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| 1 | Unpacking the challenge of gastric varices: A review on indication, timing and modality of therapy显示文摘Upper gastrointestinal bleeding from oesophageal or gastric varices is an important medical condition in patients with portal hypertension.Despite the emergence of a number of novel endoscopic and radiologic therapies for oesophagogastric varices,controversy exists regarding the indication,timing and modality of therapy.The aim of this review is to provide a concise and practical evidence-based overview of these issues. | Karl Vaz Marios Efthymiou Rhys Vaughan Adam G Testro Hin-Boon Lew Leonardo Zorron Cheng Tao Pu Sujievvan Chandran | 2021 | World Journal of Hepatology2021，13，8： | 2 |
| 2 | Right-sided adenoma detection with retroflexion versus forward-view colonoscopy显示文摘 | Sujievvan Chandran Frank Parker Rhys Vaughan Brent Mitchell Scott Fanning Gregor Brown Jenny Yu Marios Efthymiou | 2014 | Gastrointestinal Endoscopy2014，，： | 1 |
| 3 | Risk stratification of upper GI bleeding with an esophageal capsule显示文摘 | Sujievvan Chandran Adam Testro Paul Urquhart Richard La Nauze Sim Ong Edward Shelton Hamish Philpott Siddarth Sood Rhys Vaughan William Kemp Gregor Brown Paul Froomes | 2013 | Gastrointestinal Endoscopy2013，，6： | 1 |
| 4 | High-flow oxygen via oxygenating mouthguard in short upper gastrointestinal endoscopy:A randomised controlled trial显示文摘BACKGROUND Anaesthetic care during upper gastrointestinal(GI)endoscopy has the unique challenge of maintaining ventilation and oxygenation via a shared upper airway.Supplemental oxygen is recommended by international society guidelines,however,the optimal route or rate of oxygen delivery is not known.Various oxygen delivery devices have been investigated to improve oxygenation during upper GI endoscopy,however,these are limited by commercial availability,costs and in some cases,the expertise required for insertion.Anecdotally at our centre,higher flows of supplemental oxygen can safely be delivered via an oxygenating mouthguard routinely used during upper GI endoscopic procedures.AIM To assess the incidence of hypoxaemia(SpO2<90%)in patients undergoing upper GI endoscopy receiving supplemental oxygen using an oxygenating mouthguard at 20 L/min flow compared to standard nasal cannula(SNC)at 2 L/min flow.METHODS A single centre,prospective,randomised clinical trial at two sites of an Australian tertiary hospital between October 2020 and September 2021 was conducted.Patients undergoing elective upper gastrointestinal endoscopy under deep sedation were randomised to receive supplemental oxygen via high-flow via oxygenating mouthguard(HFMG)at 20 L/min flow or SNC at 2 L/min flow.The primary outcome was the incidence of hypoxaemia of any duration measured by pulse oximetry.Intraprocedural-related,procedural-related,and sedation-related adverse events and patient-reported outcomes were also recorded.RESULTS Three hundred patients were randomised.Eight patients were excluded after randomisation.292 patients were included in the intention-to-treat analysis.The incidence of hypoxaemia was significantly reduced in those allocated HFMG.Six patients(4.4%)allocated to HFMG experienced an episode of hypoxaemia,compared to thirty-four(22.1%)patients allocated to SNC(P value<0.001).No significant difference was observed in the rates of adverse events or patient-reported outcome measures.CONCLUSION The use of HFMG offers a novel approach to reducing the incidence of hypoxaemia during short upper gastrointestinal endoscopic procedures in low-risk patients undergoing deep sedation. | Kim Hay Be Leonardo Zorron Cheng Tao Pu Brett Pearce Matthew Lee Luke Fletcher Rebecca Cogan Philip Peyton Rhys Vaughan Marios Efthymiou Sujievvan Chandran | 2022 | World Journal of Gastrointestinal Endoscopy2022，14，12： | 0 |
| 5 | Long-term clinical outcomes of lipiodol marking using standard gastroscopy for image-guided radiotherapy of upper gastrointestinal cancers显示文摘BACKGROUND Image-guided radiotherapy(IGRT)has significantly improved the precision in which radiotherapy is delivered in cancer treatment.Typically,IGRT uses bony landmarks and key anatomical structures to locate the tumor.Recent studies have demonstrated the feasibility of peri-tumor fiducials in enabling even more accurate delineation of target and normal tissue.The use of gold coils as fiducials in gastrointestinal tumors has been extensively studied.However,placement requires expertise and specialized endoscopic ultrasound equipment.This article reports the long-term outcomes of using a standard gastroscopy to inject liquid fiducials for the treatment of oesophageal and gastric tumors with IGRT.AIM To assess the long-term outcomes of liquid fiducial-guided IGRT in a cohort of oesophageal and gastric cancer patients.METHODS A retrospective cohort study of consecutive adults with Oesophagogastric cancers referred for liquid fiducial placement before definitive/neo-adjuvant or palliative IGRT between 2013 and 2021 at a tertiary hospital in Melbourne,Australia was conducted.Up to four liquid fiducials were inserted per patient,each injection consisting of 0.2-0.5mL of a 1:1 mixture of iodized oil(Lipiodol;Aspen Pharmacare)and n-butyl 2-cyanoacrylate(Histoacryl®;B.Braun).A 23-gauge injector(Cook Medical)was used for the injection.All procedures were performed by or under the supervision of a gastroenterologist.Liquid fiducial-based IGRT(LF-IGRT)consisted of computer-assisted direct matching of the fiducial region on cone-beam computerised tomography at the time of radiotherapy.Patients received standard-IGRT(S-IGRT)if fiducial visibility was insufficient,consisting of bone match as a surrogate for tumor position.Radiotherapy was delivered to 54Gy in 30 fractions for curative patients and up to 45Gy in 15 fractions for palliative treatments.RESULTS 52 patients were referred for liquid fiducial placement within the study period.A total of 51 patients underwent liquid fiducial implantation.Of these a total of 31 patients received radiotherapy.Among these,the median age was 77.4 years with a range between 57.5 and 88.8,and 64.5%were male.Twenty-seven out of the 31 patients were able to have LF-IGRT while four had S-IGRT.There were no complications after endoscopic implantation of liquid fiducials in our cohort.The cohort overall survival(OS)post-radiotherapy was 19 mo(range 0 to 87 mo).Whilst the progression-free survival(PFS)post-radiotherapy was 13 mo(range 0 to 74 mo).For those treated with curative intent,the median OS was 22.0 mo(range 0 to 87 mo)with a PFS median of 14.0 mo(range 0 to 74 mo).Grade 3 complication rate post-radiotherapy was 29%.CONCLUSION LF-IGRT is feasible in 87.1%of patients undergoing liquid fiducial placement through standard gastroscopy injection technique.Our cohort has an overall survival of 19 mo and PFS of 13 mo.Further studies are warranted to determine the long-term outcomes of liquid-fiducial based IGRT. | Kim Hay Be Richard Khor Daryl Lim Joon Ben Starvaggi Michael Chao Sweet Ping Ng Michael Ng Leonardo Zorron Cheng Tao Pu Marios Efthymiou Rhys Vaughan Sujievvan Chandran | 2021 | World Journal of Gastroenterology2021，27，42： | 0 |
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