Publications by authors named "Mohammad A Al-Haddad"

Article Synopsis
  • This study compares the effectiveness and safety of two treatments for Zenker's diverticulum: flexible endoscopic needle-knife septotomy (FENKS) and peroral endoscopic myotomy (Z-POEM).
  • A total of 60 patients underwent these procedures, and while both had a high technical success rate, FENKS resulted in more complications and hospitalizations compared to Z-POEM.
  • Overall, Z-POEM showed to be a safer option with similar clinical success in the short and mid-term follow-ups.
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Article Synopsis
  • This study aimed to evaluate the effectiveness and safety of two procedures—peroral endoscopic myotomy with septotomy (POEM+S) and without septotomy (POEM-S)—in treating symptomatic epiphrenic diverticula (ED) alongside motility disorders.
  • Conducted across 21 international centers from 2014 to 2023, the study included 85 patients, measuring clinical success primarily through the Eckardt score.
  • Results indicated that both procedures had similar clinical success rates (83% for POEM+S vs. 86.8% for POEM-S), technical success, and adverse event rates, but POEM-S patients had a longer hospital stay.
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Introduction: Acute necrotizing pancreatitis (ANP) complicates 15 % of acute pancreatitis cases and is associated with prolonged length of stay (LOS). There are limited studies exploring potential predictors.

Methods: We carried out a retrospective study of all consecutive patients presenting to a large referral healthcare system with ANP.

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Objectives: Endoscopic ultrasound (EUS)-guided injection of cyanoacrylate (CYA) for primary prophylaxis (PP) of gastric varices (GV) is controversial. This study evaluates the safety and efficacy of this intervention.

Methods: Patients treated for PP of GV bleeding by EUS injection of CYA with or without coils were identified.

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Article Synopsis
  • This study examines the most effective resection techniques for early gastric cancer (EGC) in patients who have previously undergone resection, comparing endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) against traditional surgery.
  • The analysis included 10 observational studies, showing that ESD had a significantly higher rate of complete resection compared to EMR, while there were no notable differences in outcomes between ESD and surgery.
  • The findings suggest that ESD or surgery is generally preferred over EMR for metachronous EGC due to EMR's higher risk of incomplete resection, with treatment choice depending on local expertise and patient preferences
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Background/objectives: Pancreatic serous cystic neoplasms (SCN) present a diagnostic challenge given their increasing frequency of detection and benign nature yet relatively high rate of misdiagnosis. Here, imaging and analyses associated with EUS-guided fine-needle aspiration (EUS-FNA) are evaluated for their ability to provide a correct preoperative diagnosis of SCN.

Methods: A surgical cohort with confirmed pathological diagnosis of SCN (n = 62) and a surveillance cohort with likely SCN (n = 31) were assessed for imaging (CT/MRI/EUS) and EUS-FNA-based analyses (cytology/DNA analysis for Von Hippel-Lindau [VHL] gene alterations/biomarkers).

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This clinical practice guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based summary and recommendations regarding the role of endoscopic submucosal dissection (ESD) in the management of early esophageal and gastric cancers. It is accompanied by the document subtitled "Methodology and Review of Evidence," which provides a detailed account of the methodology used for the evidence review. This guideline was developed using the Grading of Recommendations, Assessment, Development and Evaluation framework and specifically addresses the role of ESD versus EMR and/or surgery, where applicable, for the management of early esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), and gastric adenocarcinoma (GAC) and their corresponding precursor lesions.

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This document from the American Society for Gastrointestinal Endoscopy (ASGE) provides a full description of the methodology used in the review of the evidence used to inform the final guidance outlined in the accompanying Summary and Recommendations document regarding the role of endoscopic submucosal dissection (ESD) in the management of early esophageal and gastric cancers. This guideline used the Grading of Recommendations, Assessment, Development and Evaluation framework and specifically addresses the role of ESD versus EMR and/or surgery, where applicable, for the management of early esophageal squamous cell carcinoma (ESCC), esophageal adenocarcinoma (EAC), and gastric adenocarcinoma (GAC) and their corresponding precursor lesions. For ESCC, the ASGE suggests ESD over EMR for patients with early-stage, well-differentiated, nonulcerated cancer >15 mm, whereas in patients with similar lesions ≤15 mm, the ASGE suggests either ESD or EMR.

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Background And Aims: The use of EUS for peristomal varices (PV) is limited to case reports.

Methods: Patients who underwent EUS-guided treatment of PV with cyanoacrylate (CYA) and/or coils between April 2013 and December 2019 were identified. All patients had failed previous therapies or had comorbidities precluding other options.

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Background And Aims: Gastric neurostimulation (GNS) and gastric peroral myotomy (G-POEM), therapies for refractory gastroparesis, are associated with suboptimal outcomes. We studied the role of G-POEM as a salvage therapy in patients with refractory symptoms after GNS implantation.

Methods: This was a multicenter, retrospective, matched case-control study.

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Background And Aims: EUS-directed transgastric ERCP (EDGE) is an established method for managing pancreaticobiliary pathology in Roux-en-Y gastric bypass patients, with high rates of technical success and low rates of serious adverse events (AEs). However, widespread adoption of the technique has been limited because of concerns about the development of persistent gastrogastric or jejunogastric fistulas. Gastrogastric and jejunogastric fistulas have been reported in up to 20% of cases in some series, but predictive risk factors and long-term management and outcomes are lacking.

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There are limited data on the safety of same-day discharge (SDD) after peroral endoscopic myotomy (POEM). The aim of our study is to assess the frequency and relationship to POEM for emergency department (ED) visits and hospitalizations after SDD in these patients. We retrospectively identified consecutive patients between November 2019 and August 2021 who underwent POEM with SDD and at least 6 months follow-up.

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Background And Aims: Placement of a lumen-apposing metal stent (LAMS) between the gastric pouch and the excluded stomach allows for EUS-guided transgastric interventions (EDGIs) in patients with Roux-en-Y gastric bypass (RYGB). Although EUS-guided transgastric ERCP (EDGE) outcomes have been reported, data are scant on other endoscopic interventions. We aimed to evaluate the outcomes and safety of EDGIs.

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Article Synopsis
  • The study evaluates a high-fidelity simulated live animal model (HiFi SAM) for teaching therapeutic endoscopic ultrasound (TEUS) to improve training for endoscopists.
  • Twenty-seven trainees completed a comprehensive 3-day program, performing 616 TEUS procedures under expert guidance, with a high success rate and positive feedback on the training quality.
  • Trainees expressed a desire for more specific skills practice and reported improvements in their procedural capabilities after training with HiFi SAM, indicating its effectiveness in skill development.
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Introduction: There are limited data correlating symptoms with reflux episodes during pH studies after peroral endoscopic myotomy.

Methods: Consecutive patients who underwent POEM followed up ≥6 months later by 48-hour ambulatory wireless pH testing off antisecretory therapy were identified. Reflux symptom association was defined as symptom association probability >95%.

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Informed consent is the cornerstone of the ethical practice of procedures and treatments in medicine. The purpose of this document from the American Society for Gastrointestinal Endoscopy (ASGE) Standards of Practice Committee is to provide an update on best practice of the informed consent process and other issues around informed consent and shared decision-making for endoscopic procedures. The principles of informed consent are based on longstanding legal doctrine.

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Background: Endoscopic ultrasound (EUS)-guided drainage of pancreatic fluid collections (PFCs) by cautery-enhanced lumen-apposing metal stents (LAMS) has largely been limited to collections located < 10 mm from the luminal wall. We present outcomes of the use of a novel 15-mm-long cautery-enhanced LAMS for drainage of PFCs located ≥ 10 mm away.

Methods: This international, multicenter study analyzed all adults with PFCs located ≥ 10 mm from the luminal wall who were treated by EUS-guided drainage using the 15-mm-long cautery-enhanced LAMS.

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 The aim of this study was to evaluate whether timed barium esophagram within 24 hours post-per-oral endoscopic myotomy (POEM) (TBE-PP) could predict clinical outcomes.  This was a single-center retrospective study of prospectively collected data on consecutive patients with ≥ 6-month follow-up who underwent POEM followed by TBE-PP. Esophageal contrast retention 2 minutes after TBE-PP was assessed as Grade 1 (< 10 %), 2 (10 %-49 %), 3 (50 %-89 %) or 4 (> 90 %).

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Objectives: Select patients with anatomically favorable walled off pancreatic necrosis may be treated by endoscopic (Endo-TGD) or operative (OR-TGD) transgastric debridement (TGD). We compared our experience with these 2 approaches.

Summary Background Data: Select necrotizing pancreatitis (NP) patients are suitable for TGD which may be accomplished endoscopically or surgically.

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Background: Pancreatic cysts are incidentally detected in up to 13% of patients undergoing radiographic imaging. Of the most frequently encountered types, mucin-producing (mucinous) pancreatic cystic lesions may develop into pancreatic cancer, while nonmucinous ones have little or no malignant potential. Accurate preoperative diagnosis is critical for optimal management, but has been difficult to achieve, resulting in unnecessary major surgery.

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Article Synopsis
  • Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is being tested for its effectiveness against traditional fine-needle aspiration (EUS-FNA) in sampling solid lesions.
  • The study compared outcomes from 180 patients undergoing EUS-FNB with a new Franseen-tip needle to 183 patients undergoing EUS-FNA, finding that FNB procedures took less time (37.4 minutes vs 44.9 minutes) and required fewer needle passes (2.9 vs 3.8).
  • Results showed a higher diagnostic yield for the FNB group (98.3% vs 90.2%) without significant differences in adverse events, suggesting EUS-FNB may be a safer and more efficient
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