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Maurizio Zizzo, Carla Galeone, Luca Braglia, Lara Ugoletti, Alessandra Siciliani, Dania Nachira, Stefano Margaritora, Claudio Pedrazzoli, Massimiliano Paci, Filippo Lococo
BACKGROUND/AIMS: At present, benefits of surgical resection and appropriate selection criteria in patients affected by both hepatic and pulmonary metastases of colorectal cancer (CRC) are under discussion. Our analysis focused on a surgical series of such patients and our final aim consisted in identifying potential prognostic factors. METHODS: Eighty-five patients undergoing resection of both hepatic and pulmonary metastases at 2 Healthcare Institutions from January 1993 to June 2015 were retrospectively reviewed as concerned clinical information, surgical notes and pathological features...
February 15, 2019: Digestion
Takahide Shinagawa, Keisuke Hata, Teppei Morikawa, Keigo Matsunaga, Shigenobu Emoto, Koji Murono, Manabu Kaneko, Kazuhito Sasaki, Takeshi Nishikawa, Toshiaki Tanaka, Kazushige Kawai, Hiroaki Nozawa, Masashi Fukayama, Soichiro Ishihara
BACKGROUND/AIMS: Runt-related transcription factor (RUNX) 3 is a tumor suppressor whose expression is reduced in non-neoplastic rectal mucosa of patients with ulcerative colitis (UC) with coexisting colitis-associated cancer (CAC). We aimed to evaluate RUNX3 utility as a predictive marker for CAC using immunohistochemistry (IHC) for non-neoplastic UC mucosa. METHODS: We retrospectively compared the RUNX3 expression detected by IHC between non-neoplastic rectal biopsy specimens from 20 cases with invasive cancer (CAC group) and 20 cases selected from 138 patients without CAC (non-CAC group) that were treated during the same period (2006-2017) and were matched for sex, duration, extension, and age...
February 14, 2019: Digestion
Mario Peláez-Luna, Claudia Medina-Campos, Luis Uscanga-Domínuez, Jorge Hernandez-Calleros, Carlos Chan-Nuñez, Eduardo Negrete, Arturo Angeles
BACKGROUND: Chronic pancreatitis (CP), pancreatic cancer (PCa), and autoimmune pancreatitis (AIP) often present as a pancreatic mass. Accurate diagnosis is not always possible; up to 8% of surgical procedures are performed in benign pancreatic masses presumed to be malignant. OBJECTIVES: We aimed to compare clinical and imaging characteristics of resected focal type 2 AIP, CP, and PCa and identify factors that could improve preoperative differential diagnosis. METHODS: Charts from patients that underwent pancreatic resection under suspicion of PCa between 2000 and 2014 were reviewed...
February 13, 2019: Digestion
Dirk Raddatz
BACKGROUND: Obesity and its metabolic sequelae are among the most serious challenges faced by health systems today and they are expected to pose a serious threat in the future as well. Therapy ranges from lifestyle modification to drug treatment to surgery. Metabolic endoscopy (ME) might close the gap between invasive "metabolic" surgery and conservative, less effective treatment. In recent years, several endoscopic approaches have emerged, promising a safe and effective approach to cope with obesity...
February 7, 2019: Digestion
Saori Kashiwagi, Yuji Naito, Ryo Inoue, Tomohisa Takagi, Takahiro Nakano, Yutaka Inada, Akifumi Fukui, Kazuhiro Katada, Katsura Mizushima, Kazuhiro Kamada, Kazuhiko Uchiyama, Osamu Handa, Takeshi Ishikawa, Yoshito Itoh
BACKGROUND: The importance of microbiota infiltrating the gut mucus layer has been reported in the pathogenesis of various gastrointestinal and systemic diseases. However, little is known about the mucosa-associated microbiota (MAM) in healthy subjects. The present study aimed to clarify the characteristics of the gastrointestinal MAM from the oral cavity to the rectum in healthy Japanese subjects. METHODS: Seventeen healthy subjects were enrolled. In this study, 5 mucosa samples from the upper gut (intraoral, mid-esophagus, gastric corpus, gastric antrum, and duodenum) and 7 from the lower gut (ileum, cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum) were collected with a brush under endoscopic examination...
February 5, 2019: Digestion
Akira Harada, Takehiro Torisu, Yasuharu Okamoto, Atsushi Hirano, Junji Umeno, Tomohiko Moriyama, Ema Washio, Yuta Fuyuno, Shin Fujioka, Takanari Kitazono, Motohiro Esaki
BACKGROUND: Although capsule endoscopy (CE) is useful to evaluate obscure gastrointestinal bleeding (OGIB), CE does not always identify the responsible lesions in patients with overt OGIB. OBJECTIVES: To identify factors predictive of rebleeding after negative CE in patients with overt OGIB. METHODS: We retrospectively analyzed the clinical data of 221 patients who underwent CE for overt OGIB. Among 120 patients with negative CE findings, clinical course of 112 patients after CE was followed-up...
February 1, 2019: Digestion
Min Li, Tao Jiang, Peng Peng, Xinqing Yang
OBJECTIVE: Dyssynergic defecation (DD) and pelvic floor prolapse often coexist in female functional defecation disorder. A retrospective study was performed to evaluate the ability of dynamic MR sequences with the straining and defecation phase to detect paradoxical puborectalis contraction and occult multiple-compartments disorders. METHODS: Fifty-three females clinically diagnosed with DD underwent magnetic resonance defecography. The dynamic sequences consist of rest, squeeze, straining, and defecation...
January 29, 2019: Digestion
Makoto Arai, Tomoaki Matsumura, Yuki Ohta, Soichiro Kiyono, Masahiro Hayashi, Takashi Taida, Keiko Saito, Kenichiro Okimoto, Daisuke Maruoka, Tomoo Nakagawa, Tatsuro Katsuno, Naoya Kato, Yuichi Takiguchi
AIMS: We evaluated the long-term prognosis of patients with obscure gastrointestinal bleeding (OGIB) who underwent capsule endoscopy (CE). METHODS: In our hospital, 429 patients underwent CE between November 2007 and March 2012. Among them, 259 patients underwent CE as the first examination for OGIB and were then followed at 77 clinics and hospitals. The clinical characteristics were investigated, including age, gender, overt/occult bleeding, the use of antithrombotic drugs and NSAIDs, complications (liver cirrhosis and hemodialysis), and CE...
January 11, 2019: Digestion
Yurika Kawamura, Yasushi Funaki, Takashi Yoshimine, Yasuhiro Tamura, Sayuri Yamamoto, Shinya Izawa, Toshihiko Hayakawa, Masahide Ebi, Kenta Murotani, Naotaka Ogasawara, Makoto Sasaki, Kunio Kasugai
BACKGROUND/AIM: Helicobacter pylori (HP) eradication therapy was first recommended as pharmacotherapy for functional dyspepsia (FD). However, the mechanism and effect of eradication on FD symptom improvement have not been fully investigated. This study aimed to investigate the pathology of patients with HP-associated FD, and predictive factors for HP-associated FD. METHODS: Ninety-seven patients with chronic gastritis caused by HP infection were divided into the group with FD symptoms and the group -without FD symptoms...
January 10, 2019: Digestion
Michael Hirth, Nicolai Härtel, Christel Weiss, Philip Hardt, Natalia Gubergrits, Matthias P Ebert, Alexander Schneider
BACKGROUND: Several guidelines recommend the risk-adapted monitoring of patients with chronic pancreatitis (CP). However, dedicated risk stratification is widely missing in CP. Elderly-CP (disease onset with 60 or more years of age) may represent a subgroup of CP subjects with a distinct course of disease. AIMS: We aimed to investigate the clinical presentation of elderly-CP, and if elderly-CP requires an adapted monitoring. METHODS: Seven hundred forty one patients with CP were analyzed in a multicenter (Mannheim/Germany, n = 537; Gießen/Germany, n = 100; Donetsk/Ukraine, n = 104), cross-sectional, retrospective study and classified according to the M-ANNHEIM classification...
January 10, 2019: Digestion
Anat Yerushalmy-Feler, Hadar Moran-Lev, Tut Galai, Shlomi Cohen
OBJECTIVE: Combinations of antitumor necrosis factor alpha (TNFα) and immunomodulators may be indicated in high-risk inflammatory bowel disease patients. Our aims were to compare disease course between children that did and did not step down to anti-TNFα monotherapy and to define risk factors for complicated disease course after stepping down. METHODS: A retrospective review of the medical records of consecutive children who were treated with combination therapy...
January 9, 2019: Digestion
Koichi Hamano, Aiji Noda, Eri Ibuki, Nobuo Ashizawa, Shunsuke Inamoto, Junko Izumi, Jun Usami, Hiroaki Nakagawa, Yoshinori Wakita, Masato Maekawa
BACKGROUND/AIMS: Our study aimed to evaluate the effect of oral litholysis in patients with chronic calcific pancreatitis (CCP) unresponsive to or ineligible for extracorporeal shock wave lithotripsy (ESWL) and endoscopic therapy. METHODS: Trimethadione, an antiepileptic agent, was administered orally at a dose of 0.6-0.9 g/day to 15 patients with this condition. Treatment outcome was evaluated by assessment of dissolution of the pancreatic stones on plain X-ray films and computed tomography scans of the upper abdomen...
January 3, 2019: Digestion
Atsuyo Ikeda, Norikatsu Miyoshi, Shiki Fujino, Hideki Iijima, Hidekazu Takahashi, Naotsugu Haraguchi, Junichi Nishimura, Taishi Hata, Chu Matsuda, Yuichiro Doki, Masaki Mori, Tsunekazu Mizushima
BACKGROUND/AIMS: Endoscopic recurrence (ER) after intestinal resection for Crohn's disease (CD) precedes the clinical recurrence, and the severity of ER correlates with the severity of the subsequent clinical recurrence. This study aimed to identify risk factors related to early ER after intestinal resection for CD and to create a prediction model. METHODS: The patients who underwent intestinal resection for CD between April 2008 and April 2017 and took endoscopic evaluation between 6 and 12 months after surgery were retrospectively analyzed...
January 2, 2019: Digestion
Kenichiro Takahashi, Shigeki Bamba, Yasuhiro Morita, Atsushi Nishida, Masahiro Kawahara, Osamu Inatomi, Mitsushige Sugimoto, Masaya Sasaki, Akira Andoh
BACKGROUND/AIMS: Thiopurines are key drugs in maintenance therapy for treating inflammatory bowel disease (IBD). Time-dependent 5-aminosalicylates (5-ASA) releasing preparations (time-dependent 5-ASA) increase 6-thioguanine nucleotide (6-TGN), an active metabolite of thiopurines. However, the effects of pH-dependent 5-ASA releasing preparations (pH-dependent 5-ASA) on thiopurine metabolism were not reported. METHODS: We conducted a retrospective study of 134 IBD patients who received thiopurine treatment...
January 2, 2019: Digestion
Yoshishiro Hiramatsu, Hiroya Takeuchi, Osamu Goto, Hirotoshi Kikuchi, Yuko Kitagawa
BACKGROUND: Recently, minimally invasive approaches such as endoscopic treatment or laparoscopic gastrectomy for early gastric cancer have made rapid progress. However, the extent of gastrectomy and lymphadenectomy in laparoscopic surgery is radical, similar to that of open gastrectomy for patients with early gastric cancer diagnosed as not indicated for endoscopic treatment. Since it is well known that lymph node metastasis is an important prognostic factor, the standard procedure of gastrectomy with radical lymph node dissection has been performed for the purpose of curative resection...
December 14, 2018: Digestion
Kohei Takizawa, Waku Hatta, Takuji Gotoda, Noboru Kawata, Masahiro Nakagawa, Akiko Takahashi, Mitsuru Esaki, Akira Mitoro, Shinya Yamada, Keiko Tanaka, Mitsuru Matsuda, Jun Takada, Shiro Oka, Hirotaka Ito, Ken Ohnita, Ryo Shimoda, Shu Hoteya, Tsuneo Oyama, Tooru Shimosegawa
BACKGROUND/AIMS: The outcomes of salvage surgery for recurrence after non-curative endoscopic submucosal dissection (ESD) without additional radical surgery for early gastric cancer (EGC) remain unclear. We determined the recurrence patterns and outcomes of salvage surgery in such cases using data from a multicenter, retrospective study. METHODS: Of 15,785 patients who underwent ESD for EGC at 19 participating institutions between January 2000 and August 2011, 1,969 failed to meet the current curative criteria after ESD...
December 14, 2018: Digestion
Yuji Miyamoto, Yukiharu Hiyoshi, Takahiko Akiyama, Yuki Kiyozumi, Kojiro Eto, Nagai Yohei, Shiro Iwagami, Yoshifumi Baba, Naoya Yoshida, Hideo Baba
BACKGROUND: Regorafenib and TAS-102 are standard salvage-line treatment options for patients with chemorefractory metastatic colorectal cancer (mCRC). We aimed to evaluate the prognostic significance of skeletal muscle mass in mCRC patients receiving these salvage-line therapies. METHODS: We conducted a retrospective analysis of 52 patients with mCRC who received regorafenib or TAS-102 as salvage-line treatment. Skeletal muscle cross-sectional area was measured by pretreatment CT to obtain the skeletal muscle index (SMI, cm2/m2)...
December 14, 2018: Digestion
Katsuyoshi Ando, Mikihiro Fujiya, Yoshiki Nomura, Yuhei Inaba, Yuya Sugiyama, Yu Kobayashi, Takuya Iwama, Masami Ijiri, Keitaro Takahashi, Nobuhiro Ueno, Shin Kashima, Kentaro Moriichi, Hiroki Tanabe, Yusuke Mizukami, Kazumi Akasaka, Satoshi Fujii, Satoshi Yamada, Hiroshi Nakase, Toshikatsu Okumura
BACKGROUND: Venous thromboembolism (VTE) has been shown to be more frequent in inflammatory bowel disease (IBD) than in the general population in Western studies. However, the actual state of VTE in Asian IBD remains poorly understood. AIMS: To reveal the incidence of VTE in IBD patients in Japan. METHODS: Eighty-five patients admitted to 3 gastroenterology centers were registered from 2013 to 2018. The incidence of VTE in patients with IBD (n = 42) was prospectively compared to that among patients with other digestive diseases (n = 43)...
December 14, 2018: Digestion
Kosaku Hata, Masanori Ito, Tomoyuki Boda, Takahiro Kotachi, Mariko Kiso, Kazuhiko Masuda, Mio Kurihara, Kazutaka Kuroki, Naoki Yorita, Naoko Nagasaki, Madina Abduwali, Shinji Tanaka, Kazuaki Chayama
BACKGROUND AND AIM: The incidence of gastric cancer occurring after successful Helicobacter pylori eradication has been increasing. We aimed to clarify the influence of eradication therapy on the ability to diagnose early gastric cancer after successful H. pylori eradication in patients who underwent annual endoscopic screening. METHODS: A total of 220 patients (179 men; mean age 71.0 years) had differentiated-type early gastric cancer that was discovered through annual endoscopic screening...
December 14, 2018: Digestion
Akihiro Miyakawa, Satoshi Kodera, Yukie Sakuma, Taro Shimada, Manabu Kubota, Akira Nakamura, Ei Itobayashi, Haruhisa Shimura, Yoshio Suzuki, Yasunori Sato, Kenji Shimura
BACKGROUND/AIMS: Feeding recommendations after endoscopic submucosal dissection (ESD) for gastric neoplasms are not established and based on clinical experience. METHODS: This was a prospective pilot randomized controlled trial. Patients undergoing ESD for gastric neoplasms were randomly assigned to solid (n = 50) or liquid diet (n = 50) groups. Beginning the day after hemostasis confirmation until discharge, the solid diet group started on a diet of rice porridge, whereas the liquid diet group started on a liquid diet, with gradual transition to solid food...
December 14, 2018: Digestion
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