journal
Journals Gastroenterology Clinics of No...

Gastroenterology Clinics of North America

https://read.qxmd.com/read/38719383/not-even-a-ribbon-for-intestinal-failure
#1
EDITORIAL
Alan L Buchman
No abstract text is available yet for this article.
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38719382/strategies-to-promote-success-in-oral-feedings-in-infants-and-children-with-intestinal-failure-due-to-short-bowel-syndrome
#2
REVIEW
Judy Hopkins, Russell Merritt
Infants and children with intestinal failure are at risk for pediatric feeding disorders, which challenge their oral feeding development. This article explores these challenges and offers several practical strategies that can be used by multidisciplinary care teams and at-home caregivers to help support the development of oral feeding in these children and eventually lead to their attaining enteral autonomy.
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38719381/pediatric-intestinal-failure-associated-eating-disorder-an-overview-of-the-importance-of-oral-feeding-in-a-population-at-risk-for-feeding-difficulties
#3
REVIEW
Dana Liza Boctor, Tanis R Fenton, Olivier Goulet, Cecile Lambe
Achieving feeding skills and food acceptance is a multi-layered process. In pediatric intestinal failure (PIF), oral feeding is important for feeding skills development, physiologic adaptation, quality of life and the prevention of eating disorders. In PIF, risk factors for feeding difficulties are common and early data suggests that feeding difficulties are prevalent. There is a unique paradigm for the feeding challenges in PIF. Conventional definitions of eating disorders have limited application in this context...
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38719380/should-a-stoma-be-used-after-intestinal-transplant
#4
REVIEW
Akin Tekin, Gennaro Selvaggi, Brent J Pfeiffer, Jennifer Garcia, Vighnesh Vetrivel Venkatasamy, Rafael Miyashiro Nunes Dos Santos, Rodrigo M Vianna
As we all acknowledge benefits of ostomies, they can come with significant morbidity, quality of life issues, and major complications, especially during reversal procedures. In recent years, we have started to observe that similar graft and patient survival can be achieved without ostomies in certain cases. This observation and practice adopted in a few large-volume transplant centers opened a new discussion about the necessity of ostomies in intestinal transplantation. There is still more time and randomized studies will be needed to better understand and analyze the risk/benefits of "No-ostomy" approach in intestinal transplantation...
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38719379/intestinal-transplant-for-hirschsprung-s-disease-stoma-for-life-or-not
#5
REVIEW
Geoffrey James Bond
Hirschsprung's disease is a dysmotility disease caused by lack of ganglion cells in the bowel wall that can affect varying lengths of the intestine. In extreme circumstances, there can be little remaining ganglionated bowel, and the patient becomes dependent on parental nutrition (PN) for survival. Intestinal transplant has been utilized to salvage these patients suffering terminal complications of PN. The question as to whether to reestablish intestinal continuity, and thus not require a stoma is vexed. However, data and experience would suggest this can be safely done with good functional results...
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38719378/intestinal-transplantation-include-the-spleen-with-intestinal-graft
#6
REVIEW
Rei Matsumoto, Tomoaki Kato
The traditional procedure for multivisceral transplant (MVT) is to transplant the stomach, pancreas, intestine, and liver en bloc. During surgery, the native spleen is routinely removed from the recipient, and it usually creates more space in the abdomen to insert the allogeneic graft. Thus, recipients often become asplenic after MVT. Considering all of the risks and benefits, we advocate that temporary transplant of the donor spleen could be the best option for MVT recipients; it could potentially reduce the rate of intestinal allograft rejection without increasing the risk for graft-versus-host disease...
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38719377/abdominal-wall-closure-in-intestinal-and-multivisceral-transplantation-a-state-of-the-art-review-of-vascularized-abdominal-wall-and-nonvascularized-rectus-fascia-transplantation
#7
REVIEW
Ewout Muylle, Nele Van De Winkel, Ina Hennion, Antoine Dubois, Lieven Thorrez, Nathalie P Deferm, Jacques Pirenne, Laurens J Ceulemans
Failure to close the abdomen after intestinal or multivisceral transplantation (Tx) remains a frequently occurring problem. Two attractive reconstruction methods, especially in large abdominal wall defects, are full-thickness abdominal wall vascularized composite allograft (AW-VCA) and nonvascularized rectus fascia (NVRF) Tx. This review compares surgical technique, immunology, integration, clinical experience, and indications of both techniques. In AW-VCA Tx, vascular anastomosis is required and the graft undergoes hypotrophy post-Tx...
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38719376/indications-for-multivisceral-transplantation-a-systematic-review
#8
REVIEW
Pierpaolo Di Cocco, Alessandro Martinino, Amy Lian, Jess Johnson, Mario Spaggiari, Ivo Tzvetanov, Enrico Benedetti
Consensus remains elusive in the definition and indications of multivisceral transplantation (MVT) within the transplant community. MVT encompasses transplantation of all organs reliant on the celiac artery axis and the superior mesenteric artery in different combinations. Some institutions classify MVT as involving the grafting of the stomach or ascending colon in addition to the jejunoileal complex. MVT indications span a wide spectrum of conditions, including tumors, intestinal dysmotility disorders, and trauma...
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38719375/indications-for-intestinal-transplantation
#9
REVIEW
Kishore R Iyer
Outcomes for patients with chronic intestinal failure have improved with organization of experts into multidisciplinary teams delivering care in intestinal rehabilitation programs. There have been improvements in understanding of intestinal failure complications as well as development of newer therapies that have amplified the improvements in survival. In spite of this encouraging trend, patients who fail PN are often referred too late for intestinal transplantation. The author proposes a more rational framework that might allow earlier identification of intestinal failure patients at risk for PN-failure, who could appropriately be considered earlier for intestinal transplantation with improvements in overall outcomes...
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38719374/normothermic-preservation-of-the-intestinal-allograft
#10
REVIEW
Joseph M Ladowski, Debra L Sudan
Intestinal allotransplantation was first described in the 1960s and successfully performed in the 1980s. Since that time, less progress has been made in the preservation of the allograft before transplantation and static cold storage remains the current standard. Normothermic machine perfusion represents an opportunity to simultaneously preserve, assess, and recondition the organ for transplantation and improve the procurement radius for allografts. The substantial progress made in the field during the last 60 years, coupled with the success of the preclinical animal model of machine perfusion-preserved intestinal transplantation, suggest we are approaching the point of clinical application...
June 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280754/gastrointestinal-tract-liver-and-pancreatic-biliary-precursor-lesions
#11
EDITORIAL
Robert D Odze
No abstract text is available yet for this article.
March 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280753/singing-with-or-about-gastrointestinal-cancers
#12
EDITORIAL
Alan L Buchman
No abstract text is available yet for this article.
March 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280752/dysplasia-and-early-carcinoma-of-the-gallbladder-and-bile-ducts-terminology-classification-and-significance
#13
REVIEW
N Volkan Adsay, Olca Basturk
Most precursor lesions and early cancerous changes in the gallbladder and bile ducts present as clinically/grossly inapparent lesions. Low-grade dysplasia is difficult to define and clinically inconsequential by itself; however, extra sampling is required to exclude accompanying significant lesions. For high-grade dysplasia ('carcinoma in situ'), a complete sampling is necessary to rule out invasion. Tumoral intramucosal neoplasms (ie, intracholecystic and intraductal neoplasia) form radiologically/grossly visible masses, and they account for (present in the background of) about 5% to 10% of invasive cancers of the region...
March 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280751/early-cancerous-lesions-of-the-pancreas-and-ampulla-current-concepts-and-challenges
#14
REVIEW
Olca Basturk, N Volkan Adsay
Owing to the increased use of advanced imaging techniques, mass-forming (cystic/intraductal) preinvasive neoplasms are being detected much more frequently and they have rapidly become one of the main focuses of interests in medical field. These neoplasms have very distinctive clinical and radiographic findings, exhibit a spectrum of dysplastic transformation, from low-grade dysplasia to high-grade dysplasia, and may be associated with an invasive carcinoma. Accounting for about 5% to 10% of pancreatic ductal adenocarcinomas, they provide a curable target subset in an otherwise biologically dismal pancreas cancer category...
March 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280750/pathology-and-clinical-relevance-of-gastric-epithelial-dysplasia
#15
REVIEW
Tetsuo Ushiku, Gregory Y Lauwers
Gastric dysplasia is defined as an unequivocally neoplastic epithelium. Dysplastic lesions are characterized by cellular atypia reflective of abnormal differentiation and disorganized glandular architecture. The last few years have been marked by a refinement of the prognosis and risk of progression of gastric dysplasia and the recognition of novel morphologic patterns of dysplasia. Determination of the correct diagnosis and grade of dysplasia are critical steps since it will be predicting the risk of malignant transformation and help tailor appropriate surveillance strategy...
March 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280749/squamous-neoplastic-precursor-lesions-of-the-esophagus
#16
REVIEW
Tomio Arai, Satoshi Ono, Kaiyo Takubo
Clinicopathological and molecular studies have demonstrated that dysplasia is a precancerous and/or neoplastic lesion with malignant potential. Further, it is subclassified into two grades: high-grade and low-grade dysplasia. High-grade dysplasia is a clinically significant lesion requiring resection or ablation. Low-grade dysplasia has a much lower risk of carcinoma; thus, it should be followed by endoscopic surveillance. Because squamous dysplasia may progress to squamous cell carcinoma, periodic endoscopy is useful to detect the lesion in patients with risk factors...
March 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280748/anal-and-perianal-preneoplastic-lesions
#17
REVIEW
Maurice B Loughrey, Neil A Shepherd
Anal cancer, mainly squamous cell carcinoma, is rare but increasing in prevalence, as is its precursor lesion, anal squamous dysplasia. They are both strongly associated with human papillomavirus infection. The 2-tiered Lower Anogenital Squamous Terminology classification, low-grade SIL and high-grade SIL, is preferred to the 3-tiered anal intraepithelial neoplasia classification because of better interobserver agreement and clearer management implications. Immunohistochemistry with p16 is helpful to corroborate the diagnosis of squamous dysplasia...
March 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280747/pathology-of-gastrointestinal-polyposis-disorders
#18
REVIEW
Christophe Rosty, Lodewijk A A Brosens
Gastrointestinal polyposis disorders are a group of syndromes defined by clinicopathologic features that include the predominant histologic type of colorectal polyp and specific inherited gene mutations. Adenomatous polyposis syndromes comprise the prototypical familial adenomatous polyposis syndrome and other recently identified genetic conditions inherited in a dominant or recessive manner. Serrated polyposis syndrome is defined by arbitrary clinical criteria. The diagnosis of hamartomatous polyposis syndromes can be suggested from the histologic characteristics of colorectal polyps and the association with various extraintestinal manifestations...
March 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280746/sporadic-polyps-of-the-colorectum
#19
REVIEW
Ian Brown, Mark Bettington
Colorectal polyps are common, and their diagnosis and classification represent a major component of gastrointestinal pathology practice. The majority of colorectal polyps represent precursors of either the chromosomal instability or serrated neoplasia pathways to colorectal carcinoma. Accurate reporting of these polyps has major implications for surveillance and thus for cancer prevention. In this review, we discuss the key histologic features of the major colorectal polyps with a particular emphasis on diagnostic pitfalls and areas of contention...
March 2024: Gastroenterology Clinics of North America
https://read.qxmd.com/read/38280745/pathology-and-clinical-significance-of-inflammatory-bowel-disease-associated-colorectal-dysplastic-lesions
#20
REVIEW
Noam Harpaz, Steven H Itzkowitz
Timely diagnosis and effective management of colorectal dysplasia play a vital role in preventing mortality from colorectal cancer in patients with chronic inflammatory bowel disease. This review provides a contemporary overview of the pathologic and endoscopic classification of dysplasia in inflammatory bowel disease, their roles in determining surveillance and management algorithms, and emerging diagnostic and therapeutic approaches that might further enhance patient management.
March 2024: Gastroenterology Clinics of North America
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