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Confocal Laser Endomicroscopic Findings of Refractory Erosive Reflux Disease versus Non-Erosive Reflux Disease with Anti-Reflux Mucosectomy: An in vivo and ex vivo Study
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Eunju Jeong, In Kyung Yoo, Abdullah Özgür Yeniova, Dong Keon Yon, Joo Young Cho
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Clin Endosc 2021;54(1):55-63. Published online May 7, 2020
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DOI: https://doi.org/10.5946/ce.2020.040
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background
/Aims: To date, there is no standard tool to diagnose gastroesophageal reflux disease (GERD). Typically, GERD is a non-erosive reflux disease (NERD) that does not present endoscopic abnormalities. Confocal laser endomicroscopy (CLE) has been shown to be an effective tool to identify and diagnose GERD. We aimed to investigate the cellular and vascular changes in vivo and ex vivo through CLE in patients with GERD.
Methods Patients with refractory GERD who underwent mucosectomy were recruited. The distal esophagus was observed in vivo using CLE. Mucosectomy tissue was stained with acriflavine and CLE image was obtained ex vivo. We compared cellular and vascular changes in CLE between erosive reflux disease (ERD), NERD, and a control group.
Results Eleven patients who underwent anti-reflux mucosectomy and five control patients were enrolled in the study. Patients with ERD and NERD presented greater dilated intercellular space than patients in the control group on CLE image. The diameter, number, and cross-sectional area of the intra-papillary capillary loops (IPCLs) were significantly larger in the ERD group than in the NERD group. The irregular shape of the IPCLs were observed in both patients with ERD and NERD.
Conclusions The irregular shape of the IPCLs were significantly correlated with a positive diagnosis of GERD. CLE may diagnose NERD with high sensitivity and accuracy.
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Citations
Citations to this article as recorded by
- Outcomes of Endoscopic Antireflux Mucosectomy for the Treatment of Gastroesophageal Reflux Disease
Martin Galvarini, Cristian A. Angeramo, Javier Kerman, Rubén Balmaceda, Ignacio Debes, Fernando A.M. Herbella, Francisco Schlottmann Journal of Clinical Gastroenterology.2024; 58(9): 851. CrossRef - Gastroesophageal reflux disease: indications for antireflux surgery, outcomes, and side effects
Francisco Schlottmann, Sofia Bertona, Fernando A.M. Herbella, Marco G. Patti Expert Review of Gastroenterology & Hepatology.2024; 18(11): 693. CrossRef - Anti-reflux mucosal resection for treatment of refractory gastro-oesophageal reflux disease: Efficacy and impact on perioperative indicators
Xing-Feng Ge, Xian Zhu, Fei Min, Jian-Wei Shen World Chinese Journal of Digestology.2023; 31(4): 157. CrossRef
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Effectiveness of Autologous Platelet-Rich Plasma for the Healing of Ulcers after Endoscopic Submucosal Dissection
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Eunju Jeong, In kyung Yoo, Ozlem Ozer Cakir, Hee Kyung Kim, Won Hee Kim, Sung Pyo Hong, Joo Young Cho
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Clin Endosc 2019;52(5):472-478. Published online May 17, 2019
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DOI: https://doi.org/10.5946/ce.2018.152
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Abstract
PDFPubReaderePub
- Background
/Aims: Platelet-rich plasma (PRP) has been used for wound healing in various medical fields. The aim of this study was to evaluate the clinical efficacy and safety of local PRP injections after endoscopic submucosal dissection (ESD).
Methods Patients were non-randomly divided into the following two groups: (1) control group in which patients were administered only an intravenous proton pump inhibitor (PPI), and (2) a study group in which patients were administered an intravenous PPI and a topical PRP injection. We assessed the reduction in the ulcer area and stage of the ulcer after the procedure (24 hours, 48 hours, and 28 days after endoscopic surgery).
Results We enrolled 7 study and 7 control patients. In the study group, the rate of ulcer reduction was 59% compared to 52% in the control group (p=0.372), 28 days after ESD. There were 5 patients in the S stage and 2 patients in the H stage in the study group compared to no patient in the S stage and 7 patients in the H stage in the control group (p=0.05), 28 days after ESD. There were no serious complications in either group.
Conclusions The local injection of PRP is a safe and effective procedure for ulcer healing after ESD.
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Citations
Citations to this article as recorded by
- Clinical efficacy of blood derivatives on wound healing: A systematic review and network meta‐analysis
Yanhong Wu, Guang Peng, Yuzhi Wang, Jianwu Chen, Bin Zhang, Jianbing Tang, Biao Cheng International Wound Journal.2024;[Epub] CrossRef - Endoscopic Shielding With Platelet-rich Plasma After Resection Of Large Colorectal Lesions
Vicente Lorenzo-Zúñiga, Vicente Moreno de Vega, Ramón Bartolí Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(3): 376. CrossRef - The Additive Effect of Platelet-Rich Plasma in the Treatment of Actively Bleeding Peptic Ulcer
Waseem M. Seleem, Amr Shaaban Hanafy Clinical Endoscopy.2021; 54(6): 864. CrossRef - Endless Challenges in Overcoming Complications Associated with Endoscopic Submucosal Dissection
Satoshi Ono, Shun Ito, Kenji Ogata Clinical Endoscopy.2019; 52(5): 395. CrossRef
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