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RISS 인기검색어
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- 저자 : Henning Gerke (검색결과 2 건)
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Maen Masadeh,Peter Nau,Subhash Chandra,Jagpal Klair,John Keech,Kalpaj Parekh,Rami El Abiad,Henning Gerke 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.3
Background/Aims: Peroral endoscopic myotomy (POEM) is a novel procedure for the treatment of achalasia and spastic esophagealdisorders. Experience with POEM is limited, but its reported outcomes are excellent. It is deemed safe even for patients with priorinterventions. Methods: This retrospective review included patients who underwent POEM at a tertiary US center. POEM was performed in amultidisciplinary approach by advanced endoscopists and foregut surgeons. Clinical success was defined as a post-POEM Eckardt score ≤3. Results: A total of 125 patients were included. Median follow-up period was 18 months (interquartile range, 10–22 months). Clinicalsuccess was achieved in 92% of patients and persisted at 12 months in 88% of patients. Mucosal barrier failure (MBF) occurred in7 patients, 2 of whom required surgical intervention. MBF was more common in patients with prior laparoscopic Heller myotomy (19%vs. 3%, p=0.015). MBF requiring surgical intervention occurred early in the learning curve. Conclusions: POEM is safe and effective in the treatment of achalasia and spastic esophageal disorders even after failed priorinterventions.
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Munish Ashat,Kaartik Soota,Jagpal S. Klair,Sarika Gupta,Chris Jensen,Arvind R. Murali,Randhir Jesudoss,Rami El Abiad,Henning Gerke 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.4
Background/Aims: Endoscopic ultrasound (EUS)-guided fine-needle aspiration is very effective for providing specimens forcytological evaluation. However, the ability to provide sufficient tissue for histological evaluation has been challenging due to thetechnical limitations of dedicated core biopsy needles. Recently, a modified EUS needle has been introduced to obtain tissue coresamples for histological analysis. We aimed to determine (1) its ability to obtain specimens for histological assessment and (2) thediagnostic accuracy of EUS-guided fine-needle biopsy (EUS-FNB) using this needle. Methods: We retrospectively analyzed consecutive cases of FNB using modified EUS needles for 342 lesions in 303 patients. Thecytology and histological specimens were analyzed. Diagnostic accuracy was calculated. Results: Adequate cytological and histological assessment was possible in 293/342 (86%) and 264/342 (77%) lesions, respectively. Diagnostic accuracy of the cytological specimen was 294/342 (86%) versus 254/342 (74%) for the histological specimen (p<0.01). Diagnostic accuracy of the combined cytological and histological assessment was 323/342 (94.4%), which was significantly higher thanthat of both histology alone (p<0.001) and cytology alone (p=0.001). Conclusions: EUS-FNB with the modified EUS needle provided histologic tissue cores in the majority of cases and achieved excellentdiagnostic accuracy with few needle passes.
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