322 results on '"Christophe Cellier"'
Search Results
2. Effectiveness of a dedicated small bowel neoplasia screening program by capsule endoscopy in Lynch syndrome: 5 years results from a tertiary care center
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Guillaume Perrod, Elia Samaha, Enrique Perez-Cuadrado-Robles, Arthur Berger, Hedi Benosman, Sherine Khater, Ariane Vienne, Charles-André Cuenod, Aziz Zaanan, Pierre Laurent-Puig, Gabriel Rahmi, and Christophe Cellier
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and aims: The role of small bowel neoplasia (SBN) screening in asymptomatic patients with Lynch syndrome (LS) is uncertain. The aim of our study was to assess the effectiveness of screening by capsule endoscopy (CE) in these patients. Methods: This study was an observational, analytical, and retrospective single-center study within the PRED-IdF network. All consecutive asymptomatic patients older than 35 years-old with confirmed LS and no personal history of SBN who started the screening from 2010–2015 were included. The baseline screening and 24 months follow-up were performed by CE. The CE diagnostic yield (positive tumor or polyp) and accuracy, using the follow-up as gold standard, were evaluated. Results: A total of 150 patients underwent the SBN screening program and 135 (52.7 ± 11.2 years-old, 37.8% male) met the inclusion criteria. The baseline CE diagnostic yield was 4.4% (3 polyps, 3 tumors) and the proximal small bowel was the most common location ( n = 4, 66.7%). In total, 87 patients underwent follow-up and the diagnostic yield was 4.6%. Four patients were considered positive at follow-up (2 adenomas, 2 adenocarcinomas). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CE were 60%, 100%, 100%, 96.9%, and 97%, respectively. Conclusions: CE is an accurate procedure for baseline screening of SBN in LS patients and may be efficient for follow-up procedures. However, the optimal starting age of screening and intervals of follow-up must be clarified.
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- 2020
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3. Noninvasive continuous monitoring versus intermittent oscillometric measurements for the detection of hypotension during digestive endoscopy.
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Anh-Dao Phan, Arthur Neuschwander, Guillaume Perrod, Gabriel Rahmi, Christophe Cellier, and Bernard Cholley
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Medicine ,Science - Abstract
BackgroundHemodynamic monitoring during digestive endoscopy is usually minimal and involves intermittent brachial pressure measurements. New continuous noninvasive devices to acquire instantaneous arterial blood pressure may be more sensitive to detect procedural hypotension.PurposeTo compare the ability of noninvasive continuous monitoring with that of intermittent oscillometric measurements to detect hypotension during digestive endoscopy.MethodsIn this observational prospective study, patients scheduled for gastrointestinal endoscopy and colonoscopy under sedation were monitored using intermittent pressure measurements and a noninvasive continuous technique (ClearSight™, Edwards). Stroke volume was estimated from the arterial pressure waveform. Mean arterial pressure and stroke volume values were recorded at T1 (prior to anesthetic induction), T2 (after anesthetic induction), T3 (gastric insufflation), T4 (end of gastroscopy), T5 (colonic insufflation). Hypotension was defined as mean arterial pressure < 65 mmHg.ResultsTwenty patients (53±17 years) were included. Six patients (30%) had a hypotension detected using intermittent pressure measurements versus twelve patients (60%) using noninvasive continuous monitoring (p = 0.06). Mean arterial pressure decreased during the procedure with respect to T1 (p < 0.05), but the continuous method provided an earlier warning than the intermittent method (T3 vs T4). Nine patients (45%) had at least a 25% reduction in stroke volume, with respect to baseline.ConclusionNoninvasive continuous monitoring was more sensitive than intermittent measurements to detect hypotension. Estimation of stroke volume revealed profound reductions in systemic flow. Noninvasive continuous monitoring in high-risk patients undergoing digestive endoscopy under sedation could help in detecting hypoperfusion earlier than the usual intermittent blood pressure measurements.
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- 2020
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4. Feline low-grade alimentary lymphoma: an emerging entity and a potential animal model for human disease
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Mathieu V Paulin, Lucile Couronné, Jérémy Beguin, Sophie Le Poder, Maxence Delverdier, Marie-Odile Semin, Julie Bruneau, Nadine Cerf-Bensussan, Georgia Malamut, Christophe Cellier, Ghita Benchekroun, Laurent Tiret, Alexander J German, Olivier Hermine, and Valérie Freiche
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Comparative oncology ,Cat ,Inflammatory bowel disease ,Human indolent digestive T-cell lymphoproliferative disorder ,Veterinary medicine ,SF600-1100 - Abstract
Abstract Background Low-grade alimentary lymphoma (LGAL) is characterised by the infiltration of neoplastic T-lymphocytes, typically in the small intestine. The incidence of LGAL has increased over the last ten years and it is now the most frequent digestive neoplasia in cats and comprises 60 to 75% of gastrointestinal lymphoma cases. Given that LGAL shares common clinical, paraclinical and ultrasonographic features with inflammatory bowel diseases, establishing a diagnosis is challenging. A review was designed to summarise current knowledge of the pathogenesis, diagnosis, prognosis and treatment of feline LGAL. Electronic searches of PubMed and Science Direct were carried out without date or language restrictions. Results A total of 176 peer-reviewed documents were identified and most of which were published in the last twenty years. 130 studies were found from the veterinary literature and 46 from the human medicine literature. Heterogeneity of study designs and outcome measures made meta-analysis inappropriate. The pathophysiology of feline LGAL still needs to be elucidated, not least the putative roles of infectious agents, environmental factors as well as genetic events. The most common therapeutic strategy is combination treatment with prednisolone and chlorambucil, and prolonged remission can often be achieved. Developments in immunohistochemical analysis and clonality testing have improved the confidence of clinicians in obtaining a correct diagnosis between LGAL and IBD. The condition shares similarities with some diseases in humans, especially human indolent T-cell lymphoproliferative disorder of the gastrointestinal tract. Conclusions The pathophysiology of feline LGAL still needs to be elucidated and prospective studies as well as standardisation of therapeutic strategies are needed. A combination of conventional histopathology and immunohistochemistry remains the current gold-standard test, but clinicians should be cautious about reclassifying cats previously diagnosed with IBD to lymphoma on the basis of clonality testing. Importantly, feline LGAL could be considered to be a potential animal model for indolent digestive T-cell lymphoproliferative disorder, a rare condition in human medicine.
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- 2018
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5. A novel data-driven workflow combining literature and electronic health records to estimate comorbidities burden for a specific disease: a case study on autoimmune comorbidities in patients with celiac disease
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Jean-Baptiste Escudié, Bastien Rance, Georgia Malamut, Sherine Khater, Anita Burgun, Christophe Cellier, and Anne-Sophie Jannot
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Autoimmune diseases ,Celiac disease ,Electronic health records ,Icd 10 ,Phenotype ,Prevalence study ,Computer applications to medicine. Medical informatics ,R858-859.7 - Abstract
Abstract Background Data collected in EHRs have been widely used to identifying specific conditions; however there is still a need for methods to define comorbidities and sources to identify comorbidities burden. We propose an approach to assess comorbidities burden for a specific disease using the literature and EHR data sources in the case of autoimmune diseases in celiac disease (CD). Methods We generated a restricted set of comorbidities using the literature (via the MeSH® co-occurrence file). We extracted the 15 most co-occurring autoimmune diseases of the CD. We used mappings of the comorbidities to EHR terminologies: ICD-10 (billing codes), ATC (drugs) and UMLS (clinical reports). Finally, we extracted the concepts from the different data sources. We evaluated our approach using the correlation between prevalence estimates in our cohort and co-occurrence ranking in the literature. Results We retrieved the comorbidities for 741 patients with CD. 18.1% of patients had at least one of the 15 studied autoimmune disorders. Overall, 79.3% of the mapped concepts were detected only in text, 5.3% only in ICD codes and/or drugs prescriptions, and 15.4% could be found in both sources. Prevalence in our cohort were correlated with literature (Spearman’s coefficient 0.789, p = 0.0005). The three most prevalent comorbidities were thyroiditis 12.6% (95% CI 10.1–14.9), type 1 diabetes 2.3% (95% CI 1.2–3.4) and dermatitis herpetiformis 2.0% (95% CI 1.0–3.0). Conclusion We introduced a process that leveraged the MeSH terminology to identify relevant autoimmune comorbidities of the CD and several data sources from EHRs to phenotype a large population of CD patients. We achieved prevalence estimates comparable to the literature.
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- 2017
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6. Duodenal duplication cyst: a rare cause of recurrent pancreatitis
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Guillaume Perrod, MD, Gabriel Rahmi, MD, PhD, Elia Samaha, MD, Ariane Vienne, MD, and Christophe Cellier, MD, PhD
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2018
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7. Impact of an optimized colonoscopic screening program for patients with Lynch syndrome: 6-year results of a specialized French network
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Guillaume Perrod, Elia Samaha, Gabriel Rahmi, Sherine Khater, Leila Abbes, Camille Savale, Geraldine Perkins, Aziz Zaanan, Gilles Chatellier, Georgia Malamut, and Christophe Cellier
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background: Despite colonoscopic screening, colorectal cancer (CRC) remains frequent in patients with Lynch syndrome (LS). The objective of this study was to evaluate the impact of an optimized colorectal screening program within a French dedicated network. Methods: All LS patients followed at our institution were consecutively included in the Prédisposition au Cancer Colorectal-Ile de France (PRED-IdF) network. Patients were offered an optimized screening program allowing an adjustment of the interval between colonoscopies, depending on bowel preparation, chromoendoscopy achievement and adenoma detection. Colonoscopies were defined as optimal when all the screening criteria were respected. We compared colonoscopy quality and colonoscopy detection rate before and after PRED-IdF inclusion, including polyp detection rate (PDR), adenoma detection rate (ADR) and cancer detection rate (CDR). Results: Between January 2010 and January 2016, 144 LS patients were consecutively included (male/female = 50/94, mean age = 51 ± 13 years and mutations: MLH1 = 39%, MSH2 = 44%, MSH6 = 15%, PMS2 = 1%). A total of 564 colonoscopies were analyzed, 353 after inclusion and 211 before. After PRED-IdF inclusion, 98/144 (68%) patients had optimal screening colonoscopies versus 33/132 (25%) before ( p < 0.0005). The optimal colonoscopy rate was 304/353 (86%) after inclusion versus 87/211 (41%) before, ( p < 0.0001). PRED-IdF inclusion was associated with a reduction of CRC occurrence with a CDR of 1/353 (0.3%) after inclusion versus 6/211 (2.8%) before ( p = 0.012). ADR and PDR were 99/353 (28%) versus 60/211 (28.8%) ( p > 0.05) and 167/353 (48.1%) versus 90/211 (42.2%) ( p > 0.05), respectively after and before inclusion. Conclusions: An optimized colonoscopic surveillance program in LS patients seems to improve colonoscopic screening quality and might possibly decrease colorectal interval cancer occurrence. Long-term cohort studies are needed to confirm these results.
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- 2018
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8. Efficacy and safety of pasireotide-LAR for the treatment of refractory bleeding due to gastrointestinal angiodysplasias: results of the ANGIOPAS multicenter phase II noncomparative prospective double-blinded randomized study
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Robert Benamouzig, Mourad Benallaoua, Jean-Christophe Saurin, Marouane Boubaya, Christophe Cellier, René Laugier, Magalie Vincent, Christian Boustière, Rodica Gincul, Elia Samaha, Philippe Grandval, Thomas Aparicio, Gheorghe Airinei, Bakhtiar Bejou, Cyriaque Bon, Jean-Jacques Raynaud, Vincent Levy, and Denis Sautereau
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background: Gastrointestinal angiodysplasias (GIADs) could be responsible for recurrent bleeding and severe anemia. Somatostatin analogs could reduce transfusion requirements in these patients but no randomized controlled study is available. The main objective of the ANGIOPAS phase II double-blinded randomized, noncomparative study was to assess the effectiveness of pasireotide-LAR in reducing transfusion requirements in patients with refractory GIADs bleeding. Methods: A total of 22 patients with transfusion requirements ⩾6 units of packed red blood cells (pRBCs) during the 6 months prior to inclusion were randomized to receive pasireotide-LAR 60 mg ( n = 10) or placebo ( n = 12) every 28 days for 6 months. Patients were then followed for an additional 6 months after stopping treatment. Results: The pasireotide-LAR and placebo groups were equivalent for age, sex, comorbidities and transfusion requirement during the reference period (median 13 and 9.5 pRBCs). A 50 and 83% success rate (success defined as a decrease of at least 30% of transfused pRBCs) was observed in the pasireotide-LAR arm in the Intent to Treat (ITT) and per protocol (PP) analysis respectively. The need for transfusion during the intervention period was 3 pRBC units in the pasireotide-LAR group (range 0–26) and 11.5 pRBC units in the placebo group (range 0–23). Overall, three cases with glycemic control impairment were observed in the pasireotide-LAR group including one de novo diabetes. Conclusion: This double-blinded noncomparative randomized phase II study suggests, for the first time, the effectiveness of pasireotide-LAR 60 mg every 28 days to decrease the transfusion requirement in patients with recurrent bleeding due to GIADs.
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- 2018
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9. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts’ Criteria
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Carlo Catassi, Luca Elli, Bruno Bonaz, Gerd Bouma, Antonio Carroccio, Gemma Castillejo, Christophe Cellier, Fernanda Cristofori, Laura de Magistris, Jernej Dolinsek, Walburga Dieterich, Ruggiero Francavilla, Marios Hadjivassiliou, Wolfgang Holtmeier, Ute Körner, Dan A. Leffler, Knut E. A. Lundin, Giuseppe Mazzarella, Chris J. Mulder, Nicoletta Pellegrini, Kamran Rostami, David Sanders, Gry Irene Skodje, Detlef Schuppan, Reiner Ullrich, Umberto Volta, Marianne Williams, Victor F. Zevallos, Yurdagül Zopf, and Alessio Fasano
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non-celiac gluten sensitivity ,diagnosis ,double-blind placebo-controlled challenge ,gastrointestinal symptom rating scale ,irritable bowel syndrome ,Nutrition. Foods and food supply ,TX341-641 - Abstract
Non-Celiac Gluten Sensitivity (NCGS) is a syndrome characterized by intestinal and extra-intestinal symptoms related to the ingestion of gluten-containing food, in subjects that are not affected by either celiac disease or wheat allergy. Given the lack of a NCGS biomarker, there is the need for standardizing the procedure leading to the diagnosis confirmation. In this paper we report experts’ recommendations on how the diagnostic protocol should be performed for the confirmation of NCGS. A full diagnostic procedure should assess the clinical response to the gluten-free diet (GFD) and measure the effect of a gluten challenge after a period of treatment with the GFD. The clinical evaluation is performed using a self-administered instrument incorporating a modified version of the Gastrointestinal Symptom Rating Scale. The patient identifies one to three main symptoms that are quantitatively assessed using a Numerical Rating Scale with a score ranging from 1 to 10. The double-blind placebo-controlled gluten challenge (8 g/day) includes a one-week challenge followed by a one-week washout of strict GFD and by the crossover to the second one-week challenge. The vehicle should contain cooked, homogeneously distributed gluten. At least a variation of 30% of one to three main symptoms between the gluten and the placebo challenge should be detected to discriminate a positive from a negative result. The guidelines provided in this paper will help the clinician to reach a firm and positive diagnosis of NCGS and facilitate the comparisons of different studies, if adopted internationally.
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- 2015
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10. Efficacy of double-balloon enteroscopy for small-bowel polypectomy: clinical and economic evaluation
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Gabriel Rahmi, Marie-Amélie Vinet, Guillaume Perrod, Jean-Christophe Saurin, Elia Samaha, Thierry Ponchon, Jean-Marc Canard, Joël Edery, Hassani Maoulida, Gilles Chatellier, Isabelle Durand-Zaleski, and Christophe Cellier
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background: We evaluated first the feasibility of endoscopic small-bowel polypectomy and second, the economic aspects, by comparing the cost of endoscopic and surgical polyp resection. Methods: A prospective, observational, multicenter study included 494 patients with positive capsule endoscopy (CE) before double-balloon enteroscopy (DBE). We selected only CE with at least one polyp. The retrospective economic evaluation compared patients treated by DBE or surgery for small-bowel polypectomy. Hospital readmission because of repeat polyp resection or complication-related interventions was noted. The 1-year cost was estimated from the viewpoint of the healthcare system and included procedures, hospital admissions and follow up. Results: CE indicated one or more polyps in 62 (12.5%) patients (32 males, 49 ± 5 years), all of whom underwent a successful DBE exploration. The DBE polyp diagnostic yield was 58%. There were no major complications. A total of 26 (42%) patients in the DBE group and 19 (39%) in the control group required hospital readmission. All readmissions in the DBE group were for repeat procedures to remove all polyps, and in the control group, for surgical complications. The total cost of the initial hospitalization (€4014 ± 2239 DBE versus €11,620 ± 7183 surgery, p < 0.0001) and the 1-year total cost (€8438 ± 9227 DBE versus €13,402 ± 7919 surgery, p < 0.0001) were lower in the DBE group. Conclusions: Endoscopic polypectomy was efficient and safe. The total cost at 1 year was less for endoscopy than surgery. DBE should be proposed as the first-line treatment for small-bowel polyp resection.
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- 2017
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11. Over-the-scope clip (OTSC) reduces surgery rate in the management of iatrogenic gastrointestinal perforations
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Sherine Khater, Gabriel Rahmi, Guillaume Perrod, Elia Samaha, Hedi Benosman, Leila Abbes, Georgia Malamut, and Christophe Cellier
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and study aims Over-the-scope clip (OTSC) has been recently used in management of gastrointestinal perforations, but data on it are still limited. The aim of this study was to compare management of iatrogenic perforations before and after the OTSC was available in our endoscopy unit. Patients and methods We conducted a monocentric retrospective study from June 2007 to June 2015. All iatrogenic gastrointestinal perforations detected during endoscopy were included. Two time periods were compared in terms of surgery and mortality rates: before use of OTSC (June 2007 to June 2011) and after OTSC became available (June 2011 to June 2015). Results During the first period, 24 perforations were recorded. Fifteen (62.5 %) were managed with surgery. The mortality rate was 8 %. During the second period, 16 perforations occurred. In 11 patients (68.7 %), an OTSC was used to close the perforation, with complete sealing of the perforation in 100 % of cases. However, 2 patients with sigmoid perforation had to undergo surgery due to right ureteral obstruction by the clip in 1 case and to presence of a localized peritonitis in the other. The surgery rate during this period was 12.5 % (2 /16), with a statistically significant difference compared to the first period (P = 0.002). There was no mortality in the second period versus 8 % in the first one (P = 0.23). Conclusions OTSC is effective for endoluminal closure of iatrogenic perforations and results in a significant decrease in surgery rate.
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- 2017
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12. Cell Sheet Transplantation for Esophageal Stricture Prevention after Endoscopic Submucosal Dissection in a Porcine Model.
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Guillaume Perrod, Gabriel Rahmi, Laetitia Pidial, Sophie Camilleri, Alexandre Bellucci, Amaury Casanova, Thomas Viel, Bertrand Tavitian, Christophe Cellier, and Olivier Clement
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Medicine ,Science - Abstract
BACKGROUND & AIMS:Extended esophageal endoscopic submucosal dissection (ESD) is highly responsible for esophageal stricture. We conducted a comparative study in a porcine model to evaluate the effectiveness of adipose tissue-derived stromal cell (ADSC) double cell sheet transplantation. METHODS:Twelve female pigs were treated with 5 cm long hemi-circumferential ESD and randomized in two groups. ADSC group (n = 6) received 4 double cell sheets of allogenic ADSC on a paper support membrane and control group (n = 6) received 4 paper support membranes. ADSC were labelled with PKH-67 fluorophore to allow probe-based confocal laser endomicroscopie (pCLE) monitoring. After 28 days follow-up, animals were sacrificed. At days 3, 14 and 28, endoscopic evaluation with pCLE and esophagography were performed. RESULTS:One animal from the control group was excluded (anesthetic complication). Animals from ADSC group showed less frequent alimentary trouble (17% vs 80%; P = 0.08) and higher gain weight on day 28. pCLE demonstrated a compatible cell signal in 4 animals of the ADSC group at day 3. In ADSC group, endoscopy showed that 1 out of 6 (17%) animals developed a severe esophageal stricture comparatively to 100% (5/5) in the control group; P = 0.015. Esophagography demonstrated a decreased degree of stricture in the ADSC group on day 14 (44% vs 81%; P = 0.017) and day 28 (46% vs 90%; P = 0.035). Histological analysis showed a decreased fibrosis development in the ADSC group, in terms of surface (9.7 vs 26.1 mm²; P = 0.017) and maximal depth (1.6 vs 3.2 mm; P = 0.052). CONCLUSION:In this model, transplantation of allogenic ADSC organized in double cell sheets after extended esophegeal ESD is strongly associated with a lower esophageal stricture's rate.
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- 2016
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13. Gastrointestinal Disorder Associated with Olmesartan Mimics Autoimmune Enteropathy.
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Sophie Scialom, Georgia Malamut, Bertrand Meresse, Nicolas Guegan, Nicole Brousse, Virginie Verkarre, Coralie Derrieux, Elizabeth Macintyre, Philippe Seksik, Guillaume Savoye, Guillaume Cadiot, Lucine Vuitton, Lysiane Marthey, Franck Carbonnel, Nadine Cerf-Bensussan, and Christophe Cellier
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Medicine ,Science - Abstract
Background and objectivesAnti-hypertensive treatment with the angiotensin II receptor antagonist olmesartan is a rare cause of severe Sprue-like enteropathy. To substantiate the hypothesis that olmesartan interferes with gut immune homeostasis, clinical, histopathological and immune features were compared in olmesartan-induced-enteropathy (OIE) and in autoimmune enteropathy (AIE).MethodsMedical files of seven patients with OIE and 4 patients with AIE enrolled during the same period were retrospectively reviewed. Intestinal biopsies were collected for central histopathological review, T cell Receptor clonality and flow cytometric analysis of isolated intestinal lymphocytes.ResultsAmong seven olmesartan-treated patients who developed villous atrophy refractory to a gluten free diet, three had extra-intestinal autoimmune diseases, two had antibodies reacting with the 75 kilodalton antigen characteristic of AIE and one had serum anti-goblet cell antibodies. Small intestinal lesions and signs of intestinal lymphocyte activation were thus reminiscent of the four cases of AIE diagnosed during the same period. Before olmesartan discontinuation, remission was induced in all patients (7/7) by immunosuppressive drugs. After interruption of both olmesartan and immunosuppressive drugs in six patients, remission was maintained in 4 but anti-TNF-α therapy was needed in two.ConclusionThis case-series shows that olmesartan can induce intestinal damage mimicking AIE. OIE usually resolved after olmesartan interruption but immunosuppressive drugs may be necessary to achieve remission. Our data sustain the hypothesis that olmesartan interferes with intestinal immuno regulation in predisposed individuals.
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- 2015
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14. Application of Deamidated Gliadin Antibodies in the Follow-Up of Treated Celiac Disease.
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Luc de Chaisemartin, Tchao Meatchi, Georgia Malamut, Fahima Fernani-Oukil, Frédérique Hosking, Dorothée Rault, Fabienne Bellery, Christophe Cellier, and Marie-Agnès Dragon-Durey
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Medicine ,Science - Abstract
The role of serological tests such as IgA anti-transglutaminase autoantibodies has become increasingly important in celiac disease (CD) diagnosis. However, the efficiency of these tests for patient follow-up is controversial. We investigated the correlation of 12 different serological tests, including recent deamidated gliadin and actin IgA tests, with villous atrophy (VA) in a retrospective cohort of treated celiac patients.Serum samples were collected from 100 treated CD patients who had intestinal biopsy in the course of their follow-up. Antibodies against transglutaminase, deamidated gliadin peptides, and native gliadin were measured, along with IgA anti-actin. The biopsy slides were all blind-reviewed and scored according to Marsh classification.For all deamidated gliadin and transglutaminase tests, we found that a positive result was significantly associated with persistence of intestinal VA, with a diagnostic efficacy up to 80%. Furthermore, antibodies titers directly correlated with the degree of VA, indicating a strong link between disease activity and presence of antibodies in the serum. Interestingly, the tests with the highest association with persistent VA were those for deamidated gliadin IgG. Using a test positivity pattern analysis, we were also able to identify several groups of patients with distinct antibody profiles that showed significant differences in intestinal damage and diet compliance.Altogether, these results show that deamidated gliadin antibodies are strongly correlated with VA and should be considered valuable tools in CD follow-up and that multiplex serologic analysis for treated CD represents a promising tool for personalized patient management.
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- 2015
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15. Acute Colitis Caused by Helicobacter trogontum in Immunocompetent Patient
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Fabien Dutasta, Elia Samaha, Nathalie Carayol, Jean-Marc Masse, Camille Bourillon, Clémence Richaud, Arthur Neuschwander, Hidayeth Rostane, Marie Lyse Parolini, Patrick Bruneval, Christophe Cellier, and Isabelle Podglajen
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colitis ,bacteremia ,non–pylori Helicobacter ,Caco-2 cell cycle arrest ,inflammatory bowel disease ,bacteria ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Published
- 2016
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16. PROgnosticating COeliac patieNts SUrvivaL: the PROCONSUL score.
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Federico Biagi, Annalisa Schiepatti, Georgia Malamut, Alessandra Marchese, Christophe Cellier, Sjoerd F Bakker, Chris J J Mulder, Umberto Volta, Fabiana Zingone, Carolina Ciacci, Anna D'Odorico, Alida Andrealli, Marco Astegiano, Catherine Klersy, and Gino R Corazza
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Medicine ,Science - Abstract
IntroductionIt has been shown that mortality rates of coeliac patients correlate with age at diagnosis of coeliac disease, diagnostic delay for coeliac disease, pattern of clinical presentation and HLA typing. Our aim was to create a tool that identifies coeliac patients at higher risk of developing complications.MethodsTo identify predictors of complications in patients with coeliac disease, we organised an observational multicenter case-control study based on a retrospective collection of clinical data. Clinical data from 116 cases (patients with complicated coeliac disease) and 181 controls (coeliac patients without any complications) were collected from seven European centres. For each case, one or two controls, matched to cases according to the year of assessment, gender and age, were selected. Diagnostic delay, pattern of clinical presentation, HLA typing and age at diagnosis were used as predictors.ResultsDifferences between cases and controls were detected for diagnostic delay and classical presentation. Conditional logistic models based on these statistically different predictors allowed the development of a score system. Tertiles analysis showed a relationship between score and risk of developing complications.DiscussionA score that shows the risk of a newly diagnosed coeliac patient developing complications was devised for the first time. This will make it possible to set up the follow-up of coeliac patients with great benefits not only for their health but also for management of economic resources.ConclusionsWe think that our results are very encouraging and represent the first attempt to build a prognostic score for coeliac patients.
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- 2014
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17. Validation of a French version of the quality of life 'Celiac Disease Questionnaire'.
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Jacques Pouchot, Carole Despujol, Georgia Malamut, Emmanuel Ecosse, Joël Coste, and Christophe Cellier
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Medicine ,Science - Abstract
BACKGROUND AND OBJECTIVE: Celiac disease (CD) is a common chronic autoimmune disorder. Both the manifestations of the disease and the burden of the compulsory life-long gluten-free diet (GFD) have been shown to be associated with impairment of health-related quality of life. The objectives of this study were to provide a cross-cultural adaptation of the specific quality of life "Celiac Disease Questionnaire" (CDQ) and to analyze its psychometric properties. MATERIALS AND METHODS: A cross-cultural French adaptation of the CDQ (F-CDQ) was obtained according to the revised international guidelines. The questionnaire was administered at baseline to 211 patients with biopsy proven CD followed-up in a single tertiary referral centre. The questionnaire was also administered after 7 days and 6 months. Reliability (intraclass correlation coefficients (ICC), Cronbach's alpha and Bland and Altman graphical analysis), validity (factorial structure and Rasch analysis, convergent validity), and responsiveness (effect size) of the F-CDQ were studied. RESULTS: The reliability of the F-CDQ was excellent with ICC and Cronbach's alpha coefficients being between 0.79 and 0.94 for the four subscales and the total score. The factorial structure and the Rasch analysis showed that the four dimensions of the original instrument were retained. Correlations with external measures (a generic measure of quality of life, an anxiety and depression instrument, a self-assessed disease severity, and clinical manifestations) were all in the expected direction confirming the validity of the instrument. Responsiveness was studied and effect sizes ≥ 0.20 were demonstrated for most of the subscales for patients who reported improvement or deterioration after 6 months. CONCLUSION: The F-CDQ retains the psychometric properties of the original instrument and should be useful in cross-national surveys and to assess outcome in clinical trials involving patients with CD.
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- 2014
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18. Factors associated with adenoma detection rate and diagnosis of polyps and colorectal cancer during colonoscopy in France: results of a prospective, nationwide survey.
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Maximilien Barret, Christian Boustiere, Jean-Marc Canard, Jean-Pierre Arpurt, David Bernardini, Philippe Bulois, Stanislas Chaussade, Denis Heresbach, Isabelle Joly, Jean Lapuelle, René Laugier, Gilles Lesur, Patrice Pienkowski, Thierry Ponchon, Bertrand Pujol, Bruno Richard-Molard, Michel Robaszkiewicz, Rémi Systchenko, Fatima Abbas, Anne-Marie Schott-Pethelaz, Christophe Cellier, and Société Française d'Endoscopie Digestive
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Medicine ,Science - Abstract
IntroductionColonoscopy can prevent deaths due to colorectal cancer (CRC) through early diagnosis or resection of colonic adenomas. We conducted a prospective, nationwide study on colonoscopy practice in France.MethodsAn online questionnaire was administered to 2,600 French gastroenterologists. Data from all consecutive colonoscopies performed during one week were collected. A statistical extrapolation of the results to a whole year was performed, and factors potentially associated with the adenoma detection rate (ADR) or the diagnosis of polyps or cancer were assessed.ResultsA total of 342 gastroenterologists, representative of the overall population of French gastroenterologists, provided data on 3,266 colonoscopies, corresponding to 1,200,529 (95% CI: 1,125,936-1,275,122) procedures for the year 2011. The indication for colonoscopy was CRC screening and digestive symptoms in 49.6% and 38.9% of cases, respectively. Polypectomy was performed in 35.5% of cases. The ADR and prevalence of CRC were 17.7% and 2.9%, respectively. The main factors associated with a high ADR were male gender (p=0.0001), age over 50 (p=0.0001), personal or family history of CRC or colorectal polyps (pConclusionsFor the first time in France, we report nationwide prospective data on colonoscopy practice, including histological results. We found an average ADR of 17.7%, and observed reduced CRC incidence in patients with previous colonoscopy.
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- 2013
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19. Immunopathologie de l’intestin grêle
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Julie Bruneau, Shérine Khater, Pierre Isnard, Ludovic Lhermitte, Chantal Brouzes, David Sibon, Vahid Asnafi, Dominique Berrebi, Marion Rabant, Bénédicte Neven, Christophe Cellier, Olivier Hermine, and Thierry Jo Molina
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Pathology and Forensic Medicine - Published
- 2023
20. Anastomoses digestives non biliaires guidées par écho-endoscopie
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Enrique Pérez-Cuadrado-Robles, Hadrien Alric, Hedi Benosman, Boris Rosenbaum, Ali Aidibi, Gabriel Rahmi, and Christophe Cellier
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Hepatology ,Gastroenterology - Published
- 2023
21. Risk factors of anastomosis‐related difficult endoscopic retrograde cholangiopancreatography following endoscopic ultrasound‐guided gastro‐gastrostomy using a standardized protocol (with video)
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Enrique Pérez‐Cuadrado‐Robles, Hadrien Alric, Lucille Quénéhervé, Laurent Monino, Tigran Poghosyan, Hedi Benosman, Ariane Vienne, Guillaume Perrod, Lionel Rebibo, Ali Aidibi, Elena Tenorio‐González, Emilia Ragot, Mehdi Karoui, Christophe Cellier, and Gabriel Rahmi
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Gastroenterology ,Radiology, Nuclear Medicine and imaging - Published
- 2023
22. EUS-Guided Gastroenterostomy in Malignant Gastric Outlet Obstruction: A Comparative Study between First- and Second-Line Approaches after Enteral Stent Placement
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Enrique Perez-Cuadrado-Robles, Hadrien Alric, Ali Aidibi, Michiel Bronswijk, Giuseppe Vanella, Claire Gallois, Hedi Benosman, Emilia Ragot, Claire Rives-Lange, Gabriel Rahmi, and Christophe Cellier
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EVENTS ,LAMS ,Cancer Research ,Science & Technology ,Oncology ,gastric outlet obstruction ,pancreatic cancer ,endoscopic ultrasound ,MANAGEMENT ,Life Sciences & Biomedicine ,CLASSIFICATION - Abstract
INTRODUCTION: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is increasingly used in the setting of malignant gastric outlet obstruction (GOO). However, little is known about the role of primary EUS-GE. The aim of the present study is to compare the outcomes of EUS-GE by using the freehand technique as a first- and second-line approach after enteral stenting (ES). METHODS: This is an observational single-center study using a prospectively collected database. All consecutive patients who underwent an EUS-GE using the freehand technique due to malignant GOO were included. Patients with previous gastric surgery, a wire-guided EUS-GE technique, or those presenting without GOO were excluded. The primary outcome was the clinical success, defined as a solid oral intake at 1 week after the procedure (GOO Score, GOOSS ≥ 2). The secondary outcomes were technical success and adverse event (AE) rates. The impact on nutritional parameters was also assessed. RESULTS: Forty-five patients underwent an EUS-GE for all indications. Finally, 28 patients (mean age: 63 ± 17.2 years, 57.1% male) with (n = 13, 46.4%) and without (n = 15, 53.6%) a previous ES were included. The technical success was achieved in 25 cases (89.3%), with no differences between the two groups (92.3% vs. 86.7%, p = 1). The median limb diameter and procedure time were 27 mm (range:15-48) and 37 min. Overall, clinical success was achieved in 22 cases (88%), with three failures due to AEs (n = 2) or peritoneal carcinomatosis (n = 1). The diet progression was quicker in patients with a previous ES (GOOSS at 48 h, 2 vs. 1, p = 0.023), but the GOOSS at 1 week (p = 0.299), albumin gain (p = 0.366), and BMI gain (0.257) were comparable in the two groups. The AE rate was 7.1%. CONCLUSIONS: EUS-GE achieves a high technical and clinical success in patients with GOO regardless of the presence of a previous ES. Patients with previous ES may have a quicker progression of their diet, but the GOOSS and nutritional status in the long term at 1 week or 1 month are comparable. Primary EUS-GE might require fewer procedures and less discontinuation of chemotherapy to achieve a comparable result. ispartof: CANCERS vol:14 issue:22 ispartof: location:Switzerland status: published
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- 2022
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23. Endoscopic salvage extraction of a fish bone impacted in a liver abscess by extra-anatomic cholangioscopy
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Enrique Pérez-Cuadrado-Robles, Bernard El Khoury, Guillaume Perrod, Hadrien Alric, Gabrielle Martin, Christophe Cellier, and Gabriel Rahmi
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Cholangiopancreatography, Endoscopic Retrograde ,Biliary Tract Surgical Procedures ,Liver Abscess ,Gastroenterology ,Humans - Published
- 2022
24. Acid Reflux Is Common in Patients With Gastroesophageal Reflux Disease After One-Anastomosis Gastric Bypass
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Tigran Poghosyan, Vincent Guillet, Sylvia Krivan, William A Nehmeh, Jean-Marc Chevallier, Sébastien Czernichow, Hortense Boullenois, Clement Baratte, Christophe Cellier, Chloé Martineau, Maude Le Gall, Claire Rives-Lange, and Claire Carette
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Impedance–pH monitoring ,medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Endocrinology, Diabetes and Metabolism ,Reflux ,Disease ,Anastomosis ,medicine.disease ,Gastroenterology ,digestive system diseases ,Bile reflux ,Internal medicine ,GERD ,Medicine ,Surgery ,In patient ,business ,Body mass index - Abstract
Patients with one-anastomosis gastric bypass (OAGB) can develop gastroesophageal reflux disease (GERD). The nature of this GERD (acid or biliary) remains unclear. To assess the nature of GERD via impedance pH testing in patients presenting with reflux post OAGB. Retrospective analysis of a prospectively collected database of 43 patients with OAGB backgrounds who developed postoperative GERD and were investigated with impedance pH monitoring between 2006 and 2019. Mean age was 52.48 ± 9 years. Mean body mass index (BMI) prior to OAGB was 46.82 kg/m2. None of these patients had clinical GERD before surgery. The median time interval between surgery and investigation with 24-h impedance pH monitoring was 64 (56) months. The mean BMI at the time of investigations was 32.67 ± 6.9 kg/m2. The type of reflux was acid in 13 (30.2%), non-acid (biliary) in 12 (27.9%), and mixed (acid and biliary) in 5 (11.6%) patients. However, it remained not confirmed in 13 (30.2%). Median DeMeester score was 48.95 (27.67) in patients with acid, 2.8 (7.4) in patients with biliary, and 28.7 (5.6) in patients with mixed reflux. Median percent of time spent with pH < 4 was 9.65 (8) in patients with acid, 0.6 (1.75) in patients with biliary, and 7.7 (3.9) in patients with mixed reflux. Acid reflux seems to be as common as bile reflux in patients presenting with GERD after OAGB. In case of revisional surgery for severe GERD post OAGB, 24-h impedance pH monitoring could be essential to determine the surgical procedure of choice.
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- 2021
25. Extracellular vesicles from adipose stromal cells combined with a thermoresponsive hydrogel prevent esophageal stricture after extensive endoscopic submucosal dissection in a porcine model
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Christophe Cellier, Olivier Clément, Florence Gazeau, Iris Marangon, Elise Coffin, Guillaume Perrod, Claire Wilhelm, Max Piffoux, Coralie L. Guerin, Thierry Lecomte, Amanda K. A. Silva, Imane Boucenna, Gabriel Rahmi, Leila M'Harzi, Anna Chipont, Alice Grangier, Arthur Berger, Jessica Assouline, Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Matière et Systèmes Complexes (MSC (UMR_7057)), Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiologie de la reproduction et des comportements [Nouzilly] (PRC), Institut Français du Cheval et de l'Equitation [Saumur]-Université de Tours (UT)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Institut Curie [Paris], and Laboratoire MSC Matière et Systèmes Complexes, Université de Paris, CNRS UMR 7057, 75006 Paris, France.
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medicine.medical_specialty ,Muscularis mucosae ,Stromal cell ,Endoscopic Mucosal Resection ,Esophageal Neoplasms ,Swine ,[SDV]Life Sciences [q-bio] ,Urology ,Adipose tissue ,Endoscopic mucosal resection ,Extracellular Vesicles ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,medicine ,Extracellular ,Animals ,General Materials Science ,030304 developmental biology ,0303 health sciences ,Chemistry ,Hydrogels ,medicine.disease ,3. Good health ,Adipose Tissue ,Esophageal stricture ,Esophageal Stenosis ,030211 gastroenterology & hepatology ,Stromal Cells ,Ex vivo - Abstract
International audience; In this study, we investigated the combination of extracellular (nano) vesicles (EVs) from pig adipose tissue-derived stromal cells (ADSCs) and a thermoresponsive gel, Pluronic (R) F-127 (PF-127), to prevent stricture formation after endoscopic resection in a porcine model. ADSC EVs were produced at a liter scale by a high-yielding turbulence approach from ADSCs 3D cultured in bioreactors and characterized in terms of size, morphology and membrane markers. The thermoresponsive property of the PF-127 gel was assessed by rheology. The pro-regenerative potency of ADSC EVs was investigated ex vivo in esophageal biopsies under starvation. In vivo tests were performed in a porcine model after extended esophageal endoscopic mucosal dissection (ESD). Pigs were randomized into 3 groups: control (n = 6), gel (n = 6) or a combination of 1.45 x 10(12) EVs + gel (n = 6). Application of gel +/- EVs was performed just after ESD with a follow-up finalized on day 21 post-ESD. There was a trend towards less feeding disorder in the EV + gel group in comparison with the gel and the control groups (16.67% vs. 66.7% vs. 83.33%, respectively) but without reaching a statistically significant difference. A significant decrease in the esophageal stricture rate was confirmed by endoscopic, radiological and histological examination for the EV + gel group. A decrease in the mean fibrosis area and larger regenerated muscularis mucosae were observed for the EV + gel group. In summary, the application of EVs + gel after extended esophageal endoscopic resection succeeded in preventing stricture formation with an anti-fibrotic effect. This nano-therapy may be of interest to tackle an unmet medical need considering that esophageal stricture is the most challenging delayed complication after extended superficial cancer resection by endoscopy.
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- 2021
26. Local administration of stem cell-derived extracellular vesicles in a thermoresponsive hydrogel promotes a pro-healing effect in a rat model of colo-cutaneous post-surgical fistula
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Chloé Broudin, Carlos Alberto Buchpiguel, Florence Gazeau, Alba Nicolas-Boluda, Caroline Cristiano Real, Amália Cínthia Meneses Rêgo, Fábio Marques, Christophe Cellier, Alice Grangier, Amanda K. A. Silva, Olivier Clément, Claire Wilhelm, Imane Boucenna, Max Piffoux, Gabriel Rahmi, Irami Araújo-Filho, Arthur Berger, Daniele de Paula Faria, and Laboratoire MSC Matière et Systèmes Complexes, Université de Paris, CNRS UMR 7057, 75006 Paris, France.
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Biodistribution ,Pathology ,medicine.medical_specialty ,Stromal cell ,Colon ,Cutaneous Fistula ,[SDV]Life Sciences [q-bio] ,Fistula ,Inflammation ,Regenerative medicine ,Extracellular Vesicles ,Mice ,03 medical and health sciences ,Cecum ,0302 clinical medicine ,Fibrosis ,medicine ,Animals ,Tissue Distribution ,General Materials Science ,Rats, Wistar ,030304 developmental biology ,0303 health sciences ,business.industry ,Stem Cells ,Hydrogels ,Mesenchymal Stem Cells ,medicine.disease ,digestive system diseases ,Rats ,3. Good health ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,medicine.symptom ,Stem cell ,business - Abstract
Extracellular vesicles (EVs), especially from stem/stromal cells (SCs), represent a cell-free alternative in regenerative medicine holding promises to promote tissue healing while providing safety and logistic advantages in comparison to cellular counterparts. Herein, we hypothesize that SC EVs, administered locally in a thermoresponsive gel, is a therapeutic strategy for managing post-surgical colo-cutaneous fistulas. This disease is a neglected and challenging condition associated to low remission rates and high refractoriness. Herein, EVs from a murine SC line were produced by a high-yield scalable method in bioreactors. The post-surgical intestinal fistula model was induced via a surgical cecostomy communicating the cecum and the skin in Wistar rats. Animals were treated just after cecostomy with PBS, thermoresponsive Pluronic F-127 hydrogel alone or containing SC EVs. A PET-monitored biodistribution investigation of SC EVs labelled with 89Zr was performed. Fistula external orifice and output assessment, probe-based confocal laser endomicroscopy, MRI and histology were carried out for therapy follow-up. The relevance of percutaneous EV administration embedded in the hydrogel vehicle was indicated by the PET-biodistribution study. Local administration of SC EVs in the hydrogel reduced colo-cutaneous fistula diameter, output, fibrosis and inflammation while increasing the density of neo-vessels when compared to the PBS and gel groups. This multi-modal investigation pointed-out the therapeutic potential of SC EVs administered locally and in a thermoresponsive hydrogel for the management of challenging post-surgical colon fistulas in a minimally-invasive cell-free strategy.
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- 2021
27. Probe-based Confocal Laser Endomicroscopy for In Vivo Assessment of Histological Healing in Ulcerative Colitis: Development and Validation of the ENHANCE Index
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Christophe Cellier, Emmanuel Coron, Laurent Peyrin-Biroulet, Arnaud Bourreille, Aude Marchal, L Quénéhervé, Jacques Moreau, Driffa Moussata, Enrique Pérez-Cuadrado-Robles, Gabriel Rahmi, Antoine Chupin, Michael Levy, and Guillaume Perrod
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Male ,medicine.medical_specialty ,Colon ,Lumen (anatomy) ,Colonoscopy ,Sensitivity and Specificity ,Inflammatory bowel disease ,Predictive Value of Tests ,Biopsy ,medicine ,Mucositis ,Humans ,Intestinal Mucosa ,Wound Healing ,Microscopy, Confocal ,Microscopy, Video ,medicine.diagnostic_test ,business.industry ,Remission Induction ,Patient Acuity ,Gastroenterology ,General Medicine ,Gold standard (test) ,Middle Aged ,medicine.disease ,Ulcerative colitis ,Endoscopy ,Colitis, Ulcerative ,Female ,France ,Radiology ,business - Abstract
Background and Aims Histological healing may represent the ultimate therapeutic goal in ulcerative colitis [UC], but it requires biopsies. Our aim was to develop a non-invasive index able to assess histological disease activity in ulcerative colitis, using probe-based confocal laser endomicroscopy [pCLE]. Methods One hundred patients with quiescent UC were prospectively included in five French centres. After fluorescein intravenous injection, during colonoscopy, the colorectal mucosa was analysed by white light imaging and pCLE, and then biopsied in different locations. Five endoscopists performed central reading of pCLE images blinded to clinical, endoscopic, and histological data. One expert pathologist performed a central histological reading [Nancy index: gold standard]. Univariate and multivariate analyses were performed to identify the endomicroscopic items associated with the presence of histologically active disease. Results Over 1000 pCLE videos sequences performed in 100 UC patients in endoscopic remission [Mayo 0 and 1] were evaluated. We observed that vessel diameter >20 µm, dilated crypt lumen, fluorescein leakage, and irregular crypt architecture were statistically associated with histologically proven inflammation according to the Nancy index. Hence, we built a pCLE index of mucosal inflammation with overall accuracy of 79.6% and overall sensitivity and specificity of, respectively, 57.8% and 82.8%. Negative predictive value, especially when a pCLE index ≤1 was observed, was high [93.1%]. Conclusions Using a robust methodology, large vessel diameter, dilated crypt lumen, fluorescein leakage,and irregular crypt architecture are reliable endomicroscopic items defining the ENHANCE index for real-time assessment of histological disease activity in UC.
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- 2020
28. A NEW BIODEGRADABLE STENT IN BILIO-PANCREATIC DISEASES: A PROSPECTIVE MULTI-CENTER FEASIBILITY STUDY
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Enrique Pérez-Cuadrado Robles, Sundeep Lakhtakia, Hairol Othman, Harsh Vardhan Tewethia, Nur Yaacob, Razman Jarmin, Zahiah Mohamed, Elsa Jasmin Roslan, Guillaume Perrod, Hédi Benosman, Christophe Cellier, Gabriel Rahmi, and Nageshwar Reddy
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Cholangiopancreatography, Endoscopic Retrograde ,Male ,Treatment Outcome ,Adolescent ,Gastroenterology ,Feasibility Studies ,Humans ,Pancreatic Diseases ,Female ,Pilot Projects ,Stents ,Prospective Studies ,General Medicine - Abstract
biodegradable stents of various designs are reportedly used in pancreato-biliary conditions with promising results. Their major advantage is the avoidance of repeat endoscopic procedure for stent removal, thereby reducing overall costs and endoscopic retrograde cholangiopancreatography (ERCP) associated adverse events. The aim of the study was to evaluate the feasibility and safety of a new biodegradable stent in patients with pancreato-biliary diseases.a prospective multicenter pilot study was performed. All consecutive patients ≥ 18 years old who underwent biliary or pancreatic stenting using the new biodegradable Archimedes stent were included in the study. There were three biodegradation profiles. Technical and clinical success and feasibility and safety were assessed during a pre-established follow-up schedule.fifty-three patients (mean age: 48.54 ± 19.29, 66 % male) with biliary (n = 29, 54.7 %) or pancreatic (n = 24, 45.3 %) indications were included. The distribution of stents used according to degradation properties were as follows: fast (n = 11, 20.8 %), medium (n = 16, 30.2 %) and slow (n = 26, 49.1 %). The technical and clinical success were 100 % and 77.8 %, respectively. Thirty-five patients were followed for a median of 26 weeks (range: 4-56, 66 %). There were nine procedure-related adverse events (17 %), all mild, including one uneventful stent-related event (external migration).the biodegradable Archimedes stent placement is feasible and safe in pancreato-biliary diseases.
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- 2022
29. Narrow-band imaging versus Lugol chromoendoscopy for esophageal squamous cell cancer screening in normal endoscopic practice: randomized controlled trial
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Béatrice Guerrier, Pascal Renkes, Sandrine Touzet, Melissa Gruner, B. Prost, Christophe Cellier, Mathieu Pioche, Angélique Denis, Verena Landel, Medhi Kaasis, Dominique Luet, Anne-Laure Tarreirias, Michel Antonietti, E Metivier-Cesbron, Gabriel Rahmi, Morgane Amil, Thierry Ponchon, Serge Fratte, Philippe Balian, Laurent Lefrou, P. Rey, Marc Le Rhun, Elia Samaha, Claude Masliah, Stéphane Lecleire, Jean-Louis Legoux, and Emmanuel Coron
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medicine.medical_specialty ,Esophageal Neoplasms ,Sensitivity and Specificity ,law.invention ,Chromoendoscopy ,Narrow Band Imaging ,Randomized controlled trial ,law ,Multicenter trial ,Carcinoma ,Humans ,Medicine ,Prospective Studies ,Coloring Agents ,Prospective cohort study ,Early Detection of Cancer ,Squamous cell cancer ,Narrow-band imaging ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Iodides ,medicine.disease ,Endoscopy ,Carcinoma, Squamous Cell ,Esophageal Squamous Cell Carcinoma ,Esophagoscopy ,Radiology ,business - Abstract
Background Narrow-band imaging (NBI) is as sensitive as Lugol chromoendoscopy to detect esophageal squamous cell carcinoma (SCC) but its specificity, which appears higher than that of Lugol chromoendoscopy in expert centers, remains to be established in general practice. This study aimed to prove the superiority of NBI specificity over Lugol chromoendoscopy in the detection of esophageal SCC and high grade dysplasia (HGD) in current general practice (including tertiary care centers, local hospitals, and private clinics). Methods This prospective randomized multicenter trial included consecutive patients with previous or current SCC of the upper aerodigestive tract who were scheduled for gastroscopy. Patients were randomly allocated to either the Lugol or NBI group. In the Lugol group, examination with white light and Lugol chromoendoscopy were successively performed. In the NBI group, NBI examination was performed after white-light endoscopy. We compared the diagnostic characteristics of NBI and Lugol chromoendoscopy in a per-patient analysis. Results 334 patients with history of SCC were included and analyzed (intention-to-treat) from 15 French institutions between March 2011 and December 2015. In per-patient analysis, sensitivity, specificity, positive and negative likelihood values were 100 %, 66.0 %, 21.2 %, and 100 %, respectively, for Lugol chromoendoscopy vs. 100 %, 79.9 %, 37.5 %, and 100 %, respectively, for NBI. Specificity was greater with NBI than with Lugol (P = 0.002). Conclusions As previously demonstrated in expert centers, NBI was more specific than Lugol in current gastroenterology practice for the detection of early SCC, but combined approaches with both NBI and Lugol could improve the detection of squamous neoplasia.
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- 2020
30. Colorectal cancer screening in Lynch syndrome: Indication, techniques and future perspectives
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Gabriel Rahmi, Christophe Cellier, and Guillaume Perrod
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Oncology ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Colorectal cancer ,Colonoscopy ,MLH1 ,DNA Mismatch Repair ,Chromoendoscopy ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,PMS2 ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,neoplasms ,Early Detection of Cancer ,Germ-Line Mutation ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Infant, Newborn ,Gastroenterology ,medicine.disease ,Colorectal Neoplasms, Hereditary Nonpolyposis ,digestive system diseases ,Lynch syndrome ,MSH6 ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Colorectal Neoplasms ,business - Abstract
Lynch syndrome (LS) is an inherited predisposition to colorectal cancer (CRC), responsible for 3-5% of all CRC. This syndrome is characterized by the early occurrence of colorectal neoplastic lesions, with variable incidences depending on the type of pathogenic variants in MMR genes (MLH1, MSH2, MSH6, PMS2 and EPCAM) and demographics factors such as gender, body mass index, tobacco use and physical activity. Similar to sporadic cancers, colorectal screening by colonoscopy is efficient because it is associated with a reduction >50% of both CRC incidence and CRC related mortality. To that end, most guidelines recommend high definition screening colonoscopies in dedicated centers, starting at the age of 20-25 years old, with a surveillance interval of 1-2 years. In this review, we discuss the importance of high definition colonoscopies, including the compliance to specific key performance indicators, as well as the expected benefits of specific imaging modalities including virtual chromoendoscopy and dye-spray chromoendoscopy.
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- 2020
31. Rôle du réseau PRED-IdF, premier réseau régional spécialisé dans la prise en charge et suivi des patients présentant une prédisposition héréditaire aux cancers digestifs
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Elia Samaha, Anne-Sophie Bats, Christophe Cellier, and Guillaume Perrod
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0301 basic medicine ,Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,030104 developmental biology ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,medicine ,business ,Pathology and Forensic Medicine - Abstract
Resume Les patients presentant une predisposition genetique aux cancers digestifs sont a haut risque de developper une neoplasie et doivent etre suivis au sein de reseaux specialises. Le reseau PRED-IdF a ete mis en place par l’INCa en 2009 pour l’ensemble de la region Ile-de-France et comporte depuis 2012 (deploiement du dispositif national d’oncogenetique) 7 centres experts dans la prise en charge des predispositions genetiques aux cancers digestifs. L’objectif de ce reseau est de proposer aux patients une prise en charge et un suivi multidisciplinaire specifique a chaque syndrome de predisposition. Tout patient presentant une suspicion de syndrome de predisposition peut etre adresse a l’un des centres du reseau pour un avis specialise. Les principales missions du reseau incluent l’etablissement d’un plan personnalise de suivi (PPS) et sa coordination, la mise en place d’activite de recours et d’expertise pour les cas difficiles et le developpement de l’activite recherche. Depuis 2009, 3384 patients ont ete inclus dans le reseau dont 1925 pour syndrome de Lynch et 539 pour polypose adenomateuse familiale (mutations APC et MUTYH), representant ainsi 72,8 % de la cohorte PRED-IdF. L’impact benefique du reseau a ete recemment demontre pour les patients suivis pour syndrome de Lynch, marque par une diminution de la survenue de cancers colorectaux apres inclusion. Le reseau s’implique aussi dans de nombreux projets de recherche, allant du developpement de collaborations en recherche fondamentale a la participation aux etudes controlees randomisees. L’objectif a terme, etant de proposer une medecine personnalisee a l’ensemble des patients inclus dans le reseau.
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- 2020
32. Small bowel polyp resection using device‐assisted enteroscopy in Peutz‐Jeghers Syndrome: Results of a specialised tertiary care centre
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Enrique Pérez-Cuadrado-Robles, A Vienne, Guillaume Perrod, C.A. Cuenod, Christophe Cellier, Hedi Benosman, Elia Samaha, Arthur Berger, Pierre Laurent-Puig, Gabriel Rahmi, Aziz Zaanan, and Sherine Khater
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Adult ,Male ,Enteroscopy ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Balloon Enteroscopy ,Adolescent ,Biopsy ,Peutz-Jeghers Syndrome ,Peutz–Jeghers syndrome ,Capsule Endoscopy ,Tertiary care ,law.invention ,Resection ,Tertiary Care Centers ,Young Adult ,Hamartomatous Polyp ,Capsule endoscopy ,law ,Intestine, Small ,medicine ,Humans ,Intestinal Mucosa ,Device assisted enteroscopy ,skin and connective tissue diseases ,Aged ,Retrospective Studies ,Intraoperative Care ,business.industry ,Gastroenterology ,Intestinal Polyps ,Original Articles ,Middle Aged ,medicine.disease ,Magnetic Resonance Imaging ,digestive system diseases ,Treatment Outcome ,Oncology ,Female ,Small Bowel Polyp ,Radiology ,business ,Follow-Up Studies - Abstract
INTRODUCTION: Enteroscopy resection of small bowel polyps in Peutz-Jeghers syndrome has only been described in small case series. Herein, we aimed to assess the efficacy of enteroscopy resection of small bowel polyps within a specialised tertiary care centre and the impact on intraoperative enteroscopy. METHODS: This was an observational single-centre study. All adult Peutz-Jeghers syndrome patients followed in the Predisposition Digestive Ile-de-France network who underwent an endoscopic resection of at least one small bowel polyp ≥ 1 cm by enteroscopy between 2002–2015 were included. Small bowel polyps were detected under a dedicated screening programme by previous capsule endoscopy and/or magnetic resonance enterography, performed every 2–3 years. Complete treatment was defined as the absence of polyps ≥ 1 cm after conventional endoscopic resection. Intraoperative enteroscopy or surgical resection were indicated in incomplete treatments. The overall complete treatment rate including conventional enteroscopy and intraoperative enteroscopy was also considered. RESULTS: Endoscopic resection of 216 small bowel polyps (median: 8.6 per patient, size: 6–60 mm) was performed by 50 enteroscopies in 25 patients (mean age: 36 years, range: 18–71, 56% male) with small bowel polyp ≥ 1 cm. Twenty-three patients (92%) underwent 42 screening capsule endoscopies and 14 (57%) had 23 magnetic resonance enterographies during a median follow-up of 60 months. Complete treatment was achieved in 76%. Intraoperative enteroscopy and surgical resection were performed in four (16%) and two (8%) patients. Intraoperative enteroscopy improved by 16% the complete treatment rate and the overall rate was 92%. The complication rate was 6%. CONCLUSION: This long-term study confirmed the efficacy and safety of endoscopic resection of small bowel polyps in Peutz-Jeghers syndrome. Intraoperative enteroscopy can be a complementary approach in selected cases.
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- 2020
33. Endoscopic ultrasound-guided drainage using lumen-apposing metal stent of malignant afferent limb syndrome in patients with previous Whipple surgery: Multicenter study (with video)
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Enrique Pérez‐Cuadrado‐Robles, Michiel Bronswijk, Fréderic Prat, Marc Barthet, Maxime Palazzo, Paolo Arcidiacono, Marion Schaefer, Jacques Devière, Roy L. J. van Wanrooij, Ilaria Tarantino, Gianfranco Donatelli, Marine Camus, Andres Sanchez‐Yague, Khanh Do‐Cong Pham, Jean‐Michel Gonzalez, Andrea Anderloni, Juan J. Vila, Julien Jezequel, Alberto Larghi, Bénédicte Jaïs, Enrique Vazquez‐Sequeiros, Pierre H. Deprez, Schalk Van der Merwe, Christophe Cellier, Gabriel Rahmi, UCL - (SLuc) Centre du cancer, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (SLuc) Service de gastro-entérologie, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Biomécanique Appliquée (LBA UMR T24), Aix Marseille Université (AMU)-Université Gustave Eiffel, Hôpital Nord [CHU - APHM], Hôpital Beaujon, Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université libre de Bruxelles (ULB), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), BREST - Hépato-Gastro-Entérologie (BREST - HGE), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), and Gastroenterology and hepatology
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Male ,Adolescent ,Cholangitis ,[SDV]Life Sciences [q-bio] ,anastomosis ,endoscopic ultrasound ,gastrojejunostomy ,LAMS ,stent ,Gastroenterology ,Middle Aged ,Endosonography ,Treatment Outcome ,Humans ,Drainage ,Radiology, Nuclear Medicine and imaging ,Female ,Stents ,Ultrasonography, Interventional ,Aged - Abstract
OBJECTIVES: Endoscopic ultrasound-guided digestive anastomosis (EUS-A) is a new alternative under evaluation in patients presenting with afferent limb syndrome (ALS) after Whipple surgery. The aim of the present study is to analyze the safety and effectiveness of EUS-A in ALS. METHODS: This is an observational multicenter study. All patients ≥18 years old with previous Whipple surgery presenting with ALS who underwent an EUS-A using a lumen-apposing metal stent (LAMS) between 2015 and 2021 were included. The primary outcome was clinical success, defined as resolution of the ALS or ALS-related cholangitis. Furthermore, technical success, adverse event rate, and mortality were evaluated. RESULTS: Forty-five patients (mean age: 65.5 ± 10.2 years; 44.4% male) were included. The most common underlying disease was pancreatic cancer (68.9%). EUS-A was performed at a median of 6 weeks after local tumor recurrence. The most common approach used was the direct/freehand technique (66.7%). Technical success was achieved in 95.6%, with no differences between large (≥15 mm) and small LAMS (97.4% vs. 100%, P = 0.664). Clinical success was retained in 91.1% of patients. A complementary treatment by dilation of the stent followed by endoscopic retrograde cholangiopancreatography through the LAMS was performed in three cases (6.7%). There were six recurrent episodes of cholangitis (14.6%) and two procedure-related adverse events (4.4%) after a median follow-up of 4 months. Twenty-six patients (57.8%) died during the follow-up due to disease progression. CONCLUSION: EUS-A is a safe and effective technique in the treatment of malignant ALS, achieving high clinical success with an acceptable recurrence rate. ispartof: DIGESTIVE ENDOSCOPY vol:34 issue:7 pages:1433-1439 ispartof: location:Australia status: published
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- 2022
34. Efficacy of Organ Preservation Strategy by Adjuvant Chemoradiotherapy after Non-Curative Endoscopic Resection for Superficial SCC: A Multicenter Western Study
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Arthur Berger, Guillaume Perrod, Mathieu Pioche, Maximilien Barret, Elodie Cesbron-Métivier, Vincent Lépilliez, Marianne Hupé, Enrique Perez-Cuadrado-Robles, Franck Cholet, Augustin Daubigny, Charles Texier, Einas Abou Ali, Edouard Chabrun, Jérémie Jacques, Timothee Wallenhorst, Jean Baptiste Chevaux, Marion Schaefer, Christophe Cellier, and Gabriel Rahmi
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esophageal squamous cell carcinoma ,endoscopic resection ,adjuvant chemoradiotherapy ,organ preservation ,Cancer Research ,Oncology - Abstract
Background. In case of high risk of lymph node invasion after endoscopic resection (ER) of superficial esophageal squamous cell carcinoma (SCC), adjuvant chemoradiotherapy (CRT) can be an alternative to surgery. We assessed long-term clinical outcomes of adjuvant therapy by CRT after non-curative ER for superficial SCC. Methods. We performed a retrospective multicenter study. From April 1999 to April 2018, all consecutive patients who underwent ER for SCC with tumor infiltration beyond the muscularis mucosae were included. Results. A total of 137 ER were analyzed. The overall nodal or metastatic recurrence-free survival rate at 5 years was 88% and specific recurrence-free survival rates at 5 years with and without adjuvant therapy were, respectively, 97.9% and 79.1% (p = 0.011). Independent factors for nodal and/or distal metastatic recurrence were age (HR = 1.075, p = 0.031), Sm infiltration depth > 200 µm (HR = 4.129, p = 0.040), and the absence of adjuvant CRT or surgery (HR = 11.322, p = 0.029). Conclusion. In this study, adjuvant therapy is associated with a higher recurrence-free survival rate at 5 years after non-curative ER. This result suggests this approach may be considered as an alternative to surgery in selected patients.
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- 2023
35. Safety and efficacy of AMG 714 in patients with type 2 refractory coeliac disease: a phase 2a, randomised, double-blind, placebo-controlled, parallel-group study
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Ciaran P. Kelly, Garbiñe Roy Ariño, Anthony J. DiMarino, George Vlad, Laura Crespo, Raquel Perez Maseda, Amélie Trinquand, Ralph Raymond, Michael Schumann, Anne Blanchard, Olivier Hermine, Georgia Malamut, Jane R. Parnes, Samuli Rounioja, Eric Butz, Valerie Byrnes, Hetty J. Bontkes, Wayne Tsuji, Christophe Cellier, Gerd Bouma, Beth Llewellyn, Nadine Cerf-Bensussan, Tom van Gils, Peter H.R. Green, Joseph A. Murray, Govind Bhagat, Jack D. Bui, Ashleigh Palmer, Bana Jabri, Knut E.A. Lundin, Elizabeth Macintyre, Pekka Collin, Carlota García-Hoz, Sherine Khater, Bertrand Meresse, Francisco Leon, Chris J. J. Mulder, Sheila E. Crowe, David S Sanders, Michel Azizi, Marios Hadjivassiliou, Keijo Viiri, Vrije Universiteit Medical Centre (VUMC), Vrije Universiteit Amsterdam [Amsterdam] (VU), Columbia University Medical Center (CUMC), Columbia University [New York], Department of Medicine, University of Washington [Seattle], Laboratory of Intestinal Immunity (Equipe Inserm U1163), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), CCSD, Accord Elsevier, Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hospital Universitario Ramón y Cajal [Madrid], Universidad de Alcalá - University of Alcalá (UAH), Tampere University Hospital, University of California [San Diego] (UC San Diego), University of California (UC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Université Paris Descartes - Paris 5 (UPD5), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Amgen Inc., RCD-II Study Group Investigators: Bana Jabri, Joseph Murray, Anthony DiMarino, Ciaran P Kelly, Valerie Byrnes, David Sanders, Knut Ea Lundin, Michael Schumann, Hetty Bontkes, Bertrand Meresse, Garbiñe Roy Ariño, Govind Bhagat, Keijo Viiri, Samuli Rounioja, Jack Bui, Raquel Perez Maseda, Carlota García-Hoz, Amelie Trinquand, George Vlad, Marios Hadjivassiliou, Michel Azizi, Anne Blanchard, Beth Llewellyn, Ashleigh Palmer, Ralph Raymond, Gastroenterology and hepatology, AGEM - Digestive immunity, AGEM - Re-generation and cancer of the digestive system, and AII - Inflammatory diseases
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medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Population ,Placebo ,Gastroenterology ,Coeliac disease ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Biopsy ,medicine ,Clinical endpoint ,Adverse effect ,education ,education.field_of_study ,Hepatology ,medicine.diagnostic_test ,business.industry ,medicine.disease ,3. Good health ,[SDV] Life Sciences [q-bio] ,030220 oncology & carcinogenesis ,Intraepithelial lymphocyte ,030211 gastroenterology & hepatology ,business - Abstract
Summary Background Refractory coeliac disease type 2 is a rare subtype of coeliac disease with high mortality rates; interleukin 15 (IL-15) is strongly implicated in its pathophysiology. This trial aimed to investigate the effects of AMG 714, an anti-IL-15 monoclonal antibody, on the activity and symptoms of refractory coeliac disease type 2. Methods This was a randomised, double-blind, placebo-controlled, phase 2a study of adults with a confirmed diagnosis of refractory coeliac disease type 2. Patients were randomly assigned at a 2:1 ratio to receive seven intravenous doses over 10 weeks of AMG 714 (8 mg/kg) or matching placebo. Biopsy samples were obtained at baseline and week 12 for cellular analysis and histology. The change in the proportion of aberrant intraepithelial lymphocytes from baseline to week 12 with respect to all intraepithelial lymphocytes was the primary endpoint and was quantified using flow cytometry. Secondary endpoints were the change in aberrant intraepithelial lymphocytes with respect to intestinal epithelial cells; intestinal histological scores (villous height-to-crypt depth ratio; VHCD); intraepithelial lymphocyte counts; Marsh score; and patient-reported symptom measures, including the Bristol stool form scale (BSFS) and gastrointestinal symptom rating scale (GSRS). Main analyses were done in the per-protocol population of patients who received their assigned treatment, provided evaluable biopsy samples, and did not have major protocol deviations; only patients with non-atypical disease were included in the analyses of aberrant intraepithelial lymphocytes, including the primary analysis. Safety was assessed in all patients who received at least one dose of study drug. This study is registered at ClinicalTrials.gov (NCT02633020) and EudraCT (2015-004063-36). Findings From April 13, 2016, to Jan 19, 2017, 28 patients were enrolled and randomly assigned to AMG 714 (n=19) and placebo (n=9). Six patients were not included in the primary analysis because of protocol deviation (one in the AMG 714 group), insufficient biopsy samples (one in the AMG 714 group), and atypical intraepithelial lymphocytes (three in the AMG 714 group and one in the placebo group). At 12 weeks, the least square mean difference between AMG 714 and placebo in the relative change from baseline in aberrant intraepithelial lymphocyte percentage was −4·85% (90% CI −30·26 to 20·56; p=0·75). The difference between the AMG 714 and placebo groups in aberrant intraepithelial lymphocytes with respect to epithelial cells at 12 weeks was −38·22% (90% CI −95·73 to 19·29; nominal p=0·18); the difference in change in Marsh score from baseline was 0·09% (95% CI −1·60–1·90; nominal p=0·92); the difference in VHCD ratio was 10·67% (95% CI −38·97 to 60·31; nominal p=0·66); and the difference in change in total intraepithelial lymphocyte count was −12·73% (95% CI −77·57–52·12); nominal p=0·69). Regarding symptoms, the proportion of patients with diarrhoea per the BSFS score decreased from ten (53%) of 19 at baseline to seven (37%) of 19 at week 12 in the AMG 714 group and increased from two (22%) of nine at baseline to four (44%) of nine at week 12 in the placebo group (nominal p=0·0008); and the difference between the groups in change in GSRS score was −0·14 (SE 0·19; nominal p=0·48). Eight (89%) patients in the placebo group and 17 (89%) in the AMG 714 group had treatment-emergent adverse events, including one (11%) patient in the placebo group and five (26%) in the AMG 714 group who had serious adverse events. The most common adverse event in the AMG 714 group was nasopharyngitis (eight [42%] patients vs one [11%] in the placebo group). Interpretation In patients with refractory coeliac disease type 2 who were treated with AMG 714 or placebo for 10 weeks, there was no difference between the groups in terms of the primary endpoint of aberrant intraepithelial lymphocyte reduction from baseline. Effects on symptoms and other endpoints suggest that further research of AMG 714 may be warranted in patients with refractory coeliac disease type 2. Funding Celimmune and Amgen.
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- 2019
36. Endoscopic submucosal dissection in tumors extending to the dentate line compared to proximal rectal tumors: a systematic review with meta-analysis
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Enrique Pérez-Cuadrado-Robles, Gabriel Rahmi, Christophe Cellier, Thomas Severyns, Antoine Chupin, and Guillaume Perrod
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medicine.medical_specialty ,Hepatology ,Endoscopic Mucosal Resection ,business.industry ,Rectal Neoplasms ,Gastroenterology ,Endoscopic submucosal dissection ,Rectal Tumors ,Treatment Outcome ,Meta-analysis ,Medicine ,Humans ,Female ,Radiology ,Line (text file) ,Intestinal Mucosa ,Neoplasm Recurrence, Local ,business ,Retrospective Studies - Abstract
Endoscopic submucosal dissection (ESD) is a validated treatment for early rectal tumors, but whether this therapy is efficient or not for rectal tumors extending to the dentate line (RTDL) remains unclear. We performed a systematic review and meta-analysis to assess the effectiveness and safety of ESD in RTDL compared to non-RTDL. A search in PubMed, Scopus and the Cochrane library up to April 2020 was conducted to identify studies that compared ESD in both localizations (RTDL and non-RTDL), reporting at least one main outcome (en bloc, complete resection, recurrence). Secondary outcomes were adverse event occurrence. Five observational studies including 739 patients with a total of 201 RTDL and 538 non-RTDL were considered. The proportion of female sex (66% vs. 36.9%, P0.001) and tumor size [mean difference = 7.75, 95% confidence interval (CI): 3.01-12.49, P = 0.001] were higher in the RTDL group. There were no differences in en bloc resection rates between RTDL and non-RTDL groups [odds ratio (OR): 0.95, 95% CI: 0.50-1.79, P = 0.087]. The complete resection rate was significantly higher in the non-RTDL group (OR: 1.72, 95% CI: 1.18-2.53, P = 0.005, I2 = 0%). However, recurrence rates were comparable (RD: -0.04, 95% CI: -0.07 to 0.00, P = 0.06, I2 = 0%). Concerning adverse events, there were no differences in terms of perforation (OR: 0.9, 95% CI: 0.26-3.08, P = 0.86, I2 = 0%) or delayed bleeding (OR: 0.64, 95% CI: 0.17-2.42, P = 0.51, I2 = 35%). Anal pain rate was 28% (95% CI: 21.4-35.8%). ESD is an effective and safe therapeutic approach for RTDL with comparable recurrence rate to non-RTDL. The lower complete resection rate in RTDL needs to be clarified in studies.
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- 2021
37. Challenging case of a locally recurrent adenoma in a patient with ulcerative colitis
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Gabriel Rahmi, Christophe Cellier, and Guillaume Perrod
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Adenoma ,medicine.medical_specialty ,business.industry ,Gastroenterology ,medicine.disease ,Ulcerative colitis ,Internal medicine ,Colonic Neoplasms ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Colitis, Ulcerative ,Neoplasm Recurrence, Local ,business - Published
- 2021
38. Endoscopic ultrasound-guided jejunojejunal anastomosis as salvage therapy for a complex gastric outlet obstruction
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Enrique Pérez-Cuadrado-Robles, Guillaume Perrod, Alexandre Lansier, Juliette Palle, Antoine Mariani, Christophe Cellier, and Gabriel Rahmi
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Salvage Therapy ,Gastric Outlet Obstruction ,Anastomosis, Surgical ,Gastroenterology ,Humans ,Ultrasonography, Interventional ,Endosonography - Published
- 2022
39. Ulcerative jejunitis secondary to Zollinger-Ellison syndrome following endoscopic ultrasound guided gastrojejunostomy
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Christophe Cellier, Gabriel Rahmi, Emilie Moati, Enrique Pérez-Cuadrado-Robles, and H Benosman
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Endoscopic ultrasound ,medicine.medical_specialty ,Hepatology ,medicine.diagnostic_test ,Ulcerative jejunitis ,business.industry ,Gastroenterology ,medicine ,Radiology ,business ,medicine.disease ,Zollinger-Ellison syndrome - Published
- 2022
40. An unusual cause of acute cholangitis
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Enrique Pérez-Cuadrado-Robles, Gabriel Rahmi, Christophe Cellier, Hadrien Alric, Guillaume Perrod, and H Benosman
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medicine.medical_specialty ,Text mining ,business.industry ,Cholangitis ,Acute Disease ,Gastroenterology ,MEDLINE ,medicine ,Humans ,business ,Intensive care medicine - Published
- 2021
41. Effect of Different Modalities of Purgative Preparation on the Diagnostic Yield of Small Bowel Capsule for the Exploration of Suspected Small Bowel Bleeding: A Multicenter Randomized Controlled Trial
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Gabriel, Rahmi, Franck, Cholet, Marianne, Gaudric, Jérôme, Filippi, Clotilde, Duburque, Slim, Bramli, Vincent, Quentin, Zarrin, Alavi, Emmanuel, Nowak, Jean Christophe, Saurin, Christophe, Cellier, and Lucille, Quénéhervé
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Male ,Surface-Active Agents ,Cathartics ,Intestine, Small ,Humans ,Patient Compliance ,Female ,Prospective Studies ,Middle Aged ,Gastrointestinal Hemorrhage ,Capsule Endoscopy ,Polyethylene Glycols - Abstract
The aim of our study was to compare clear liquid diet with 2 different polyethylene glycol (PEG)-based bowel preparation methods regarding diagnostic yield of small bowel capsule endoscopy (SBCE) in patients with suspected small bowel bleeding (SBB).In this prospective multicenter randomized controlled trial, consecutive patients undergoing SBCE for suspected SBB between September 2010 and February 2016 were considered. Patients were randomly assigned to standard regimen, that is, clear fluids only (prep 1), standard regimen plus 500 mL PEG after SBCE ingestion (prep 2), or standard regimen plus 2 L PEG plus 500 mL PEG after SBCE ingestion (prep 3). The primary outcome was the detection of at least one clinically significant lesion in the small bowel. The quality of small bowel cleansing was assessed. A questionnaire on the clinical tolerance was filled by the patients.We analyzed 834 patients. No significant difference was observed for detection of P1 or P2 small bowel lesions between prep1 group (40.5%), prep 2 group (40.2%), and prep 3 group (38.5%). Small bowel cleansing was improved in prep 2 and 3 groups compared with that in prep 1 group. Compliance to the preparation and tolerance was better in prep 2 group than in prep 3 group.Small bowel purgative before SBCE allowed better quality of cleansing. However, it did not improve diagnostic yield of SBCE for suspected SBB.
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- 2021
42. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten‐related disorders
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David S Sanders, Chris J. J. Mulder, Umberto Volta, Renata Auricchio, Knut E.A. Lundin, Gemma Castillejo, Abdulbaqi Al-toma, Christophe Cellier, Al-Toma, Abdulbaqi, Volta, Umberto, Auricchio, Renata, Castillejo, Gemma, Sanders, David S, Cellier, Christophe, Mulder, Chris J, and Lundin, Knut E A
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Adult ,medicine.medical_specialty ,Dermatitis Herpetiformis ,enteropathy associated T-cell lymphoma ,Coeliac disease ,Serology ,Diet, Gluten-Free ,03 medical and health sciences ,0302 clinical medicine ,Dermatitis herpetiformis ,dermatitis herpetiformi ,Biopsy ,refractory coeliac disease ,medicine ,Humans ,coeliac neuropathy ,Child ,Letters to the Editor ,Dietary Supplement ,chemistry.chemical_classification ,medicine.diagnostic_test ,non-coeliac gluten sensitivity ,business.industry ,neurocoeliac ,seronegative coeliac disease ,Gastroenterology ,nutritional and metabolic diseases ,Guideline ,medicine.disease ,Dermatology ,Gluten ,digestive system diseases ,Clinical trial ,slow-responder coeliac ,Celiac Disease ,Oncology ,chemistry ,030220 oncology & carcinogenesis ,Dietary Supplements ,Quality of Life ,Enteropathy-associated T-cell lymphoma ,030211 gastroenterology & hepatology ,Immunotherapy ,business ,gluten ataxia ,Human - Abstract
This guideline presents recommendations for the management of coeliac disease (CD) and other gluten-related disorders both in adults and children. There has been a substantial increase in the prevalence of CD over the last 50 years and many patients remain undiagnosed. Diagnostic testing, including serology and biopsy, should be performed on a gluten-containing diet. The diagnosis of CD is based on a combination of clinical, serological and histopathological data. In a group of children the diagnosis may be made without biopsy if strict criteria are available. The treatment for CD is primarily a gluten-free diet (GFD), which requires significant patient education, motivation and follow-up. Slow-responsiveness occurs frequently, particularly in those diagnosed in adulthood. Persistent or recurring symptoms necessitate a review of the original diagnosis, exclude alternative diagnoses, confirm dietary adherence (dietary review and serology) and follow-up biopsy. In addition, evaluation to exclude complications of CD, such as refractory CD or lymphoma, should be performed. The guideline also deals with other gluten-related disorders, such as dermatitis herpetiformis, which is a cutaneous manifestation of CD characterized by granular IgA deposits in the dermal papillae. The skin lesions clear with gluten withdrawal. Also, less well-defined conditions such as non-coeliac gluten sensitivity (NCGS) and gluten-sensitive neurological manifestations, such as ataxia, have been addressed. Newer therapeutic modalities for CD are being studied in clinical trials but are not yet approved for use in practice.
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- 2019
43. Acid Reflux Is Common in Patients With Gastroesophageal Reflux Disease After One-Anastomosis Gastric Bypass
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William A, Nehmeh, Clement, Baratte, Claire, Rives-Lange, Chloe, Martineau, Hortense, Boullenois, Sylvia, Krivan, Vincent, Guillet, Maude, Le Gall, Christophe, Cellier, Claire, Carette, Sebastien, Czernichow, Jean-Marc, Chevallier, and Tigran, Poghosyan
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Adult ,Heartburn ,Gastric Bypass ,Gastroesophageal Reflux ,Humans ,Middle Aged ,Obesity, Morbid ,Retrospective Studies - Abstract
Patients with one-anastomosis gastric bypass (OAGB) can develop gastroesophageal reflux disease (GERD). The nature of this GERD (acid or biliary) remains unclear.To assess the nature of GERD via impedance pH testing in patients presenting with reflux post OAGB.Retrospective analysis of a prospectively collected database of 43 patients with OAGB backgrounds who developed postoperative GERD and were investigated with impedance pH monitoring between 2006 and 2019.Mean age was 52.48 ± 9 years. Mean body mass index (BMI) prior to OAGB was 46.82 kg/mAcid reflux seems to be as common as bile reflux in patients presenting with GERD after OAGB. In case of revisional surgery for severe GERD post OAGB, 24-h impedance pH monitoring could be essential to determine the surgical procedure of choice.
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- 2021
44. Upper Gastrointestinal Lesions during Endoscopy Surveillance in Patients with Lynch Syndrome: A Multicentre Cohort Study
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Sandrine Féau, Thierry Lecomte, Olivier Caron, Romain Chautard, Christophe Cellier, Gabriel Rahmi, T. Barrioz, David Malka, Didier Barbereau, David Tougeron, and Elia Samaha
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Cancer Research ,medicine.medical_specialty ,Gastroenterology ,lcsh:RC254-282 ,Article ,03 medical and health sciences ,0302 clinical medicine ,duodenal cancer ,Internal medicine ,medicine ,medicine.diagnostic_test ,biology ,Helicobacter pylori ,business.industry ,Incidence (epidemiology) ,gastric cancer ,screening ,Retrospective cohort study ,medicine.disease ,biology.organism_classification ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Lynch syndrome ,Endoscopy ,upper gastrointestinal endoscopy ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,030211 gastroenterology & hepatology ,Duodenal cancer ,business ,Cohort study - Abstract
Background: Patients with Lynch syndrome are at increased risk of gastric and duodenal cancer. Upper gastrointestinal endoscopy surveillance is generally proposed, even though little data are available on upper gastrointestinal endoscopy in these patients. The aim of this retrospective study was to evaluate the prevalence and incidence of gastrointestinal lesions following upper gastrointestinal endoscopy examination in Lynch patients. Methods: A large, multicentre cohort of 172 patients with a proven germline mutation in one of the mismatch repair genes and at least one documented upper gastrointestinal endoscopy screening was assessed. Detailed information was collected on upper gastrointestinal endoscopy findings and the outcome of endoscopic follow-up. Results: Seventy neoplastic gastrointestinal lesions were diagnosed in 45 patients (26%) out of the 172 patients included. The median age at diagnosis of upper gastrointestinal lesions was 54 years. The prevalence of cancer at initial upper gastrointestinal endoscopy was 5% and the prevalence of precancerous lesions was 12%. Upper gastrointestinal lesions were more frequent after 40 years of age (p <, 0.001). Helicobacter pylori infection was associated with an increased prevalence of gastric, but not duodenal, lesions (p <, 0.001). Conclusions: Neoplastic upper gastrointestinal lesions are frequent in patients with Lynch syndrome, especially in those over 40 years of age. The results of our study suggest that Lynch patients should be considered for upper gastrointestinal endoscopic and Helicobacter pylori screening.
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- 2021
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45. Ampullectomy of an unusual lesion developing 20 years after endoscopic treatment of a type III choledochocele
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Chloé Broudin, A Vienne, Hedi Benosman, Christophe Cellier, Enrique Pérez-Cuadrado-Robles, Guillaume Perrod, and Gabriel Rahmi
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medicine.medical_specialty ,Ampulla of Vater ,business.industry ,Ampullectomy ,Common Bile Duct Neoplasms ,Gastroenterology ,MEDLINE ,Endoscopy ,Lesion ,Text mining ,Choledochal Cyst ,medicine ,Humans ,Radiology ,medicine.symptom ,business ,Endoscopic treatment - Published
- 2021
46. Eus-Guided Gastrojejunostomy as a Rescue Therapy in a Patient With Multiple Previous Procedures
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Gabriel Rahmi, Christophe Cellier, C Gallois, E Perez-Cuadrado Robles, Guillaume Perrod, H Benosman, and E Ragot
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medicine.medical_specialty ,Rescue therapy ,business.industry ,Medicine ,business ,Surgery - Published
- 2021
47. Impact On Nutritional Status Of Eus-Guided Gastroenterostomy In Patients With A Malignant Duodenal Stenosis
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Christophe Cellier, H Benosman, E Perez-Cuadrado Robles, E Coffin, Guillaume Perrod, J Taieb, Gabriel Rahmi, and E Moati
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine.medical_treatment ,medicine ,Nutritional status ,In patient ,Duodenal stenosis ,business ,Gastroenterostomy ,Gastroenterology - Published
- 2021
48. Oncogenetic Landscape Of Lymphomagenesis In Coeliac Disease
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Thierry Jo Molina, Ludovic Lhermitte, Christine Bole-Feysot, Georgia Malamut, Elizabeth Macintyre, Morgane Cheminant, Amélie Trinquand, Sophie Kaltenbach, Bruno Tesson, Olivier Hermine, David Sibon, Sofia Berrabah, Patrick Villarese, Christophe Cellier, Sherine Khater, Nicolas Guegan, Sascha Cording, Julie Bruneau, Marc Bras, Bertrand Meresse, Nadine Cerf-Bensussan, Vahid Asnafi, and Michael Dussiot
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Bortezomib ,medicine ,Cancer research ,Proteasome inhibitor ,Biology ,medicine.disease ,DDX3X ,TNFAIP3 ,Coeliac disease ,Exome sequencing ,Comparative genomic hybridization ,medicine.drug ,Lymphoma - Abstract
ObjectiveEnteropathy-associated T-cell lymphoma (EATL) is a rare but severe complication of celiac disease (CeD), often preceded by low-grade clonal intraepithelial lymphoproliferation, referred to as type II refractory CeD (RCDII). Knowledge on underlying oncogenic mechanisms remains scarce. Here, we analysed and compared the mutational landscape of RCDII and EATL in order to identify genetic drivers of CeD-associated lymphomagenesis.DesignPure populations of RCDII-cells derived from intestinal biopsies (n=9) or sorted from blood (n=2) were analysed by whole exome sequencing, comparative genomic hybridization and RNA-sequencing. Biopsies from RCDII (n=50), EATL (n=19), type I refractory CeD (n=7) and uncomplicated CeD (n=7) were analysed by targeted next-generation sequencing. Moreover, functional in vitro studies and drug testing were performed in RCDII-derived cell lines.Results80% of RCDII and 90% of EATL displayed somatic gain-of-functions mutations in the JAK1-STAT3 pathway, including a remarkable p.G1097 hotspot mutation in the JAK1 kinase-domain in approximately 50% of cases. Other recurrent somatic events were deleterious mutations in NFκB-regulators TNFAIP3 and TNIP3 and potentially oncogenic mutations in TET2, KMT2D and DDX3X. JAK1 inhibitors and the proteasome inhibitor bortezomib could block survival and proliferation of malignant RCDII-cell lines.ConclusionMutations activating the JAK1-STAT3 pathway appear to be the main drivers of CeD-associated lymphomagenesis. In concert with mutations in negative regulators of NFκB, they may favour the clonal emergence of malignant lymphocytes in the cytokine-rich coeliac intestine. The identified mutations are attractive therapeutic targets to treat RCDII and block progression towards EATL.
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- 2020
49. Enhancing digestive fistula healing by the off-label use of a thermoresponsive vessel occluder polymer associated with esophageal stent placement: A case report
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Imane Boucenna, Eric Caudron, Florence Gazeau, Gabriel Rahmi, Arthur Berger, Olivier Clément, Anne Berger, Christophe Cellier, Claire Wilhelm, Amanda K. A. Silva, Guillaume Perrod, Centre National de la Recherche Scientifique (CNRS), Université de Paris (UP), Matière et Systèmes Complexes (MSC (UMR_7057)), Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Service de gastroenterologie [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)
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medicine.medical_specialty ,endoscopic treatment ,Percutaneous ,Medical device ,Fistula ,health care facilities, manpower, and services ,[SDV]Life Sciences [q-bio] ,education ,Off-label use ,03 medical and health sciences ,0302 clinical medicine ,Esophageal stent ,Medicine ,health care economics and organizations ,ComputingMilieux_MISCELLANEOUS ,thermoresponsive vessel occluder polymer ,Hepatology ,business.industry ,Gastroenterology ,medicine.disease ,humanities ,3. Good health ,Surgery ,Stent placement ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,Endoscopic treatment - Abstract
Summary This case report relates to the first-in-man use of a vessel occluder gel medical device as a fistula occluder in a repurposing strategy. A patient with chronic colocutaneous fistula received an off-label treatment with a thermoresponsive Poloxamer 407 gel (20%) via percutaneous administration and injected under endoscopic control. Treatment consisted in the association of esophageal stent placement and gel injection. The product was administered just after the stent placement at
- Published
- 2020
50. Endoscopic ultrasound-guided gastrojejunostomy as a rescue therapy for gastric outlet obstruction in a patient with multiple previous procedures
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Claire Gallois, Gabriel Rahmi, Christophe Cellier, Emilia Ragot, Guillaume Perrod, H Benosman, and Enrique Pérez-Cuadrado-Robles
- Subjects
Endoscopic ultrasound ,medicine.medical_specialty ,Palliative care ,medicine.diagnostic_test ,business.industry ,Gastric Outlet Obstruction ,Palliative Care ,Gastroenterology ,MEDLINE ,Gastric Bypass ,Gastric outlet obstruction ,medicine.disease ,Endosonography ,Text mining ,Rescue therapy ,medicine ,Humans ,Radiology ,Ultrasonography ,business ,Ultrasonography, Interventional - Published
- 2020
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