Early diagnostic endoscopy and prophylactic stenting after robotic transthoracic esophagectomy - From scepticism to standardization.

Dehiscence following esophagectomy for cancer has a mortality rate of 10-40%, prolongs hospital stay, and reduces survival. To prevent it, proper patient selection and surgical techniques that minimize tension and ischemia are essential. Procedures such as ERAS protocols and the use of indocyanine green have improved the detection of well-vascularized areas, but the leak rate still exceeds 10%.

Prospective multicenter study to identify optimal target population for motorized spiral enteroscopy.

Motorized spiral enteroscopy (MSE) enhances small bowel exploration, but the optimal target population for this technique is unknown. We aimed to identify the target population for MSE by evaluating its efficacy and safety, as well as detecting predictors of efficacy. A prospective multicenter observational study was conducted at 9 tertiary hospitals in Spain, enrolling patients between June 2020-2022.

A comprehensive examination of small-bowel capsule endoscopy in Spanish centers to meet European Society of Gastrointestinal Endoscopy standards.

In 2019, the European Society of Gastrointestinal Endoscopy (ESGE) created a working group to develop technical and quality standards for small-bowel capsule endoscopy (SBCE) to improve the daily practice of endoscopy services. They developed 10 quality parameters, which have yet to be tested in a real-life setting. Our study aimed to evaluate the accomplishment of the quality standards in SBCE established by the ESGE in several Spanish centers.

Endoscopic management of intraluminal gastric band erosion using a laser lithotripsy probe.

Intraluminal erosion of adjustable and non adjustable gastric bands generally occurs years after placement. Different endoscopic techniques have been described for the management of bands that erode the gastric wall, using endoscopic scissors, rigid endoscopic guides wire coupled to a mechanical lithotripter or even less frequently used devices such as the Gastric Band Cutter System to cut it. We present a clinical case in which we used a lithotripsy laser probe to break the band with great effectiveness without complications.

Gut Microbiome Modification through Dietary Intervention in Patients with Colorectal Cancer: Protocol for a Prospective, Interventional, Controlled, Randomized Clinical Trial in Patients with Scheduled Surgical Intervention for CRC.

Colorectal cancer (CRC) is the third most common cancer and the second cause of cancer death worldwide. Several factors have been postulated to be involved in CRC pathophysiology, including heritable and environmental factors, which are the latest to be closely associated with nutritional habits, physical activity, obesity, and the gut microbiota. The latter may also play a key role in CRC prognosis and derived complications in patients undergoing surgery.

Dietary modulation of gut microbiota in patients with colorectal cancer undergoing surgery: A review.

Colorectal cancer (CRC) is the third most frequent malignancy and the second cause of cancer death worldwide. Several factors have been postulated to be involved in CRC pathophysiology, including physical inactivity, unhealthy dietary habits, obesity, and the gut microbiota. Emerging data suggest that the microbiome may play a key role in CRC prognosis and derived complications in patients undergoing colorectal surgery.

Extramedullary plasmacytoma with colonic involvement: experience in a tertiary hospital.

A 71-year-old woman diagnosed with type II diabetes mellitus with severe iron deficiency anemia and positive fecal occult blood. Colonoscopy was performed, showing a soft mass in the ascending colon, with biopsies compatible with plasmacytoma and restriction for Kappa light chains. After bone marrow aspiration, associated IgG multiple myeloma was detected, so chemotherapy with VMP (bortezomib, melphalan and prednisone) was started.

A New Comorbidity in Periodontitis: and Colorectal Cancer.

There is very recent and strong evidence relating to colorectal cancer. In this narrative review, we update the knowledge about gingival dysbiosis and the characteristics of as one of the main bacteria related to periodontitis. We provide data on microbiome, epidemiology, risk factors, prognosis, and treatment of colorectal cancer, one of the most frequent tumours diagnosed and whose incidence increases every year.

Oral ingestion versus endoscopic delivery of endoscopic capsule in patients with previous gastrointestinal surgery (ORENCES study): A Spanish multicentre observational study.

Background: Small Bowel Capsule Endoscopy is the first-choice technique for investigating the majority of small bowel diseases. Its most common complications are related to incomplete examinations and capsule retention. There is no consensus on how patients with previous gastrointestinal surgery should receive the capsule.

Leukocytoclastic vasculitis with cutaneous and systemic (intestinal) involvement. Diagnosis by capsule endoscopy.

A 26-year-old male diagnosed with cutaneous leukocytoclastic vasculitis was admitted due to abdominal pain and rectal bleeding with slight clinical-analytical impact. On examination, he presented multiple palpable purpuric lesions on his legs.

The role of endoscopy in caustic ingestion in the pediatric population: experience in a tertiary center.

Introduction: caustic ingestion in children is rare but has potentially serious consequences.

Aim: to analyze the clinical and endoscopic features and the type of caustic ingested in our population.

Methods: the upper endoscopies performed in this setting, as well as the characteristics of patients and caustics, were analyzed from 2010 to 2018.

Endoscopic treatment of postoperative esophagogastric leaks with fully covered self-expanding metal stents.

Background: the management of postoperative esophageal leaks is a huge therapeutic challenge. Thanks to the advances in endoscopy, treatment with esophageal stents has been proposed as a valid option.

Aims: the main objective of the study was to evaluate the effectiveness and safety of the use of fully covered esophageal metal stents in the treatment of postoperative esophageal leaks.

Small Bowel Enteroscopy - A Joint Clinical Guideline from the Spanish and Portuguese Small Bowel Study Groups.

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication and on its diagnostic and therapeutic yields. A set of recommendations were issued accordingly.

Perforation of the small bowel secondary to capsule endoscopy retention.

A 71-year-old female with liver cirrhosis underwent a capsule endoscopy (CE) due to middle gastrointestinal bleeding. A neoplastic stenotic lesion showing stigmata of a recent hemorrhage was observed in jejunum and the capsule was retained.

Factors associated with the presence of abnormal levels of fecal calprotectin in patients with negative panenteric studies.

Background: fecal calprotectin is a selection tool prior to endoscopic studies in patients with gastrointestinal symptoms. However, some symptomatic patients with altered fecal calprotectin will not have any endoscopic lesions. The aim of the study was to determine the factors associated with the presence of altered fecal calprotectin in patients with negative endoscopic studies of the colon and small bowel.

Small bowel enteroscopy - A joint clinical guideline by the Spanish and Portuguese small-bowel study groups.

The present evidence-based guidelines are focused on the use of device-assisted enteroscopy in the management of small-bowel diseases. A panel of experts selected by the Spanish and Portuguese small-bowel study groups reviewed the available evidence focusing on the main indications of this technique, its role in the management algorithm of each indication, and its diagnostic and therapeutic yield. A set of recommendations was issued accordingly.

Endoscopic retrograde cholangiopancreatography in the management of biliary complications after orthotopic liver transplantation.

Background: biliary complications are frequent after orthotopic liver transplantation and the management of these complications with endoscopic retrograde cholangiopancreatography (ERCP) is available. The aims of the study were to analyze the experience in the endoscopic management of biliary complications after liver transplantation in a third level center. Furthermore, the factors associated with higher rates of technical and clinical success were determined.

Influence of demographic and clinical features of the patient on transit times and impact the on the diagnostic yield of capsule endoscopy.

Background: transit times in the gastric cavity and the small bowel can be easily calculated using capsule endoscopy software. The factors that can influence these times and impact on diagnostic yield have not been completely assessed.

Aims: to analyze the influence of demographic and clinical features on transit times and the impact on diagnostic yield.

Use of biomarkers in inflammatory bowel disease.

There are many useful biomarkers for initial diagnosis and the management of inflammatory bowel disease. Serologic biomarkers have been traditionally used because they are widely disposable, but recently faecal biomarkers, especially faecal calprotectin, have acquired great importance as they have shown to be more precise when establishing suspicion of the disease and also as predictors of mucosal healing or persistence of inflammatory activity. Faecal calprotectin is a good tool for predicting abnormal endoscopic studies, but has limited specificity because its levels can be altered in many digestive diseases presenting with similar symptoms.

Development and validation of a scoring index to predict the presence of lesions in capsule endoscopy in patients with suspected Crohn's disease of the small bowel: a Spanish multicenter study.

Background: Capsule endoscopy (CE) is the first-line investigation in cases of suspected Crohn's disease (CD) of the small bowel, but the factors associated with a higher diagnostic yield remain unclear.

Objective: Our aim is to develop and validate a scoring index to assess the risk of the patients in this setting on the basis of biomarkers.

Patients And Methods: Data on fecal calprotectin, C-reactive protein, and other biomarkers from a population of 124 patients with suspected CD of the small bowel studied by CE and included in a PhD study were used to build a scoring index.

Role of capsule endoscopy in alarm features and non-responsive celiac disease: A European multicenter study.

Background And Aim: The role of capsule endoscopy (CE) in established celiac disease (CD) remains unclear. Our objective was to analyze the usefulness of CE in the suspicion of complicated CD.

Methods: This was a retrospective multicenter study.

Diagnostic and therapeutic features of small bowel involvement in portal hypertension.

Enteropathy is a lesser known complication of portal hypertension and consists of different changes in the mucosal layer of the small bowel which lead to the appearance of vascular and inflammatory lesions. It can be an important co-factor in the development of anemia in the cirrhotic population, and nowadays an easy and non-invasive diagnosis can be made thanks to capsule endoscopy. However, it is rarely considered in the management of patients with portal hypertension.

Symptomatic retention of the Agile® patency capsule.

The Agile® capsule has shown to be useful when evaluating the patency of the small bowel in patients prior to capsule endoscopy studies. It is a safe tool and a low rate of complications have been reported, highlighting symptomatic retention, although references in literature are scarce and it is only observed in 1.2% of the procedures.