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From advanced diagnosis to advanced resection in early neoplastic colorectal lesions:Never-ending and trending topics in the 2020s

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World Journal of Gastrointestinal Surgery 2022年第7期14卷 632-655页

作者： Francesco Auriemma Sandro Sferrazza Mario Bianchetti Maria Flavia Savarese Laura Lamonaca danilo paduano Nicole Piazza Enrica Giuffrida Lupe Sanchez Mete Alessandra Tucci Sebastian Manuel Milluzzo Chiara Iannelli Alessandro Repici Benedetto Mangiavillano Gastrointestinal Endoscopy Unit Humanitas Mater DominiCastellanza 21053Italy Gastroenterology and Endoscopy Unit Santa Chiara HospitalTrento 38014Italy Digestive Endoscopy Unit San Giuseppe Hospital-MultimedicaMilan 20123Italy Department of Gastroenterology and Gastrointestinal Endoscopy General HospitalSanremo 18038Italy Gastroenterology Unit IRCCS Policlinico San DonatoSan Donato MilaneseDepartment of Biomedical Sciences for HealthUniversity of MilanMilan 20122Italy Gastroenterology and Hepatology Unit A.O.U.Policlinico"G.Giaccone"Palermo 90127Italy Department of Gastroenterology and Digestive Endoscopy IRCCS Regina Elena National Cancer InstituteRome 00144Italy Department of Gastroenterology Molinette HospitalCittàdella salute e della Scienza di TorinoTurin 10126Italy Digestive Endoscopy Unit and Gastroenterology Fondazione PoliambulanzaBrescia 25100Italy Department of Health Sciences Magna Graecia UniversityCatanzaro 88100Italy Digestive Endoscopy Unit and Gastroenterology Humanitas Clinical and Research Center and Humanitas UniversityRozzano 20089Italy Biomedical Science HunimedPieve Emanuele 20090Italy Gastrointestinal Endoscopy Unit Humanitas Mater DominiCastellanzaVarese 21053Italy

Colonoscopy represents the most widespread and effective tool for the prevention and treatment of early stage preneoplastic and neoplastic lesions in the panorama of cancer *** the world there are different approaches to the topic of colorectal cancer prevention and screening:different starting ages(45-50 years);different initial screening tools such as fecal occult blood with immunohistochemical or immune-enzymatic tests;recto-sigmoidoscopy;and *** key aspects of this scenario are composed of a proper bowel preparation that ensures a valid diagnostic examination,experienced endoscopist in detection of preneoplastic and early neoplastic lesions and open-minded to upcoming artificial intelligence-aided examination,knowledge in the field of resection of these lesions(from cold-snaring,through endoscopic mucosal resection and endoscopic submucosal dissection,up to advanced tools),and management of complications.

关键词： Colorectal lesions Colorectal tumor Endoscopic submucosal dissection Endoscopic mucosal resection Cold-endoscopic mucosal resection FTRD® Complications Adverse events Polypectomy

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Nonalcoholic fatty liver disease in patients with inflammatory bowel disease: Beyond the natural history

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World Journal of Gastroenterology 2019年第37期25卷 5676-5686页

作者： Salvatore Magrì danilo paduano Fabio Chicco Arianna Cingolani Cristiana Farris Giovanna Delogu Francesca Tumbarello Mariantonia Lai Alessandro Melis Laura Casula Massimo C Fantini Paolo Usai Department of Medical Sciences and Public Health University of CagliariMonserrato 09042Italy Department of Systems Medicine University of Rome"Tor Vergata"Rome 00133Italy

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is a frequently reported condition in patients with inflammatory bowel disease(IBD).Both intestinal inflammation and metabolic factors are believed to contribute to the pathogenesis of IBDassociated *** To evaluate the prevalence of steatosis and liver fibrosis(LF)in a cohort of IBD patients and the identification of metabolic-and IBD-related risk factors for NAFLD and *** IBD patients were consecutively enrolled from December 2016 to January ***,anthropometric and biochemical data were collected so as eating *** ultrasound and transient elastography were performed to evaluate the presence of NAFLD and LF *** A total of 178 consecutive patients were enrolled and included in the analysis(95 Ulcerative colitis,83 Crohn’s disease).NAFLD was detected by imaging in 72(40.4%)*** between patients with and without NAFLD showed no significant differences in terms of IBD severity,disease duration,location/extension,use of IBD-related medications(i.e.,steroids,anti-TNFs,and immunomodulators)and *** was significantly associated with the presence of metabolic syndrome[MetS;odds ratio(OR):4.13,P=0.001]and obesity defined by body mass index(OR:9.21,P=0.0002).IBD patients with NAFLD showed higher caloric intake and lipid consumption than those without NAFLD,regardless disease *** the multivariate analysis,male sex,advanced age and high lipid consumption were independent risk factors for the development of *** increased liver stiffness was detected in 21 patients(16%)and the presence of MetS was the only relevant factor associated to LF(OR:3.40,P=0.01).CONCLUSION In this study,we demonstrate that risk factors for NAFLD and LF in the IBD population do not differ from those in the general population.

关键词： Nonalcoholic fatty liver disease Liver fibrosis Inflammatory bowel disease Risk factors Dietary habits

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