Cost-effectiveness Analysis of Radiofrequency Ablation in Patients With Barrett Esophagus and High-grade Dysplasia or Low-grade Dysplasia.

Purpose: Clinical guidelines recommend radiofrequency ablation (RFA) for eradication of Barrett esophagus in patients with low-grade dysplasia (LGD) and high-grade dysplasia (HGD), but evidence on whether RFA provides good value for money is still sparse. This study evaluates the cost-effectiveness of RFA in Italy.

Methods: A Markov model was used to estimate lifelong costs and consequences of disease progression with different treatments.

Association of Polygenic Risk Score and Bacterial Toxins at Screening Colonoscopy with Colorectal Cancer Progression: A Multicenter Case-Control Study.

Colorectal cancer (CRC) is a leading cause of cancer death worldwide, and its incidence is correlated with infections, chronic inflammation, diet, and genetic factors. An emerging aspect is that microbial dysbiosis and chronic infections triggered by certain bacteria can be risk factors for tumor progression. Recent data suggest that certain bacterial toxins implicated in DNA attack or in proliferation, replication, and death can be risk factors for insurgence and progression of CRC.

Sporadic pedunculated duodenal adenomas. Clinical presentations and endoscopic management: a case series.

The prevalence of sporadic duodenal polyps is estimated to be 0.3%-4.6% in patients referred for an upper endoscopy.

Are clinical features able to predict Helicobacter pylori gastritis patterns? Evidence from tertiary centers.

Outcome of Helicobacter pylori infection is different according to gastritis extension (i.e. antrum-restricted gastritis or pangastritis).

Surgical treatment of esophageal carcinoma with curative intent: analysis of a single center experience.

Background: We retrospectively reviewed our series of 76 patients who underwent esophagectomy, with curative intent, for esophageal carcinoma over the last 10 years.

Method: The mean age was 60 years ranging between 46 to 76 years. Fifty-seven patients had a squamous cell carcinoma and 19 patients had an adenocarcinoma.

Complete endoscopic closure (clipping) of a large esophageal perforation after pneumatic dilation in a patient with achalasia.

The risk of esophageal perforation following endoscopic balloon dilation for achalasia is in the range of 1%-5%, with a mortality rate of 1%-20%. Perforations need to be recognized early, and, if reasonable, an immediate endoscopic repair should be pursued quickly. Herein, we report a case of successful endoscopic closure by clipping of a large iatrogenic perforation in a patient with achalasia.

A Western single-center experience with endoscopic submucosal dissection for early gastrointestinal cancers.

Endoscopic submucosal dissection (ESD) has gained worldwide acceptance as a treatment for early gastrointestinal cancers (EGICs). However, the management of these tumors in the Western world is still mainly surgical. Our aim was to evaluate the safety and feasibility of ESD at a European center.

Endoscopic sphincterotomy of the major duodenal papilla in acute relapsing pancreatitis associated with pancreas divisum: a case report.

We report a case of acute relapsing pancreatitis associated with pancreas divisum, who underwent major papilla sphincterotomy after failed minor papilla cannulation. Long-term results were satisfactory. The possible explanations of the efficacy of major papilla endoscopic resection in this particular case are discussed.

Nonsurgical treatment of staple line leaks after laparoscopic sleeve gastrectomy.

Background: Laparoscopic sleeve gastrectomy (LSG) is gaining popularity as a "per se" bariatric procedure due to its effectiveness on weight loss and comorbidity resolution. The most feared and life-threatening complication after LSG is the staple line leak and its management is still a debated issue. Aim of this paper is to analyze the incidence of leak and the treatment solutions adopted in a consecutive series of 200 LSG.

Complete mechanical cervical anastomosis using a narrow gastric tube after esophagectomy for cancer.

Objective: Fibrous stenosis of the esophagogastric cervical anastomosis remains a significant complication occurring in up to one-third of cases. Trying to reduce the incidence of this complication, we describe our technique of cervical esophagogastric anastomosis using endoscopic linear stapler which seems to reduce the incidence of fibrous stricture formation after resection of esophageal cancer.

Methods: Between March 2000 and June 2003, 26 patients (15 males and 11 females) underwent esophagectomy using tubulized stomach for reconstruction.

Laparoscopic treatment of gastric stromal tumors.

Background: The laparoscopic resection of gastric stromal tumors (GST) is being performed with increased frequency.

Methods: Between November 1993 and October 1998, nine consecutive patients with benign and low-grade gastric stromal tumors underwent laparoscopic resection using intraoperative endoscopy. For lesions located on the anterior wall (three cases), a direct approach was utilized.

[Acute biliary pancreatitis. Role of laparoscopy after 30 years of traditional surgery experience].

The authors herein show their own experience in the treatment of acute biliary pancreatitis. Aim of this study is to evaluate the effectiveness and the safety of the "early" laparoscopic approach to the mild to moderate acute biliary pancreatitis. The authors studied sixty cases of laparoscopic cholecystectomy with intraoperative colangiography for acute biliary pancreatitis (M/F 1:1.

Laparoscopic cholecystectomy and intraoperative endoscopic sphincterotomy in the treatment of cholecysto-choledocholithiasis.

Background: A single-stage minimally invasive procedure would be optimal for management of cholecysto-choledocholithiasis. Two alternative strategies are available: management by laparoscopy alone or a combined laparoscopic-endoscopic approach. This study evaluates the results of the latter procedure.

Predictive value of early postoperative esophagoscopy for occurrence of benign stenosis after cervical esophagogastrostomy.

Background And Study Aims: Benign anastomotic stenosis (BAS) represents a frequent complication following esophagectomy and cervical esophagogastrostomy for cancer. This study was undertaken to evaluate through early postoperative esophagoscopy the morphologic change of the anastomosis which could be related to BAS development.

Patients And Methods: Thirty-nine patients who underwent subtotal esophagectomy and cervical esophagogastrostomy were prospectively evaluated.

Laparoscopic resection of solitary gastric schwannoma.

We report a case of successful laparoscopic resection of a solitary schwannoma of the gastric fundus performed on emergency. The patient was a 52-year-old man who presented with an upper gastrointestinal hemorrhage. At admission, the endoscopy and hydro-CT scan showed a submucosal tumor, 2.

Esophageal metastasis from clear cell carcinoma of the kidney.

Esophageal metastasis from distant primary malignancies is an uncommon occurrence. The first case of a clear cell carcinoma of the kidney metastatic to the esophagus 5 yr after nephrectomy is reported.

Giant leiomyoma of the oesophagus and cardia. Diagnostic and therapeutic considerations: case report and literature review.

A case of giant leiomyoma of the oesophagus and cardia is presented. Magnetic resonance imaging was particularly useful for assessing the relationship of the tumour to the neighbouring structures. Radical resection was performed by partial oesophagogastrectomy with intrathoracic oesophagogastrostomy.

Conservative approach to granular cell tumour of the oesophagus. Three case reports.

Granular cell tumour is an uncommon and generally benign lesion. In oesophageal location it is often asymptomatic and incidentally diagnosed at endoscopy. Three cases of granular cell oesophageal tumour are reported, with multiple location in one.

[Esophageal manometry and pH-monitoring for surgical indications].

The Authors report a review of the data gathered by manometry and pH-metry in the functional esophageal diseases. Manometric and pH-metric patterns of gastro-esophageal reflux, Barrett esophagus, diverticula, achalasia, aspecific motility disorders and non-cardiac chest pain, are analyzed. Data conditioning the choice of surgical treatment in the literature and in the authors' experience are reported in detail.

[Partial splenectomy using a stapler and the role of regeneration of the residual splenic stump].

Current evidence indicates that only complete or partial intact spleen can protect the organism against pneumococcal sepsis. What is not clear is the amount of minimal splenic tissue needed to protect the organism against such infection. This study has been carried out on 20 dogs which underwent partial or total splenectomy with stapler.