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10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (20 December 2022) | Viewed by 27669

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Special Issue Editor

Prof. Dr. Hidekazu Suzuki

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Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan
Interests: gastroesophageal reflux disease; esophageal cancer; eosinophilic esophagitis; chronic gastritis; gastric cancer; peptic ulcer; gastric MALT lymphoma; colorectal cancer; functional dyspepsia; IBS; IBD
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Special Issue Information

Dear Colleagues,

The year 2021 marks the 10th anniversary of Journal of Clinical Medicine, and as one of the major sections of JCM, we are launching a 10th anniversary Special Issue in the section “Gastroenterology & Hepatopancreatobiliary Medicine”.

We are accepting papers for the Special Issue, titled "Recent diagnostic and therapeutic advance in Gastroenterology & Hepatopancreatobiliary Medicine". This medical field is a complex and wide-ranging field that deals with diseases in multiple organs such as the gastrointestinal tract and hepatobiliary pancreas. With recent advances in diagnostic imaging and interventional treatment, those in endoscopic diagnosis and treatment, those in functional test and those in genetic diagnosis and drug therapy, including the molecular-targeted therapy, many new medical findings have been accumulated.

In this Special Issue, we are looking for reports that make full use of advances in diagnostics and therapeutics in the field of Gastroenterology and Hepatopancreatobiliary Medicine.

Prof. Dr. Hidekazu Suzuki
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

endoscopy
imaging
molecular targeting
genetic diagnosis and treatment
liquid biopsy
functional disorders

Published Papers (13 papers)

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Editorial

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3 pages, 170 KiB

Open AccessEditorial

Special Issue: “10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advances in Gastroenterology and Hepatopancreatobiliary Medicine”

by Takashi Ueda and Hidekazu Suzuki

J. Clin. Med. 2022, 11(20), 6008; https://doi.org/10.3390/jcm11206008 - 12 Oct 2022

Viewed by 904

Abstract

This Special Issue, “10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advances in Gastroenterology and Hepatopancreatobiliary Medicine”, presents five original articles and two review articles [...] Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

Research

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13 pages, 5338 KiB

Open AccessArticle

Sarcopenia Is a Prognostic Factor in Patients Undergoing Percutaneous Endoscopic Gastrostomy

by Shingo Ono, Hiroto Furuhashi, Shunsuke Kisaki, Hideka Horiuchi, Hiroaki Matsui, Akira Dobashi, Hiroya Ojiri and Kazuki Sumiyama

J. Clin. Med. 2023, 12(10), 3360; https://doi.org/10.3390/jcm12103360 - 09 May 2023

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Abstract

(1) Background: Percutaneous endoscopic gastrostomy (PEG) is a widely used long-term enteral nutrition method, but little is known about the associated prognostic factors in patients with PEG. Sarcopenia, a condition characterized by a loss of skeletal muscle mass, increases the risk of developing various gastrointestinal disorders. Yet, the relationship between sarcopenia and the prognosis after PEG remains unclear. (2) Methods: We conducted a retrospective study of patients who underwent PEG consecutively from March 2008 to April 2020. We analyzed preoperative sarcopenia and the prognosis of patients after PEG. We defined sarcopenia as a skeletal muscle index at the level of the third lumbar vertebra of ≤29.6 cm²/m² for women and ≤36.2 cm²/m² for men. Cross-sectional computed tomography images of skeletal muscle at the level of the third lumbar vertebra were evaluated using DICOM image analysis software (OsiriX). The primary outcome was the difference in overall survival after PEG based on the status of sarcopenia. We also performed a covariate balancing propensity score matching analysis. (3) Results: Of 127 patients (99 men, 28 women), 71 (56%) were diagnosed with sarcopenia, and 64 patients died during the observation period. The median follow-up period did not differ between patients with and without sarcopenia (p = 0.5). The median survival time after PEG was 273 days in patients with sarcopenia and 1133 days in those without (p < 0.001). Cox proportional hazard model analyses identified three factors that were significantly associated with overall survival: sarcopenia (adjusted hazard ratio [HR]: 2.9, 95% confidence interval [CI]: 1.6–5.4, p < 0.001), serum albumin level (adjusted HR: 0.34, 95% CI: 0.21–0.55, p < 0.001) and male sex (adjusted HR: 2.0, 95% CI: 1.1–3.7, p = 0.03). Propensity score-matched analysis (n = 37 vs. 37) showed that the survival rate was lower in the sarcopenia group than in the non-sarcopenia group (at 90 days: 77% (95% CI, 59–88) vs. 92% (76–97), at 180 days: 56% (38–71) vs. 92% (76–97), and at one year: 35% (19–51) vs. 81% (63–91), p = 0.0014). (4) Conclusions: Sarcopenia was associated with poor prognosis in patients having undergone PEG. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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10 pages, 1299 KiB

Open AccessArticle

Impact of Sarcopenia on Survival in Patients Treated with FOLFIRINOX in a First-Line Setting for Metastatic Pancreatic Carcinoma

by Lisa Lellouche, Maxime Barat, Anna Pellat, Juliette Leroux, Felix Corre, Rachel Hallit, Antoine Assaf, Catherine Brezault, Marion Dhooge, Philippe Soyer and Romain Coriat

J. Clin. Med. 2023, 12(6), 2211; https://doi.org/10.3390/jcm12062211 - 13 Mar 2023

Viewed by 1075

Abstract

Sarcopenia, defined as decreased muscle mass and strength, can be evaluated by a computed tomography (CT) examination and might be associated with reduced survival in patients with carcinoma. The prognosis of patients with metastatic pancreatic carcinoma is poor. The FOLFIRINOX (a combination of 5-fluorouracil, irinotecan, and oxaliplatin) chemotherapy regimen is a validated first-line treatment option. We investigated the impact of sarcopenia on overall survival (OS) and progression-free survival (PFS) in patients with metastatic pancreatic carcinoma. Clinical data and CT examinations of patients treated with FOLFIRINOX were retrospectively reviewed. Sarcopenia was estimated using baseline CT examinations. Seventy-five patients were included. Forty-three (57.3%) were classified as sarcopenic. The median OS of non-sarcopenic and sarcopenic patients were 15.6 and 14.1 months, respectively (p = 0.36). The median PFS was 10.3 in non-sarcopenic patients and 9.3 in sarcopenic patients (p = 0.83). No differences in toxicity of FOLFIRINOX were observed. There was a trend towards a higher probability of short-term death (within 4 months of diagnosis) in sarcopenic patients. In this study, the detection of sarcopenia failed to predict a longer OS or PFS in selected patients deemed eligible by a physician for triplet chemotherapy and receiving the FOLFIRINOX regimen in a first-line setting, confirming the major importance of a comprehensive patient assessment by physicians in selecting the best treatment option. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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12 pages, 2924 KiB

Open AccessArticle

Ustekinumab Promotes Radiological Fistula Healing in Perianal Fistulizing Crohn’s Disease: A Retrospective Real-World Analysis

by Jiayin Yao, Heng Zhang, Tao Su, Xiang Peng, Junzhang Zhao, Tao Liu, Wei Wang, Pinjin Hu, Min Zhi and Min Zhang

J. Clin. Med. 2023, 12(3), 939; https://doi.org/10.3390/jcm12030939 - 25 Jan 2023

Cited by 6 | Viewed by 1942

Abstract

There is insufficient evidence to confirm the efficacy of ustekinumab (UST) in promoting fistula closure in perianal fistulizing Crohn’s disease (CD) patients. We aimed to evaluate the efficacy of UST in a real-world setting. The data were retrospectively analyzed. Intestinal clinical and endoscopic changes were evaluated. Fistula radiological outcomes were determined using the Van Assche score. A total of 108 patients were included, 43.5% of whom had complex perianal fistulas. Intestinal clinical and endoscopic remission was achieved in 65.7% and 31.5% of patients, respectively. The fistula clinical remission and response rates were 40.7% and 63.0%, respectively, with a significant reduction in Perianal Crohn’s disease Activity Index [5.0(3.0, 8.0) vs. 7.5(5.0, 10.0), p < 0.001] and Crohn’s Anal Fistula Quality of Life [23.5(9.3, 38.8) vs. 49.0(32.3, 60.0), p < 0.001]. Radiological healing, partial response, no change, and deterioration were observed in 44.8%, 31.4%, 13.4%, and 10.4% of patients, respectively. The cut-off UST trough concentration for predicting fistula clinical remission was 2.11 μg/mL with an area under the curve of 0.795, a sensitivity of 93.3%, and a specificity of 67.6%. UST is efficacious in promoting radiological fistula closure in patients with perianal fistulizing CD. A UST trough concentration over 2.11 μg/mL was correlated with a higher likelihood of perianal fistula clinical remission. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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9 pages, 609 KiB

Open AccessArticle

Efficacy of AI-Assisted Personalized Microbiome Modulation by Diet in Functional Constipation: A Randomized Controlled Trial

by Naciye Çiğdem Arslan, Aycan Gündoğdu, Varol Tunali, Oğuzhan Hakan Topgül, Damla Beyazgül and Özkan Ufuk Nalbantoğlu

J. Clin. Med. 2022, 11(22), 6612; https://doi.org/10.3390/jcm11226612 - 08 Nov 2022

Cited by 2 | Viewed by 2799

Abstract

Background: Currently, medications and behavioral modifications have limited success in the treatment of functional constipation (FC). An individualized diet based on microbiome analysis may improve symptoms in FC. In the present study, we aimed to investigate the impacts of microbiome modulation on chronic constipation. Methods: Between December 2020–December 2021, 50 patients fulfilling the Rome IV criteria for functional constipation were randomized into two groups. The control group received sodium picosulfate plus conventional treatments (i.e., laxatives, enemas, increased fiber, and fluid intake). The study group underwent microbiome analysis and received an individualized diet with the assistance of a soft computing system (Enbiosis Biotechnology^®, Sariyer, Istanbul). Differences in patient assessment constipation–quality of life (PAC-QoL) scores and complete bowel movements per week (CBMpW) were compared between groups after 6-weeks of intervention. Results: The mean age of the overall cohort (n = 45) was 31.5 ± 10.2 years, with 88.9% female predominance. The customized diet developed for subjects in the study arm resulted in a 2.5-fold increase in CBMpW after 6-weeks (1.7 vs. 4.3). The proportion of the study group patients with CBMpW > 3 was 83% at the end of the study, and the satisfaction score was increased 4-fold from the baseline (3.1 to 10.7 points). More than 50% improvement in PAC-QoL scores was observed in 88% of the study cohort compared to 40% in the control group (p = 0.001). Conclusion: The AI-assisted customized diet based on individual microbiome analysis performed significantly better compared to conventional therapy based on patient-reported outcomes in the treatment of functional constipation. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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12 pages, 1827 KiB

Open AccessArticle

Surgery for Liver Metastasis of Non-Colorectal and Non-Neuroendocrine Tumors

by Shadi Katou, Franziska Schmid, Carolina Silveira, Lina Schäfer, Tizian Naim, Felix Becker, Sonia Radunz, Mazen A. Juratli, Leon Louis Seifert, Hauke Heinzow, Benjamin Struecker, Andreas Pascher and M. Haluk Morgul

J. Clin. Med. 2022, 11(7), 1906; https://doi.org/10.3390/jcm11071906 - 29 Mar 2022

Cited by 2 | Viewed by 1678

Abstract

Surgery has become well established for patients with colorectal and neuroendocrine liver metastases. However, the value of this procedure in non-colorectal and non-neuroendocrine metastases (NCRNNELMs) remains unclear. We analyzed the outcomes of patients that underwent liver surgery for NCRNNELMs and for colorectal liver metastases (CRLMs) between 2012 and 2017 at our institution. Prognostic factors of overall and recurrence-free survival were analyzed, and a comparison of survival between two groups was performed. Seventy-three patients (30 NCRNNELM and 43 CRLM) were included in this study. Although the mean age, extrahepatic metastases, and rate of reoperation were significantly different between the groups, recurrence-free survival was comparable. The 5-year overall survival rates were 38% for NCRNNELM and 55% for CRLM. In univariate analysis, a patient age of ≥60 years, endodermal origin of the primary tumor, and major complications were negative prognostic factors. Resection for NCRNNELM showed comparable results to resection for CRLM. Age, the embryological origin of the primary tumor, and the number of metastases might be the criteria for patient selection. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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11 pages, 3146 KiB

Open AccessArticle

Risk of Mortality among Patients with Gastrointestinal Bleeding with Early and Late Treatment with Tranexamic Acid: A Population-Based Cohort Study

by Ke-Hsin Ting, Bei-Hao Shiu, Shun-Fa Yang, Pei-Lun Liao, Jing-Yang Huang, Yin-Yang Chen and Chao-Bin Yeh

J. Clin. Med. 2022, 11(6), 1741; https://doi.org/10.3390/jcm11061741 - 21 Mar 2022

Cited by 4 | Viewed by 2863

Abstract

Tranexamic acid (TXA) is an antifibrinolytic pharmacological agent, but its use in gastrointestinal bleeding remains contentious. Moreover, studies on the timing of TXA administration are limited. We examined whether early TXA administration reduced the risk of mortality in patients with gastrointestinal bleeding in a Taiwanese population. We used the National Health Insurance Research Database to identify patients diagnosed with gastrointestinal bleeding with early and late TXA treatment. We defined early treatment as initial TXA treatment in an emergency department and late treatment as initial TXA treatment after hospitalization. Mortality within 52 weeks was the primary outcome. A multivariable analysis using a multiple Cox regression model was applied for data analysis. Propensity score matching (PSM) was performed to reduce the potential for bias caused by measured confounding variables. Of the 52,949 selected patients with gastrointestinal bleeding, 5127 were assigned to either an early or late TXA treatment group after PSM. The incidence of mortality was significantly decreased during the first and fourth weeks (adjusted HR (aHR): 0.65, 95% CI: 0.56–0.75). A Kaplan–Meier curve revealed a significant decrease in cumulative incidence of mortality in the early TXA treatment group (log-rank test: p < 0.0001). Multiple Cox regression analysis revealed significantly lower mortality in the early TXA treatment group compared with the late treatment group (aHR: 0.64, 95% CI: 0.57–0.73). Thromboembolic events were not significantly associated with early or late TXA treatment (aHR: 1.03, 95% CI: 0.94–1.12). A Kaplan–Meier curve also revealed no significant difference in either venous or arterial events (log-rank test: p = 0.3654 and 0.0975, respectively). In conclusion, early TXA treatment was associated with a reduced risk of mortality in patients with gastrointestinal bleeding compared with late treatment, without an increase in thromboembolic events. The risk of rebleeding and need for urgent endoscopic intervention require further randomized clinical trials. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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9 pages, 924 KiB

Open AccessArticle

Relief Effect of Carbon Dioxide Insufflation in Transnasal Endoscopy for Health Checks—A Prospective, Double-Blind, Case-Control Trial

by Toshio Fujisawa, Hiroshi Fukuda, Naoto Sakamoto, Mariko Hojo, Ko Tomishima, Shigeto Ishii, Hirohide Yokokawa, Mizue Saita, Toshio Naito, Akihito Nagahara, Sumio Watanabe and Hiroyuki Isayama

J. Clin. Med. 2022, 11(5), 1231; https://doi.org/10.3390/jcm11051231 - 24 Feb 2022

Cited by 1 | Viewed by 1309

Abstract

CO₂ insufflation has proven effective in reducing patients’ pain after colonoscopies but has not been examined in esophagogastroduodenoscopies. Therefore, we examined the effect of CO₂ insufflation in examinees who underwent transnasal endoscopies without sedation. This study is a single-center, prospective, double-blind, case-control trial conducted between March 2017 and August 2018. Subjects were assigned weekly to receive insufflation with either CO₂ or air. The primary outcome was improvement of abdominal pain and distension at 2 h and 1-day postprocedure. In total, 336 and 338 examinees were assigned to the CO₂ and air groups, respectively. Visual analog scale (VAS) scores for abdominal distension (15.4 vs. 25.5; p < 0.001) and distress from flatus (16.0 vs. 28.8; p < 0.001) at 2 h postprocedure were significantly reduced in the CO₂ group. VAS scores for pain during the procedure (33.5 vs. 37.1; p = 0.059) and abdominal pain after the procedure (3.9 vs. 5.7; p = 0.052) also tended to be lower at 2 h postprocedure, but all parameters showed no significant difference at 1-day postprocedure. All procedures were safely completed through the planned program, and no apparent adverse events requiring treatment or follow-up occurred. In conclusion, CO₂ insufflation may reduce postprocedural abdominal discomfort from transnasal esophagogastroduodenoscopies. (UMIN000028543). Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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9 pages, 2210 KiB

Open AccessArticle

Effectiveness of S-O Clip-Assisted Colorectal Endoscopic Submucosal Dissection

by Haruka Fujinami, Akira Teramoto, Saeko Takahashi, Takayuki Ando, Shinya Kajiura and Ichiro Yasuda

J. Clin. Med. 2022, 11(1), 141; https://doi.org/10.3390/jcm11010141 - 27 Dec 2021

Cited by 4 | Viewed by 2384

Abstract

This study aimed to assess the utility of the S-O clip during colorectal endoscopic submucosal dissection (ESD). We conducted a retrospective study on 185 patients who underwent colorectal ESD from January 2015 to January 2020. The patients were divided into two groups: before and after the introduction of the S-O clip. Forty-two patients underwent conventional ESD (CO group) and 29 patients underwent ESD using the S-O clip (SO group). We compared the surgery duration, dissection speed, en bloc resection rate, and complication rate between both groups. Compared with the CO group, the SO group had a significantly shorter surgery duration (70.7 ± 37.9 min vs. 51.2 ± 18.6 min; p = 0.017), a significantly higher dissection speed (15.1 ± 9.0 min vs. 26.3 ± 13.8 min; p < 0.001), a significantly higher en bloc resection rate (80.9% vs. 98.8%; p ≤ 0.001), and a significantly lower perforation rate (4.3% vs. 1.3%). In the right colon, the surgery duration was significantly shorter and the dissection speed was significantly higher in the SO group than in the CO group. Moreover, the rate of en bloc resection improved significantly in the right colon. S-O clip-assisted ESD reduces the procedure time and improves the treatment effects, especially in the right colon. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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9 pages, 17284 KiB

Open AccessArticle

TXI (Texture and Color Enhancement Imaging) for Serrated Colorectal Lesions

by Toshihiro Nishizawa, Osamu Toyoshima, Shuntaro Yoshida, Chie Uekura, Ken Kurokawa, Munkhbayar Munkhjargal, Miho Obata, Tomoharu Yamada, Mitsuhiro Fujishiro, Hirotoshi Ebinuma and Hidekazu Suzuki

J. Clin. Med. 2022, 11(1), 119; https://doi.org/10.3390/jcm11010119 - 27 Dec 2021

Cited by 12 | Viewed by 3155

Abstract

Background and aim: Olympus Corporation released the texture and color enhancement imaging (TXI) technology as a novel image-enhancing endoscopic technique. We investigated the effectiveness of TXI in the imaging of serrated colorectal polyps, including sessile serrated lesions (SSLs). Methods: Serrated colorectal polyps were observed using white light imaging (WLI), TXI, narrow-band imaging (NBI), and chromoendoscopy with and without magnification. Serrated polyps were histologically confirmed. TXI was compared with WLI, NBI, and chromoendoscopy for the visibility of the lesions without magnification and for that of the vessel and surface patterns with magnification. Three expert endoscopists evaluated the visibility scores, which were classified from 1 to 4. Results: Twenty-nine consecutive serrated polyps were evaluated. In the visibility score without magnification, TXI was significantly superior to WLI but inferior to chromoendoscopy in the imaging of serrated polyps and the sub-analysis of SSLs. In the visibility score for vessel patterns with magnification, TXI was significantly superior to WLI and chromoendoscopy in the imaging of serrated polyps and the sub-analysis of SSLs. In the visibility score for surface patterns with magnification, TXI was significantly superior to WLI but inferior to NBI in serrated polyps and in the sub-analysis of SSLs and hyperplastic polyps. Conclusions: TXI provided higher visibility than did WLI for serrated, colorectal polyps, including SSLs. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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Review

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13 pages, 658 KiB

Open AccessReview

Gastric Cancer Screening in Japan: A Narrative Review

by Kazuo Yashima, Michiko Shabana, Hiroki Kurumi, Koichiro Kawaguchi and Hajime Isomoto

J. Clin. Med. 2022, 11(15), 4337; https://doi.org/10.3390/jcm11154337 - 26 Jul 2022

Cited by 13 | Viewed by 4385

Abstract

Gastric cancer is the second leading cause of cancer incidence in Japan, although gastric cancer mortality has decreased over the past few decades. This decrease is attributed to a decline in the prevalence of H. pylori infection. Radiographic examination has long been performed as the only method of gastric screening with evidence of reduction in mortality in the past. The revised 2014 Japanese Guidelines for Gastric Cancer Screening approved gastric endoscopy for use in population-based screening, together with radiography. While endoscopic gastric cancer screening has begun, there are some problems associated with its implementation, including endoscopic capacity, equal access, and cost-effectiveness. As H. pylori infection and atrophic gastritis are well-known risk factors for gastric cancer, a different screening method might be considered, depending on its association with the individual’s background and gastric cancer risk. In this review, we summarize the current status and problems of gastric cancer screening in Japan. We also introduce and discuss the results of gastric cancer screening using H. pylori infection status in Hoki-cho, Tottori prefecture. Further, we review risk stratification as a system for improving gastric cancer screening in the future. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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Other

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13 pages, 4739 KiB

Open AccessSystematic Review

A Meta-Analysis and Systematic Review of Normothermic and Hypothermic Machine Perfusion in Liver Transplantation

by Joseph Mugaanyi, Lei Dai, Changjiang Lu, Shuqi Mao, Jing Huang and Caide Lu

J. Clin. Med. 2023, 12(1), 235; https://doi.org/10.3390/jcm12010235 - 28 Dec 2022

Cited by 4 | Viewed by 1579

Abstract

Background: The gap between the demand and supply of donor livers is still a considerable challenge. Since static cold storage is not sufficient in marginal livers, machine perfusion is being explored as an alternative. The objective of this study was to assess (dual) hypothermic oxygenated machine perfusion (HOPE/D-HOPE) and normothermic machine perfusion (NMP) in contrast to static cold storage (SCS). Methods: Three databases were searched to identify studies about machine perfusion. Graft and patient survival and postoperative complications were evaluated using the random effects model. Results: the incidence of biliary complications was lower in HOPE vs. SCS (OR: 0.59, 95% CI: 0.36–0.98, p = 0.04, I²: 0%). There was no significant difference in biliary complications between NMP and SCS (OR: 0.76, 95% CI: 0.41–1.40, p = 0.38, I²: 55%). Graft and patient survival were significantly better in HOPE than in SCS (HR: 0.40, 95% CI: 0.23–0.71, p = 0.002, I²: 0%) and (pooled HR: 0.43, 95% CI: 0.20–0.93, p = 0.03, I²: 0%). Graft and patient survival were not significantly different between NMP and SCS. Conclusion: HOPE/D-HOPE and NMP are promising alternatives to SCS for donor liver preservation. They may help address the widening gap between the demand for and availability of donor livers by enabling the rescue and transplantation of marginal livers. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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23 pages, 1434 KiB

Open AccessSystematic Review

by Hasan Aladraj, Mohamed Abdulla, Salman Yousuf Guraya and Shaista Salman Guraya

J. Clin. Med. 2022, 11(13), 3743; https://doi.org/10.3390/jcm11133743 - 28 Jun 2022

Cited by 5 | Viewed by 1660

Abstract

Crohn’s disease (CD) leads to a poor health-related quality of life (HRQoL). This review aimed to investigate the effect of biological agents and small-molecule drugs in improving the HRQoL of patients with moderate to severe CD. We adopted a systematic protocol to search PubMed and Cochrane Central Register of Controlled Trials (CENTRAL), which was supplemented with manual searches. Eligible studies were RCTs that matched the research objective based on population, intervention, comparison and outcomes. Studies in paediatric populations, reviews and conference abstracts were excluded. Covidence was used for screening and data extraction. We assessed all research findings using RoB2 and reported them narratively. We included 16 multicentre, multinational RCTs in this review. Of the 15 studies that compared the effect of an intervention to a placebo, 9 were induction studies and 6 investigated maintenance therapy. Of these, 13 studies showed a significant (p < 0.05) improvement in the HRQoL of patients with CD. One non-inferiority study compared the intervention with another active drug and favoured the intervention. This systematic review reported a substantial improvement in the HRQoL of patients with CD using biological agents and small-molecule drugs. These pharmaceutical substances have the potential to improve the HRQoL of patients with CD. However, further large clinical trials with long-term follow-up are essential to validate these findings. Full article

(This article belongs to the Special Issue 10th Anniversary of JCM—Recent Diagnostic and Therapeutic Advance in Gastroenterology and Hepatopancreatobiliary Medicine)

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