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1. Migration rate using Fully-covered metal stent in anastomotic strictures after liver transplantation: Results from the BASALT Study Group

Author

Conigliaro, Rita, Pigò, Flavia, Bertani, Helga, Greco, Salvatore, Burti, Cesare, Indriolo, Amedeo, Di Sario, Antonio, Ortolani, Alessio, Maroni, Luca, Tringali, Andrea, Barbaro, Federico, Costamagna, Guido, Magarotto, Andrea, Masci, Enzo, Mutignani, Massimiliano, Forti, Edoardo, Tringali, Alberto, Parodi, Maria Caterina, Assandri, Lorenzo, Marrone, Ciro, Fantin, Alberto, Penagini, Roberto, Cantù, Paolo, Di Benedetto, Fabrizio, Ravelli, Paolo, Vivarelli, Marco, Agnes, Salvatore, Mazzaferro, Vincenzo, De Carlis, Luciano, Andorno, Enzo, Cillo, Umberto, Rossi, Giorgio, Tringali, Andrea (ORCID:0000-0002-9614-3449), Costamagna, Guido (ORCID:0000-0002-8100-2731), Agnes, Salvatore (ORCID:0000-0002-3341-4221), Conigliaro, Rita, Pigò, Flavia, Bertani, Helga, Greco, Salvatore, Burti, Cesare, Indriolo, Amedeo, Di Sario, Antonio, Ortolani, Alessio, Maroni, Luca, Tringali, Andrea, Barbaro, Federico, Costamagna, Guido, Magarotto, Andrea, Masci, Enzo, Mutignani, Massimiliano, Forti, Edoardo, Tringali, Alberto, Parodi, Maria Caterina, Assandri, Lorenzo, Marrone, Ciro, Fantin, Alberto, Penagini, Roberto, Cantù, Paolo, Di Benedetto, Fabrizio, Ravelli, Paolo, Vivarelli, Marco, Agnes, Salvatore, Mazzaferro, Vincenzo, De Carlis, Luciano, Andorno, Enzo, Cillo, Umberto, Rossi, Giorgio, Tringali, Andrea (ORCID:0000-0002-9614-3449), Costamagna, Guido (ORCID:0000-0002-8100-2731), and Agnes, Salvatore (ORCID:0000-0002-3341-4221)

Abstract

Background and study aim: The traditional endoscopic therapy of anastomotic strictures (AS) after orthotopic liver transplantation (OLT) is multiple ERCPs with insertion of an increasing number of plastic stents side-by-side. Fully covered self-expanding metal stents (cSEMS) could be a valuable option to decrease the number of procedures needed or non-responders to plastic stents. This study aims to retrospectively analyze the results of AS endoscopic treatment by cSEMS and to identify any factors associated to its success. Patients and Methods Ninety-one patients (mean age 55.9 ± 7.6 DS; 73 males) from 9 Italian transplantation centers, had a cSEMS positioned for post-OLT AS between 2007 and 2017. 49 (54%) patients were treated with cSEMS as a second-line treatment. Results All the procedures were successfully performed without with no immediate complications. After ERCP, adverse events occurred in 11% of cases (2 moderate pancreatitis, 8 cholangitis). In 49 patients (54%) cSEMSs migrated. After cSEMS removal, 46 patients (51%) needed further endoscopic (45 patients) or radiologic (1 patient) treatments to solve the AS. Lastly, 7 patients underwent surgery. Multivariable stepwise logistic regression showed that cSEMS migration was the only factor associated with further treatments (OR 2.6, 95% CI 1.0-6.6; p-value 0.03); cSEMS implantation before 12 months from OLT was associated with stent migration (OR 5.2, 95% CI 1.7-16.0; p-value 0.004). Conclusions cSEMS appears to be a safe tool to treat AS. cSEMS migration is the main limitation to its routinary implantation and needs to be prevented, probably with the use of new generation anti-migration stents.

Published
2022

6. Oesophageal Motility And Bolus Transit Abnormalities Increase In Parallel With The Severity Of Gastro-Oesophageal Reflux Disease

Author

Savarino, Edoardo, Gemignani, Lorenzo, Pohl, Daniel, Zentilin, Patrizia, Dulbecco, Pietro, Assandri, Lorenzo, Marabotto, Elisa, Bonfanti, Daria, Inferrera, Simona, Fazio, Valentina, Malesci, Alberto C, Tutuian, Radu, Savarino, Vincenzo, Gastroenterology Unit, Universita degli Studi di Padova, Division of Gastroenterology and Hepatology, Medical University of South Carolina [Charleston] (MUSC), University of Genoa (UNIGE), Division of Gastroenterology, Istituto Clinico Humanitas [Milan] (IRCCS Milan), Humanitas University [Milan] (Hunimed)-Humanitas University [Milan] (Hunimed), Gastroenterology, and Inselspital

Subjects
Adult, Male, Esophageal pH Monitoring, FUNCTIONAL HEARTBURN, NERD, Manometry, Severity of Illness Index, Barrett's esophagus, Young Adult, Electric Impedance, Humans, Prospective Studies, Gastrointestinal Transit, Aged, Retrospective Studies, digestive, oral, and skin physiology, Gastric Acidity Determination, Middle Aged, digestive system diseases, Italy, Case-Control Studies, Gastroesophageal Reflux, Regression Analysis, Medicine, Female, Peristalsis, Gastrointestinal Motility
Abstract

International audience; Introduction: Limited data are available regarding the frequency of oesophageal motility and bolus transit abnormalities in subgroups of patients with gastro-oesophageal reflux disease (GORD). Aim: To assess oesophageal motility and bolus transit in endoscopically-defined GORD subgroups. Methods: Patients (N=755) with typical reflux symptoms underwent upper endoscopy, conventional or impedance oesophageal manometry and/or impedance-pH testing. They were divided into: erosive oesophagitis (EO; N=340), Barrett Oesophagus (BO; N=106), non-erosive reflux disease (NERD; endoscopy−, abnormal pH and/or SAP/SI+; N=239) and functional heartburn (FH; endoscopy-, normal pH and SAP/SI-; N=70). Manometric patterns and bolus transit were defined according to previously published criteria. Results: Increasing GORD severity was associated with decreased lower oesophageal sphincter resting pressure (p

Published
2011

7. Clinical Trial: The Association Between Rifaximin And Partially Hydrolyzed Guar Gum Is More Effective Than Rifaximin Alone In Eradicating SIBO

Author

Furnari , Manuele, Parodi , Andrea, Gemignani , Lorenzo, Giannini , Edoardo G, Marenco , Simona, Savarino , Edoardo, Assandri , Lorenzo, Fazio , Valentina, Bonfanti , Daria, Inferrera , Simona, Savarino , Vincenzo, Gastroenterology Unit, Universita degli Studi di Padova, Gastroenterology, and Sanremo Hospital

Subjects
Medicine
Abstract

International audience; Background: Abnormal intestinal clearance is involved in the pathogenesis of small intestinal bacterial overgrowth (SIBO). It is known that partially hydrolyzed Guar gum (PHGG) affects intestinal motility. Eradication therapy of SIBO is based on antibiotic treatment: no data are available about the role of fibers supplementation in eradicating SIBO. Aims: To assess whether the association between PHGG plus rifaximin is more effective than rifaximin alone in the treatment of SIBO. Methods: 50g-glucose breath test (GBT) was given to 500 consecutive patients. Patients with positive GBT and predisposing conditions to SIBO entered into the study, and were randomized to receive rifaximin 1200mg/die or rifaximin 1200mg/die plus PHGG 5g/die for 10 days. Patients completed a symptom questionnaire and GBT both in basal condition and 1 month after withdrawal of therapy. Results: Seventy-seven patients had SIBO. SIBO eradication rate was 62.1% in the rifaximin group (both on per-protocol and intention-to-treat analyses), and 87.1% (per-protocol, p=0.017) and 85.0% (intention-to-treat, p=0.036) in the rifaximin-plus-PHGG group. Clinical improvement was observed in 86.9% and 91.1% of eradicated cases in rifaximin and rifaximin-plus-PHGG groups, respectively (p=0.677). Conclusion: The association between rifaximin and PHGG seems to be more useful in eradicating SIBO compared to rifaximin alone.

Published
2010

9. Adalimumab Is More Effective Than Azathioprine and Mesalamine at Preventing Postoperative Recurrence of Crohn's Disease: A Randomized Controlled Trial

Author

Savarino, Edoardo, primary, Bodini, Giorgia, additional, Dulbecco, Pietro, additional, Assandri, Lorenzo, additional, Bruzzone, Linda, additional, Mazza, Fabrizio, additional, Frigo, Anna Chiara, additional, Fazio, Valentina, additional, Marabotto, Elisa, additional, and Savarino, Vincenzo, additional

Published
2013
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10. Tu1169 Correlation Between Adalimumab Trough Serum Concentration, Anti-Adalimumab Antibodies and TNF-α Levels With Clinical Outcome in Patients Affected by Crohn's Disease

Author

Bodini, Giorgia, primary, Savarino, Vincenzo, additional, Dulbecco, Pietro, additional, Assandri, Lorenzo, additional, Bruzzone, Linda, additional, Mazza, Fabrizio, additional, Fazio, Valentina, additional, Giambruno, Elisa, additional, Gemignani, Lorenzo, additional, and Savarino, Edoardo, additional

Published
2013
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11. 92 Adalimumab Is More Effective Than Azathioprine and Mesalamine At Preventing Postoperative Recurrence of Crohn's Disease - A Randomized Trial

Author

Savarino, Edoardo, primary, Bodini, Giorgia, additional, Dulbecco, Pietro, additional, Marabotto, Elisa, additional, Assandri, Lorenzo, additional, Bruzzone, Linda, additional, Mazza, Fabrizio, additional, Fazio, Valentina, additional, Giambruno, Elisa, additional, Gemignani, Lorenzo, additional, and Savarino, Vincenzo, additional

Published
2013
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17. Migration rate using fully covered metal stent in anastomotic strictures after liver transplantation: Results from the BASALT study group.

Author

Conigliaro R, Pigò F, Bertani H, Greco S, Burti C, Indriolo A, Di Sario A, Ortolani A, Maroni L, Tringali A, Barbaro F, Costamagna G, Magarotto A, Masci E, Mutignani M, Forti E, Tringali A, Parodi MC, Assandri L, Marrone C, Fantin A, Penagini R, Cantù P, Di Benedetto F, Ravelli P, Vivarelli M, Agnes S, Mazzaferro V, De Carlis L, Andorno E, Cillo U, and Rossi G

Subjects
Cholangiopancreatography, Endoscopic Retrograde adverse effects, Constriction, Pathologic surgery, Humans, Male, Middle Aged, Plastics, Retrospective Studies, Silicates, Stents adverse effects, Treatment Outcome, Cholestasis etiology, Cholestasis surgery, Liver Transplantation adverse effects
Abstract

Background and Study Aim: The traditional endoscopic therapy of anastomotic strictures (AS) after orthotopic liver transplantation (OLT) is multiple ERCPs with the insertion of an increasing number of plastic stents side-by-side. Fully covered self-expanding metal stents (cSEMS) could be a valuable option to decrease the number of procedures needed or non-responders to plastic stents. This study aims to retrospectively analyse the results of AS endoscopic treatment by cSEMS and to identify any factors associated with its success., Patients and Methods: Ninety-one patients (mean age 55.9 ± 7.6 SD; 73 males) from nine Italian transplantation centres, had a cSEMS positioned for post-OLT-AS between 2007 and 2017. Forty-nine (54%) patients were treated with cSEMS as a second-line treatment., Results: All the procedures were successfully performed without immediate complications. After ERCP, adverse events occurred in 11% of cases (2 moderate pancreatitis and 8 cholangitis). In 49 patients (54%), cSEMSs migrated. After cSEMS removal, 46 patients (51%) needed further endoscopic (45 patients) or radiological (1 patient) treatments to solve the AS. Lastly, seven patients underwent surgery. Multivariable stepwise logistic regression showed that cSEMS migration was the only factor associated with further treatments (OR 2.6, 95% CI 1.0-6.6; p value 0.03); cSEMS implantation before 12 months from OLT was associated with stent migration (OR 5.2, 95% CI 1.7-16.0; p value 0.004)., Conclusions: cSEMS appears to be a safe tool to treat AS. cSEMS migration is the main limitation to its routinary implantation and needs to be prevented, probably with the use of new generation anti-migration stents., (© 2022 John Wiley & Sons A/S . Published by John Wiley & Sons Ltd.)

Published
2022
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