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RISS 인기검색어
- 검색키워드
- 저자 : Steven Keilin (검색결과 3 건)
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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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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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Epidemiology of early esophageal adenocarcinoma
Thuy-Van P. Hang,Zachary Spiritos,Anthony M. Gamboa,Zhengjia Chen,Seth Force,Vaishali Patel,Saurabh Chawla,Steven Keilin,Nabil F. Saba,Bassel El-Rayes,Qiang Cai,Field F. Willingham 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.3
Background/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma(EAC); however, the epidemiology of early stage disease has not been well defined. Methods: Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates amongmajor epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according totumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data wereavailable. Results: The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annualpercent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%−5.56%). The annual percent change appearedto plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of −5.78%. Conclusions: There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelialmalignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients hasnode negative, potentially resectable early stage disease.
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