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| 1 | Multicenter evaluation of recurrence in endoscopic submucosal dissection and endoscopic mucosal resection in the colon:A Western perspective显示文摘BACKGROUND While colon endoscopic mucosal resection(EMR)is an effective technique,removal of larger polyps often requires piecemeal resection,which can increase recurrence rates.Endoscopic submucosal dissection(ESD)in the colon offers the ability for en bloc resection and is well-described in Asia,but there are limited studies comparing ESD vs EMR in the West.AIM To evaluate different techniques in endoscopic resection of large polyps in the colon and to identify factors for recurrence.METHODS The study is a retrospective comparison of ESD,EMR and knife-assisted endoscopic resection performed at Stanford University Medical Center and Veterans Affairs Palo Alto Health Care System between 2016 and 2020.Knife-assisted endoscopic resection was defined as use of electrosurgical knife to facilitate snare resection,such as for circumferential incision.Patients≥18 years of age undergoing colonoscopy with removal of polyp(s)≥20 mm were included.The primary outcome was recurrence on follow-up.RESULTS A total of 376 patients and 428 polyps were included.Mean polyp size was greatest in the ESD group(35.8 mm),followed by knife-assisted endoscopic resection(33.3 mm)and EMR(30.5 mm)(P<0.001).ESD achieved highest en bloc resection(90.4%)followed by knife-assisted endoscopic resection(31.1%)and EMR(20.2%)(P<0.001).A total of 287 polyps had follow-up(67.1%).On follow-up analysis,recurrence rate was lowest in knife-assisted endoscopic resection(0.0%)and ESD(1.3%)and highest in EMR(12.9%)(P=0.0017).En bloc polyp resection had significantly lower rate of recurrence(1.9%)compared to non-en bloc(12.0%,P=0.003).On multivariate analysis,ESD(in comparison to EMR)adjusted for polyp size was found to significantly reduce risk of recurrence[adjusted hazard ratio 0.06(95%CI:0.01-0.57,P=0.014)].CONCLUSION In our study,EMR had significantly higher recurrence compared to ESD and knife-assisted endoscopic resection.We found factors including resection by ESD,en bloc removal,and use of circumferential incision were associated with significantly decreased recurrence.While further studies are needed,we have demonstrated the efficacy of ESD in a Western population. | Mike T Wei Margaret J Zhou Andrew A Li Andrew Ofosu Joo Ha Hwang Shai Friedland | 2023 | World Journal of Gastrointestinal Endoscopy2023，15，6： | 2 |
| 2 | Transarterial chemoembolization as adjuvant treatment after surgery: The cure of huge hepatocellular carcinoma?显示文摘Hepatocellular carcinoma(HCC) represents the sixth common cancer and the second leading cause of cancer-related death. Its incidence is higher in Eastern countries. HCC is frequently detected at advanced stage of disease, and therefore, the mortality is high [1]. | Andrea Chierici Andrew Ofosu Ivan Cincione Rodolfo Sacco Christian Cotsoglou Antonio Facciorusso | 2021 | Hepatobiliary & Pancreatic Diseases International2021，20，3： | 1 |
| 3 | Potassium-competitive acid blockers-are they the next generation of proton pump inhibitors?显示文摘The modern lifestyle caters to an increase in the incidence of peptic ulcer disease,gastroesophageal reflux disease and several other acid-related conditions of the gut. The drugs to prevent these conditions work either through H2 receptor blockade or inhibition of the H^+, K^+ ATPase enzyme. Although proton pump inhibitors have been proven to be efficacious, they have a slow onset of action with limited resolution of symptoms in most patients. Potassium-competitive acid blockers(P-CABs) are novel drugs that bind reversibly to K^+ ions and block the H^+, K^+ ATPase enzyme, thus preventing acid production. P-CABs have a fast onset of action and have dose-dependent effects on acid production. Animal studies exist that differentiate the better results of P-CABs from proton pump inhibitors; further human trials will give a comprehensive picture of the results and will help to elucidate the therapeutic benefits of this new group of drugs. | Prashanth Rawla Tagore Sunkara Andrew Ofosu Vinaya Gaduputi | 2018 | World Journal of Gastrointestinal Pharmacology and Therapeutics2018，9，7： | 1 |
| 4 | Diagnostic performance of endoscopic ultrasound-guided tissue acquisition of splenic lesions:systematic review with pooled analysis显示文摘Background Focal splenic lesions are usually incidentally discovered on radiological assessments.Although percutaneous tissue acquisition(TA)under trans-abdominal ultrasound guidance is a well-established technique for obtaining cyto-histological diagnosis of focal splenic lesions,endoscopic ultrasound(EUS)-guided TA has been described in several studies,reporting different safety and outcomes.The aimwas to assess the pooled safety,adequacy,and accuracy of EUS-TA of splenic lesions.Methods A comprehensive review of available evidence was conducted at the end of November 2021.All studies including more than five patients and reporting about the safety,adequacy,and accuracy of EUS-TA of the spleen were included.Results Six studies(62 patients)were identified;all studies have been conducted using fine-needle aspiration(FNA)needles.Pooled specimen adequacy and accuracy of EUS-TA for spleen characterization were 92.8%[95%confidence interval(CI),86.3%–99.3%]and 88.2%(95%CI,79.3%–97.1%),respectively.The pooled incidence of adverse events(six studies,62 patients)was 4.7%(95%CI,0.4%–9.7%).Conclusion EUS-FNA of the spleen is a safe technique with high diagnostic adequacy and accuracy.The EUS-guided approach could be considered a valid alternative to the percutaneous approach for spleen TA. | Andrea Lisotti Stefano Francesco Crino` Benedetto Mangiavillano Anna Cominardi Andrew Ofosu Nicole Brighi Flavio Metelli Rocco Maurizio Zagari Antonio Facciorusso Pietro Fusaroli | 2022 | Gastroenterology Report2022，10，1： | 0 |
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