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Rectal neuroendocrine tumors:Current advances in management,treatment,and surveillance

World Journal of Gastroenterology 2022年第11期28卷 1123-1138页

作者： Camilla Gallo Roberta Elisa Rossi Federica Cavalcoli federico barbaro Ivo Boškoski Pietro Invernizzi Sara Massironi Division of Gastroenterology and Center for Autoimmune Liver Diseases Department of Medicine and SurgeryUniversity of Milano-BicoccaEuropean Reference Network on Hepatological DiseasesSan Gerardo HospitalMonza 20900Italy Division of HPB Surgery Hepatology and Liver TransplantationDepartment of Pathophysiology and TransplantationUniversity of MilanENETS Center of ExcellenceFondazione IRCCS Istituto Nazionale Tumori(INTNational Cancer Institute)Milan 20133Italy Diagnostic and Therapeutic Endoscopy Unit Fondazione IRCCS Istituto Nazionale TumoriMilan 20133Italy Digestive Endoscopy Unit UniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingFondazione Policlinico Universitario Agostino Gemelli IRCSSRome 00168Italy

Rectal neuroendocrine neoplasms(r-NENs)are considered among the most frequent digestive NENs,together with small bowel *** incidence has increased over the past few years,and this is probably due to the widespread use of endoscopic screening for colorectal cancer and the advanced endoscopic procedures available *** to the current European Neuroendocrine Tumor Society(ENETS)guidelines,well-differentiated r-NENs smaller than 10 mm should be endoscopically removed in view of their low risk of local and distant invasion.R-NENs larger than 20 mm are candidates for surgical resection because of their high risk of distant spreading and the involvement of the muscularis *** is an area of uncertainty regarding tumors between 10 and 20 mm,in which the metastatic risk is intermediate and the endoscopic treatment can be *** removed,the indications for surveillance are scarce and poorly codified by international guidelines,therefore in this paper,a possible algorithm is proposed.

关键词： Rectal neuroendocrine tumors Endoscopy Endoscopic submucosal dissection Resectable advanced disease Systemic therapy

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Colon capsule endoscopy:What we know and what we would like to know

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World Journal of Gastroenterology 2014年第45期20卷 16948-16955页

作者： Cristiano Spada federico barbaro Gianluca Andrisani Leonardo Minelli Grazioli Cesare Hassan Isabella Costamagna Mariachiara Campanale Guido Costamagna Department of General Surgery Digestive Endoscopy Unit Catholic University

Colonoscopy is usually perceived as an invasive and potentially painful procedure, being also affected by a small, but definite, risk of major complications (cardiopulmonary complications, perforation, hemorrhage) and even mortality. To improve both acceptability and safety, PillCam Colon Capsule Endoscopy (CCE) (Given Imaging Ltd, Yoqneam, Israel) has been developed. CCE represents a non-invasive technique that is able to explore the colon without sedation and air insufflation. The Second Generation of Colon Capsule Endoscopy (PillCam Colon 2) (CCE-2) was proven to be an accurate tool to detect colonic neoplastic lesions when used in average risk individuals. To date, the evidence supports the use of CCE-2 in case of colonoscopy failure, in patients unwilling to perform colonoscopy and when colonoscopy is contraindicated. Other potential applications, such as colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease need to be clarified. In this paper, the current “state of the art”, potential application of CCE and future needs are evaluated.

关键词： Colon capsule endoscopy Incomplete colonoscopy Regimen of preparation Accuracy Fields of application

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How to preserve the native or reconstructed esophagus after perforations or postoperative leaks: A multidisciplinary 15-year experience

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World Journal of Gastrointestinal Surgery 2024年第11期16卷 3471-3483页

作者： Dania Nachira Giuseppe Calabrese Alessia Senatore Valerio Pontecorvi Khrystyna Kuzmych Claudia Belletatti Ivo Boskoski Elisa Meacci Alberto Biondi federico Raveglia Vincenzo Bove Maria Teresa Congedo Maria Letizia Vita Gloria Santoro Leonardo Petracca Ciavarella Filippo Lococo Giovanni Punzo Angelo Trivisonno Francesco Petrella federico barbaro Cristiano Spada Domenico D'Ugo Ugo Cioffi Stefano Margaritora Department of General Thoracic Surgery Fondazione Policlinico Universitario Agostino Gemelli-IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli-IRCCSUniversitàCattolica del Sacro CuoreRome 00168Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCSSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and TrainingRome 00168Italy General Surgery Unit Fondazione Policlinico Universitario Agostino Gemelli-IRCCSRome 00168Italy Department of Thoracic Surgery IRCCS-San Gerardo dei TintoriMonza 20900LombardyItaly Department of Surgery Fondazione Policlinico Universitario Agostino Gemelli-IRCCSRome 00168Italy Department of Anesthesiology and Intensive Care Medicine Fondazione Policlinico Universitario Agostino Gemelli-IRCCSUniversitàCattolica del Sacro CuoreRome 00168LazioItaly Department of Plastic Surgery Assunzione di Maria Santissima ClinicRome 00135Italy Department of Surgery “Agostino Gemelli”University HospitalCatholic University of RomeRome 00168Italy Department of Surgery University of MilanMilan 20122Italy

BACKGROUND Esophageal perforation or postoperative leak after esophageal surgery remain a life-threatening *** optimal management strategy is still *** To determine clinical outcomes and complications of our 15-year experience in the multidisciplinary management of esophageal perforations and anastomotic *** A retrospective single-center observational study was performed on 60 patients admitted at our department for esophageal perforations or treated for an anastomotic leak developed after esophageal surgery from January 2008 to December *** outcomes were analyzed,and complications were evaluated to investigate the efficacy and safety of our multidisciplinary management based on the preservation of the native or reconstructed esophagus,when *** Among the whole series of 60 patients,an urgent surgery was required in 8 cases due to a septic ***-six patients were managed by endoscopic or hybrid treatments,obtaining the resolution of the esophageal leak/perforation without removal of the native or reconstructed *** mean time to resolution was 54.95±52.64 days,with a median of 35.5 *** severe complications were *** patients out of 56(17.9%)developed pneumonia that was treated by specific antibiotic therapy,and in 6 cases(10.7%)an atrial fibrillation was *** patients(12.5%)developed a stricture within 12 months,requiring one or two endoscopic pneumatic dilations to solve the *** was 1.7%.CONCLUSION A proper multidisciplinary approach with the choice of the most appropriate treatment can be the key for success in managing esophageal leaks or perforations and preserving the esophagus.

关键词： Esophageal perforations Postoperative leak Endoscopic vacuum-assisted closure therapy Metal stent Endoscopic suture Lateral esophagostomy Autologous emulsified stromal vascular fraction

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Endoscopic techniques for gastric neuroendocrine tumors:An update

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World Journal of Gastrointestinal Endoscopy 2023年第3期15卷 103-113页

作者： Sara Massironi Camilla Gallo Alice Laffusa Cristina Ciuffini Clara Benedetta Conti federico barbaro Ivo Boskoski Marco Emilio Dinelli Pietro Invernizzi Gastroenterology Unit Fondazione IRCCS SanGerardo dei TintoriMonza(MB)20900Italy Interventional Endoscopy Unit Fondazione IRCCS San Gerardo dei TintoriMonza(MB)20900Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSUniversitàCattolica del Sacro Cuore di RomaCenter for Endoscopic Research Therapeutics and Training(CERTT)Roma 00168Italy

Gastric neuroendocrine neoplasms(gNENs)are a rare type of gastric neoplasm,even if their frequency is increasing according to the latest epidemiologic revisions of the main registries *** are divided into three main subtypes,with different pathogeneses,biological behaviors,and clinical *** heterogeneity poses challenges,therefore these neoplasms require different management *** the knowledge on the endoscopic treatment options to manage *** manuscript is a narrative review of the *** recent years,many advances have been made not only in the knowledge of both the pathogenesis and the molecular profiling of gNENs but also in the endoscopic expertise towards innovative treatment options,which proved to be less aggressive without losing the capa-bility of being *** endoscopic approach is increasingly applied in the field of gastrointestinal(GI)luminal neoplasms,and this is true not only for adenocarcinomas but also for *** particular,different techniques have been described for the endoscopic removal of suspected lesions,ranging from classical polypectomy(cold or hot snare)to endoscopic mucosal resection(both with“en bloc”or piecemeal technique),endoscopic submucosal dissection,and endoscopic full-thickness *** comprise different subtypes of neoplasms with distinct management and *** endoscopic techniques offer a wide variety of approaches for GI localized neoplasms,which demonstrated to be appropriate and effective also in the case of *** evaluation of size,site,morphology,and clinical context allows the choice of tailored therapy in order to guarantee a definitive treatment.

关键词： Stomach neoplasm Neuroendocrine tumors Endoscopy Endoscopic mucosal resection Endoscopic submucosal dissection

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