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Pawlak KM, Teshima C. Resolution of dysphagia following endoscopic resection of a large, nodular, esophageal inlet patch with low grade dysplasia. Endoscopy 2024; 56:E369. [PMID: 38684196 PMCID: PMC11057907 DOI: 10.1055/a-2302-7690] [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: 05/02/2024]
Affiliation(s)
- Katarzyna M. Pawlak
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto, Canada
| | - Christopher Teshima
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto, Canada
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Alavinejad P, Hashemi SJ, Behl N, Hormati A, Elbasuny A, Daryani NE, Modarres MP, Arshadzadeh M, Panahande S, Hang DV, Mahros AM, Parsi A, Javaherizadeh H, Rehman A, Pawlak KM, Ahmadi M, Ahmed MH, Farsi F, Arefi M, Quadri A, Tran QT, Alborzi F, Amin Alavi SM, Cheraghian B, Ramezani E, Gouda MF, Saadati B, Quadri AA, Hirani R, Maher M, Ghoneem E. Inflammatory bowel disease evolution in the past two decades: a chronological multinational study. EClinicalMedicine 2024; 70:102542. [PMID: 38525407 PMCID: PMC10959644 DOI: 10.1016/j.eclinm.2024.102542] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 02/20/2024] [Accepted: 02/27/2024] [Indexed: 03/26/2024] Open
Abstract
Background The multifactorial nature of inflammatory bowel disease (IBD), which manifests differently in individuals creates a need for a better understanding of the behaviour and pattern of the disease due to environmental factors. The current study aimed to study the changes in IBD behaviour, presentation, and characteristics in patients over the past two decades with a goal of improving patients' diagnosis, management and outcomes. Methods During a 6-month period (1/02/2022-30/07/2022), the information of patients with IBD who attended IBD outpatient clinics of 11 referral centre's in six countries was collected, and based on the first time of diagnosis with IBD, they were allocated as group A (those who were diagnosed more than 15 years ago), group B (those who were diagnosed with IBD between 5 and 15 years ago) and group C (IBD cases who diagnosed in recent 5 years). Then the most prevalent subtypes and characters of the disease are evaluated and compared to make clear if the presenting pattern and behaviour of the disease has changed in the last 2 decades. Findings Overall 1430 patients with IBD including 1207 patients with ulcerative colitis (UC) (84.5%) and 205 patients with Crohn's disease (CD; 14.3%) included. Mean age of participants at the first time of diagnosis with IBD was 30 years. The extra-intestinal involvement of IBD in groups A and B was more prevalent in comparison with group C. Most of those in groups A & B had academic education but in group C, the most prevalent educational status was high school or diploma (P = 0.012). In contrast to groups A and B, the relative prevalence of medium socioeconomic level in group C had decreased (65%). Relative prevalence of UC subtypes was similar among groups A and B (extensive colitis as most prevalent) but in group C, the most prevalent subtype is left side colitis (38.17%). The most prevalent subtype of CD in groups A and B was ileocolic involvement while in group C, upper GI involvement is significantly increased. The rate of food sensitivity among groups A and B was more than group C (P = 0.00001). The relative prevalence of patients with no flare has increased with a steady slope (P < 0.00001). Relative prevalence of presenting symptoms among patients with UC in group C differs and nowadays the rate abdominal pain (70.7%) and bloating (43.9%) have increased and frequency of diarrhoea (67.4%) has decreased. Interpretation In the recent 5 years, the pattern of UC presentation has changed. The rate of upper GI involvement in CD and relative prevalence of patients with no disease flare increased and the rate of extra intestinal involvement decreased. Funding None.
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Affiliation(s)
- Pezhman Alavinejad
- Alimentary Tract Research Centre, Imam Khomeini Hospital Clinical Research Development Unit, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Jalal Hashemi
- Alimentary Tract Research Centre, Imam Khomeini Hospital Clinical Research Development Unit, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nitin Behl
- Institute of Gastro and Liver Diseases, Fortis Hospital, Ludhiana, India
| | - Ahmad Hormati
- Liver and Pancreatobiliary Diseases Research Centre, Digestive Diseases Research Institute, Shariati Hospital, Department of Internal Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abubakr Elbasuny
- Mit Ghamr Oncology Centre, Gastroenterology and Hepatology Department, Faculty of Medicine, Mansoura University, Egypt
| | | | | | - Masoud Arshadzadeh
- Imam Khomeini Hospital GI Ward, Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Panahande
- Alimentary Tract Research Centre, Imam Khomeini Hospital Clinical Research Development Unit, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Dao Viet Hang
- Internal Medicine Faculty, Hanoi Medical University, Endoscopy Centre, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Aya Mohammed Mahros
- Hepatology, Gastroenterology and Infectious Diseases, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Abazar Parsi
- Alimentary Tract Research Centre, Imam Khomeini Hospital Clinical Research Development Unit, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hazhir Javaherizadeh
- Alimentary Tract Research Centre, Imam Khomeini Hospital Clinical Research Development Unit, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ata Rehman
- Faisalabad Medical University, Faisalabad, Pakistan
| | - Katarzyna M. Pawlak
- Division of Gastroenterology Department, St. Michael's Hospital, University of Toronto, Toronto, Canada
| | - Mitra Ahmadi
- Alimentary Tract Research Centre, Imam Khomeini Hospital Clinical Research Development Unit, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammed Hussien Ahmed
- Hepatology, Gastroenterology and Infectious Diseases, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Farnaz Farsi
- Minimally Invasive Surgery Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Arefi
- Toxicology Centre of Baharloo Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Afreen Quadri
- Dr VRK Woman's Medical College, Aziznagar, Telangana, India
| | | | - Foroogh Alborzi
- Imam Khomeini Hospital GI Ward, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Amin Alavi
- Alimentary Tract Research Centre, Imam Khomeini Hospital Clinical Research Development Unit, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Alimentary Tract Research Centre, Imam Khomeini Hospital Clinical Research Development Unit, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elmira Ramezani
- Department of Nutrition, Faculty of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammed Fathi Gouda
- Consultant of Gastroenterology and Endoscopy Theodor Bilharz Research Institute, Giza, Egypt
- Mouwasat Medical Hospital, Dammam, Saudi Arabia
| | | | | | - Rahim Hirani
- School of Medicine, New York Medical College, Valhalla, NY, 10595, USA
| | - Maha Maher
- Gastroenterology and Hepatology (Internal Medicine) Department, Specialised Medical Hospital, Mansoura University
| | - Elsayed Ghoneem
- Mouwasat Medical Hospital, Dammam, Saudi Arabia
- Gastroenterology and Hepatology (Internal Medicine) Department, Specialised Medical Hospital, Mansoura University
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3
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Affiliation(s)
- Katarzyna M Pawlak
- Centre for Therapeutic Endoscopy and Endoscopic Oncology and Division of Gastroenterology, St Michael's Hospital, Toronto, Canada
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Khalaf K, Seleq S, Bourke MJ, Alkandari A, Bapaye A, Bechara R, Calo NC, Fedorov ED, Hassan C, Kalauz M, Kandel GP, Matsuda T, May GR, Mönkemüller K, Mosko JD, Ohno A, Pavic T, Pellisé M, Raos Z, Repici A, Rex DK, Saxena P, Schauer C, Sethi A, Sharma P, Shaukat A, Siddiqui UD, Singh R, Smith LA, Tanabe M, Teshima CW, von Renteln D, Gimpaya N, Pawlak KM, Fujiyoshi MRA, Fujiyoshi Y, Lamba M, Li S, Malipatil SB, Grover SC. Establishment of Standards for the Referral of Large Non-Pedunculated Colorectal Polyps: An International Expert Consensus Using a Modified Delphi Process. Gastrointest Endosc 2024:S0016-5107(24)00090-7. [PMID: 38331224 DOI: 10.1016/j.gie.2024.02.001] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/10/2024] [Accepted: 02/02/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND AND AIMS Resection of colorectal polyps has been shown to decrease the incidence and mortality of colorectal cancer. Large non-pedunculated colorectal polyps are often referred to expert centres for endoscopic resection, which requires relevant information to be conveyed to the therapeutic endoscopist to allow for triage and planning of resection technique. The primary objective of our study was to establish minimum expected standards for the referral of LNPCP for potential ER. METHODS A Delphi methodology was employed to establish consensus on minimum expected standards for the referral of large colorectal polyps among a panel of international endoscopy experts. The expert panel was recruited through purposive sampling, and three rounds of surveys were conducted to achieve consensus, with quantitative and qualitative data analysed for each round. RESULTS A total of 24 international experts from diverse continents participated in the Delphi study, resulting in consensus on 19 statements related to the referral of large colorectal polyps. The identified factors, including patient demographics, relevant medications, lesion factors, photodocumentation and the presence of a tattoo, were deemed important for conveying the necessary information to therapeutic endoscopists. The mean scores for the statements ranged from 7.04 to 9.29 out of 10, with high percentages of experts considering most statements as a very high priority. Subgroup analysis by continent revealed some variations in consensus rates among experts from different regions. CONCLUSION The identified consensus statements can aid in improving the triage and planning of resection techniques for large colorectal polyps, ultimately contributing to the reduction of colorectal cancer incidence and mortality.
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Affiliation(s)
- Kareem Khalaf
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Samir Seleq
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Michael J Bourke
- Westmead Hospital University of Sydney, Sydney, New South Wales, Australia
| | - Asma Alkandari
- Thanyan Alghanim Center for Gastroenterology and Hepatology, Alamiri Hospital, Kuwait, Kuwait
| | - Amol Bapaye
- Shivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Pune, Maharashtra, India
| | - Robert Bechara
- Division of Gastroenterology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Natalia C Calo
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Evgeniy D Fedorov
- Pirogov Russia National Research Medical University, Moscow, Russian Federation
| | - Cesare Hassan
- Endoscopy Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Mirjana Kalauz
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Gabor P Kandel
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Takahisa Matsuda
- Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, Japan
| | - Gary R May
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Klaus Mönkemüller
- Department of Gastroenterology, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Jeffrey D Mosko
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Akiko Ohno
- Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan
| | - Tajana Pavic
- Department of Gastroenterology and Hepatology, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Maria Pellisé
- Gastroenterology Department, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Zoe Raos
- Department of Gastroenterology, Te Whatu Ora - Waitemata. Faculty of Medicine, The University of Auckland, Auckland, New Zealand
| | - Alessandro Repici
- Endoscopy Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Rozzano, Italy
| | - Douglas K Rex
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indiana, USA
| | - Payal Saxena
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Cameron Schauer
- Department of Gastroenterology, Te Whatu Ora - Waitemata. Faculty of Medicine, The University of Auckland, Auckland, New Zealand
| | - Amrita Sethi
- Division of Digestive and Liver Disease, Irving Medical Center, Columbia University, New York, New York, USA
| | - Prateek Sharma
- University of Kansas School of Medicine, VA Medical Center, Kansas City, Kansas, USA
| | - Aasma Shaukat
- Division of Gastroenterology, Department of Medicine, NYU Grossman School of Medicine, New York City, New York, USA
| | - Uzma D Siddiqui
- Center for Endoscopic Research and Therapeutics (CERT), University of Chicago, Chicago, Illinois, USA
| | - Rajvinder Singh
- Lyell McEwin Hospital, NALHN & the University of Adelaide, Adelaide, Australia
| | - Lesley-Ann Smith
- Department of Gastroenterology, Te Whatu Ora - Te TokaTumai, Auckland, New Zealand
| | - Mayo Tanabe
- Showa University Koto Toyosu Hospital, Digestive Diseases Center, Tokyo, Japan
| | - Christopher W Teshima
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Daniel von Renteln
- Centre Hospitalier de l'Universite de Montreal (CHUM), Universite de Montreal, Montreal, Canada
| | - Nikko Gimpaya
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Katarzyna M Pawlak
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Mary Raina Angeli Fujiyoshi
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Yusuke Fujiyoshi
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Mehul Lamba
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Suqing Li
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sharan B Malipatil
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada
| | - Samir C Grover
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada; Canadian Endoscopy Research Network (CanENDO), Canada.
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Antonelli G, Voiosu AM, Pawlak KM, Gonçalves TC, Le N, Bronswijk M, Hollenbach M, Elshaarawy O, Beilenhoff U, Mascagni P, Voiosu T, Pellisé M, Dinis-Ribeiro M, Triantafyllou K, Arvanitakis M, Bisschops R, Hassan C, Messmann H, Gralnek IM. Training in basic gastrointestinal endoscopic procedures: a European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement. Endoscopy 2024; 56:131-150. [PMID: 38040025 DOI: 10.1055/a-2205-2613] [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: 12/03/2023]
Abstract
This ESGE Position Statement provides structured and evidence-based guidance on the essential requirements and processes involved in training in basic gastrointestinal (GI) endoscopic procedures. The document outlines definitions; competencies required, and means to their assessment and maintenance; the structure and requirements of training programs; patient safety and medicolegal issues. 1: ESGE and ESGENA define basic endoscopic procedures as those procedures that are commonly indicated, generally accessible, and expected to be mastered (technically and cognitively) by the end of any core training program in gastrointestinal endoscopy. 2: ESGE and ESGENA consider the following as basic endoscopic procedures: diagnostic upper and lower GI endoscopy, as well as a limited range of interventions such as: tissue acquisition via cold biopsy forceps, polypectomy for lesions ≤ 10 mm, hemostasis techniques, enteral feeding tube placement, foreign body retrieval, dilation of simple esophageal strictures, and India ink tattooing of lesion location. 3: ESGE and ESGENA recommend that training in GI endoscopy should be subject to stringent formal requirements that ensure all ESGE key performance indicators (KPIs) are met. 4: Training in basic endoscopic procedures is a complex process and includes the development and acquisition of cognitive, technical/motor, and integrative skills. Therefore, ESGE and ESGENA recommend the use of validated tools to track the development of skills and assess competence. 5: ESGE and ESGENA recommend incorporating a multimodal approach to evaluating competence in basic GI endoscopic procedures, including procedural thresholds and the measurement and documentation of established ESGE KPIs. 7: ESGE and ESGENA recommend the continuous monitoring of ESGE KPIs during GI endoscopy training to ensure the trainee's maintenance of competence. 9: ESGE and ESGENA recommend that GI endoscopy training units fulfil the ESGE KPIs for endoscopy units and, furthermore, be capable of providing the dedicated personnel, infrastructure, and sufficient case volume required for successful training within a structured training program. 10: ESGE and ESGENA recommend that trainers in basic GI endoscopic procedures should be endoscopists with formal educational training in the teaching of endoscopy, which allows them to successfully and safely teach trainees.
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Affiliation(s)
- Giulio Antonelli
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, "Sapienza" University of Rome, Italy
- Gastroenterology and Digestive Endoscopy Unit, Ospedale dei Castelli Hospital, Ariccia, Rome, Italy
| | - Andrei M Voiosu
- Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Katarzyna M Pawlak
- Endoscopy Unit, Gastroenterology Department, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
- The Center for Therapeutic Endoscopy and Endoscopic Oncology, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Tiago Cúrdia Gonçalves
- Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
| | - Nha Le
- Gastroenterology Division, Internal Medicine and Hematology Department, Semmelweis University, Budapest, Hungary
| | - Michiel Bronswijk
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Belgium
- Department of Gastroenterology and Hepatology, Imelda General Hospital, Bonheiden, Belgium
| | - Marcus Hollenbach
- Division of Gastroenterology, Medical Department II, University of Leipzig Medical Center, Leipzig, Germany
| | - Omar Elshaarawy
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Menoufia, Egypt
| | | | - Pietro Mascagni
- IHU Strasbourg, Strasbourg, France
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Theodor Voiosu
- Department of Gastroenterology, Colentina Clinical Hospital, Bucharest, Romania
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Maria Pellisé
- Department of Gastroenterology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Mário Dinis-Ribeiro
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal
- MEDCIDS/Faculty of Medicine, University of Porto, Porto, Portugal
| | | | - Marianna Arvanitakis
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, TARGID, Leuven, Belgium
| | - Raf Bisschops
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, TARGID, Leuven, Belgium
| | - Cesare Hassan
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Endoscopy Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Helmut Messmann
- Department of Gastroenterology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Ian M Gralnek
- Institute of Gastroenterology and Hepatology, Emek Medical Center, Afula, Israel
- Rappaport Faculty of Medicine Technion Israel Institute of Technology, Haifa, Israel
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Fugazza A, Khalaf K, Pawlak KM, Spadaccini M, Colombo M, Andreozzi M, Giacchetto M, Carrara S, Ferrari C, Binda C, Mangiavillano B, Anderloni A, Repici A. Use of endoscopic ultrasound-guided gallbladder drainage as a rescue approach in cases of unsuccessful biliary drainage. World J Gastroenterol 2024; 30:70-78. [PMID: 38293324 PMCID: PMC10823897 DOI: 10.3748/wjg.v30.i1.70] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/14/2023] [Accepted: 12/22/2023] [Indexed: 01/06/2024] Open
Abstract
This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) as a salvage approach in cases of unsuccessful conventional management. EUS-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of surgery. The procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events, making it a safe and effective option for appropriate candidates. Furthermore, EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary stricture. However, patient selection is critical for the success of EUS-GBD, and proper patient selection and risk assessment are important to ensure the safety and efficacy of the procedure. As the field continues to evolve and mature, ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD, ultimately leading to improved outcomes for patients.
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Affiliation(s)
- Alessandro Fugazza
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
| | - Kareem Khalaf
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto M5B 1W8, ON, Canada
| | - Katarzyna M Pawlak
- Division of Gastroenterology, St. Michael’s Hospital, University of Toronto, Toronto M5B 1W8, ON, Canada
| | - Marco Spadaccini
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
| | - Matteo Colombo
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
| | - Marta Andreozzi
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
| | - Marco Giacchetto
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
| | - Silvia Carrara
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
| | - Chiara Ferrari
- Department of Anesthesia, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
| | - Cecilia Binda
- Gastroenterology and Digestive Endoscopy Unit, Forlì-Cesena Hospitals, Romagna 47121, Italy
| | | | - Andrea Anderloni
- Gastroenterology and Digestive Endoscopy Unit, Fondazione IRCCS Policlinico San Matteo, Pavia 27100, Italy
| | - Alessandro Repici
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital - IRCCS, Rozzano 20089, Milano, Italy
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Khalaf K, Pawlak KM, May GR. Unusual Villiform Re-epithelialization in Barrett's Esophagus Following Endoscopic Treatment. Clin Gastroenterol Hepatol 2023:S1542-3565(23)00959-X. [PMID: 38043692 DOI: 10.1016/j.cgh.2023.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Kareem Khalaf
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
| | - Katarzyna M Pawlak
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Gary R May
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
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Pawlak KM, Jagielski M, Bella E, Khalaf K, Mönkemüller K, Jackowski M. Endoscopic ultrasound-guided drainage of a complex kidney abscess penetrating to the gallbladder and right liver lobe. Endoscopy 2023; 55:E1139-E1141. [PMID: 37875151 PMCID: PMC10597682 DOI: 10.1055/a-2186-3511] [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: 10/26/2023]
Affiliation(s)
- Katarzyna M. Pawlak
- The Center for Therapeutic Endoscopy and Endoscopic Oncology, St. Michaelʼs Hospital, University of Toronto, Toronto, Canada
| | - Mateusz Jagielski
- Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland
| | - Eryk Bella
- Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland
| | - Kareem Khalaf
- The Center for Therapeutic Endoscopy and Endoscopic Oncology, St. Michaelʼs Hospital, University of Toronto, Toronto, Canada
| | - Klaus Mönkemüller
- Department of Gastroenterology, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | - Marek Jackowski
- Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toruń, Poland
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Pawlak KM, Martínez-Alcalá A, Kröner PT, Fry LC, Mönkemüller K. Small-bowel B-cell lymphoma presenting as autoimmune hemolytic anemia and severe obscure gastrointestinal bleeding. Endoscopy 2023; 55:E854-E855. [PMID: 37433323 PMCID: PMC10335864 DOI: 10.1055/a-2098-0883] [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: 07/13/2023]
Affiliation(s)
- Katarzyna M Pawlak
- Department of Gastroenterology, Hospital of the Ministry of Internal Affairs, Szczecin, Poland
| | | | - Paul Thomas Kröner
- Department of Gastroenterology, Ameos Teaching University Hospital (Otto-von-Guericke University - Magdeburg), Halberstadt, Germany
| | - Lucía C Fry
- Department of Gastroenterology, Helios Frankenwaldklinik, Kronach, Germany
| | - Klaus Mönkemüller
- Department of Gastroenterology, Helios Frankenwaldklinik, Kronach, Germany
- Department of Gastroenterology, Ameos Teaching University Hospital (Otto-von-Guericke University - Magdeburg), Halberstadt, Germany
- University of Belgrade, Belgrade, Serbia
- Department of Gastroenterology "Prof. Carolina Olano", Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
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10
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Pawlak KM. Can a high-quality screening colonoscopy decrease the need for subsequent surveillance colonoscopies? Endoscopy 2023; 55:754-755. [PMID: 37380032 DOI: 10.1055/a-2082-8002] [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: 06/30/2023]
Affiliation(s)
- Katarzyna M Pawlak
- Centre for Therapeutic Endoscopy and Endoscopic Oncology and Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
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11
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Pawlak KM, Khalaf K, Mönkemüller K, Kurek K. Systemic multiple myeloma and colonic abnormalities. VideoGIE 2023; 8:328-329. [PMID: 37575143 PMCID: PMC10422100 DOI: 10.1016/j.vgie.2023.05.003] [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] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Video 1Colonic abnormalities observed in the course of systemic multiple myeloma.
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Affiliation(s)
- Katarzyna M Pawlak
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Kareem Khalaf
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
- Humanitas Research Hospital-IRCCS, Department of Gastroenterology, Endoscopy Unit, Rozzano, Italy
| | - Klaus Mönkemüller
- University of Belgrade, Belgrade, Serbia
- Department of Gastroenterology, Ameos Teaching University Hospital (Otto-von-Guericke University-Magdeburg), Halberstadt, Germany
- Department of Gastroenterology, Helios Frankenwaldklinik, Kronach, Germany
| | - Krzysztof Kurek
- Department of Gastroenterology and Internal Medicine, Medicał University of Bialystok, Bialystok, Poland
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12
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Okasha HH, Gouda M, Tag-Adeen M, Farouk M, Alzamzamy A, Abou Elenin S, Pawlak KM, Awad A, Mohamed B. Clinical, Radiological, and Endoscopic Ultrasound Findings in Groove Pancreatitis: A Multicenter Retrospective Study. Turk J Gastroenterol 2023; 34:771-778. [PMID: 37403979 PMCID: PMC10441148 DOI: 10.5152/tjg.2023.22875] [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] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/01/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND/AIMS Groove pancreatitis is a rare form of focal pancreatitis that affects the groove area. Since groove pancreatitis may be mistaken for malignancy, it should be considered in patients with pancreatic head mass lesions or duodenal stenosis to avoid unnecessary surgical procedures. The aim of the study was to document the clinical, radiologic, endoscopic characteristics, and treatment outcomes of patients with groove pancreatitis. MATERIALS AND METHODS This retrospective multicenter observational study included all patients diagnosed with one or more imaging criteria suggestive of groove pancreatitis in the participating centers. Patients with proven malignant fine-needle aspiration/biopsy results were excluded. All patients were followed in their own centers and were retrospectively evaluated. RESULTS Out of the initially included 30 patients with imaging criteria suggestive of groove pancreatitis, 9 patients (30%) were excluded because of malignant endoscopic ultrasound fine-needle aspiration or biopsy results. The mean age of the included 21 patients was 49 ± 10.6 years, with a male predominance of 71%. There was a history of smoking in 66.7% and alcohol consumption in 76.2% of patients. The main endoscopic finding was gastric outlet obstruction observed in 16 patients (76%). There was duodenal wall thickening in 9 (42.8%), 5 (23.8%), and 16 (76.2%) patients on computed tomography, magnetic resonance imaging, and endoscopic ultrasound, respectively. Moreover, pancreatic head enlargement/mass was observed in 10 (47.6%), 8 (38%), and 12 (57%) patients, and duodenal wall cysts in 5 (23.8%), 1 (4.8%), and 11 (52.4%) patients, respectively. Conservative and endoscopic treatment has achieved favorable outcomes in more than 90% of patients. CONCLUSIONS Groove pancreatitis should be considered in any case with duodenal stenosis, duodenal wall cysts, or thickening of the groove area. Various imaging modalities, including computerized tomography, endoscopic ultrasound, and magnetic resonance imaging, have a valuable role in characterizing groove pancreatitis. However, endoscopic fine-needle aspiration or biopsy should be considered in all cases to diagnose groove pancreatitis and exclude malignancy, which can have similar findings.
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Affiliation(s)
- Hussein Hassan Okasha
- Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Gouda
- Theodor Bilharz Research Institute, Mouwasat Hospital Dammam, Giza, Egypt
| | - Mohammed Tag-Adeen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, South Valley University Qena Faculty of Medicine, Egypt
| | - Mahmoud Farouk
- Department of Tropical Medicine and Gastroenterology, Assiut University, Assiut, Egypt
| | - Ahmed Alzamzamy
- Department of Internal Medicine and Gastroenterology, Maadi Armed Forces Medical Complex, Military Medical Academy, Cairo, Egypt
| | - Sameh Abou Elenin
- Department of Internal Medicine and Gastroenterology, Maadi Armed Forces Medical Complex, Military Medical Academy, Cairo, Egypt
| | - Katarzyna M. Pawlak
- Division of Internal Medicine, Department of Cardiology, Gastroenterology and Endocrinology, Endoscopy Unit of Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Abeer Awad
- Department of Internal Medicine and Hepatogastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Borahma Mohamed
- Division of Internal Medicine, Department of Cardiology, Gastroenterology and Endocrinology, Endoscopy Unit of Hospital of the Ministry of Interior and Administration, Szczecin, Poland
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13
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Pawlak KM, Lui RN, Bilal M, Siau K. How to use social media for scientific advocacy and personal branding. United European Gastroenterol J 2023; 11:488-491. [PMID: 37194749 PMCID: PMC10256987 DOI: 10.1002/ueg2.12404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023] Open
Affiliation(s)
- Katarzyna M. Pawlak
- The Center for Therapeutic Endoscopy and Endoscopic OncologySt. Michael's HospitalUniversity of TorontoTorontoOntarioCanada
| | - Rashid N. Lui
- Division of Gastroenterology and HepatologyDepartment of Medicine and TherapeuticsThe Chinese University of Hong KongHong KongChina
- Department of Clinical OncologyThe Chinese University of Hong KongHong KongChina
| | - Mohammad Bilal
- Division of GastroenterologyDepartment of MedicineMinneapolis VA Medical CenterMinneapolisMinnesotaUSA
| | - Keith Siau
- Department of GastroenterologyRoyal Cornwall Hospitals NHS TrustTruroCornwallUK
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14
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Khalaf K, Terrin M, Jovani M, Rizkala T, Spadaccini M, Pawlak KM, Colombo M, Andreozzi M, Fugazza A, Facciorusso A, Grizzi F, Hassan C, Repici A, Carrara S. A Comprehensive Guide to Artificial Intelligence in Endoscopic Ultrasound. J Clin Med 2023; 12:jcm12113757. [PMID: 37297953 DOI: 10.3390/jcm12113757] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Endoscopic Ultrasound (EUS) is widely used for the diagnosis of bilio-pancreatic and gastrointestinal (GI) tract diseases, for the evaluation of subepithelial lesions, and for sampling of lymph nodes and solid masses located next to the GI tract. The role of Artificial Intelligence in healthcare in growing. This review aimed to provide an overview of the current state of AI in EUS from imaging to pathological diagnosis and training. METHODS AI algorithms can assist in lesion detection and characterization in EUS by analyzing EUS images and identifying suspicious areas that may require further clinical evaluation or biopsy sampling. Deep learning techniques, such as convolutional neural networks (CNNs), have shown great potential for tumor identification and subepithelial lesion (SEL) evaluation by extracting important features from EUS images and using them to classify or segment the images. RESULTS AI models with new features can increase the accuracy of diagnoses, provide faster diagnoses, identify subtle differences in disease presentation that may be missed by human eyes, and provide more information and insights into disease pathology. CONCLUSIONS The integration of AI in EUS images and biopsies has the potential to improve the diagnostic accuracy, leading to better patient outcomes and to a reduction in repeated procedures in case of non-diagnostic biopsies.
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Affiliation(s)
- Kareem Khalaf
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Maria Terrin
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital IRCCS, Rozzano, 20089 Milan, Italy
| | - Manol Jovani
- Division of Gastroenterology, Maimonides Medical Center, SUNY Downstate University, Brooklyn, NY 11219, USA
| | - Tommy Rizkala
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy
| | - Marco Spadaccini
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital IRCCS, Rozzano, 20089 Milan, Italy
| | - Katarzyna M Pawlak
- Division of Gastroenterology, St. Michael's Hospital, University of Toronto, Toronto, ON M5S 1A1, Canada
| | - Matteo Colombo
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital IRCCS, Rozzano, 20089 Milan, Italy
| | - Marta Andreozzi
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital IRCCS, Rozzano, 20089 Milan, Italy
| | - Alessandro Fugazza
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital IRCCS, Rozzano, 20089 Milan, Italy
| | - Antonio Facciorusso
- Section of Gastroenterology, Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy
| | - Fabio Grizzi
- Department of Immunology and Inflammation, Humanitas Research Hospital IRCCS, Rozzano, 20089 Milan, Italy
| | - Cesare Hassan
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital IRCCS, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy
| | - Alessandro Repici
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital IRCCS, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20089 Milan, Italy
| | - Silvia Carrara
- Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital IRCCS, Rozzano, 20089 Milan, Italy
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15
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Pawlak KM, Tehami N, Maher B, Asif S, Rawal KK, Balaban DV, Tag-Adeen M, Ghalim F, Abbas WA, Ghoneem E, Ragab K, El-Ansary M, Kadir S, Amin S, Siau K, Wiechowska-Kozlowska A, Mönkemüller K, Abdelfatah D, Abdellatef A, Lakhtakia S, Okasha HH. Role of endoscopic ultrasound in the characterization of solid pseudopapillary neoplasm of the pancreas. World J Gastrointest Endosc 2023; 15:273-284. [PMID: 37138939 PMCID: PMC10150282 DOI: 10.4253/wjge.v15.i4.273] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/17/2023] [Accepted: 03/29/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Solid pseudopapillary neoplasm (SPN) is an uncommon pathology of the pancreas with unpredictable malignant potential. Endoscopic ultrasound (EUS) assessment plays a vital role in lesion characterization and confirmation of the tissue diagnosis. However, there is a paucity of data regarding the imaging assessment of these lesions.
AIM To determine the characteristic EUS features of SPN and define its role in preoperative assessment.
METHODS This was an international, multicenter, retrospective, observational study of prospective cohorts from 7 large hepatopancreaticobiliary centers. All cases with postoperative histology of SPN were included in the study. Data collected included clinical, biochemical, histological and EUS characteristics.
RESULTS One hundred and six patients with the diagnosis of SPN were included. The mean age was 26 years (range 9 to 70 years), with female predominance (89.6%). The most frequent clinical presentation was abdominal pain (80/106; 75.5%). The mean diameter of the lesion was 53.7 mm (range 15 to 130 mm), with the slight predominant location in the head of the pancreas (44/106; 41.5%). The majority of lesions presented with solid imaging features (59/106; 55.7%) although 33.0% (35/106) had mixed solid/cystic characteristics and 11.3% (12/106) had cystic morphology. Calcification was observed in only 4 (3.8%) cases. Main pancreatic duct dilation was uncommon, evident in only 2 cases (1.9%), whilst common bile duct dilation was observed in 5 (11.3%) cases. One patient demonstrated a double duct sign at presentation. Elastography and Doppler evaluation demonstrated inconsistent appearances with no emergence of a predictable pattern. EUS guided biopsy was performed using three different types of needles: Fine needle aspiration (67/106; 63.2%), fine needle biopsy (37/106; 34.9%), and Sonar Trucut (2/106; 1.9%). The diagnosis was conclusive in 103 (97.2%) cases. Ninety-seven patients were treated surgically (91.5%) and the post-surgical SPN diagnosis was confirmed in all cases. During the 2-year follow-up period, no recurrence was observed.
CONCLUSION SPN presented primarily as a solid lesion on endosonographic assessment. The lesion tended to be located in the head or body of the pancreas. There was no consistent characteristic pattern apparent on either elastography or Doppler assessment. Similarly SPN did not frequently cause stricture of the pancreatic duct or common bile duct. Importantly, we confirmed that EUS-guided biopsy was an efficient and safe diagnostic tool. The needle type used does not appear to have a significant impact on the diagnostic yield. Overall SPN remains a challenging diagnosis based on EUS imaging with no pathognomonic features. EUS guided biopsy remains the gold standard in establishing the diagnosis.
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Affiliation(s)
- Katarzyna M Pawlak
- Endoscopy Unit, Department of Gastroenterology, Hospital of The Ministry of Interior and Administration, Szczecin 01-218, Poland
| | - Nadeem Tehami
- Interventional Endoscopy Unit, University Hospital Southampton NHS Foundation Trust, 3AX PO, United Kingdom
| | - Ben Maher
- Interventional Endoscopy Unit, University Hospital Southampton NHS Foundation Trust, 3AX PO, United Kingdom
| | - Shujaath Asif
- Consultant Gastroenterologist, AIG Hospitals, Hyderabad 500032, India
| | - Krishn Kant Rawal
- Department of Gastroenterology, Prime Institute of Digestive Sciences, Rajkot 360001, India
| | - Daniel Vasile Balaban
- Department of Gastroenterology, Central Military Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest 010011, Romania
| | - Mohammed Tag-Adeen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Qena Faculty of Medicine, South Valley University, Qena 83511, Egypt
- Department of Endoscopy, Shefa Al-Orman Hospital, Luxor 85951, Egypt
| | - Fahd Ghalim
- Interventional Endoscopy Unit, Sainte Marie Hospital, OSNY 95520, France
| | - Wael A Abbas
- Department of Internal Medicine, Gastroenterology Unit, Faculty of Medicine, Assuit University, Assuit 71511, Egypt
| | - Elsayed Ghoneem
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Mansoura University, Mansoura 35511, Egypt
| | - Khaled Ragab
- Department of Hepatology and Gastroenterology, Theodor Bilharz Research Institute, Giza 12511, Egypt
| | - Mahmoud El-Ansary
- Department of Hepatology & Gastroenterology, Theodor Bilharz Research Institute, Giza 12511, Egypt
| | - Shanil Kadir
- Department of Gastroenterology, Liaquat National Hospital & Medical College, Karachi 75900, Pakistan
| | - Sunil Amin
- Division of Digestive and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 32118, United States
| | - Keith Siau
- Department of Gastroenterology, Royal Cornwall Hospitals NHS Trust, Truro, Cornwall, United Kingdom
| | | | - Klaus Mönkemüller
- Department of Gastroenterology, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, AL 35294, United States
| | - Dalia Abdelfatah
- Department of Cancer Epidemiology and Biostatistics, National Cancer Institute, Cairo University, Cairo 11511, Egypt
| | - Abeer Abdellatef
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kasr Al-Aini School of Medicine, Faculty of Medicine, Cairo University, Cairo 11511, Egypt
| | - Sundeep Lakhtakia
- Consultant Gastroenterologist, AIG Hospitals, Hyderabad 500032, India
| | - Hussein Hassan Okasha
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kasr Al-Aini School of Medicine, Faculty of Medicine, Cairo University, Cairo 11451, Egypt
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16
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Kozłowska-Petriczko K, Pawlak KM, Wojciechowska K, Reiter A, Błaszczyk Ł, Szełemej J, Petriczko J, Wiechowska-Kozłowska A. The Efficacy Comparison of Endoscopic Bariatric Therapies: 6-Month Versus 12-Month Intragastric Balloon Versus Endoscopic Sleeve Gastroplasty. Obes Surg 2023; 33:498-505. [PMID: 36525237 PMCID: PMC9889469 DOI: 10.1007/s11695-022-06398-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Intragastric balloon (IGB) insertion and endoscopic sleeve gastroplasty (ESG) are known to be effective and safe in achieving weight loss. The aim of this study was to compare the effects of a 6-month IGB therapy, a 12-month IGB therapy, and ESG. METHODS We retrospectively analyzed the weight loss at IGB (Orbera) removal after 6 months (124 patients), at IGB (Orbera365) removal after 12 months (61 patients) and at 6 and 12 months after ESG (42 and 34 patients, respectively). Postprocedural care, including medication and diet, was the same for all procedures. RESULTS Mean TBWL in patients undergoing IGB placement for 6 and 12 months and ESG after 6 and 12 months were 15.2, 15.8, 26.5, and 28.7 kg, respectively. There was no significant difference in the mean %TBWL in patients undergoing IGB placement for 6 or for 12 months (15.3% vs. 14.7%, P = 0.7). ESG patients showed a significantly higher mean %TBWL than IGB patients after 6 months (15.3 vs. 19.8, P = 0.005) and 12 months (14.7 vs. 22.5, P < 0.001). CONCLUSION All three studied methods were effective for achieving weight loss. However, there was no significant difference between 6-month and 12-month IGB therapies outcomes. ESG appeared to be a more effective obesity treatment modality than IGB.
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Affiliation(s)
| | - K M Pawlak
- Endoscopy Unit, Department of Gastroenterology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - K Wojciechowska
- Department of Internal Medicine and Gastroenterology, Pomeranian Medical University, Szczecin, Poland
| | - A Reiter
- Endoscopy Unit, Regional Health Center, Lubin, Poland
| | - Ł Błaszczyk
- Endoscopy Unit, Sonomed Medical Centre, Szczecin, Poland
| | - J Szełemej
- Endoscopy Unit, Regional Health Center, Lubin, Poland
| | - J Petriczko
- Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University, Szczecin, Poland
| | - A Wiechowska-Kozłowska
- Endoscopy Unit, Department of Gastroenterology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
- Endoscopy Unit, Sonomed Medical Centre, Szczecin, Poland
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17
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Drenth JPH, Pawlak KM. UEG journal's editorial team. United European Gastroenterol J 2022; 10:1041-1043. [PMID: 36424368 PMCID: PMC9752279 DOI: 10.1002/ueg2.12340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Joost P H Drenth
- Department of Gastroenterology and Hepatology, Radboudumc Nijmegen, Nijmegen, The Netherlands
| | - Katarzyna M Pawlak
- Endoscopy Unit, Department of Gastroenterology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
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18
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Martínez-Alcalá Á, Pawlak KM, Jovanovic I, Mönkemüller K. Sequential double stent placement using the stent-pushing-stent technique over a single wire during double-balloon ERCP. Endoscopy 2022; 54:E755-E756. [PMID: 35405759 DOI: 10.1055/a-1792-2601] [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)
| | - Katarzyna M Pawlak
- Department of Gastroenterology, Hospital of the Ministry of Internal Affairs in Szczecin, Poland
| | | | - Klaus Mönkemüller
- University of Belgrade, Belgrade, Serbia.,Department of Gastroenterology, Ameos Teaching University Hospital (Otto-von-Guericke University - Magdeburg), Halberstadt, Germany.,Department of Gastroenterology, Helios Frankenwaldklinik, Kronach, Germany
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19
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Okasha HH, Pawlak KM, Abou-elmagd A, El-Meligui A, Atalla H, Othman MO, Elenin SA, Alzamzamy A, Mahdy RE. Practical approach to linear endoscopic ultrasound examination of the rectum and anal canal. Endosc Int Open 2022; 10:E1417-E1426. [PMID: 36262505 PMCID: PMC9576334 DOI: 10.1055/a-1922-6500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/08/2022] [Indexed: 11/09/2022] Open
Abstract
Standard endosonographic examination of the rectal area is usually performed with radial endoscopic ultrasound (EUS). However, in recent years, widespread availability of linear EUS for assessing various anatomical regions in the gastrointestinal tract has facilitated its use in the assessment of anorectal disorders. Currently, many rectal and anal diseases, including perianal abscesses, fistulae, polyps, and neoplastic lesions, can be well-visualized and evaluated with linear EUS. The aim of this review is to shed light on the anatomy and systematic examination of the anorectal region with linear EUS and clinical implications for different anorectal pathologies.
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Affiliation(s)
- Hussein Hassan Okasha
- Internal Medicine Department, Division of Gastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Katarzyna M. Pawlak
- Hospital of the Ministry of Interior and Administration, Endoscopy Unit, Department of Gastroenterology, Szczecin, Poland
| | | | - Ahmed El-Meligui
- Internal Medicine Department, Division of Gastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Hassan Atalla
- Internal Medicine Department, Hepatology and Gastroenterology Unit, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Sameh Abou Elenin
- Department of Gastroenterology and Hepatology, Military Medical Academy, Cairo Egypt
| | - Ahmed Alzamzamy
- Department of Gastroenterology and Hepatology, Military Medical Academy, Cairo Egypt
| | - Reem Ezzat Mahdy
- Internal Medicine, gastroenterology and Hepatology Department, Assiut University, Assiut, Egypt
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20
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Rodríguez‐Lago I, Hollenbach M, Archibugi L, Ciocan D, Libânio D, Nuzzo A, Pawlak KM, Zanetto A, Melchior C. Young GI angle: Challenges and opportunities as a trainee editor: The United European Gastroenterology journal experience. United European Gastroenterol J 2022; 10:348-353. [PMID: 35307961 PMCID: PMC9004251 DOI: 10.1002/ueg2.12222] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Iago Rodríguez‐Lago
- Gastroenterology Department Hospital Universitario de Galdakao, and Biocruces Bizkaia HRI Galdakao Spain
- Deusto University Bilbao Spain
| | - Marcus Hollenbach
- Division of Gastroenterology Medical Department II University of Leipzig Medical Center Leipzig Germany
| | - Livia Archibugi
- Pancreato‐Biliary Endoscopy and Endosonography Division Pancreas Translational and Clinical Research Center San Raffaele Scientific Institute IRCCS Milan Italy
| | - Dragos Ciocan
- Université Paris‐Saclay Inserm U996 Inflammation Microbiome and Immunosurveillance; AP‐HP, Hepato‐Gastroenterology and Nutrition, Hôpital Antoine‐Béclère Clamart France
| | - Diogo Libânio
- Gastroenterology Department Portuguese Oncology Institute of Porto Porto Portugal
- MEDCIDS ‐ Faculty of Medicine University of Porto Porto Portugal
| | - Alexandre Nuzzo
- Department of Gastroenterology IBD and Intestinal Failure Beaujon Hospital AP‐HP.Nord Université de Paris Paris France
| | - Katarzyna M. Pawlak
- Depatment of Gastroenterology Endoscopy Unit Hospital of the Ministry of Interior and Administration Szczecin Poland
| | - Alberto Zanetto
- Department of Surgery, Oncology, and Gastroenterology Gastroenterology and Multivisceral Transplant Unit Padova University Hospital Padova Italy
| | - Chloé Melchior
- Department of Molecular and Clinical Medicine Institute of Medicine Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- INSERM UMR 1073 Institute for Research and Innovation in Biomedicine Normandy University Rouen France
- Gastroenterology Department and INSERM CIC‐CRB Rouen University Hospital Rouen France
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21
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Seleq S, Khan R, Gimpaya N, Vargas JI, Amin S, Bilal M, Bollipo S, Charabaty A, de-Madaria E, Hashim A, Kral J, Pawlak KM, Sandhu DS, Lui RN, Sanchez-Luna S, Siau K, Mosko J, Grover S. A32 DEVELOPMENT AND VALIDATION OF THE TORONTO UPPER GASTROINTESTINAL CLEANING SCORE. J Can Assoc Gastroenterol 2022. [PMCID: PMC8859122 DOI: 10.1093/jcag/gwab049.031] [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] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
High quality esophagogastroduodenoscopy (EGD) depends on the ability to appropriately visualize upper gastrointestinal (GI) mucosa pathology. Evaluation can be limited by the presence of mucus, foam, bubbles and solid materials. Currently, there is no standardized method to assess mucosal visualization for use in clinical or research settings.
Aims
To develop and establish the content validity of the Toronto Upper Gastrointestinal Cleaning Score (TUGCS) and evaluate its interrater reliability.
Methods
An international panel of endoscopy experts rated potential items and their associated anchors for importance as indicators of adequacy of mucosal visualization during EGD. The survey utilized a Likert scale (1 (strongly disagree) to 5 (strongly agree)). The Delphi process was repeated until consensus was reached. Consensus was defined priori as ≥80% of experts in a given round scoring ≥4 on all survey items. To assess content validity, 48 EGD procedures were evaluated in real-time by two endoscopist reviewers using the TUGCS at a single institution. The interrater agreement between assessments was calculated for TUGCS total scores using intraclass correlation coefficient, one-way random effects model (ICC 1,1).
Results
Fourteen experts agreed to be part of the Delphi panel. An anatomical framework representing the upper GI mucosa and anchors for each mucosal portion representing various levels of visibility was generated through systematic review. Three survey rounds, with response rates of 100%, 100% and 71% respectively, achieved consensus. The final TUGCS includes four anatomical areas (fundus, body, antrum, duodenum) and mucosal visualization anchors ranging from 0 to 3 (Figure 1). TUGCS was used to assess foregut cleaning in 48 procedures (Table 1). The mean TUGCS for staff and trainee were 8.1 (±2.4) and 8.1 (±2.6), respectively. The ICC was 0.78 (95% confidence interval 0.62–0.88) indicating good reliability.
Conclusions
We developed and generated content validity evidence for the TUGCS through rigorous Delphi methodology, reflective of practice across different centres. Planned as future research is a video survey distributed to endoscopists internationally to further validate the TUGCS to create a tool that may be used to judge mucosal visualization for EGD in research and clinical settings.
Funding Agencies
None
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Affiliation(s)
- S Seleq
- St Michael’s Hospital, Toronto, ON, Canada
| | - R Khan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - N Gimpaya
- St Michael’s Hospital, Toronto, ON, Canada
| | - J I Vargas
- Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - S Amin
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, Miami, FL
| | - M Bilal
- Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, Boston, MA
| | - S Bollipo
- Gastroenterology Department, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia, Newcastle, New South Wales, Australia
| | - A Charabaty
- Division of Gastroenterology, Johns Hopkins-Sibley Memorial Hospital, Washington, DC, Washington, DC
| | - E de-Madaria
- Alicante University General Hospital, Alicante Institute for Health and Biomedical Research, Alicante, Spain, Alicante, Spain
| | - A Hashim
- Department of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - J Kral
- Institution for Clinical and Experimental Medicine, Prague, Czech Republic, Prague, Czechia
| | - K M Pawlak
- Hospital of the Ministry of Interior and Administration, Szczecin, Poland, Szczecin, Poland
| | - D S Sandhu
- Division of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio, Cleveland, OH
| | - R N Lui
- Division of Gastroenterology and Hepatology, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China, Hong Kong, China
| | - S Sanchez-Luna
- Division of Gastroenterology and Hepatology, The University of New Mexico, Albuquerque, NM
| | - K Siau
- Institute of Translational Medicine, University Hospitals Birmingham, Birmingham, Birmingham, United Kingdom
| | - J Mosko
- St Michael’s Hospital, Toronto, ON, Canada
| | - S Grover
- St Michael’s Hospital, Toronto, ON, Canada
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22
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Raiter A, Szełemej J, Kozłowska-Petriczko K, Petriczko J, Pawlak KM. Simultaneous endoscopic ultrasound-guided treatment of intestinal and biliary obstruction due to massive lymphoma of the duodenal papilla. Endoscopy 2022; 54:E51-E52. [PMID: 33682903 DOI: 10.1055/a-1375-0053] [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)
- Artur Raiter
- Department of Endoscopy, Specialist Hospital of Alfred Sokolowski, Wałbrzych, Poland
| | - Joanna Szełemej
- Department of Endoscopy, Specialist Hospital of Alfred Sokolowski, Wałbrzych, Poland
| | | | - Jan Petriczko
- Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna M Pawlak
- Department of Gastroenterology, Hospital of the Ministry of Internal Affairs in Szczecin, Poland
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23
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Raiter A, Szełemej J, Kozłowska-Petriczko K, Petriczko J, Pawlak KM. The complex advanced endoscopic approach in the treatment of choledocholitiasis and empyema of gallbladder. Endoscopy 2022; 54:E55-E56. [PMID: 33682902 DOI: 10.1055/a-1352-2468] [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: 12/10/2022]
Affiliation(s)
- Artur Raiter
- Department of Endoscopy, Specialist Hospital of Alfred Sokolowski, Wałbrzych, Poland
| | - Joanna Szełemej
- Department of Endoscopy, Specialist Hospital of Alfred Sokolowski, Wałbrzych, Poland
| | | | - Jan Petriczko
- Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University, Szczecin, Poland
| | - Katarzyna M Pawlak
- Department of Gastroenterology, Hospital of the Ministry of Internal Affairs in Szczecin, Poland
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24
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Affiliation(s)
- Katarzyna M Pawlak
- Endoscopy Unit, Department of Gastroenterology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Lucas Wauters
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
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25
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Bendall O, James J, Pawlak KM, Ishaq S, Tau JA, Suzuki N, Bollipo S, Siau K. Delayed Bleeding After Endoscopic Resection of Colorectal Polyps: Identifying High-Risk Patients. Clin Exp Gastroenterol 2022; 14:477-492. [PMID: 34992406 PMCID: PMC8714413 DOI: 10.2147/ceg.s282699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/02/2021] [Indexed: 12/13/2022] Open
Abstract
Delayed post-polypectomy bleeding (DPPB) is a potentially severe complication of therapeutic colonoscopy which can result in hospital readmission and re-intervention. Over the last decade, rates of DPPB reported in the literature have fallen from over 2% to 0.3–1.2%, largely due to improvements in resection technique, a shift towards cold snare polypectomy, better training, adherence to guidelines on periprocedural antithrombotic management, and the use of antithrombotics with more favourable bleeding profiles. However, as the complexity of polypectomy undertaken worldwide increases, so does the importance of identifying patients at increased risk of DPPB. Risk factors can be categorised according to patient, polyp and personnel related factors, and their integration together to provide an individualised risk score is an evolving field. Strategies to reduce DPPB include safe practices relevant to all patients undergoing colonoscopy, as well as specific considerations for patients identified to be high risk. This narrative review sets out an evidence-based summary of factors that contribute to the risk of DPPB before discussing pragmatic interventions to mitigate their risk and improve patient safety.
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Affiliation(s)
- Oliver Bendall
- Department of Gastroenterology, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Joel James
- Department of Gastroenterology, Royal Cornwall Hospitals NHS Trust, Truro, UK
| | - Katarzyna M Pawlak
- Endoscopy Unit, Department of Gastroenterology, Ministry of Interior and Administration, Szczecin, Poland
| | - Sauid Ishaq
- Department of Gastroenterology, Dudley Group Hospitals NHS Foundation Trust, Dudley, UK.,Medicine, Birmingham City Hospital, Birmingham, UK
| | - J Andy Tau
- Austin Gastroenterology, Austin, TX, USA
| | - Noriko Suzuki
- Wolfson Unit for Endoscopy, St. Mark's Hospital, London, UK
| | - Steven Bollipo
- School of Medicine & Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Department of Gastroenterology, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
| | - Keith Siau
- Department of Gastroenterology, Royal Cornwall Hospitals NHS Trust, Truro, UK
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26
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Romańczyk M, Ostrowski B, Kozłowska-Petriczko K, Pawlak KM, Kurek K, Zatorski H, Koziej M, Romańczyk T, Wosiewicz P, Marek T, Wiechowska-Kozłowska A, Małecka-Panas E, Hartleb M. Scoring system assessing mucosal visibility of upper gastrointestinal tract: The POLPREP scale. J Gastroenterol Hepatol 2022; 37:164-168. [PMID: 34397116 DOI: 10.1111/jgh.15662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/06/2021] [Revised: 07/20/2021] [Accepted: 08/07/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM The proper visibility of mucosa during esophagogastroduodenoscopy (EGD) is crucial for the detection of early upper gastrointestinal tract lesions. In contrast to colonoscopy, no validated scoring system for the assessment of upper gastrointestinal mucosal cleanliness has been developed so far. The aim of the study was to create and validate standardized grading system (POLPREP) to assess the mucosal cleanliness during EGD. METHODS To assess the visibility of mucosa during EGD, 4-point scale was developed (0-3). Twelve operators assessed 18 images of esophagus, stomach, and duodenum twice (in 2 weeks interval). In validation round, the images and endoscopy reports of 443 EGDs performed in six centers were assessed. RESULTS The inter-observer accordance of POLPREP was 0.8 (intra-class correlation coefficient; 0.79 consultants, 0.85 trainees). The intra-observer repeatability was 0.64 (Fleiss kappa value; 0.64 consultants, 0.64 trainees). The lesions detection rate was significantly higher in clean (scores 2 and 3; 19.7%) than in "unclean" segments (score 1; 7.7%, P = 0.049). Score 3 was associated with over three-fold higher lesion detection than score 1 (odds ratio 3.2, 95% confidence interval 1.1-9; P = 0.03). CONCLUSIONS The proposed POLPREP scale allows for unified assessment of upper gastrointestinal tract mucosal cleanliness. The higher cleanliness scores are related with greater upper gastrointestinal pathologies detection.
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Affiliation(s)
- Marcin Romańczyk
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.,Endotherapy, H-T. Medical Center, Tychy, Poland
| | - Bartosz Ostrowski
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Katarzyna M Pawlak
- Department of Gastroenterology, Endoscopy Unit, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Krzysztof Kurek
- Department of Gastroenterology and Internal Medicine, Medical University of Białystok, Białystok, Poland
| | - Hubert Zatorski
- Department of Digestive Tract Diseases, Medical University of Łódź, Łódź, Poland
| | - Mateusz Koziej
- Department of Anatomy, Jagiellonian University Medical College, Kraków, Poland
| | | | - Piotr Wosiewicz
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Tomasz Marek
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | | | - Ewa Małecka-Panas
- Department of Digestive Tract Diseases, Medical University of Łódź, Łódź, Poland
| | - Marek Hartleb
- Department of Gastroenterology and Hepatology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
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27
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Okasha HH, El-Meligui A, Pawlak KM, Żorniak M, Atalla H, Abou-Elmagd A, Abou-Elenen S, El-Husseiny R, Alzamzamy A. Practical approach to linear EUS examination of the mediastinum. Endosc Ultrasound 2021; 10:406-413. [PMID: 34854401 PMCID: PMC8785678 DOI: 10.4103/eus-d-21-00019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
EUS has become a substantial diagnostic and therapeutic modality for many anatomical regions. The extent of endosonographic assessment is wide, and among others, allows for the evaluation of the mediastinal anatomy and related pathologies such as mediastinal lymphadenopathy and staging of central malignant lung lesions. Moreover, EUS assessment has proved more accurate in detecting small lesions missed by standard imaging examinations such as computed tomography or magnetic resonance. Endosonographically, various mediastinal anatomical landmarks and stations can be visualized by transesophageal scanning, thus providing arranged systematic examination of the mediastinum. In addition, the correct position during the examination is crucial for EUS-guided procedures such as tissue sampling and drainage of mediastinal abscesses. The evolution of EUS-guided diagnostic and interventional procedures has contributed to the increasing importance of understanding the mediastinal anatomy during the EUS examination.
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Affiliation(s)
- Hussein Hassan Okasha
- Department of Internal Medicine, Division of Gastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed El-Meligui
- Department of Internal Medicine, Division of Gastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Katarzyna M Pawlak
- Department of Internal Medicine, Cardiology, Gastroenterology and Endocrinology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Michał Żorniak
- Department of Medicine II, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany; Department of Gastroenterology, Hepatology and Oncology, Medical Center for Postgraduate Education, Warsaw, Poland
| | - Hassan Atalla
- Department of Internal Medicine, Hepatology and Gastroenterology Unit, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Amr Abou-Elmagd
- Department of Internal Medicine, Armed Forces College of Medicine, Cairo, Egypt
| | - Sameh Abou-Elenen
- Department of Gastroenterology and Hepatology, Military Medical Academy, Cairo, Egypt
| | - Ramy El-Husseiny
- National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Ahmed Alzamzamy
- Department of Gastroenterology and Hepatology, Military Medical Academy, Cairo, Egypt
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28
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Okasha HH, Wifi MN, Awad A, Abdelfatah Y, Abdelfatah D, El-Sawy SS, Alzamzamy A, Abou-Elenin S, Abou-Elmagd A, ElHusseiny R, Wahba M, El-Feki MA, Pawlak KM. Role of EUS in detection of liver metastasis not seen by computed tomography or magnetic resonance imaging during staging of pancreatic, gastrointestinal, and thoracic malignancies. Endosc Ultrasound 2021; 10:344-354. [PMID: 34558421 PMCID: PMC8544012 DOI: 10.4103/eus-d-20-00178] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background and Objectives: Liver metastases might not be detected by computed tomography (CT) and magnetic resonance imaging (MRI) due to their small size, but they can be detected by EUS. Furthermore, EUS-FNA has a significant impact on improving the diagnostic accuracy of EUS. The purpose of this study was to assess the feasibility of EUS in detection of occult small hepatic focal lesions at the time of primary tumor staging, not seen by CT or MRI. Methods: This prospective study included 730 patients who underwent EUS for staging or sampling of gastrointestinal, pancreatic, or thoracic malignancy. The liver was examined thoroughly for detection of occult lesions. CT or MRI was done within 1 week of EUS examination. Results: EUS examination of the liver detected focal lesions in 150 patients (20.5%) and metastases in 118 patients (16.2%); meanwhile, CT and MRI detected focal lesions in 99 patients (13.6%) and metastases in 82 patients (11.2%). EUS missed focal lesions in 7 patients, 6 of which were liver metastases (1.0% and 0.8%, respectively), while CT and MRI missed focal lesions in 58 patients, 42 of which were metastases (7.9% and 5.8%, respectively), which were detected by EUS. Conclusion: Thorough dedicated EUS examination of the liver is a feasible useful tool for detection of small hepatic lesions missed by CT and MRI. It is not considered an extra financial burden to the patient or health-care system because those patients are indicated for EUS examination for evaluation of their original lesion in the first place. Furthermore, EUS-FNA can add another advantage in diagnosing the etiology of such lesions.
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Affiliation(s)
- Hussein Hassan Okasha
- Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed-Naguib Wifi
- Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Abeer Awad
- Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Yasmine Abdelfatah
- Department of Internal Medicine, Endocrinology and Metabolism Unit, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Dalia Abdelfatah
- Department of Cancer Epidemiology and Biostatistics, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Shereen Sadik El-Sawy
- Department of Internal Medicine, Endocrinology and Metabolism Unit, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Alzamzamy
- Department of Gastroenterology and Hepatology, Maadi Armed Forces Medical Complex, Military Medical Academy, Cairo, Egypt
| | - Sameh Abou-Elenin
- Department of Gastroenterology and Hepatology, Military Medical Academy, Cairo, Egypt
| | - Amr Abou-Elmagd
- Department of Gastroenterology and Hepatology, Armed Forces College of Medicine, Cairo, Egypt
| | - Ramy ElHusseiny
- National Hepatology and Tropical Medicine Research Institute, Cairo, Egypt
| | - Mahmoud Wahba
- Department of Internal Medicine, Hepatogastroenterology Unit, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed A El-Feki
- Department of Internal Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Katarzyna M Pawlak
- Department of Internal Medicine, Cardiology, Gastroenterology and Endocrinology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
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29
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Raiter A, Pawlak KM, Kozłowska-Petriczko K, Petriczko J, Wiechowska-Kozłowska A. Endoscopic ultrasound-guided gastrojejunal anastomosis followed by retrograde colonoscope-assisted metal stenting of the bile duct. Endoscopy 2021; 53:E315-E316. [PMID: 33075826 DOI: 10.1055/a-1268-6961] [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)
- Artur Raiter
- Department of Endoscopy, Specialist Hospital of Alfred Sokolowski, Wałbrzych, Poland
| | - Katarzyna M Pawlak
- Department of Gastroenterology, Hospital of the Ministry of Internal Affairs in Szczecin, Poland
| | | | - Jan Petriczko
- Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University, Szczecin, Poland
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30
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Kozieł S, Kozłowska-Petriczko K, Pawlak KM, Petriczko J, Wiechowska-Kozłowska A. Endoscopic sigmoidorectal reanastomosis using a dual endoscope technique: rendezvous single-balloon enteroscopy and endoscopic ultrasound. Endoscopy 2021; 53:E257-E258. [PMID: 32968980 DOI: 10.1055/a-1247-4503] [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)
- Sławomir Kozieł
- Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
| | | | - Katarzyna M Pawlak
- Department of Gastroenterology, Hospital of the Ministry of Internal Affairs in Szczecin, Poland
| | - Jan Petriczko
- Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University, Szczecin, Poland
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31
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Raiter A, Pawlak KM, Kozłowska-Petriczko K, Petriczko J, Szełemej J, Wiechowska-Kozłowska A. On the Track of New Endoscopic Alternatives for the Treatment of Selected Gastric GISTs-A Pilot Study. ACTA ACUST UNITED AC 2021; 57:medicina57060625. [PMID: 34208475 PMCID: PMC8234534 DOI: 10.3390/medicina57060625] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 12/04/2022]
Abstract
Background and Objectives: GISTs (Gastrointestinal stromal tumors) are the most common mesenchymal gastrointestinal tract tumours and are mainly located in the stomach. Their malignant potential depends on size, location, and type. Endoscopic techniques are a less invasive modality for patients not eligible for surgery. ESD (endoscopic submucosal dissection) is mainly used for the removal of smaller GISTs, with intraluminal growth and a more superficial location. Thus, R0 resection capability in some cases may be not sufficient, limited by tumour size, location in the gastric wall, and its connection level with the muscularis propria. In such cases, an endoscopic full-thickness resection can become a new alternative. In this retrospective pilot study, we evaluated ESD and hybrid resection techniques in terms of safety, efficacy, and disease recurrence for selected types of gastric GISTs. Materials and Methods: A retrospective comparison was conducted in a group of patients who underwent ESD or a hybrid technique combining endoscopic resection with endoscopic suturing using the OverStitch system (HT) for type II or III gastric GISTs. A total of 21 patients aged 70 ± 8 years underwent endoscopic resection. Seventeen lesions were treated with ESD and four with the HT. Results: R0 resection was achieved in all patients treated using HT (type III lesions) and in 53% of those treated with ESD (p = 0.08). None of the type III lesions treated with ESD were excised with R0. Lesions treated with R0 ESD resections were significantly smaller (1.76 ± 0.35 cm) than those with R1 ESD resections (2.39 ± 0.40 cm) (p < 0.01). The mean lesion size treated with the HT was 2.88 ± 0.85 cm. Conclusions: HT may be a new resection modality for large gastric GISTs with high muscularis propria connection grades. Further studies are required to evaluate its safety and efficacy and to form precise inclusion criteria for endoscopic resection techniques.
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Affiliation(s)
- Artur Raiter
- Department of Endoscopy, Specialist Hospital of Alfred Sokolowski, 58-309 Wałbrzych, Poland; (A.R.); (J.S.)
| | - Katarzyna M. Pawlak
- Endoscopy Unit, Department of Gastroenterology, Ministry of Interior and Administration, ul. Jagiellońska 44, 70-382 Szczecin, Poland;
- Correspondence: ; Tel.: +48-601447543
| | | | - Jan Petriczko
- Department of Plastic, Endocrine and General Surgery, Pomeranian Medical University, 70-382 Szczecin, Poland;
| | - Joanna Szełemej
- Department of Endoscopy, Specialist Hospital of Alfred Sokolowski, 58-309 Wałbrzych, Poland; (A.R.); (J.S.)
| | - Anna Wiechowska-Kozłowska
- Endoscopy Unit, Department of Gastroenterology, Ministry of Interior and Administration, ul. Jagiellońska 44, 70-382 Szczecin, Poland;
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32
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Affiliation(s)
- Lívia Archibugi
- Pancreato-Biliary Endoscopy and Endosonography Division, Vita-Salute San Raffaele University, Milan, Italy
| | - Katarzyna M Pawlak
- Department of Internal Medicine, Gastroenterology, Endoscopy Unit, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Diogo Libânio
- Gastroenterology Department, Portuguese Oncology Institute of Porto, Porto, Portugal
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33
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Pawlak KM, Siau K, Bilal M, Donet JA, Charabaty A, Bollipo S. Young GI angle #Twitter2Paper: Taking an idea from Twitter to paper. United European Gastroenterol J 2021; 9:129-132. [PMID: 33650281 PMCID: PMC8259252 DOI: 10.1002/ueg2.12053] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 12/18/2022] Open
Affiliation(s)
- Katarzyna M. Pawlak
- Gastroenterology DepartmentEndoscopy UnitHospital of the Ministry of Internal Affairs and AdministrationSzczecinPoland
| | - Keith Siau
- Endoscopy UnitDudley Group Hospitals NHSFTDudleyUK
- Medical and Dental SciencesUniversity of BirminghamBirminghamUK
| | - Mohammad Bilal
- Division of Gastroenterology & HepatologyMinneapolis VA Medical CenterUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Jean A. Donet
- Division of Gastroenterology and HepatologyUniversity of California San Francisco‐FresnoFresnoCaliforniaUSA
| | - Aline Charabaty
- Division of Gastroenterology and HepatologyJohns Hopkins School of MedicineWashingtonDistrict of ColumbiaUSA
| | - Steven Bollipo
- Department of GastroenterologyJohn Hunter HospitalNewcastleNew South WalesAustralia
- School of Medicine & Public HealthUniversity of NewcastleCallaghanAustralia
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Abstract
EUS has become a substantial diagnostic and therapeutic modality for digestive tract conditions. The extent of endosonographic assessment is wide, and, among others, it allows for the evaluation of liver anatomy and related pathologies. Moreover, EUS assessment has proved more accurate in detecting small focal liver lesions missed by standard imaging examinations such as computed tomography or magnetic resonance. Endosonographically, various liver segments can be visualized by transgastric and transduodenal scanning following anatomical landmarks, thus providing arranged systematic examination. In addition, knowledge considering the correct position during examination is crucial for EUS-guided procedures such as hepaticogastrostomy, ablation of tumors, and measurement of portal pressure gradient. The evolution of EUS-guided intervention has contributed to the increasing importance of understanding the hepatic segmental anatomy during the EUS examination.
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Affiliation(s)
- Hussein Hassan Okasha
- Department of Internal Medicine, Division of Gastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Mahmoud Farouk
- Department of Tropical Medicine and Gastroenterology, Assiut University, Assiut, Egypt
| | | | - Rasha Mohamed Mahmoud
- Department of Internal Medicine, Gastroenterology Unit, Assiut University, Assiut, Egypt
| | - Ahmed El-Meligui
- Department of Internal Medicine, Division of Gastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Hassan Atalla
- Department of Internal Medicine, Hepatology and Gastroenterology Unit, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmed Morad Hashim
- Department of Internal Medicine, Division of Gastroenterology, Kasr Al-Aini School of Medicine, Cairo University, Cairo, Egypt
| | - Katarzyna M Pawlak
- Department of Internal Medicine, Cardiology, Gastroenterology and Endocrinology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
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Pawlak KM, Charabaty A, Khan R, Siau K. Response. Gastrointest Endosc 2020; 92:1147. [PMID: 33160506 DOI: 10.1016/j.gie.2020.06.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/28/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Katarzyna M Pawlak
- Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Aline Charabaty
- Division of Gastroenterology, Johns Hopkins School of Medicine, Johns Hopkins-Sibley Memorial Hospital, Washington, DC, USA
| | - Rishad Khan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Keith Siau
- Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Liver Unit, University Hospitals Birmingham, Birmingham, UK
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Khan R, Tandon P, Scaffidi MA, Bishay K, Pawlak KM, Kral J, Amin S, Bilal M, Lui RN, Sandhu DS, Hashim A, Bollipo S, Charabaty A, de-Madaria E, Rodríguez-Parra AF, Sánchez-Luna SA, Żorniak M, Siau K, Walsh CM, Grover SC. COVID-19 and Canadian Gastroenterology Trainees. J Can Assoc Gastroenterol 2020; 4:156-162. [PMID: 34056533 PMCID: PMC7665532 DOI: 10.1093/jcag/gwaa034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 09/17/2020] [Indexed: 12/18/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has impacted endoscopy services and education worldwide. This study aimed to characterize the impact of COVID-19 on gastroenterology trainees in Canada. Methods An analysis of Canadian respondents from the international EndoTrain survey, open from April 11 to May 2 2020 and distributed by program directors, trainees, and national and international gastroenterology societies’ representatives, was completed. The survey included questions on monthly endoscopy volume, personal protective equipment availability, trainee well-being and educational resources. The primary outcome was change in procedural volume during the COVID-19 pandemic. Secondary outcomes included trainee’s professional and personal concerns, anxiety and burnout. Results Thirty-four Canadian trainees completed the survey. Per month, participants completed a median of 30 esophagogastroduodenoscopies (interquartile range 16 to 50) prior to the pandemic compared to 2 (0 to 10) during the pandemic, 20 (8 to 30) compared to 2 (0 to 5) colonoscopies and 3 (1 to 10) compared to 0 (0 to 3) upper gastrointestinal bleeding procedures. There was a significant decrease in procedural volumes between the pre-COVID-19 and COVID-19 time periods for all procedures (P < 0.001). Thirty (88%) trainees were concerned about personal COVID-19 exposure, 32 (94%) were concerned about achieving and/or maintaining clinical competence and 24 (71%) were concerned about prolongation of training time due to the pandemic. Twenty-six (79%) respondents experienced some degree of anxiety, and 10 (31%) experienced some degree of burnout. Conclusion The COVID-19 pandemic has substantially impacted gastroenterology trainees in Canada. As the pandemic eases, it important for gastrointestinal programs to adapt to maximize resident learning, maintain effective clinical care and ensure development of endoscopic competence.
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Affiliation(s)
- Rishad Khan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Parul Tandon
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael A Scaffidi
- Division of Gastroenterology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Kirles Bishay
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Katarzyna M Pawlak
- Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Jan Kral
- Institution for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Sunil Amin
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Mohammad Bilal
- Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Rashid N Lui
- Division of Gastroenterology and Hepatology, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Dalbir S Sandhu
- Division of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio
| | - Almoutaz Hashim
- Department of Medicine at The University Of Jeddah, Jeddah, Saudi Arabia
| | - Steven Bollipo
- Gastroenterology Department, John Hunter Hospital, University of Newcastle, Newcastle, New South Wales, Australia
| | - Aline Charabaty
- Division of Gastroenterology, Johns Hopkins-Sibley Memorial Hospital, Washington, DC
| | - Enrique de-Madaria
- Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research, Alicante, Spain
| | - Andrés F Rodríguez-Parra
- General Hospital Dr. Manuel Gea González, National Autonomous University of Mexico, Mexico City, Mexico
| | - Sergio A Sánchez-Luna
- Division of Gastroenterology and Hepatology, The University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Michał Żorniak
- Department of Gastroenterology, Medical University of Silesia, Katowice, Poland
| | - Keith Siau
- Medical and Dental Sciences, University of Birmingham, Birmingham.,Institute of Translational Medicine, University Hospitals Birmingham, Birmingham
| | - Catharine M Walsh
- Division of Gastroenterology, Hepatology and Nutrition and the Research and Learning Institutes, Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada.,The Wilson Centre, University of Toronto, Toronto, Ontario, Canada
| | - Samir C Grover
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Gastroenterology and Hepatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,Division of Gastroenterology, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.,Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
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Pawlak KM, Kral J, Khan R, Amin S, Bilal M, Lui RN, Sandhu DS, Hashim A, Bollipo S, Charabaty A, de-Madaria E, Rodríguez-Parra AF, Sánchez-Luna SA, Żorniak M, Walsh CM, Grover SC, Siau K. Impact of COVID-19 on endoscopy trainees: an international survey. Gastrointest Endosc 2020; 92:925-935. [PMID: 32535193 PMCID: PMC7287420 DOI: 10.1016/j.gie.2020.06.010] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Although coronavirus disease 2019 (COVID-19) has affected endoscopy services globally, the impact on trainees has not been evaluated. We aimed to assess the impact of COVID-19 on procedural volumes and on the emotional well-being of endoscopy trainees worldwide. METHODS An international survey was disseminated over a 3-week period in April 2020. The primary outcome was the percentage reduction in monthly procedure volume before and during COVID-19. Secondary outcomes included potential variation of COVID-19 impact between different continents and rates and predictors of anxiety and burnout among trainees. RESULTS Across 770 trainees from 63 countries, 93.8% reported a reduction in endoscopy case volume. The median percentage reduction in total procedures was 99% (interquartile range, 85%-100%), which varied internationally (P < .001) and was greatest for colonoscopy procedures. Restrictions in case volume and trainee activity were common barriers. A total of 71.9% were concerned that the COVID-19 pandemic could prolonged training. Anxiety was reported in 52.4% of respondents and burnout in 18.8%. Anxiety was independently associated with female gender (odds ratio [OR], 2.15; P < .001), adequacy of personal protective equipment (OR, 1.75; P = .005), lack of institutional support for emotional health (OR, 1.67; P = .008), and concerns regarding prolongation of training (OR, 1.60; P = .013). Modifying existing national guidelines to support adequate endoscopy training during the pandemic was supported by 68.9%. CONCLUSIONS The COVID-19 pandemic has led to restrictions in endoscopic volumes and endoscopy training, with high rates of anxiety and burnout among endoscopy trainees worldwide. Targeted measures by training programs to address these key issues are warranted to improve trainee well-being and support trainee education.
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Affiliation(s)
- Katarzyna M Pawlak
- Department of Internal Medicine, Cardiology, Gastroenterology and Endocrinology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Jan Kral
- Hepatogastroenterology Department, Institution for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Rishad Khan
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sunil Amin
- Division of Digestive Health and Liver Diseases, Department of Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Mohammad Bilal
- Division of Gastroenterology & Hepatology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Rashid N Lui
- Division of Gastroenterology and Hepatology, Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Dalbir S Sandhu
- Case Western Reserve University, Division of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio, USA
| | | | - Steven Bollipo
- Gastroenterology & Endoscopy, John Hunter Hospital, Newcastle, Australia; University of Newcastle, Australia
| | - Aline Charabaty
- Division of Gastroenterology, Johns Hopkins School of Medicine, Johns Hopkins-Sibley Memorial Hospital, Washington DC, USA
| | - Enrique de-Madaria
- Gastroenterology Department, Alicante University General Hospital, Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
| | - Andrés F Rodríguez-Parra
- General Hospital Dr. Manuel Gea González, National Autonomous University of Mexico, Mexico City, Mexico
| | - Sergio A Sánchez-Luna
- Division of Gastroenterology and Hepatology, The University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Michał Żorniak
- Department of Gastroenterology, Medical University of Silesia, Katowice, Poland and Department of Medicine II, Ludwig-Maximillian's Univeristy, Munich, Germany
| | - Catharine M Walsh
- Division of Gastroenterology, Hepatology and Nutrition and the Research and Learning Institutes, Hospital for Sick Children, Department of Paediatrics and the Wilson Centre, University of Toronto, Toronto, Ontario, Canada
| | - Samir C Grover
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada; Division of Gastroenterology, University of Toronto, Toronto, Ontario, Canada
| | - Keith Siau
- Medical and Dental Sciences, University of Birmingham, Birmingham, UK; Liver Unit, University Hospitals Birmingham, Birmingham, UK
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Okasha HH, Pawlak KM, Żorniak M, Wiechowska-Kozłowska A, Naga YM, ElHusseiny R. EUS in the evaluation of metastatic lesions to the pancreas. Endosc Ultrasound 2020; 9:147-150. [PMID: 32584308 PMCID: PMC7430902 DOI: 10.4103/eus.eus_31_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hussein Hassan Okasha
- Department of Internal Medicine, Gastroenterology Division, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Katarzyna M Pawlak
- Department of Internal Medicine, Cardiology, Gastroenterology and Endocrinology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Michał Żorniak
- Department of Gastroenterology and Hepatology, Medical University of Silesia, Katowice, Poland
| | - Anna Wiechowska-Kozłowska
- Department of Internal Medicine, Cardiology, Gastroenterology and Endocrinology, Hospital of the Ministry of Interior and Administration, Szczecin, Poland
| | - Yehia Mazen Naga
- Department of Medicine, Division of Digestive Diseases, University of Mississippi Medical Center, Jackson, MS, USA
| | - Ramy ElHusseiny
- Department of Internal Medicine, National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt
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