Current surgical strategies for the treatment of rectal adenocarcinoma and the risk of local recurrence
Background
Despite new medical and surgical strategies, 5-year local recurrence of rectal adenocarcinoma was reported in up to 25% of cases. Therefore, we aimed to review surgical strategies for the prevention of local recurrences in rectal cancer.
Summary
After implementation of the total mesorectal excision (TME), surgical resection of rectal adenocarcinoma with anterior resection or abdominoperineal excision (APE) allowed decrease in local recurrence (3% at 5 years). More recently, extralevator APE was described as an alternative to APE, decreasing specimen perforation and recurrence rate.
Moreover, technique modifi...
Source: Digestive Diseases - October 1, 2020 Category: Gastroenterology Source Type: research
Comparison in the diagnostic yield between “Pillcam SB3” capsule endoscopy and “OMOM Smart Capsule 2” in small bowel bleeding. A randomized head-to-head study
The objective of this study was to compare the diagnostic yield of the Pillcam SB3 and OMOM capsule endoscopy in small bowel bleeding.
Material and methods
This is a prospective, comparative, randomized and blinded study. Patients with suspected small bowel bleeding were included. All the patients were given both types of capsules endoscopy in random order. Diagnostic yield and functionality between the two types of capsule endos copy were analyzed.
Results
We included 44 patients, 54.5% female with a median of 63.5 years old. Battery time was significantly longer with SB3 (816.5 vs. 700.5 minutes, p (Source: Digestive Diseases)
Source: Digestive Diseases - October 1, 2020 Category: Gastroenterology Source Type: research
High prevalence of small intestinal bacterial overgrowth among functional dyspepsia patients
Conclusion: In a c ohort of Greek FD patients, SIBO prevalence was similar to that of IBS subjects and higher compared to that of controls. (Source: Digestive Diseases)
Source: Digestive Diseases - October 1, 2020 Category: Gastroenterology Source Type: research
Biopsy sampling in upper gastrointestinal endoscopy – a survey from ten tertiary referral centres across Europe.
This study aimed to give an overview on current practice in tertiary referral centres across Europe.
METHODS: Data was collected at ten tertiary referral centres. Demographic data, the indication for each procedure, endoscopic findings and the number and sampling site of biopsies were recorded. Findings were compared between centres and factors influencing the decision to take biopsies explored.
RESULTS: Biopsies were taken in 56.6% of 9425 procedures, with significant variation between centres (p (Source: Digestive Diseases)
Source: Digestive Diseases - September 30, 2020 Category: Gastroenterology Source Type: research
Patient engagement with interactive text message system improves successful colonoscopy rates in an outpatient endoscopy center
Introduction: Text message based interventions reduce colonoscopy no show rates and improved bowel preparation scores. In this non-randomized study, we assessed whether an interactive text messaging system could improve colonoscopy outcomes.
Methods: Colonoscopy pre-procedural instructions were programmed into a dedicated software platform created for this study. In the intervention arm, text messages were sent to veterans during a 4-week study period. Validated pre-procedural satisfaction questionnaires were completed by patients during standard protocol and intervention periods. Demographics and colonoscopy outcomes dat...
Source: Digestive Diseases - September 21, 2020 Category: Gastroenterology Source Type: research
Endoscopic biliary large balloon dilation lithotripsy for giant and impacted stones removal: an Western series
Conclusions: Large balloon lithotripsy, in order to crush the stones or make working room for baskets or balloons in the bile duct is an effective , safe and low cost technique for impacted, packed or giant bile duct stones. (Source: Digestive Diseases)
Source: Digestive Diseases - September 21, 2020 Category: Gastroenterology Source Type: research
The behavior of MMP-2, MMP-7, MMP-9 and their inhibitors TIMP-1, TIMP-2 in adenoma-colorectal cancer sequence
Background: We and others have previously shown that matrix metalloproteinases (MMPs) play role in colorectal cancer (CRC) invasion and metastasis. However, the serum changes of various MMPs and their inhibitors (TIMPs) have scarcely been concomitantly investigated in identical blood samples in the normal colon-adenoma-CRC sequence.
Methods: The MMP-2, MMP-7, MMP-9, TIMP-1 and TIMP-2 serum antigen concentrations were determined concomitantly in 19 tumor-free control patients, 19 patients with high-risk colorectal adenoma and 47 patients with CRC by ELISA technique. The analyzed parameters were also investigated in correla...
Source: Digestive Diseases - September 21, 2020 Category: Gastroenterology Source Type: research
Biomarkers of inflammation in Inflammatory Bowel Disease: how long before abandoning single-marker approaches?
BACKGROUND: Inflammatory bowel disease (IBD) is a chronically relapsing disease with a continuous need for proactive monitoring to decide appropriate treatments and follow-up strategies. To date, gastrointestinal endoscopy with histological examination of biopsies and contrast-enhanced imaging are mandatory techniques for the diagnosis and the activity assessment of IBD.
SUMMARY: In recent decades, many research efforts in the IBD field have been placed on finding non-invasive and reliable biomarkers of disease burden that can be easily tested in body fluids without impacting the quality of life of patients. Unfortunately...
Source: Digestive Diseases - September 16, 2020 Category: Gastroenterology Source Type: research
Antimitochondrial rather than antinuclear antibodies correlate with severe drug-induced liver injury
Conclusion: A closer look in a causality proven DILI cohort provided no evidence that presence of ANA titers is specific for DILI by a certain medication. AMA rather than ANA positivity was related to a more pronounced liver injury. (Source: Digestive Diseases)
Source: Digestive Diseases - September 16, 2020 Category: Gastroenterology Source Type: research
Increasing age and non-liver comorbidities in patients with chronic hepatitis B in Taiwan: A nationwide population-based analysis
This study identified adult patients ( ≥18 years) who were diagnosed with CHB in 2001, 2006, and 2011, from the Taiwan National Health Insurance Research Database (NHIRD). Changes in demographic characteristics, prevalence of non-liver comorbidities, and medication usage over the decade were examined. Non-CHB controls were adults witho ut CHB diagnosis from the Longitudinal Health Insurance Database 2000 (LHID2000).
Results: A total of 102,158, 252,809, and 338,200 eligible patients were identified in 2001, 2006, and 2011, respectively. The mean age significantly advanced from
45.4 to 52.3 years over the decade (P (Sour...
Source: Digestive Diseases - September 14, 2020 Category: Gastroenterology Source Type: research
An improved scoring system based on PALBI in predicting post-hepatectomy liver failure outcomes
Background : Posthepatectomy liver failure (PHLF) is one of the major complications of liver resection that causes perioperative mortality. Accurate preoperative assessment of PHLF is of great significance to reduce the complication rate after hepatectomy and improve the survival rate.
Methods: A retrospective study of patients who received hepatectomy from January 2016 to October 2019 at Tang Du hospital was performed. The area under the ROC curve was used to compare the predictive effects of various scoring models on PHLF.
Results: The area under ROC curve of PALBI score, I-PALBI score, ALBI score and MELD score was re...
Source: Digestive Diseases - August 25, 2020 Category: Gastroenterology Source Type: research
Influence of COVID-19 pandemic on endoscopic procedures in two European large-capacity endoscopy units: "keep calm, keep safe and scope on"?
Conclusions
The SARS-CoV2-pandemic halved the endoscopy service of two tertiary centers while maintaining an urgent therapeutic service. Recommended personal safety measures in endoscopy proved to be efficient and safe in preventing SARS-CoV2 infection of staff or spreading. Unnecessarily, the SARS-CoV2 pandemic prevented routine endoscopy training. (Source: Digestive Diseases)
Source: Digestive Diseases - August 23, 2020 Category: Gastroenterology Source Type: research
Doppler activity and ultrasonographic detection of intra-abdominal fistulas are predictors of surgery in crohn ’s disease.
BAKGROUND AND AIM: Predictors of the need for surgery in Sticturing Crohn ’s Disease (SCD) are lacking. Bowel ultrasound (US) is a harmless, non-invasive and inexpensive diagnostic procedure that has proven to be a valuable tool in the management of Crohn’s Disease. Our aim was to identify ultrasonographic findings in SCD that may associate with a higher risk of surge ry, allowing us to make early choices regarding treatment election in this specific group of patients.
MATERIALS AND METHODS: Retrospective, case-control study. 24 patients diagnosed with SCD between 2013 and 2017 with a past history of stricture-related...
Source: Digestive Diseases - August 23, 2020 Category: Gastroenterology Source Type: research
Opioid Use is More Common in Non-Alcoholic Fatty Liver Disease Patients with Cirrhosis, Higher Body Mass Index and Psychiatric Disease
Conclusion: Prescription opio ids were used in nearly one of five patients with NAFLD. Given the safety concerns of opioids in patients with NAFLD, alternative therapies including low dose acetaminophen and non-pharmacologic treatments should be considered for these patients. (Source: Digestive Diseases)
Source: Digestive Diseases - August 23, 2020 Category: Gastroenterology Source Type: research
Moving Forward: Gradual Return of Gastroenterology Practice during the COVID-19 Pandemic
Background: The COVID-19 pandemic has caused disruption of routine gastroenterology practice which has resulted in the suspension of elective endoscopic procedures and outpatient consults. For the past months, the strategy was to mitigate infection risk for the healthcare team while still providing essential service to patients. A prolonged suspension of the outpatient clinics and endoscopy practice, however, is deemed unsustainable and could even be detrimental. It can compromise patient care and result in poor outcomes, hence a well-crafted plan is needed for the gradual resumption of clinic operations and endoscopic pro...
Source: Digestive Diseases - August 19, 2020 Category: Gastroenterology Source Type: research
