21 results on '"F Riu Pons"'
Search Results
2. EDUCATIONAL TELEPHONE INTERVENTION BY ENDOSCOPY NURSE. IMPACT ON THE ADHERENCE OF OUTPATIENT COLONOSCOPY
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R Pérez Berbegal, X Font Lagarriga, J Romero Xandre, C Pérez Carregal, L Barranco Priego, F Riu Pons, M Parrilla Carrasco, I.A. Ibáñez Zafón, J.M. Dedeu Cuscó, X Bessa Caserras, MA Alvarez Gonzalez, MA Pantaleón Sánchez, A Seoane Urgorri, and Carlos Fernando Enriquez
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Family medicine ,Intervention (counseling) ,medicine ,Colonoscopy ,business ,Endoscopy - Published
- 2019
3. HEMOSPRAY FOR GASTROINTESTINAL BLEEDING: EFFECTIVENESS, PREDICTORS OF FAILURE AND SURVIVAL IN A NATIONWIDE STUDY
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D Oyón Lara, A Guerrero García, A. Albillos, J Aranda Hernández, R Borobia Sánchez, C Carbonell Blanco, S Parejo Carbonell, D Coto Ugarte, Á Terán Lantarón, S Prados Leira, C. Froilán Torres, I Ortiz Polo, D Burgos Santamaría, E Vázquez Sequeiros, C Chavarria Herbozo, L Ciriano Hernández, E Martínez Bauer, Enric Brullet, A Ibañez Pinto, M Angel de Jorge Turrión, C. Ferre Aracil, Hmm Prieto, J García Lledó, C Santander Vaquero, A. López Serrano, M López Ibáñez, D Pérez Corte, N Volpato Machado, D. Juzgado Lucas, F Riu Pons, C Rodríguez Escaja, M De Benito Sanz, O Murcia Palomares, S Sevilla Ribota, Giulia Pagano, I Becerro González, FJ García Alonso, I Fernández-Urién Sainz, A Barturen Barroso, B Peñas García, O Nogales Rincón, M González-Haba Ruíz, E. Rodríguez de Santiago, E. Martínez Moneo, and L Pérez Carazo
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medicine.medical_specialty ,Gastrointestinal bleeding ,business.industry ,Internal medicine ,Medicine ,business ,medicine.disease - Published
- 2019
4. NARROW BAND IMAGING VERSUS LUZ BLANCA EN LA CARACTERIZACIÓN DE NEOPLASIA RESIDUAL TRAS RESECCIÓN ENDOSCÓPICA MUCOSA, ESTUDIO CONTROLADO Y ALEATORIZADO
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Marco Antonio Álvarez, J Gimeno, Agustín Seoane, Montserrat Andreu, Xavier Bessa, Josep Maria Dedeu, F Riu Pons, and Luis Barranco
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business.industry ,Gastroenterology ,Medicine ,Nuclear medicine ,business - Abstract
Introduccion: La Reseccion Endoscopica Mucosa (REM) de polipos colorrectales sesiles se asocia a una recurrencia de alrededor del 25%. No existe evidencia si NBI respecto Luz blanca (LB) pueda mejorar la deteccion de tejido residual en el seguimiento de estas lesiones. Objetivo: Evaluar la eficacia de NBI respecto LB para la deteccion de neoplasia residual en la cicatriz de una REM. Material y Metodo: Estudio prospectivo aleatorizado y controlado, unicentrico de lesiones REM colorrectales (mayo 2015-mayo 2016). El mismo endoscopista evaluo la cicatriz utilizando colonoscopios de Alta Definicion, de forma secuencial (NBI-LB o LB-NBI). Cualquier sospecha de neoplasia se clasifico de forma independiente dando un nivel de confianza bajo/alto. Se tomaron biopsias aunque la cicatriz fuera aparentemente normal. Resultados: Se incluyeron 120 lesiones de 111 pacientes (media de edad 67,8 anos; 57,5% hombres). Tamano mediano 20 mm (rango: 12 – 30); 80% colon derecho. El tiempo mediano hasta revision fue 3,9 meses. Para cada lesion, se tomaron como maximo 3 biopsias (numero total de puntos evaluados: 142). Las caracteristicas basales fueron similares en ambos grupos. NBI obtuvo respecto LB una sensibilidad superior, aunque no significativa (87,8% vs. 78,0%, p = 0,125). No hubo diferencias en especificidad (85,1% vs. 86,1%) ni en precision global (85,9% vs. 83,8%). Hubo 41/113 (36,3%) lesiones con recurrencia histologica. En el analisis univariado, la displasia residual se relaciono con el tamano, el peso corporal y el indice de masa corporal (IMC). En el multivariado, lesiones ≥25 mm (OR 2,73; IC95%: 1,15 – 6,47) e IMC ≥27 Kg/m2 (OR 3,03; IC95%: 1,34 – 6,89) fueron factores predictivos de displasia residual, con una AUC 0,69 (IC 95%: 0,59 a 0,79). Conclusiones: NBI tiene una eficacia similar a LB para la deteccion de displasia residual tras una REM. Aquellos pacientes con lesiones ≥25 mm tienen un alto riesgo de neoplasia residual.
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- 2016
5. UTILIDAD DE LA PANCROMOENDOSCOPIA CON ÍNDIGO CARMÍN PARA EL SEGUIMIENTO DE LOS PACIENTES CON SÍNDROME DE POLIPOSIS SERRADA
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P Vega Villaamil, F Riu Pons, D Rodriguez Alcalde, I Salces Franco, J López Vicente, J Santiago García, M López-Cerón Pinilla, M Domínguez Antonaya, L Hernández Villalba, and M Bustamante Balén
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business.industry ,Gastroenterology ,Medicine ,business ,Humanities - Published
- 2016
6. CROMOENDOSCOPIA VIRTUAL CON NBI Y LUZ BLANCA, ESTUDIO ALEATORIZADO EN TÁNDEM EN PACIENTES CON LESIONES SERRADAS
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D Naranjo, Luis Barranco, Marco Antonio Álvarez, Montserrat Andreu, F Riu Pons, Xavier Bessa, Agustín Seoane, and Josep Maria Dedeu
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business.industry ,Gastroenterology ,Medicine ,Nuclear medicine ,business - Published
- 2016
7. ¿HEMOS DE RECOMENDAR DIETA LÍQUIDA O DIETA SIN RESIDUOS, EL DÍA ANTES DE UNA COLONOSCOPIA DE CRIBADO?. ESTUDIO CLÍNICO RANDOMIZADO CON DOS GRUPOS PARALELOS
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A Fernández Clotet, IA Ibañez Zafón, X Bessa Caserras, F Riu Pons, MA Alvarez Gonzalez, MA Pantaleón Sánchez, M Bonilla Montón, A Seoane Urgorri, G Casals Urquiza, A Raga Gil, M Dedeu Josep, L Barranco Priego, and D Zaffalon Espinal
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business.industry ,Gastroenterology ,Medicine ,business ,Humanities - Published
- 2015
8. An artificial intelligence-assisted system versus white light endoscopy alone for adenoma detection in individuals with Lynch syndrome (TIMELY): an international, multicentre, randomised controlled trial.
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Ortiz O, Daca-Alvarez M, Rivero-Sanchez L, Gimeno-Garcia AZ, Carrillo-Palau M, Alvarez V, Ledo-Rodriguez A, Ricciardiello L, Pierantoni C, Hüneburg R, Nattermann J, Bisschops R, Tejpar S, Huerta A, Riu Pons F, Alvarez-Urturi C, López-Vicente J, Repici A, Hassan C, Cid L, Cavestro GM, Romero-Mascarell C, Gordillo J, Puig I, Herraiz M, Betes M, Herrero J, Jover R, Balaguer F, and Pellisé M
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- Humans, Male, Female, Middle Aged, Adult, Early Detection of Cancer methods, Aged, Diagnosis, Computer-Assisted methods, Colorectal Neoplasms, Hereditary Nonpolyposis diagnosis, Colonoscopy methods, Adenoma diagnosis, Adenoma pathology, Artificial Intelligence
- Abstract
Background: Computer-aided detection (CADe) systems for colonoscopy have been shown to increase small polyp detection during colonoscopy in the general population. People with Lynch syndrome represent an ideal target population for CADe-assisted colonoscopy because adenomas, the primary cancer precursor lesions, are characterised by their small size and higher likelihood of showing advanced histology. We aimed to evaluate the performance of CADe-assisted colonoscopy in detecting adenomas in individuals with Lynch syndrome., Methods: TIMELY was an international, multicentre, parallel, randomised controlled trial done in 11 academic centres and six community centres in Belgium, Germany, Italy, and Spain. We enrolled individuals aged 18 years or older with pathogenic or likely pathogenic MLH1, MSH2, MSH6, or EPCAM variants. Participants were consecutively randomly assigned (1:1) to either CADe (GI Genius) assisted white light endoscopy (WLE) or WLE alone. A centre-stratified randomisation sequence was generated through a computer-generated system with a separate randomisation list for each centre according to block-permuted randomisation (block size 26 patients per centre). Allocation was automatically provided by the online AEG-REDCap database. Participants were masked to the random assignment but endoscopists were not. The primary outcome was the mean number of adenomas per colonoscopy, calculated by dividing the total number of adenomas detected by the total number of colonoscopies and assessed in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT04909671., Findings: Between Sept 13, 2021, and April 6, 2023, 456 participants were screened for eligibility, 430 of whom were randomly assigned to receive CADe-assisted colonoscopy (n=214) or WLE (n=216). 256 (60%) participants were female and 174 (40%) were male. In the intention-to-treat analysis, the mean number of adenomas per colonoscopy was 0·64 (SD 1·57) in the CADe group and 0·64 (1·17) in the WLE group (adjusted rate ratio 1·03 [95% CI 0·72-1·47); p=0·87). No adverse events were reported during the trial., Interpretation: In this multicentre international trial, CADe did not improve the detection of adenomas in individuals with Lynch syndrome. High-quality procedures and thorough inspection and exposure of the colonic mucosa remain the cornerstone in surveillance of Lynch syndrome., Funding: Spanish Gastroenterology Association, Spanish Society of Digestive Endoscopy, European Society of Gastrointestinal Endoscopy, Societat Catalana de Digestologia, Instituto Carlos III, Beca de la Marato de TV3 2020. Co-funded by the European Union., Competing Interests: Declaration of interests AL-R received payment or honoraria for lectures, presentations, speakers bureaus, or educational events from Boston Scientific, Fujifilm, NEC, and Olympus. AZG-G received grants from Fundación de la Sociedad Española de Endoscopia Digestiva and University Hospital of the Canary Islands. CH received a grant from AIRC under IG 2022 (ID 27843) project and consulting fees from Boston Scientific, Fujifilm, Olympus, and Odin. IP received consulting fees from Fujifilm and support for travels and attending meetings from Fujifilm and Casen. JN received grants or contracts from Deutsche Forschungsgemeinschaft (DFG), Deutsches Zentrum für Infektionsforschung (DZIF), Deutsche Krebshilfe, Hector-Stiftung, Bundesministerium für Bildung und Forschung (BMBF); and payment honoraria for lectures and presentations, travel, and attending meetings from Falk foundation. RB received research funding, speaker, and advisory fees from Medtronic; grants and contracts from Pentax, Digital Endoscopy, and Fujifilm; payment or honoraria for lectures and presentations from Medtronic, Pentax, and Fujifilm; receipt of equipment from Fujifilm and Pentax; and payment for expert testimony from Pentax. RB is also supported by a grant of Research Foundation Flanders. RH received grants or contracts from DFG, DZIF, Deutsche Krebshilfe, Hector-Stiftung, and BMBF; received payment for lectures and presentations from Falk Foundation and MSD Sharp&Dohme; and received equipment from Fujifilm. MP received speakers fees from Medtronic and advisory and speakers fees from Fujifilm and Olympus. FB received consultant fees from Olympus, Nouscom, Sysmex, and Norgine, and editorial fees from Elsevier. RJ received contracts from Medtronic through a research grant institution. All other authors declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)
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- 2024
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9. Underwater versus conventional EMR of large nonpedunculated colorectal lesions: a multicenter randomized controlled trial.
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Rodríguez Sánchez J, Alvarez-Gonzalez MA, Pellisé M, Coto-Ugarte D, Uchima H, Aranda-Hernández J, Santiago García J, Marín-Gabriel JC, Riu Pons F, Nogales O, Carreño Macian R, Herreros-de-Tejada A, Hernández L, Patrón GO, Rodriguez-Tellez M, Redondo-Cerezo E, Sánchez Alonso M, Daca M, Valdivielso-Cortazar E, Álvarez Delgado A, Enguita M, Montori S, and Albéniz E
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- Humans, Colonoscopy methods, Water, Intestinal Mucosa pathology, Colorectal Neoplasms pathology, Colonic Polyps pathology, Endoscopic Mucosal Resection methods
- Abstract
Background and Aims: Underwater EMR (UEMR) is an alternative procedure to conventional EMR (CEMR) to treat large, nonpedunculated colorectal lesions (LNPCLs). In this multicenter, randomized controlled clinical trial, we aimed to compare the efficacy and safety of UEMR versus CEMR on LNPCLs., Methods: We conducted a multicenter, randomized controlled clinical trial from February 2018 to February 2020 in 11 hospitals in Spain. A total of 298 patients (311 lesions) were randomized to the UEMR (n = 149) and CEMR (n = 162) groups. The main outcome was the lesion recurrence rate in at least 1 follow-up colonoscopy. Secondary outcomes included technical aspects, en bloc resection rate, R0 resection rates, and adverse events, among others., Results: There were no differences in the overall recurrence rate (9.5% UEMR vs 11.7% CEMR; absolute risk difference, -2.2%; 95% CI, -9.4 to 4.9). However, considering polyp sizes between 20 and 30 mm, the recurrence rate was lower for UEMR (3.4% UEMR vs 13.1% CEMR; absolute risk difference, -9.7%; 95% CI, -19.4 to 0). The R0 resection showed the same tendency, with significant differences favoring UEMR only for polyps between 20 and 30 mm. Overall, UEMR was faster and easier to perform than CEMR. Importantly, the techniques were equally safe., Conclusions: UEMR is a valid alternative to CEMR for treating LNPCLs and could be considered the first option of treatment for lesions between 20 and 30 mm due to its higher en bloc and R0 resection rates. (Clinical trial registration number: NCT03567746.)., (Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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10. Findings in the distal and proximal colon in colonoscopy screening after positive FIT and related pre-procedure factors.
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Núñez Rodríguez MªH, Díez Redondo P, Riu Pons F, Cimavilla M, Loza A, and Perez-Miranda M
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- Female, Humans, Male, Middle Aged, Cross-Sectional Studies, Colonoscopy, Early Detection of Cancer methods, Mass Screening methods, Colorectal Neoplasms diagnosis, Polyps
- Abstract
Background: Colonoscopy is the gold standard method for the early diagnosis and prevention of colorectal cancer (CRC). Screening programs include immune determination of blood in feces. Regardless of the method used, proximal colon lesions appear to be detected less frequently., Objective: Analyze the characteristics of proximal and distal lesions and possible predisposing factors., Methods: A cross-sectional study was performed of 692 patients from the CRC screening program with FIT ≥ 100ngHb/ml (October 2017 - October 2018). The right colon was examined twice as patients were participating in a randomized clinical trial to re-evaluate the right colon by forward-viewing endoscope or proximal retroflexion. The adenoma detection rate (ADR), advanced neoplasia (AN) and CRC in the proximal and distal colon, the histological and morphological characteristics in each section were analyzed., Results: 52.9% of the patients were male, with a mean age of 59.5 years (SD: 7.6). 1490 polyps were found and the ADR was 57.7% (distal 42% and proximal 37%). Detection rates were 45.8% for AN, 40.9% for advanced adenomas, 5.2% for advanced SSL and CRC was diagnosed in 4.8% of patients. Males had more AN than females. The mean age of patients with AN was significantly higher. AN were associated with smoking and alcohol consumption (p=0.0001). Globally, FIT levels were higher in patients with AN (p=0.003). Sixty-six per cent of cancers were distally located and 61.3% of CRC were diagnosed in the early stages., Conclusions: In an average-risk asymptomatic population undergoing colonoscopy after positive FIT, AN were more common in the distal colon in males, older patients, smokers and those with alcohol intake.
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- 2022
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11. Prevalence of missed lesions in patients with inadequate bowel preparation through a very early repeat colonoscopy.
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Pantaleón Sánchez M, Gimeno Garcia AZ, Bernad Cabredo B, García-Rodríguez A, Frago S, Nogales O, Diez Redondo P, Puig I, Romero Mascarell C, Romero Sánchez-Miguel I, Caballero N, Ibañez I, Hernandez Negrín D, Bujedo Sadornill G, Pérez Oltra A, Pérez Berbegal R, Casals G, Seoane Urgorri A, Riu Pons F, Amorós J, and Alvarez-Gonzalez MA
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- Cathartics, Colonoscopy, Humans, Prevalence, Prospective Studies, Adenoma diagnosis, Colonic Polyps diagnosis, Colonic Polyps pathology
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Objectives: When bowel preparation (BP) is inadequate, international guidelines recommend repeating the colonoscopy within 1 year to avoid missing clinically relevant lesions. We aimed to determine the rate of missed lesions in patients with inadequate BP through a very early repeat colonoscopy with adequate BP., Methods: Post hoc analysis was conducted using data collected from a prospective multicenter randomized clinical trial including patients with inadequate BP and then repeat colonoscopy. Inadequate BP was defined as the Boston Bowel Preparation Scale (BBPS) score <2 points in any segment. We included patients with any indication for colonoscopy. The adenoma detection rate (ADR), advanced ADR (AADR), and serrated polyp detection rate (SPDR) were calculated for index and repeat colonoscopies., Results: Of the 651 patients with inadequate BP from the original trial, 413 (63.4%) achieved adequate BP on repeat colonoscopy. The median interval between index and repeat colonoscopies was 28 days. On repeat colonoscopy, the ADR was 45.3% (95% confidence interval [CI] 40.5-50.1%), the AADR was 10.9% (95% CI 8.1-14.3%), and the SPDR was 14.3% (95% CI 10.9-17.7%). Cancer was discovered in four patients (1%; 95% CI 0.2-2.5%). A total of 60.2% of all advanced adenoma (AA) were discovered on repeat colonoscopy. A colon segment scored BBPS = 0 had most AA (66.1%) and all four cancers., Conclusion: Patients with inadequate BP present a high rate of AAs on repeat colonoscopy. When a colonoscopy has a colon segment score BBPS = 0, we recommend repeating the colonoscopy as soon as possible., (© 2022 The Authors. Digestive Endoscopy published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)
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- 2022
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12. Endoscopy-Related Bleeding and Thromboembolic Events in Patients on Direct Oral Anticoagulants or Vitamin K Antagonists.
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Rodríguez de Santiago E, Sánchez Aldehuelo R, Riu Pons F, Rodríguez Escaja C, Fernández-Esparrach G, Cañete-Ruiz Á, Ferre Aracil C, Pérez-Corte D, Ríos León R, Marcos-Prieto HM, Delgado-Guillena PG, García-Rodríguez A, Guarner-Argente C, Muriel A, de la Fuente-Briongos E, García García de Paredes A, Parejo-Carbonell S, Téllez L, Senosiaín-Lalastra C, Burgos-Santamaría D, Aicart-Ramos M, Mateos Muñoz B, Peñas-García B, Pagano G, Casals Urquiza G, Urpi Ferreruela M, Ángel de Jorge-Turrión M, Barreiro-Alonso E, Fraile-López M, Gómez-Outomuro A, Altamirano MI, Núñez Esteban M, Ruiz-Andreu M, Arribas-Anta J, de Frutos D, Herreros-de-Tejada A, Arias-Rivera ML, Roldán-Fernández M, Marcos Martín ÁF, Zamora J, Vázquez-Sequeiros E, and Albillos A
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- Administration, Oral, Anticoagulants adverse effects, Colonoscopy, Gastrointestinal Hemorrhage chemically induced, Gastrointestinal Hemorrhage epidemiology, Humans, Prospective Studies, Vitamin K, Colonic Polyps
- Abstract
Background & Aims: Few prospective studies have assessed the safety of direct oral anticoagulants (DOACs) in elective endoscopy. Our primary aim was to compare the risks of endoscopy-related gastrointestinal bleeding and thromboembolic events in patients on DOACs or vitamin K antagonists (VKAs) in this setting. Secondarily, we examined the impact of the timing of anticoagulant resumption on the risk of delayed bleeding in high-risk therapeutic procedures., Methods: We conducted a multicenter, prospective, observational study from January 2018 to March 2020 of 1602 patients on oral anticoagulants (1004 on VKAs and 598 on DOACs) undergoing 1874 elective endoscopic procedures. Our primary outcomes were 90-day thromboembolic events and 30-day endoscopy-related gastrointestinal bleeding. The inverse probability of treatment weighting propensity score method was used for baseline covariate adjustment., Results: The 2 groups had similar risks of endoscopy-related gastrointestinal bleeding (VKAs vs DOACs, 6.2% vs 6.7%; adjusted odds ratio [OR], 1.05; 95% CI, 0.67-1.65) and thromboembolic events (VKAs vs DOACs, 1.3% vs 1.5%; adjusted OR, 0.90; 95% CI, 0.34-2.38). In high bleeding risk procedures (n = 747), delayed anticoagulant resumption (> 48 hours or 24-48 hours vs < 24 hours) did not reduce the risk of postprocedural bleeding (10.3%, 9%, and 5.8%, respectively; adjusted P = .43). Hot and cold snare polypectomy were the most frequent high-risk interventions (41.8% and 39.8%, respectively)., Conclusion: In a prospective study of patients on DOACs or VKAs undergoing elective endoscopy, endoscopy-related bleeding and thromboembolic events showed similar risk. Our study suggests that early anticoagulant resumption is safe in most patients, but more data are needed for advanced high-risk therapeutic procedures., (Copyright © 2022 AGA Institute. Published by Elsevier Inc. All rights reserved.)
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- 2022
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13. Colonic stent vs surgical resection of the primary tumor. Effect on survival from stage-IV obstructive colorectal cancer.
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Seoane Urgorri A, Saperas E, O'Callaghan Castella E, Pera Román M, Raga Gil A, Riu Pons F, Barranco Priego L, Dedeu Cusco JM, Pantaleón Sánchez M, Bessa Caserras X, and Álvarez-González MA
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- Humans, Prospective Studies, Retrospective Studies, Stents, Treatment Outcome, Colonic Neoplasms, Colorectal Neoplasms surgery, Rectal Neoplasms
- Abstract
Background and Objectives: the impact of surgical primary tumor resection on survival of obstructive metastatic colorectal cancer remains controversial. The primary goal of this study was to analyze survival in patients with obstructive metastatic colorectal cancer after treatment with either resection surgery or a colonic stent., Material and Methods: a prospective study was performed of all patients with stage-IV colorectal cancer and obstructive manifestations, diagnosed from 2005 to 2012 and managed with either resection surgery or a colonic stent. Cases with a perforation, abscess, right colon or distal rectal malignancy, multiple colorectal cancer or derivative surgery were excluded., Results: a total of 95 patients were included, 49 were managed with resection surgery and 46 with a colonic stent. The colonic stent group had a higher Charlson index (9.5 ± 2.1 vs 8.6 ± 1.5, p = 0.01), a shorter time to oral intake (0.9 ± 1.1 vs 16.4 ± 53.5 days, p = 0.05), a shorter hospital stay (4 ± 4.8 vs 16.7 ± 15.5 days, p = 0.0001), less need for stomata (11.1 % vs 32.7 %, p = 0.01), fewer early complications (4.3 % vs 46.9 %, p = 0.0001) and more late complications (33.3 % vs 6.4 %, p = 0.001). Undergoing chemotherapy (p = 0.008) was the only independent factor related to increased survival. In the subgroup of patients managed with chemotherapy, surgical primary tumor resection was an independent factor associated with increased survival., Conclusion: both treatments are effective for resolving obstructive manifestations in patients diagnosed with stage-IV obstructive colorectal cancer. Resection surgery has no positive impact on survival and thus cannot be recommended as a therapy of choice.
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- 2020
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14. Proximal retroflexion versus second forward view of the right colon during screening colonoscopy: A multicentre randomized controlled trial.
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Núñez Rodríguez MH, Díez Redondo P, Riu Pons F, Cimavilla M, Hernández L, Loza A, and Pérez-Miranda M
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- Adenoma diagnosis, Aged, Colon diagnostic imaging, Colon pathology, Colonic Neoplasms diagnosis, Colonic Polyps diagnosis, Colonoscopy statistics & numerical data, Early Detection of Cancer statistics & numerical data, Female, Humans, Intestinal Mucosa diagnostic imaging, Intestinal Mucosa pathology, Male, Middle Aged, Missed Diagnosis statistics & numerical data, Occult Blood, Prospective Studies, Adenoma epidemiology, Colonic Neoplasms epidemiology, Colonic Polyps epidemiology, Colonoscopy methods, Early Detection of Cancer methods
- Abstract
Background: Colonoscopy is the gold standard investigation for the detection of colorectal cancer, but the right colon is more difficult to examine than the left colon. A second examination of the proximal colon has the potential to reduce rates of missed pathology., Objective: To determine whether proximal retroflexion improves the adenoma detection rate or other outcomes in the right colon compared with the forward view., Methods: We performed a multicentre randomized controlled trial of patients from the colorectal cancer screening programme with a positive faecal immunochemical test. Patients were randomized to a second right colon examination using proximal retroflexion or forward view., Results: A total of 692 patients were included. A second examination of the right colon, with an average additional procedure time of 1.62 min, increased the adenoma detection rate by 11%, regardless of the method used (9% proximal retroflexion vs . 12% second forward view, p = 0.21). The adenoma miss rate was 19% (17% proximal retroflexion vs . 20% forward view, p = 0.28) The success rate of retroflexion was 83%, without secondary complications. In the 15.6% of patients in whom lesions were detected during the second pass, endoscopic follow-up was modified by reducing the time of the next colonoscopy., Conclusions: A second examination of the right colon, either from retroflexion or second forward view, can increase adenoma detection rate and shorten surveillance intervals in patients undergoing screening colonoscopy. This should be emphasized during colonoscopy training and integrated into diagnostic colonoscopy practice.
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- 2020
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15. Narrow-band imaging and high-definition white-light endoscopy in patients with serrated lesions not fulfilling criteria for serrated polyposis syndrome: a randomized controlled trial with tandem colonoscopy.
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Riu Pons F, Andreu M, Naranjo D, Álvarez-González MA, Seoane A, Dedeu JM, Barranco L, and Bessa X
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- Aged, Colonic Polyps pathology, Cross-Over Studies, Female, Humans, Male, Middle Aged, Reproducibility of Results, Syndrome, Colonic Polyps diagnostic imaging, Colonoscopy methods, Narrow Band Imaging, Precancerous Conditions diagnostic imaging
- Abstract
Background: It is unknown whether narrow-band imaging (NBI) could be more effective than high-definition white-light endoscopy (HD-WLE) in detecting serrated lesions in patients with prior serrated lesions > 5 mm not completely fulfilling serrated polyposis syndrome (SPS) criteria., Methods: We conducted a randomized, cross-over trial in consecutive patients with prior detection of at least one serrated polyp ≥10 mm or ≥ 3 serrated polyps larger than 5 mm, both proximal to the sigmoid colon. Five experienced endoscopists performed same-day tandem colonoscopies, with the order being randomized 1:1 to NBI-HD-WLE or HD-WLE-NBI. All tandem colonoscopies were performed by the same endoscopist., Results: We included 41 patients. Baseline characteristics were similar in the two cohorts: NBI-HD-WLE (n = 21) and HD-WLE-NBI (n = 20). No differences were observed in the serrated lesion detection rate of NBI versus HD-WLE: 47.4% versus 51.9% (OR 0.84, 95% CI: 0.37-1.91) for the first and second withdrawal, respectively. Equally, no differences were found in the polyp miss rate of NBI versus HD-WLE: 21.3% versus 26.1% (OR 0.77, 95% CI: 0.43-1.38). Follow-up colonoscopy in nine patients (22%) allowed them to be reclassified as having SPS., Conclusions: In patients with previous serrated lesions, the serrated lesion detection rate was similar with NBI and HD-WLE. A shorter surveillance colonoscopy interval increases the detection of missed serrated polyps and could change the diagnosis of SPS in approximately one in every five patients., Trial Registration: ClinicalTrials.gov NCT02406547, registered on April 2, 2015.
- Published
- 2020
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16. Hemostatic spray powder TC-325 for GI bleeding in a nationwide study: survival and predictors of failure via competing risks analysis.
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Rodríguez de Santiago E, Burgos-Santamaría D, Pérez-Carazo L, Brullet E, Ciriano L, Riu Pons F, de Jorge Turrión MÁ, Prados S, Pérez-Corte D, Becerro-Gonzalez I, Martinez-Moneo E, Barturen A, Fernández-Urién I, López-Serrano A, Ferre-Aracil C, Lopez-Ibañez M, Carbonell C, Nogales O, Martínez-Bauer E, Terán Lantarón Á, Pagano G, Vázquez-Sequeiros E, and Albillos A
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- Aged, Aged, 80 and over, Endoscopy, Gastrointestinal, Female, Gastrointestinal Hemorrhage etiology, Gastrointestinal Neoplasms complications, Hemostasis, Endoscopic, Humans, Male, Middle Aged, Peptic Ulcer Hemorrhage drug therapy, Recurrence, Retrospective Studies, Treatment Failure, Gastrointestinal Hemorrhage drug therapy, Hemostatics therapeutic use, Minerals therapeutic use, Postoperative Hemorrhage drug therapy
- Abstract
Background and Aims: TC-325 (Hemospray, Cook Medical, Winston-Salem, NC) is an inorganic hemostatic powder recently approved by the U.S. Food and Drug Administration. This study aimed to examine the effectiveness, safety, and predictors of TC-325 failure in a large real-life cohort., Methods: This was a retrospective study conducted at 21 Spanish centers. All patients treated with TC-325 until September 2018 were included. The primary outcome was treatment failure, defined as failed intraprocedural hemostasis or recurrent bleeding within the first 30 postprocedural days. Secondary outcomes included safety and survival. Risk and predictors of failure were assessed via competing-risk models., Results: The cohort comprised 261 patients, of whom 219 (83.9%) presented with upper gastrointestinal bleeding (GIB). The most common causes were peptic ulcer (28%), malignancy (18.4%), and therapeutic endoscopy-related GIB (17.6%). TC-325 was used as rescue therapy in 191 (73.2%) patients. The rate of intraprocedural hemostasis was 93.5% (95% confidence interval [CI], 90%-96%). Risks of TC-325 failure at postprocedural days 3, 7, and 30 were 21.1%, 24.6%, and 27.4%, respectively. On multivariate analysis, spurting bleeding (P = .004), use of vasoactive drugs (P = .02), and hypotension (P = .008) were independent predictors of failure. Overall 30-day survival was 81.9% (95% CI, 76%-86%) and intraprocedural hemostasis was associated with a better prognosis (adjusted hazard ratio, 0.29; P = .006). Two severe adverse events were noted., Conclusion: TC-325 was safe and effective for intraprocedural hemostasis in more than 90% of patients, regardless of the cause or site of bleeding and its use as rescue therapy. In this high-risk cohort treated with TC-325, the 30-day failure rate exceeded 25% and was highest with spurting bleeding or hemodynamic instability., (Copyright © 2019 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.)
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- 2019
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17. Panchromoendoscopy Increases Detection of Polyps in Patients With Serrated Polyposis Syndrome.
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López-Vicente J, Rodríguez-Alcalde D, Hernández L, Riu Pons F, Vega P, Herrero Rivas JM, Santiago García J, Salces Franco I, Bustamante Balén M, López-Cerón M, and Pellisé M
- Subjects
- Adenoma diagnosis, Adenoma pathology, Adenomatous Polyps pathology, Colonic Polyps pathology, Colorectal Neoplasms pathology, Female, Humans, Indigo Carmine, Male, Middle Aged, Syndrome, Adenomatous Polyps diagnosis, Colonic Polyps diagnosis, Colonoscopy methods, Colorectal Neoplasms diagnosis, Coloring Agents
- Abstract
Background & Aims: Serrated polyposis syndrome (SPS), characterized by multiple and/or large proximal serrated lesions, increases the risk of colorectal cancer. Serrated lesions often are missed during colonoscopy but panchromoendoscopy can increase their detection in an average-risk population. We performed a randomized controlled study to determine the efficacy of panchromoendoscopy in detection of polyps in patients with SPS., Methods: Patients with SPS (n = 86 patients) underwent tandem high-definition (HD) colonoscopies from February 2015 through July 2016 at 7 centers in Spain. Patients were assigned randomly to groups that received 2 HD white-light endoscopy examinations (HD-WLE group; n = 43) or HD-WLE followed by 0.4% indigo carmine panchromoendoscopy (HD-CE group; n = 43). For each procedure, polyps detected were described, removed, and analyzed by histology. The primary outcome was additional polyp detection rate, defined as the number of polyps detected during the second inspection divided by the total number of polyps detected during the first and the second examination., Results: A total of 774 polyps were detected (362 in the HD-WLE group and 412 in the HD-CE group); 54.2% were hyperplastic, 13.8% were adenomas, and 10.9% were sessile serrated polyps. There was a significantly higher additional polyp detection rate in the HD-CE group (0.39; 95% CI, 0.35-0.44) than in the HD-WLE group (0.22; 95% CI, 0.18-0.27) (P < .001). A higher additional rate of serrated lesions proximal to the sigmoid colon were detected in the second inspection with HD-CE (0.40; 95% CI, 0.33-0.47) than with HD-WLE (0.24; 95% CI, 0.19-0.31) (P = .001). Detection of adenomas and serrated lesions greater than 10 mm did not differ significantly between groups. In a multivariate logistic regression analysis, only use of HD-CE was associated independently with increased polyp detection throughout the colon., Conclusions: In a randomized controlled trial, we found that panchromoendoscopy increases detection of polyps (mostly of small serrated lesions) and should be considered the standard of care in patients with SPS. Studies are needed to determine the effects of this strategy on the incidence of advanced neoplasia during long-term follow-up evaluation. ClinicalTrials.gov no: NCT03476434., (Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.)
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- 2019
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18. Narrow band imaging and white light endoscopy in the characterization of a polypectomy scar: A single-blind observational study.
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Riu Pons F, Andreu M, Gimeno Beltran J, Álvarez-Gonzalez MA, Seoane Urgorri A, Dedeu JM, Barranco Priego L, and Bessa X
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- Aged, Cicatrix etiology, Colon diagnostic imaging, Colon pathology, Colon surgery, Colonic Polyps pathology, Endoscopic Mucosal Resection methods, Female, Follow-Up Studies, Humans, Intestinal Mucosa diagnostic imaging, Intestinal Mucosa pathology, Intestinal Mucosa surgery, Male, Middle Aged, Neoplasm, Residual, Random Allocation, Single-Blind Method, Cicatrix diagnostic imaging, Colonic Polyps surgery, Colonoscopy methods, Endoscopic Mucosal Resection adverse effects, Narrow Band Imaging methods
- Abstract
Aim: To assess the incremental benefit of narrow band imaging (NBI) and white light endoscopy (WLE), randomizing the initial technique for the detection of residual neoplasia at the polypectomy scar after an endoscopic piecemeal mucosal resection (EPMR)., Methods: We conducted an observational study in an academic center to assess the incremental benefit of NBI and WLE randomly applied 1:1 (NBI-WLE or WLE-NBI) in the follow-up of a post-EPMR scar by the same endoscopist., Results: A total of 112 EPMR scars were included. The median baseline polyp size was 20 mm (interquartile range: 14-30). At first review, NBI and WLE showed good sensitivity (85.0% vs 78.9%), specificity (77.1% vs 84.2%) and overall accuracy (80.0% vs 82.5%). NBI after WLE (WLE-NBI group) improved accuracy, but this difference was not statistically significant [area under the curve (AUC): 86.8% vs 81.6%, P = 0.15]. WLE after NBI (NBI-WLE group) did not improve accuracy (AUC: 81.4% vs 81.1%, P = 0.9). Overall, recurrence was found in 39/112 (34.8%) lesions., Conclusion: Although no statistically significant differences were found between the two techniques at the first post-EPMR assessment, the use of NBI after WLE may improve residual neoplasia detection. Nevertheless, biopsy is still required in the first scar review., Competing Interests: Conflict-of-interest statement: There are no conflicts of interest to report for any of the authors.
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- 2018
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19. Routine lower gastrointestinal endoscopy for radiographically confirmed acute diverticulitis. In whom and when is it indicated?
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Seoane Urgorri A, Zaffalon D, Pera Román M, Batlle García M, Riu Pons F, Dedeu Cusco JM, Pantaleón Sánchez M, Bessa Caserras X, Barranco Priego L, and Álvarez-González MA
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- Acute Disease, Adult, Aged, Colonic Neoplasms diagnostic imaging, Colonoscopy, Female, Humans, Male, Middle Aged, Retrospective Studies, Tomography, X-Ray Computed, Diverticulitis diagnostic imaging, Endoscopy, Gastrointestinal methods
- Abstract
Introduction: international guidelines recommend a routine colonoscopy to rule out advanced neoplasm after an acute diverticulitis event. However, in recent years, this recommendation has been called into question following the advent of computerized tomography (CT), particularly with regard to uncomplicated diverticulitis. Furthermore, colonoscopy is associated with a risk and additional costs., Objective: to understand the diagnostic yield, quality and safety of colonoscopy in the setting of acute diverticulitis., Methods: this was a retrospective study of all patients diagnosed with acute diverticulitis via CT between 2005 and 2013, who subsequently underwent a colonoscopy., Results: two hundred and sixteen patients diagnosed with acute diverticulitis via CT were enrolled. These included 58 cases with complicated diverticulitis (27%) and 158 with uncomplicated diverticulitis (73%). An advanced neoplasm was found in 12 patients (5.6%); 11.7% were complicated and 3.2% were uncomplicated (p = 0.02). No major complications were identified. The quality was low but improved over time; the complete procedure rate was 88%, an effective preparation was achieved in 75% and excision of polyps < 2 cm was performed in 78% of cases. The optimum colonoscopy quality cu-off was 9.5 weeks., Conclusion: routine colonoscopy is advisable after a complicated diverticulitis event but its recommendation is unclear with regard to uncomplicated episodes. Colonoscopy is safe even when performed early. The overall quality is low but may be optimized via a subsequent endoscopy, two months after a diverticulitis diagnosis.
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- 2018
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20. Rate of adverse events of gastroduodenal snare polypectomy for non-flat polyp is low: A prospective and multicenter study.
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Córdova H, Argüello L, Loras C, Naranjo Rodríguez A, Riu Pons F, Gornals JB, Nicolás-Pérez D, Andújar Murcia X, Hernández L, Santolaria S, Leal C, Pons C, Pérez-Cuadrado-Robles E, García-Bosch O, Papo Berger M, Ulla Rocha JL, Sánchez-Montes C, and Fernández-Esparrach G
- Subjects
- Adult, Aged, Aged, 80 and over, Duodenum pathology, Duodenum surgery, Endoscopy, Gastrointestinal methods, Female, Humans, Incidence, Male, Microsurgery methods, Middle Aged, Postoperative Hemorrhage etiology, Postoperative Hemorrhage therapy, Prospective Studies, Risk Factors, Spain, Stomach pathology, Stomach surgery, Young Adult, Duodenal Diseases surgery, Endoscopy, Gastrointestinal adverse effects, Microsurgery adverse effects, Polyps surgery, Postoperative Hemorrhage epidemiology, Stomach Diseases surgery
- Abstract
Aim: To evaluate the rate of adverse events (AEs) during consecutive gastric and duodenal polypectomies in several Spanish centers., Methods: Polypectomies of protruded gastric or duodenal polyps ≥ 5 mm using hot snare were prospectively included. Prophylactic measures of hemorrhage were allowed in predefined cases. AEs were defined and graded according to the lexicon recommended by the American Society for Gastrointestinal Endoscopy. Patients were followed for 48 h, one week and 1 mo after the procedure., Results: 308 patients were included and a single polypectomy was performed in 205. Only 36 (11.7%) were on prior anticoagulant therapy. Mean polyp size was 15 ± 8.9 mm (5-60) and in 294 cases (95.4%) were located in the stomach. Hemorrhage prophylaxis was performed in 219 (71.1%) patients. Nine patients presented AEs (2.9%), and 6 of them were bleeding ( n = 6, 1.9%) (in 5 out of 6 AE, different types of endoscopic treatment were performed). Other 24 hemorrhagic episodes could be managed without any change in the outcome of the endoscopy and, consequently, were considered incidents. We did not find any independent risk factor of bleeding., Conclusion: Gastroduodenal polypectomy using prophylactic measures has a rate of AEs small enough to consider this procedure a safe and effective method for polyp resection independently of the polyp size and location., Competing Interests: Conflict-of-interest statement: None of the authors of this manuscript, Henry Córdova, Lidia Argüello, Carme Loras, Antonio Naranjo Rodríguez, Faust Riu Pons, Joan B Gornals, David Nicolás-Pérez, Xavier Andújar Murcia, Luis Hernández, Santos Santolaria, Carles Leal, Carles Pons, Enrique Pérez-Cuadrado-Robles, Orlando García-Bosch, Michel Papo Berger, José Luis Ulla Rocha, Cristina Sánchez-Montes, Gloria Fernández-Esparrach have any conflicts of interest or financial ties to disclose.
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- 2017
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21. An unusual presentation of anisakiasis in the colon (with video).
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Riu Pons F, Gimeno Beltran J, Albero Gonzalez R, Álvarez Gonzalez MA, Dedeu Cusco JM, Barranco Priego L, and Seoane Urgorri A
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- Abdominal Abscess pathology, Abdominal Abscess surgery, Anisakiasis complications, Colonic Polyps pathology, Colonic Polyps surgery, Colonoscopy, Female, Humans, Middle Aged, Abdominal Abscess parasitology, Anisakiasis diagnosis, Colonic Polyps parasitology
- Published
- 2015
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