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Applications of endoscopic vacuum therapy in the lower gastrointestinal tract: Tips and tricks and a review of the literature 下消化道内窥镜真空疗法的应用：技巧和方法以及文献综述
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-06-01 DOI: 10.1016/j.bpg.2024.101927
{"title":"Applications of endoscopic vacuum therapy in the lower gastrointestinal tract: Tips and tricks and a review of the literature","authors":"","doi":"10.1016/j.bpg.2024.101927","DOIUrl":"10.1016/j.bpg.2024.101927","url":null,"abstract":"<div><p>Endoscopic vacuum therapy (EVT) is an established technique for the treatment of rectal wall defects and especially anastomotic leaks. A wide range of EVT devices, both handmade and commercially available, allow for their successful placement even in small defects and difficult localizations. Reported success rates range between 85 and 97 %, while periintervenional morbidity is low and major adverse events are very rare. EVT has proven its effectiveness in the lower gastrointestinal tract and is now considered first line treatment for pelvic anastomotic leaks. This narrative review summarizes the current literature on EVT in the lower gastrointestinal tract, focusing on its indications, technical aspects and results, and offers tips and tricks for its clinical applications.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141395828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 role of radiology in diagnosing gastrointestinal tract perforation 放射学在诊断胃肠道穿孔中的作用
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-06-01 DOI: 10.1016/j.bpg.2024.101928
{"title":"The role of radiology in diagnosing gastrointestinal tract perforation","authors":"","doi":"10.1016/j.bpg.2024.101928","DOIUrl":"10.1016/j.bpg.2024.101928","url":null,"abstract":"<div><p>Spontaneous, iatrogenic or surgical perforation of the whole gastrointestinal wall can lead to serious complications, resulting in increased morbidity and mortality. Optimal patient management requires early clinical appraisal and prompt imaging evaluation. Both radiologists and referring clinicians should recognize the importance of choosing the ideal imaging modality and the usefulness of oral and rectal contrast medium. Surgeons and radiologists should be familiar with CT and fluoroscopy findings of the normal and pathologic anatomy after esophageal, stomach or colon surgery. Specifically, they should be able to differentiate innocuous from clinically-relevant, life-threatening postoperative complications to guide appropriate treatment. Advantages of esophagram, CT-esophagram, CT after rectal contrast enema and other imaging modalities are discussed.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521691824000532/pdfft?md5=887a9e377e1a1c82245edd127b3ecb4b&pid=1-s2.0-S1521691824000532-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141391525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Considerations in case of suspected anastomotic leakage in the lower GI tract 下消化道吻合口疑似渗漏时的注意事项
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-06-01 DOI: 10.1016/j.bpg.2024.101925
{"title":"Considerations in case of suspected anastomotic leakage in the lower GI tract","authors":"","doi":"10.1016/j.bpg.2024.101925","DOIUrl":"10.1016/j.bpg.2024.101925","url":null,"abstract":"<div><p>Colorectal anastomotic leakage (CAL) remains a feared complication after colorectal surgery and requires prompt detection and proper treatment. With the upswing of fast-track recovery programs in recent years this challenge has increased, as clinical features may only arise after discharge. Therefore, identification of the best diagnostic tools is of utmost importance, also since early treatment is associated with high success rates. Diagnostic tools range from general screening tools to invasive procedures to assess the severity of the leak. Laboratory tests, in particular the inflammation biomarkers C-reactive protein and procalcitonin, have a significant role in the detection of CAL after colorectal surgery. As these biomarkers are unspecific for CAL, additional imaging should be performed when blood levels are elevated. The golden standard for the detection of AL after colonic resections is a computed tomography (CT-scan). If tolerated, a contrast medium should be administered rectally to enhance diagnostic accuracy. When suspicion of CAL remains high despite negative previous tests, further endoscopy examination should be conducted. However, endoscopic examinations become more suitable for the early diagnostic work-up after rectal resections. This review aims to provide an overview of current diagnostics for the screening and assessment of the severity of CAL after colorectal surgery.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521691824000507/pdfft?md5=234a8c41dad1c66d99915a982008c9f2&pid=1-s2.0-S1521691824000507-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141394735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Navigating complexities and considerations for suspected anastomotic leakage in the upper gastrointestinal tract: A state of the art review 上消化道疑似吻合口漏的复杂性和注意事项：最新进展综述
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-06-01 DOI: 10.1016/j.bpg.2024.101916
{"title":"Navigating complexities and considerations for suspected anastomotic leakage in the upper gastrointestinal tract: A state of the art review","authors":"","doi":"10.1016/j.bpg.2024.101916","DOIUrl":"10.1016/j.bpg.2024.101916","url":null,"abstract":"<div><p>This state-of-the-art review explores the intricacies of anastomotic leaks following oesophagectomy and gastrectomy, crucial surgeries for globally increasing esophageal and gastric cancers. Despite advancements, anastomotic leaks occur in up to 30 % and 10 % of oesophagectomy and gastrectomy cases, respectively, leading to prolonged hospital stays, substantial impact upon short- and long-term health-related quality of life and greater mortality. Recognising factors contributing to leaks, including patient characteristics and surgical techniques, are vital for preoperative risk stratification. Diagnosis is challenging, involving clinical signs, biochemical markers, and various imaging modalities. Management strategies range from non-invasive approaches, including antibiotic therapy and nutritional support, to endoscopic interventions such as stent placement and emerging vacuum-assisted closure devices, and surgical interventions, necessitating timely recognition and tailored interventions. A step-up approach, beginning non-invasively and progressing based on treatment success, is more commonly advocated. This comprehensive review highlights the absence of standardised treatment algorithms, emphasizing the importance of individualised patient-specific management.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140928909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Management of leakage and fistulas after bariatric surgery 减肥手术后的渗漏和瘘管处理
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-06-01 DOI: 10.1016/j.bpg.2024.101926
{"title":"Management of leakage and fistulas after bariatric surgery","authors":"","doi":"10.1016/j.bpg.2024.101926","DOIUrl":"10.1016/j.bpg.2024.101926","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141400563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Multi-modality management of defects in the gastrointestinal tract: Where the endoscope meets the scalpel 胃肠道缺损的多模式治疗：内窥镜与手术刀的完美结合
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-06-01 DOI: 10.1016/j.bpg.2024.101936
{"title":"Multi-modality management of defects in the gastrointestinal tract: Where the endoscope meets the scalpel","authors":"","doi":"10.1016/j.bpg.2024.101936","DOIUrl":"10.1016/j.bpg.2024.101936","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Management of fistulas in the upper gastrointestinal tract 上消化道瘘管的处理。
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-06-01 DOI: 10.1016/j.bpg.2024.101929
{"title":"Management of fistulas in the upper gastrointestinal tract","authors":"","doi":"10.1016/j.bpg.2024.101929","DOIUrl":"10.1016/j.bpg.2024.101929","url":null,"abstract":"<div><p>Fistulas in the upper gastrointestinal (GI) tract are complex conditions associated with elevated morbidity and mortality. They may arise as a result of inflammatory or malignant processes or following medical procedures, including endoscopic and surgical interventions. The management of upper GI is often challenging and requires a multidisciplinary approach. Accurate diagnosis, including endoscopic and radiological evaluations, is crucial to build a proper and personalized therapeutic plan, that should take into account patient's clinical conditions, time of onset, size, and anatomical characteristics of the defect. In recent years, several endoscopic techniques have been introduced for the minimally invasive management of upper GI fistulas, including through-the-scope and over-the-scope clips, stents, endoscopic suturing, endoluminal vacuum therapy (EVT), tissue adhesives, endoscopic internal drainage. This review aims to discuss and detail the current available endoscopic techniques for the treatment of upper GI fistulas.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1521691824000544/pdfft?md5=afabdab5e41fbc8c1c3e72903914717a&pid=1-s2.0-S1521691824000544-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141397263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of iatrogenic perforations during endoscopic interventions in the hepato-pancreatico-biliary tract 肝胰胆管内窥镜介入手术中的先天性穿孔处理方法
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-06-01 DOI: 10.1016/j.bpg.2024.101890
{"title":"Management of iatrogenic perforations during endoscopic interventions in the hepato-pancreatico-biliary tract","authors":"","doi":"10.1016/j.bpg.2024.101890","DOIUrl":"10.1016/j.bpg.2024.101890","url":null,"abstract":"<div><p>Endoscopic retrograde cholangiopancreaticography (ERCP) and endoscopic ultrasound (EUS) guided interventions are among the most challenging procedures performed by interventional endoscopists and are associated with a significant risk of complications. Early recognition and classification of perforations allows immediate therapy which improves clinical outcomes. In this article we review the different aspects of iatrogenic perforations associated with pancreatico-biliary interventions, elucidating risk factors, diagnostic challenges and the latest therapeutic interventions.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S152169182400009X/pdfft?md5=c7b24dc69799611541df8aa1e006e4c8&pid=1-s2.0-S152169182400009X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139668923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of perforations during endoscopic resection 内窥镜切除术中穿孔的处理方法
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101900
Ludovico Alfarone , Marco Spadaccini , Alessandro Repici , Cesare Hassan , Roberta Maselli
{"title":"Management of perforations during endoscopic resection","authors":"Ludovico Alfarone ,&nbsp;Marco Spadaccini ,&nbsp;Alessandro Repici ,&nbsp;Cesare Hassan ,&nbsp;Roberta Maselli","doi":"10.1016/j.bpg.2024.101900","DOIUrl":"10.1016/j.bpg.2024.101900","url":null,"abstract":"<div><p>Despite the evolution in tools and techniques, perforation is still one of the most pernicious adverse events of therapeutic endoscopy with potentially huge consequences. As advanced endoscopic resection techniques are worldwide spreading, endoscopists must be ready to manage intraprocedural perforations. In fact, immediate endoscopic closure through a prompt diagnosis represents the first-line option, saving patients from surgery, long hospitalizations and worse outcomes. Traditional and novel endoscopic closure modalities, including clips, suturing devices, stents and vacuum therapy, are increasingly expanding the therapeutic armamentarium for closing these defects. Nevertheless, available literature on this topic is currently limited. In this review our goal is to give an overview on the management of perforations occurring during endoscopic resections, with particular attention to characteristics, advantages, disadvantages and new horizons of endoscopic closure tools.</p></div>","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140010168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Preface to special edition: The management of GI endoscopy complications 特刊前言：消化内镜检查并发症的处理
IF 3.2 3区 医学
Best Practice & Research Clinical Gastroenterology Pub Date : 2024-03-01 DOI: 10.1016/j.bpg.2024.101913
Gaius Longcroft-Wheaton (Dr), Pradeep Bhandari (Prof)
{"title":"Preface to special edition: The management of GI endoscopy complications","authors":"Gaius Longcroft-Wheaton (Dr),&nbsp;Pradeep Bhandari (Prof)","doi":"10.1016/j.bpg.2024.101913","DOIUrl":"10.1016/j.bpg.2024.101913","url":null,"abstract":"","PeriodicalId":56031,"journal":{"name":"Best Practice & Research Clinical Gastroenterology","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140796158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
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