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Use of the Endocuff during routine colonoscopy examination improves adenoma detection: A meta-analysis

World Journal of Gastroenterology 2016年第43期22卷 9642-9649页

作者： Matthew Chin William Karnes M Mazen Jamal John G Lee Robert Lee jason samarasena Matthew L Bechtold Douglas L Nguyen Division of Gastroenterology and Hepatology University of California Irvine Division of Gastroenterology Long Beach Veterans Affairs Health System Division of Gastroenterology University of Missouri Health

AIM To perform meta-analysis of the use of Endocuff during average risk screening *** Scopus, Cochrane databases, MEDLINE/Pub Med, and CINAHL were searched in April 2016. Abstracts from Digestive Disease Week, United European Gastroenterology, and the American College of Gastroenterology meeting were also searched from 2004-2015. Studies comparing EC-assisted colonoscopy(EAC) to standard colonoscopy, for any indication, were included in the analysis. The analysis was conducted by using the Mantel-Haenszel or DerS imonian and Laird models with the odds ratio(OR) to assess adenoma detection, cecal intubation rate, and complications performed. RESULTS Nine studies(n = 5624 patients) were included in the analysis. Compared to standard colonoscopy, procedures performed with EC had higher frequencies for adenoma(OR = 1.49, 95%CI: 1.23-1.80; P = 0.03), and sessile serrated adenomas detection(OR = 2.34 95%CI: 1.63-3.36; P < 0.001). There was no significant difference in cecal intubation rates between the EACgroup and standard colonoscopy(OR = 1.26, 95%CI: 0.70-2.27, I2 = 0%; P = 0.44). EAC was associated with a higher risk of complications, most commonly being superficial mucosal injury without higher frequency for *** The use of an EC on colonoscopy appears to improve pre-cancerous polyp detection without any difference in cecal intubation rates compared to standard colonoscopy.

关键词： Colonoscopy Endocuff 腺瘤察觉

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Endoscopic ultrasound-through-the-needle biopsy in pancreatic cystic lesions: A large single center experience

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World Journal of Gastrointestinal Endoscopy 2019年第11期11卷 531-540页

作者： Rintaro Hashimoto John G Lee Kenneth J Chang Nabil El Hage Chehade jason B samarasena H.H.Chao Comprehensive Digestive Disease Center Division of Gastroenterology and Hepatology Department of Medicine University of CaliforniaIrvine

BACKGROUND Establishing a diagnosis of pancreatic cystic lesions(PCLs)preoperatively still remains ***,endoscopic ultrasound(EUS)-through-the-needle biopsy(EUS-TTNB)using microforceps in PCLs has been made *** To assess the efficacy and safety of EUS-TTNB in the diagnosis of *** We retrospectively collected data of patients with PCLs who underwent both EUS-fine-needle aspiration(FNA)for cytology and EUS-TTNB at our institution since ***-FNA for cytology was followed by EUS-TTNB in the same *** of the cyst location,primary diagnosis,adverse events,and comparison between the cytologic fluid analyses and histopathology was *** success of EUS-TTNB was defined as visible tissue present after *** success was defined as the presence of a specimen adequate to make a histologic or cytologic *** A total of 56 patients(mean age 66.9±11.7,53.6%females)with PCLs were enrolled over the study *** mean cyst size was 28.8 mm(12-85 mm).The EUS-TTNB procedure was technically successful in all patients(100%).The clinical success rate using EUS-TTNB was much higher than standard EUS-FNA,respectively 80.4%(45/56)vs 25%(14/56).Adverse events occurred in 2 patients(3.6%)who developed mild pancreatitis that resolved with medical *** TTNB specimens,23 of 32 cases(71.9%)with intraductal papillary mucinous neoplasm were further differentiated into gastric type(19 patients)and pancreaticobiliary type(4 patients)based on immunochemical *** EUS-TTNB for PCLs was technically feasible and had a favorable safety ***,the diagnostic yield for PCLs was much higher with EUS-TTNB than standard EUS-FNA cytology and fluid carcinoembryonic *** should be considered as an adjunct to EUS-FNA and cytologic analysis in the diagnosis and management of PCLs.

关键词： Pancreatic cyst lesion Endoscopic ultrasound Endoscopic ultrasound-guided fine needle aspiration Cyst fluid Biopsy

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Lumen-apposing metal stents for benign gastrointestinal tract strictures: An international multicenter experience

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World Journal of Gastrointestinal Endoscopy 2017年第12期9卷 571-578页

作者： Javier Santos-Fernandez Christopher Paiji Mohammad Shakhatreh Irene Becerro-Gonzalez Ramon Sanchez-Ocana Paul Yeaton jason samarasena Manuel Perez-Miranda Gastroenterology Department Hospital Universitario Rio Hortega Division of Gastro- enterology and Hepatology University of California -Irvine Section of Gastro- enterology and Hepatology Virginia Tech Carilion School of Medicine and Research Institute

AIM To investigate technical feasibility, outcomes and adverse events of the lumen-apposing metal stent(LAMS) for benign gastrointestinal(GI) tract *** Between July 2015 and January 2017, patients undergoing treatment by LAMS for benign GI strictures at three tertiary referral centers were included in this study. Primary outcomes included technical success, shortterm clinical success, long-term clinical success, and adverse events. Short-term clinical success was defined as symptom resolution at 30 d after stent placement. Longterm clinical success was defined by symptom resolution at 60 d in patients who continued to have indwelling stent, or continued symptom resolution at 30 d after elective stent *** A total of 21 patients(mean age 62.6 years, 47.6% males) underwent placement of LAMS for benign GI strictures. A 15 mm × 10 mm LAMS was placed in 16 patients, a 10 mm × 10 mm LAMS was placed in 2 patients, and a 16 mm × 30 mm LAMS was placed in 3 patients. Technical success was obtained in all cases. Short-term clinical success was achieved in 19 out of 21 cases(90.5%), and long-term clinical success was achieved in 12 out of 18(66.7%). Mean(range) stent indwell time was 107.2(28-370) d. After a mean(range) dwell time of 104.3(28-306) d, 9 LAMSs were removed due to the following complications: ulceration at stent site(n = 1), angulation(n = 2), migration(n = 4) and stricture overgrowth(n = 2). Migration occurred in 4 cases(19.0%), and it was associated with stricture resolution in one case. Median(range) follow-up period was 119(31-422) d. CONCLUSION Utilization of LAMS for benign strictures has shown to be technically feasible and safe, but adverse events highlight the need for further study of its indications.

关键词： Endoscopy Stent Gastrointestinal diseases Stricture Biomedical technology

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