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RISS 인기검색어
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- 저자 : Helmut Messmann (검색결과 3 건)
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Role of artificial intelligence in diagnosing Barrett’s esophagus-related neoplasia
Michael Meinikheim,Helmut Messmann,Alanna Ebigbo 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.1
Barrett’s esophagus is associated with an increased risk of adenocarcinoma. Thorough screening during endoscopic surveillance is crucialto improve patient prognosis. Detecting and characterizing dysplastic or neoplastic Barrett’s esophagus during routine endoscopyare challenging, even for expert endoscopists. Artificial intelligence-based clinical decision support systems have been developed toprovide additional assistance to physicians performing diagnostic and therapeutic gastrointestinal endoscopy. In this article, we reviewthe current role of artificial intelligence in the management of Barrett’s esophagus and elaborate on potential artificial intelligence inthe future.
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Georgios Tziatzios,Alanna Ebigbo,Stefan Karl Gölder,Andreas Probst,Helmut Messmann 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.3
Endoscopic submucosal dissection (ESD) is a well-established method for the treatment of early-stage gastrointestinal neoplasms. Adequate submucosal exposure is one of the most significant factors related to an effective and safe dissection. The aim of thissystematic review was to evaluate the effcacy and safety of various methods that assist traction during ESD of precancerous and earlystageneoplastic lesions of the gastrointestinal tract. We performed an electronic search of the MEDLINE and the Cochrane ControlledTrials Register databases for relevant studies published up to May 2019. Trials exclusively recruiting patients undergoing ESD forsuperficial gastrointestinal cancer were considered eligible for inclusion. Thirty-three articles including 3,134 patients met the inclusioncriteria. The studies evaluated different approaches for widening the endoscopic view, including magnetic anchor-guided ESD (3studies), use of a second endoscope (5 studies), clip-involving technique (21 studies), and miscellaneous methods (4 studies). Amongthem, only 6 were randomized controlled trials evaluating different approaches. Overall, the implementation of methods that assisttraction during ESD significantly improved the operating time and R0 resection rate and decreased the rate of complications (bleedingand perforation). Interventions that assist traction seem effcacious in improving tissue traction, thus facilitating ESD performance.
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Andreas Probst,Stefan Eser,Carola Fleischmann,Tina Schaller,Bruno Märkl,Stefan Schiele,Bernd Geissler,Gernot Müller,Helmut Messmann 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.1
Background/Aims: Endoscopic submucosal dissection (ESD) has been established as a treatment modality for superficial esophagealsquamous cell carcinoma (ESCC). Long-term follow-up data are lacking in Western countries. The aim of this study was to analyzelong-term survival in a Western center. Methods: Patients undergoing ESD for ESCC were included. The analysis was performed retrospectively using a prospectively collecteddatabase. Results: R0 resection rate was 96.7% (59/61 lesions in 58 patients). Twenty-seven patients (46.6%) fulfilled the curative resection criteria(M1/M2) (group A), 11 patients (19.0%) had M3 lesions without lymphovascular invasion (LVI) (group B), and 20 patients (34.5%)had lesions with submucosal invasion or LVI (group C). Additional treatment was recommended after non-curative resection. It wasnot performed in 20/31 patients (64.5%), mainly because of comorbidities (75%). Twenty-nine out of 58 (50.0%) patients died during amean follow-up of 3.7 years. Death was related to ESCC in 17.2% (5/29) of patients. The disease-specific survival rate after curative resectionwas 100%. Overall survival rates after 5 years were 61.5%, 63.6% and 28.1% for groups A, B, and C, respectively. The overallsurvival was significantly worse after non-curative resection (p=0.038). Conclusions: Non-curative resection is frequent after ESD for ESCC in Western patients. The long-term prognosis is limited andmainly determined by comorbidity. Early diagnosis and pre-interventional assessments need to be improved.
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