1
|
Strnisa L, Plut S, Golob S, Gavric A. Endoscopic resection of a large symptomatic duodenal lipoma. Gastroenterol Hepatol 2024; 47:384-386. [PMID: 36965578 DOI: 10.1016/j.gastrohep.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/03/2023] [Accepted: 03/09/2023] [Indexed: 03/27/2023]
Affiliation(s)
- Luka Strnisa
- Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Samo Plut
- Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Sasa Golob
- Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Aleksandar Gavric
- Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia.
| |
Collapse
|
2
|
Gavric A, Krajc M, Strnisa L, Gavric AU, Plut S. MSH3-related adenomatous polyposis in a patient with the negative family history of colorectal polyps. Gastroenterol Hepatol 2024; 47:397-400. [PMID: 37597744 DOI: 10.1016/j.gastrohep.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/02/2023] [Accepted: 08/14/2023] [Indexed: 08/21/2023]
Abstract
Recently, biallelic MSH3 germline pathogenic/likely pathogenic variants have been recognized as a rare cause of adenomatous polyposis. We present a 49-year-old woman who was admitted to our high-risk colorectal cancer clinic after incidental detection of a biallelic MSH3 (likely) pathogenic variant when tested for the germline (likely) pathogenic variants in hereditary breast and ovarian cancer related genes. The focus of this case report is to describe the genotype and phenotype of our patient with MSH3-related adenomatous polyposis. More than half of the polyps (13/19) were located in the right colon. In addition, benign and malignant extraintestinal lesions may be common as our patient had simple liver and kidney cysts and two basal cell skin carcinomas.
Collapse
Affiliation(s)
- Aleksandar Gavric
- Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
| | - Mateja Krajc
- Department of Clinical Cancer Genetics, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Luka Strnisa
- Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ana Ursula Gavric
- Eye Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Samo Plut
- Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group (LuDERG), Department of Gastroenterology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
3
|
Plut S, Hanzel J, Gavric A. COVID-19-associated colitis. Gastrointest Endosc 2023; 98:130-131. [PMID: 36731582 PMCID: PMC9886387 DOI: 10.1016/j.gie.2023.01.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/27/2022] [Accepted: 01/25/2023] [Indexed: 02/02/2023]
Affiliation(s)
- Samo Plut
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Jurij Hanzel
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Aleksandar Gavric
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
4
|
Rivero-Sánchez L, Gavric A, Herrero J, Remedios D, Alvarez V, Albéniz E, Gordillo J, Puig I, López-Vicente J, Huerta A, López-Cerón M, Salces I, Peñas B, Parejo S, Rodriguez E, Herraiz M, Carretero C, Gimeno-Garcia AZ, Saperas E, Alvarez C, Arnau-Collell C, Ortiz O, Sánchez A, Jung G, Balaguer F, Pellisé M. The "diagnose and leave in" strategy for diminutive rectosigmoid polyps in Lynch syndrome: a post hoc analysis from a randomized controlled trial. Endoscopy 2022; 54:27-34. [PMID: 33271604 DOI: 10.1055/a-1328-5405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The "diagnose-and-leave-in" policy has been established to reduce the risks and costs related to unnecessary polypectomies in the average-risk population. In individuals with Lynch syndrome, owing to accelerated carcinogenesis, the general recommendation is to remove all polyps, irrespective of size, location, and appearance. We evaluated the feasibility and safety of the diagnose-and-leave-in strategy in individuals with Lynch syndrome. METHODS : We performed a post hoc analysis based on per-polyp data from a randomized, clinical trial conducted by 24 dedicated colonoscopists at 14 academic centers, in which 256 patients with confirmed Lynch syndrome underwent surveillance colonoscopy from July 2016 to January 2018. In vivo optical diagnosis with confidence level for all detected lesions was obtained before polypectomy using virtual chromoendoscopy alone or with dye-based chromoendoscopy. Primary outcome was the negative predictive value (NPV) for neoplasia of high-confidence optical diagnosis among diminutive (≤ 5 mm) rectosigmoid lesions. Histology was the reference standard. RESULTS Of 147 rectosigmoid lesions, 128 were diminutive. In 103 of the 128 lesions (81 %), the optical diagnostic confidence was high and showed an NPV of 96.0 % (95 % confidence interval [CI] 88.9 %-98.6 %) and accuracy of 89.3 % (95 %CI 81.9 %-93.9 %). By following the diagnose-and-leave-in policy, we would have avoided 59 % (75/128) of polypectomies at the expense of two diminutive low grade dysplastic adenomas and one diminutive sessile serrated lesion that would have been left in situ. CONCLUSION In patients with Lynch syndrome, the diagnose-and-leave-in strategy for diminutive rectosigmoid polyps would be feasible and safe.
Collapse
Affiliation(s)
- Liseth Rivero-Sánchez
- Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Aleksandar Gavric
- Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,University Medical Centre Ljubljana, Department of Gastroenterology and Hepatology Ljubljana, Slovenia
| | - Jesús Herrero
- Complexo Hospitalario Universitario de Ourense, Instituto de Investigación Biomédica Galicia Sur, CIBERehd, Gastroenterology, Ourense, Spain
| | - David Remedios
- Complexo Hospitalario Universitario de Ourense, Instituto de Investigación Biomédica Galicia Sur, CIBERehd, Gastroenterology, Ourense, Spain
| | - Victoria Alvarez
- Complexo Hospitalario de Pontevedra, Digestive Department, Pontevedra, Spain
| | - Eduardo Albéniz
- Complejo Hospitalario de Navarra, Digestive System Service, Endoscopy Unit, Navarrabiomed, Universidad Pública de Navarra, IdiSNa, Pamplona, Spain
| | - Jordi Gordillo
- Hospital de la Santa Creu i Sant Pau, Gastroenterology Unit, Barcelona, Spain
| | - Ignasi Puig
- Althaia, Xarxa Assistencial Universitària de Manresa, Gastroenterology Department, Manresa, Spain
| | - Jorge López-Vicente
- Hospital Universitario de Móstoles, Digestive System Service, Móstoles, Madrid, Spain
| | - Alain Huerta
- Hospital Galdakao-Usansolo, Department of Gastroenterology, Galdakao, Spain
| | - María López-Cerón
- Hospital Universitario 12 de Octubre, Digestive System Service, Madrid, Spain
| | - Inmaculada Salces
- Hospital Universitario 12 de Octubre, Digestive System Service, Madrid, Spain
| | - Beatriz Peñas
- Hospital Universitario Ramon y Cajal, Department of Gastroenterology, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Sofía Parejo
- Hospital Universitario Ramon y Cajal, Department of Gastroenterology, Madrid, Spain
| | - Enrique Rodriguez
- Hospital Universitario Ramon y Cajal, Department of Gastroenterology, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Maite Herraiz
- University of Navarra Clinic-IdiSNA, Gastroenterology Department, Pamplona, Spain
| | - Cristina Carretero
- University of Navarra Clinic-IdiSNA, Gastroenterology Department, Pamplona, Spain
| | - Antonio Z Gimeno-Garcia
- Hospital Universitario de Canarias, Gastroenterology Department, Santa Cruz de Tenerife, Spain
| | - Esteban Saperas
- Hospital General de Catalunya, Gastroenterology Department, Sant Cugat del Vallès, Spain
| | | | - Coral Arnau-Collell
- Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Oswaldo Ortiz
- Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Ariadna Sánchez
- Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Gerhard Jung
- Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - Francesc Balaguer
- Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| | - María Pellisé
- Hospital Clinic de Barcelona, Department of Gastroenterology, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain
| |
Collapse
|
5
|
Affiliation(s)
- Martin Zaplotnik
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Samo Plut
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Nina Zidar
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Luka Strnisa
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Aleksandar Gavric
- Department of Gastroenterology and Hepatology, University Medical Center Ljubljana, Ljubljana, Slovenia; Ljubljana Digestive Endoscopy Research Group, Department of Gastroenterology, University Medical Center Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
7
|
Gavric A, Drobne D, Novak G. Young GI angle: International research fellowship as a way to foster clinical research at your department - our stories. United European Gastroenterol J 2020; 8:835-838. [PMID: 32731842 DOI: 10.1177/2050640620944713] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Aleksandar Gavric
- Department of Gastroenterology and Hepatology, University Medical Centre, Ljubljana, Slovenia.,United European Gastroenterology (UEG), Young Talent Group member
| | - David Drobne
- Department of Gastroenterology and Hepatology, University Medical Centre, Ljubljana, Slovenia.,Medical Faculty Ljubljana, University of Ljubljana, Slovenia
| | - Gregor Novak
- Department of Gastroenterology and Hepatology, University Medical Centre, Ljubljana, Slovenia.,Medical Faculty Ljubljana, University of Ljubljana, Slovenia
| |
Collapse
|