significant reduction in microbial diversity and changes in the abundance of both beneficial and pathogenic bacteria were found.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446444","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}

引用次数: 0

The Treatment Effects of Percutaneous Drainage with or without Sclerotherapy for Symptomatic Liver Cysts 症状性肝囊肿经皮穿刺引流术加或不加硬化疗法的治疗效果

Gastrointestinal Disorders Pub Date : 2024-01-05 DOI: 10.3390/gidisord6010002

S. Takakusagi, Satoru Kakizaki, N. Saito, T. Kohga, T. Ueno, T. Hatanaka, M. Namikawa, H. Tojima, A. Naganuma, T. Kosone, Toshio Uraoka, Hitoshi Takagi

{"title":"The Treatment Effects of Percutaneous Drainage with or without Sclerotherapy for Symptomatic Liver Cysts","authors":"S. Takakusagi, Satoru Kakizaki, N. Saito, T. Kohga, T. Ueno, T. Hatanaka, M. Namikawa, H. Tojima, A. Naganuma, T. Kosone, Toshio Uraoka, Hitoshi Takagi","doi":"10.3390/gidisord6010002","DOIUrl":"https://doi.org/10.3390/gidisord6010002","url":null,"abstract":"Background: While the current guidelines recommend laparoscopic deroofing for symptomatic simple liver cysts, percutaneous drainage may serve as a less invasive alternative method. In this study, the treatment effects of percutaneous drainage with or without sclerotherapy for symptomatic simple liver cysts were evaluated. Methods: Between April 2016 and March 2021, 79 patients who initially required hospitalization due to symptomatic simple liver cysts were enrolled in this multicenter retrospective study. They were treated percutaneously with or without sclerotherapy. The factors associated with symptom recurrence, clinical course and prognosis were investigated. Results: Of the 79 patients treated percutaneously, 11 (13.9%) had symptom recurrence due to liver cysts during the observation period. The maximum diameter of liver cysts at baseline was the only significant factor for the recurrence of these symptoms (p = 0.004). In a receiver operating characteristics analysis, the cut-off of the diameter for symptom recurrence was 16.5 cm. No additional effect of sclerotherapy on drainage was demonstrated in patients with a cyst diameter of <16.5 cm, and in patients with a cyst diameter of ≥16.5 cm, the cumulative recurrence rates of symptoms were significantly lower in the patients treated via sclerotherapy with 5% ethanolamine oleate or with minocycline hydrochloride than in those treated with drainage alone or via sclerotherapy with absolute ethanol. No problematic adverse effects were observed of sclerotherapy. Conclusions: Drainage with sclerotherapy with 5% ethanolamine oleate or minocycline hydrochloride was an effective and safe treatment for patients whose liver cysts had a maximum diameter of ≥16.5 cm. Considering both its efficacy and safety, sclerotherapy with either of these agents is recommended for patients with a maximum liver cyst diameter of ≥16.5 cm.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139383248","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}

引用次数: 0

Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control Study 基于粪便免疫化学检验的结直肠癌筛查中随访结肠镜检查后的出血和穿孔并发症：一项回顾性病例对照研究的启示

Gastrointestinal Disorders Pub Date : 2024-01-05 DOI: 10.3390/gidisord6010003

T. Tran, Joanna Bouchat, Marc Peeters, B. Berghmans, Eric Van Cutsem, G. Van Hal, Koen Van Herck, S. Hoeck

{"title":"Bleeding and Perforation Complications after Follow-Up Colonoscopies in Faecal Immunochemical Test-Based Colorectal Cancer Screening: Insights from a Retrospective Case–Control Study","authors":"T. Tran, Joanna Bouchat, Marc Peeters, B. Berghmans, Eric Van Cutsem, G. Van Hal, Koen Van Herck, S. Hoeck","doi":"10.3390/gidisord6010003","DOIUrl":"https://doi.org/10.3390/gidisord6010003","url":null,"abstract":"Monitoring complications of colonoscopies after a positive faecal immunochemical test (FIT-colonoscopies) is crucial in FIT-based colorectal cancer (CRC) screening. We investigated the occurrence of bleeding and perforation post FIT-colonoscopies (2013–2019) in Flanders and the contributing factors. A retrospective case–control study was conducted, including bleeding/perforation cases within 14 days after index colonoscopy, and controls without such events. Bleeding rates dropped from 0.9–1.1% (pre-2017) to 0.3% (2017–2018) and further to 0.05% (2019), while perforation rates remained at 0.05–0.11% (2014–2019). Male gender, polypectomy, general anaesthesia, and recent antiplatelet/antithrombotic drug use increased bleeding odds. Incomplete colonoscopy, polypectomy, general anaesthesia, and recent antiplatelet/antithrombotic drug use raised perforation odds. The endoscopists (n = 16) with highest bleeding rates (top 5%) performed only 6% of total FIT-colonoscopies, yet their patients experienced 45.5% of bleeding events. Similarly, for the top 5% of perforation rates, endoscopists conducting only 4.5% of total FIT-colonoscopy had 49.0% of perforation events occur in their patients. This study sheds light on FIT-colonoscopy-related complications in Flanders, their rates and risk factors. These findings can be incorporated into CRC screening materials and guide interventions to mitigate complications. A central colonoscopy register is currently lacking in Belgium, highlighting the need for its establishment to facilitate recurrent monitoring and evaluation.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139383175","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}

引用次数: 0

Gastrointestinal Group Education for Children and Adolescents with Functional Abdominal Pain Disorders—A Feasibility Study of a Brief Intervention 针对患有功能性腹痛疾病的儿童和青少年的胃肠道集体教育--一项简短干预措施的可行性研究

Gastrointestinal Disorders Pub Date : 2023-12-20 DOI: 10.3390/gidisord6010001

Emilia Löfgren, P. Lindfors, Karin Nilsson, Jenny Wannstedt, M. Bonnert, Agneta Uusijärvi

{"title":"Gastrointestinal Group Education for Children and Adolescents with Functional Abdominal Pain Disorders—A Feasibility Study of a Brief Intervention","authors":"Emilia Löfgren, P. Lindfors, Karin Nilsson, Jenny Wannstedt, M. Bonnert, Agneta Uusijärvi","doi":"10.3390/gidisord6010001","DOIUrl":"https://doi.org/10.3390/gidisord6010001","url":null,"abstract":"Functional abdominal pain disorders are common and disabling in children, but treatment options are limited. In a pilot study, we aimed to investigate if a brief group education program for pediatric patients with functional abdominal pain disorders and their parents is feasible and acceptable. Group education in adult irritable bowel syndrome has shown large treatment effects, but it has not been evaluated in children. The gastrointestinal (GI) group education, delivered in the clinic to 23 child–parent dyads, consisted of lectures by a pediatric gastroenterologist, a psychologist, and a dietician. Validated digital questionnaires were filled in by children and parents before and after the intervention. Most participants in the GI group education attended all sessions, and credibility in treatment was deemed high. Children’s self-reported knowledge of functional abdominal pain disorders increased, and improvements in gastrointestinal symptoms were reported at the end of this study. Our findings indicate that group education for children and adolescents with functional abdominal pain disorders, and their parents, is acceptable and feasible and may improve symptoms. A brief group education program may be of benefit in the management of pediatric functional abdominal pain disorders in several cases and when the family needs more knowledge than can be provided in primary care.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139169096","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}

引用次数: 0

Colorectal Cancer Liver Metastasis—State-of-the-Art and Future Perspectives 结直肠癌肝转移--最新进展与未来展望

Gastrointestinal Disorders Pub Date : 2023-12-15 DOI: 10.3390/gidisord5040046

Ana Ruivo, Rui Caetano Oliveira, P. Silva-Vaz, J. Tralhão

{"title":"Colorectal Cancer Liver Metastasis—State-of-the-Art and Future Perspectives","authors":"Ana Ruivo, Rui Caetano Oliveira, P. Silva-Vaz, J. Tralhão","doi":"10.3390/gidisord5040046","DOIUrl":"https://doi.org/10.3390/gidisord5040046","url":null,"abstract":"The current management of colorectal cancer liver metastasis (CRCLM) patients involves a multidisciplinary approach, with surgical resection remaining the primary curative option. The advances in liver surgery have improved outcomes, enabling more patients to undergo surgery successfully. In addition, the development of imaging software has improved the preoperative planning and patient selection for surgery and other interventions. Systemic therapies, such as targeted therapies and immunotherapies, have enhanced the chances of complete resection. Targeted agents, in combination with chemotherapy, have shown efficacy in downstaging tumors and increasing resectability. The algorithm approach for these patients continues to evolve, driven by a deeper understanding of the underlying biology. Personalized medicine, guided by molecular profiling and the potential of liquid biopsies in this field, may lead to more tailored treatment strategies. A greater understanding of the immune microenvironment in CRLM may unlock the potential for immune checkpoint inhibitors and novel immunotherapies to become more prominent in the treatment landscape. This review explores the current state-of-the-art treatment of CRCLM and discusses promising future perspectives.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178485","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}

引用次数: 0