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Clinical Treatment and Innovation of Gastroenterology

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A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (25 March 2024) | Viewed by 3952

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Special Issue Editor

Prof. Dr. Željko Puljiz

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Guest Editor

Department of Gastroenterology, University Hospital of Split, Spinciceva 1, 21 000 Split, Croatia
Interests: gastroenterology; internal medicine; life sciences; hepatology

Special Issue Information

Dear Colleagues,

In the last several decades there has been a significant shift from a conventional, surgical approach in the treatment of gastroenterological conditions to minimally invasive treatments using cutting-edge endoscopic innovations. Recent advances in endoscopy using high-definition imaging and the development of ultrasound-guided interventions made this progress a reality.

Traditionally, conditions involving the oesophagus, stomach, pancreas and colon have been considered primarily as surgical diseases, but recent advancements have meant that this trend has given way to the rapidly evolving area of interventional gastroenterology. Advances in the endoscopic treatment of different mucosal and submucosal lesions, even early cancers, by using full-thickness resection (FTR), have significantly reduced the need for prolonged hospital stays, also reducing overall morbidity and mortality as well as hospital stay costs. Different advances in therapeutics in relation to transabdominal (US) and endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), endoscopic suturing using over-the-scope clips and bariatric endoscopy are now part of everyday clinical practice.

For all these reasons, we invite colleagues to report their clinical experience with case series or case reports in the everyday treatment of gastroenterological patients. Contributions regarding different endoscopy techniques, such as ERCP, EUS, FTR, dilatations, stenting, ligations, treatment of gastrointestinal bleedings and imaging techniques are all welcome for this collection.

Prof. Dr. Željko Puljiz
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

endoscopy
interventional gastroenterology
EUS
ERCP
FTRD
achalasia

Published Papers (4 papers)

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Research

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9 pages, 912 KiB

Open AccessArticle

The Promising Effects of Erdosteine and Vitamin B in the Liver Ischemia/Reperfusion Model in Anesthetized Rats

by Elif Eygi, Rauf Gul, Murat Aslan, Zeynel Abidin Tas and Recep Dokuyucu

Medicina 2024, 60(5), 783; https://doi.org/10.3390/medicina60050783 - 8 May 2024

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Abstract

Background and Objectives: Erdosteine (Erd) is an antioxidant and anti-inflammatory drug. Vitamin B has been reported to exert anti-inflammatory and antioxidant effects. In this study, we investigated the effect of erdosteine and vitamin B complex on a liver ischemia/reperfusion (I/R) model. Materials and Methods: Thirty-two Wistar Albino male rats weighing 350–400 g were used. The animals were randomly selected and divided into four groups. The groups are as follows: first group (Sham), second group (I/R), third group (I/R + vit B), and fourth group (I/R + vit B + Erd). Rats were subjected to 45 min of hepatic ischemia, followed by a 45 min reperfusion period in the I/R and Vitamin B + Erd groups. An amount of 150 mg/kg/day of erdosteine was given orally for 2 days, and 0.05 mL/kg of i.p. vitamin B complex was given 30 min before the reperfusion. Serum biochemical parameters were measured. Serum Total Antioxidant Status (TAS) and Total Oxidant Status (TOS) were measured, and the Oxidative Stress Index (OSI) was calculated. Hepatic tissue samples were taken for the evaluation of histopathological features. Results: In terms of all histopathological parameters, there were significant differences in the I/R + vit B group and I/R + vit B + Erd group compared with the I/R group (p < 0.01). In terms of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), TNF-alpha, and IL-6 levels, there were significant differences between the I/R group and treatment groups (p < 0.01). The lowest TOS and OSI levels were obtained in the treatment groups, and these groups had statistically significantly higher TAS levels compared with the sham and I/R groups (p < 0.01). Conclusions: As a preliminary experimental study, our study suggests that these agents may have potential diagnostic and therapeutic implications for both ischemic conditions and liver-related diseases. These results suggest that the combination of vit B + Erd may be used to protect against the devastating effects of I/R injury. Our study needs to be confirmed by clinical studies with large participation. Full article

(This article belongs to the Special Issue Clinical Treatment and Innovation of Gastroenterology)

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11 pages, 3764 KiB

Open AccessArticle

Association of Periodontal Disease with Activity of Crohn’s Disease

by Miloš Živić, Nebojša Zdravković, Bojan Stojanović, Bojan Milošević, Željko Todorović, Miljan Adamović and Nataša Zdravković

Medicina 2023, 59(12), 2154; https://doi.org/10.3390/medicina59122154 - 12 Dec 2023

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Abstract

Introduction: Crohn’s disease (CD) is a chronic inflammatory granulomatous disease that can affect the entire gastrointestinal tract. It is characterized by various extraintestinal manifestations (EIMs), of which oral manifestations (OMs) are often possible. One of the possible OMs is periodontal disease (PD), a chronic inflammatory condition of the supporting tissues of the teeth. This study aimed to show the existence of a mutual relationship between the clinical activity of PD and the clinical and endoscopic activity of CD. Materials and methods: One clinical and two endoscopic indexes were used for the assessment of CD activity and clinical attachment loss (CAL), bleeding on probing (BOP), pocket probing depth (PPD), and radiographic bone loss (RBL) in a dental panoramic tomogram to assess PD in CD patients. Results: A total of 38 patients underwent the entire study process, of which 20 patients had CD and 18 patients had CD and PD. Considering all CD activity scores, there were 26 patients with active disease; half of them had PD, and 85.7% of operated patients had active CD. The values of CAL, PPD, BOP, and RBL were higher in active CD patients than those in remission, except for BOP when comparing to the CDAI score, which was higher in those in remission of CD. Conclusion: The results of this study indicate that there is a connection between the activity of CD and worse conditions of the supporting tissues of the gums in the oral cavity, so it is important to keep in mind the necessity of referring patients with CD to a dentist for timely and adequate therapeutic measures. Full article

(This article belongs to the Special Issue Clinical Treatment and Innovation of Gastroenterology)

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8 pages, 4082 KiB

Open AccessCase Report

Two Cases of Lymph Node Metastasis Found in Differentiated, Small-Sized Gastric Adenocarcinomas: Did Tumor Budding Play a Critical Role?

by Young Sub Lee, Yosep Chong, Kyung Jin Seo and Kwangil Yim

Medicina 2023, 59(12), 2126; https://doi.org/10.3390/medicina59122126 - 5 Dec 2023

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Abstract

Background: Endoscopic resection (ER) is a minimally invasive therapeutic approach for early gastric cancer (EGC), particularly for cases with a low risk of lymph node metastasis (LNM). Tumor budding (TB) has gained attention as a potential prognostic indicator for LNM in EGC. Case Presentation: We report two cases—a 73-year-old and an 81-year-old male patient—who presented with gastric adenocarcinoma. Both patients had small-sized, differentiated, and intramucosal adenocarcinomas. However, high-grade TBs per high-power field under ×200 magnification at the invasive front and LNMs were found in both cases. Conclusions: These cases conformed to the post-ER observation guidelines of the current treatment protocol, yet demonstrated LNMs. We found that TB could serve as an effective prognostic marker for LNM compared to traditional risk factors. The aim of this study is to re-examine the ability of TB to predict LNM in EGC, thereby providing an impetus for reconsideration and potential revision of the current treatment guidelines for EGC. Full article

(This article belongs to the Special Issue Clinical Treatment and Innovation of Gastroenterology)

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5 pages, 1023 KiB

Open AccessBrief Report

Prevention of Migration of Esophageal Self-Expandable Metallic Stents Using Endoscopic Clips

by Nikola Boyanov, Katina Shtereva, Katerina Madzharova, Liuben Kirkov, Neno Shopov and Vladimir Andonov

Medicina 2023, 59(11), 2035; https://doi.org/10.3390/medicina59112035 - 17 Nov 2023

Cited by 1 | Viewed by 1011

Abstract

Background and Objectives: Esophageal stenting with self-expandable metallic stents (SEMS), for both benign and malignant reasons, has been widely practiced for decades, but migration still remains the most common complication of the procedure. In this report we aim to review our experience and results in stent fixation with clips. Materials and Methods: We present 18 patients who underwent esophageal stenting for both benign and malignant reasons. The SEMSs used were partially covered and were fixated with two to four through the scope hemostatic clips in the proximal end of the prothesis. The procedure was performed only on patients with a high risk of migration of the stent. Results: Migration occurred in only one of the above-mentioned patients and was treated with stent repositioning. The other adverse events that occurred were related to tumor growth in patients with malignant diseases. Conclusions: Clip fixation of an esophageal self-expandable metallic stent in cases considered high-risk for migration is a safe procedure. It reduces the migration rate significantly for both benign and malignant indications. Full article

(This article belongs to the Special Issue Clinical Treatment and Innovation of Gastroenterology)

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