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Non-optical polyp-based resect and discard strategy:A prospective clinical study

World Journal of Gastroenterology 2022年第19期28卷 2137-2147页

作者： Mahsa Taghiakbari Celia Hammar Mira Frenn Roupen Djinbachian Heiko Pohl Erik Deslandres simon bouchard Mickael Bouin Daniel von Renteln Department of Gastroenterology Montreal University Hospital Research Center(CRCHUM)Montréal H2X 0A9QuebecCanada Department of Gastroenterology University of MontrealFaculty of MedicineMontreal H2X 0A9QuebceCanada Department of Internal Medicine University of Montreal Hospital Center(CHUM)Montreal H2X 0A9QuebecCanada Department of Medicine Veterans Affairs Medical CenterWhite River JunctionVT 05009United States Department of Gastroenterology Dartmouth Geisel School of Medicine and The Dartmouth InstituteHanoverNH 03755United States

BACKGROUND Post-polypectomy surveillance intervals are currently determined based on pathology *** To evaluate a polyp-based resect and discard model that assigns surveillance intervals based solely on polyp number and *** Patients undergoing elective colonoscopies at the Montreal University Medical Center were enrolled *** polyp-based strategy was used to assign the next surveillance interval using polyp size and *** intervals were also assigned using optical diagnosis for small polyps(<10 mm).The primary outcome was surveillance interval agreement between the polyp-based model,optical diagnosis,and the pathology-based reference standard using the 2020 United States Multi-Society Task Force *** outcomes included the proportion of reduction in required histopathology evaluations and proportion of immediate post-colonoscopy recommendations provided to *** Of 944 patients(mean age 62.6 years,49.3%male,933 polyps)were *** surveillance interval agreement for the polyp-based strategy was 98.0%[95%confidence interval(CI):0.97-0.99]compared with pathology-based *** diagnosis-based intervals achieved 95.8%(95%CI:0.94-0.97)agreement with *** using the polyp-based strategy and optical diagnosis,the need for pathology assessment was reduced by 87.8%and 70.6%,*** polyp-based strategy provided 93.7%of patients with immediate surveillance interval recommendations vs 76.1%for optical *** The polyp-based strategy achieved almost perfect surveillance interval agreement compared with pathology-based assignments,significantly reduced the number of required pathology evaluations,and provided most patients with immediate surveillance interval recommendations.

关键词： Colonoscopy Colorectal pathology Colorectal adenomas Endoscopy Surveillance Optical diagnosis

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Video capsule endoscopy:Perspectives of a revolutionary technique

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World Journal of Gastroenterology 2014年第46期20卷 17330-17344页

作者： simon bouchard Mostafa Ibrahim Andre Van Gossum Department of Gastroenterology Hepatopancreatology and Digestive OncologyErasme HospitalULB1070 BrusselsBelgium Gastroenterology Department Theodor Bilahrz Research InstituteCairo 12411Egypt

Video capsule endoscopy(VCE)was launched in 2000and has revolutionized direct endoscopic imaging of the *** is now a first-line procedure for exploring the small bowel in cases of obscure digestive bleeding and is also indicated in some patients with Crohn’s disease,celiac disease,and polyposis syndrome.A video capsule has also been designed for visualizing the esophagus in order to detect Barrett’s esophagus or esophageal *** capsules are now available and differ with regard to dimensions,image acquisition rate,battery life,field of view,and possible optical *** recently,the use of VCE has been extended to exploring the *** the last 5 years,tremendous developments have been made toward increasing the capabilities of the colon *** colon capsule cannot be proposed as a first-line colorectal cancer screening procedure,colon capsule may be used in patients with incomplete colonoscopy or in patients who are unwilling to undergo *** the near future,new technological developments will improve the diagnostic yield of VCE and broaden its therapeutic capabilities.

关键词： Video capsule endoscopy Esophagus Small bowel Colo

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Relationship between clinical remission of perianal fistulas in Crohn’s disease and serum adalimumab concentrations:A multicenter cross-sectional study

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World Journal of Gastroenterology 2022年第9期28卷 961-972页

作者： Laura Sirmai Anne-Laure Pelletier Nathalie Gault Camille Zallot Guillaume Bouguen Dominique bouchard Pascale Roland Nicaise Marine Peyneau Sandrine Sironneau Marcelo De Carvalho Bittencourt Antoine Petitcollin Pedro Fernandez Xavier Roblin Laurent Siproudhis Laurent Abramowitz Division of Hepato-Gastroenterology and Digestive Oncology Bichat Claude Bernard University HospitalParis 75018France Division of Hepato-Gastroenterology Hospital Croix Saint SimonParis 75020France Division of Epidemiology Biostatistics and Clinical ResearchUniversity Hospital Center BichatParis 75018France National Institute of Health and Medical Research CIC-EC1425 University Hospital Center BichatParis 75018France Division of Gastroenterology Nancy Regional and University Hospital CenterNancy 54035France Imphy CIC 1414 Group and Division of Gastroenterology and Hepatology University Hospital of RennesPontchaillouRennes 35033France Division of Proctology Hospital BagatelleTalence 33400France Division of Immunology University Hospital Center BichatParis 75018France Inflammation Microbiome and ImmunosurveillanceFaculty of PharmacyUniversitéParis-SaclayChâtenay-Malabry 92290France Division of Radiology Bagatelle Hospital CenterTalence 33400France Division of Immunology Nancy Regional and University Hospital CenterNancy 54000France University of Lorraine CNRS UMR 7365IMoPANancy 54000France Antoine Petitcol Department of Clinical and Biological Pharmacology and Pharmacovigilance Pharmacoepidemiology and Drug Information CenterRennes University HospitalRennes 35700France Division of Radiology University Hospital Center BichatParis 75018France Orangerie Center Le Perreux-sur-Marne 94170France Division of Gastroenterology CHU Saint EtienneSaint-Priest-en-Jarez 42270France Division of Gastroenterology and Hepatology and Proctology University Hospital Center BichatParis 75018France Ramsay GDS Clinique Blomet Paris 75018France

BACKGROUND Crohn’s disease(CD)is complicated by perianal fistulas in approximately 20%of *** permanent fistula closure remains a challenge for *** association between serum anti-tumor necrosis factor-αconcentrations and clinical outcomes in patients with CD has been demonstrated;however,little information is available on serum adalimumab(ADA)concentrations and remission of perianal fistulas in such *** To study the relationship between serum ADA concentrations and clinical remission of CDassociated perianal *** This cross-sectional study of patients with CD-associated perianal fistulas treated with ADA was performed at four French hospitals between December 2013 and March *** the time of each serum ADA concentration measurement,we collected information about the patients and their *** primary study endpoint was clinical remission of fistulas defined as the absence of drainage(in accordance with Present’s criteria),with a PDAI≤4,absence of a seton and assessment of the overall evaluation as favorable by the proctologist at the relevant *** also assessed fistula healing[defined as being in clinical and radiological(magnetic resonance imaging,MRI)remission]and adverse *** The study cohort comprised 34 patients who underwent 56 evaluations(patients had between one and four evaluations).Fifteen patients had clinical remissions(44%),four of whom had healed fistulas on *** ADA concentrations were significantly higher at evaluations in which clinical remission was identified than at evaluations in which it was not[14(10-16)vs 10(2-15)μg/mL,P=0.01].Serum ADA concentrations were comparable at the times of evaluation of patients with and without healed fistulas[11(7-14)vs 10(4-16)μg/mL,P=0.69].The adverse event rate did not differ between different serum ADA *** We found a significant association between high serum ADA concentrations and clinical remission of CD-associated

关键词： Crohn’s disease Clinical pharmacology Peri-anal disorders Adalimumab

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