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Alfarone L, Albouys J, Legros R, Pioche M, Wallenhorst T, Geyl S, Jacques J. Endoscopic submucosal dissection of recurrent duodenal adenoma: combined use of multiple strategies for a difficult case. Endoscopy 2024; 56:E120-E121. [PMID: 38325414 PMCID: PMC10849840 DOI: 10.1055/a-2239-3182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Affiliation(s)
- Ludovico Alfarone
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
- Department of Gastroenterology, Humanitas Research Hospital, Milan, Italy
| | - Jérémie Albouys
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Romain Legros
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Lyon, France
| | - Timothée Wallenhorst
- Endoscopy and Gastroenterology Unit, Pontchaillou University Hospital, Rennes, France
| | - Sophie Geyl
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Jérémie Jacques
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
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Albouys J, Guilmoteau T, Schaefer M, Jacques J. How to prevent and treat biliary lumen-apposing metal stent dysfunction? Dig Endosc 2024; 36:492-494. [PMID: 38514464 DOI: 10.1111/den.14787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 02/18/2024] [Indexed: 03/23/2024]
Affiliation(s)
- Jérémie Albouys
- Department of Gastroenterology and Digestive Endoscopy, Dupuytren University Hospital, Limoges, France
| | - Thomas Guilmoteau
- Department of Digestive Medicine, Estaing University Hospital, Clermont-Ferrand, France
| | - Marion Schaefer
- Department of Gastroenterology and Digestive Endoscopy, Nancy University Hospital, Nancy, France
| | - Jérémie Jacques
- Department of Gastroenterology and Digestive Endoscopy, Dupuytren University Hospital, Limoges, France
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Albouys J, Manzah I, Schaefer M, Legros R, Masrour O, Henno S, Leclercq P, Dahan M, Guyot A, Charissoux A, Grainville T, Loustaud-Ratti V, Lepetit H, Geyl S, Carrier P, Pioche M, Wallenhorst T, Jacques J. Prevalence and clinical significance of the muscle retracting sign during endoscopic submucosal dissection of large macronodular colorectal lesions (with videos). Gastrointest Endosc 2024; 99:398-407. [PMID: 37866709 DOI: 10.1016/j.gie.2023.10.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 10/05/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND AND AIMS The muscle retracting sign (MRS) can be present during endoscopic submucosal dissection (ESD) of macronodular colorectal lesions. The prevalence of MRS and its pathologic and clinical implications is unclear. This study evaluated the effect of MRS on the technical and clinical outcomes of ESD. METHODS All patients referred for ESD of protruding lesions or granular mixed lesions with >10 mm macronodule granular mixed laterally spreading tumors (LST-GMs) in 2 academic centers from January 2017 to October 2022 were prospectively included. Size of the macronodule was analyzed retrospectively. The primary outcome was the curative resection rate according to MRS status. Secondary outcomes were R0 resection, perforation, secondary surgery rate, and risk factors for MRS. RESULTS Of 694 lesions, 84 (12%) had MRS (MRS+). The curative resection rate was decreased by MRS (MRS+ 41.6% vs lesions without MRS [MRS-] 81.3%), whereas the perforation (MRS+ 22.6% vs MRS- 9.2%), submucosal cancer (MRS+ 34.9% vs MRS- 9.2%), and surgery (MRS+ 45.2% vs MRS- 6%) rates were increased. The R0 resection rate of MRS+ colonic lesions was lower than that of rectal lesions (53% vs 74.3%). In multivariate analysis, protruding lesions (odds ratio, 2.47; 95% confidence interval, 1.27-4.80) and macronodules >4 cm (odds ratio, 4.24; 95% confidence interval, 2.23-8.05) were risk factors for MRS. CONCLUSIONS MRS reduces oncologic outcomes and increases the perforation rate. Consequently, procedures in the colon should be stopped if MRS is detected, and those in the rectum should be continued due to the morbidity of alternative therapy.
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Affiliation(s)
- Jérémie Albouys
- Service d'Hepato Gastro Entérologie et endoscopie digestive, CHU Dupuytren, Limoges, France.
| | - Imane Manzah
- Service d'Hepato Gastro Entérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Marion Schaefer
- Service d'Hepato Gastro Entérologie et endoscopie digestive, CHU de Nancy, Nancy, France
| | - Romain Legros
- Service d'Hepato Gastro Entérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Oumnia Masrour
- Service de gastroenterologie et endoscopie digestive, Centre hospitalier Universitaire Pontchaillou, Rennes, France
| | - Sebastien Henno
- Service d'anatomopathologie, Centre hospitalier Universitaire Pontchaillou, Rennes, France
| | - Philippe Leclercq
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, TARGID, Leuven and Clinique Montlegia, Liege, Belgium
| | - Martin Dahan
- Service de gastroenterologie et endoscopie digestive, Clinique mutualiste de Pessac, Pessac, France
| | - Anne Guyot
- Service d'anatomopathologie, Dupuytren University CHU Dupuytren, Limoges, France
| | - Aurélie Charissoux
- Service d'anatomopathologie, Dupuytren University CHU Dupuytren, Limoges, France
| | - Thomas Grainville
- Service de gastroenterologie et endoscopie digestive, Centre hospitalier Universitaire Pontchaillou, Rennes, France
| | | | - Hugo Lepetit
- Service d'Hepato Gastro Entérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Sophie Geyl
- Service d'Hepato Gastro Entérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Paul Carrier
- Service d'Hepato Gastro Entérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Service de gastroenterologie et endoscopie digestive, Hôpital universitaire Edouard Herriot, Lyon, France
| | - Timothee Wallenhorst
- Service de gastroenterologie et endoscopie digestive, Centre hospitalier Universitaire Pontchaillou, Rennes, France
| | - Jeremie Jacques
- Service d'Hepato Gastro Entérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
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Corre F, Albouys J, Tran VT, Lepilliez V, Ratone JP, Coron E, Lambin T, Rahmi G, Karsenti D, Canard JM, Chabrun E, Camus M, Wallenhorst T, Chevaux JB, Schaefer M, Gerard R, Rouquette A, Terris B, Coriat R, Jacques J, Barret M, Pioche M, Chaussade S, Cappelle E. Impact of surgery after endoscopically resected high-risk T1 colorectal cancer: results of an emulated target trial. Gastrointest Endosc 2024; 99:408-416.e2. [PMID: 37793506 DOI: 10.1016/j.gie.2023.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND AND AIMS We aimed to compare the long-term outcomes of patients with high-risk T1 colorectal cancer (CRC) resected endoscopically who received either additional surgery or surveillance. METHODS We used data from routine care to emulate a target trial aimed at comparing 2 strategies after endoscopic resection of high-risk T1 CRC: surgery with lymph node dissection (treatment group) versus surveillance alone (control group). All patients from 14 tertiary centers who underwent an endoscopic resection for high-risk T1 CRC between March 2012 and August 2019 were included. The primary outcome was a composite outcome of cancer recurrence or death at 48 months. RESULTS Of 197 patients included in the analysis, 107 were categorized in the treatment group and 90 were categorized in the control group. From baseline to 48 months, 4 of 107 patients (3.7%) died in the treatment group and 6 of 90 patients (6.7%) died in the control group. Four of 107 patients (3.7%) in the treatment group experienced a cancer recurrence and 4 of 90 patients (4.4%) in the control group experienced a cancer recurrence. After balancing the baseline covariates by inverse probability of treatment weighting, we found no significant difference in the rate of death and cancer recurrence between patients in the 2 groups (weighted hazard ratio, .95; 95% confidence interval, .52-1.75). CONCLUSIONS Our study suggests that patients with high-risk T1 CRC initially treated with endoscopic resection may not benefit from additional surgery.
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Affiliation(s)
- Félix Corre
- Department of Gastroenterology, Digestive Oncology and Endoscopy, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Cité University, Paris, France
| | - Jérémie Albouys
- Department of Gastroenterology and Endoscopy, Dupuytren University Hospital, Limoges, France
| | - Viet-Thi Tran
- Paris Cité University and Sorbonne Paris Nord University, INSERM, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Paris, France
| | | | | | - Emmanuel Coron
- Department of Gastroenterology and Hepatology, University Hospital of Geneva, Geneva, Switzerland; Digestive Diseases Institute, University Hospital of Nantes, Nantes, France
| | - Thomas Lambin
- Department of Gastroenterology and Endoscopy, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Gabriel Rahmi
- Department of Gastroenterology and Endoscopy, Georges Pompidou European Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | | | | | - Marine Camus
- Department of Endoscopy, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Timothée Wallenhorst
- Department of Gastroenterology, Pontchaillou University Hospital, Rennes, France
| | | | - Marion Schaefer
- Department of Gastroenterology, Brabois University Hospital, Nancy, France
| | - Romain Gerard
- Department of Gastroenterology, Claude Huriez Hospital, Lille, France
| | - Alexandre Rouquette
- Paris Cité University, Paris, France; Department of Pathology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Benoit Terris
- Paris Cité University, Paris, France; Department of Pathology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Romain Coriat
- Department of Gastroenterology, Digestive Oncology and Endoscopy, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Cité University, Paris, France
| | - Jérémie Jacques
- Department of Gastroenterology and Endoscopy, Dupuytren University Hospital, Limoges, France
| | - Maximilien Barret
- Department of Gastroenterology, Digestive Oncology and Endoscopy, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Cité University, Paris, France
| | - Mathieu Pioche
- Department of Gastroenterology and Endoscopy, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Stanislas Chaussade
- Department of Gastroenterology, Digestive Oncology and Endoscopy, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Cité University, Paris, France
| | - Elisabeth Cappelle
- Department of Gastroenterology, Digestive Oncology and Endoscopy, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; Paris Cité University, Paris, France
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Pioche M, Masgnaux LJ, Legros R, Wallenhorst T, Albouys J, Rivory J, Jacques J. Innovations for colonic endoscopic submucosal dissection: combination of the latest game changers. Endoscopy 2024; 56:242-243. [PMID: 38417429 PMCID: PMC10901623 DOI: 10.1055/a-2224-8465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Affiliation(s)
- Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Louis Jean Masgnaux
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Romain Legros
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | | | - Jérémie Albouys
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Jérôme Rivory
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jeremie Jacques
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
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Albouys J, Montori Pina S, Boukechiche S, Albéniz E, Vidal G, Legros R, Dahan M, Lepetit H, Pioche M, Schaefer M, Geyl S, Carrier P, Loustaud-Ratti V, Valgueblasse V, Brule C, Rodrigues R, Enguita German M, Jacques J. Risk of delayed bleeding after colorectal endoscopic submucosal dissection: the Limoges Bleeding Score. Endoscopy 2024; 56:110-118. [PMID: 37816392 DOI: 10.1055/a-2189-0807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
BACKGROUND Clinically significant delayed bleeding (CSDB) is a frequent, and sometimes severe, adverse event after colorectal endoscopic submucosal dissection (ESD). We evaluated risk factors of CSDB after colorectal ESD. METHODS We analyzed a prospective registry of 940 colorectal ESDs performed from 2013 to 2022. The incidence of bleeding was evaluated up to 30 days. Risk factors for delayed bleeding were evaluated by multivariate logistic regression. A Korean scoring model was tested, and a new risk-scoring model was developed and internally validated. RESULTS CSDB occurred in 75 patients (8.0%). The Korean score performed poorly in our cohort, with a receiver operating characteristic (ROC) curve of 0.567. In the multivariate analysis, risk factors were age ≥75 years (odds ratio [OR] 1.63; 95%CI 0.97-2.73; 1 point), use of antithrombotics (OR 1.72; 95%CI 1.01-2.94; 1 point), rectal location (OR 1.51; 95%CI 0.92-2.48; 1 point), size >50 mm (OR 3.67; 95%CI 2.02-7.14; 3 points), and American Society of Anesthesiologists (ASA) score of III or IV (OR 2.26; 95%CI 1.32-3.92; 2 points). The model showed fair calibration and good discrimination, with an area under the ROC curve of 0.751 (95%CI 0.690-0.812). The score was used to define two groups of patients, those with low-medium risk (0 to 4 points) and high risk (5 to 8 points) for CSDB (respective bleeding rates 4.1% and 17.5%). CONCLUSION A score based on five simple and meaningful variables was predictive of CSDB.
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Affiliation(s)
- Jérémie Albouys
- Hépato-gastro-entérology, Hopital Dupuytren, Limoges, France
| | - Sheyla Montori Pina
- Gastrointestinal Endoscopy Research Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | | | - Eduardo Albéniz
- IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Gastroenterology Department, Hospital Universitario de Navarra (HUN), Navarrabiomed, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Guillaume Vidal
- Hépato-gastro-entérologie, Hospital Dupuytren, Limoges, France
| | - Romain Legros
- Hépato-gastro-entérologie, Hospital Dupuytren, Limoges, France
| | - Martin Dahan
- Hépato-gastro-entérologie, Hospital Dupuytren, Limoges, France
| | - Hugo Lepetit
- Hépato-gastro-entérologie, Hospital Dupuytren, Limoges, France
| | | | - Marion Schaefer
- Hépato-gastro-entérology, Nancy University Hospital, Nancy, France
| | - Sophie Geyl
- Hépato-gastro-entérologie, Hospital Dupuytren, Limoges, France
| | - Paul Carrier
- Hépato-gastro-entérologie, Hospital Dupuytren, Limoges, France
| | | | | | | | | | - Monica Enguita German
- Methodology Unit, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Jérémie Jacques
- Hépato-gastro-entérologie, Hospital Dupuytren, Limoges, France
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Cheminel L, Lupu A, Wallenhorst T, Lepilliez V, Leblanc S, Albouys J, Abou Ali E, Barret M, Lorenzo D, De Mestier L, Burtin P, Girot P, Le Baleur Y, Gerard R, Yzet C, Tchirikhtchian K, Degand T, Culetto A, Lemmers A, Schaefer M, Chevaux JB, Zhong P, Hervieu V, Subtil F, Rivory J, Fine C, Jacques J, Walter T, Pioche M. Systematic Resection of the Visible Scar After Incomplete Endoscopic Resection of Rectal Neuroendocrine Tumors. Am J Gastroenterol 2024; 119:378-381. [PMID: 37734341 DOI: 10.14309/ajg.0000000000002516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/06/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION When initial resection of rectal neuroendocrine tumors (r-NETs) is not R0, persistence of local residue could lead to disease recurrence. This study aimed to evaluate the interest of systematic resection of non-R0 r-NET scars. METHODS Retrospective analysis of all the consecutive endoscopic revisions and resections of the scar after non-R0 resections of r-NETs. RESULTS A total of 100 patients were included. Salvage endoscopic procedure using endoscopic submucosal dissection or endoscopic full-thickness resection showed an R0 rate of near 100%. Residual r-NET was found in 43% of cases. DISCUSSION In case of non-R0 resected r-NET, systematic scar resection by endoscopic full-thickness resection or endoscopic submucosal dissection seems necessary.
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Affiliation(s)
- Loïc Cheminel
- Endoscopy and Gastroenterology Unit, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Alexandru Lupu
- Endoscopy and Gastroenterology Unit, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Timothée Wallenhorst
- Department of Endoscopy and Gastroenterology, Pontchaillou Hospital, Rennes University Hospital, Rennes, France
| | - Vincent Lepilliez
- Department of Endoscopy and Gastroenterology, Jean Mermoz Private Hospital, Ramsay Santé, Lyon, France
| | - Sarah Leblanc
- Department of Endoscopy and Gastroenterology, Jean Mermoz Private Hospital, Ramsay Santé, Lyon, France
| | - Jérémie Albouys
- Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
| | - Einas Abou Ali
- Department of Endoscopy and Gastroenterology, Cochin Hospital, APHP, Paris, France
| | - Maximilien Barret
- Department of Endoscopy and Gastroenterology, Cochin Hospital, APHP, Paris, France
| | - Diane Lorenzo
- Department of Endoscopy and Gastroenterology, Beaujon Hospital, APHP, Paris, France
| | - Louis De Mestier
- Department of Endoscopy and Gastroenterology, Beaujon Hospital, APHP, Paris, France
| | - Pascal Burtin
- Digestive Endoscopy Unit, Gustave Roussy Oncology Institute, Villejuif, France
| | - Paul Girot
- Department of Oncology, Loire Vendée Océan Hospital, La Roche sur Yon, France
| | - Yann Le Baleur
- Digestive Endoscopy Unit, Department of Gastroenterology, Paris Saint-joseph Hospital, Paris, France
| | - Romain Gerard
- Department of Digestive Diseases, Claude Huriez Hospital, Lille University Hospital, Lille, France
| | - Clara Yzet
- Endoscopy and Gastroenterology Unit, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | | | - Thibault Degand
- Department of Endoscopy and Gastroenterology, Dijon University Hospital, Dijon, France
| | - Adrian Culetto
- Department of Gastroenterology and Pancreatology, Rangueil University Hospital, Toulouse, France
| | - Arnaud Lemmers
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, CUB Erasme Hospital, Brussels, Belgium
| | - Marion Schaefer
- Endoscopy and Gastroenterology Unit, Brabois Hospitals, Nancy, France
| | | | - Peng Zhong
- Department of Endoscopy and Gastroenterology, Besançon Regional University Hospital, Besançon, France
| | | | - Fabien Subtil
- Service de Biostatistique, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Université Lyon 1, CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France
| | - Jérôme Rivory
- Endoscopy and Gastroenterology Unit, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Caroline Fine
- Department of Endoscopy and Gastroenterology, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France ; and
| | - Jérémie Jacques
- Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
| | - Thomas Walter
- Department of Medical Oncology, Pavillon E, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Mathieu Pioche
- Endoscopy and Gastroenterology Unit, Pavillon L, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
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8
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Guilmoteau T, Albouys J, Taibi A, Legros R, Schaefer M, Jacques J. Will Endoscopic-Ultrasound-Guided Choledocoduodenostomy with Electrocautery-Enhanced Lumen-Apposing Metal Stent Placement Replace Endoscopic Retrograde Cholangiopancreatography When Treating Distal Malignant Biliary Obstructions? Medicina (Kaunas) 2024; 60:220. [PMID: 38399508 PMCID: PMC10889952 DOI: 10.3390/medicina60020220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/09/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024]
Abstract
Malignant distal biliary obstructions are becoming increasingly common, especially in patients with cancers of the pancreatic head, despite progress in medical oncology research. ERCP is the current gold standard for management of such strictures, but the emergence of EC-LAMS has rendered EUS-CDS both safe and efficient. It is a "game changer"; originally intended for ERCP failure, two randomised clinical trials recently proposed EUS-CDS as a first-intent procedure in palliative settings. For resectable diseases, the absence of iatrogenic pancreatitis associated with a lower rate of postsurgical adverse events (compared with ERCP) leads us to believe that EUS-CDS might be used in first-intent as a pre-operative endoscopic biliary drainage.
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Affiliation(s)
- Thomas Guilmoteau
- Hepatogastroenterology, Centre Hospitalier Universitaire Dupuytren, 87000 Limoges, France; (T.G.); (J.A.); (A.T.); (R.L.)
| | - Jérémie Albouys
- Hepatogastroenterology, Centre Hospitalier Universitaire Dupuytren, 87000 Limoges, France; (T.G.); (J.A.); (A.T.); (R.L.)
| | - Abdelkader Taibi
- Hepatogastroenterology, Centre Hospitalier Universitaire Dupuytren, 87000 Limoges, France; (T.G.); (J.A.); (A.T.); (R.L.)
| | - Romain Legros
- Hepatogastroenterology, Centre Hospitalier Universitaire Dupuytren, 87000 Limoges, France; (T.G.); (J.A.); (A.T.); (R.L.)
| | - Marion Schaefer
- Hepatogastroenterology, Nancy Regional University Hospital Center, 54500 Nancy, France;
| | - Jérémie Jacques
- Hepatogastroenterology, Centre Hospitalier Universitaire Dupuytren, 87000 Limoges, France; (T.G.); (J.A.); (A.T.); (R.L.)
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9
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Jacques J, Schaefer M, Wallenhorst T, Rösch T, Lépilliez V, Chaussade S, Rivory J, Legros R, Chevaux JB, Leblanc S, Rostain F, Barret M, Albouys J, Belle A, Labrunie A, Preux PM, Lepetit H, Dahan M, Ponchon T, Crépin S, Marais L, Magne J, Pioche M. Endoscopic En Bloc Versus Piecemeal Resection of Large Nonpedunculated Colonic Adenomas : A Randomized Comparative Trial. Ann Intern Med 2024; 177:29-38. [PMID: 38079634 DOI: 10.7326/m23-1812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Endoscopic resection of adenomas prevents colorectal cancer, but the optimal technique for larger lesions is controversial. Piecemeal endoscopic mucosal resection (EMR) has a low adverse event (AE) rate but a variable recurrence rate necessitating early follow-up. Endoscopic submucosal dissection (ESD) can reduce recurrence but may increase AEs. OBJECTIVE To compare ESD and EMR for large colonic adenomas. DESIGN Participant-masked, parallel-group, superiority, randomized controlled trial. (ClinicalTrials.gov: NCT03962868). SETTING Multicenter study involving 6 French referral centers from November 2019 to February 2021. PARTICIPANTS Patients with large (≥25 mm) benign colonic lesions referred for resection. INTERVENTION The patients were randomly assigned by computer 1:1 (stratification by lesion location and center) to ESD or EMR. MEASUREMENTS The primary end point was 6-month local recurrence (neoplastic tissue on endoscopic assessment and scar biopsy). The secondary end points were technical failure, en bloc R0 resection, and cumulative AEs. RESULTS In total, 360 patients were randomly assigned to ESD (n = 178) or EMR (n = 182). In the primary analysis set (n = 318 lesions in 318 patients), recurrence occurred after 1 of 161 ESDs (0.6%) and 8 of 157 EMRs (5.1%) (relative risk, 0.12 [95% CI, 0.01 to 0.96]). No recurrence occurred in R0-resected cases (90%) after ESD. The AEs occurred more often after ESD than EMR (35.6% vs. 24.5%, respectively; relative risk, 1.4 [CI, 1.0 to 2.0]). LIMITATION Procedures were performed under general anesthesia during hospitalization in accordance with the French health system. CONCLUSION Compared with EMR, ESD reduces the 6-month recurrence rate, obviating the need for systematic early follow-up colonoscopy at the cost of more AEs. PRIMARY FUNDING SOURCE French Ministry of Health.
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Affiliation(s)
- Jérémie Jacques
- Hépato-Gastro-Entérologie, CHU de Limoges, Limoges, France (J.J., R.L., J.A., H.L., M.D.)
| | - Marion Schaefer
- Hépato-Gastro-Entérologie, CHRU de Nancy, Nancy, France (M.S., J.-B.C.)
| | | | - Thomas Rösch
- Department of Interdisciplinary Endoscopy, University Hospital, Hamburg-Eppendorf, Hamburg, Germany (T.R.)
| | - Vincent Lépilliez
- Hépato-Gastro-Entérologie, Hôpital Privé Jean Mermoz, Lyon, France (V.L., S.L.)
| | | | - Jérôme Rivory
- Hépato-Gastro-Entérologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France (J.R., F.R., T.P., M.P.)
| | - Romain Legros
- Hépato-Gastro-Entérologie, CHU de Limoges, Limoges, France (J.J., R.L., J.A., H.L., M.D.)
| | | | - Sarah Leblanc
- Hépato-Gastro-Entérologie, Hôpital Privé Jean Mermoz, Lyon, France (V.L., S.L.)
| | - Florian Rostain
- Hépato-Gastro-Entérologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France (J.R., F.R., T.P., M.P.)
| | - Maximilien Barret
- Hépato-Gastro-Entérologie, Hôpital Cochin, Paris, France (S.C., M.B., A.B.)
| | - Jérémie Albouys
- Hépato-Gastro-Entérologie, CHU de Limoges, Limoges, France (J.J., R.L., J.A., H.L., M.D.)
| | - Arthur Belle
- Hépato-Gastro-Entérologie, Hôpital Cochin, Paris, France (S.C., M.B., A.B.)
| | - Anaïs Labrunie
- Centre d'Epidémiologie de Biostatistiques et Méthodologie de la Recherche (CEBIMER), CHU de Limoges, Limoges, France (A.L., P.-M.P., J.M.)
| | - Pierre-Marie Preux
- Centre d'Epidémiologie de Biostatistiques et Méthodologie de la Recherche (CEBIMER), CHU de Limoges, Limoges, France (A.L., P.-M.P., J.M.)
| | - Hugo Lepetit
- Hépato-Gastro-Entérologie, CHU de Limoges, Limoges, France (J.J., R.L., J.A., H.L., M.D.)
| | - Martin Dahan
- Hépato-Gastro-Entérologie, CHU de Limoges, Limoges, France (J.J., R.L., J.A., H.L., M.D.)
| | - Thierry Ponchon
- Hépato-Gastro-Entérologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France (J.R., F.R., T.P., M.P.)
| | - Sabrina Crépin
- Service de Pharmacologie-Toxicologie et Pharmacovigilfance-Unité de Vigilance des Essais Cliniques, CHU de Limoges, Limoges, France (S.C.)
| | - Loïc Marais
- Direction de la Recherche et de l'Innovation, CHU de Limoges, Limoges, France (L.M.)
| | - Julien Magne
- Centre d'Epidémiologie de Biostatistiques et Méthodologie de la Recherche (CEBIMER), CHU de Limoges, Limoges, France (A.L., P.-M.P., J.M.)
| | - Mathieu Pioche
- Hépato-Gastro-Entérologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France (J.R., F.R., T.P., M.P.)
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Pioche M, Masgnaux LJ, Legros R, Wallenhorst T, Albouys J, Rivory J, Jacques J. Innovations for colonic endoscopic submucosal dissection: combination of the latest game changers. Endoscopy 2023; 55:E1172-E1173. [PMID: 37984396 PMCID: PMC10659825 DOI: 10.1055/a-2191-5546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Affiliation(s)
- Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Louis Jean Masgnaux
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Romain Legros
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | | | - Jérémie Albouys
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Jérôme Rivory
- Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jeremie Jacques
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
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Schaefer M, Albouys J, Geyl S, Legros R, Pioche M, Chevaux JB, Jacques J. Multitraction with a single rubber band and clips: a simple tip for endoscopic submucosal dissection of a recurrent lesion with previous clip. Endoscopy 2023; 55:E815-E816. [PMID: 37321265 PMCID: PMC10270749 DOI: 10.1055/a-2094-9919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Marion Schaefer
- Department of Hepatogastroenterology, Regional University Hospital of Nancy, Nancy, France
| | - Jérémie Albouys
- Department of Hepatogastroenterology, Dupuytren Hospital, Limoges, France
| | - Sophie Geyl
- Department of Hepatogastroenterology, Dupuytren Hospital, Limoges, France
| | - Romain Legros
- Department of Hepatogastroenterology, Dupuytren Hospital, Limoges, France
| | - Mathieu Pioche
- Department of Endoscopy and Hepatogastroenterology, Edouard Herriot Hospital, Lyon, France
| | - Jean-Baptiste Chevaux
- Department of Hepatogastroenterology, Regional University Hospital of Nancy, Nancy, France
| | - Jérémie Jacques
- Department of Hepatogastroenterology, Dupuytren Hospital, Limoges, France
- BioEM, XLim, UMR 7252, CNRS, Limoges, France
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Schaefer M, Albouys J, Geyl S, Legros R, Wallenhorst T, Pioche M, Jacques J. Endoscopic intermuscular dissection of a residual rectal neuroendocrine tumor with high-pressure injection and double-clip traction. Endoscopy 2023; 55:E1126-E1127. [PMID: 37935431 PMCID: PMC10630080 DOI: 10.1055/a-2173-7103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Affiliation(s)
- Marion Schaefer
- Hepatogastroenterology, Nancy Regional University Hospital Center, Nancy, France
| | | | - Sophie Geyl
- Hepatogastroenterology, Dupuytren Hospital, Limoges, France
| | - Romain Legros
- Hepatogastroenterology, Dupuytren Hospital, Limoges, France
| | | | - Mathieu Pioche
- Endoscopy and Gastroenterology, Edouard Herriot Hospital, Lyon, France
| | - Jérémie Jacques
- Hepatogastroenterology, Dupuytren Hospital, Limoges, France
- BioEM, XLim, UMR 7252, CNRS, Limoges, France
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Yzet C, Le Baleur Y, Albouys J, Jacques J, Doumbe-Mandengue P, Barret M, Abou Ali E, Schaefer M, Chevaux JB, Leblanc S, Lepillez V, Privat J, Degand T, Wallenhorst T, Rivory J, Chaput U, Berger A, Aziz K, Rahmi G, Coron E, Kull E, Caillo L, Vanbiervliet G, Koch S, Subtil F, Pioche M. Use of endoscopic submucosal dissection or full-thickness resection device to treat residual colorectal neoplasia after endoscopic resection: a multicenter historical cohort study. Endoscopy 2023; 55:1002-1009. [PMID: 37500072 DOI: 10.1055/a-2116-9930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
INTRODUCTION : Residual colorectal neoplasia (RCN) after previous endoscopic mucosal resection is a frequent challenge. Different management techniques are feasible including endoscopic full-thickness resection using the full-thickness resection device (FTRD) system and endoscopic submucosal dissection (ESD). We aimed to compare the efficacy and safety of these two techniques for the treatment of such lesions. METHODS : All consecutive patients with RCN treated either using the FTRD or by ESD were retrospectively included in this multicenter study. The primary outcome was the R0 resection rate, defined as an en bloc resection with histologically tumor-free lateral and deep margins. RESULTS : 275 patients (median age 70 years; 160 men) who underwent 177 ESD and 98 FTRD procedures for RCN were included. R0 resection was achieved in 83.3 % and 77.6 % for ESD and FTRD, respectively (P = 0.25). Lesions treated by ESD were however larger than those treated by FTRD (P < 0.001). The R0 rates for lesions of 20-30 mm were 83.9 % and 57.1 % in the ESD and FTRD groups, respectively, and for lesions of 30-40 mm were 93.6 % and 33.3 %, respectively. On multivariable analysis, ESD procedures were associated with statistically higher en bloc and R0 resection rates after adjustment for lesion size (P = 0.02 and P < 0.001, respectively). The adverse event rate was higher in the ESD group (16.3 % vs. 5.1 %), mostly owing to intraoperative perforations. CONCLUSION: ESD is effective in achieving R0 resection for RCN whatever the size and location of the lesions. When residual lesions are smaller than 20 mm, the FTRD is an effective alternative.
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Affiliation(s)
- Clara Yzet
- Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Yann Le Baleur
- Endoscopy and Gastroenterology Unit, Hospital Saint Joseph, Paris, France
| | - Jérémie Albouys
- Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
| | - Jérémie Jacques
- Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
| | - Paul Doumbe-Mandengue
- Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
| | - Maximilien Barret
- Endoscopy and Gastroenterology Unit, Cochin University Hospital, Paris, France
| | - Einas Abou Ali
- Endoscopy and Gastroenterology Unit, Cochin University Hospital, Paris, France
| | - Marion Schaefer
- Endoscopy and Gastroenterology Unit, Nancy University Hospital, Nancy, France
| | | | - Sarah Leblanc
- Department of Endoscopy and Gastroenterology, Hôpital Privé Jean Mermoz, Lyon, France
| | - Vincent Lepillez
- Department of Endoscopy and Gastroenterology, Hôpital Privé Jean Mermoz, Lyon, France
| | - Jocelyn Privat
- Endoscopy and Gastroenterology Unit, Vichy Hospital, Vichy, France
| | - Thibault Degand
- Endoscopy and Gastroenterology Unit, Dijon University Hospital, Dijon, France
| | - Timothée Wallenhorst
- Endoscopy and Gastroenterology Unit, Pontchaillou University Hospital, Rennes, France
| | - Jérôme Rivory
- Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Ulriikka Chaput
- Endoscopy and Gastroenterology Unit, Saint-Antoine University Hospital, Paris, France
| | - Arthur Berger
- Endoscopy and Gastroenterology Unit, Bordeaux University Hospital, Bordeaux, France
| | - Karim Aziz
- Endoscopy and Gastroenterology Unit, Saint Brieuc Hospital, Saint Brieuc, France
| | - Gabriel Rahmi
- Endoscopy and Gastroenterology Unit, Georges Pompidou European Hospital, Paris, France
| | - Emmanuel Coron
- Department of Gastroenterology and Hepatology, University Hospital of Geneva (HUG), Geneva, Switzerland
- Digestive Diseases Institute, University Hospital Nantes, Nantes, France
| | - Eric Kull
- Endoscopy and Gastroenterology Unit, Metz Hospital, Metz, France
| | - Ludovic Caillo
- Endoscopy and Gastroenterology Unit, Nîmes University Hospital, Nîmes, France
| | | | - Stéphane Koch
- Endoscopy and Gastroenterology Unit, Besançon University Hospital, Besançon, France
| | - Fabien Subtil
- Biostatistics Unit, Hospices Civils de Lyon, Université de Lyon, Université Claude Bernard Lyon 1, CNRS, and Laboratoire de Biométrie et Biologie Évolutive, Lyon, France
| | - Mathieu Pioche
- Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
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Figueiredo M, Yzet C, Wallenhorst T, Rivory J, Rostain F, Schaefer M, Chevaux JB, Leblanc S, Lépilliez V, Corre F, Rahmi G, Jacques J, Albouys J, Pioche M. Endoscopic submucosal dissection of appendicular lesions is feasible and safe: a retrospective multicenter study (with video). Gastrointest Endosc 2023; 98:634-638. [PMID: 37380005 DOI: 10.1016/j.gie.2023.06.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/01/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND AND AIMS Endoscopic submucosal dissection (ESD) is challenging for appendicular lesions. We report the outcomes of ESD in this context. METHODS We collected data of ESD procedures for appendiceal neoplasia in a multicenter prospective registry. Main study endpoints were R0, en-bloc, and curative resection rates and adverse event rate. RESULTS One hundred twelve patients were included, 47 (42%) with previous appendectomy. Fifty-six (50%) were Toyonaga type 3 lesions (15 [13.4%] postappendectomy). En-bloc and R0 resection rates were 86.6% and 80.4%, respectively, with no significant difference associated with different grades of appendiceal invasion (P = .9 and P = .4, respectively) or previous appendectomy (P = .3 for both). The curative resection rate was 78.6%. Additional surgery was performed in 16 cases (14.3%), including 10 (62.5%) Toyonaga type 3 lesions (P = .04). This included the treatment of 5 cases (4.5%) of delayed perforation and 1 acute appendicitis. CONCLUSIONS ESD for appendicular lesions is a potentially safer and effective alternative to surgery for a significant proportion of patients.
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Affiliation(s)
- Mariana Figueiredo
- Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Clara Yzet
- Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Timothée Wallenhorst
- Endoscopy and Gastroenterology Unit, Pontchaillou University Hospital, Rennes, France
| | - Jérôme Rivory
- Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Florian Rostain
- Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Marion Schaefer
- Endoscopy and Gastroenterology Unit, Nancy University Hospital, Nancy, France
| | | | - Sarah Leblanc
- Department of Endoscopy and Gastroenterology, Hôpital Privé Jean Mermoz, Lyon, France
| | - Vincent Lépilliez
- Department of Endoscopy and Gastroenterology, Hôpital Privé Jean Mermoz, Lyon, France
| | - Felix Corre
- Endoscopy and Gastroenterology Unit, Hôpital Cochin, Paris, France
| | - Gabriel Rahmi
- Gastroenterology and Endoscopy Unit, Hôpital Européen Georges Pompidou, Paris, France
| | - Jérémie Jacques
- Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
| | - Jérémie Albouys
- Department of Endoscopy and Gastroenterology, Dupuytren University Hospital, Limoges, France
| | - Mathieu Pioche
- Endoscopy and Gastroenterology Unit, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
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Geyl S, Albouys J, Schaefer M, Jacques J. Should colorectal endoscopic submucosal dissection defects be closed just because we can? Endoscopy 2023; 55:977. [PMID: 37757800 DOI: 10.1055/a-2077-5034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Affiliation(s)
- Sophie Geyl
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Albouys
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Marion Schaefer
- Service d'Hépato-gastro-entérologie, CHU Nancy, Nancy, France
| | - Jérémie Jacques
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
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Albouys J, Schaefer M, Pioche M, Jacques J. Large rectal laterally spreading lesions are more likely to contain submucosal cancer: Do we have the correct perspective? Gastrointest Endosc 2023; 98:471. [PMID: 37597943 DOI: 10.1016/j.gie.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 08/21/2023]
Affiliation(s)
- Jérémie Albouys
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Marion Schaefer
- Service d'Hépato-gastro-entérologie, CHU Nancy, Nancy, France
| | - Mathieu Pioche
- Service d'Hépato-gastro-entérologie, Hôpital Édouard Herriot, Lyon, France
| | - Jérémie Jacques
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
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Simonnot M, Deprez PH, Pioche M, Albuisson E, Wallenhorst T, Caillol F, Koch S, Coron E, Archambeaud I, Jacques J, Basile P, Caillo L, Degand T, Lepilliez V, Grandval P, Culetto A, Vanbiervliet G, Camus Duboc M, Gronier O, Leal C, Albouys J, Chevaux JB, Barret M, Schaefer M. Endoscopic resection of early esophageal tumors in patients with cirrhosis or portal hypertension: a multicenter observational study. Endoscopy 2023; 55:785-795. [PMID: 37137331 DOI: 10.1055/a-2085-3964] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Liver cirrhosis and esophageal cancer share several risk factors, such as alcohol intake and excess weight. Endoscopic resection is the gold standard treatment for superficial tumors. Portal hypertension and coagulopathy may increase the bleeding risk in these patients. This study aimed to assess the safety and efficacy of endoscopic resection for early esophageal neoplasia in patients with cirrhosis or portal hypertension. METHODS This retrospective multicenter international study included consecutive patients with cirrhosis or portal hypertension who underwent endoscopic resection in the esophagus from January 2005 to March 2021. RESULTS 134 lesions in 112 patients were treated, including by endoscopic submucosal dissection in 101 cases (75 %). Most lesions (128/134, 96 %) were in patients with liver cirrhosis, with esophageal varices in 71 procedures. To prevent bleeding, 7 patients received a transjugular intrahepatic portosystemic shunt, 8 underwent endoscopic band ligation (EBL) before resection, 15 received vasoactive drugs, 8 received platelet transfusion, and 9 underwent EBL during the resection procedure. Rates of complete macroscopic resection, en bloc resection, and curative resection were 92 %, 86 %, and 63 %, respectively. Adverse events included 3 perforations, 8 delayed bleedings, 8 sepsis, 6 cirrhosis decompensations within 30 days, and 22 esophageal strictures; none required surgery. In univariate analysis, cap-assisted endoscopic mucosal resection was associated with delayed bleeding (P = 0.01). CONCLUSIONS In patients with liver cirrhosis or portal hypertension, endoscopic resection of early esophageal neoplasia appeared to be effective and should be considered in expert centers with choice of resection technique, following European Society of Gastrointestinal Endoscopy guidelines to avoid undertreatment.
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Affiliation(s)
- Mathilde Simonnot
- Department of Gastroenterology, Nancy Regional University Hospital Center, Nancy, France
| | - Pierre H Deprez
- Hepatogastroenterology Department, Cliniques universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Mathieu Pioche
- Gastroenterology Department, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Eliane Albuisson
- DRCI, Department MPI, Data management and Statistics UMDS, Nancy Regional University Hospital Center , Nancy, France
| | - Timothée Wallenhorst
- Department of Gastroenterology, Pontchaillou University Hospital, Rennes, France
| | - Fabrice Caillol
- Endoscopy Unit, Paoli-Calmettes Institute, Marseille, France
| | - Stéphane Koch
- Department of Gastroenterology, Besançon Regional University Hospital Center, Besançon, France
| | - Emmanuel Coron
- Institut de Maladies de l'Appareil Digestif, Hotêl Dieu University Hospital Center, Nantes, France
| | - Isabelle Archambeaud
- Institut de Maladies de l'Appareil Digestif, Hotêl Dieu University Hospital Center, Nantes, France
| | - Jérémie Jacques
- Hepato-Gastroenterology Department, Dupuytren University Hospital, Limoges, France
| | - Paul Basile
- Digestive Endoscopy Unit, Gastroenterology Department, University Hospital of Rouen, Rouen, France
| | - Ludovic Caillo
- Gastroenterology Department, University Hospital of Nîmes, Nîmes, France
| | - Thibault Degand
- Division of Gastroenterology, Dijon Bourgogne University Hospital, Dijon, France
| | | | - Philippe Grandval
- Hepatogastroenterology Department, AP-HM, Hôpital La Timone, Marseille, France
| | - Adrian Culetto
- Department of Gastroenterology, Toulouse University Hospital, Toulouse, France
| | | | | | - Olivier Gronier
- Department of Gastroenterology and Hepatology, Clinique Sainte Barbe, Strasbourg, France
| | - Carina Leal
- Hepatogastroenterology Department, Cliniques universitaires St-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Jérémie Albouys
- Hepato-Gastroenterology Department, Dupuytren University Hospital, Limoges, France
| | - Jean-Baptiste Chevaux
- Department of Gastroenterology, Nancy Regional University Hospital Center, Nancy, France
| | | | - Marion Schaefer
- Department of Gastroenterology, Nancy Regional University Hospital Center, Nancy, France
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Schaefer M, Albouys J, Jacques J. Measurement of colorectal polyp size: End of a long-running story? Endosc Int Open 2023; 11:E349-E350. [PMID: 37077664 PMCID: PMC10110356 DOI: 10.1055/a-2036-7533] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Affiliation(s)
- Marion Schaefer
- Department of Hepatology and Gastroenterology, Regional University Hospital of Nancy, Nancy, France
| | - Jérémie Albouys
- Department of Endoscopy and Gastroenterology, Centre Hospitalier Universitaire Dupuytren, Limoges, France
| | - Jérémie Jacques
- Department of Endoscopy and Gastroenterology, Centre Hospitalier Universitaire Dupuytren, Limoges, France
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Geyl S, Redelsperger B, Yzet C, Napoleon B, Legros R, Dahan M, Lepetit H, Ginestet C, Jacques J, Albouys J. Risk factors for stent dysfunction during long-term follow-up after EUS-guided biliary drainage using lumen-apposing metal stents: A prospective study. Endosc Ultrasound 2023; 12:237-244. [PMID: 36891940 PMCID: PMC10237614 DOI: 10.4103/eus-d-22-00120] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 10/09/2022] [Indexed: 03/10/2023] Open
Abstract
Background EUS-guided choledoco-duodenostomy using electrocautery-enhanced lumen-apposing metal stents (ECE-LAMS) is becoming the gold standard in case of endoscopic retrograde cholangio-pancreatography failure for distal malignant obstruction. Long-term data in larger samples are lacking. Methods This was a prospective monocentric study including all patients who underwent EUS-guided choledochoduodenostomy (CDS) between September 2016 and December 2021. The primary endpoint was the rate of biliary obstruction during follow-up. Secondary endpoints were technical and clinical success rates, adverse event rates, and identification of risk factors for biliary obstruction. Results One hundred and twenty-three EUS-guided CDS using ECE-LAMS were performed at Limoges University Hospital were performed during the study period and included in the study. The main cause of obstruction was pancreatic adenocarcinoma in 91 (74.5%) cases. The technical and clinical success rates were 97.5% and 91%, respectively. Twenty patients (16.3%) suffered from biliary obstructions during a mean follow-up of 242 days. The clinical success rate for endoscopic desobstruction was 80% (16/20). In uni- and multivariate analyses, only the presence of a duodenal stent (odds ratio [OR]: 3.6, 95% confidence interval [CI] 95%: 1.2-10.2; P = 0.018) and a bile duct thinner than 15 mm (OR: 3.9, CI 95%: 1.3-11.7; P = 0.015) were the significant risk factors for biliary obstruction during the follow-up. Conclusion Obstruction of LAMS occurred in 16.3% of cases during follow-up and endoscopic desobstruction is efficacious in 80% of cases. The presence of duodenal stent and a bile duct thinner than 15 mm are the risk factors of obstruction. Except in these situation, EUS-CDS with ECE-LAMS could be proposed in the first intent in case of distal malignant obstruction.
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Affiliation(s)
- Sophie Geyl
- Department of Gastroenterology, Limoges University Hospital, Limoges, France
| | | | - Clara Yzet
- Department of Gastroenterology, Amiens University Hospital, Amiens, France
| | - Bertrand Napoleon
- Department of Gastroenterology, Private Hospital Jean-Mermoz, Lyon, France
| | - Romain Legros
- Department of Gastroenterology, Limoges University Hospital, Limoges, France
| | - Martin Dahan
- Department of Gastroenterology, Limoges University Hospital, Limoges, France
| | - Hugo Lepetit
- Department of Gastroenterology, Limoges University Hospital, Limoges, France
| | - Claire Ginestet
- Department of Gastroenterology, Limoges University Hospital, Limoges, France
| | - Jérémie Jacques
- Department of Gastroenterology, Limoges University Hospital, Limoges, France
| | - Jérémie Albouys
- Department of Gastroenterology, Limoges University Hospital, Limoges, France
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20
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Masson E, Ewers M, Paliwal S, Kume K, Scotet V, Cooper DN, Rebours V, Buscail L, Rouault K, Abrantes A, Aguilera Munoz L, Albouys J, Alric L, Amiot X, Archambeaud I, Audiau S, Bastide L, Baudon J, Bellaiche G, Bellon S, Bertrand V, Bideau K, Billiemaz K, Billioud C, Bonnefoy S, Borderon C, Bournet B, Breton E, Brugel M, Buscail L, Cadiot G, Camus M, Carpentier-Pourquier M, Chamouard P, Chaput U, Chen JM, Cholet F, Ciocan DM, Clavel C, Coffin B, Coimet-Berger L, Cosconea S, Creveaux I, Culetto A, Daboussi O, De Mestier L, Degand T, D'engremont C, Denis B, Dermine S, Drouet D'Aubigny A, Enaud R, Fabre A, Férec C, Gargot D, Gelsi E, Gentilcore E, Gincul R, Ginglinger-Favre E, Giovannini M, Gomercic C, Gondran H, Grainville T, Grandval P, Grasset D, Grimaldi S, Grimbert S, Hagege H, Heissat S, Hentic O, Herber-Mayne A, Hervouet M, Hoibian S, Jacques J, Jais B, Kaassis M, Koch S, Lacaze E, Lacroute J, Lamireau T, Laurent L, Le Guillou X, Le Rhun M, Leblanc S, Levy P, Lievre A, Lorenzo D, Maire F, Marcel K, Masson E, Mauillon J, Morgant S, Moussata D, Muller N, Nambot S, Napoleon B, Olivier A, Pagenault M, Pelletier AL, Pennec O, Pinard F, Pioche M, Prost B, Queneherve L, Rebours V, Reboux N, Rekik S, Riachi G, Rohmer B, Roquelaure B, Rosa Hezode I, Rostain F, Saurin JC, Servais L, Stan-Iuga R, Subtil C, Tanneche J, Texier C, Thomassin L, Tougeron D, Vuitton L, Wallenhorst T, Wangerme M, Zanaldi H, Zerbib F, Bhaskar S, Kikuta K, Rao GV, Hamada S, Reddy DN, Masamune A, Chandak GR, Witt H, Férec C, Chen JM. The PRSS3P2 and TRY7 deletion copy number variant modifies risk for chronic pancreatitis. Pancreatology 2023; 23:48-56. [PMID: 36517351 DOI: 10.1016/j.pan.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND PRSS1 and PRSS2 constitute the only functional copies of a tandemly-arranged five-trypsinogen-gene cluster (i.e., PRSS1, PRSS3P1, PRSS3P2, TRY7 and PRSS2) on chromosome 7q35. Variants in PRSS1 and PRSS2, including missense and copy number variants (CNVs), have been reported to predispose to or protect against chronic pancreatitis (CP). We wondered whether a common trypsinogen pseudogene deletion CNV (that removes two of the three trypsinogen pseudogenes, PRSS3P2 and TRY7) might be associated with CP causation/predisposition. METHODS We analyzed the common PRSS3P2 and TRY7 deletion CNV in a total of 1536 CP patients and 3506 controls from France, Germany, India and Japan by means of quantitative fluorescent multiplex polymerase chain reaction. RESULTS We demonstrated that the deletion CNV variant was associated with a protective effect against CP in the French, German and Japanese cohorts whilst a trend toward the same association was noted in the Indian cohort. Meta-analysis under a dominant model yielded a pooled odds ratio (OR) of 0.68 (95% confidence interval (CI) 0.52-0.89; p = 0.005) whereas an allele-based meta-analysis yielded a pooled OR of 0.84 (95% CI 0.77-0.92; p = 0.0001). This protective effect is explicable by reference to the recent finding that the still functional PRSS3P2/TRY7 pseudogene enhancers upregulate pancreatic PRSS2 expression. CONCLUSIONS The common PRSS3P2 and TRY7 deletion CNV was associated with a reduced risk for CP. This finding provides additional support for the emerging view that dysregulated PRSS2 expression represents a discrete mechanism underlying CP predisposition or protection.
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Affiliation(s)
- Emmanuelle Masson
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France; Service de Génétique Médicale et de Biologie de la Reproduction, CHRU Brest, F-29200, Brest, France
| | - Maren Ewers
- Paediatric Nutritional Medicine & Else Kröner-Fresenius-Centre for Nutritional Medicine (EKFZ), Technical University Munich (TUM), Freising, Germany
| | - Sumit Paliwal
- Genomic Research on Complex Diseases (GRC Group), CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Kiyoshi Kume
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Virginie Scotet
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France
| | - David N Cooper
- Institute of Medical Genetics, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Vinciane Rebours
- Pancreatology and Digestive Oncology Department, Beaujon Hospital, APHP - Clichy, Université Paris Cité, Paris, France
| | - Louis Buscail
- Department of Gastroenterology and Pancreatology, CHU Rangueil and University of Toulouse, Toulouse, France
| | - Karen Rouault
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France; Service de Génétique Médicale et de Biologie de la Reproduction, CHRU Brest, F-29200, Brest, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marc Hervouet
- Hôpital d'instruction des Armées Percy, Clamart, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Seema Bhaskar
- Genomic Research on Complex Diseases (GRC Group), CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Kazuhiro Kikuta
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Shin Hamada
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Atsushi Masamune
- Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Giriraj Ratan Chandak
- Genomic Research on Complex Diseases (GRC Group), CSIR-Centre for Cellular and Molecular Biology, Hyderabad, India
| | - Heiko Witt
- Paediatric Nutritional Medicine & Else Kröner-Fresenius-Centre for Nutritional Medicine (EKFZ), Technical University Munich (TUM), Freising, Germany
| | - Claude Férec
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France
| | - Jian-Min Chen
- Univ Brest, Inserm, EFS, UMR 1078, GGB, F-29200, Brest, France.
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21
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Geyl S, Olivier R, Pioche M, Dahan M, Legros R, Albouys J, Jacques J. Clip-induced esophageal perforation during endoscopic submucosal dissection: the perfect is the enemy of the good! Endoscopy 2022; 54:E693. [PMID: 35180789 DOI: 10.1055/a-1750-9054] [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] [Indexed: 12/13/2022]
Affiliation(s)
- Sophie Geyl
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Raphael Olivier
- Service d'Hépato-gastro-entérologie, CHU de Poitiers, Poitiers, France
| | - Mathieu Pioche
- Service d'Hépato-gastro-entérologie, Hôpital Edouard Herriot, CHU Lyon, France
| | - Martin Dahan
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Romain Legros
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Albouys
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Jacques
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France.,BioEM, XLim, UMR 7252, CNRS, Limoges, France
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22
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Geyl S, Albouys J, Schaefer M, Lepetit H, Legros R, Pioche M, Jacques J. Is endoscopic mucosal resection optimum for treating colonic angiodysplasia? Endoscopy 2022; 54:1233-1234. [PMID: 35180788 DOI: 10.1055/a-1750-9105] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Sophie Geyl
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Albouys
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Marion Schaefer
- Service d'Hépato-gastro-entérologie, CHU de Poitiers, Poitiers, France
| | - Hugo Lepetit
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Romain Legros
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Service d'Hépato-gastro-entérologie, Hôpital Edouard Herriot, CHU Lyon, France
| | - Jérémie Jacques
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France.,BioEM, XLim, UMR 7252, CNRS, Limoges
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23
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Albouys J, Geyl S, Lambin T, Legros R, Charissoux A, Pioche M, Jacques J. Diagnosis of an unexpected colonic submucosal lesion by double-clip traction endoscopic submucosal dissection. Endoscopy 2022; 55:E240-E241. [PMID: 36410401 PMCID: PMC9831777 DOI: 10.1055/a-1941-8301] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Jérémie Albouys
- Department of Endoscopy and Gastroenterology, Centre Hospitalier Universitaire Dupuytren, Limoges, France
| | - Sophie Geyl
- Department of Endoscopy and Gastroenterology, Centre Hospitalier Universitaire Dupuytren, Limoges, France
| | - Thomas Lambin
- Department of Endoscopy and Hepatogastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Romain Legros
- Department of Endoscopy and Gastroenterology, Centre Hospitalier Universitaire Dupuytren, Limoges, France
| | - Aurélie Charissoux
- Anatomopathology, Centre Hospitalier Universitaire Dupuytren, Limoges, France
| | - Mathieu Pioche
- Department of Endoscopy and Hepatogastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Jérémie Jacques
- Department of Endoscopy and Gastroenterology, Centre Hospitalier Universitaire Dupuytren, Limoges, France
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24
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Oung B, Albouys J, Geyl S, Legros R, Lambin T, Pioche M, Jacques J. "Spider traction" endoscopic submucosal dissection for colonic lesion. Endoscopy 2022; 54:E560-E561. [PMID: 34911115 DOI: 10.1055/a-1694-3066] [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] [Indexed: 12/10/2022]
Affiliation(s)
- Borathchakra Oung
- Department of Gastroenterology and Digestive Endoscopy, Calmette Hospital, Phnom Penh, Cambodia
| | - Jérémie Albouys
- Service d'Hépato-gastro-entérologie, Dupuytren University Hospital, Limoges, France
| | - Sophie Geyl
- Service d'Hépato-gastro-entérologie, Dupuytren University Hospital, Limoges, France
| | - Romain Legros
- Service d'Hépato-gastro-entérologie, Dupuytren University Hospital, Limoges, France
| | - Thomas Lambin
- Service d'Hépato-gastro-entérologie, Dupuytren University Hospital, Limoges, France
| | - Mathieu Pioche
- Department of Endoscopy and Gastroenterology, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Jérémie Jacques
- Service d'Hépato-gastro-entérologie, Dupuytren University Hospital, Limoges, France
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25
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Labonde A, Lades G, Debourdeau A, Ragi O, Lehmann L, Vitton V, Barthet M, Legros R, Albouys J, Geyl S, Loustaud-Ratti V, Monteil J, Gonzalez S, Gonzalez JM, Jacques J. Gastric peroral endoscopic myotomy in refractory gastroparesis: long-term outcomes and predictive score to improve patient selection. Gastrointest Endosc 2022; 96:500-508.e2. [PMID: 35413333 DOI: 10.1016/j.gie.2022.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 04/03/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Limited data exist concerning the long-term efficiency of gastric peroral endoscopic myotomy (G-POEM) as a treatment of refractory gastroparesis. This study evaluated the 3-year results of G-POEM in patients with refractory gastroparesis. METHODS This was a prospective multicenter study of all G-POEM operations performed in 2 expert French centers for 46 patients with refractory gastroparesis with at least 3 years of follow-up. RESULTS Clinical success was 65.2% at 36 months. There was significant improvement in symptom severity. Median Gastroparesis Cardinal Symptom Index decreased from 3.33 to 1.80 (P < .0001), with improvement in all subscales. We created a predictive score concerning G-POEM success (G-POEM predictive score) to which points were assigned as follows: nausea subscale <2: predictive of success, 1 point; satiety subscale >4: predictive of success, 1 point; bloating subscale >3.5: predictive of success, 1 point; percentage of gastric retention at 4 hours on scintigraphy >50%: 1 point. A threshold of 2 was identified by receiver operating characteristic curve analysis with an area under the curve of .825 that predicted clinical success with a sensitivity of 93.3% (95% confidence interval [CI], .77-.99), specificity of 56.3% (95% CI, .33-.77), positive predictive value of 80% (95% CI, .67-.93), negative predictive value of 81.8% (95% CI, .59-1.00), and accuracy of 80.4% (95% CI, .69-.92). Patients with a score ≥2 were significantly more likely to be responders at 3 years than were patients with a score <2 (80% and 18%, respectively; P = .0004). CONCLUSIONS The clinical success of G-POEM for refractory gastroparesis was 65.2% at 36 months. Our predictive score offers an easy tool that needs to be confirmed in other studies.
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Affiliation(s)
- Amélie Labonde
- Service d'Hépato-gastro-entérologie, CHU Limoges, Limoges, France
| | | | - Antoine Debourdeau
- Service d'Hépato-gastro-entérologie, CHU Montpellier, Montpellier, France
| | - Olivier Ragi
- Service d'Hépato-gastro-entérologie, CHU Lyon, Lyon, France
| | - Lauriane Lehmann
- Service d'Hépato-gastro-entérologie, Polyclinique de Limoges, Limoges, France
| | - Véronique Vitton
- Service d'Hépato-gastro-entérologie, APHM Hôpital Nord, Marseille, France
| | - Marc Barthet
- Service d'Hépato-gastro-entérologie, APHM Hôpital Nord, Marseille, France
| | - Romain Legros
- Service d'Hépato-gastro-entérologie, CHU Limoges, Limoges, France
| | - Jérémie Albouys
- Service d'Hépato-gastro-entérologie, CHU Limoges, Limoges, France
| | - Sophie Geyl
- Service d'Hépato-gastro-entérologie, CHU Limoges, Limoges, France
| | | | - Jacques Monteil
- Service d'Hépato-gastro-entérologie, CHU Limoges, Limoges, France
| | - Sandra Gonzalez
- Service de médecine nucléaire, APHM Hôpital Nord, Marseille, France
| | | | - Jérémie Jacques
- Service d'Hépato-gastro-entérologie, CHU Limoges, Limoges, France.
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26
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Lambin T, Albouys J, Yzet C, Brun S, Rostain F, Rivory J, Pioche M. Endoscopic submucosal dissection of a lateral spreading tumor involving the appendiceal orifice using a multi-traction device. Endoscopy 2022; 54:E425-E426. [PMID: 34496432 DOI: 10.1055/a-1581-7411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
- Thomas Lambin
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France.,Inserm U1032, Labtau, Lyon, France
| | - Jérémie Albouys
- Gastroenterology and Endoscopy Unit, CHU Dupuytren, Limoges, France
| | - Clara Yzet
- Department of Gastroenterology, Amiens University Hospital, Amiens, France
| | - Soline Brun
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Florian Rostain
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Jérôme Rivory
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France.,Inserm U1032, Labtau, Lyon, France
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27
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Schaefer M, Leclerc J, Albouys J, Lambin T, Jacques J, Fouquet T, Chevaux JB. Double-scope rendezvous technique: a safe way to perform an endoscopic ultrasound-guided ileorectal anastomosis after complete stenosis. Endoscopy 2022; 54:E429-E430. [PMID: 34496439 DOI: 10.1055/a-1560-2199] [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] [Indexed: 12/10/2022]
Affiliation(s)
- Marion Schaefer
- Department of Hepatogastroenterology, Regional University Hospital of Nancy, Nancy, France
| | - Julie Leclerc
- Department of Digestive Surgery, Regional University Hospital of Nancy, Nancy, France
| | - Jérémie Albouys
- Department of Hepatogastroenterology, Dupuytren Hospital, Limoges, France
| | - Thomas Lambin
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Jérémie Jacques
- Department of Hepatogastroenterology, Dupuytren Hospital, Limoges, France.,BioEM, XLim, UMR 7252, CNRS, Limoges, France
| | - Thibaut Fouquet
- Department of Digestive Surgery, Regional University Hospital of Nancy, Nancy, France
| | - Jean-Baptiste Chevaux
- Department of Hepatogastroenterology, Regional University Hospital of Nancy, Nancy, France
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28
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Albouys J, Geyl S, Thomas L, Kaighobadi T, Legros R, Pioche M, Jacques J. Double-clip traction endoscopic submucosal dissection: an interesting alternative method for the resection of pedunculated polyps. Endoscopy 2022; 54:E929-E930. [PMID: 35790180 PMCID: PMC9736899 DOI: 10.1055/a-1841-5513] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Jérémie Albouys
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Sophie Geyl
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Lambin Thomas
- Unité d’endoscopie digestive, service de Gastroentérologie pavillon H, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Thibault Kaighobadi
- Gastroenterologie et endoscopie digestive, Clinique Croix du Sud, Toulouse, France
| | - Romain Legros
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Unité d’endoscopie digestive, service de Gastroentérologie pavillon H, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
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29
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Geyl S, Schaefer M, Pioche M, Dahan M, Legros R, Albouys J, Jacques J. Cold-snare endoscopic mucosal resection of large duodenal laterally spreading tumors: is cold the future gold standard? Endoscopy 2022; 54:E894-E895. [PMID: 35777374 PMCID: PMC9735399 DOI: 10.1055/a-1841-5607] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Sophie Geyl
- Service d’Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Marion Schaefer
- Service d’Hépato-gastro-entérologie, CHU de Nancy, Nancy, France
| | - Mathieu Pioche
- Service d’Hépato-gastro-entérologie, Hôpital Edouard Herriot, CHU Lyon, France
| | - Martin Dahan
- Service d’Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Romain Legros
- Service d’Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Albouys
- Service d’Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Jacques
- Service d’Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France,BioEM, XLim, UMR 7252, CNRS, Limoges, France
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Doumbe-Mandengue P, Geyl S, Guyot A, Pioche M, Rodrigues R, Albouys J, Jacques J. Underwater endoscopic mucosal resection for a protruding lesion in the esophagus. Endoscopy 2022; 54:E869-E870. [PMID: 35750074 PMCID: PMC9735341 DOI: 10.1055/a-1847-7235] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Paul Doumbe-Mandengue
- Department of Gastroenterology and Hepatology, University Hospital Dupuytren, Limoges, France
| | - Sophie Geyl
- Department of Gastroenterology and Hepatology, University Hospital Dupuytren, Limoges, France
| | - Anne Guyot
- Department of Pathology, University Hospital Dupuytren, Limoges, France
| | - Mathieu Pioche
- Department of Gastroenterology and Hepatology, University Hospital Edouard Herriot, Lyon, France
| | - Rebecca Rodrigues
- Department of Gastroenterology and Hepatology, University Hospital Dupuytren, Limoges, France
| | - Jérémie Albouys
- Department of Gastroenterology and Hepatology, University Hospital Dupuytren, Limoges, France
| | - Jérémie Jacques
- Department of Gastroenterology and Hepatology, University Hospital Dupuytren, Limoges, France
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Lambin T, Yzet C, Albouys J, Lafeuille P, Rostain F, Rivory J, Pioche M. Endoscopic submucosal dissection of a subepithelial neuroendocrine tumor located in the duodenum using a countertraction technique. Endoscopy 2022; 54:E230-E231. [PMID: 34058754 DOI: 10.1055/a-1492-2362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Thomas Lambin
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France.,Inserm U1032, Labtau, Lyon, France
| | - Clara Yzet
- Department of Gastroenterology, Amiens University Hospital, Amiens, France
| | - Jérémie Albouys
- Gastroenterology and Endoscopy Unit, CHU Dupuytren, Limoges, France
| | - Pierre Lafeuille
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Florian Rostain
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Jérôme Rivory
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France
| | - Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, France.,Inserm U1032, Labtau, Lyon, France
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32
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Albouys J, Geyl S, Redelsperger B, Loustaud-Ratti V, Legros R, Pioche M, Jacques J. Double-pigtail plastic stent is effective as a rescue therapy after obstruction of choledochoduodenostomy using a lumen-apposing metal stent. Endoscopy 2022; 54:E184-E185. [PMID: 33979849 DOI: 10.1055/a-1471-1444] [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] [Indexed: 12/10/2022]
Affiliation(s)
- Jérémie Albouys
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Sophie Geyl
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | | | | | - Romain Legros
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Unité d'endoscopie digestive, Service de Gastroentérologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
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33
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Olivier R, Scheer S, Albouys J, Schaefer M, Taibi A, Geyl S, Jacques J. Rescue lumen-apposing metal stent to treat a perforation secondary to balloon dilation of a Crohn's disease stenosis. Endoscopy 2022; 54:E197-E198. [PMID: 33979862 DOI: 10.1055/a-1463-2333] [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] [Indexed: 12/10/2022]
Affiliation(s)
- Raphael Olivier
- Poitiers University Hospital Center, Hepato-Gastroenterology Department, Poitiers, France
| | - Stéphane Scheer
- Poitiers University Hospital Center, Hepato-Gastroenterology Department, Poitiers, France
| | - Jérémie Albouys
- Limoges University Hospital Center, Hepato-Gastroenterology Department, Limoges, France
| | - Marion Schaefer
- Nancy University Hospital Center, Hepato-Gastroenterology Department, Nancy, France
| | - Abdelkader Taibi
- Limoges University Hospital Center, Hepato-Gastroenterology Department, Limoges, France
| | - Sophie Geyl
- Limoges University Hospital Center, Hepato-Gastroenterology Department, Limoges, France
| | - Jérémie Jacques
- Limoges University Hospital Center, Hepato-Gastroenterology Department, Limoges, France
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34
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Geyl S, Albouys J, Legros R, Lepetit H, Dahan M, Pioche M, Jacques J. Sessile serrated adenoma invading a diverticulum in the right colon: tips and tricks for a safe complete endoscopic resection. Endoscopy 2022; 54:E170-E171. [PMID: 33910246 DOI: 10.1055/a-1463-2045] [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] [Indexed: 12/10/2022]
Affiliation(s)
- Sophie Geyl
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Albouys
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Romain Legros
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Hugo Lepetit
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Martin Dahan
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Service d'Hépato-gastro-entérologie, Hôpital Édouard Herriot, Lyon, France
| | - Jérémie Jacques
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
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35
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Bordillon P, Pioche M, Wallenhorst T, Rivory J, Legros R, Albouys J, Lepetit H, Rostain F, Dahan M, Ponchon T, Sautereau D, Loustaud-Ratti V, Geyl S, Jacques J. Double-clip traction for colonic endoscopic submucosal dissection: a multicenter study of 599 consecutive cases (with video). Gastrointest Endosc 2021; 94:333-343. [PMID: 33548280 DOI: 10.1016/j.gie.2021.01.036] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 01/24/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Colonic endoscopic submucosal dissection (ESD) is particularly challenging and limited to a few expert centers. We recently conducted a pilot study on improvement of colonic ESD with systematic use of a countertraction device (double-clip traction with rubber band [DCT-ESD]). METHODS A French prospective multicenter study was conducted between March 2017 and September 2019, including all consecutive cases of naive colonic ESD. Since the first case of DCT-ESD in March 2017, all cases of colonic ESD have been performed using the DCT-ESD strategy in the 3 centers involved in the study. RESULTS Five hundred ninety-nine lesions with a mean size of 53 mm were included in this study, resected by 5 operators in 3 centers. The en bloc, R0, and curative resection rates were 95.7%, 83.5%, and 81.1%, respectively. The adverse event rates were 4.9% for perforation and 4.2% for postprocedure bleeding. Between 2017 and 2019, the rates of R0 and curative resections increased significantly from 74.7% in 2017 to 88.4% in 2019 (P = .003) and from 72.6% in 2017 to 86.3% in 2019 (P = .004), respectively. Procedure duration and speed of resection were 62.4 minutes and 39.4 mm2/minute, respectively. No differences were noted between operators. CONCLUSION DCT-ESD is a safe and reproducible technique, with results comparable with those of the large Japanese teams with speed of resection twice as high as previously reported studies. The DCT strategy is promising, cheap, and seems to be reproducible. Physicians performing colonic ESD should be aware of this promising tool to improve their results in ESD.
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Affiliation(s)
- Pierre Bordillon
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Service d'Hépato-gastro-entérologie, CHU Edouard Herriot, Lyon, France
| | | | - Jérôme Rivory
- Service d'Hépato-gastro-entérologie, CHU Edouard Herriot, Lyon, France
| | - Romain Legros
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Albouys
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Hugo Lepetit
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Florian Rostain
- Service d'Hépato-gastro-entérologie, CHU Edouard Herriot, Lyon, France
| | - Martin Dahan
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Thierry Ponchon
- Service d'Hépato-gastro-entérologie, CHU Edouard Herriot, Lyon, France
| | - Denis Sautereau
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | | | - Sophie Geyl
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Jacques
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
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36
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Héroin L, Rivory J, Ponchon T, Legros R, Albouys J, Chaussade S, Gronier O, Reimund JM, Fabacher T, Sautereau D, Dumeirain F, Pioche M, Jacques J. Video clips compared with high-definition still images for characterization of colorectal neoplastic lesions: a randomized comparative prospective study. Endosc Int Open 2021; 9:E1255-E1263. [PMID: 34447873 PMCID: PMC8383078 DOI: 10.1055/a-1487-5628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 12/17/2020] [Accepted: 03/14/2021] [Indexed: 12/15/2022] Open
Abstract
Background and study aims Accurate real-time characterization of colorectal neoplastic lesions (CNLs) during colonoscopy is important for deciding appropriate treatment. No studies have evaluated whether still images or video clips are better for characterization. We compared histological predictions and size estimations of CNLs between two groups of gastroenterologists: one viewing still images and the other viewing video clips. Materials and methods Participants were shown 20 CNLs as either 3-5 still images or a video clip. Three endoscopy experts obtained the images using high-definition white light and virtual chromoendoscopy without magnification. Stratified randomization was performed according to experience. For each lesion, participants assessed the size and histological subtype according to the CONECCT classification (hyperplastic polyp [IH], sessile serrated lesion [IS], adenoma [IIA], high-risk adenoma or superficial adenocarcinoma [IIC], or deeply invasive adenocarcinoma [III]). The correct histological status and size were defined by the pathology reports or combined criteria between histology and expert opinion for high-risk adenoma or superficial adenocarcinoma (CONECCT IIC). Results 332 participants were randomized and 233 performed the characterization. Participants comprised 118 residents, 75 gastroenterologists, and 40 endoscopy experts; 47.6 % were shown still images and 52.4 % viewed video clips. There was no statistically significant difference between the two groups in histological prediction, our primary end point. However, the lesion size was better assessed using still images than video clips ( P = 0.03). Conclusions Video clips did not improve the histological prediction of CNLs compared with still images. Size was better assessed using still images.
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Affiliation(s)
- Lucile Héroin
- Department of Gastroenterology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jérôme Rivory
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Thierry Ponchon
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Romain Legros
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Jérémie Albouys
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | | | - Olivier Gronier
- Endoscopy and Gastroenterology Unit, Clinique Sainte Barbe, Groupe Hospitalier Saint-Vincent, Strasbourg, France
| | - Jean-Marie Reimund
- Department of Gastroenterology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Thibaut Fabacher
- Department of Public Health, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Denis Sautereau
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Franck Dumeirain
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Mathieu Pioche
- Endoscopy and Gastroenterology Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
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Taibi A, Perrin ML, Albouys J, Jacques J, Yardin C, Durand-Fontanier S, Bardet SM. 10 ns PEFs induce a histological response linked to cell death and cytotoxic T-lymphocytes in an immunocompetent mouse model of peritoneal metastasis. Clin Transl Oncol 2021; 23:1220-1237. [PMID: 33677709 DOI: 10.1007/s12094-020-02525-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The application of nanosecond pulsed electric fields (nsPEFs) could be an effective therapeutic strategy for peritoneal metastasis (PM) from colorectal cancer (CRC). The aim of this study was to evaluate in vitro the sensitivity of CT-26 CRC cells to nsPEFs in combination with chemotherapeutic agents, and to observe the subsequent in vivo histologic response. METHODS In vitro cellular assays were performed to assess the effects of exposure to 1, 10, 100, 500 and 1000 10 ns pulses in a cuvette or bi-electrode system at 10 and 200 Hz. nsPEF treatment was applied alone or in combination with oxaliplatin and mitomycin. Cell death was detected by flow cytometry, and permeabilization and intracellular calcium levels by fluorescent confocal microscopy after treatment. A mouse model of PM was used to investigate the effects of in vivo exposure to pulses delivered using a bi-electrode system; morphological changes in mitochondria were assessed by electron microscopy. Fibrosis was measured by multiphoton microscopy, while the histological response (HR; hematoxylin-eosin-safran stain), proliferation (KI67, DAPI), and expression of immunological factors (CD3, CD4, CD8) were evaluated by classic histology. RESULTS 10 ns PEFs exerted a dose-dependent effect on CT-26 cells in vitro and in vivo, by inducing cell death and altering mitochondrial morphology after plasma membrane permeabilization. In vivo results indicated a specific CD8+ T cell immune response, together with a strong HR according to the Peritoneal Regression Grading Score (PRGS). CONCLUSIONS The effects of nsPEFs on CT-26 were confirmed in a mouse model of CRC with PM.
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Affiliation(s)
- A Taibi
- Digestive Surgery Department, Limoges University Hospital, Limoges, France.,Univ. Limoges, CNRS, XLIM, UMR 7252, 87000, Limoges, France
| | - M-L Perrin
- Univ. Limoges, CNRS, XLIM, UMR 7252, 87000, Limoges, France
| | - J Albouys
- Univ. Limoges, CNRS, XLIM, UMR 7252, 87000, Limoges, France.,Gastroenterology Department, Limoges University Hospital, Limoges, France
| | - J Jacques
- Univ. Limoges, CNRS, XLIM, UMR 7252, 87000, Limoges, France.,Gastroenterology Department, Limoges University Hospital, Limoges, France
| | - C Yardin
- Univ. Limoges, CNRS, XLIM, UMR 7252, 87000, Limoges, France.,Cytology and Histology Department, Limoges University Hospital, Limoges, France
| | - S Durand-Fontanier
- Digestive Surgery Department, Limoges University Hospital, Limoges, France.,Univ. Limoges, CNRS, XLIM, UMR 7252, 87000, Limoges, France
| | - S M Bardet
- Univ. Limoges, CNRS, XLIM, UMR 7252, 87000, Limoges, France.
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38
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Albouys J, Geyl S, Rodrigues R, Loustaud-Ratti V, Legros R, Pioche M, Jacques J. An unexpected diagnosis of undetermined biliary stenosis via endoscopic ultrasound. Endoscopy 2021; 53:E31-E32. [PMID: 32483778 DOI: 10.1055/a-1173-8067] [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] [Indexed: 12/10/2022]
Affiliation(s)
- Jérémie Albouys
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Sophie Geyl
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Rebecca Rodrigues
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | | | - Romain Legros
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Unité d'endoscopie digestive, service de Gastroentérologie - Pavillon H, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
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39
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Albouys J, Geyl S, Charissoux A, Loustaud-Ratti V, Legros R, Pioche M, Jacques J. A hematoma caused by an excessively superficial injection: go under the red bleb! Endoscopy 2021; 53:E1-E2. [PMID: 32428948 DOI: 10.1055/a-1167-1115] [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] [Indexed: 12/10/2022]
Affiliation(s)
- Jérémie Albouys
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Sophie Geyl
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | | | | | - Romain Legros
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Unité d'endoscopie digestive, service de Gastroentérologie - pavillon H, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
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40
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Albouys J, Geyl S, Guyot A, Charissoux A, Legros R, Pioche M, Jacques J. Endoscopic submucosal dissection with double-clip traction for recurrent adenoma. Endoscopy 2020; 52:E439-E440. [PMID: 32396950 DOI: 10.1055/a-1158-8518] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Jérémie Albouys
- Gastroentérologie et Endoscopie Digestive, CHU Dupuytren, Limoges, France
| | - Sophie Geyl
- Gastroentérologie et Endoscopie Digestive, CHU Dupuytren, Limoges, France
| | - Anne Guyot
- Anatomopathologie, CHU Dupuytren, Limoges, France
| | | | - Romain Legros
- Gastroentérologie et Endoscopie Digestive, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Unité d'Endoscopie Digestive, Service de Gastroentérologie, Pavillon H, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroentérologie et Endoscopie Digestive, CHU Dupuytren, Limoges, France
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41
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Forté E, Petit B, Walter T, Lépilliez V, Vanbiervliet G, Rostain F, Barsic N, Albeniz E, Gete GG, Gabriel JCM, Cuadrado-Tiemblo C, Ratone JP, Jacques J, Wallenhorst T, Subtil F, Albouys J, Giovannini M, Chaussade S, Landel V, Ponchon T, Saurin JC, Barret M, Pioche M. Risk of neoplastic change in large gastric hyperplastic polyps and recurrence after endoscopic resection. Endoscopy 2020; 52:444-453. [PMID: 32120411 DOI: 10.1055/a-1117-3166] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gastric hyperplastic polyps (GHPs) have a risk of neoplastic transformation reaching 5 %. Current endoscopic resection techniques appear suboptimal with a high risk of local recurrence. This study assessed the outcomes of endoscopic resection for GHPs and identified risk factors for recurrence and neoplastic transformation. METHODS This retrospective, multicenter, European study included adult patients with at least one GHP ≥ 10 mm who underwent endoscopic resection and at least one follow-up endoscopy. Patients with recurrent GHPs or hereditary gastric polyposis were excluded. All data were retrieved from the endoscopy, pathology, and hospitalization reports. RESULTS From June 2007 to August 2018, 145 GHPs in 108 patients were included. Recurrence after endoscopic resection was 51.0 % (74 /145) in 55 patients. R0 resection or en bloc resection did not impact the risk of polyp recurrence. In multivariate analysis, cirrhosis was the only risk factor for recurrence (odds ratio [OR] 4.82, 95 % confidence interval [CI] 1.33 - 17.46; P = 0.02). Overall, 15 GHPs (10.4 %) showed neoplastic transformation, with size > 25 mm (OR 10.24, 95 %CI 2.71 - 38.69; P < 0.001) and presence of intestinal metaplasia (OR 5.93, 95 %CI 1.56 - 22.47; P = 0.01) being associated with an increased risk of neoplastic transformation in multivariate analysis. CONCLUSIONS Results confirmed the risk of recurrence and neoplastic transformation of large GHPs. The risk of neoplastic change was significantly increased for lesions > 25 mm, with a risk of high grade dysplasia appearing in polyps ≥ 50 mm. The risk of recurrence was high, particularly in cirrhosis patients, and long-term follow-up is recommended in such patients.
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Affiliation(s)
- Emmanuel Forté
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Lyon, France
| | - Bérénice Petit
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Lyon, France
| | - Thomas Walter
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - Vincent Lépilliez
- Hôpital Privé Jean Mermoz, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Lyon, France
| | - Geoffroy Vanbiervliet
- Hôpital Archet, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Nice, France
| | - Florian Rostain
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Lyon, France
| | - Neven Barsic
- Department of Gastroenterology and Hepatology, Sisters of Charity University Hospital, Zagreb, Croatia
| | - Eduardo Albeniz
- Complejo Hospitalario de Navarra, Endoscopy Unit and Gastroenterology Department, Pamplona, Spain.,Navarrabiomed Biomedical Research Center, University of Navarra, IdiSNA, Pamplona, Spain
| | - Gonzalo Gonzalez Gete
- Complejo Hospitalario de Navarra, Endoscopy Unit and Gastroenterology Department, Pamplona, Spain.,Navarrabiomed Biomedical Research Center, University of Navarra, IdiSNA, Pamplona, Spain
| | - Jose Carlos Marín Gabriel
- "12 de Octubre" University Hospital, Digestive Disease and Endoscopy Unit, "i+12" Research Institute, Madrid, Spain
| | - Cristina Cuadrado-Tiemblo
- "12 de Octubre" University Hospital, Digestive Disease and Endoscopy Unit, "i+12" Research Institute, Madrid, Spain
| | - Jean-Philippe Ratone
- Institut Paoli-Calmettes, Service d'Oncologie et d'Endoscopie Digestives, Marseille, France
| | - Jérémie Jacques
- Centre Hospitalier Universitaire Dupuytren, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Limoges, France
| | - Timothée Wallenhorst
- Hôpital Pontchaillou, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Rennes, France
| | - Fabien Subtil
- Hospices Civils de Lyon, Service de Biostatistique, Lyon, France.,CNRS, Laboratoire de Biométrie et Biologie Évolutive UMR 5558, Villeurbanne, France
| | - Jérémie Albouys
- Centre Hospitalier Universitaire Dupuytren, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Limoges, France
| | - Marc Giovannini
- Institut Paoli-Calmettes, Service d'Oncologie et d'Endoscopie Digestives, Marseille, France
| | - Stanislas Chaussade
- Hôpital Cochin AP-HP, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Paris, France
| | - Véréna Landel
- Hospices Civils de Lyon, Direction de la Recherche Clinique et de l'Innovation, Lyon, France
| | - Thierry Ponchon
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - Jean-Christophe Saurin
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Lyon, France.,Université Claude Bernard Lyon 1, Lyon, France
| | - Maximilien Barret
- Hôpital Cochin AP-HP, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Paris, France
| | - Mathieu Pioche
- Hospices Civils de Lyon, Hôpital Edouard Herriot, Service d'Hépato-Gastro-Entérologie et d'Endoscopie Digestive, Lyon, France
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42
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Roland D, Rahmi G, Pérez-Cuadrado-Robles E, Perrod G, Jacques J, Barret M, Leblanc S, Berger A, Albouys J, Chaussade S, Cellier C. Endoscopic submucosal dissection in rectal tumors extending or not to the dentate line: A comparative analysis. Dig Liver Dis 2020; 52:296-300. [PMID: 31744774 DOI: 10.1016/j.dld.2019.10.009] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 09/13/2019] [Accepted: 10/12/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The feasibility of endoscopic submucosal dissection (ESD) in rectal tumors extending to the dentate line (RTDL) is unclear. AIMS To analyze the outcomes of ESD in RTDL compared to non-RTDL, with a special focus on the lower rectum location. METHODS Observational multicenter retrospective study. All patients with a rectal tumor who underwent ESD in 2013-2017 were included. A comparative analysis between RTDL and non-RTDL groups was done. RESULTS Two-hundred and twenty-eight patients (median age: 69 years, range: 33-89, 51.3% male) with RTDL (n = 65, 28.5%) and non-RTDL lesions (n = 163, 71.5%) were included. There were no significant differences between the en-bloc (89.2% vs. 90.8%, p = 0.718), complete (60% vs. 71.8%, p = 0.084) and curative resection rates (58.5% vs. 68.7%, p = 0.141). The overall complication rate (4.6% vs. 8%, p = 0.370) was not different, independently of the rectal location. Local recurrence was higher in RTDL (7.3% vs. 1.5%, p = 0.065). The indication for surgery due to non-curative resections in the lower rectum was lower in RTDL (9.2% vs. 14.6%, p = 0.378). CONCLUSION The safety, effectiveness and long-term impact of ESD in RTDL and non-RTDLs is comparable. Local recurrence in the lower rectum may be higher in RTDL.
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Affiliation(s)
- Déborah Roland
- Department of Gastroenterology and Endoscopy, Georges-Pompidou European Hospital, Paris, France
| | - Gabriel Rahmi
- Department of Gastroenterology and Endoscopy, Georges-Pompidou European Hospital, Paris, France.
| | | | - Guillaume Perrod
- Department of Gastroenterology and Endoscopy, Georges-Pompidou European Hospital, Paris, France
| | - Jérémie Jacques
- Department of Gastroenterology, Dupuytren University Hospital, Limoges, France
| | | | - Sarah Leblanc
- Department of Gastroenterology, Cochin Hospital, Paris, France
| | - Arthur Berger
- Department of Gastroenterology and Endoscopy, Georges-Pompidou European Hospital, Paris, France
| | - Jérémie Albouys
- Department of Gastroenterology, Dupuytren University Hospital, Limoges, France
| | | | - Christophe Cellier
- Department of Gastroenterology and Endoscopy, Georges-Pompidou European Hospital, Paris, France
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Jacques J, Albouys J, Guyot A, Geyl S, Legros R, Chaput U, Pioche M. Endoscopic submucosal dissection of a laterally spreading tumor in the right colon with a gastroscope after shortening the colon using a new double-balloon platform. Endoscopy 2019; 51:E364-E365. [PMID: 31261428 DOI: 10.1055/a-0948-3844] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Jérémie Jacques
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France.,Bio-Em, Xlim CNRS UMR 7252, Limoges, France
| | - Jérémie Albouys
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Anne Guyot
- Pathology Division, Dupuytren University Hospital, Limoges, France
| | - Sophie Geyl
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Romain Legros
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Ulriikka Chaput
- Gastroenterology Department, Saint-Antoine Hospital, APHP, Paris, France
| | - Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, Hospices Civils de Lyon, France
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44
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Albouys J, Geyl S, Charissoux A, Legros R, Sautereau D, Pioche M, Jacques J. Counter-traction using clips and rubber banding for endoscopic submucosal dissection of a laterally spreading tumor involving a diverticulum in the colon. Endoscopy 2019; 51:E295-E296. [PMID: 31121615 DOI: 10.1055/a-0915-1463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Jérémie Albouys
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Sophie Geyl
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | | | - Romain Legros
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Denis Sautereau
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Unité d'endoscopie digestive, Service de Gastroentérologie - pavillon H, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Jacques
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
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Albouys J, Deluche É, Legros R, Charissoux A, Geyl S, Sautereau D, Jacques J. An unusual lesion of the pancreas. Endoscopy 2019; 51:E307-E308. [PMID: 31121614 DOI: 10.1055/a-0915-1944] [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] [Indexed: 12/10/2022]
Affiliation(s)
- Jérémie Albouys
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Élise Deluche
- Oncologie et radiothérapie, CHU Dupuytren, Limoges, France
| | - Romain Legros
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | | | - Sophie Geyl
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Denis Sautereau
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
| | - Jérémie Jacques
- Gastroentérologie et endoscopie digestive, CHU Dupuytren, Limoges, France
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Jacques J, Charissoux A, Bordillon P, Legros R, Rivory J, Hervieu V, Albouys J, Guyot A, Ponchon T, Sautereau D, Kerever S, Pioche M. High proficiency of colonic endoscopic submucosal dissection in Europe thanks to countertraction strategy using a double clip and rubber band. Endosc Int Open 2019; 7:E1166-E1174. [PMID: 31475236 PMCID: PMC6715438 DOI: 10.1055/a-0965-8531] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 12/05/2018] [Accepted: 05/22/2019] [Indexed: 02/06/2023] Open
Abstract
Background and study aims ESD in the colon is more challenging technically than in other locations. Here, we report the first comparative case series of colon ESD using a systematic countertraction strategy using two clips and a rubber band. Patients and methods Retrospective comparative study of classic versus countertraction colon ESD performed in colon ESD cases collected prospectively at Lyon Edouard Herriot Hospital and Limoges University Hospital from January 2016 until December 2017. Results The study included 192 cases (control = 76, countertraction = 116). Countertraction using the double clip and rubber band technique versus the control group resulted in a significant decrease in the procedure time (94.7 vs . 117 min; P = 0.004) and significant increases in procedure speed (28.2 vs . 16.7 mm 2 /min; P < 0.0001), en bloc resection rate (95.7 % vs . 76.3 %, P < 0.0001), and R0 resection rate (78.5 % vs . 64.5 %, P = 0.04). At an individual operator point of view, results varied between operators but the double clip countertraction strategy significantly increased the en bloc resection rate, R0 resection rate, and speed of dissection for each of the 4 operators. Conclusion Systematic countertraction using a double clip and rubber band facilitates colon ESD. This strategy should become the standard for colon ESD.
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Affiliation(s)
- Jérémie Jacques
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France,Bio-Em, Xlim CNRS UMR 7252 Limoges, France,Corresponding author Jérémie Jacques, MD Service d’Hépato-Gastro-EntérologieCHU Dupuytren 87042LimogesFrance+33 5 55 05 87 33
| | | | - Pierre Bordillon
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Romain Legros
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Jérôme Rivory
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, Hospices Civils de Lyon, France
| | - Valérie Hervieu
- Pathology Division, East Hospital Group, Hospices Civils de Lyon, France
| | - Jérémie Albouys
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | - Anne Guyot
- Pathology Division, Dupuytren University Hospital, Limoges, France
| | - Thierry Ponchon
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, Hospices Civils de Lyon, France,Inserm U1032, Labtau, Lyon, France
| | - Denis Sautereau
- Gastroenterology and Endoscopy Unit, Dupuytren University Hospital, Limoges, France
| | | | - Mathieu Pioche
- Gastroenterology and Endoscopy Unit, Pavillon L, Edouard Herriot Hospital, Lyon, Hospices Civils de Lyon, France,Inserm U1032, Labtau, Lyon, France
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47
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Schaefer M, Albouys J, Legros R, Sautereau D, Charissoux A, Lepetit H, Jacques J. Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) using electrocautery-enhanced lumen-apposing metal stent: the easiest way to perform EUS-CDS? Endoscopy 2019; 51:E219-E220. [PMID: 31039593 DOI: 10.1055/a-0885-9196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Marion Schaefer
- Service d'Hépato-gastro-entérologie, CHU de Nancy, Vandoeuvre-les-Nancy, France.,Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Albouys
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Romain Legros
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Denis Sautereau
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | | | - Hugo Lepetit
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jeremie Jacques
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France.,BioEM, UMR 7252, CNRS, Limoges, France
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48
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Schaefer M, Albouys J, Charissoux A, Sautereau D, Legros R, Pioche M, Jacques J. Circumferential esophageal endoscopic submucosal dissection thanks to the tunnel + clip strategy: four tunnels to facilitate the procedure. Endoscopy 2018; 50:E350-E351. [PMID: 30332693 DOI: 10.1055/a-0733-3607] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Marion Schaefer
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Jérémie Albouys
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | | | - Denis Sautereau
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Romain Legros
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France
| | - Mathieu Pioche
- Service d'Hépato-gastro-entérologie, Hôpital Edouard Herriot, CHU Lyon, France
| | - Jérémie Jacques
- Service d'Hépato-gastro-entérologie, CHU Dupuytren, Limoges, France.,BioEM, UMR 7252, CNRS, Limoges
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