Dataset Information

Gastric mucosal devitalization (GMD): translation to a novel endoscopic metabolic therapy.

ABSTRACT: Background and study aims ?The metabolic effects of bariatric surgery may partially result from removal of the gastric mucosa, an often underappreciated endocrine organ. Using argon plasma coagulation (APC), we may be able to selectively devitalize (ablate) the mucosa. The aim of this study was to identify the optimal tissue color that would correspond to selective gastric mucosal devitalization (GMD) using ex-vivo human stomach specimens. Patients and methods ?Stomach specimens were obtained at sleeve gastrectomy. Prior to APC application, a submucosal fluid cushion was created. APC was then applied over a 2?×?2-cm area to the fundus and body, aiming for the three indicator colors (white, golden, brown). Pathological analysis was then performed independently and in a blinded fashion by two pathologists to determine the depth of mucosal and submucosal percent thermal injury and mucosal percent cell death. Results ?Six patients were enrolled. There was a significant correlation between tissue color and mucosal percent thermal injury. The highest percent mucosal thermal injury was seen with brown (99.6?%, 95?% CI: 98.7, 100), followed by golden (92.5?%, 95?% CI: 85.5, 99.5), and then white (75.2?%, 95?% CI: 58.3, 92.1, P ??10?% depth) was found significantly more with brown tissue color (91.6?%) than golden (75?%) or white (33.3?%, P ?

SUBMITTER: Fayad L

PROVIDER: S-EPMC6877422 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Gastric mucosal devitalization (GMD): translation to a novel endoscopic metabolic therapy.

Fayad Lea L Oberbach Andreas A Schweitzer Michael M Askin Frederic F Voltaggio Lysandra L Larman Tatianna T Enderle Markus M Hahn Hartmut H Khashab Mouen A MA Kalloo Anthony N AN Kumbhari Vivek V

Endoscopy international open 20191125 12

<b>Background and study aims</b> The metabolic effects of bariatric surgery may partially result from removal of the gastric mucosa, an often underappreciated endocrine organ. Using argon plasma coagulation (APC), we may be able to selectively devitalize (ablate) the mucosa. The aim of this study was to identify the optimal tissue color that would correspond to selective gastric mucosal devitalization (GMD) using ex-vivo human stomach specimens. <b>Patients and methods</b> Stomach specimens we ...[more]

PMID: 31788546

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Project description:ObjectivesTo investigate the treatment effects of endoscopic submucosal dissection (ESD) versus endoscopic mucosal resection (EMR) for early gastric cancer (EGC).DesignMeta-analysis.MethodsWe systematically searched three electronic databases, including PubMed, EmBase and the Cochrane library for studies published with inception to January 2018. The eligible studies should be evaluated for the efficacy and safety of ESD versus EMR for patients with EGC. The summary ORs and standard mean differences (SMDs) with 95% CIs were employed as effect estimates. Sensitivity analyses were conducted to evaluate the impact of single study on overall analysis. Subgroup analyses were performed for investigated outcomes to evaluate the treatment effects of ESD versus EMR for patients with EGC with specific subsets.ResultsEighteen studies, with a total of 6723 patients with EGC, were included in final analysis. The summary ORs indicated that patients with EGC who received ESD were associated with an increased incidence of en bloc resection (OR: 9.00; 95% CI: 6.66 to 12.17; p<0.001), complete resection (OR: 8.43; 95% CI: 5.04 to 14.09; p<0.001) and curative resection (OR: 2.92; 95% CI: 1.85 to 4.61; p<0.001) when compared with EMR. Furthermore, ESD was associated with lower risk of local recurrence (OR: 0.18; 95% CI: 0.09 to 0.34; p<0.001). In addition, there was no significant difference between ESD and EMR for the risk of bleeding (OR: 1.26; 95% CI: 0.88 to 1.80; p=0.203). Though, ESD was correlated with greater risk of perforation (OR: 2.55; 95% CI: 1.48 to 4.39; p=0.001), and longer operation time (SMD: 1.12; 95% CI: 0.13 to 2.10; p=0.026) as compared with EMR. Additionally, several different features observed in included studies and patients could bias the effectiveness of ESD versus EMR in patients with EGC.ConclusionsESD is superior than EMR for en bloc resection, complete resection, curative resection and local recurrence, while it increased perforation risk and longer operation time.

Dataset Information

Gastric mucosal devitalization (GMD): translation to a novel endoscopic metabolic therapy.

Publications

Gastric mucosal devitalization (GMD): translation to a novel endoscopic metabolic therapy.

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