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World Journal of Gastroenterology 2020年第39期26卷 5911-5918页

作者： Emanuele Sinagra Matteo Badalamenti Marcello Maida Marco Spadaccini roberta maselli Francesca Rossi Giuseppe Conoscenti Dario Raimondo Socrate Pallio Alessandro Repici Andrea Anderloni Gastroenterology and Endoscopy Unit Fondazione Istituto San Raffaele GiglioCefalù90015Italy Digestive Endoscopy Unit Division of GastroenterologyHumanitas Clinical and Research Center IRCCSRozzano 20089Italy Gastroenterology and Endoscopy Unit S.Elia-Raimondi HospitalCaltanissetta 93100Italy Endoscopy Unit AOUP Policlinico G.MartinoMessina 98125Italy

Colonoscopy remains the standard strategy for screening for colorectal cancer around the world due to its efficacy in both detecting adenomatous or precancerous lesions and the capacity to remove them *** detection and diagnosis(CAD),thanks to the brand new developed innovations of artificial intelligence,and especially deep-learning techniques,leads to a promising solution to human biases in performance by guarantying decision support during *** application of CAD on real-time colonoscopy helps increasing the adenoma detection rate,and therefore contributes to reduce the incidence of interval cancers improving the effectiveness of colonoscopy screening on critical outcome such as colorectal cancer related ***,a significant reduction in costs is also *** addition,the assistance of the machine will lead to a reduction of the examination time and therefore an optimization of the endoscopic *** aim of this opinion review is to analyze the clinical applications of CAD and artificial intelligence in colonoscopy,as it is reported in literature,addressing evidence,limitations,and future prospects.

关键词： Colonoscopy Artificial intelligence Adenoma detection rate Pathology Endoscopy Computer-aided detection and diagnosis

Endoscopic ultrasound-guided ablation of solid pancreatic lesions:A systematic review of early outcomes with pooled analysis

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World Journal of Gastrointestinal Oncology 2022年第2期14卷 533-542页

作者： Marco Spadaccini Milena Di Leo Andrea Iannone Daan von den Hoff Alessandro Fugazza Piera Alessia Galtieri Gaia Pellegatta roberta maselli Andrea Anderloni Matteo Colombo Peter D Siersema Silvia Carrara Alessandro Repici Endoscopic Unit Department of GastroenterologyIRCCS Humanitas Research HospitalRozzano 20089MilanItaly Department of Biomedical Sciences Humanitas UniversityPieve Emanuele 20090MilanItaly Endoscopy Unit Azienda Ospedale PoliclinicoBari 70124Italy Endoscopy Unit Radboud University Medical CenterNijmegen 6525 GANetherlands

BACKGROUND Endoscopic ultrasound-guided radiofrequency ablation(EUS-RFA)is emerging as a complementary therapeutic approach for pancreatic solid ***,results of published data are difficult to interpret because of a retrospective design and small sample *** To systematically review data on EUS-RFA for solid lesions and to pool the results of the different experiences in order to provide more consistent evidence in terms of safety and *** A comprehensive systematic literature search on the main databases was performed to identify articles in which patients with pancreatic solid lesions underwent *** primary outcomes were procedure-related adverse events(AEs)and *** outcomes were the technical success rate and the effects on primary tumor *** analyses were performed using Stata version *** In total,14 studies were included,with 120 patients undergoing 153 ablations of 129 solid pancreatic *** STARmed technology was used in seven studies,the Habib system in six studies,and the HybridTherm probe in one *** pooled technical success rate was 99.0%(I2:25.82%).The pooled overall AE rate was 8.0%(I2:11.46%).Excluding mild AEs,the pooled rates of serious AEs was 1.0%(I2:0%).No mortality related to the procedure was *** The present pooled analysis confirms the safety and feasibility of EUS-RFA.

关键词： Pancreatic cancer Neuroendocrine tumors Habib Cryotechnology Pancreas Endoscopic ultrasound

Submucosal tunnel endoscopy:Peroral endoscopicmyotomy and peroral endoscopic tumor resection

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World Journal of Gastrointestinal Endoscopy 2016年第2期8卷 86-103页

作者： Nikolas Eleftheriadis Haruhiro Inoue Haruo Ikeda Manabu Onimaru roberta maselli Grace Santi Digestive Diseases Center Showa UniversityKoto Toyosu HospitalTokyo 135-8577Japan Gastroenterology Unit Metropolitan Hospital18547 AthensGreece

Peroral endoscopic myotomy(POEM) is an innovative,minimally invasive, endoscopic treatment for esophageal achalasia and other esophageal motility disorders, emerged from the natural orifice transluminal endoscopic surgery procedures, and since the first human case performed by Inoue in 2008, showed exciting results in international level, with more than 4000 cases globally up to now. POEM showed superior characteristics than the standard 100-year-old surgical or laparoscopic Heller myotomy(LHM), not only for all types of esophageal achalasia [classical(Ⅰ), vigorous(Ⅱ), spastic(Ⅲ), Chicago Classification], but also for advanced sigmoid type achalasia(S1 and S2), failed LHM, or other esophageal motility disorders(diffuse esophageal spasm, nutcracker esophagus or Jackhammer esophagus). POEM starts with a mucosal incision, followed by submucosal tunnel creation crossing the esophagogastric junction(EGJ) and myotomy. Finally the mucosal entry is closed with endoscopic clip placement. POEM permitted relatively free choice of myotomy length and localization. Although it is technically demanding procedure, POEM can be performed safely and achieves very good control of dysphagia and chest pain. Gastroesophageal reflux is the most common troublesome side effect, and is well controllable with proton pump inhibitors. Furthermore, POEM opened the era of submucosal tunnel endoscopy, with many other applications. Based on the same principles with POEM, in combination with new technological developments, such as endoscopic suturing, peroral endoscopic tumor resection(POET), is safely and effectively applied for challenging submucosal esophageal, EGJ and gastric cardia tumors(submucosal tumors), emerged from muscularis propria. POET showed up to know promising results, however, it is restricted to specialized centers. The present article reviews the recent data of POEM and POET and discussed controversial issues that need further study and future perspectives.

关键词： Achalasia Heller myotomy Laparoscopicmyotomy Per-oral endoscopic myotomy Natural orificetransluminal endoscopy surgery Endoscopic submucosaldissection Submucosal endoscopy LES Transluminaltechnique Minimally invasive surgery Peroral endoscopic tumorectomy EndoFLIP

Advanced imaging and artificial intelligence for Barrett's esophagus:What we should and soon will do

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World Journal of Gastroenterology 2022年第11期28卷 1113-1122页

作者： Marco Spadaccini Edoardo Vespa Viveksandeep Thoguluva Chandrasekar Madhav Desai Harsh K Patel roberta maselli Alessandro Fugazza Silvia Carrara Andrea Anderloni Gianluca Franchellucci Alessandro De Marco Cesare Hassan Pradeep Bhandari Prateek Sharma Alessandro Repici Department of Endoscopy Humanitas Research HospitalIRCCSRozzano 20089Italy Department of Biomedical Sciences Humanitas UniversityRozzano 20089Italy Department of Gastroenterology and Hepatology Mayo ClinicPhoenixAZ 85054United States Department of Gastroenterology and Hepatology Kansas City VA Medical CenterKansas CityMO 66045United States Department of Internal Medicine Ochsner Clinic FoundationNew OrleansLA 70124United States Endoscopy Unit Nuovo Regina Margherita HospitalRoma 00153Italy Department of Gastroenterology Portsmouth Hospitals University NHS TrustPortsmouth PO63LYUnited Kingdom School of Pharmacy and Biomedical Sciences University of PortsmouthPortsmouth PO63LYUnited Kingdom

Barrett’s esophagus(BE)is a well-established risk factor for esophageal *** is recommended that patients have regular endoscopic surveillance,with the ultimate goal of detecting early-stage neoplastic lesions before they can progress to invasive *** of both dysplasia or early adenocarcinoma permits curative endoscopic treatments,and with this aim,thorough endoscopic assessment is crucial and improves *** burden of missed neoplasia in BE is still far from being negligible,likely due to inappropriate endoscopic *** the last two decades,advanced imaging techniques,moving from traditional dye-spray chromoendoscopy to more practical virtual chromoendoscopy technologies,have been introduced with the aim to enhance neoplasia detection in *** witnessed in other fields,artificial intelligence(AI)has revolutionized the field of diagnostic endoscopy and is set to cover a pivotal role in BE as *** aim of this commentary is to comprehensively summarize present evidence,recent research advances,and future perspectives regarding advanced imaging technology and AI in BE;the combination of computer-aided diagnosis to a widespread adoption of advanced imaging technologies is eagerly *** will also provide a useful step-by-step approach for performing high-quality endoscopy in BE,in order to increase the diagnostic yield of endoscopy in clinical practice.

关键词： Barrett’s esophagus Endoscopy Artificial intelligence Surveillance Advanced imaging Neoplasia

Artificial intelligence and inflammatory bowel disease: Where are we going?

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World Journal of Gastroenterology 2023年第3期29卷 508-520页

作者： Leonardo Da Rio Marco Spadaccini Tommaso Lorenzo Parigi Roberto Gabbiadini Arianna Dal Buono Anita Busacca roberta maselli Alessandro Fugazza Matteo Colombo Silvia Carrara Gianluca Franchellucci Ludovico Alfarone Antonio Facciorusso Cesare Hassan Alessandro Repici Alessandro Armuzzi Department of Endoscopy Humanitas Research HospitalIRCCSRozzano 20089MilanoItaly Department of Biomedical Sciences Humanitas UniversityRozzano 20089MilanoItaly IBD Center Humanitas Research HospitalIRCCSRozzano 20089MilanoItaly Gastroenterology Unit Department of Medical SciencesUniversity of FoggiaFoggia 71122FoggiaItaly

Inflammatory bowel diseases,namely ulcerative colitis and Crohn’s disease,are chronic and relapsing conditions that pose a growing burden on healthcare systems *** of their complex and partly unknown etiology and pathogenesis,the management of ulcerative colitis and Crohn’s disease can prove challenging not only from a clinical point of view but also for resource *** intelligence,an umbrella term that encompasses any cognitive function developed by machines for learning or problem solving,and its subsets machine learning and deep learning are becoming ever more essential tools with a plethora of applications in most medical *** this regard gastroenterology is no exception,and due to the importance of endoscopy and imaging numerous clinical studies have been gradually highlighting the relevant role that artificial intelligence has in inflammatory bowel diseases as *** aim of this review was to summarize the most recent evidence on the use of artificial intelligence in inflammatory bowel diseases in various contexts such as diagnosis,follow-up,treatment,prognosis,cancer surveillance,data collection,and ***,insights into the potential further developments in this field and their effects on future clinical practice were discussed.

关键词： Inflammatory bowel disease Artificial intelligence Machine learning Crohn’s disease Ulcerative colitis Computer-aided diagnosis

Artificial intelligence technologies for the detection of colorectal lesions: The future is now

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World Journal of Gastroenterology 2020年第37期26卷 5606-5616页

作者： Simona Attardo Viveksandeep Thoguluva Chandrasekar Marco Spadaccini roberta maselli Harsh K Patel Madhav Desai Antonio Capogreco Matteo Badalamenti Piera Alessia Galtieri Gaia Pellegatta Alessandro Fugazza Silvia Carrara Andrea Anderloni Pietro Occhipinti Cesare Hassan Prateek Sharma Alessandro Repici Department of Endoscopy and Digestive Disease AOU Maggiore della CaritàNovara 28100Italy Department of Gastroenterology and Hepatology Kansas City VA Medical CenterKansas CityMO 66045United States Department of Endoscopy Humanitas Research HospitalRozzano 20089Italy Department of Biomedical Sciences Humanitas UniversityRozzano 20089Italy Department of Internal Medicine Ochsner Clinic FoundationNew OrleansLA 70124United States Endoscopy Unit Nuovo Regina Margherita HospitalRoma 00153Italy

Several studies have shown a significant adenoma miss rate up to 35%during screening colonoscopy,especially in patients with diminutive *** use of artificial intelligence(AI)in colonoscopy has been gaining popularity by helping endoscopists in polyp detection,with the aim to increase their adenoma detection rate(ADR)and polyp detection rate(PDR)in order to reduce the incidence of interval *** efficacy of deep convolutional neural network(DCNN)-based AI system for polyp detection has been trained and tested in ex vivo settings such as colonoscopy still images or *** trials have evaluated the real-time efficacy of DCNN-based systems showing promising results in term of improved ADR and *** this review we reported data from the preliminary ex vivo experiences and summarized the results of the initial randomized controlled trials.

关键词： Endoscopy Colonoscopy Screening Surveillance Technology Quality Artificial intelligence

Endoscopic management of benign biliary strictures:Looking for the best stent to place

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World Journal of Clinical Cases 2023年第31期11卷 7521-7529页

作者： Matteo Colombo Edoardo Forcignanò Leonardo Da Rio Marco Spadaccini Marta Andreozzi Carmelo Marco Giacchetto Silvia Carrara roberta maselli Piera Alessia Galtieri Gaia Pellegatta Antonio Capogreco Davide Massimi Kareem Khalaf Cesare Hassan Andrea Anderloni Alessandro Repici Alessandro Fugazza Digestive Endoscopy Unit Division of GastroenterologyHumanitas Research HospitalRozzano 20089MilanItaly Department of Surgical Sciences University of TurinTorino 10124PiemonteItaly Department of Biomedical Sciences Humanitas UniversityPieve Emanuele 20089MilanItaly Division of Gastroenterology St.Michael’s HospitalUniversity of TorontoToronto M5B1T8OntarioCanada Endoscopy Unit First Department of Internal MedicineFondazione IRCCS Policlinico San MatteoUniversity of PaviaPavia 27100Italy

Benign biliary strictures(BBS)might occur due to different pancreaticobiliary *** etiology and location of biliary strictures are responsible of a wide array of clinical *** endoscopic approach endoscopic retrograde cholangiopancreatography represents the first-line treatment for BBS,considering interventional radiology and surgery when endoscopic treatment fails or it is not *** purpose of this review is to provide an overview of possible endoscopic treatments for the optimal management of this subset of patients.

关键词： Benign biliary strictures Endoscopic retrograde cholangiopancreatography Endoscopic management Biliary stent

Antisense therapy:a potential breakthrough in the treatment of neurodegenerative diseases

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Neural Regeneration Research 2024年第5期19卷 1027-1035页

作者： roberta Romano Cecilia Bucci Department of Biological and Environmental Sciences and Technologies(DiSTeBA) University of SalentoLecceItaly

Neurodegenerative diseases are a group of disorders characterized by the progressive degeneration of neurons in the central or peripheral nervous ***,there is no cure for neurodegenerative diseases and this means a heavy burden for patients and the health system ***,it is necessary to find new therapeutic approaches,and antisense therapies offer this possibility,having the great advantage of not modifying cellular genome and potentially being *** preclinical and clinical studies aim to test the safety and effectiveness of antisense therapies in the treatment of neurodegenerative *** objective of this review is to summarize the recent advances in the development of these new technologies to treat the most common neurodegenerative diseases,with a focus on those antisense therapies that have already received the approval of the *** and Drug Administration.

关键词： Alzheimer’s disease amyotrophic lateral sclerosis antisense oligonucleotide Huntington’s disease neurodegenerative disorders Parkinson’s disease siRNA

Role of endoscopic ultrasound in vascular interventions:Where are we now?

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World Journal of Gastrointestinal Endoscopy 2022年第6期14卷 354-366页

作者： Alessandro Fugazza Kareem Khalaf Matteo Colombo Silvia Carrara Marco Spadaccini Glenn Koleth Edoardo Troncone roberta maselli Alessandro Repici Andrea Anderloni Division of Gastroenterology and Digestive Endoscopy Department of GastroenterologyHumanitas Research HospitalRozzano 20089Italy Department of Biomedical Sciences Humanitas UniversityPieve Emanuele 20090Italy Department of Systems Medicine University of Rome"Tor Vergata"Roma 00133Italy

From a mere diagnostic tool to an imperative treatment modality,endoscopic ultrasound(EUS)has evolved and revolutionized safer efficient options for vascular *** it is an alternative treatment option in the management of gastrointestinal bleeding,primarily variceal type *** treatment option prior to EUS incorporation had limited efficiency and high adverse *** characterization and detail provided by EUS gives a cutting edge towards a holistically successful management *** indicates that EUS-guided combination therapy of coil embolization and glue injection has the higher efficacy for the treatment of ***,similar treatment options that exist for esophageal and other ectopic variceal bleeding was also *** conclusion,many studies refer that a combination therapy of coil and glue injection under EUS guidance provides higher technical success with fewer recurrence and adverse events,making its adaptation in the guideline extremely ***-hepatology is a novel disciple with a promising future outlook,we reviewed topics regarding portal vein access,pressure gradient measurement,and thrombus biopsy that are crucial interventions as alternative of radiological *** purpose of this review is to provide an update on the latest available evidence in the literature regarding the role of EUS in vascular *** reviewed the role of EUS in variceal bleeding in recent studies,especially gastric varices and novel approaches aimed at the portal vein.

关键词： Endoscopic ultrasound Cyanoacrylate Coil injection Gastric varices Gastrointestinal bleeding Vascular endoscopic treatments

Microvasculature of the esophagus and gastroesophageal junction: Lesson learned from submucosal endoscopy

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World Journal of Gastrointestinal Endoscopy 2016年第19期8卷 690-696页

作者： roberta maselli Haruhiro Inoue Haruo Ikeda Manabu Onimaru Akira Yoshida Esperanza Grace Santi Hiroki Sato Bu'Hussain Hayee Shin-Ei Kudo Digestive Disease Center Showa University Northern Yokohama Hospital Department of "Paride Stefanini" Surgical Umberto I° General HospitalSapienza University of Rome King's College Hospital NHSFT

Advanced therapeutic endoscopy,in particular endoscopic mucosal resection,endoscopic submucosal dissection,per-oral endoscopic myotomy,submucosal endoscopic tumor resection opened a new era where direct esophageal visualization is *** these information with advanced diagnostic endoscopy,the esophagus is organized,from the luminal side to outside,into five layers(epithelium,lamina propria with lamina muscularis mucosa,submucosa,muscle layer,adventitia).A specific vascular system belonging to each layer is thus visible: Mucosa with the intra papillary capillary loop in the epithelium and the sub-epithelial capillary network in the lamina propria and,at the lower esophageal sphincter(LES) level with the palisade vessels; submucosa with the drainage vessels and the spindle veins at LES level; muscle layer with the perforating vessels; periesophageal veins in *** structures are particularly important to define endoscopic landmark for the gastro-esophageal junction,helpful in performing submucosal therapeutic endoscopy.

关键词： Microvasculature Esophageal anatomy Submucosal endoscopy Per-oral endoscopic myotomy Advanced imaging