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Costa-Santos MP, Ferreira AO, Mouradides C, Pérez-Cuadrado-Robles E, Yeung R, Garcés-Duran R, Snauwaert C, Dano H, Piessevaux H, Deprez PH. Is Lugol necessary for endoscopic resection of esophageal squamous cell neoplasia? Endosc Int Open 2020; 8:E1471-E1477. [PMID: 33043116 PMCID: PMC7541178 DOI: 10.1055/a-1198-4316] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/22/2020] [Indexed: 12/27/2022] Open
Abstract
Background and study aims Recent evidence suggests that lugol chromoendoscopy (LCE) and narrow-band imaging (NBI) have comparable sensitivity for detection of superficial esophageal squamous cell carcinoma (SCC). However, LCE is time-consuming and associated with side effects. The aim of this study was to compare the effectiveness of NBI and LCE in defining resection margins of esophageal SCC. Patients and methods This was a retrospective observational cohort study of patients with esophageal SCC and dysplasia who underwent en-bloc resection between 1999 and 2017 at the Cliniques universitaires Saint-Luc, Brussels. Two groups were defined: 1) inspection with NBI only; and 2) inspection with LCE (with or without NBI). The primary endpoint was complete lateral resection rate. Multivariate regression was used to adjust for potential confounders. Results A total of 102 patients with 132 lesions were included. Lesions were inspected with LCE in 52 % (n = 68) and with NBI only in 48 % (n = 64). Lesions 0-IIa were more frequent in the NBI group (37 %) and 0-IIb (60 %) in LCE. Lesion location, size, and histology and resection technique (endoscopic submucosal dissection in 122/132 cases, 92 %) were similar between the groups. The rate of complete lateral resection for invasive carcinoma was 90 % in LCE group and 94 % in NBI group ( P = 0.498) and 65 % and 67 % ( P = 0.813), respectively, for dysplasia complete lateral resection. These results remained non-significant after adjusting for potential confounders. Conclusions Mucosal inspection and delineation of tumors with lugol chromoendoscopy before endoscopic resection of esophageal squamous cell lesions was not associated with increased complete lateral resection rate when compared to NBI.
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Affiliation(s)
| | | | - Christina Mouradides
- Gastroenterology and Hepatology Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Enrique Pérez-Cuadrado-Robles
- Gastroenterology and Hepatology Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Ralph Yeung
- Gastroenterology and Hepatology Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Rodrigo Garcés-Duran
- Gastroenterology and Hepatology Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Christophe Snauwaert
- Gastroenterology and Hepatology Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Hélène Dano
- Pathology Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Hubert Piessevaux
- Gastroenterology and Hepatology Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Pierre H. Deprez
- Gastroenterology and Hepatology Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Mouradides C, Taha A, Borbath I, Deprez PH, Moreels TG. How to treat intestinal obstruction due to malignant recurrence after Whipple’s resection for pancreatic head cancer: Description of 2 new endoscopic techniques. World J Gastroenterol 2017; 23:6181-6186. [PMID: 28970734 PMCID: PMC5597510 DOI: 10.3748/wjg.v23.i33.6181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 05/23/2017] [Accepted: 06/12/2017] [Indexed: 02/06/2023] Open
Abstract
The prognosis of pancreatic cancer remains poor, even after initial surgical therapy. Local recurrence after Whipple’s pancreatico-duodenectomy may lead to intestinal obstruction at the level of the afferent limb or the alimentary limb. Endoscopic insertion of a self-expandable metal stent (SEMS) into the intestinal malignant stricture is the preferred method of choice for palliation. We describe two new endoscopic techniques to treat a malignant intestinal obstruction with the insertion of a SEMS into the afferent limb and the alimentary limb. A case of malignant gastric outlet obstruction after a Whipple’s resection was treated by the creation of an endoscopic gastrojejunostomy by the insertion of a lumen apposing HotAxios stent in between the stomach and the alimentary limb under fluoroscopic and endoscopic ultrasound control. Biliary obstruction and jaundice caused by a malignant stricture of the afferent limb after a Roux-en-Y Whipple’s resection was treated by the insertion of a SEMS by means of the single-balloon overtube-assisted technique under fluoroscopic control. Feasibility and advantages of both techniques are discussed.
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MESH Headings
- Aged
- Anastomosis, Roux-en-Y/adverse effects
- Anastomosis, Roux-en-Y/methods
- Constriction, Pathologic/etiology
- Constriction, Pathologic/surgery
- Endoscopy, Digestive System/instrumentation
- Endoscopy, Digestive System/methods
- Endosonography/methods
- Feasibility Studies
- Female
- Fluoroscopy/methods
- Gastric Bypass/instrumentation
- Gastric Bypass/methods
- Gastric Outlet Obstruction/etiology
- Gastric Outlet Obstruction/surgery
- Humans
- Intestinal Obstruction/etiology
- Intestinal Obstruction/surgery
- Neoplasm Recurrence, Local/complications
- Neoplasm Recurrence, Local/pathology
- Neoplasm Recurrence, Local/surgery
- Palliative Care/methods
- Pancreatic Neoplasms/complications
- Pancreatic Neoplasms/pathology
- Pancreatic Neoplasms/surgery
- Pancreaticoduodenectomy/instrumentation
- Pancreaticoduodenectomy/methods
- Self Expandable Metallic Stents
- Ultrasonography, Interventional/methods
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Affiliation(s)
- Christina Mouradides
- Cliniques universitaires Saint-Luc, Hépato-Gastroentérologie, B-1200 Brussels, Belgium
| | - Alaa Taha
- Cliniques universitaires Saint-Luc, Hépato-Gastroentérologie, B-1200 Brussels, Belgium
| | - Ivan Borbath
- Cliniques universitaires Saint-Luc, Hépato-Gastroentérologie, B-1200 Brussels, Belgium
| | - Pierre H Deprez
- Cliniques universitaires Saint-Luc, Hépato-Gastroentérologie, B-1200 Brussels, Belgium
| | - Tom G Moreels
- Cliniques universitaires Saint-Luc, Hépato-Gastroentérologie, B-1200 Brussels, Belgium
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Affiliation(s)
| | - Alaa Taha
- Hépato-Gastroentérologie, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Tom G Moreels
- Hépato-Gastroentérologie, Cliniques universitaires Saint-Luc, Brussels, Belgium
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Mouradides C, Abbes L, Cellier C. Fleeting Gastrointestinal Thickening. Clin Gastroenterol Hepatol 2016; 14:A21-2. [PMID: 26707681 DOI: 10.1016/j.cgh.2015.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Revised: 12/03/2015] [Accepted: 12/12/2015] [Indexed: 02/07/2023]
Affiliation(s)
- Christina Mouradides
- Department of Gastroenterology and Endoscopy, European Georges Pompidou Hospital, Paris, France
| | - Leila Abbes
- Department of Gastroenterology and Endoscopy, European Georges Pompidou Hospital, Paris, France
| | - Christophe Cellier
- Department of Gastroenterology and Endoscopy, European Georges Pompidou Hospital, Paris, France
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Riachy M, Juvelikian G, Sleilaty G, Bazarbachi T, Khayat G, Mouradides C. Validation de la version arabe de l’échelle de somnolence d’Epworth : étude multicentrique. Rev Mal Respir 2012; 29:697-704. [DOI: 10.1016/j.rmr.2011.12.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Accepted: 12/01/2011] [Indexed: 10/28/2022]
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