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Endoscopic versus surgical management for colonic volvulus hospitalizations in the United States
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Dushyant Singh Dahiya, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Amandeep Singh, Rajat Garg, Chin-I Cheng, Mohammad Al-Haddad, Madhusudhan R. Sanaka, Neil Sharma
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Clin Endosc 2023;56(3):340-352. Published online April 17, 2023
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DOI: https://doi.org/10.5946/ce.2022.166
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Graphical Abstract
Abstract
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- Background
/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States.
Methods We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared.
Results From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p=0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management.
Conclusions Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.
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Citations
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Peroral endoscopic myotomy versus Heller’s myotomy for achalasia hospitalizations in the United States: what does the future hold?
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Dushyant Singh Dahiya, Vinay Jahagirdar, Manesh Kumar Gangwani, Muhammad Aziz, Chin-I Cheng, Sumant Inamdar, Madhusudhan R. Sanaka, Mohammad Al-Haddad
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Clin Endosc 2022;55(6):826-828. Published online November 3, 2022
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DOI: https://doi.org/10.5946/ce.2022.283
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PDFPubReaderePub
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Radiation Proctitis and Management Strategies
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Dushyant Singh Dahiya, Asim Kichloo, Faiz Tuma, Michael Albosta, Farah Wani
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Clin Endosc 2022;55(1):22-32. Published online November 18, 2021
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DOI: https://doi.org/10.5946/ce.2020.288
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Abstract
PDFPubReaderePub
- Radiotherapy (RT) is a treatment modality that uses high-energy rays or radioactive agents to generate ionizing radiation against rapidly dividing cells. The main objective of using radiation in cancer therapy is to impair or halt the division of the tumor cells. Over the past few decades, advancements in technology, the introduction of newer methods of RT, and a better understanding of the pathophysiology of cancers have enabled physicians to deliver doses of radiation that match the exact dimensions of the tumor for greater efficacy, with minimal exposure of the surrounding tissues. However, RT has numerous complications, the most common being radiation proctitis (RP). It is characterized by damage to the rectal epithelium by secondary ionizing radiation. Based on the onset of signs and symptoms, post-radiotherapy RP can be classified as acute or chronic, each with varying levels of severity and complication rates. The treatment options available for RP are limited, with most of the data on treatment available from case reports or small studies. Here, we describe the types of RT used in modern-day medicine and radiation-mediated tissue injury. We have primarily focused on the classification, epidemiology, pathogenesis, clinical features, treatment strategies, complications, and prognosis of RP.
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Robert Klimkowski, Jakub Krzyzkowiak, Nastazja Dagny Pilonis, Krzysztof Bujko, Michal F. Kaminski Best Practice & Research Clinical Gastroenterology.2024; 68: 101896. CrossRef - Radiation injuries of organs and tissues: mechanisms of occurrence, methods of prevention and treatment: A review
Daiana A. Balaeva, Denis S. Romanov, Oxana P. Trofimova, Zarina Z. Gadzhibabaeva, Yury Yu. Gorchak, Garia A. Gariaev Journal of Modern Oncology.2024; 25(4): 504. CrossRef - Interventions for Managing Late Gastrointestinal Symptoms Following Pelvic Radiotherapy: a Systematic Review and Meta-analysis
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C. Iniesta Cavero, L. Menchén-Viso Medicine - Programa de Formación Médica Continuada Acreditado.2024; 14(8): 468. CrossRef - Feel the Burn: RFA for Chronic Radiation Proctitis
Gabriele De Sena, Federico Maria Mongardini, Danilo Porpora, Maria Mauro, Davide Bentivoglio, Davide Centore, Luigi Brusciano, Claudio Gambardella, Augusto Lauro, Ludovico Docimo, Vincenzo Napolitano Digestive Diseases and Sciences.2024; 69(9): 3147. CrossRef - Pelvic Radiation Therapy Increases Risk of Pouch Failure in Patients with Inflammatory Bowel Disease and Ileal Pouch
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F. Sinzabakira, L. Incrocci, K. de Vries, M.E.M.C. Christianen, M. Franckena, F.E. Froklage, H. Westerveld, W.D. Heemsbergen Clinical and Translational Radiation Oncology.2024; 48: 100842. CrossRef - Prevention and management of radiotherapy-related toxicities in gynecological malignancies. Position paper on behalf of AIRO (Italian Association of Radiotherapy and Clinical Oncology)
Elisabetta Perrucci, Gabriella Macchia, Annamaria Cerrotta, Angela Damiana Andrulli, Rosa Autorino, Amelia Barcellini, Maura Campitelli, Giulia Corrao, Sara Costantini, Vitaliana De Sanctis, Jacopo Di Muzio, Valeria Epifani, Patrizia Ferrazza, Andrei Fodo La radiologia medica.2024; 129(9): 1329. CrossRef - Radiation-Induced Intestinal Injury: Molecular Mechanisms and Therapeutic Status
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Mohammad Mohammadianpanah, Maryam Tazang, Nam Phong Nguyen, Niloofar Ahmadloo, Shapour Omidvari, Ahmad Mosalaei, Mansour Ansari, Hamid Nasrollahi, Behnam Kadkhodaei, Nezhat Khanjani, Seyed Vahid Hosseini Annals of Coloproctology.2024; 40(5): 506. CrossRef - Administration of modified Gegen Qinlian decoction for hemorrhagic chronic radiation proctitis: A case report and review of literature
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Qiulian Li, Guangjie Liao Annals of Oncology Research and Therapy.2022; 2(1): 10. CrossRef
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Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials
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Vishali Moond, Priyadarshini Loganathan, Sheza Malik, Dushyant Singh Dahiya, Babu P. Mohan, Daryl Ramai, Michele McGinnis, Deepak Madhu, Mohammad Bilal, Aasma Shaukat, Saurabh Chandan
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Received April 3, 2024 Accepted April 28, 2024 Published online August 23, 2024
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DOI: https://doi.org/10.5946/ce.2024.081
[Epub ahead of print]
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Graphical Abstract
Abstract
PDFSupplementary MaterialPubReaderePub
- Background
/Aims: Cold snare polypectomy (CSP) is routinely performed for small colorectal polyps (≤10 mm). However, challenges include insufficient resection depth and immediate bleeding, hindering precise pathological evaluation. We aimed to compare the outcomes of cold endoscopic mucosal resection (CEMR) with that of CSP for colorectal polyps ≤10 mm, using data from randomized controlled trials (RCTs).
Methods Multiple databases were searched in December 2023 for RCTs reporting outcomes of CSP versus CEMR for colorectal polyps ≤10 mm in size. Our primary outcomes were rates of complete and en-bloc resections, while our secondary outcomes were total resection time (seconds) and adverse events, including immediate bleeding, delayed bleeding, and perforation.
Results The complete resection rates did not significantly differ (CSP, 91.8% vs. CEMR 94.6%), nor did the rates of en-bloc resection (CSP, 98.9% vs. CEMR, 98.3%) or incomplete resection (CSP, 6.7% vs. CEMR, 4.8%). Adverse event rates were similarly insignificant in variance. However, CEMR had a notably longer mean resection time (133.51 vs. 91.30 seconds).
Conclusions Our meta-analysis of seven RCTs showed that while both CSP and CEMR are equally safe and effective for resecting small (≤10 mm) colorectal polyps, the latter is associated with a longer resection time.
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Comparison of peroral endoscopic myotomy, laparoscopic Heller myotomy, and pneumatic dilation for patients with achalasia: a United States national experience
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Dushyant Singh Dahiya, Bhanu Siva Mohan Pinnam, Saurabh Chandan, Hassam Ali, Manesh Kumar Gangwani, Amir Humza Sohail, Dennis Yang, Amit Rastogi
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Received April 28, 2024 Accepted August 5, 2024 Published online September 5, 2024
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DOI: https://doi.org/10.5946/ce.2024.103
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