Outcomes of Surgical and Endoscopic Resection of Duodenal Neuroendocrine Tumours (NETs): a Systematic Review of the Literature

Background. Duodenal neuroendocrine tumours are very rare, if they are limited to the mucosal layer and have no nodal involvement, endoscopic resection may be curative. Case report. We present the case of a Mexican 52 years old female with a duodenal neuroendocrine tumour who underwent successful endoscopic submucosal dissection with no complications. Pathology of the specimen revealed a complete R0 resection with negative resection margins. Endoscopic biopsies 4 weeks later showed no malignant cells. Conclusions. Because of their low frequency the management of primary duodenal carcinoid tumours is controversial; for tumours less than 1 cm endoscopic resection is recommended, for those bigger than 2 cm surgical resection is advised. Management of tumours between 1 and 2 cm is controversial and should be individualized.

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A82 SUCCESSFUL RESECTION OF GRADE 1 DUODENAL NEUROENDOCRINE TUMOURS USING ENDOSCOPIC TECHNIQUES IN TWO CANADIAN HOSPITALS

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.081 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 96-97

Author(s):

N K Klemm ◽

D Lu-Cleary ◽

D Chahal ◽

R Trasolini ◽

E Lam ◽

...

Keyword(s):

Literature Review ◽

Endoscopic Resection ◽

Neuroendocrine Tumours ◽

Residual Disease ◽

Duodenal Bulb ◽

Muscularis Propria ◽

Duodenal Perforation ◽

En Bloc ◽

Well Differentiated ◽

Duodenal Neuroendocrine Tumours

Abstract Background Given the rarity of duodenal neuroendocrine tumours (dNETs), limited guidelines exist for resection of well-differentiated, ≤10 mm dNETS. As incidence rises, alternatives to surgery are valuable. We present 9 cases of endoscopic dNET resections and a literature review. Aims To demonstrate efficacy and safety of endoscopic resection for dNETs ≤10 mm at 2 Canadian hospitals. Methods We retrospectively analyzed data on 7 patients that had endoscopic dNET resection from 2013–2018. Endoscopic resection occurred if dNETs were ≤10 mm in diameter, did not extend to the muscularis propria and lymphovascular invasion was absent. WHO 2017 classification was used. Results All patients had biopsies and 5 (71%) had EUS prior to resection; 4 females and 3 males underwent resection of 9 dNETs; 2 via cap-assisted snare polypectomy; 4 with cap-assisted band mucosectomy; and 2 over-the-scope clip-assisted resection. The median size was 10 mm (4–11); 6 (67%) dNETS were found in the duodenal bulb, 2 at the D1/D2 junction and 1 in D2 alone. The median age was 68.5 (50–79) years. All dNETs were submucosal and well-differentiated. The dNETs were resected en bloc, but 3 did not have clear margins. Two procedures were complicated by duodenal perforation; 1 requiring surgery and 18 days in hospital. One case was complicated by bleeding with successful endoscopic hemostasis. The majority (75%) of resections were day procedures. Patients were followed for 6–12 months with an EGD or chromogrannin A. None of the patients had endoscopic residual disease, but 1 patient required a second procedure to remove a dNET left in situ following the initial resection of 2 dNETs 12 months earlier. In our literature review of 178 patients, the majority of dNETs were resected by EMR 81% (150/185) versus ESD, similar to our experience. Patients were slightly younger with a mean age of 63.28, and most dNETs (46%) were found in the duodenal bulb. Complications included intraoperative bleeding, perforation and death in 17 (9.55%), 9 (5.06%) and 1 (0.06%) patient(s) respectively. The rate of recurrence was 4/178 (2.25%) and patients had a mean follow up of 26.1 months. Conclusions Well-differentiated dNETs ≤10 mm in diameter can be successfully resected endoscopically. Complications can be managed intraoperatively and hospital stay remains minimal. Funding Agencies None

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Exclusive Endoscopic Resection of Juvenile Nasopharyngeal Angiofibroma: A Systematic Review of the Literature

Otolaryngology ◽

10.1177/0194599814541627a283 ◽

2014 ◽

Vol 151 (1_suppl) ◽

pp. P119-P120

Author(s):

Nadim P. Khoueir ◽

Nicolas Nicolas ◽

Ziad Rohayem ◽

Amine Haddad ◽

Walid M. Abou Hamad

Keyword(s):

Systematic Review ◽

Endoscopic Resection ◽

Juvenile Nasopharyngeal Angiofibroma ◽

Review Of The Literature ◽

Nasopharyngeal Angiofibroma

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Telepractice for Adult Speech-Language Pathology Services: A Systematic Review

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_persp-19-00146 ◽

2020 ◽

Vol 5 (1) ◽

pp. 326-338 ◽

Cited By ~ 9

Author(s):

Kristen Weidner ◽

Joneen Lowman

Keyword(s):

Systematic Review ◽

Primary Progressive Aphasia ◽

Future Research ◽

Service Delivery Model ◽

Speech Language Pathology ◽

Review Of The Literature ◽

Research Designs ◽

Assessment And Treatment ◽

Language Pathology ◽

Screening Assessment

Purpose We conducted a systematic review of the literature regarding adult telepractice services (screening, assessment, and treatment) from approximately 2014 to 2019. Method Thirty-one relevant studies were identified from a literature search, assessed for quality, and reported. Results Included studies illustrated feasibility, efficacy, diagnostic accuracy, and noninferiority of various speech-language pathology services across adult populations, including chronic aphasia, Parkinson's disease, dysphagia, and primary progressive aphasia. Technical aspects of the equipment and software used to deliver services were discussed. Some general themes were noted as areas for future research. Conclusion Overall, results of the review continue to support the use of telepractice as an appropriate service delivery model in speech-language pathology for adults. Strong research designs, including experimental control, across multiple well-described settings are still needed to definitively determine effectiveness of telepractice services.

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Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis – case report and systematic review of dabigatran use

VASA ◽

10.1024/0301-1526/a000876 ◽

2020 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Marina Di Pilla ◽

Stefano Barco ◽

Clara Sacco ◽

Giovanni Barosi ◽

Corrado Lodigiani

Keyword(s):

Systematic Review ◽

Case Report ◽

Lower Limb ◽

Limb Ischemia ◽

Acute Limb Ischemia ◽

Review Of The Literature ◽

Heparin Induced Thrombocytopenia ◽

Lower Limb Ischemia ◽

Vein Thrombosis ◽

Left Lower Limb

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

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Psychological and Cognitive Aspects of Borderline Intellectual Functioning

European Psychologist ◽

10.1027/1016-9040/a000293 ◽

2017 ◽

Vol 22 (3) ◽

pp. 159-166 ◽

Cited By ~ 2

Author(s):

Bastianina Contena ◽

Stefano Taddei

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Intellectual Functioning ◽

Clinical Impact ◽

Review Of The Literature ◽

Borderline Intellectual Functioning ◽

General Quality ◽

Meta Analyses ◽

Over Time

Abstract. Borderline Intellectual Functioning (BIF) refers to a global IQ ranging from 71 to 84, and it represents a condition of clinical attention for its association with other disorders and its influence on the outcomes of treatments and, in general, quality of life and adaptation. Furthermore, its definition has changed over time causing a relevant clinical impact. For this reason, a systematic review of the literature on this topic can promote an understanding of what has been studied, and can differentiate what is currently attributable to BIF from that which cannot be associated with this kind of intellectual functioning. Using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we have conducted a review of the literature about BIF. The results suggest that this condition is still associated with mental retardation, and only a few studies have focused specifically on this condition.

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