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51. Exploring a novel composite method using non-contrast EUS enhanced microvascular imaging and cyst fluid analysis to differentiate pancreatic cystic lesions

Author

Carrara, Silvia, Fantin, Alberto, Khalaf, Kareem, Rizkala, Tommy, Koleth, Glenn, Andreozzi, Marta, Spadaccini, Marco, Colombo, Matteo, Gruppo, Mario, Bonifacio, Cristiana, Gavazzi, Francesca, Capretti, Giovanni Luigi, Ridolfi, Cristina, Nappo, Gennaro, Spaggiari, Paola, Tommaso, Luca Di, Sollai, Mauro, Zerbi, Alessandro, Maselli, Roberta, Fugazza, Alessandro, Hassan, Cesare, Facciorusso, Antonio, and Repici, Alessandro

Published
2023
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52. EUS-guided gallbladder drainage using a lumen-apposing metal stent as rescue treatment for malignant distal biliary obstruction: a large multicenter experience

Author

Binda, Cecilia, Anderloni, Andrea, Fugazza, Alessandro, Amato, Arnaldo, de Nucci, Germana, Redaelli, Alessandro, Di Mitri, Roberto, Cugia, Luigi, Pollino, Valeria, Macchiarelli, Raffaele, Mangiavillano, Benedetto, Forti, Edoardo, Brancaccio, Mario Luciano, Badas, Roberta, Maida, Marcello, Sinagra, Emanuele, Repici, Alessandro, Fabbri, Carlo, and Tarantino, Ilaria

Published
2023
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53. Outcome of Endoscopic Resection of Rectal Neuroendocrine Tumors ≤ 10 mm

Author

Roberta Elisa Rossi, Maria Terrin, Silvia Carrara, Roberta Maselli, Alexia Francesca Bertuzzi, Silvia Uccella, Andrea Gerardo Antonio Lania, Alessandro Zerbi, Cesare Hassan, and Alessandro Repici

Subjects
endoscopic resection, endoscopic mucosal resection, endoscopic submucosal dissection rectal, neuroendocrine, neoplasm, tumor, Medicine (General), R5-920
Abstract

Background and aim: Guidelines suggest endoscopic resection for rectal neuroendocrine tumors (rNETs) < 10 mm, but the most appropriate resection technique is unclear. In real-life clinical practice, the endoscopic removal of unrecognized rNETs can take place with “simple” techniques and without preliminary staging. The aim of the current study is to report our own experience at a referral center for both neuroendocrine neoplasms and endoscopy. Methods: Retrospective analyses of polypectomies were performed at the Humanitas Research Hospital for rNETs (already diagnosed or previously unrecognized). Results: A total of 19 patients were included, with a median lesion size of 5 mm (range 3–10 mm). Only five lesions were suspected as NETs before removal and underwent endoscopic ultrasound (EUS) before resection, being removed with advanced endoscopic techniques. Unsuspected rNETs were removed by cold polypectomy in eleven cases, EMR in two, and biopsy forceps in one. When described, the margins were negative in four cases, positive in four (R1), and indeterminate in one. The median follow-up was 40 months. A 10 mm polypoid lesion removed with cold snare polypectomy (G2 R1) needed subsequent surgery. Eighteen patients underwent EUS after a median time of 6.5 months from resection. The EUS identified local recurrence after 14 months in a 7 mm polypoid lesion removed with cold snare polypectomy (G1 R1); the lesion was treated with cap-assisted EMR. For all the other lesions, the follow-up was negative. Conclusions: When rNETs are improperly removed without prior staging, caution must be exercised. The data from our cohort suggest that even if inappropriate resection had happened, patients may be safely managed with early EUS evaluation.

Published
2024
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54. Marine Algae and Deriving Biomolecules for the Management of Inflammatory Bowel Diseases: Potential Clinical Therapeutics to Decrease Gut Inflammatory and Oxidative Stress Markers?

Author

Alberto Repici, Ahmed Hasan, Anna Paola Capra, Sarah Adriana Scuderi, Irene Paterniti, Michela Campolo, Alessio Ardizzone, and Emanuela Esposito

Subjects
inflammatory bowel disease (IBD), marine algae, inflammation, oxidative stress, Biology (General), QH301-705.5
Abstract

The term “inflammatory bowel disease” (IBD) describes a class of relapse-remitting conditions that affect the gastrointestinal (GI) tract. Among these, Crohn’s disease (CD) and ulcerative colitis (UC) are two of the most globally prevalent and debilitating conditions. Several articles have brought attention to the significant role that inflammation and oxidative stress cooperatively play in the development of IBD, offering a different viewpoint both on its etiopathogenesis and on strategies for the effective treatment of these conditions. Marine ecosystems may be a significant source of physiologically active substances, supporting the search for new potential clinical therapeutics. Based on this evidence, this review aims to comprehensively evaluate the activity of marine algae and deriving biomolecules in decreasing pathological features of CD and UC. To match this purpose, a deep search of the literature on PubMed (MEDLINE) and Google Scholar was performed to highlight primary biological mechanisms, the modulation of inflammatory and oxidative stress biochemical parameters, and potential clinical benefits deriving from marine species. From our findings, both macroalgae and microalgae have shown potential as therapeutic solutions for IBD due to their bioactive compounds and their anti-inflammatory and antioxidant activities which are capable of modulating markers such as cytokines, the NF-κB pathway, reactive oxidative and nitrosative species (ROS and RNS), trefoil factor 3 (TFF3), lactoferrin, SIRT1, etc. However, while we found promising preclinical evidence, more extensive and long-term clinical studies are necessary to establish the efficacy and safety of marine algae for IBD treatment.

Published
2024
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55. Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Meta-Analysis of Randomized Controlled Trials and Trial Sequential Analysis

Author

Megha Bhandari, Jayanta Samanta, Marco Spadaccini, Alessandro Fugazza, Stefano Francesco Crinò, Paraskevas Gkolfakis, Konstantinos Triantafyllou, Jahnvi Dhar, Marcello Maida, Nicola Pugliese, Cesare Hassan, Alessandro Repici, Alessio Aghemo, Gaetano Serviddio, and Antonio Facciorusso

Subjects
EUS, FNB, FNA, adequacy, tissue, cirrhosis, Medicine (General), R5-920
Abstract

Background: The efficacy of endoscopic ultrasound-guided liver biopsy (EUS-LB) compared to percutaneous liver biopsy (PC-LB) remains uncertain. Methods: Our data consist of randomized controlled trials (RCTs) comparing EUS-LB to PC-LB, found through a literature search via PubMed/Medline and Embase. The primary outcome was sample adequacy, whereas secondary outcomes were longest and total lengths of tissue specimens, diagnostic accuracy, and number of complete portal tracts (CPTs). Results: Sample adequacy did not significantly differ between EUS-LB and PC-LB (risk ratio [RR] 1.18; 95% confidence interval [CI] 0.58–2.38; p = 0.65), with very low evidence quality and inadequate sample size as per trial sequential analysis (TSA). The two techniques were equivalent with respect to diagnostic accuracy (RR: 1; CI: 0.95–1.05; p = 0.88), mean number of complete portal tracts (mean difference: 2.29, −4.08 to 8.66; p = 0.48), and total specimen length (mean difference: −0.51, −20.92 to 19.9; p = 0.96). The mean maximum specimen length was significantly longer in the PC-LB group (mean difference: −3.11, −5.51 to −0.71; p = 0.01), and TSA showed that the required information size was reached. Conclusion: EUS-LB and PC-LB are comparable in terms of diagnostic performance although PC-LB provides longer non-fragmented specimens.

Published
2024
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57. Endoscopic Ultrasound-guided Radiofrequency Ablation Versus Surgical Resection for Treatment of Pancreatic Insulinoma

Author

Alfieri, Sergio, Arcidiacono, Paolo Giorgio, Arvanitakis, Marianna, Battistella, Anna, Bernadroni, Laura, Brink, Lene, Cintolo, Marcello, Conti Bellocchi, Maria Cristina, Davì, Maria Vittoria, Deguelte, Sophie, Deprez, Pierre, Deviere, Jaques, Ewald, Jacques, Fabbri, Carlo, Ferrari, Giovanni, Furnica, Raluca Maria, Gabbrielli, Armando, Garcés-Duran, Rodrigo, Giovannini, Marc, Gonda, Tamas, Gornals, Joan B., Marx, Mariola, Mazzola, Michele, Mutignani, Massimiliano, Ofosu, Andrew, Pereira, Stephan P., Perrier, Marine, Przybylkowski, Adam, Repici, Alessandro, Sundaram, Sridhar, Tripodi, Giulia, Crinò, Stefano Francesco, Napoleon, Bertrand, Facciorusso, Antonio, Lakhtakia, Sundeep, Borbath, Ivan, Caillol, Fabrice, Do-Cong Pham, Khanh, Rizzatti, Gianenrico, Forti, Edoardo, Palazzo, Laurent, Belle, Arthur, Vilmann, Peter, van Laethem, Jean-Luc, Mohamadnejad, Mehdi, Godat, Sebastien, Hindryckx, Pieter, Benson, Ariel, Tacelli, Matteo, De Nucci, Germana, Binda, Cecilia, Kovacevic, Bojan, Jacob, Harold, Partelli, Stefano, Falconi, Massimo, Salvia, Roberto, Landoni, Luca, and Larghi, Alberto

Published
2023
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58. Study protocol for a multicenter randomized controlled trial to compare radiofrequency ablation with surgical resection for treatment of pancreatic insulinoma

Author

Crinò, Stefano Francesco, Partelli, Stefano, Napoleon, Bertrand, Conti Bellocchi, Maria Cristina, Facciorusso, Antonio, Salvia, Roberto, Forti, Edoardo, Cintolo, Marcello, Mazzola, Michele, Ferrari, Giovanni, Carrara, Silvia, Repici, Alessandro, Zerbi, Alessandro, Lania, Andrea, Tacelli, Matteo, Arcidiacono, Paolo Giorgio, Falconi, Massimo, Larghi, Alberto, Rizzatti, Gianenrico, Alfieri, Sergio, Panzuto, Francesco, Hindryckx, Pieter, Berrevoet, Frederik, Lapauw, Bruno, Lakhtakia, Sundeep, Sundaram, Sridhar, Samanta, Jayanta, Rastogi, Ashu, and Landoni, Luca

Published
2023
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61. Diagnostic accuracy and safety of EUS-guided end-cutting fine-needle biopsy needles for tissue sampling of abdominal and mediastinal lymphadenopathies: a prospective multicenter series

Author

Carrara, Silvia, Rahal, Daoud, Khalaf, Kareem, Rizkala, Tommy, Koleth, Glenn, Bonifacio, Cristiana, Andreozzi, Marta, Mangiavillano, Benedetto, Auriemma, Francesco, Bossi, Paola, Balzarotti, Monica, Facciorusso, Antonio, Staiano, Teresa, Maldi, Elena, Spadaccini, Marco, Colombo, Matteo, Fugazza, Alessandro, Maselli, Roberta, Hassan, Cesare, and Repici, Alessandro

Published
2023
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62. Comparative efficacy and safety of resection techniques for treating 6 to 20mm, nonpedunculated colorectal polyps: A systematic review and network meta-analysis

Author

Tziatzios, Georgios, Papaefthymiou, Apostolis, Facciorusso, Antonio, Papanikolaou, Ioannis S., Antonelli, Giulio, Marco, Spadaccini, Frazzoni, Leonardo, Fuccio, Lorenzo, Paraskeva, Konstantina D., Hassan, Cesare, Repici, Alessandro, Sharma, Prateek, Rex, Douglas K, Triantafyllou, Konstantinos, Messmann, Helmut, and Gkolfakis, Paraskevas

Published
2023
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64. Combination of Mucosa-Exposure Device and Computer-Aided Detection for Adenoma Detection During Colonoscopy: A Randomized Trial

Author

Amato, Arnaldo, Andrealli, Alida, Bevivino, Gerolamo, Carrara, Silvia, Capogreco, Antonio, Colombo, Matteo, De Gottardi, Andrea, De Marco, Alessandro, Di Fonzo, Michela, Di Paolo, Dhanai, Galtieri, Piera Alessia, Lamonaca, Laura, Lenoci, Nicoletta, Paduano, Danilo, Paggi, Silvia, Pellegatta, Gaia, Scardino, Giulia, Schilirò, Alessandro, Spadaccini, Marco, Hassan, Cesare, Rondonotti, Emanuele, Antonelli, Giulio, Andrisani, Gianluca, Lollo, Gianluca, Auriemma, Francesco, Iacopini, Federico, Facciorusso, Antonio, Maselli, Roberta, Fugazza, Alessandro, Bambina Bergna, Irene Maria, Cereatti, Fabrizio, Mangiavillano, Benedetto, Radaelli, Franco, Di Matteo, Francesco, Gross, Seth A., Sharma, Prateek, Mori, Yuichi, Bretthauer, Michael, Rex, Douglas K., and Repici, Alessandro

Published
2023
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65. EUS-guided gastroenterostomy using a novel electrocautery lumen apposing metal stent for treatment of gastric outlet obstruction (with video)

Author

Mangiavillano, Benedetto, Larghi, Alberto, Vargas-Madrigal, Jorge, Facciorusso, Antonio, Di Matteo, Francesco, Crinò, Stefano Francesco, Pham, Khanh Do-Cong, Moon, Jong Hoo, Auriemma, Francesco, Camellini, Lorenzo, Paduano, Danilo, Stigliano, Serena, Calabrese, Federica, Ofosu, Andrew, Al-Lehibi, Abed, and Repici, Alessandro

Published
2023
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71. Dysfunctional Extracellular Matrix Remodeling Supports Perianal Fistulizing Crohn′s Disease by a Mechanoregulated Activation of the Epithelial-to-Mesenchymal TransitionSummary

Author

Giulia Rizzo, Federica Rubbino, Sudharshan Elangovan, Giusy Sammarco, Sara Lovisa, Silvia Restelli, Samuel Elias Pineda Chavez, Luca Massimino, Luigi Lamparelli, Marianna Paulis, Annalisa Maroli, Giulia Roda, Mohammad Shalaby, Michele Carvello, Caterina Foppa, Sheona P. Drummond, Paola Spaggiari, Federica Ungaro, Antonino Spinelli, Alberto Malesci, Alessandro Repici, Anthony J. Day, Alessandro Armuzzi, Silvio Danese, and Stefania Vetrano

Subjects
Perianal Fistula, Crohn′s Disease, TSG-6, Extracellular Matrix, EMT, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background and Aims: Perianal fistula represents one of the most disabling manifestations of Crohn′s disease (CD) due to complete destruction of the affected mucosa, which is replaced by granulation tissue and associated with changes in tissue organization. To date, the molecular mechanisms underlying perianal fistula formation are not well defined. Here, we dissected the tissue changes in the fistula area and addressed whether a dysregulation of extracellular matrix (ECM) homeostasis can support fistula formation. Methods: Surgical specimens from perianal fistula tissue and the surrounding region of fistulizing CD were analyzed histologically and by RNA sequencing. Genes significantly modulated were validated by real-time polymerase chain reaction, Western blot, and immunofluorescence assays. The effect of the protein product of TNF-stimulated gene-6 (TSG-6) on cell morphology, phenotype, and ECM organization was investigated with endogenous lentivirus-induced overexpression of TSG-6 in Caco-2 cells and with exogenous addition of recombinant human TSG-6 protein to primary fibroblasts from region surrounding fistula. Proliferative and migratory assays were performed. Results: A markedly different organization of ECM was found across fistula and surrounding fistula regions with an increased expression of integrins and matrix metalloproteinases and hyaluronan (HA) staining in the fistula, associated with increased newly synthesized collagen fibers and mechanosensitive proteins. Among dysregulated genes associated with ECM, TNFAI6 (gene encoding for TSG-6) was as significantly upregulated in the fistula compared with area surrounding fistula, where it promoted the pathological formation of complexes between heavy chains from inter-alpha-inhibitor and HA responsible for the formation of a crosslinked ECM. There was a positive correlation between TNFAI6 expression and expression of mechanosensitive genes in fistula tissue. The overexpression of TSG-6 in Caco-2 cells promoted migration, epithelial–mesenchymal transition, transcription factor SNAI1, and HA synthase (HAs) levels, while in fibroblasts, isolated from the area surrounding the fistula, it promoted an activated phenotype. Moreover, the enrichment of an HA scaffold with recombinant human TSG-6 protein promoted collagen release and increase of SNAI1, ITGA4, ITGA42B, and PTK2B genes, the latter being involved in the transduction of responses to mechanical stimuli. Conclusions: By mediating changes in the ECM organization, TSG-6 triggers the epithelial–mesenchymal transition transcription factor SNAI1 through the activation of mechanosensitive proteins. These data point to regulators of ECM as new potential targets for the treatment of CD perianal fistula.

Published
2023
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72. Impact of Artificial Intelligence on Colonoscopy Surveillance After Polyp Removal: A Pooled Analysis of Randomized Trials

Author

Mori, Yuichi, Wang, Pu, Løberg, Magnus, Misawa, Masashi, Repici, Alessandro, Spadaccini, Marco, Correale, Loredana, Antonelli, Giulio, Yu, Honggang, Gong, Dexin, Ishiyama, Misaki, Kudo, Shin-ei, Kamba, Shunsuke, Sumiyama, Kazuki, Saito, Yutaka, Nishino, Haruo, Liu, Peixi, Glissen Brown, Jeremy R., Mansour, Nabil M., Gross, Seth A., Kalager, Mette, Bretthauer, Michael, Rex, Douglas K., Sharma, Prateek, Berzin, Tyler M., and Hassan, Cesare

Published
2023
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74. Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines

Author

Cavestro, Giulia Martina, Mannucci, Alessandro, Balaguer, Francesc, Hampel, Heather, Kupfer, Sonia S., Repici, Alessandro, Sartore-Bianchi, Andrea, Seppälä, Toni T., Valentini, Vincenzo, Boland, Clement Richard, Brand, Randall E., Buffart, Tineke E., Burke, Carol A., Caccialanza, Riccardo, Cannizzaro, Renato, Cascinu, Stefano, Cercek, Andrea, Crosbie, Emma J., Danese, Silvio, Dekker, Evelien, Daca-Alvarez, Maria, Deni, Francesco, Dominguez-Valentin, Mev, Eng, Cathy, Goel, Ajay, Guillem, Josè G., Houwen, Britt B.S.L., Kahi, Charles, Kalady, Matthew F., Kastrinos, Fay, Kühn, Florian, Laghi, Luigi, Latchford, Andrew, Liska, David, Lynch, Patrick, Malesci, Alberto, Mauri, Gianluca, Meldolesi, Elisa, Møller, Pål, Monahan, Kevin J., Möslein, Gabriela, Murphy, Caitlin C., Nass, Karlijn, Ng, Kimmie, Oliani, Cristina, Papaleo, Enrico, Patel, Swati G., Puzzono, Marta, Remo, Andrea, Ricciardiello, Luigi, Ripamonti, Carla Ida, Siena, Salvatore, Singh, Satish K., Stadler, Zsofia K., Stanich, Peter P., Syngal, Sapna, Turi, Stefano, Urso, Emanuele Damiano, Valle, Laura, Vanni, Valeria Stella, Vilar, Eduardo, Vitellaro, Marco, You, Yi-Qian Nancy, Yurgelun, Matthew B., Zuppardo, Raffaella Alessia, and Stoffel, Elena M.

Published
2023
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76. Comparative Performance of Artificial Intelligence Optical Diagnosis Systems for Leaving in Situ Colorectal Polyps

Author

Spadaccini, Marco, Selvaggio, Carmelo, Antonelli, Giulio, Khalaf, Kareem, Rizkala, Tommy, Ferrara, Elisa, Savevski, Victor, Maselli, Roberta, Fugazza, Alessandro, Capogreco, Antonio, Poletti, Valeria, Ferretti, Silvia, Alkandari, Asma, Correale, Loredana, Hassan, Cesare, Sharma, Prateek, Mori, Yuichi, Bretthauer, Michael, Rex, Douglas K., and Repici, Alessandro

Published
2023
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78. Management of Malignant Gastric Outlet Obstruction: A Comprehensive Review on the Old, the Classic and the Innovative Approaches

Author

Alessandro Fugazza, Marta Andreozzi, Hamid Asadzadeh Aghdaei, Agustin Insausti, Marco Spadaccini, Matteo Colombo, Silvia Carrara, Maria Terrin, Alessandro De Marco, Gianluca Franchellucci, Kareem Khalaf, Pardis Ketabi Moghadam, Chiara Ferrari, Andrea Anderloni, Giovanni Capretti, Gennaro Nappo, Alessandro Zerbi, and Alessandro Repici

Subjects
gastric outlet obstruction, EUS-guided gastrojejunostomy, duodenal stricture, gastroduodenal stenting, self-expanding metal stents, Medicine (General), R5-920
Abstract

Gastrojejunostomy is the principal method of palliation for unresectable malignant gastric outlet obstructions (GOO). Gastrojejunostomy was traditionally performed as a surgical procedure with an open approach butrecently, notable progress in the development of minimally invasive procedures such as laparoscopic gastrojejunostomies have emerged. Additionally, advancements in endoscopic techniques, including endoscopic stenting (ES) and endoscopic ultrasound-guided gastroenterostomy (EUS-GE), are becoming more prominent. ES involves the placement of self-expandable metal stents (SEMS) to restore luminal patency. ES is commonly the first choice for patients deemed unfit for surgery or at high surgical risk. However, although ES leads to rapid improvement of symptoms, it carries limitations like higher stent dysfunction rates and the need for frequent re-interventions. Recently, EUS-GE has emerged as a potential alternative, combining the minimally invasive nature of the endoscopic approach with the long-lasting effects of a gastrojejunostomy. Having reviewed the advantages and disadvantages of these different techniques, this article aims to provide a comprehensive review regarding the management of unresectable malignant GOO.

Published
2024
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79. Signaling Pathways of AXL Receptor Tyrosine Kinase Contribute to the Pathogenetic Mechanisms of Glioblastoma

Author

Alberto Repici, Alessio Ardizzone, Fabiola De Luca, Lorenzo Colarossi, Angela Prestifilippo, Gabriele Pizzino, Irene Paterniti, Emanuela Esposito, and Anna Paola Capra

Subjects
neuro-oncology, Central Nervous System (CNS), glioblastoma, AXL receptor, neuroinflammation, Cytology, QH573-671
Abstract

Brain tumors are a diverse collection of neoplasms affecting the brain with a high prevalence rate in people of all ages around the globe. In this pathological context, glioblastoma, a form of glioma that belongs to the IV-grade astrocytoma group, is the most common and most aggressive form of the primary brain tumors. Indeed, despite the best treatments available including surgery, radiotherapy or a pharmacological approach with Temozolomide, glioblastoma patients’ mortality is still high, within a few months of diagnosis. Therefore, to increase the chances of these patients surviving, it is critical to keep finding novel treatment opportunities. In the past, efforts to treat glioblastoma have mostly concentrated on customized treatment plans that target specific mutations such as epidermal growth factor receptor (EGFR) mutations, Neurotrophic Tyrosine Receptor Kinase (NTRK) fusions, or multiple receptors using multi-kinase inhibitors like Sunitinib and Regorafenib, with varying degrees of success. Here, we focused on the receptor tyrosine kinase AXL that has been identified as a mediator for tumor progression and therapy resistance in various cancer types, including squamous cell tumors, small cell lung cancer, and breast cancer. Activated AXL leads to a significant increase in tumor proliferation, tumor cell migration, and angiogenesis in different in vitro and in vivo models of cancer since this receptor regulates interplay with apoptotic, angiogenic and inflammatory pathways. Based on these premises, in this review we mainly focused on the role of AXL in the course of glioblastoma, considering its primary biological mechanisms and as a possible target for the application of the most recent treatments.

Published
2024
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80. EUS-Guided Gallbladder Drainage Using a Lumen-Apposing Metal Stent for Acute Cholecystitis: Results of a Nationwide Study with Long-Term Follow-Up

Author

Cecilia Binda, Andrea Anderloni, Edoardo Forti, Pietro Fusaroli, Raffaele Macchiarelli, Mauro Manno, Alessandro Fugazza, Alessandro Redaelli, Giovanni Aragona, Mauro Lovera, Thomas Togliani, Elia Armellini, Arnaldo Amato, Mario Luciano Brancaccio, Roberta Badas, Nicola Leone, Germana de Nucci, Benedetto Mangiavillano, Monica Sbrancia, Valeria Pollino, Andrea Lisotti, Marcello Maida, Emanuele Sinagra, Marco Ventimiglia, Alessandro Repici, Carlo Fabbri, and Ilaria Tarantino

Subjects
acute cholecystitis, lumen apposing metal stent, EUS-guided drainage, EUS-guided gallbladder drainage, Medicine (General), R5-920
Abstract

Background: Although endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using lumen-apposing metal stents (LAMS) has become one of the treatments of choice for acute cholecystitis (AC) in fragile patients, scant data are available on real-life settings and long-term outcomes. Methods: We performed a multicenter retrospective study including EUS-guided GBD using LAMS for AC in 19 Italian centers from June 2014 to July 2020. The primary outcomes were technical and clinical success, and the secondary outcomes were the rate of adverse events (AE) and long-term follow-up. Results: In total, 116 patients (48.3% female) were included, with a mean age of 82.7 ± 11 years. LAMS were placed, transgastric in 44.8% of cases, transduodenal in 53.3% and transjejunal in 1.7%, in patients with altered anatomy. Technical success was achieved in 94% and clinical success in 87.1% of cases. The mean follow-up was 309 days. AEs occurred in 12/116 pts (10.3%); 8/12 were intraprocedural, while 1 was classified as early (15 days). According to the ASGE lexicon, two (16.7%) were mild, three (25%) were moderate, and seven (58.3%) were severe. No fatal AEs occurred. In subgroup analysis of 40 patients with a follow-up longer than one year, no recurrence of AC was observed. Conclusions: EUS-GBD had high technical and clinical success rates, despite the non-negligible rate of AEs, thus representing an effective treatment option for fragile patients.

Published
2024
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83. Transgastric Necrosectomy

Author

Anderloni, Andrea, Fugazza, Alessandro, Colombo, Matteo, Repici, Alessandro, Teoh, Anthony Y.B., editor, Giovaninni, Marc, editor, Khashab, Mouen A., editor, and Itoi, Takao, editor

Published
2022
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87. Incidence, risk and protective factors of symptoms after colonoscopy

Author

Collatuzzo, Giulia, Boffetta, Paolo, Radaelli, Franco, Cadoni, Sergio, Hassan, Cesare, Frazzoni, Leonardo, Anderloni, Andrea, Laterza, Liboria, La Marca, Marina, Rogai, Francesca, Binda, Cecilia, Montale, Amedeo, Soriani, Paola, Fabbri, Carlo, Sacco, Marco, Gallittu, Paolo, Mura, Donatella, Trovato, Cristina, Vitale, Giovanna, Mussetto, Alessandro, Musso, Alessandro, Conti, Clara Benedetta, Manno, Mauro, Repici, Alessandro, Zagari, Rocco Maurizio, Farioli, Andrea, and Fuccio, Lorenzo

Published
2022
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89. Determinants of symptom burden related to bowel preparation for colonoscopy

Author

Collatuzzo, Giulia, Fuccio, Lorenzo, Frazzoni, Leonardo, Radaelli, Franco, Hassan, Cesare, Fabbri, Carlo, Cadoni, Sergio, Laterza, Liboria, Anderloni, Andrea, Binda, Cecilia, La Marca, Marina, Montale, Amedeo, Soriani, Paola, Sacco, Marco, Gallittu, Paolo, Mura, Donatella, Manno, Mauro, Mussetto, Alessandro, Rogai, Francesca, Trovato, Cristina, Vitale, Giovanna, Musso, Alessandro, Conti, Clara Benedetta, Repici, Alessandro, Farioli, Andrea, Zagari, Rocco Maurizio, and Boffetta, Paolo

Published
2022
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92. Comparison of focal cryoballoon ablation with 10- and 8-second doses for treatment of Barrett’s esophagus–related neoplasia: results from a prospective European multicenter study (with video)

Author

Frederiks, Charlotte N., Overwater, Anouk, Alvarez Herrero, Lorenza, Alkhalaf, Alaa, Schenk, Ed, Repici, Alessandro, Bergman, Jacques J.G. H.M., Pouw, Roos E., Bisschops, Raf, Haidry, Rehan J., Beyna, Torsten, Neuhaus, Horst, and Weusten, Bas L.A. M.

Published
2022
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94. Pilot study on a new endoscopic platform for colorectal endoscopic submucosal dissection

Author

Roberta Maselli, Marco Spadaccini, Piera Alessia Galtieri, Matteo Badalamenti, Elisa Chiara Ferrara, Gaia Pellegatta, Antonio Capogreco, Silvia Carrara, Andrea Anderloni, Alessandro Fugazza, Cesare Hassan, and Alessandro Repici

Subjects
Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background: The endoscopic submucosal dissection (ESD) is a technically demanding and time-consuming procedure, with an increased risk of adverse events compared to standard endoscopic resection techniques. The main difficulties are related to the instability of the operating field and to the loss of traction. We aimed to evaluate in a pilot trial a new endoscopic platform [tissue retractor system (TRS); ORISE, Boston scientific Co., Marlborough, MA, USA], designed to stabilize the intraluminal space, and to provide tissue retraction and counter traction. Method: We prospectively enrolled all consecutive patients who underwent an ESD for sigmoid/rectal lesions. The primary outcome was the rate of technical feasibility. Further technical aspects such as en-bloc and R0 resection rate, number of graspers used, circumferential incision time, TRS assemblage time, submucosal dissection time, and submucosal dissection speed were provided. Clinical outcomes (recurrence rate and adverse events) were recorded as well. Results: In all, 10 patients (M/F 4/6, age: 70.4 ± 11.0 years old) were enrolled. Eight out of 10 lesions were located in the rectum. Average lesion size was 31.2 ± 2.7 mm, and mean lesion area was 1628.88 ± 205.3 mm 2 . The two sigmoid lesions were removed through standard ESD, because the platform assemblage failed after several attempts. All rectal lesions were removed in an en-bloc fashion. R0 resection was achieved in 7/8 (87.5%) patients in an average procedure time of 60.5 ± 23.3 min. None of the patients developed neither intraprocedural nor postprocedural adverse events. Conclusion: TRS-assisted ESD is a feasible option when used in the rectum, with promising result in terms of efficacy and safety outcomes. Nevertheless, our pilot study underlines few technical limitations of the present platform that need to be overcome before the system could be widely and routinely used.

Published
2023
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95. Atherosclerotic cardiovascular diseases in inflammatory bowel diseases: to the heart of the issue

Author

Roberto Gabbiadini, Arianna Dal Buono, Elisabetta Mastrorocco, Virginia Solitano, Alessandro Repici, Antonino Spinelli, Gianluigi Condorelli, and Alessandro Armuzzi

Subjects
inflammatory bowel disease, atherosclerotic cardiovascular disease, ischemic heart disease, ischemic stroke, IBD therapy, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Atherosclerotic cardiovascular disease and stroke are the leading causes of morbidity and mortality worldwide. Along to the traditional risk factors for these diseases, chronic inflammation is known to be an important player in accelerating the process of atherosclerosis, which can result in an increased incidence of arterial thromboembolic events. As in other chronic inflammatory diseases, in the past few years, several studies suggested that subjects affected by inflammatory bowel diseases (IBD) may also be at an incremented risk of atherosclerotic disease, especially during the periods of disease's flare. Therefore, IBD treatment may assume an important role for achieving both disease remission and the control of the atherosclerotic risk. In this article we aimed to perform a comprehensive review on evidence on the increased risk of arterial thromboembolic events in patients affected by IBD and discuss the potential role of IBD therapy in reducing this risk.

Published
2023
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97. Management of Helicobacter pylori infection: Guidelines of the Italian Society of Gastroenterology (SIGE) and the Italian Society of Digestive Endoscopy (SIED)

Author

Benedetti, Antonio, Annibale, Bruno, Burra, Patrizia, Maida, Marcello Fabio, Luzza, Francesco, Ricciardiello, Luigi, Vecchi, Maurizio, Frulloni, Luca, Repici, Alessandro, Savarino, Edoardo Vincenzo, Pasquale, Luigi, Pisani, Antonio, Lamazza, Antonietta, Cengia, Gianpaolo, Ciliberto, Enrico, Conigliaro, Rita Luisa, Da Massa Carrara, Paola, Germanà, Bastianello, Romano, Marco, Gravina, Antonietta Gerarda, Eusebi, Leonardo Henry, Pellegrino, Raffaele, Palladino, Giovanna, Frazzoni, Leonardo, Dajti, Elton, Gasbarrini, Antonio, Di Mario, Francesco, and Zagari, Rocco Maurizio

Published
2022
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98. Digital single-operator cholangioscopy in diagnostic and therapeutic bilio-pancreatic diseases: A prospective, multicenter study

Author

Fugazza, Alessandro, Gabbiadini, Roberto, Tringali, Andrea, De Angelis, Claudio Giovanni, Mosca, Piergiorgio, Maurano, Attilio, Di Mitri, Roberto, Manno, Mauro, Mariani, Alberto, Cereatti, Fabrizio, Bertani, Helga, Sferrazza, Sandro, Donato, Giulio, Tarantino, Ilaria, Cugia, Luigi, Aragona, Giovanni, Cantù, Paolo, Mazzocchi, Alessandro, Canfora, Maria Laura, Venezia, Ludovica, Bendia, Emanuele, Maroni, Luca, Zulli, Claudio, Conte, Elisabetta, Soriani, Paola, Ligresti, Dario, Vilardo, Emmanuelle, Penagini, Roberto, Benedetti, Antonio, Arcidiacono, Paolo Giorgio, Khalaf, Kareem, Troncone, Edoardo, Costamagna, Guido, Repici, Alessandro, and Anderloni, Andrea

Published
2022
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