GE Portuguese Journal of Gastroenterology最新文献

{"title":"Cap-Assisted Endoscopic Mucosal Resection for Rectal Neuroendocrine Tumors: An Effective Option.","authors":"Mafalda João,&nbsp;Susana Alves,&nbsp;Miguel Areia,&nbsp;Luís Elvas,&nbsp;Daniel Brito,&nbsp;Sandra Saraiva,&nbsp;Raquel Martins,&nbsp;Ana Teresa Cadime","doi":"10.1159/000525964","DOIUrl":"https://doi.org/10.1159/000525964","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of rectal neuroendocrine tumors (r-NETs) is increasing, and most small r-NETs can be treated endoscopically. The optimal endoscopic approach is still debatable. Conventional endoscopic mucosal resection (EMR) leads to frequent incomplete resection. Endoscopic submucosal dissection (ESD) allows higher complete resection rates but is also associated with higher complication rates. According to some studies, cap-assisted EMR (EMR-C) is an effective and safe alternative for endoscopic resection of r-NETs.</p><p><strong>Aims: </strong>This study aimed to evaluate the efficacy and safety of EMR-C for r-NETs ≤10 mm without muscularis propria invasion or lymphovascular infiltration.</p><p><strong>Methods: </strong>Single-center prospective study including consecutive patients with r-NETs ≤10 mm without muscularis propria invasion or lymphovascular invasion confirmed by endoscopic ultrasound (EUS), submitted to EMR-C between January 2017 and September 2021. Demographic, endoscopic, histopathologic, and follow-up data were retrieved from medical records.</p><p><strong>Results: </strong>A total of 13 patients (male: 54%; <i>n</i> = 7) with a median age of 64 (interquartile range: 54-76) years were included. Most lesions were located at the lower rectum (69.2%, <i>n</i> = 9), and median lesion size was 6 (interquartile range: 4.5-7.5) mm. On EUS evaluation, 69.2% (<i>n</i> = 9) of tumors were limited to muscularis mucosa. EUS accuracy for the depth of invasion was 84.6%. We found a strong correlation between size measurements by histology and EUS (<i>r</i> = 0.83, <i>p</i> < 0.01). Overall, 15.4% (<i>n</i> = 2) were recurrent r-NETs and had been pretreated by conventional EMR. Resection was histologically complete in 92% (n = 12) of cases. Histologic analysis revealed grade 1 tumor in 76.9% (<i>n</i> = 10) of cases. Ki-67 index was inferior to 3% in 84.6% (<i>n</i> = 11) of cases. The median procedure time was 5 (interquartile range: 4-8) min. Only 1 case of intraprocedural bleeding was reported and was successfully controlled endoscopically. Follow-up was available in 92% (<i>n</i> = 12) of cases with a median follow-up of 6 (interquartile range: 12-24) months with no evidence of residual or recurrent lesion on endoscopic or EUS evaluation.</p><p><strong>Conclusion: </strong>EMR-C is fast, safe, and effective for resection of small r-NETs without high-risk features. EUS accurately assesses risk factors. Prospective comparative trials are needed to define the best endoscopic approach.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"107-114"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5e/89/pjg-0030-0107.PMC10050888.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235468","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":"Erratum.","authors":"","doi":"10.1159/000528339","DOIUrl":"https://doi.org/10.1159/000528339","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000525963.].</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"171"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/1b/pjg-0030-0171.PMC10050832.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9597023","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":"Validation and Application of Predictive Models for Inadequate Bowel Preparation in Colonoscopies in a Tertiary Hospital Population.","authors":"Edgar Afecto,&nbsp;Ana Ponte,&nbsp;Sónia Fernandes,&nbsp;Catarina Gomes,&nbsp;João Paulo Correia,&nbsp;João Carvalho","doi":"10.1159/000520905","DOIUrl":"https://doi.org/10.1159/000520905","url":null,"abstract":"<p><strong>Background: </strong>Bowel preparation is a major quality criterion for colonoscopies. Models developed to identify patients with inadequate preparation have not been validated in external cohorts. We aim to validate these models and determine their applicability.</p><p><strong>Methods: </strong>Colonoscopies between April and November 2019 were retrospectively included. Boston Bowel Preparation Scale ≥2 per segment was considered adequate. Insufficient data, incomplete colonoscopies, and total colectomies were excluded. Two models were tested: model 1 (tricyclic antidepressants, opioids, diabetes, constipation, abdominal surgery, previous inadequate preparation, inpatient status, and American Society of Anesthesiology [ASA] score ≥3); model 2 (co-morbidities, tricyclic antidepressants, constipation, and abdominal surgery).</p><p><strong>Results: </strong>We included 514 patients (63% males; age 61.7 ± 15.6 years), 441 with adequate preparation. The main indications were inflammatory bowel disease (26.1%) and endoscopic treatment (24.9%). Previous surgery (36.2%) and ASA score ≥3 (23.7%) were the most common comorbidities. An ASA score ≥3 was the only identified predictor for inadequate preparation in this study (<i>p</i> < 0.001, OR 3.28). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of model 1 were 60.3, 64.2, 21.8, and 90.7%, respectively. Model 2 had a sensitivity, specificity, PPV, and NPV of 57.5, 67.4, 22.6, and 90.5%, respectively. The AUC for the ROC curves was 0.62 for model 1, 0.62 for model 2, and 0.65 for the ASA score.</p><p><strong>Conclusions: </strong>Although both models accurately predict adequate bowel preparation, they are still unreliable in predicting inadequate preparation and, as such, new models, or further optimization of current ones, are needed. Utilizing the ASA score might be an appropriate approximation of the risk for inadequate bowel preparation in tertiary hospital populations.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"134-140"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/b0/pjg-0030-0134.PMC10050840.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235471","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":"Pharmacological Treatment of Functional Dyspepsia: An Old Story Revisited or a New Story to Be Told? A Clinical Review.","authors":"Jéssica Chaves,&nbsp;Inês Pita,&nbsp;Diogo Libânio,&nbsp;Pedro Pimentel-Nunes","doi":"10.1159/000526674","DOIUrl":"https://doi.org/10.1159/000526674","url":null,"abstract":"<p><p>Dyspepsia incorporates a set of symptoms originating from the gastroduodenal region, frequently encountered in the adult population in the Western world. Most patients with symptoms compatible with dyspepsia eventually end up, in the absence of a potential organic cause, being diagnosed with functional dyspepsia. Many have been the new insights in the pathophysiology behind functional dyspeptic symptoms, namely, hypersensitivity to acid, duodenal eosinophilia, and altered gastric emptying, among others. Since these discoveries, new therapies have been proposed. Even so, an established mechanism for functional dyspepsia is not yet a reality, which makes its treatment a clinical challenge. In this paper, we review some of the possible approaches to treatment, both well established and some new therapeutic targets. Recommendations about dose and time of use are also made.</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"86-97"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/6f/pjg-0030-0086.PMC10050843.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235470","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":"Erratum.","authors":"","doi":"10.1159/000528338","DOIUrl":"https://doi.org/10.1159/000528338","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000525853.].</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"171"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7f/54/pjg-0030-0171.PMC10050851.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9597021","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":"Erratum.","authors":"","doi":"10.1159/000528367","DOIUrl":"https://doi.org/10.1159/000528367","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000526127.].</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"173"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/ad/pjg-0030-0173.PMC10050827.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9597036","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":"Erratum.","authors":"","doi":"10.1159/000528364","DOIUrl":"https://doi.org/10.1159/000528364","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000526060.].</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"173"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/8a/pjg-0030-0173.PMC10050847.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9597040","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":"Sodium-Polystyrene Sulfonate-Induced Colitis.","authors":"Francisco Souza Dos Santos,&nbsp;Gabriel Peixoto Aver,&nbsp;Thais Vieira Paim,&nbsp;Floriano Riva,&nbsp;Eduardo Brambilla,&nbsp;Jonathan Soldera","doi":"10.1159/000521195","DOIUrl":"https://doi.org/10.1159/000521195","url":null,"abstract":"a School of Medicine, Universidade de Caxias do Sul, Caxias do Sul, Brazil; b Centro de Patologia Médica (CPM), Caxias do Sul, Brazil; c Clinical Gastroenterology, School of Medicine, Universidade de Caxias do Sul, Caxias do Sul, Brazil; d Post-Graduate Program, Surgery, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; e Post-Graduate Program, Pathology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brazil Received: July 20, 2021 Accepted: October 28, 2021 Published online: December 14, 2021","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"153-155"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fa/a0/pjg-0030-0153.PMC10050855.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235463","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":"An Unusual Endoscopic Finding of Gastric Crohn's Disease.","authors":"Isabel Garrido,&nbsp;João Santos-Antunes,&nbsp;Guilherme Macedo","doi":"10.1159/000520907","DOIUrl":"https://doi.org/10.1159/000520907","url":null,"abstract":"A 37-year-old woman with a past medical history of obesity (body mass index 50 kg/m2) and Crohn’s disease (Montreal classification – A2 L2+L4 B1) was referred to our institution for bariatric surgery after several unsuccessful weight loss attempts. The diagnosis of Crohn’s disease was established at age 19 (Fig. 1) and at that time she started therapy with azathioprine and a prednisolone taper. Due to poor control of the disease, the patient underwent several long courses of corticosteroid therapy. At this point, she began to gradually increase her weight. Over the past 4 years, the patient has been on infliximab at 5 mg/kg every 8 weeks, with evidence of clinical and endoscopic remission. A preoperative esophagogastroduodenoscopy was requested in order to assess the upper gastrointestinal tract for any abnormal findings as well as the presence of Helicobacter pylori (HP) infection. The endoscopy revealed retracted scar tissue in the gastric body (Fig. 2a) and antrum (Fig. 2b), with lesions with a bamboo-joint-like appearance and several pseudopolyps (Fig. 3). The esophagus and duodenum appeared normal. Histopathologic examination of biopsies from the stomach demonstrated mild foveolar hyperplasia and HP-negative chronic gastritis, with no signs of activity. No epithelioid granulomas, glandular atrophy, dysplasia, or signs of malignancy were identified. The patient underwent a sleeve gastrectomy without complications. The surgical specimen did not reveal any specific sign for inactive Crohn’s disease. Indeed, histopathological evaluation of the surgical specimen showed chronic gastritis and hyperplasia of the foveolar epithelium cells, without active inflammation, granulomas, dysplasia, or signs of malignancy. Five months after the surgery, she has already lost 36 kg and Crohn’s disease remains in remission. Crohn’s disease is defined by chronic inflammation that may involve any site of the gastrointestinal tract.","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"166-168"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7a/99/pjg-0030-0166.PMC10050835.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9235466","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":"Erratum.","authors":"","doi":"10.1159/000528363","DOIUrl":"https://doi.org/10.1159/000528363","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000526059.].</p>","PeriodicalId":51838,"journal":{"name":"GE Portuguese Journal of Gastroenterology","volume":"30 2","pages":"172"},"PeriodicalIF":0.9,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dd/29/pjg-0030-0172.PMC10050858.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9597025","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}