Feasibility and Safety of Through-the-scope versus Over-the-wire Stents for the Palliation of Malignant Dysphagia. A Cohort Real- Life Study.

BACKGROUND AND AIMS: In the presence of malignant dysphagia in non-surgical candidates, a self-expanding metal stent (SEMS) represents a safe and effective approach. Recently, a through-the-scope (TTS) SEMS was launched. The aim of our study was to assess the feasibility and safety of the TTS versus over-the-wire (OTW) SEMS in patients with malignant dysphagia. METHODS: This single-center retrospective cohort study included patients with malignant dysphagia undergoing esophageal TTS and OTW-SEMS from 2012 to May-2022. The primary outcomes were the technical and the clinical success of the SEMS placement. Secondary outcomes included adverse events, patency, and survival. Patients were prospectively followed until death or loss of follow-up. RESULTS: A total of 98 patients were enrolled, including 34 patients in the TTS group and 64 patients in the OTW group. TTS and OTW SEMS placement were feasible in 33 (97.1%) and 64 (100%) procedures , respectively (p=0.118). Overall, 32 patients (94.1%) in the TTS group and 62 patients (96.9%) in the OTW group showed an improvement in Ogilvie score (p=0.432). Recurrent dysphagia occurred in 30 patients, 12 in TTS group and 18 in OTW group, due to migration (4 vs. 5), stent deformation (1 vs. 1), tissue ingrowth (5 vs. 5) and overgrowth (2 vs. 7). No patient died from a stent-related cause. Median survival was 123 days (IQR: 59-209) in TTS group and 113 days (IQR: 73-271) in OTW group (p=0.349). CONCLUSIONS: Placement of esophageal TTS and OTW stents resulted in similar technical and clinical outcomes, stent patency and survival in patients with malignant dysphagia.

Impact of the SARS-CoV-2 pandemic on pancreatic cancer: diagnosis and short-term survival.

INTRODUCTION: The COVID-19 pandemic has delayed medical consultation, possibly leading to the diagnosis of gastrointestinal cancer. The aim of the study was to analyze the impact of SARS-Cov-2 pandemic on new diagnosis and short-term survival of patients with pancreatic cancer (PC). METHODS: All consecutive patients who had a suspected diagnosis of pancreatic lesion before (from March to September 2019) and during COVID 19 pandemic (from March to September 2020). Demographics, clinical and treatment were collected and compared. Short-term survival was assessed. RESULTS: A total of 25 patients (n=13 men) with diagnosis of adenocarcinoma of the pancreas and a median age of 70 years (IQR 62-74) were included. An increase was observed in the number of patients with newly diagnosed PC (n= 12 [19.1%] versus n=13 [20.9%]; P= 0.603). The subgroup analysis revealed a tendency toward a longer diagnosis (11 versus 12 days; P= 0.219) and treatment (28 versus 44; P= 0.375) delay for patients with PC during COVID-19 pandemic. A significant increase was observed for number of cases of advanced stage III and IV (n=4 [30.8%] versus n=7 [53.8%]; P= 0.006). Palliative treatment was the most frequent approach during COVID-19 period. During 1-year follow-up, 6 (50%) and 7 (61.5%) deaths were observed among patients diagnosed before and after COVID-19 (P= 0.449), respectively. CONCLUSIONS: The COVID-19 pandemic has led to delays in diagnosis and treatment in PC, which translates into an advanced staging and a worse prognosis. These data should stimulate health care provider to facilitate procedures for detection pancreatic cancer.

Drenaje de abscesos pélvicos posquirúrgicos guiado por ecoendoscopia mediante prótesis de aposición luminal / EUS-guided drainage of postsurgical pelvic abscesses using lumen-apposing metal stents

El drenaje guiado por ecoendoscopia (USE) de colecciones pélvicas es una alternativa al drenaje percutáneo o quirúrgico. Se presenta nuestra experiencia con el uso de prótesis de aposición luminal (LAMS) en el drenaje de abscesos pélvicos posquirúrgicos

Endoscopic ultrasound (EUS) guided drainage of pelvic collections is an alternative to percutaneous or surgical drainage. We present our experience using lumen-apposing metal stents (LAMS) for the drainage of postoperative pelvic abscesses

EUS-guided drainage of postsurgical pelvic abscesses using lumen-apposing metal stents.

Endoscopic ultrasound (EUS) guided drainage of pelvic collections is an alternative to percutaneous or surgical drainage. We present our experience using lumen-apposing metal stents (LAMS) for the drainage of postoperative pelvic abscesses.

Ictericia obstructiva secundaria a adenoma en conducto hepático común / Obstructive jaundice caused by an adenoma of the common hepatic duct

No disponible

Colitis asociada a rituximab / Rituximab-associated colitis

No disponible