Clinical Endoscopy

Rajat Garg

3 Articles

Endoscopic versus surgical management for colonic volvulus hospitalizations in the United States: Dushyant Singh Dahiya, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Amandeep Singh, Rajat Garg, Chin-I Cheng, Mohammad Al-Haddad, Madhusudhan R. Sanaka, Neil Sharma; Clin Endosc 2023;56(3):340-352. Published online April 17, 2023; DOI: https://doi.org/10.5946/ce.2022.166

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States.
Methods
We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared.
Results
From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p=0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management.
Conclusions
Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.

Citations

Citations to this article as recorded by

Navigating Abdominal Volvulus: A Comprehensive Review of Management Strategies
Simran Chauhan, Raju K Shinde, Yashraj Jain
Cureus.2024;[Epub] CrossRef
Clinicopathological Features of Elderly Patients with Colonic Volvulus
Mehmet Onur Gul, Selda Oğuz Aşlayan, Kadir Çorbacı, Aytaç Selman, Emre Berat Akçay, Oğuzhan Sunamak, Cebrail Akyüz
European Journal of Therapeutics.2024; 30(3): 303. CrossRef
Incidental Sigmoid Volvulus after a Ground-level Fall: An Unusual Case Report
Ziya Karimov, Elchin Shirinov, Gunay Huseynova, Mirhuseyn Mammadov, Meltem Songür Kodik
Caucasian Medical Journal.2023; 1(3): 36. CrossRef
Colonic Volvulus
Samantha L. Savitch, Calista M. Harbaugh
Clinics in Colon and Rectal Surgery.2023;[Epub] CrossRef

2,465 View
153 Download
4 Web of Science
4 Crossref

Underwater Endoscopic Mucosal Resection for 10 mm or Larger Nonpedunculated Colorectal Polyps: A Systematic Review and Meta-Analysis: Rajat Garg, Amandeep Singh, Manik Aggarwal, Jaideep Bhalla, Babu P. Mohan, Carol Burke, Tarun Rustagi, Prabhleen Chahal; Clin Endosc 2021;54(3):379-389. Published online April 29, 2021; DOI: https://doi.org/10.5946/ce.2020.276

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Recent studies have reported the favorable outcomes of underwater endoscopic mucosal resection (UEMR) for colorectal polyps. We performed a systematic review and meta-analysis evaluating the efficacy and safety of UEMR for nonpedunculated polyps ≥10 mm.
Methods
We performed a comprehensive search of multiple databases (through May 2020) to identify studies reporting the outcomes of UEMR for ≥10 mm nonpedunculated colorectal polyps. The assessed outcomes were recurrence rate on the first follow-up, en bloc resection, incomplete resection, and adverse events after UEMR.
Results
A total of 1276 polyps from 16 articles were included in our study. The recurrence rate was 7.3% (95% confidence interval [CI], 4.3–12) and 5.9% (95% CI, 3.6–9.4) for nonpedunculated polyps ≥10 and ≥20 mm, respectively. For nonpedunculated polyps ≥10 mm, the en bloc resection, R0 resection, and incomplete resection rates were 57.7% (95% CI, 42.4–71.6), 58.9% (95% CI, 42.4–73.6), and 1.5% (95% CI, 0.8–2.6), respectively. The rates of pooled adverse events, intraprocedural bleeding, and delayed bleeding were 7.0%, 5.4%, and 2.9%, respectively. The rate of perforation and postpolypectomy syndrome was 0.8%.
Conclusions
Our systematic review and meta-analysis demonstrates that UEMR for nonpedunculated colorectal polyps ≥10 mm is safe and effective with a low rate of recurrence.

Citations

Citations to this article as recorded by

Polypectomy Techniques for Pedunculated and Nonpedunculated Polyps
Karl Kwok, Sasan Mosadeghi, Daniel Lew
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 361. CrossRef
Underwater versus conventional endoscopic mucosal resection for colorectal lesions: a systematic review and meta-analysis of randomized clinical trials
Matheus Henrique Gonçalves de Souza, Paula Arruda do Espirito Santo, Fauze Maluf-Filho, Luciano Lenz
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef
EMR and ESD: Indications, techniques and results
Mamoon Ur Rashid, Mohammad Alomari, Sadaf Afraz, Tolga Erim
Surgical Oncology.2022; 43: 101742. CrossRef
Safety and effectiveness of underwater cold snare resection without submucosal injection of large non-pedunculated colorectal lesions
Andrew W. Yen, Joseph W. Leung, Malcom Koo, Felix W. Leung
Endoscopy International Open.2022; 10(06): E791. CrossRef
Underwater or conventional endoscopic mucosal resection for intermediate‐sized colorectal neoplasm?
Li‐Chun Chang
Advances in Digestive Medicine.2021; 8(3): 133. CrossRef

5,119 View
144 Download
6 Web of Science
6 Crossref

Efficacy and Safety of Lumen-Apposing Stents for Management of Pancreatic Fluid Collections in a Community Hospital Setting: Rajat Garg, Abdelkader Chaar, Susan Szpunar, Babu P. Mohan, Mohammed Barawi; Clin Endosc 2020;53(4):480-486. Published online October 16, 2019; DOI: https://doi.org/10.5946/ce.2019.116

Abstract PDF PubReader ePub

Background
/Aims: Endoscopic ultrasound-guided transmural drainage and necrosectomy employing lumen-apposing metal stent (LAMS) are used for treating pancreatic fluid collections (PFCs) with excellent results from academic centers. Herein, we report the efficacy and safety of LAMS in the treatment of PFCs at a community hospital.
Methods
We retrospectively reviewed the etiology of pancreatitis, type and size of PFCs, length of procedure, technical success, clinical success, adverse events, and stent removal. The primary outcome was the rate of clinical success, and secondary outcomes were technical success and adverse events.
Results
Twenty-seven patients with a mean age of 54.1±6.5 years were included, 44% of which were men. The mean size of the PFCs was 9.7±5.0 cm (range, 3–21). The most common etiology of pancreatitis was alcohol (44%) followed by idiopathic causes (30%) and presence of gallstones (22%). The diagnosis was pseudocyst in 44.4% (12/27) and walled off necrosis in 55.6% (15/27) of patients. There was 100% technical success without any complications. Clinical success was achieved in 22 of 27 patients (81.5%) who underwent stent removal.
Conclusions
Our study is the first to report that endoscopic therapy of PFCs using LAMS is safe and effective even in a community hospital setting with limited resources and support compared to large academic centers.

Citations

Citations to this article as recorded by

EUS-guided interventional therapies for pancreatic diseases
Rongmin Xu, Kai Zhang, Nan Ge, Siyu Sun
Frontiers in Medicine.2024;[Epub] CrossRef
Trans-cavity lumen-apposing metal stent removal: an alternative safe modality
Giacomo Emanuele Maria Rizzo, Ilaria Tarantino
Clinical Endoscopy.2023; 56(1): 129. CrossRef
Lumen-apposing-metal stent misdeployment in endoscopic ultrasound-guided drainages: A systematic review focusing on issues and rescue management
Elia Armellini, Flavio Metelli, Andrea Anderloni, Anna Cominardi, Giovanni Aragona, Michele Marini, Fabio Pace
World Journal of Gastroenterology.2023; 29(21): 3341. CrossRef
Lumen-apposing metal stents: How far are we from standardization? An Italian survey
Carlo Fabbri, Chiara Coluccio, Cecilia Binda, Alessandro Fugazza, Andrea Anderloni, Ilaria Tarantino, NA i-EUS Group
Endoscopic Ultrasound.2022; 11(1): 59. CrossRef
Endoscopic Drainage of Giant Pancreatic Pseudocysts Using Both Lumen-Apposing Metal Stent and Plastic Stent: A Report of Two Cases and Review of the Current Literature
Hussam I. A. Alzeerelhouseini, Muawiyah Elqadi, Mohammad N. Elqadi, Sadi A. Abukhalaf, Hazem A. Ashhab, Yoshifumi Nakayama
Case Reports in Gastrointestinal Medicine.2021; 2021: 1. CrossRef
Editors' Choice of Noteworthy Clinical Endoscopy Publications in the First Decade
Gwang Ha Kim, Kwang An Kwon, Do Hyun Park, Jimin Han
Clinical Endoscopy.2021; 54(5): 633. CrossRef
Comparative outcomes of endoscopic ultrasound‐guided lumen‐apposing mental stents drainage for pancreatic pseudocysts and walled‐off necrosis: Case series and meta‐analysis
Jing Li, Qian Zhang, Anni Zhou, Guiping Zhao, Peng Li
Chronic Diseases and Translational Medicine.2021; 7(3): 157. CrossRef
Reply
Kazuki Takeishi, Toru Ikegami, Tomoharu Yoshizumi, Nao Fujimori, Masaki Mori
Liver Transplantation.2020; 26(5): 727. CrossRef
Safety and efficacy of lumen-apposing metal stents versus plastic stents to treat walled-off pancreatic necrosis: systematic review and meta-analysis
Vinay Chandrasekhara, Marc Barthet, Jacques Devière, Fateh Bazerbachi, Sundeep Lakhtakia, Jeffrey J. Easler, Joyce A. Peetermans, Edmund McMullen, Ornela Gjata, Margaret L. Gourlay, Barham K. Abu Dayyeh
Endoscopy International Open.2020; 08(11): E1639. CrossRef

10,441 View
204 Download
8 Web of Science
9 Crossref

Author index