Digestive medicine research最新文献

{"title":"Relapse of ulcerative colitis in a patient with Takayasu arteritis treated with tocilizumab and tacrolimus―successful induction with infliximab: a case report","authors":"M. Chiba, Tsuyotoshi Tsuji, Satoko Tsuda, Takashi Fujiwara, Y. Shindo, Haruhiko Tozawa","doi":"10.21037/dmr-22-33","DOIUrl":"https://doi.org/10.21037/dmr-22-33","url":null,"abstract":"","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49564864","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":"Time to define long-term outcomes after Barrett’s endoscopic therapy","authors":"M. Desai","doi":"10.21037/dmr-22-59","DOIUrl":"https://doi.org/10.21037/dmr-22-59","url":null,"abstract":"","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44967577","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":"The versatility of adipose derived stem cells in liver transplantation: a narrative review","authors":"T. Yılmaz, Lal Karakayali","doi":"10.21037/dmr-22-24","DOIUrl":"https://doi.org/10.21037/dmr-22-24","url":null,"abstract":"","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47193496","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":"Histopathologic diagnosis of gastritis and gastropathy: a narrative review","authors":"Sarah L. Zhang, Trang K Lollie, Zhengshan Chen, Tara Narasimhalu, Hanlin L. Wang","doi":"10.21037/dmr-22-42","DOIUrl":"https://doi.org/10.21037/dmr-22-42","url":null,"abstract":"","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45524937","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":"Boerhaave syndrome complicated by undiagnosed gastroesophageal junction outlet obstruction: a case report","authors":"Ryan P. Anderson, Jason Budde, T. Stevens","doi":"10.21037/dmr-22-61","DOIUrl":"https://doi.org/10.21037/dmr-22-61","url":null,"abstract":"","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43996400","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":"Long-term efficacy of total and partial posterior fundoplication to treat gastroesophageal reflux disease","authors":"Rafael C Katayama, A. C. D. de Grande, F. Herbella","doi":"10.21037/dmr-22-53","DOIUrl":"https://doi.org/10.21037/dmr-22-53","url":null,"abstract":"","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47711695","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":"Perioperative veno-venous extracorporeal membrane oxygenation for facilitation of bronchogastric fistula repair following Ivor-Lewis oesophagectomy—case report","authors":"Aveechal Prasad, A. Frankel, C. Cole, I. Thomson","doi":"10.21037/dmr-21-78","DOIUrl":"https://doi.org/10.21037/dmr-21-78","url":null,"abstract":"Background: Bronchogastric fistulae are a devastating complication following oesophagectomy and despite their rare prevalence of 0.4–3.9%, can present significant morbidity and mortality. This case report presents a contribution that is first in the southern hemisphere, and only third in the world, of peri-operative veno-venous extra-corporeal membrane oxygenation was utilised for respiratory support in the repair of a bronchogastric fistula (BGF) following an Ivor-Lewis Oesophagectomy. The significance of this successful and relatively novel management of such a morbid complication is that it displays a significant, lifesaving methodology which could be replicated and become the status quo as extracorporeal membrane oxygenation (ECMO) becomes more ubiquitously available globally. Case Presentation: A 47-year-old male presented to the emergency department with dyspnoea progressing into rapid type-1 respiratory failure 13 days following an Ivor Lewis Oesophagectomy for oesophageal adenocarcinoma. Diagnosis of a BGF with bronchoscopy and gastroscopy was made and he was transferred to a quaternary centre for deterioration with adult respiratory distress syndrome (ARDS). Further deterioration following dual-lumen ventilation prompted the initiation of veno-venous extracorporeal membrane oxygenation (VV-ECMO) and surgical management. A primary repair of the airway defect and oesophagus was made followed by an intercostal muscle flap. The patient was decannulated post-operative day 10 and discharged to rehabilitation day 40. He is engaging back to his daily activities 6 months following procedure. Conclusions: It is evident from this case that prompt transfer of a patient with a morbid complication such as a BGF to a larger centre with more specialised surgical and intensive care can be lifesaving, despite the inherent challenges of a relatively novel combined surgical/ECMO management confounded by the complications associated with a long intensive care unit (ICU) and inpatient stay. While there may never be effective studies performed to assess their feasibility, we have learned throughout the course of managing this case that the power and utility of ECMO in the management of BGFs cannot be denied, especially in quaternary centres where ECMO has become an integral part of intensive care.","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47417919","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":"Toupet versus Nissen fundoplication for gastroesophageal reflux disease: are the outcomes different?","authors":"L. Bonavina","doi":"10.21037/dmr-22-65","DOIUrl":"https://doi.org/10.21037/dmr-22-65","url":null,"abstract":"© Digestive Medicine Research. All rights reserved. Dig Med Res 2022 | https://dx.doi.org/10.21037/dmr-22-65 Until the first half of the twentieth-century, gastroesophageal reflux disease (GERD) was not a common clinical problem. At that time, Allison (1) reported the outcomes of trans-thoracic crural diaphragmatic repair for hiatal hernia showing a modest 50% success rate. The concept of antireflux surgery (ARS) emerged following the key observation of Nissen (2) that plicating the gastric fundus for 360 degrees around the esophago-gastric anastomosis was highly effective not only to avoid leakage but also to prevent peptic esophagitis. This proof-of-concept experiment led to a change in focus from trans-thoracic crural repair to trans-abdominal fundoplication. A few years later Toupet described a partial posterior fundoplication (3), but the Nissen procedure is still quoted as the “gold standard” surgical therapy for GERD. With the inception of the laparoscopic era, restoration of the esophagogastric antireflux barrier, including remodeling of the hiatal orifice and lower esophageal sphincter augmentation using either the Nissen or the Toupet fundoplication, have become standard procedures (4). Despite the very low morbidity and mortality rates, ARS remains underused due to the perceived risk of persistent side-effects and limited durability. As a consequence, the majority of patients referred for surgical intervention are those with refractory symptoms, recurrent esophagitis, and large hiatal hernia. Today, many gastroenterologists and patients continue to consider proton-pump inhibitors (PPIs) as the therapy of choice, and bad publicity of the “gold standard” Nissen fundoplication has largely contributed to the current decline of ARS utilization. In an attempt to reduce the potential side-effects of the Nissen operation, partial fundoplication has emerged as the procedure of choice or as a “tailored” option for patients with poor esophageal motility. Systematic reviews and meta-analyses have shown that the Toupet fundoplication can decrease the incidence of dysphagia and gas-bloating compared to Nissen fundoplication (5,6). In some studies, the favorable outcomes of Toupet fundoplication have been offset by a higher incidence of recurrent reflux over time, and this may reflect heterogeneity due to selection bias, inclusion of patients with preoperative motility disorders, surgical approach, or variations in the circumference of the wrap (3). The late results of a randomized clinical trial comparing Nissen and Toupet fundoplication recently shed some light on this controversial issue and fill a gap in the interpretation of long-term ARS outcomes (7). This study follows a previous report (8) showing that the Toupet procedure was beneficial because of a reduced dysphagia rate up at 2 years and equivalent control of esophageal acid exposure at 3 years. It appears now that Toupet and Nissen fundoplication are equally effective in controlling sympt","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46919114","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":"Adipose derived mesenchymal stem cells in gastrointestinal system anastomosis: a narrative review","authors":"Huasheng Lai, Zhiwei Dong, P. Chiu","doi":"10.21037/dmr-22-21","DOIUrl":"https://doi.org/10.21037/dmr-22-21","url":null,"abstract":"Background and Objective: Gastrointestinal (GI) system anastomosis is an artificial connection procedure after a resection of all or part of the digestive organs. GI system anastomosis may lead to many complications, including anastomotic leakage (AL), anastomotic dehiscence, or stenosis. AL from anastomosis is one of the most important and fatal complication of any GI resection. Prevention of AL has been a hot topic of ongoing research for decades. Methods: To elucidate recent advances on therapeutic efficacy of adipose-derived mesenchymal stem cells (ADMSCs) in anastomosis, we performed a review of the published literature in English from September 2008 to February 2022 by independent searches using publicly available databases, including NIH National Library of Medicine PubMed, Web of Science, MEDLINE and conferences on this topic. Key Content and Findings: Physical reinforcement of the anastomosis with supporting materials is considered as an effective method to prevent leakage. Liquid-based sealants have also been explored as one of the preventive methods. Finally, manipulating the interaction between the gut microbiome microenvironment and anastomotic healing has also been studied as a means to reduce leakage rates. However, although various surgical techniques have been developed to reduce AL, it remains to be one of the most serious and fatal postoperative complications. Recently, ADMSCs have been popularly used for accelerating anastomotic wound healing through their angiogenesis, immunomodulatory effects and tissue repair ability. Conclusions: An understanding of above developing advances will be important for all surgeons who operate on the GI systems. Here, our review discusses recent advances in the application of various updated techniques, especially ADMSCs transplantation in GI system anastomosis that may stimulate future human studies exploring these new and exciting avenues. collagen-3 α 1 were evaluated. Results showed that MSC sheets enhanced intestine bursting pressure (P<0.05) and up-regulated the mRNA expression of collagen-1 and collagen-3. Hydroxyproline expression was significantly higher in MSC sheet subgroup on PO d 7 (P<0.01) but not PO d 5.","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43412854","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":"S-1 plus docetaxel combination: another adjuvant treatment option for stage III gastric cancer","authors":"H. Jeung, S. Noh","doi":"10.21037/dmr-22-50","DOIUrl":"https://doi.org/10.21037/dmr-22-50","url":null,"abstract":"© Digestive Medicine Research. All rights reserved. Dig Med Res 2022 | https://dx.doi.org/10.21037/dmr-22-50 Despite decades of declining prevalence, gastric cancer (GC) still accounts for over 770,000 cancer-related mortalities worldwide (1). A common therapeutic approach for the treatment of GC involves gastric resection plus with D2 lymph node dissection. However, even following radical surgery, recurrence is typical in the case of locally advanced GC (stage II–III). Postoperative adjuvant chemotherapy trials, which were conducted mainly in Asian patients, confirmed a significant improvement in the survival rate in the adjuvant chemotherapy compared with observation only in resectable GC. Therefore, this surgery-first approach has been strengthened in Asian nations where hematogenous and peritoneal recurrences are common (2). The Japanese ACTS-GC trial was the first positive phase III outcome to address adjuvant chemotherapy with S-1, an oral fluoropyrimidine, as being superior to the “surgery alone” (3). In this trial, 1,059 patients with stage II (excluding T1) or stage III GCs according to the Japanese classification were randomly assigned to the ‘surgery-only’ arm or ‘S-1 treatment’ arm, in which S-1 was administered for a year following D2 gastrectomy. At 3 years, recurrencefree survival (RFS) was 72% in the S-1 arm and 60% in the surgery-only arm [hazard ratio (HR) =0.62; 95% confidence interval (CI): 0.50–0.77; P<0.001], and the overall 3-year survival rates were 80% and 70%, respectively (HR =0.68; 95% CI: 0.52–0.87; P=0.003). However, subgroup analysis revealed that S-1 could only prolong survival in patients with early disease stages (stage II or IIIA) and was unable to prevent hematogenous dissemination (3). Moreover, S-1 is also not widely available worldwide. As a result, in order to improve the clinical outcome, particularly in a more advanced stage IIIB state, it was required to look for a better alternative option, such as one based on a pharmaceutical doublet. In this regard, JACCRO GC-07 study provided an intriguing alternative to S-1 monotherapy (4). The study’s objective was to address whether S-1 plus docetaxel doublet was superior to S-1 alone following R0 resection of pathologic stage III GC. The third English edition of the Japanese Classification of Gastric Carcinoma, which includes stage IIIA (T2N3, T3N2, T4aN1), stage IIIB (T3N3, T4aN2, T4bN0, T4bN1), or stage IIIC (T4aN3, T4bN2, T4bN3), was used to define pathologic stage III GC (5). To briefly summarize the treatment schedule, S-1 was delivered on days 1 through 14 of the first course’s 3-week cycle. After that, patients received intravenous infusions of docetaxel (40 mg/m body surface area) on the first day of each cycle and S-1 (days 1 through 14 of a 3-week cycle) throughout the second to seventh cycle. Patients in the S-1 group received S-1 from days 1 to 28 of a 6-week up to 1 year. The investigators had planned to enroll 1,100 patients between 2013 and 2017, ","PeriodicalId":72814,"journal":{"name":"Digestive medicine research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46515455","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}