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Matheus Cavalcante Franco,Sunguk Jang,Bruno da Costa Martins,Tyler Stevens,Vipul Jairath,Rocio Lopez,John J. Vargo,Alan Barkun,Fauze Maluf-Filho 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.2
Background/Aims: Few studies have measured the accuracy of prognostic scores for upper gastrointestinal bleeding (UGIB)among cancer patients. Thereby, we compared the prognostic scores for predicting major outcomes in cancer patients with UGIB. Secondarily, we developed a new model to detect patients who might require hemostatic care. Methods: A prospective research was performed in a tertiary hospital by enrolling cancer patients admitted with UGIB. Clinical andendoscopic findings were obtained through a prospective database. Multiple logistic regression analysis was performed to gauge thepower of each score. Results: From April 2015 to May 2016, 243 patients met the inclusion criteria. The AIMS65 (area under the curve [AUC] 0.85) bestpredicted intensive care unit admission, while the Glasgow-Blatchford score best predicted blood transfusion (AUC 0.82) and thelow-risk group (AUC 0.92). All scores failed to predict hemostatic therapy and rebleeding. The new score was superior (AUC 0.74)in predicting hemostatic therapy. The AIMS65 (AUC 0.84) best predicted in-hospital mortality. Conclusions: The scoring systems for prognostication were validated in the group of cancer patients with UGIB. A new score wasdeveloped to predict hemostatic therapy. Following this result, future prospective research should be performed to validate the newscore.
Shivakumar Vignesh,Amna Subhan Butt,Mohamed Alboraie,Bruno Costa Martins,Alejandro Piscoya,Quang Trung Tran,Damien Tan Meng Yew,Shahriyar Ghazanfar,Pezhman Alavinejad,Edna Kamau,Ajay M Verma,Robin B M 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.5
Background/Aims: The coronavirus disease of 2019 (COVID-19) pandemic has impacted the training of medical traineesinternationally. The aim of this study was to assess the global impact of COVID-19 on endoscopy training from the perspective ofendoscopy trainers and to identify strategies implemented to mitigate the impact on trainee education. Methods: Teaching faculty of gastroenterology (GI) training programs globally were invited to complete a 36-question web-basedsurvey to report the characteristics of their training programs and the impact of COVID-19 on various aspects of endoscopytraining, including what factors decisions were based on. Results: The survey response rate was 52.6% (305 out of 580 individuals); 92.8% reported a negative impact on endoscopy training,with suspension of elective procedures (77.1%) being the most detrimental factor. Geographic variations were noted, with Europeanprograms reporting the lowest percentage of trainee participation in procedures. A higher proportion of trainees in the Americaswere allowed to continue performing procedures, and trainers from the Americas reported receiving the greatest support forendoscopy teaching. Conclusions: This study demonstrated that the COVID-19 pandemic has had a significant negative impact on GI endoscopytraining internationally, as reported by endoscopy trainers. Focus-optimizing endoscopy training and assessment of competenciesare necessary to ensure adequate endoscopy training.
Endoscopic ultrasound-guided gastroenterostomy (gastroenteric anastomosis)
Joel Fernandez de Oliveira,Matheus Cavalcante Franco,Gustavo Rodela,Fauze Maluf-Filho,Bruno Costa Martins 소화기인터벤션의학회 2022 Gastrointestinal Intervention Vol.11 No.3
Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as a promising minimally invasive technique for patients with gastric outlet obstruction (GOO), regardless of whether a benign or malignant condition impedes gastric emptying. EUS-GE involves creating a bypass from the stomach to the small bowel distally to the obstruction, which is similar to the surgical gastroenteric anastomosis. In fact, EUS-GE has been reported to have longer stent patency in patients with malignant GOO than conventional self-expandable metal stents deployed across a malignant obstruction. Although surgical treatment is still considered the gold-standard treatment for patients with malignant GOO, the results of recent studies have shown not only similar rates of technical and clinical success with EUS-GE, but also lower rates of adverse events. In this review, we aimed to appraise the current status of EUS-GE, describe the multiple techniques to perform this procedure, compare the outcomes of EUS-GE with those of other therapeutic modalities, and discuss the related adverse events and the future perspectives of EUS-GE.
Endoscopic ultrasound-guided gastroenterostomy (gastroenteric anastomosis)
Joel Fernandez de Oliveira,Matheus Cavalcante Franco,Gustavo Rodela,Fauze Maluf-Filho,Bruno Costa Martins 소화기인터벤션의학회 2022 International journal of gastrointestinal interven Vol.11 No.3
Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) has emerged as a promising minimally invasive technique for patients with gastric outlet obstruction (GOO), regardless of whether a benign or malignant condition impedes gastric emptying. EUS-GE involves creating a bypass from the stomach to the small bowel distally to the obstruction, which is similar to the surgical gastroenteric anastomosis. In fact, EUS-GE has been reported to have longer stent patency in patients with malignant GOO than conventional self-expandable metal stents deployed across a malignant obstruction. Although surgical treatment is still considered the gold-standard treatment for patients with malignant GOO, the results of recent studies have shown not only similar rates of technical and clinical success with EUS-GE, but also lower rates of adverse events. In this review, we aimed to appraise the current status of EUS-GE, describe the multiple techniques to perform this procedure, compare the outcomes of EUS-GE with those of other therapeutic modalities, and discuss the related adverse events and the future perspectives of EUS-GE.