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103. Sa1465 SINGLE OPERATOR CHOLANGIOSCOPY- DIRECTED BIOPSIES IMPROVES DIAGNOSTIC YIELD FOR CHOLANGIOCARCINOMA AND IS SAFE IN PATIENTS WITH PRIMARY SCLEROSING CHOLANGITIS

Author

Kaura, Karan, primary, Sawas, Tarek, additional, Bazerbachi, Fateh, additional, Martin, John A., additional, Abu Dayyeh, Barham K., additional, Storm, Andrew C., additional, Topazian, Mark, additional, Levy, Michael J., additional, Petersen, Bret T., additional, and Chandrasekhara, Vinay, additional

Published
2019
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106. Tu1110 OUTCOMES OF ERCP-GUIDED TRANSPAPILLARY VERSUS PERCUTANEOUS GALLBLADDER DRAINAGE AS BRIDGING THERAPIES FOR ACUTE CHOLECYSTITIS FOLLOWED BY INTERVAL SURGICAL CHOLECYSTECTOMY

Author

Kaura, Karan, primary, Bazerbachi, Fateh, additional, Sawas, Tarek, additional, Wise, Kevin B., additional, Storm, Andrew C., additional, Martin, John A., additional, Abu Dayyeh, Barham K., additional, Topazian, Mark, additional, Petersen, Bret T., additional, Levy, Michael J., additional, Schiller, Henry J., additional, and Chandrasekhara, Vinay, additional

Published
2019
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107. An innovative technique using a percutaneously placed guidewire allows for higher success rate for ERCP compared to balloon enteroscopy assistance in Roux-en-Y gastric bypass anatomy

Author

Sawas, Tarek, primary, Storm, Andrew C., additional, Bazerbachi, Fateh, additional, Fleming, Chad J., additional, Vargas, Eric J., additional, Chandrasekhara, Vinay, additional, Andrews, James C., additional, Levy, Michael J., additional, Martin, John A., additional, Petersen, Bret T., additional, Topazian, Mark D., additional, and Abu Dayyeh, Barham K., additional

Published
2019
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113. Risk Factor Profiles Can Distinguish Esophageal Adenocarcinoma From Barrett's Esophagus.

Author

Sawas, Tarek, Dilmaghani, Saam, Dhaliwal, Lovekirat, Wang, Kenneth K., Iyer, Prasad G., and Katzka, David A.

Subjects
*BARRETT'S esophagus, *ESOPHAGEAL abnormalities, *METABOLIC syndrome, *FATTY liver, *HYPERLIPIDEMIA
Abstract

INTRODUCTION: It is assumed that screening risk factors for Barrett's esophagus (BE) and prevalent esophageal adenocarcinoma (EAC) are the same. METHODS: A matched case-control study comparing risk factors between EAC and BE was performed. RESULTS: In 1,356 patients (678 with EAC and 678 with BE), heartburn (52.7%), diabetes, hyperlipidemia, hypertension, nonalcoholic steatohepatitis, and metabolic syndrome were less common in EAC (52.7, 29.2, 45.7, 48.2, 12, and 28.5%, resp.) compared with BE (84.5, 37.6, 82.2, 64.6, 18.4, and 44.1%, P < 0.01). Mean alanine aminotransferase and HgA1c levels were also significantly lower in EAC compared with BE. DISCUSSION: Optimal strategies for screening for prevalent EAC may be different than that for BE. [ABSTRACT FROM AUTHOR]

Published
2021
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115. Identification of Prognostic Phenotypes of Esophageal Adenocarcinoma in 2 Independent Cohorts

Author

Sawas, Tarek, primary, Killcoyne, Sarah, additional, Iyer, Prasad G., additional, Wang, Kenneth K., additional, Smyrk, Thomas C., additional, Kisiel, John B., additional, Qin, Yi, additional, Ahlquist, David A., additional, Rustgi, Anil K., additional, Costa, Rui J., additional, Gerstung, Moritz, additional, Fitzgerald, Rebecca C., additional, Katzka, David A., additional, Noorani, Ayesha, additional, Edwards, Paul A.W., additional, Grehan, Nicola, additional, Nutzinger, Barbara, additional, Hughes, Caitriona, additional, Fidziukiewicz, Elwira, additional, Bornschein, Jan, additional, MacRae, Shona, additional, Crawte, Jason, additional, Contino, Gianmarco, additional, Li, Xiaodun, additional, Rue, Rachel de la, additional, O’Donovan, Maria, additional, Miremad, Ahmad, additional, Malhotra, Shalini, additional, Tripathi, Monika, additional, Tavaré, Simon, additional, Lynch, Andy G., additional, Eldridge, Matthew, additional, Secrier, Maria, additional, Bower, Lawrence, additional, Devonshire, Ginny, additional, Perner, Juliane, additional, Jammula, Sriganesh, additional, Davies, Jim, additional, Crichton, Charles, additional, Carroll, Nick, additional, Safranek, Peter, additional, Hindmarsh, Andrew, additional, Sujendran, Vijayendran, additional, Hayes, Stephen J., additional, Ang, Yeng, additional, Preston, Shaun R., additional, Oakes, Sarah, additional, Bagwan, Izhar, additional, Save, Vicki, additional, Skipworth, Richard J.E., additional, Hupp, Ted R., additional, O’Neill, J. Robert, additional, Tucker, Olga, additional, Beggs, Andrew, additional, Taniere, Philippe, additional, Puig, Sonia, additional, Underwood, Timothy J., additional, Noble, Fergus, additional, Owsley, Jack, additional, Barr, Hugh, additional, Shepherd, Neil, additional, Old, Oliver, additional, Lagergren, Jesper, additional, Gossage, James, additional, Davies, Andrew, additional, Chang, Fuju, additional, Zylstra, Janine, additional, Mahadeva, Ula, additional, Goh, Vicky, additional, Ciccarelli, Francesca D., additional, Sanders, Grant, additional, Berrisford, Richard, additional, Harden, Catherine, additional, Bunting, David, additional, Lewis, Mike, additional, Cheong, Ed, additional, Kumar, Bhaskar, additional, Parsons, Simon L., additional, Soomro, Irshad, additional, Kaye, Philip, additional, Saunders, John, additional, Lovat, Laurence, additional, Haidry, Rehan, additional, Eneh, Victor, additional, Igali, Laszlo, additional, Scott, Michael, additional, Sothi, Sharmila, additional, Suortamo, Sari, additional, Lishman, Suzy, additional, Hanna, George B., additional, Peters, Christopher J., additional, Grabowska, Anna, additional, and Turkington, Richard, additional

Published
2018
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128. 372 - Detection of Esophageal Cancer by Assay of Novel Methylated DNA Markers in Plasma

Author

Qin, Yi, primary, Wu, Chung Wah, additional, Taylor, William R., additional, Sawas, Tarek, additional, Burger, Kelli N., additional, Mahoney, Douglas W., additional, Yab, Tracy C., additional, Lidgard, Graham P., additional, Allawi, Hatim T., additional, Buttar, Navtej S., additional, Iyer, Prasad G., additional, Katzka, David A., additional, Ahlquist, David A., additional, and Kisiel, John B., additional

Published
2018
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139. Safety and efficacy of coaxial lumen-apposing metal stents in the management of refractory gastrointestinal luminal strictures: a multicenter study

Author

Bazerbachi, Fateh, additional, Heffley, Jason, additional, Abu Dayyeh, Barham, additional, Nieto, Jose, additional, Vargas, Eric, additional, Sawas, Tarek, additional, Zaghlol, Raja, additional, Buttar, Navtej, additional, Topazian, Mark, additional, Wong Kee Song, Louis, additional, Levy, Michael, additional, Keilin, Steve, additional, Cai, Qiang, additional, and Willingham, Field, additional

Published
2017
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148. An innovative technique using a percutaneously placed guidewire allows for higher success rate for ERCP compared to balloon enteroscopy assistance in Roux-en-Y gastric bypass anatomy

Author

Sawas, Tarek, Storm, Andrew C., Bazerbachi, Fateh, Fleming, Chad J., Vargas, Eric J., Chandrasekhara, Vinay, Andrews, James C., Levy, Michael J., Martin, John A., Petersen, Bret T., Topazian, Mark D., and Abu Dayyeh, Barham K.

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is technically challenging in Roux-en-Y gastric bypass (RYGB). Current approaches either have high failure rate, are resource intensive, or invasive. Objective: To describe successful adoption of an old technique for performance of ERCP in patients with RYGB anatomy employing enteroscopy with the assistance of a percutaneously placed guidewire, which facilitates both reaching and cannulating the major papilla. Method: A retrospective cohort study in a tertiary-care center. We included patients with RYGB from 2015 to 2017 who underwent ERCP. We compared success rate and adverse events between rendezvous guidewire-assisted (RGA) and balloon-assisted enteroscopy (BAE) ERCP techniques. Results: Thirty patients with RYGB underwent 62 ERCPs. The mean age was 62.2 ± 11 years with female predominance 83.3%. The procedures were performed using BAE 43/62 (69.3%), RGA 13/62 (21%), gastrostomy tube 5/62 (8.1%), and colonoscope 1/62 (1.6%). In patients with a native papilla (n= 37 ERCPs), clinical success rate with BAE was 36.8% compared to 100% with RGA (P&lt; 0.001). There was no significant difference in bleeding (P= 0.17), post-ERCP pancreatitis (P= 0.4), or luminal perforation (P= not estimated) between the two techniques in native papilla. The mean procedure time with the RGA was significantly shorter than successful BAE with mean difference: 33 min (95% CI 8–57 min, P= 0.01). Twenty-five ERCPs were performed in eight patients with non-native papilla. BAE success rate in non-native papilla was 95.8%. The mean procedure time of the BAE in non-native papilla was 111 ± 60 min. Native papillae were associated with a significantly higher BAE failure rate compared to non-native papillae (OR: 12; 95% CI 1.44–99.7, P= 0.02). Conclusion: In patients with RYGB, RGA appears to be highly successful and safe in achieving clinical success for patients with native papilla as compared to BAE.

Published
2020
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149. Young Adults With Esophageal Adenocarcinoma Present With More Advanced Stage Tumors and Have Shorter Survival Times.

Author

Sawas, Tarek, Manrique, Gerardo Calderon, Iyer, Prasad G., Wang, Kenneth K., and Katzka, David A.

Abstract

Obesity is increasing in younger populations. Barrett's esophagus is associated with central obesity, so we investigated the occurrence of esophageal adenocarcinoma (EAC) in younger patients and compared them with older patients to determine differences in features at presentation and survival times. We performed a single-center, retrospective study of 682 patients with a diagnosis of EAC treated from 2009 through 2012. We used a Cox proportional hazards model to compare survival times among young (less than 50 years, n = 105), middle age (51–70 years, n = 383), and older age (more than 70 years, n = 194) patients. We collected data on demographic features of patients and information from medical records. Baseline characteristics were compared using χ2 analysis for categorical variables and analysis of variance for continuous variables. Higher proportions of patients in the young group presented with stage III EAC (43.8%) or stage IV EAC (33.3%), compared to the middle age group (39.7% with stage III and 21.7% with stage IV; P <.001) and older group (30.4% with stage III and 20.6% with stage IV; P <.001). The mean time of survival after diagnosis in the young group was 4 ± 4.2 years, compared to 5 ± 3.9 years in the middle age group (P =.03). The unadjusted model demonstrated an increased risk of death in the young group compared to the middle age group (hazard ratio, 1.5; 95% CI, 1.1–1.9; P =.004). Controlling for confounders such as sex, comorbidity index, stage, and the presence of intestinal metaplasia resulted in an adjusted hazard ratio of 1.34 for the young group (95% CI, 1.02–1.75; P = Intestinal metaplasia was detected in a higher proportion of patients in the middle age group (51.7%) than the young group (37.1%) (P <.001). In a retrospective analysis of patients with EAC treated at a single center, we found that a higher proportion of young patients (younger than 50 years) present advanced-stage tumors than middle age patients; young patients also have shorter survival times than middle age patients with EAC. Studies are needed to determine whether this difference is due to a lack of symptoms or endoscopic screening or distinct mechanisms of more aggressive tumors. [ABSTRACT FROM AUTHOR]

Published
2019
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150. Persistent intestinal metaplasia after endoscopic eradication therapy of neoplastic Barrett's esophagus increases the risk of dysplasia recurrence: meta-analysis.

Author

Sawas, Tarek, Alsawas, Mouaz, Bazerbachi, Fateh, Iyer, Prasad G., Wang, Kenneth K., Murad, M. Hassan, and Katzka, David A.

Abstract

Background and Aims: Endoscopic eradication therapy (EET) is the main treatment for dysplastic Barrett's esophagus and intramucosai adenocarcinoma. Although the goal of EET is to achieve complete remission of intestinal metaplasia (CRIM), treatment might achieve complete remission of dysplasia (CR-D) only, without achieving CRIM. Persistent intestinal metaplasia after eradication of dysplasia might carry a higher risk for progression into advanced neoplasia. Methods: We performed a systematic review and meta-analysis after searching multiple databases to identify studies that evaluated dysplasia recurrence risk after successful eradication of neoplasia with EET. We calculated the pooled cumulative incidence of dysplasia and advanced neoplasia recurrence after CRIM and CR-D only and then compared the two using risk ratios. Results: Forty studies were included (4410 patients with total follow-up of 12,976 patient-years). A total of 4061 achieved CRIM and 349 achieved CR-D only. The cumulative incidence of CR-D only was 14% (95% confidence interval [Cl], 10%-19%). The pooled cumulative incidence of any dysplasia recurrence after achieving CRIM was 5% (954> Cl, 3%-7%) and 12% (95% Cl, 4%-23%) after achieving CR-D only. Comparing dysplasia detection after achieving CR-D only with CRIM, there was a significantly higher risk for detection after CR-D (risk ratio [RR], 2.8; 95% Cl, 1.7-4.6). The pooled cumulative incidence rate of high-grade dysplasia (HGD)/esophageal adenocarcinoma (EAC) recurrence was 3% (95% Cl, 2%-4%) after achieving CRIM and 6% (95% Cl, 0%-l6%) after achieving CR-D only. Comparing HGD/EAC recurrence after achieving CR-D only with CRIM, there was a significantly higher risk for recurrence after CR-D (RR, 3.6; 95% Cl, 1.45-9). When excluding patients who underwent ablation for nondysplastic Barrett s esophagus only, these differences persisted with dysplasia recurrence after achieving CR-D only compared with CRIM showing a significantly higher risk for recurrence after CR-D (RR, 2.9; 95% Cl, 1.66-5). Conclusions: CRIM was associated with a lower risk of dysplasia and advanced neoplasia recurrence compared with CR-D only. Achieving CRIM should remain the goal of EET in dysplastic Barrett's esophagus. [ABSTRACT FROM AUTHOR]

Published
2019
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