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Quintanar-Martínez M, Manzano-Robleda MDC, Murcio-Pérez E, López-Arce G, Bartnicki-Navarrete I, Uscanga L, Hernández-Guerrero A, López-Cossio J, Villalobos-Garita A, Perales-Oliva J, Vargas-Jimenez J, Téllez-Ávila F. Pathology results of endoscopic ultrasound-guided tissue acquisition in retroperitoneal masses: a multicenter study. Ann Gastroenterol 2024; 37:104-108. [PMID: 38223242 PMCID: PMC10785020 DOI: 10.20524/aog.2024.0846] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/30/2023] [Indexed: 01/16/2024] Open
Abstract
Background Malignant etiologies are found in 70-80% of symptomatic retroperitoneal masses. Histology is required for diagnosis and treatment. Information about endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-GTA) is scant for retroperitoneal masses. This study aimed to assess the pathology results of EUS-GTA for diagnosing retroperitoneal masses. Methods This retrospective, multicenter study involved patients from 5 care centers. All patients with retroperitoneal masses who underwent EUS evaluation were enrolled. We recorded demographic and clinical characteristics, location and size of the mass, type of needle (FNA/FNB), and complications related to the procedure. Results A total of 43 patients were included. The median age was 50.5 (range: 23-83) years, and 22 (51.2%) were female. The initial symptom was abdominal pain in 23 (52.3%) cases and weight loss in 11 (25%). Initial imaging was by computed tomography in 33 (75%) patients. Diagnosis with EUS-GTA was reached in 67.5% (29/43) cases. The most frequent histological diagnosis was carcinoma, in 25.5% (11/43). A malignant etiology was found in 31 (72%): 20 were primary tumors from the retroperitoneum, and 11 were metastases. In patients with metastasis, surgery was avoided and medical treatment was indicated. No adverse events were reported. Conclusion EUS and EUS-GTA can frequently provide accurate tissue diagnosis and significantly impact the subsequent management.
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Affiliation(s)
- Mariana Quintanar-Martínez
- Department of Gastrointestinal Endoscopy, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México (Mariana Quintanar-Martínez)
| | - Maria del Carmen Manzano-Robleda
- Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México (Maria del Carmen Manzano-Robleda, Angélica Hernández-Guerrero)
- Gastroenterology Department, Medica Sur Clinic and Foundation, Ciudad de México, México (Maria del Carmen Manzano-Robleda, Jorge Perales-Oliva)
| | - Enrique Murcio-Pérez
- Department of Endoscopy, National Medical Center Century XXI, IMSS, Ciudad de México, México (Enrique Murcio-Pérez, Isaac Bartnicki-Navarrete)
| | | | - Isaac Bartnicki-Navarrete
- Department of Endoscopy, National Medical Center Century XXI, IMSS, Ciudad de México, México (Enrique Murcio-Pérez, Isaac Bartnicki-Navarrete)
| | - Luis Uscanga
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México (Luis Uscanga)
| | - Angélica Hernández-Guerrero
- Department of Endoscopy, Instituto Nacional de Cancerología, Ciudad de México, México (Maria del Carmen Manzano-Robleda, Angélica Hernández-Guerrero)
| | - Jorge López-Cossio
- Hospital del Prado, Tijuana, Baja California, México (Jorge López-Cossio)
| | - Alvaro Villalobos-Garita
- Department of Gastroenterology and Digestive Endoscopy, Hospital Calderón Guardia/Clínica Biblíca, San José Costa Rica (Alvaro Villalobos-Garita José Vargas-Jimenez)
| | - Jorge Perales-Oliva
- Gastroenterology Department, Medica Sur Clinic and Foundation, Ciudad de México, México (Maria del Carmen Manzano-Robleda, Jorge Perales-Oliva)
| | - José Vargas-Jimenez
- Department of Gastroenterology and Digestive Endoscopy, Hospital Calderón Guardia/Clínica Biblíca, San José Costa Rica (Alvaro Villalobos-Garita José Vargas-Jimenez)
| | - Félix Téllez-Ávila
- Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, USA (Félix Téllez-Ávila)
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Moctezuma-Velázquez C, López-Arce G, Martínez-Rodríguez L, Escalona-Huerta C, Chapa-Ibargüengoitia M, Torre A. Giant hepatic hemangioma versus conventional hepatic hemangioma: Clinical findings, risk factors, and management. Revista de Gastroenterología de México (English Edition) 2014. [DOI: 10.1016/j.rgmxen.2014.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Téllez-Ávila F, Barahona-Garrido J, García-Osogobio S, López-Arce G, Camacho-Escobedo J, Saúl A, Herrera-Gómez S, Elizondo-Rivera J, Barreto-Zúñiga R. Diagnostic yield and therapeutic impact of rectal retroflexion: a prospective, single-blind study conducted in three centers. Clin Endosc 2014; 47:79-83. [PMID: 24570887 PMCID: PMC3928497 DOI: 10.5946/ce.2014.47.1.79] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/21/2013] [Accepted: 08/12/2013] [Indexed: 01/05/2023] Open
Abstract
Background/Aims No clear data have been established and validated regarding whether rectal retroflexion has an important and therapeutic impact. The aim of the present study was to evaluate the diagnostic yield and therapeutic impact of rectal retroflexion compared with straight view examination. Methods A prospective single-blind study was conducted. Consecutive patients evaluated between October 2011 and April 2012 were included. Results A total of 934 patients (542 women, 58%) were included. The mean age was 57.4±14.8 years. Retroflexion was successful in 917 patients (98.2%). Distinct lesions in the anorectal area were detected in 32 patients (3.4%), of which 10 (1%) were identified only on retroflex view and 22 (2.4%) on both straight and retroflex views. Of the 32 identified lesions, 16 (50%) were polyps, nine (28.1%) were angiodysplasias, six (18.8%) were ulcers, and one (3.1%) was a flat lesion. All 10 patients (1%) in whom lesions were detected only by rectal retroflexion showed a therapeutic impact. Conclusions Rectal retroflexion has minimal diagnostic yield and therapeutic impact. However, its low rate of major complications and the possibility of detecting lesions undetectable by straight viewing justify its use.
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Affiliation(s)
- Félix Téllez-Ávila
- Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Josué Barahona-Garrido
- Gastroenterology and Digestive Endoscopy Unit, Hospital Las Américas, Guatemala City, Guatemala
| | | | - Gustavo López-Arce
- Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Jesús Camacho-Escobedo
- Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Angela Saúl
- Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Salvador Herrera-Gómez
- Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Javier Elizondo-Rivera
- Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Rafael Barreto-Zúñiga
- Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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López-Arce G, Zepeda-Gómez S, Chávez-Tapia NC, Garcia-Osogobio S, Franco-Guzmán AM, Ramirez-Luna MA, Téllez-Ávila FI. Upper gastrointestinal dieulafoy's lesions and endoscopie treatment: first report from a mexican centre. Therap Adv Gastroenterol 2011; 1:97-101. [PMID: 21180518 DOI: 10.1177/1756283x08096285] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim was to evaluate the initial success, rebleeding rate, need for emergent surgery, and mortality rates of patients with Dieulafoy's lesion (DL) and endoscopic treatment (ET). Patients with DL from a tertiary center were included. We included 20 patients with follow-up of 90 (60-550) days. The lesser curvature was the most common localization. Initial success, rebleeding, and emergent surgery requirement were observed in 90%, 10%, and 15%, respectively. No objective variables were related with response to ET. In conclusion, ET is secure and useful in patients with DL and it must be considered as the first-line treatment modality.
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Affiliation(s)
- Gustavo López-Arce
- Departments of Gastroenterology, Endoscopy and Surgery, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Téllez-Ávila FI, Chávez-Tapia NC, López-Arce G, Garc`a-Osogobio SM, Franco-Guzmán AM, Ruiz-Cordero R, Alfaro-Lara R, Valdovinos F. Utility of a Simplified Predictive Model to Predict Rebleeding in Patients With High-risk Stigmata Ulcers. Surg Laparosc Endosc Percutan Tech 2010; 20:420-3. [DOI: 10.1097/sle.0b013e31820089e1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Barahona-Garrido J, López-Arce G, Criales S. Lower gastrointestinal bleeding in a patient with a history of breast cancer. Gastroenterology 2010; 139:e3-5. [PMID: 20674871 DOI: 10.1053/j.gastro.2009.09.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2009] [Accepted: 09/30/2009] [Indexed: 12/02/2022]
Affiliation(s)
- Josué Barahona-Garrido
- Instituto de Enfermedades Digestivas y Nutricionales and Department of Gastroenterology and Gastrointestinal Endoscopy, Hospital General San Juan de Dios, Guatemala City, Guatemala
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López-Arce G, Téllez-Avila FI, García-Osogobio S, Chavez-Tapia NC, Barahona-Garrido J, Barreto-Zúñiga R, Valdovinos-Andraca F. Endoscopic treatment with argon plasma coagulation in postradiation proctopathy. Int J Colorectal Dis 2010; 25:895-8. [PMID: 20397021 DOI: 10.1007/s00384-010-0940-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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] [Accepted: 03/25/2010] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Postradiation proctopathy (PP) is a major complication in patients who receive radiotherapy for cancer. Medical treatments of this entity are unsatisfactory. Argon plasma coagulation (APC) had been shown to be successful with low complications. The aim was to describe our experience with APC in the management of PP. METHODS We conducted a retrospective analysis of electronic- and paper-based records of patients with PP managed with APC. RESULTS Nineteen patients with PP were included, nine were women. Median age was 64 years, and follow-up was 29 months. The most frequent cause of radiotherapy for cancer was cervicouterine and prostate ENDOSCOPIC FINDINGS: Moderate disease was observed in nine patients; mild and severe diseases were observed in five patients each. At endoscopy, telangiectasias were present in 15, ulcers in five, and active bleeding in two patients. Median of APC sessions was two (one to seven). Mean dose of APC was 30 W (30-40 W) and 1.7 l (1.5-2.0 l). Median time for relief of symptoms was 3 months. All patients were asymptomatic at the end of treatment, and bleeding was controlled at the end of treatment in all patients. Recurrence of bleeding presented in one patient at 4 months. No complications were related to the APC treatment. CONCLUSIONS According to our data, APC is successful in treatment of PP, with few sessions and low morbidity and null mortality.
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Affiliation(s)
- Gustavo López-Arce
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga, Mexico City, Mexico,
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Barahona-Garrido J, Aguirre-Gutiérrez R, Gutiérrez-Manjarrez JI, Tellez-Avila FI, López-Arce G, Fomperoza-Torres A, Criales S, Sánchez-Cortés E, Sarti HM, Yamamoto-Furusho JK. Association of GIST and somatostatinoma in a patient with type-1 neurofibromatosis: is there a common pathway? Am J Gastroenterol 2009; 104:797-9. [PMID: 19223891 DOI: 10.1038/ajg.2008.133] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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López-Arce G, Torre-Delgadillo A, Téllez-Avila FI. Salmonella sp group A: a rare cause of bacterascites. A case report. Ann Hepatol 2009; 7:260-1. [PMID: 18753997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bacterascites (BA) is a minimally studied and defined entity. Its prognosis and clinical course are not well defined, and currently there are no management guidelines. We present a rare cause of BA in which Salmonella sp group A was isolated in a 44 year old man with cirrhosis who had diarrhea and fever three days earlier. Treatment with intravenous ceftriaxone was effective.
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Affiliation(s)
- Gustavo López-Arce
- Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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López-Arce G, Espinoza-Peralta D, Hernández-Alarcón A, Arce-Salinas CA. [Factors associated with microalbuminuria in non-hypertensive type-2 diabetes patients]. Rev Invest Clin 2008; 60:4-10. [PMID: 18589581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Microalbuminuria is a well known risk factor for renal damage and for cardiovascular disease in type-2 diabetic patients. OBJECTIVE To evaluate anthropometric, laboratory, and diet factors related to the presence of microalbuminuria in non-hypertensive type 2 diabetic subjects. MATERIAL AND METHODS We carry-out an assessment of a group of non-hypertensive diabetic patients with or without microalbuminuria. Some anthropometric measures, physical fitness, tobacco and alcohol consumption, creatinine clearance, HbA1c, lipid profile, the mean fast serum glucose levels in last two years, 24 h urine protein, and caloric intake were all measured. RESULTS From 86 included patients, 19 had microalbuminuria; it was related with the length of diabetes mellitus duration (114 +/- 55 vs. 84 +/- 67 months; p = 0.03), higher HbA1c level (8.9 vs. 7.1%; p = 0.001), and lower HDL-cholesterol levels (37.7 +/- 11 vs. 42.9 +/- 12 mg/dL; p = 0.03). In the multivariate analysis HbA1c level, and mean fast glucose remained significant. CONCLUSIONS In non-hypertensive diabetic subjects, poor glucose control, and longer disease duration were both related with microalbuminuria. Moreover, caloric intake, exercise, tobacco or alcohol consumption, or BMI did not show association with microalbuminuria.
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Chávez-Tapia NC, Téllez-Avila FI, Hernández-Calleros J, López-Arce G, Franco-Guzmán A, Uribe M. [Critical analysis of awards in gastroenterology research. The Mexican experience]. Medicina (B Aires) 2008; 68:135-138. [PMID: 18499962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
The impact of Mexican gastrointestinal research worldwide is limited and the outcome of the best research papers awarded by the Asociación Mexicana de Gastroenterología (AMG) is unknown. The objective of this study was to analyze the publication pattern of the research work, awarded by the AMG and their impact in international journals. The abstracts accepted for the annual meeting of the AMG from 1998 to 2006 were reviewed. Those presented in a plenary session or awarded were included. Their abstracts were searched in electronic databases. When not found, the main author was contacted by e-mail. In those papers published in a journal with an impact factor, the times it was cited were assessed. 35 abstracts were identified, mainly in gastroenterology (57.1%) and hepatology (34.3). Only in 5.7% (n=2) some of the authors were members of the governing board of AMG. The awarded institutions were Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (48.6%), Universities (Universidad Autónoma de Nuevo León, Universidad Nacional Autónoma de México and the Benemérita Universidad Autónoma de Puebla) (31.4%), Instituto Mexicano del Seguro Social (8.6%), Fundación Clínica Médica Sur (5.7%), Hospital Juárez (2.9%), Private hospital (2.9%). Most of the papers were published within a year (73.7%). Only 2 papers had more than 10 citations in another international journal with impact factor, with a median for all paper of 5 citations (0-45). Considering all institutions, the rate of publication is 48%. Only half of the awarded works were published and mainly in journals of local distribution. The impact of these studies worldwide is limited.
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Affiliation(s)
- Norberto C Chávez-Tapia
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, México.
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Téllez-Avila FI, Chávez-Tapia NC, Franco-Guzmán AM, Duarte-Rojo A, López-Arce G, Camacho JA, Ramírez-Luna MA. Endoscopic treatment of high-risk bleeding ulcers: success, rebleeding and mortality. Rev Invest Clin 2007; 59:419-423. [PMID: 18402332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION AND AIMS Endoscopic treatment of peptic ulcers with high-risk stigmata has been probed. The rates of recurrent bleeding, need for emergent surgery and death are related to Forrest Classification, Blatchford's modified risk score and the kind of endoscopic treatment used (monotherapy vs. dual). The aims of the present study were to report the success of endoscopic therapy in the reduction of the rate of initial success, recurrent bleeding, the need for surgery, and the mortality rate for patients with bleeding peptic ulcer and high-risk stigmata. PATIENTS AND METHODS From a retrospective view, patients seen from September 2004 to March 2007 who had peptic ulcers Forrest Ia, Ib, IIa and/or IIb were included. RESULTS Fifty-six patients were included (mean [SD] age 57.3 +/-16.6 years). The success rate was 91%, whilst the rest of the patients required immediate surgery. Recurrent bleeding was presented in 14 (27%) patients and eight (14.2%) required emergency surgery. The mortality rate was 3.6%. No factors were associated with the risk of failure to initial treatment, recurrent bleeding or need for surgery. The use of monotherapy by endoscopy was associated with the mortality. The variable "performed by a fellow alone" was not associated with any kind of outcome. CONCLUSION Complication rate is similar to previous reports of general hospitals, but is higher than those of referral centers. Endoscopic monotherapy is associated with a major mortality risk.
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Affiliation(s)
- Félix I Téllez-Avila
- Gastroenterology Departament, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, Mexico City.
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