Publications by authors named "George Tribonias"

Resected rectal polyps with deep invasion into the submucosa (pT1b-sm2,3) or the muscle layer (pT2) are currently confronted with surgery due to non-curative resection. We evaluated the efficacy, safety, and locoregional control of adjuvant radiotherapy (RT) and/or chemotherapy (CT) following endoscopic KAR (knife-assisted resection) in patients with invasive early rectal cancers who are unwilling or unsuitable for additional surgical resection. Fifty-one patients with early rectal cancers, pT1b or pT2, underwent post-resection adjuvant RT and/or CT in 15 centers worldwide.

View Article and Find Full Text PDF

Background: Immune checkpoint inhibitors have demonstrated efficacy against various cancers; however, there is a rising incidence of immune-related colitis. Some cases of immune-related colitis prove resistant to treatment, even with the administration of glucocorticoids or infliximab, and there is currently no established standard treatment for such cases.

Case: The patient, a 73-year-old male, had undergone combination therapy for malignant pleural mesothelioma for 2 years, utilizing both ipilimumab (a CTLA-4 inhibitor) and nivolumab (a PD-1 inhibitor).

View Article and Find Full Text PDF

Objectives: Data of long-term follow up for large non pedunculated colorectal polyps (LNPCPs) ≥4 cm removed with piecemeal wide field endoscopic mucosal resection (PWF-EMR) are limited. We primarily evaluated the recurrence rates and secondarily the rates of post colonoscopic polypectomy colorectal cancer (PCPCRC) on a long-term basis.

Methods: We retrospectively reviewed a prospectively-stored electronic database of all patients who underwent PWF-EMR for LNPCPs at the Venizeleion General Hospital, between 2009 and 2020.

View Article and Find Full Text PDF

We aimed to determine the diagnostic yield and outcome of patients receiving antithrombotic drug therapy subjected to small bowel capsule endoscopy (SBCE) for the investigation of small bowel bleeding (SBB). A multicenter retrospective analysis of collected data from all patients undergoing SBCE for the investigation of SBB from March 2003 to June 2023 was performed. The diagnostic yield of SBCE was defined as the detection of positive findings that could explain the cause of the patient's bleeding.

View Article and Find Full Text PDF
Article Synopsis
  • Ustekinumab is a monoclonal antibody effective in treating moderate to severe ulcerative colitis (UC), with its clinical efficacy established in the UNIFI phase III trial, but real-world data were lacking.
  • This observational study analyzed 30 UC patients who received ustekinumab from April 2020 to April 2022, focusing on various outcomes such as disease activity scores and remission rates.
  • Results showed an 8-week clinical response rate of 73%, 70% remission induction, and long-term remission maintenance rates of 67% at 44 weeks and 63% at 152 weeks, demonstrating ustekinumab's effectiveness in a real-world setting.
View Article and Find Full Text PDF

Undifferentiated early gastric cancer (UD-EGC) represents an extended indication for endoscopic submucosal dissection (ESD) based on the existing guidelines. This study evaluated the prevalence of UD-EGC recurrence after ESD, and potentially implicated risk factors. Data from 17 centers were collected retrospectively including demographics, endoscopic and pathological findings, and follow-up data from UD-EGC cases treated by ESD.

View Article and Find Full Text PDF

Background And Aim: Serum leucine-rich alpha-2 glycoprotein level has been reported to be a useful biomarker in assessing mucosal healing in patients undergoing biotherapy, where mucosal lesions caused by ulcerative colitis are difficult to assess endoscopically. However, no such reports have been reported in biotherapy-naïve cases.

Methods: Sixty-eight patients with ulcerative colitis (UC) who were biotherapy-naïve at Kindai University Hospital between October 2021 and October 2022 were enrolled.

View Article and Find Full Text PDF

Background: The standard therapy for acute severe ulcerative colitis (ASUC) is intravenous corticosteroids; however, 30% of ulcerative colitis (UC) patients do not recover with corticosteroids alone. Few studies have reported the efficacy and safety of tofacitinib for ASUC with steroid resistance. We report a case series of successful first-line treatment consisting of tofacitinib (20 mg/day) administered to ASUC patients with steroid resistance.

View Article and Find Full Text PDF
Article Synopsis
  • A study was conducted to evaluate how different types of colonoscopes affect the training and quality of colonoscopy procedures, focusing on factors like technical competence and patient comfort.
  • The research involved 126 patients divided into three groups based on the type of colonoscope used: adult colonoscope (AC), intermediate pediatric colonoscope (IPC), and long pediatric colonoscope (LPC), measuring outcomes such as examination completeness and patient tolerance.
  • Results indicated that the LPC was the most effective in training, achieving higher terminal ileal intubation rates and causing less discomfort, making it the recommended choice for starting colonoscopy training.*
View Article and Find Full Text PDF

Background: Four EMA-approved vaccines against SARS-CoV-2 are currently available. Data regarding antibody responses to initial vaccination regimens in patients with inflammatory bowel diseases (IBD) are limited.

Methods: We conducted a prospective, controlled, multicenter study in tertiary Greek IBD centers.

View Article and Find Full Text PDF
Article Synopsis
  • Hyperplastic polyps are common findings during colonoscopy and generally have a low risk of cancer, but guidelines suggest that most polyps should be removed, with exceptions for certain small ones.
  • A unique case involved the discovery of a duodenal-type follicular lymphoma in a 5 mm polyp that looked hyperplastic, which later spread to the stomach and duodenum after four months.
  • The case highlights the need for caution in optical diagnosis and the use of a "resect and discard" strategy, as this situation has not been previously documented in medical literature.
View Article and Find Full Text PDF

Background: Misdiagnosed sessile serrated lesions (SSLs) are important precursors for interval colorectal cancers.

Aims: We investigated the usage of acetic acid (AA) solution for improving the detection of SSLs in the right colon in a randomized controlled trial.

Methods: A tandem observation of the right colon was performed in 412 consecutive patients.

View Article and Find Full Text PDF

 We describe a case of perforation after colonic endoscopic mucosal resection (EMR) that was treated conservatively. We would like to highlight the importance of decision-making mainly based on the endoscopist's point of view in combination with the surgical consultation. Although the radiological imaging is always needed, it cannot solely lead to a decision for operation.

View Article and Find Full Text PDF

Objective: The Japan NBI Expert Team (JNET) proposed a new narrow band imaging (NBI) classification system for colorectal tumors in June 2014. In this classification system, types 1, 2A, 2B, and 3 correspond to hyperplastic polyps (HPs) including sessile serrated polyps (SSPs), low-grade dysplasia (LGD), high-grade dysplasia (HGD) to shallow submucosal invasive (SM-s) carcinomas, and deep submucosal invasive (SM-d) carcinomas, respectively.

Methods: To validate this system, we performed a retrospective image evaluation study, in which 199 colorectal tumors previously assessed by NBI magnifying endoscopy were classified by 3 blinded experienced colonoscopists using the JNET system.

View Article and Find Full Text PDF

Aim: To compare the efficacy and safety of cold snare polypectomy (CSP) and hot forceps biopsy (HFB) for diminutive colorectal polyps.

Methods: This prospective, randomized single-center clinical trial included consecutive patients ≥ 20 years of age with diminutive colorectal polyps 3-5 mm from December 2014 to October 2015. The primary outcome measures were resection (endoscopic evaluation) and complete resection rates (pathological evaluation).

View Article and Find Full Text PDF

Background: Most colonoscopic complications are polypectomy-related and occur more frequently during the removal of numerous small polyps. Therefore, it is important to have the best polypectomy approach of small polyps. The aim of the present animal study was to investigate the effectiveness and safety of cold snare polypectomy (CSP) technique combined with light pull of the snare in order to peel the mucosal and upper submucosal layer, namely pull CSP (PCSP), for the removal of polyps sized up to 12 mm in porcine models.

View Article and Find Full Text PDF

Goals: We investigated the utility of liver function breath tests [C-Aminopyrine Breath Test (C-ABT), C-Galactose Breath Test (C-GBT)], for the diagnosis of nonalcoholic steatohepatitis (NASH) among nonalcoholic fatty liver disease (NAFLD) patients.

Background: Liver biopsy is currently the gold standard for the differentiation between simple fatty liver (NAFL) and NASH in NAFLD patients.

Materials And Methods: Thirty-six patients with histologically proven NAFLD (NAFL:16, NASH:20) underwent C-ABT and C-GBT.

View Article and Find Full Text PDF

Background-aim: The aim of this study is to identify the long term benefit of one year infliximab administration for the treatment of chronic refractory pouchitis following ileo-pouch anal anastomosis (IPAA) for ulcerative colitis (UC).

Methods: Seven patients with chronic refractory pouchitis diagnosed by clinical, endoscopic and histological criteria received infliximab 5 mg/kg at 0, 2, and 6 weeks and thereafter every 2 months for 1 year. Three patients had fistulae (1 pouch-bladder, 2 perianal) and 4 extraintestinal manifestations (2 erythema nodosum, 2 arthralgiae).

View Article and Find Full Text PDF