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- 저자 : Steven A. Keilin (검색결과 2 건)
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Zachary Spiritos,Parit Mekaroonkamol,Bassel F. El-Rayes,Seth D. Force,Steven A. Keilin,Qiang Cai,Field F. Willingham 대한소화기내시경학회 2017 Clinical Endoscopy Vol.50 No.5
Esophageal cancer has a poor overall prognosis and is frequently diagnosed at a late stage. Conventional treatment for metastatic esophageal cancer involves chemotherapy and radiation. Local disease control plays a significant role in improving survival. Endoscopic spray cryotherapy is a novel modality that involves freezing and thawing to produce local ablation of malignant tissue via ischemic mechanisms. Spray cryotherapy has been shown to be effective, particularly for early T-stage, superficial esophageal adenocarcinomas. We present the case of a 72-year-old-male with locally recurrent stage IV esophageal adenocarcinoma and long-term survival of 7 years to date, with concurrent chemoradiation and serial cryoablation. He remains asymptomatic and continues to undergo chemotherapy and sequential cryoablation. The findings highlight the long-term safety and efficacy of cryotherapy in combination with chemoradiation, and suggest that cryoablation may have an additive role in the treatment of advanced stage esophageal adenocarcinoma.
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Jonathan B. Reichstein,Vaishali Patel,Parit Mekaroonkamol,Sunil Dacha,Steven A. Keilin,Qiang Cai,Field F. Willingham 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.1
Background/Aims: There are conflicting opinions regarding the management of recurrent acute pancreatitis (RAP). While somephysicians recommend endoscopic retrograde cholangiopancreatography (ERCP) in this setting, others consider it to be contraindicatedin patients with RAP. The aim of this study was to assess the practice patterns and clinical features influencing the management of RAPin the US. Methods: An anonymous 35-question survey instrument was developed and refined through multiple iterations, and its use wasapproved by our Institutional Review Board. The survey was distributed via email to 408 gastroenterologists to assess the practicepatterns in the management of RAP in multiple clinical scenarios. Results: The survey was completed by 65 participants representing 36 of the top academic/tertiary care centers across the country. Approximately 90.8% of the participants indicated that they might offer or recommend ERCP in the management of RAP. Multinomiallogistic regression analysis revealed that ductal dilatation and presence of symptoms were the most predictive variables (p<0.001) foroffering ERCP. Conclusions: A preponderance of the respondents would consider ERCP among patients with RAP presenting to tertiary care centersin the US. Ductal dilatation, presence of symptoms, and pancreas divisum significantly increased the likelihood of a recommendationfor ERCP
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