Long-term outcomes of endoscopic mucosal resection for early-stage esophageal adenocarcinoma

Oza, Kesha; Peesay, Tejasvi; Greenspun, Benjamin C.; Carroll, J.E.; Shafa, Shervin; Zeck, Jay; Haddad, Nadim; Margolis, Marc; Khaitan, Puja Gaur

doi:10.1007/s00464-021-08884-2

Cited by 6 publications

(4 citation statements)

References 18 publications

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“…However, data were not available to calculate the pooled effect of SAP in reducing the risk of DB based on ER technique used. DB rates after ER can significantly vary based on the location of the lesion, with studies reporting rates ranging from 0 % following esophageal ERs to 20 % following duodenal EMRs [16][17][18][19]. We analyzed the rate of DB after pro- phylactic SAP based on the location of ER and showed a pooled rate of 5.60 % for esophagus, 4.15 % for gastric, 10.60 % for duodenal, and 5.07 % for colorectal ERs.…”

Section: Discussionmentioning

confidence: 99%

“…We analyzed the rate of DB after prophylactic SAP based on the location of ER and showed a pooled rate of 5.60 % for esophagus, 4.15 % for gastric, 10.60 % for duodenal, and 5.07 % for colorectal ERs. Delayed bleeding in the esophagus is considered rare, with reported rates between 0% and 0.7% [16,17]. However, this can change considerably with periprocedural antithrombotic use or coexistent conditions like severe liver disease.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

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Efficacy of self-assembling peptide in mitigating delayed bleeding after advanced endoscopic resection of gastrointestinal lesions: A meta-analysis

et al. 2023

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Background and study aims Advanced endoscopic resection techniques carry a risk of delayed bleeding (DB). A novel fully synthetic self-assembling peptide (SAP) has shown promising results in mitigating this risk. In this meta-analysis, we evaluated all available data and analyzed the effectiveness of SAP in reducing delayed bleeding (DB) after advanced endoscopic resection of gastrointestinal luminal lesions. Methods Electronic databases (PubMed, Embase, and Cochrane Library) from January 2010 through October 2022 were searched for publications addressing the use of SAP solution in patients undergoing advanced endoscopic resection of gastrointestinal lesions. Pooled proportions were calculated using fixed (inverse variance) and random-effects (DerSimonian-Laird) models. Results The initial search identified 277 studies, of which 63 relevant articles were reviewed. The final analysis included data from 6 studies comprising 307 patients that met inclusion criteria. The pooled rate of delayed bleeding was 5.73% (95% CI = 3.42 – 8.59). Mean patient age was 69.40 years (SD = 1.82). The weighted mean size of resected lesions was 36.20 mm (95% CI = 33.37 – 39.02). ESD was used in 72.69% (95% CI = 67.62 – 77.48), while EMR was used in 26.42% (95% CI = 21.69 – 31.44) of the procedures. Among the 307 patients, 36% were on antithrombotic medications. No adverse events were attributable to using SAP, with a pooled rate of 0.00% (95% CI = 0.00 – 1.49). Conclusions Self-assembling peptide solution appears promising in reducing post-procedural delayed bleeding after advanced endoscopic resection of high-risk gastrointestinal lesions with no reported adverse events.

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Section: Discussionmentioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

Efficacy of self-assembling peptide in mitigating delayed bleeding after advanced endoscopic resection of gastrointestinal lesions: A meta-analysis

et al. 2023

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“…Endoscopic submucosal dissection (ESD) is a widely used technique for the treatment of high-grade intraepithelial neoplasia and early carcinoma of the gastrointestinal mucosa because of its less invasive nature and its high success rate in achieving en bloc resection [1,2]. However, postoperative strictures still frequently occur after esophageal ESD, especially after extensive resection, involving more than 3/4 of the esophageal circumference.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Esophageal Stricture after Endoscopic Submucosal Dissection with an Autologous Esophageal Epithelial Cell Suspension: An Animal Study

Su,

Pang,

Wang

et al. 2023

Discovery Medicine

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Background: Severe esophageal stricture decreases patient's quality of life after circumferential endoscopic submucosal dissection (ESD). We aimed to evaluate the efficacy of autologous esophageal epithelial cell suspensions in preventing esophageal stricture after circumferential ESD. Methods: Twelve male mini-pigs underwent circumferential ESD and were randomized into four groups: G1 (control), G2 (esophageal stent), G3 (autologous esophageal epithelial cell suspension), and G4 (autologous esophageal epithelial cell suspension combined with esophageal stent). Post-ESD status was observed in each group, and endoscopy was performed weekly. Esophageal stents were removed 3 weeks after ESD. The esophageal stricture rates and histologic characteristics were assessed 4 weeks after ESD. Results: G1 showed the greatest weight loss (p < 0.05). Dysphagia scores were not significantly different among the groups. The esophageal mucosal stricture rates were 77.7 ± 2.9%, 74.2 ± 1.9%, 69.2 ± 3.8% and 65.9 ± 1.9% in G1-4, respectively; with the highest in G1 (G1 vs. G3, p = 0.005; G1 vs. G4, p = 0.001). The regenerated epithelium lengths were 4.408 ± 1.980 mm, 8.319 ± 0.857 mm, 11.801 ± 2.455 mm and 12.353 ± 1.111 mm in G1-4, respectively. The lowest degree of re-epithelialization was observed in G1, followed by G2, with the highest degrees in G3 and G4 (G1 vs. G3, p = 0.001; G1 vs. G4, p = 0.000). The maximum wound fibrosis thicknesses were 2.546 ± 0.389 mm, 2.136 ± 0.231 mm, 1.126 ± 0.211 mm and 1.131 ± 0.438 mm in G1-4, respectively, with higher degrees in G1 and G2 than in G3 and G4 (G1 vs. G3, p = 0.001; G1 vs. G4, p = 0.001). Conclusions: Autologous esophageal epithelial cell suspensions can promote re-epithelialization and reduce fibrosis, thus decreasing esophageal stricture severity after ESD.

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“…For patients who are poor surgical candidates, curative treatment by definitive chemoradiation may be an alternative. Very early-stage disease may be managed by endoscopic minimally invasive techniques, such as mucosal resection [ 2 ]. Metastatic disease is typically managed by chemotherapy with radiation reserved for local control and complications.…”

Section: Introductionmentioning

confidence: 99%

PET-CT in Clinical Adult Oncology: III. Gastrointestinal Malignancies

Koppula

Fine

Salem

et al. 2022

Cancers

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PET-CT is an advanced imaging modality with many oncologic applications, including staging, assessment of response to therapy, restaging and longitudinal surveillance for recurrence. The goal of this series of six review articles is to provide practical information to providers and imaging professionals regarding the best use of PET-CT for specific oncologic indications, and the potential pitfalls and nuances that characterize these applications. In the third of these review articles, key tumor-specific clinical information and representative PET-CT images are provided to outline the role that PET-CT plays in the management of patients with gastrointestinal malignancies. The focus is on the use of 18F fluorodeoxyglucose (FDG), rather than on research radiopharmaceuticals under development. Many different types of gastrointestinal tumors exist, both pediatric and adult. A discussion of the role of FDG PET-CT for all of these is beyond the scope of this review. Rather, this article focuses on the most common adult gastrointestinal malignancies that may be encountered in clinical practice. The information provided here will provide information outlining the appropriate role of PET-CT in the clinical management of patients with gastrointestinal malignancies for healthcare professionals caring for adult cancer patients. It also addresses the nuances and provides interpretive guidance related to PET-CT for imaging providers, including radiologists, nuclear medicine physicians and their trainees.

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Long-term outcomes of endoscopic mucosal resection for early-stage esophageal adenocarcinoma

Cited by 6 publications

References 18 publications

Efficacy of self-assembling peptide in mitigating delayed bleeding after advanced endoscopic resection of gastrointestinal lesions: A meta-analysis

Efficacy of self-assembling peptide in mitigating delayed bleeding after advanced endoscopic resection of gastrointestinal lesions: A meta-analysis

Prevention of Esophageal Stricture after Endoscopic Submucosal Dissection with an Autologous Esophageal Epithelial Cell Suspension: An Animal Study

PET-CT in Clinical Adult Oncology: III. Gastrointestinal Malignancies

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