scholarly journals Endoscopic Therapy for Pancreatic Benign Neoplasms

2021 ◽  
Vol 9 (1) ◽  
pp. 25-32
Author(s):  
Jun Seong Hwang ◽  
Sung Woo Ko
Keyword(s):  
Endoscopic Therapy ◽  
Benign Neoplasms

Outcome of endoscopic therapy of complex hydrocephalus

2008 ◽  
Vol 39 (05) ◽  
Author(s):  
C Gudegast ◽  
C Niesytto ◽  
MJ Fritsch ◽  
HWS Schröder ◽  
C Weigel ◽  
...  
Keyword(s):  
Endoscopic Therapy

scholarly journals Clinical outcome of endoscopic therapy in patients with symptomatic pancreas divisum: a Dutch cohort study

2021 ◽  
Vol 09 (07) ◽  
pp. E1164-E1170
Author(s):  
David M. de Jong ◽  
Pauline M. Stassen ◽  
Jan Werner Poley ◽  
Paul Fockens ◽  
Robin Timmer ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Cohort Study ◽  
Endoscopic Therapy ◽  
Clinical Success ◽  
Pancreas Divisum ◽  
Univariate Analysis ◽  
Clinical Success Rate ◽  
Recurrent Acute Pancreatitis ◽  
Pancréas Divisum

Abstract Background and study aims Although the majority of patients with pancreas divisum (PDiv) are asymptomatic, a subgroup present with recurrent pancreatitis or pain for which endoscopic therapy may be indicated. The aim of this study was to evaluate success rates and long-term outcomes of endoscopic treatment in patients with symptomatic PDiv. Patients and methods A multicenter, retrospective cohort study was performed. Patients with symptomatic PDiv presenting with recurrent acute pancreatitis (RAP), chronic pancreatitis (CP), or chronic abdominal pancreatic-type pain (CAP) who underwent endoscopic retrograde cholangiopancreatography (ERCP) between January 2000 and December 2019 were included. The primary outcome was clinical success, defined as either no recurrent episode of acute pancreatitis (AP) for RAP patients, no flares for CP patients, or absence of abdominal pain for patients with CAP after technically successful ERCP. Results In 60 of 81 patients (74.1 %) a technically successful papilla minor intervention was performed. Adverse events were reported in 30 patients (37 %), with post-ERCP pancreatitis in 18 patients. The clinical success rate for patients with at least 3 months of follow-up was 42.6 %, with higher rates of success among patients presenting with RAP (44.4 %) as compared to those with CP (33.3 %) or CAP (33.3 %). Long-term sustained response was present in 40.9 % of patients with a technically successful intervention. In patients with RAP who did not completely respond to treatment, the mean number of AP episodes after treatment decreased significantly from 3.5 to 1.1 per year, and subsequently the interval between AP episodes increased from 278 to 690 days (P = 0.0006). A potential predictive factor of failure of clinical success after technically successful ERCP, at univariate analysis, was male sex (OR = 0.25, P = 0.02). Conclusions Endoscopic therapy in patients with symptomatic PDiv is moderately effective, with its highest yield in patients presenting with RAP. Future studies are needed to assess factors predictive for success of endoscopic therapy and potential risk factors for relapse after ERCP.

scholarly journals Irradiation of Nf1 mutant mouse models of spinal plexiform neurofibromas drives pathologic progression and decreases survival

2021 ◽  
Author(s):  
Danny Laurent ◽  
Abbi E Smith ◽  
Waylan K Bessler ◽  
Marc Mendonca ◽  
Helen Chin-Sinex ◽  
...  
Keyword(s):  
Overall Survival ◽  
Mouse Models ◽  
Conditional Knockout ◽  
Benign Neoplasms ◽  
Neoplastic Progression ◽  
Plexiform Neurofibromas ◽  
Normal Tissues ◽  
Peripheral Nerve Sheath Tumors ◽  
Conditional Knockout Mouse ◽  
Therapeutic Irradiation

Abstract Background Genetically susceptible individuals can develop malignancies after irradiation of normal tissues. In the context of therapeutic irradiation, it is not known whether irradiating benign neoplasms in susceptible individuals promotes neoplastic transformation and worse clinical outcomes. Individuals with Neurofibromatosis 1 (NF1) are susceptible to both radiation-induced second malignancies and spontaneous progression of plexiform neurofibromas (PNs) to malignant peripheral nerve sheath tumors (MPNSTs). The role of radiotherapy in the treatment of benign neoplasms such as PNs is unclear. Methods To test whether radiotherapy promotes neoplastic progression of PNs and reduces overall survival, we administered spinal irradiation (SI) to conditional knockout mouse models of NF1-associated PNs in two germline contexts: Nf1 fllfl; PostnCre + and Nf1 fl/-; PostnCre +. Both genotypes develop extensive Nf1 null spinal PNs, modeling PNs in NF1 patients. A total of 101 mice were randomized to 0 Gy, 15 Gy (3 Gy x 5), or 30 Gy (3 Gy x 10) of spine-focused, fractionated SI and aged until signs of illness. Results SI decreased survival in both Nf1 fllfl mice and Nf1 fl/- mice, with the worst overall survival occurring in Nf1 fl/- mice receiving 30 Gy. SI was also associated with increasing worrisome histologic features along the PN-MPNST continuum in PNs irradiated to higher radiation doses. Conclusions This pre-clinical study provides experimental evidence that irradiation of pre-existing PNs reduces survival and may shift PNs to higher grade neoplasms.

Metastasis Prevalence and Survival of Patients with T1-2 Gastric Neuroendocrine Tumor Treated with Endoscopic Therapy and Surgery

2021 ◽  
Author(s):  
Mojin Wang ◽  
Shubang Cheng ◽  
Lili Zhu ◽  
Tao Xu ◽  
Jinglin Zhang ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Endoscopic Therapy

scholarly journals Performance Comparison of the Deep Learning and the Human Endoscopist for Bleeding Peptic Ulcer Disease

2021 ◽  
Author(s):  
Hsu-Heng Yen ◽  
Ping-Yu Wu ◽  
Pei-Yuan Su ◽  
Chia-Wei Yang ◽  
Yang-Yuan Chen ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Deep Learning ◽  
Sensitivity And Specificity ◽  
Endoscopic Therapy ◽  
Learning Model ◽  
Ulcer Bleeding ◽  
Learning Models ◽  
Peptic Ulcer Bleeding ◽  
Ulcer Disease ◽  
Deep Learning Model

Abstract Purpose Management of peptic ulcer bleeding is clinically challenging. Accurate characterization of the bleeding during endoscopy is key for endoscopic therapy. This study aimed to assess whether a deep learning model can aid in the classification of bleeding peptic ulcer disease. Methods Endoscopic still images of patients (n = 1694) with peptic ulcer bleeding for the last 5 years were retrieved and reviewed. Overall, 2289 images were collected for deep learning model training, and 449 images were validated for the performance test. Two expert endoscopists classified the images into different classes based on their appearance. Four deep learning models, including Mobile Net V2, VGG16, Inception V4, and ResNet50, were proposed and pre-trained by ImageNet with the established convolutional neural network algorithm. A comparison of the endoscopists and trained deep learning model was performed to evaluate the model’s performance on a dataset of 449 testing images. Results The results first presented the performance comparisons of four deep learning models. The Mobile Net V2 presented the optimal performance of the proposal models. The Mobile Net V2 was chosen for further comparing the performance with the diagnostic results obtained by one senior and one novice endoscopists. The sensitivity and specificity were acceptable for the prediction of “normal” lesions in both 3-class and 4-class classifications. For the 3-class category, the sensitivity and specificity were 94.83% and 92.36%, respectively. For the 4-class category, the sensitivity and specificity were 95.40% and 92.70%, respectively. The interobserver agreement of the testing dataset of the model was moderate to substantial with the senior endoscopist. The accuracy of the determination of endoscopic therapy required and high-risk endoscopic therapy of the deep learning model was higher than that of the novice endoscopist. Conclusions In this study, the deep learning model performed better than inexperienced endoscopists. Further improvement of the model may aid in clinical decision-making during clinical practice, especially for trainee endoscopist.

scholarly journals A139 IMPROVED QUALITY OF LIFE AFTER ENDOSCOPIC THERAPY FOR BARRETT’S ESOPHAGUS AND EARLY ESOPHAGEAL CANCER IN SOUTHERN ALBERTA

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 125-126
Author(s):  
T Jeyalingam ◽  
M Woo ◽  
S E Congly ◽  
J David ◽  
P J Belletrutti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Linear Regression ◽  
Multiple Linear Regression ◽  
Barrett’S Esophagus ◽  
Barrett's Esophagus ◽  
Endoscopic Therapy ◽  
Negative Impact ◽  
Older Age ◽  
The Impact

Abstract Background In patients with Barrett’s esophagus (BE), endoscopic therapy reduces the risk of progression to invasive esophageal adenocarcinoma (EAC). Data on the impact of endoscopic therapy on patient quality of life (QoL) is limited. Aims We aimed to assess: (1) change in QoL during the course of endoscopic therapy for BE, (2) factors which predict this change, (3) whether achieving complete remission of dysplasia (CRD) or intestinal metaplasia (CRIM) affect the degree of change. Methods We conducted a retrospective observational study using a prospectively maintained database of BE patients treated in Calgary, Alberta from 2013–2020 containing data on demographics, BE disease characteristics and therapeutics, QoL, and follow-up. QoL was determined prior to initiation of therapy and after each treatment session using a validated questionnaire. Descriptive statistics were calculated and change in QoL was compared using a Wilcoxon signed ranks test. Backwards multiple linear regression analysis was performed to determine predictors of change in QoL. Results Of 130 BE patients, 112 (86.1%) were male and 104 (80%) had dysplastic histology or intramucosal carcinoma on index endoscopy. Mean (SD) age was 65.6 (12.0) years. At time of analysis, 76 patients (58.5%) had completed endoscopic therapy, of whom 69 (90.8%) achieved CRIM; 54 patients (41.5%) were still undergoing treatment. There was significant improvement in all QoL measures during the treatment course except for “depression” (Table 1). Patients with CRIM or CRD had reductions in “sleep difficulty” and “negative impact on life” to a significantly greater degree vs patients not achieving CRIM (Δ sleep -0.45 vs 0.0, P=0.002; Δ negative impact -0.4 vs -0.05, P=0.014) or CRD (Δ sleep -0.40 vs +0.60, P=0.002; Δ negative impact -0.40 vs +0.20, P=0.04). Multiple linear regression revealed older age (B=-0.03, P=0.008) and fewer number of EMR sessions (B=0.254, P=0.008) were correlated with greater improvement in QoL. Conclusions Endoscopic therapy improves QoL in BE patients, especially in those achieving CRIM/CRD. Older age and fewer EMRs are correlated with greater improvement in QoL. These results further reinforce the role of endoscopic therapy as the first line treatment of BE and early EAC. Funding Agencies None

Su1458 Pancreatic Endoscopic Therapy Through the Major vs Minor Ampulla: Feasibility and Comparative Study

2011 ◽  
Vol 73 (4) ◽  
pp. AB271
Author(s):  
Juan J. Vila ◽  
Silvia GoñI ◽  
Miriam Ostiz ◽  
Marcos Kutz ◽  
Jesus Urman ◽  
...  
Keyword(s):  
Comparative Study ◽  
Endoscopic Therapy
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