Publications by authors named "Spada C"

Introduction: Inflammatory bowel disease (IBD) patients have an increased risk of developing colorectal cancer. High-risk colorectal colitis-associated neoplasia (HR-CAN) can be difficult to treat using traditional endoscopic resection methods. Aim of the study is to evaluate the outcomes of endoscopic submucosal dissection (ESD) on IBD patients with HR-CANs.

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Background And Aims: Adenoma detection rate (ADR) serves as a primary quality metric in colonoscopy. Various computer-aided detection (CADe) tools have emerged, yielding diverse impacts on ADR across different demographic cohorts. This study aims to evaluate a new CADe system in patients undergoing colonoscopy.

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Pancreatic cysts are mostly incidental findings on computed tomography or magnetic resonance imaging scans, with few patients presenting with abdominal pain or other symptoms. The accurate diagnosis of cysts is important as management depends on the type (neoplastic or non-neoplastic). Cross-sectional imaging is fast being replaced with endoscopic ultrasound (EUS) and various techniques based on that such as EUS-guided fine needle aspiration, EUS-guided needle confocal laser endomicroscopy, EUS-through-the-needle biopsy, and contrast-enhanced EUS.

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Gut microbiota analysis, until a few years ago an exclusive research tool, has recently begun to spread among doctors and nutritionists around the world as a means aimed at better understanding patient disorders. As often happens, the commercial push has literally exploded and today there are numerous companies that offer microbiota analysis of dubious quality and/or as a business appliance aimed at selling supplements and the like. For non-experts it can therefore be difficult to find one's way among the numerous proposals.

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Background: Esophageal perforation or postoperative leak after esophageal surgery remain a life-threatening condition. The optimal management strategy is still unclear.

Aim: To determine clinical outcomes and complications of our 15-year experience in the multidisciplinary management of esophageal perforations and anastomotic leaks.

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Fall from a height trauma is characterized by a multiplicity of injuries, related to multiple factors. The height of the fall is the factor that most influences the kinetic energy of the body and appears to be one of the factors that most affects the extent of injury. The purpose of this work is to evaluate, through machine learning algorithms, whether the autopsy injury pattern can be useful in estimating fall height.

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Article Synopsis
  • - Portal hypertension (PH) is a serious complication in liver disease, and endoscopic ultrasound (EUS) is being highlighted as an effective diagnostic tool for its assessment due to its high-resolution imaging capabilities
  • - The review found that EUS not only improves PH evaluation but also includes advanced methods like contrast enhancement and shear-wave elastography to assess liver stiffness, making it less invasive compared to traditional techniques
  • - Despite its advantages, EUS has limitations such as procedural invasiveness and variability in results, necessitating further research and standardization to enhance its clinical application in managing PH
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Background & Aims: A significant number of post fecal immunochemical test (FIT) colonoscopies in European-organized colorectal cancer (CRC) screening programs are performed beyond the recommended 31-day threshold due to overburdened colonoscopy services. We aimed to develop a simple predictive model to stratify CRC risk of FIT+ patients.

Methods: In a cohort of screenees undergoing colonoscopy following a positive (≥20 μg hemoglobin/g feces) OC-sensor FIT result between 2004 and 2019, we derived and validated logistic regression-based models including variables independently associated with CRC and advanced neoplasms.

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Background: Bowel preparation represents a significant issue to high-quality colonoscopy. Oral mannitol requires a single dose, is of low volume, and has a pleasant taste and rapid action.

Aims: This SATISFACTION study compared single-dose (same day) oral mannitol 100 g/750 mL with standard split-dose PEG-ASC2 L (MoviPrep®).

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Article Synopsis
  • This study examines the use of endoluminal vacuum therapy for managing anastomotic dehiscences after colorectal surgery, focusing on its effectiveness and feasibility.* -
  • Fourteen patients were treated, with a notable 57.1% achieving complete resolution of their defects; those with acute dehiscences showed an even higher success rate of 80%.* -
  • The treatment was found to be safe, with a low complication rate of only 7%, indicating that endoluminal vacuum therapy is a promising option for addressing large acute colorectal anastomotic issues.*
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  • Bariatric surgery is effective but not suitable for all patients, especially those with conditions like an "impenetrable abdomen," which complicates surgical access.
  • A case study highlights a 56-year-old woman with obesity and an abdominal complication who successfully underwent endoscopic sleeve gastroplasty (ESG), showing no complications during or after the procedure.
  • Six months post-surgery, she experienced a significant weight loss (reduction in BMI from 47.1 to 34.9 kg/m) and was able to stop using her CPAP machine for sleep apnea, indicating improved health outcomes.
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Introduction: A proper sample size calculation enables to conduct adequately powered randomized controlled trials (RCTs) and to provide a valid assessment of a specific clinical question.

Areas Covered: In the current manuscript, we tried to provide the reader with an easy guide on the principles of sample size calculation in RCTs, tailored specifically to the context of gastroenterology and hepatology. The basics of sample size calculation were commented with a description of some of the main methods, including the calculation of the non-inferiority margin for non-inferiority RCTs and the calculation of the minimum clinically important difference (MCID).

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Article Synopsis
  • EndoZip is a new robotic device designed for minimally invasive suturing to help with obesity treatment, particularly for gastric volume reduction.
  • A study involved 45 patients with a BMI of 30-40, showing significant weight loss and improvements in health markers after one year of using the device.
  • Results indicated that the procedure was successful for all participants, with most losing over 5% of their body weight and experiencing better quality of life; adverse events were rare.
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Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD, formerly nonalcoholic fatty liver disease - NAFLD) is a chronic liver condition linked to obesity and metabolic syndrome. It affects one-third of people globally and, in some cases, can lead to metabolic dysfunction-associated steatohepatitis (MASH, formerly nonalcoholic steatohepatitis, NASH) and fibrosis. Weight loss is crucial for the treatment of MASLD, but diet and lifestyle modifications often fail.

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Article Synopsis
  • Motorized spiral enteroscopy (MSE) is a new and advanced medical technique used to examine the intestines using special devices.
  • However, it was withdrawn from the market because of safety concerns, particularly related to injuries in the throat, even though it showed good results in helping doctors diagnose and treat problems.
  • A study in Italy aimed to test MSE's effectiveness and safety but had to stop early when the technique was removed from use; the study found that MSE could still be useful as a backup method if other techniques fail.
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Article Synopsis
  • - The study reveals that the implementation and monitoring of the European Society of Gastrointestinal Endoscopy (ESGE) performance measures for colonoscopy in clinical practice is lacking, with about 34% of healthcare providers able to retrieve all relevant performance measures.
  • - A nationwide survey conducted in Rome, Italy in March 2023 found that only 66.7% of participants could systematically report the cecal intubation rate and just 10.7% could report the adenoma detection rate.
  • - The results indicate a widespread deficiency in tracking colonoscopy performance measures due to inadequate reporting systems, highlighting the need for improvements to enhance the quality of endoscopy practices in Italy.
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Background: In Italy, the law n. 219/2017 regarding informed consent states that "Communication time between doctor and patient constitutes treatment time". Legal guardian is designated as a proxy to consent on the child's behalf.

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Fistulas in the upper gastrointestinal (GI) tract are complex conditions associated with elevated morbidity and mortality. They may arise as a result of inflammatory or malignant processes or following medical procedures, including endoscopic and surgical interventions. The management of upper GI is often challenging and requires a multidisciplinary approach.

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Background And Aims: Gastric restriction techniques have recently emerged as minimally invasive bariatric procedures. Endoscopic sutured gastroplasty (ESG) with the Endomina (Endo Tools Therapeutics, Gosselies, Belgium) triangulation platform proved to be safe and effective for the treatment of class I and II obesity in prospective studies. In this registry, we aimed to further assess on a larger scale the safety and efficacy of the procedure in routine practice with a dedicated device.

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With the alarmingly increasing prevalence of obesity in the Western world, it has become necessary to provide more acceptable treatment options for patients with obesity. Minimally invasive endoscopic techniques are continuously evolving. Currently, metabolic and bariatric endoscopies encompass several different techniques that can offer significant weight loss and improvement in comorbidities with a favorable safety profile.

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Background: Bowel preparation (BP) for colonoscopy induces significant changes in gut microbiota, causing dysbiosis that, in turn, elicits intestinal symptoms. Consequently, probiotics may counterbalance the disturbed microbiota after BP. So, probiotics may restore microbiota homeostasis.

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