1,721,277 research outputs found
Endoscopic mucosal resection-endoscopic submucosal dissection: Do we really need endoscopic ultrasonography assistance?
No full textEndoscopic mucosal resection has become the standard of care for early gastrointestinal cancer. The application of this new treatment requires an accurate stadiation of the neoplasia. The exclusion of nodal involvement and the evaluation of the depth of tumor penetration within the gastrointestinal wall is essential to select patients who can benefit from this approach. Echoendoscopy allows endoscopists to evaluate subde changes in the layers of the gastrointestinal wall giving an important aid to local tumor staging and planning the adequate treatment
Endoscopic submucosal dissection technique
No full textESD represents an efficient solution for the endoscopic treatment of neoplasia limited to the mucosal layer, its technique is complex and mimicks a "surgical" resection. ESD diffusion in our endoscopic structures will significantly increase our options for treatment of early neoplasms of the digestive tract
Methylene Blue Orally Administered Tablets (Mb MMx (R)) Is Effective in Detecting Intraepithelial Dysplasia in Patients With Long Standing Ulcerative Colitis: Results From an Open Label Trial
No full textConcerns on the very high complication rates reported after self-expanding metal stent (SEMS) placement for colorectal cancer in a Catalan retrospective study.
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A NEW TOOL FOR PRE-COLONOSCOPY DYING OF THE COLONIC MUCOSA WITH ORAL MULTI MATRIX RELEASE TECHNOLOGY (MMX (R))-RELEASED METHYLENE BLUE: A PRELIMINARY STUDY
No full textNew insights into inflammatory bowel disease pathophysiology: Paving the way for novel therapeutic targets
No full textThe etiopathogenesis of Crohn's disease (CD) and ulcerative Colitis (UC), the two major forms of inflammatory bowel disease (IBD), is still unknown. Although the exact cause and mechanisms of both IBD have yet to be completely understood, it is widely accepted that both CD and UC result from an inappropriate immune response that occurs in genetically susceptible individuals as the result of a complex interaction among environmental factors, microbial factors, and the intestinal immune system. In the last few years a tremendous advance in knowledge of the mechanisms underling intestinal inflammation in IBD has been achieved, leading to new therapeutic targets and novel drugs. These new therapeutic weapons have been specifically designed to selective shut down intestinal inflammation at different levels. Aim of this review is to summarize the recent advances in IBD pathophysiology and the new therapeutic targets and drugs that are changing the IBD clinical management.The etiopathogenesis of Crohn's disease (CD) and ulcerative Colitis (UC), the two major forms of inflammatory bowel disease (IBD), is still unknown. Although the exact cause and mechanisms of both IBD have yet to be completely understood, it is widely accepted that both CD and UC result from an inappropriate immune response that occurs in genetically susceptible individuals as the result of a complex interaction among environmental factors, microbial factors, and the intestinal immune system. In the last few years a tremendous advance in knowledge of the mechanisms underlying intestinal inflammation in IBD has been achieved, leading to new therapeutic targets and novel drugs. These new therapeutic weapons have been specifically designed to selective shut down intestinal inflammation at different levels. Aim of this review is to summarize the recent advances in IBD pathophysiology and the new therapeutic targets and drugs that are changing the IBD clinical managemen
Colonic stents for malignant bowel obstruction: current status and future prospects
No full textIntroduction: Although more than two decades are already passed from the first description of this technique, the debate remains open on the role of self-expanding metal stents (SEMS) placement in the management of malignant bowel obstruction (MBO). According to most recent data, SEMS placement is considered a safe and effective alternative treatment as a bridge to surgery(BTS). In addition, stent placement should be considered as primary option for palliative treatment of obstructing cancer. Areas covered: Current status, indication, technique, oncological outcomes, advantages, and risks of SEMS placement in MBO were reviewed. Expert commentary: The placement of colonic SEMS for palliation and for BTS in patients with MBO has been increasingly reported and it seems to have several advantages over emergency surgery. Substantial concerns of tumor seeding following SEMS placement, especially in case of perforation, have been raised in numerous studies. Actually, no significant differences are reported in oncologic long-term survival between patients undergoing stent placement as a BTS and those undergoing emergency surgery. Considering all the mentioned factors, indication for colorectal stenting should be evaluated only in highly specialized centers, in the context of multidisciplinary approach where risks and benefits of stenting are carefully weighed, especially in the BTS setting
Artificial intelligence for non-polypoid colorectal neoplasms
No full textThe miss rate of flat advanced colorectal neoplasia is still unacceptably high, especially in the Western setting, notwithstanding the widespread implementation of quality improvement programs and training. It is well known that flat morphology is associated with miss rate of colorectal neoplasia, and that this subset of lesions often shows a more aggressive biological behaviour. Artificial intelligence (AI) applied to the detection of colorectal neoplasia has been shown to increase adenoma detection rate, consistently across all lesion sizes and locations in the colon. However, there is still uncertainty whether AI can reduce the miss rate of flat advanced neoplasia, mainly because all published trials report a low number of flat colorectal lesions in their training sets, and this could reduce AI accuracy for this subset of lesions. In addition, flat lesions have different morphologies with variable prevalence and potentially different accuracy in their detection. For example, the subtle appearance and rarer frequency of a non-granular laterally spreading tumor (LST) could be much harder to identify than a granular mixed LST. In this review, we present a summary of the evidence on the role of AI in the identification of colorectal flat neoplasia, with a focus on data regarding presence of LSTs in the training/validation sets of the AI systems currently available on the market
New targeted therapies such as anti-adhesion molecules, anti-IL-12/23 and anti-Janus kinases are looking toward a more effective treatment of inflammatory bowel disease
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