44 results on '"Bustamante-Balén, Marco"'
Search Results
2. Early colorectal cancer diagnosed after endoscopic resection: Conservative treatment is safe in most of the cases. Proposal for a risk-based management
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Sancho-Muriel, Jorge, Pellino, Gianluca, Cholewa, Hanna, Giner, Francisco, Bustamante-Balén, Marco, Montesarchio, Luca, García-Granero, Eduardo, and Frasson, Matteo
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- 2022
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3. Development of knowledge-based clinical decision support system for patients included in colorectal screening program
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Lorenzo-Zúñiga, Vicente, Bustamante-Balén, Marco, Pons-Beltrán, Vicente, and Peña-Gil, Carlos
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- 2022
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4. Cholangioscopy-Guided Surgical Clip Extraction During Giant Stone Lithotripsy
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López-Muñoz, Pedro, García-Campos, María, Lorenzo-Zúñiga, Vicente, Alonso-Lázaro, Noelia, Argüello, Lidia, Bustamante-Balén, Marco, and Pons-Beltrán, Vicente
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- 2023
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5. When and How To Use Endoscopic Tattooing in the Colon: An International Delphi Agreement
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Medina-Prado, Lucía, Hassan, Cesare, Dekker, Evelien, Bisschops, Raf, Alfieri, Sergio, Bhandari, Pradeep, Bourke, Michael J., Bravo, Raquel, Bustamante-Balen, Marco, Dominitz, Jason, Ferlitsch, Monika, Fockens, Paul, van Leerdam, Monique, Lieberman, David, Herráiz, Maite, Kahi, Charles, Kaminski, Michal, Matsuda, Takahisa, Moss, Alan, Pellisé, Maria, Pohl, Heiko, Rees, Colin, Rex, Douglas K., Romero-Simó, Manuel, Rutter, Matthew D., Sharma, Prateek, Shaukat, Aasma, Thomas-Gibson, Siwan, Valori, Roland, and Jover, Rodrigo
- Published
- 2021
- Full Text
- View/download PDF
6. Effect of the SARS‐CoV‐2 pandemic on colorectal cancer diagnosis and prognosis.
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Medina‐Prado, Lucía, Sala‐Miquel, Noelia, Aicart‐Ramos, Marta, López‐Cardona, Julia, Ponce‐Romero, Marta, Ortíz, Oswaldo, Pellisé, María, Aguilera, Lara, Díez‐Redondo, Pilar, Núñez‐Rodríguez, Henar, Seoane, Agustín, Domper‐Arnal, María‐José, Borao‐Laguna, Cristina, González‐Bernardo, Óscar, Suárez, Adolfo, Muñoz‐Tornero, María, Bustamante‐Balén, Marco, Soutullo‐Castiñeiras, Carlos, Balleste‐Peris, Belén, and Esteban, Pilar
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COVID-19 pandemic ,CANCER diagnosis ,COLORECTAL cancer ,MEDICAL screening ,CANCER prognosis ,RECTAL cancer ,VIRTUAL colonoscopy - Abstract
Background and Study Aims: Our aim was to determine the impact of the SARS‐CoV‐2 pandemic on the diagnosis and prognosis of colorectal cancer (CRC). Patients and Methods: This prospective cohort study included individuals diagnosed with CRC between March 13, 2019 and June 20, 2021 across 21 Spanish hospitals. Two time periods were compared: prepandemic (from March 13, 2019 to March 13, 2020) and pandemic (from March 14, 2020 to June 20, 2021, lockdown period and 1 year after lockdown). Results: We observed a 46.9% decrease in the number of CRC diagnoses (95% confidence interval (CI): 45.1%–48.7%) during the lockdown and 29.7% decrease (95% CI: 28.1%–31.4%) in the year after the lockdown. The proportion of patients diagnosed at stage I significantly decreased during the pandemic (21.7% vs. 19.0%; p = 0.025). Centers that applied universal preprocedure SARS‐CoV‐2 PCR testing experienced a higher reduction in the number of colonoscopies performed during the pandemic post‐lockdown (34.0% reduction; 95% CI: 33.6%–34.4% vs. 13.7; 95% CI: 13.4%–13.9%) and in the number of CRCs diagnosed (34.1% reduction; 95% CI: 31.4%–36.8% vs. 26.7%; 95% CI: 24.6%–28.8%). Curative treatment was received by 87.5% of patients diagnosed with rectal cancer prepandemic and 80.7% of patients during the pandemic post‐lockdown period (p = 0.002). Conclusions: The COVID‐19 pandemic has led to a decrease in the number of diagnosed CRC cases and in the proportion of stage I CRC. The reduction in the number of colonoscopies and CRC diagnoses was higher in centers that applied universal SARS‐CoV‐2 PCR screening before colonoscopy. In addition, the COVID‐19 pandemic has affected curative treatment of rectal cancers. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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7. New management of hepatolithiasis: Can surgery be avoided? (with video)
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Mansilla-Vivar, Rodrigo, Alonso-Lázaro, Noelia, Argüello-Viudez, Lidia, Ponce-Romero, Marta, Bustamante-Balen, Marco, and Pons-Beltrán, Vicente
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- 2020
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8. Panchromoendoscopy Increases Detection of Polyps in Patients With Serrated Polyposis Syndrome
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López-Vicente, Jorge, Rodríguez-Alcalde, Daniel, Hernández, Luis, Riu Pons, Fausto, Vega, Pablo, Herrero Rivas, Jesus Miguel, Santiago García, José, Salces Franco, Inmaculada, Bustamante Balén, Marco, López-Cerón, María, and Pellisé, María
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- 2019
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9. Periendoscopic management of antiplatelet therapy: Prospective evaluation of adherence to guidelines
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Plumé, Gema, Satorres, Carla, Diaz, Francia C., Alonso, Noelia, Navarro, Belén, Ponce, Marta, Pons-Beltrán, Vicente, Argüello, Lidia, and Bustamante-Balén, Marco
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- 2019
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10. Accuracy of the Narrow-Band Imaging International Colorectal Endoscopic Classification System in Identification of Deep Invasion in Colorectal Polyps
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Muñoz, Guillermo, Peligros, Isabel, Tardio Baiges, Antoni, Elbouayadl, Liliam, Carames, Nuria, Iglesias, Mar, del Carmen, Sofía, González-Lois, Carmen, Núñez, Henar, García Hernández, Sonia, Guerra Pastrián, Laura, López Carreira, Montserrat, Casalots, Álex, Caminoa, Alejandra, Solano, Marina, López-Ibáñez, María, Llaó, Jordina, Estévez, Pamela, Rodríguez-Alcalde, Daniel, Soto, Santiago, Pantaleón, Miguel, Álvarez, Alberto, Zamora Martínez, Tomás, Pascual, Juan Manuel, Ducóns, Julio, García-Lledó, Javier, Porta, Francesc, Hernández, Vicent, Cubiella, Joaquin, Riu, Faust, Simón, Miguel Ángel, Martínez, David, Seoane, Agustín, Gomollón, Fernando, Cid, Lucía, Sostres, Carlos, Domínguez, Fulgencio, Macenlle, Ramiro Manuel, de la Revilla, Juan, Isava, Álvaro, Campo, Rafael, de la Poza, Gema, Martínez, Alfonso, Quintas, Paola, Sánchez, Eloy, Foruny, Jose Ramón, Marín, Eva, Martínez, José Luis, Castro, Maria Inés, González, Juan Ángel, Llop, Elba, Martín, Eduardo, Rey, Rafael, Sort, Pau, Montesinos, Jesús, Fornells, Marta, Ascon, Nadia, Puig, Ignasi, López-Cerón, María, Arnau, Anna, Rosiñol, Òria, Cuatrecasas, Miriam, Herreros-de-Tejada, Alberto, Ferrández, Ángel, Serra-Burriel, Miquel, Nogales, Óscar, Vida, Francesc, de Castro, Luisa, López-Vicente, Jorge, Vega, Pablo, Álvarez-González, Marco A., González-Santiago, Jesús, Hernández-Conde, Marta, Díez-Redondo, Pilar, Rivero-Sánchez, Liseth, Gimeno-García, Antonio Z., Burgos, Aurora, García-Alonso, Francisco Javier, Bustamante-Balén, Marco, Martínez-Bauer, Eva, Peñas, Beatriz, and Pellise, Maria
- Published
- 2019
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11. Real-life chromoendoscopy for neoplasia detection and characterisation in long-standing IBD
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Carballal, Sabela, Maisterra, Sandra, López-Serrano, Antonio, Gimeno-García, Antonio Z, Vera, María Isabel, Marín-Garbriel, José Carlos, Díaz-Tasende, José, Márquez, Lucía, Álvarez, Marco Antonio, Hernández, Luis, De Castro, Luisa, Gordillo, Jordi, Puig, Ignasi, Vega, Pablo, Bustamante-Balén, Marco, Acevedo, Juan, Peñas, Beatriz, López-Cerón, María, Ricart, Elena, Cuatrecasas, Miriam, Jimeno, Mireya, and Pellisé, María
- Published
- 2018
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12. Contrast-enhanced ultrasonography: Usefulness in the assessment of postoperative recurrence of Crohn's disease
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Paredes, José María, Ripollés, Tomás, Cortés, Xavier, Moreno, Nadia, Martínez, María Jesús, Bustamante-Balén, Marco, Delgado, Fructuoso, and Moreno-Osset, Eduardo
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- 2013
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13. Erratum: Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement (Endoscopy (2020) 52 (899-923) DOI: 10.1055/a-1231-5123)
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Dekker, Evelien, Houwen, Britt B. S. L., Puig, Ignasi, Bustamante-Balén, Marco, Coron, Emmanuel, Dobru, Daniela E., Kuvaev, Roman, Neumann, Helmut, Johnson, Gavin, Pimentel-Nunes, Pedro, Sanders, David S., Dinis-Ribeiro, Mario, Arvanitakis, Marianna, Ponchon, Thierry, East, James E., Bisschops, Raf, Gastroenterology and Hepatology, CCA - Imaging and biomarkers, Amsterdam Gastroenterology Endocrinology Metabolism, and APH - Quality of Care
- Abstract
In the above-mentioned article, one sentence on page 912 (Optical diagnosis training for early gastric cancer, Part B) has been corrected. Correct is: The curriculum committee suggests, based on personal experience, that assessment of at least 20 gastric lesions prospectively in patients at high risk of gastric dysplasia/EGC is needed before competence should be assessed. This was corrected in the online version on September 23, 2020.
- Published
- 2020
14. Definition of competence standards for optical diagnosis of diminutive colorectal polyps: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.
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Houwen, Britt B. S. L., Hassan, Cesare, Coupé, Veerle M. H., Greuter, Marjolein J. E., Hazewinkel, Yark, Vleugels, Jasper L. A., Antonelli, Giulio, Bustamante-Balén, Marco, Coron, Emmanuel, Cortas, George A., Dinis-Ribeiro, Mario, Dobru, Daniela E., East, James E., Iacucci, Marietta, Jover, Rodrigo, Kuvaev, Roman, Neumann, Helmut, Pellisé, Maria, Puig, Ignasi, and Rutter, Matthew D.
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COLON polyps ,COLONOSCOPY ,ARTIFICIAL intelligence ,COLORECTAL cancer ,ENDOSCOPIC gastrointestinal surgery - Abstract
BACKGROUND : The European Society of Gastrointestinal Endoscopy (ESGE) has developed a core curriculum for high quality optical diagnosis training for practice across Europe. The development of easy-to-measure competence standards for optical diagnosis can optimize clinical decision-making in endoscopy. This manuscript represents an official Position Statement of the ESGE aiming to define simple, safe, and easy-to-measure competence standards for endoscopists and artificial intelligence systems performing optical diagnosis of diminutive colorectal polyps (1 - 5 mm). METHODS : A panel of European experts in optical diagnosis participated in a modified Delphi process to reach consensus on Simple Optical Diagnosis Accuracy (SODA) competence standards for implementation of the optical diagnosis strategy for diminutive colorectal polyps. In order to assess the clinical benefits and harms of implementing optical diagnosis with different competence standards, a systematic literature search was performed. This was complemented with the results from a recently performed simulation study that provides guidance for setting alternative competence standards for optical diagnosis. Proposed competence standards were based on literature search and simulation study results. Competence standards were accepted if at least 80 % agreement was reached after a maximum of three voting rounds. RECOMMENDATION 1: In order to implement the leave-in-situ strategy for diminutive colorectal lesions (1-5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 90 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1-5 mm in the rectosigmoid. Histopathology is used as the gold standard.Level of agreement 95 %. RECOMMENDATION 2: In order to implement the resect-and-discard strategy for diminutive colorectal lesions (1-5 mm), it is clinically acceptable if, during real-time colonoscopy, at least 80 % sensitivity and 80 % specificity is achieved for high confidence endoscopic characterization of colorectal neoplasia of 1-5 mm. Histopathology is used as the gold standard.Level of agreement 100 %. CONCLUSION : The developed SODA competence standards define diagnostic performance thresholds in relation to clinical consequences, for training and for use when auditing the optical diagnosis of diminutive colorectal polyps. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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15. Molecular Features of the Serrated Pathway to Colorectal Cancer: Current Knowledge and Future Directions.
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Satorres, Carla, García-Campos, María, and Bustamante-Balén, Marco
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COLORECTAL cancer ,MITOGEN-activated protein kinases ,TUMOR suppressor genes ,HUMAN carcinogenesis ,PHENOTYPES ,KNOWLEDGE gap theory - Abstract
Serrated lesions are the precursor lesions of a new model of colorectal carcinogenesis. From a molecular standpoint, the serrated pathway is thought to be responsible for up to 30% of all colorectal cancer cases. The three major processes of this molecular mechanism are alterations in the mitogen-activated protein kinase pathway, production of the CpG island methylation phenotype, and generation of microsatellite instability. Other contributing processes are activation of WNT, alterations in the regulation of tumor suppressor genes, and alterations in microRNAs or in MUC5AC hypomethylation. Although alterations in the serrated pathway also contribute, their precise roles remain obscure because of the various methodologies and definitions used by different research groups. This knowledge gap affects clinical assessment of precursor lesions for their carcinogenic risk. The present review describes the current literature reporting the molecular mechanisms underlying each type of serrated lesion and each phenotype of serrated pathway colorectal cancer, identifying those areas that merit additional research. We also propose a unified serrated carcinogenesis pathway combining molecular alterations and types of serrated lesions, which ends in different serrated pathway colorectal cancer phenotypes depending on the route followed. Finally, we describe some key issues that need to be addressed in order to incorporate the newest technologies in serrated pathway research and to improve overall knowledge for developing specific prevention strategies and new therapeutic targets. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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16. Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.
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Dekker, Evelien, Houwen, Britt B. S. L., Puig, Ignasi, Bustamante-Balén, Marco, Coron, Emmanuel, Dobru, Daniela E., Kuvaev, Roman, Neumann, Helmut, Johnson, Gavin, Pimentel-Nunes, Pedro, Sanders, David S., Dinis-Ribeiro, Mario, Arvanitakis, Marianna, Ponchon, Thierry, East, James E., and Bisschops, Raf
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BARRETT'S esophagus ,ENDOSCOPY ,SQUAMOUS cell carcinoma ,REQUIRED courses (Education) ,RESEARCH ,RESEARCH methodology ,CURRICULUM ,EVALUATION research ,MEDICAL cooperation ,COMPARATIVE studies ,ENDOSCOPIC gastrointestinal surgery ,ESOPHAGEAL tumors - Abstract
This manuscript represents an official Position Statement of the European Society of Gastrointestinal Endoscopy (ESGE) aiming to guide general gastroenterologists to develop and maintain skills in optical diagnosis during endoscopy. In general, this requires additional training beyond the core curriculum currently provided in each country. In this context, ESGE have developed a European core curriculum for optical diagnosis practice across Europe for high quality optical diagnosis training. 1: ESGE suggests that every endoscopist should have achieved general competence in upper and/or lower gastrointestinal (UGI/LGI) endoscopy before commencing training in optical diagnosis of the UGI/LGI tract, meaning personal experience of at least 300 UGI and/or 300 LGI endoscopies and meeting the ESGE quality measures for UGI/LGI endoscopy. ESGE suggests that every endoscopist should be able and competent to perform UGI/LGI endoscopy with high definition white light combined with virtual and/or dye-based chromoendoscopy before commencing training in optical diagnosis. 2: ESGE suggests competency in optical diagnosis can be learned by attending a validated optical diagnosis training course based on a validated classification, and self-learning with a minimum number of lesions. If no validated training course is available, optical diagnosis can only be learned by attending a non-validated onsite training course and self-learning with a minimum number of lesions. 3: ESGE suggests endoscopists are competent in optical diagnosis after meeting the pre-adoption and learning criteria, and meeting competence thresholds by assessing a minimum number of lesions prospectively during real-time endoscopy. ESGE suggests ongoing in vivo practice by endoscopists to maintain competence in optical diagnosis. If a competent endoscopist does not perform in vivo optical diagnosis on a regular basis, ESGE suggests repeating the learning and competence phases to maintain competence.Key areas of interest were optical diagnosis training in Barrett's esophagus, esophageal squamous cell carcinoma, early gastric cancer, diminutive colorectal lesions, early colorectal cancer, and neoplasia in inflammatory bowel disease. Condition-specific recommendations are provided in the main document. [ABSTRACT FROM AUTHOR]
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- 2020
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17. Primary chancre in the rectum: an underdiagnosed cause of rectal ulcer
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Díaz-Jaime, Francia, Satorres-Paniagua, Carla, and Bustamante-Balén, Marco
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- 2017
18. Formación de un nudo en el sistema de infusión duodenal de Duodopa®
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del-Hoyo-Francisco, Javier, Bustamante-Balén, Marco, Martínez-Torres, Irene, Barrios-Barrios, Alejandra, Satorres-Paniagua, Carla, and Pons-Beltrán, Vicente
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nervous system diseases - Published
- 2015
19. Endoscopic findings of paraduodenal or groove pancreatitis.
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López-Muñoz, Pedro, Lorenzo-Zúñiga, Vicente, Alonso-Lázaro, Noelia, García-Campos, María, Argüello, Lidia, Bustamante-Balén, Marco, and Pons-Beltrán, Vicente
- Abstract
Paraduodenal pancreatitis is an uncommon type of focal chronic pancreatitis characterized by scarring of the pancreaticoduodenal space. A computed tomography (CT) scan revealed cystic thickening of the duodenal wall, with duodenal stenosis (Fig. 2014, 69, 299 - 306 3 Adsay N. V., Zamboni G. Paraduodenal pancreatitis: a clinico-pathologically distinct entity unifying "cystic dystrophy of heterotopic pancreas", "para-duodenal wall cyst", and "groove pancreatitis". [Extracted from the article]
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- 2022
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20. Insertion of self-expanding metal stent for treatment of malignant obstruction in a pregnant woman
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Alonso-Lázaro, Noelia, Bustamante-Balén, Marco, Pous-Serrano, Salvador, Braithwaite-Flores, Ana, Ponce-Romero, Marta, Argüello-Viudez, Lidia, García-Granero, Eduardo, and Pons-Beltrán, Vicente
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Pregnancy ,Embarazo ,Prótesis autoexpandible ,Cáncer colorrectal ,Colorectal cancer ,Self-expanding metal stent (SEMS) - Abstract
Colorectal cancer (CRC) is the second most frequent cancer both in incidence and mortality in women, especially in those over 60 years of age. Diagnosis in women at gestational age is rare, so its incidence during pregnancy is low. However, an increase in its diagnosis is expected during the next years because of the raise in the average age of pregnancy. In most cases, the diagnosis is delayed because symptoms related to CRC can be attributed to pregnancy itself. Up to 30 % of CRC cases may present as an intestinal obstruction. In this situation, the main objective is to solve the clinical emergency in the safest way for mother and fetus, together with performing an accurate diagnostic approach to offer the best possible therapeutic management knowing the limitations and difficulties related to pregnancy. The self-expanding metallic stent (SEMS) can be particularly useful in colon obstruction in a pregnant patient with CRC because it allows solving the acute condition providing time to perform a more accurate staging study and to prepare the patient for surgery, thus reducing both post-surgical morbidity and mortality. We report on the case of a patient who early in the second trimester of pregnancy presented with an acute colonic obstruction due to CRC which was successfully managed with the placement of a self-expanding metal stent. El cáncer colorrectal (CCR) es el segundo tumor tanto en incidencia como en mortalidad en mujeres, sobre todo en mayores de 60 años. El diagnóstico en mujeres en edad gestacional es infrecuente por lo que su incidencia durante el embarazo es baja. Sin embargo, es posible que debido al aumento de la edad media de las gestantes se observe en los próximos años un incremento en el diagnóstico de esta patología. En la mayoría de ocasiones el diagnóstico se retrasa debido a que la sintomatología derivada del CCR puede atribuirse al propio embarazo. Hasta en un 30 % de los casos el CCR puede debutar como una obstrucción intestinal. En este caso el objetivo principal es solucionar el cuadro agudo de la forma más segura posible para madre y feto y realizar una aproximación diagnóstica adecuada para plantear el mejor manejo terapéutico, con las limitaciones y dificultades que supone la gestación. La prótesis metálica autoexpandible puede ser particularmente útil en la obstrucción de colon por CCR en la paciente embarazada ya que permite solucionar el cuadro agudo y proporciona el tiempo necesario para el estudio de extensión y preparación para la cirugía, reduciendo la morbimortalidad derivada de la misma. Presentamos el caso de una paciente que al inicio del segundo trimestre de gestación presentó un cuadro obstructivo secundario a una neoplasia de sigma que se resolvió satisfactoriamente con la colocación de una prótesis autoexpandible metálica.
- Published
- 2014
21. in Vivo Optical Diagnosis of Polyp Histology : Can We Omit Pathological Examination of Diminutive Polyps?
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Bustamante-Balén, Marco
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Medical / Surgery / Colon & Rectal - Abstract
In vivo Optical Diagnosis of Polyp Histology: Can We Omit Pathological Examination of Diminutive Polyps?
- Published
- 2013
22. Clip Closure After Resection of Large Colorectal Lesions With Substantial Risk of Bleeding.
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Albéniz, Eduardo, Álvarez, Marco Antonio, Espinós, Jorge C., Nogales, Oscar, Guarner, Carlos, Alonso, Pedro, Rodríguez-Téllez, Manuel, Herreros de Tejada, Alberto, Santiago, José, Bustamante-Balén, Marco, Rodríguez Sánchez, Joaquín, Ramos-Zabala, Felipe, Valdivielso, Eduardo, Martínez-Alcalá, Felipe, Fraile, María, Elosua, Alfonso, Guerra Veloz, María Fernanda, Ibáñez Beroiz, Berta, Capdevila, Ferrán, and Enguita-Germán, Mónica
- Abstract
It is not clear whether closure of mucosal defects with clips after colonic endoscopic mucosal resection (EMR) prevents delayed bleeding, although it seems to have no protective effects when risk is low. We performed a randomized trial to evaluate the efficacy of complete clip closure of large (≥2 cm) nonpedunculated colorectal lesions after EMR in patients with an estimated average or high risk of delayed bleeding. We performed a single-blind trial at 11 hospitals in Spain from May 2016 through June 2018, including 235 consecutive patients who underwent EMR for large nonpedunculated colorectal lesions with an average or high risk of delayed bleeding (based on Spanish Endoscopy Society Endoscopic Resection Group score). Participants were randomly assigned to groups that received closure of the scar with 11-mm through-the-scope clips (treated, n = 119) or no clip (control, n = 116). The primary outcome was proportion of patients in each group with delayed bleeding, defined as evident hematochezia that required medical intervention within 15 days after colonoscopy. In the clip group, complete closure was achieved in 68 (57%) cases, with partial closure in 33 (28%) cases and failure to close in 18 (15%) cases. Delayed bleeding occurred in 14 (12.1%) patients in the control group and in 6 (5%) patients in the clip group (absolute risk difference, reduction of 7% in the clip group; 95% confidence interval, –14.7% to 0.3%). After completion of the clip closure, there was only 1 (1.5%) case of delayed bleeding (absolute risk difference, reduction of 10.6%; 95% confidence interval, –4.3% to 17.9%). In a randomized trial of patients with large nonpedunculated colorectal lesions undergoing EMR, we found that clip closure of mucosal defects in patients with a risk of bleeding can be a challenge, but also reduces delayed bleeding. Prevention of delayed bleeding required complete clip closure. ClinicalTrials.gov ID: NCT02765022. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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23. Clip closure for the prevention of polypectomy bleeding: Could antiplatelet therapy be a confounding factor?
- Author
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Bustamante-Balén, Marco and Plumé, Gema
- Published
- 2016
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24. Early colorectal cancer diagnosed after endoscopic resection: Conservative treatment is safe in most of the cases. Proposal for a risk-based management
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Marco Bustamante-Balén, Luca Montesarchio, Jorge Sancho-Muriel, Hanna Cholewa, Gianluca Pellino, Matteo Frasson, Francisco Giner, E. García-Granero, Sancho-Muriel, Jorge, Pellino, Gianluca, Cholewa, Hanna, Giner, Francisco, Bustamante-Balén, Marco, Montesarchio, Luca, García-Granero, Eduardo, and Frasson, Matteo
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medicine.medical_specialty ,Neoplasm, Residual ,Colorectal cancer ,Early colorectal cancer ,medicine.medical_treatment ,Pólipo ,Conservative Treatment ,Polipectomía ,Polyp ,Haggitt ,Cirugía ,medicine ,Humans ,Tratamiento ,Neoplasm Invasiveness ,Endoscopic resection ,Cáncer colorrectal inicial ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,General Engineering ,Margins of Excision ,Endoscopy ,Endoscopic excision ,medicine.disease ,Polypectomy ,Surgery ,Conservative treatment ,Treatment ,Lymphatic system ,Tumour budding ,Endoscopia ,Risk factor ,Colorectal Neoplasms ,business ,Factores de riesgo - Abstract
Introduction Endoscopic resection offers advantages over surgical resection for early colorectal cancer (ECC). However, there might be a presumed risk of recurrence. We aimed to determine the risk of recurrence after endoscopic removal of ECC. Methods A single-centre series of endoscopic resections for ECC. Patients were stratified according to four risk factors: positive resection margins, Haggitt 4, lymphatic/vascular invasion and tumour budding. Results We included 127 patients. Haggitt classification was grade 4 in 54.0%. Positive margins were found in 43 (33.9%), 16 (12.6%) had lymphatic or vascular invasion, and 5 (4.0%) had high grade budding. In 82 (64.5%) endoscopic excision was the definitive treatment, 45 (35.4%) underwent surgery. Six patients (13.3%) had residual tumour on specimen and/or node metastases. Postoperative complications occurred in ten (22.2%). At a median follow-up of 63 months, none of the 82 patients treated with endoscopic resection alone had recurrence. After stratifying patients according to risk factors, those who had residual tumour also had ≥2 risk factors. Conclusions Endoscopic follow up might be a valid option for patients with ECC. A risk-adjusted management seems prudent.
- Published
- 2021
25. Diagnosis of non-Hodgkin's lymphoma due to a tiny polyp in the cecum.
- Author
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Argumánez Tello V, Sánchez-Montes C, Mínguez Sabater A, Bauza M, and Bustamante-Balén M
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- Humans, Biopsy, Endoscopy, Cecum pathology, Lymphoma, Non-Hodgkin diagnostic imaging, Lymphoma
- Abstract
Endoscopic findings in primary or secondary intestinal lymphoma are non-specific, which can lead to finding a polyp, an ulcer or a completely normal mucosa. As a matter of fact, this makes having a high clinical suspicion with only the endoscopic technique, quite difficult. Due to this reason, we believe that either taking random biopsies or biopsies from visible lesions of affected sections in another imaging tests, should be indicated in order to increase the diagnostic capacity of the endoscopic technique.
- Published
- 2023
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26. The role of vitamin D and calcium in preventing recurrence of colon adenomas: is precision medicine the answer?
- Author
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Soutullo-Castiñeiras C and Bustamante-Balén M
- Abstract
Competing Interests: Conflicts of Interest: Both authors have completed the ICMJE uniform disclosure form (available at https://tcr.amegroups.com/article/view/10.21037/tcr-23-630/coif). The authors have no conflicts of interest to declare.
- Published
- 2023
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27. How to avoid overtreatment of benign colorectal lesions: Rationale for an evidence-based management.
- Author
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Bustamante-Balén M
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- Humans, Colonoscopy methods, Overtreatment, Colonic Polyps surgery, Colonic Polyps pathology, Endoscopic Mucosal Resection methods, Colorectal Neoplasms surgery, Colorectal Neoplasms pathology
- Abstract
Implementing population-based screening programs for colorectal cancer has led to an increase in the detection of large but benign histological lesions. Currently, endoscopic mucosal resection can be considered the standard technique for the removal of benign lesions of the colon due to its excellent safety profile and good clinical results. However, several studies from different geographic areas agree that many benign colon lesions are still referred for surgery. Moreover, the referral rate to surgery is not decreasing over the years, despite the theoretical improvement of endoscopic resection techniques. This article will review the leading causes for benign colorectal lesions to be referred for surgery and the influence of the endoscopist experience on the referral rate. It will also describe how to categorize a polyp as complex for resection and consider an endoscopist as an expert in endoscopic resection. And finally, we will propose a framework for the accurate and evidence-based treatment of complex benign colorectal lesions., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
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- 2022
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28. Impact of the European Society of Gastrointestinal Endoscopy 2020 guidelines on the number of scheduled post-polypectomy surveillance colonoscopies: Meeting presentations: Partial results of this research were published in abstract form at ESGE Days 2020.
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Bustamante-Balén M, García-Campos M, Lorenzo-Zúñiga V, Alonso-Lázaro N, Sanchez-Montes C, Argüello-Viudez L, and Pons-Beltrán V
- Abstract
Background and study aims In contrast with the European Society of Gastrointestinal Endoscopy (ESGE) 2013 and the US Multi-society Task Force (USMSTF) 2020 guidelines, the ESGE 2020 guideline considers patients with three to four adenomas < 10 mm or an adenoma with villous histology as low risk. The aim of this study was to quantify the influence of the application of the new ESGE 2020 guidelines, as opposed to the ESGE 2013 and USMSTF 2020 guidelines, on the number of scheduled colonoscopies, and to describe the main causes for changes in the surveillance intervals. Patients and methods A retrospective evaluation was conducted of a prospectively maintained fecal immunochemical test (FIT)-based regional colorectal cancer screening program database. Surveillance regimens following ESGE 2020, ESGE 2013, and USMSTF 2020 guidelines were compared. Results Overall, 1284 individuals with a positive FIT and undergoing colonoscopy were consecutively included. When applying the ESGE 2020 guidelines, 10.8 % of patients changed to a "no-surveillance" group (relative reduction in colonoscopies of 82.5 %). The main reason for these changes was considering three to four adenomas as low risk. The proportion of patients from the "3-year surveillance" group who moved to the "no-surveillance" group was lower when a sessile serrated lesion (SSL) was present (ESGE 2013, 32.0% vs 16.3 %; USMSTF 2020 17.2 % vs 6.8 %). Analyzing the 41 patients with SSLs who remained unchanged in the "no-surveillance" group, only in 15 (36.6 %) the cause was the presence of an SSL. Conclusions applying the new ESGE 2020 guidelines could reduce by 11 % the proportion of individuals being offered surveillance. SLLs have not a major influence on the change of surveillance intervals., Competing Interests: Competing interests The authors declare that they have no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
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- 2022
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29. Severe intestinal involvement in acute graft versus host disease.
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Soutullo-Castiñeiras C, Plumé G, Zac C, and Bustamante-Balén M
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- Acute Disease, Humans, Intestines, Graft vs Host Disease etiology, Hematopoietic Stem Cell Transplantation, Intestinal Diseases etiology
- Published
- 2022
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30. Cold loop polypectomy perforation of a tiny colon polyp.
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Mínguez Sabater A, Sánchez-Montes C, Ramos Soler D, and Bustamante-Balén M
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- Colon pathology, Colonoscopy, Female, Humans, Middle Aged, Colonic Polyps complications, Colonic Polyps pathology, Colonic Polyps surgery
- Abstract
We report the case of a 61-year-old woman having corticoid treatment with corticosteroids for polyarthralgia, who underwent a post-polypectomy surveillance colonoscopy, identifying a 5-mm diameter, flat-elevated polyp in the proximal transverse colon (Paris 0-IIa).
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- 2022
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31. Compound Endoscopic Morphological Features for Identifying Non-Pedunculated Lesions ≥20 mm with Intramucosal Neoplasia.
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da Costa-Seixas JP, López-Cerón M, Arnau A, Rosiñol Ò, Cuatrecasas M, Herreros-de-Tejada A, Ferrández Á, Serra-Burriel M, Nogales Ó, de Castro L, López-Vicente J, Vega P, Álvarez-González MA, González-Santiago JM, Hernández-Conde M, Diez-Redondo P, Rivero-Sánchez L, Gimeno-García AZ, Burgos A, García-Alonso FJ, Bustamante-Balén M, Martínez-Bauer E, Peñas B, Rodríguez-Alcalde D, Pellisé M, and Puig I
- Abstract
Background: The major limitation of piecemeal endoscopic mucosal resection (EMR) is the inaccurate histological assessment of the resected specimen, especially in cases of submucosal invasion., Objective: To classify non-pedunculated lesions ≥20 mm based on endoscopic morphological features, in order to identify those that present intramucosal neoplasia (includes low-grade neoplasia and high-grade neoplasia) and are suitable for piecemeal EMR., Design: A post-hoc analysis from an observational prospective multicentre study conducted by 58 endoscopists at 17 academic and community hospitals was performed. Unbiased conditional inference trees (CTREE) were fitted to analyse the association between intramucosal neoplasia and the lesions' endoscopic characteristics., Result: 542 lesions from 517 patients were included in the analysis. Intramucosal neoplasia was present in 484 of 542 (89.3%) lesions. A conditional inference tree including all lesions' characteristics assessed with white light imaging and narrow-band imaging (NBI) found that ulceration, pseudodepressed type and sessile morphology changed the accuracy for predicting intramucosal neoplasia. In ulcerated lesions, the probability of intramucosal neoplasia was 25% (95%CI: 8.3-52.6%; p < 0.001). In non-ulcerated lesions, its probability in lateral spreading lesions (LST) non-granular (NG) pseudodepressed-type lesions rose to 64.0% (95%CI: 42.6-81.3%; p < 0.001). Sessile morphology also raised the probability of intramucosal neoplasia to 86.3% (95%CI: 80.2-90.7%; p < 0.001). In the remaining 319 (58.9%) non-ulcerated lesions that were of the LST-granular (G) homogeneous type, LST-G nodular-mixed type, and LST-NG flat elevated morphology, the probability of intramucosal neoplasia was 96.2% (95%CI: 93.5-97.8%; p < 0.001)., Conclusion: Non-ulcerated LST-G type and LST-NG flat elevated lesions are the most common non-pedunculated lesions ≥20 mm and are associated with a high probability of intramucosal neoplasia. This means that they are good candidates for piecemeal EMR. In the remaining lesions, further diagnostic techniques like magnification or diagnostic +/- therapeutic endoscopic submucosal dissection should be considered.
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- 2021
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32. But, what are you telling me?
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Lorenzo-Zúñiga V, Bustamante-Balén M, and Pons-Beltrán V
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- Artifacts, Humans, Diverticulosis, Colonic pathology
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- 2021
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33. Early colorectal cancer diagnosed after endoscopic resection: Conservative treatment is safe in most of the cases. Proposal for a risk-based management.
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Sancho-Muriel J, Pellino G, Cholewa H, Giner F, Bustamante-Balén M, Montesarchio L, García-Granero E, and Frasson M
- Abstract
Introduction: Endoscopic resection offers advantages over surgical resection for early colorectal cancer (ECC). However, there might be a presumed risk of recurrence. We aimed to determine the risk of recurrence after endoscopic removal of ECC., Methods: A single-centre series of endoscopic resections for ECC. Patients were stratified according to four risk factors: positive resection margins, Haggitt 4, lymphatic/vascular invasion and tumour budding., Results: We included 127 patients. Haggitt classification was grade 4 in 54.0%. Positive margins were found in 43 (33.9%), 16 (12.6%) had lymphatic or vascular invasion, and 5 (4.0%) had high grade budding. In 82 (64.5%) endoscopic excision was the definitive treatment, 45 (35.4%) underwent surgery. Six patients (13.3%) had residual tumour on specimen and/or node metastases. Postoperative complications occurred in ten (22.2%). At a median follow-up of 63 months, none of the 82 patients treated with endoscopic resection alone had recurrence. After stratifying patients according to risk factors, those who had residual tumour also had ≥2 risk factors., Conclusions: Endoscopic follow up might be a valid option for patients with ECC. A risk-adjusted management seems prudent., (Copyright © 2021 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.)
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- 2021
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34. Prevention of late complications with coverage agents in endoscopic resection of colorectal lesions: Current landscape in gastrointestinal endoscopy.
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Lorenzo-Zúñiga V, Bustamante-Balén M, and Pons-Beltrán V
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- Endoscopy, Gastrointestinal, Humans, Surgical Instruments, Colorectal Neoplasms surgery, Endoscopic Mucosal Resection adverse effects
- Abstract
Endoscopic removal of large (≥ 20 mm) non-pedunculated colorectal lesions (LNPCLs) may result in major adverse events, such as delayed bleeding (DB) and delayed perforation (DP), despite closure of the mucosal defects with clips. Topical application of a coverage agent refers to the creation of a shield with a biocompatible medical device (tissue or hydrogel) with proven bioactive properties. Coverage of the eschar after endoscopic resection provides shielding protection to prevent delayed complications. The aim of the present review was to systematically collect and review the currently available literature regarding the prevention of DB and DP with coverage agents after endoscopic mucosal resection or endoscopic submucosal dissection of LNPCLs., Competing Interests: Conflict-of-interest statement: Authors declare no conflict of interest for this article., (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)
- Published
- 2021
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35. Evaluation of the optical criteria for sessile serrated lesions of the colon: A prospective study on a colorectal cancer screening population.
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Bustamante-Balén M, Satorres C, Ramos-Soler D, García-Campos M, Alonso N, Ponce M, Argüello-Viudez L, Giner F, Ferrer-Lozano J, and Pons-Beltrán V
- Abstract
Background and study aims We aimed to describe the presence and combination of Hazewinkel's optical diagnosis (OD) criteria for sessile serrated lesions (SSL), determining which lesion characteristics increase the probability of a correct OD, with a focus on diminutive lesions. Patients and methods This was a prospective study describing the presence of Hazewinkel's OD criteria for SSL in lesions found in consecutive CRC screening colonoscopies. The presence of each OD criterion and their diagnostic combinations in SSL, related to the lesion's NBI International Colorectal Endoscopic (NICE) classification category, size, and location, were described. The presence of two or more optical criteria was considered diagnostic of SSL. The OD was compared to pathology as the gold standard. Results Seventy-nine SSLs (5.6 %) were diagnosed. Cloud-like appearance was the most prevalent OD criterion (35, 44.3 %). OD criteria were more frequently identified in NICE type 1, ≥ 10 mm, and proximal lesions. Only 26 SLLs fulfilled the OD criteria (sensitivity 32.9 %, 95 % CI 29.1 %-36.7 %). The sensitivity for diminutive SSL was 14.7 %, (95 % CI 11.9 %-17.6 %). Eighty-five lesions were optically diagnosed as SSL. However, only in 26 SSL was this the definitive diagnosis (positive predictive value 30.6 %, 95 % CI 26.9 %-34.3 %). Size > 5 mm and proximal location increased the probability of a correct diagnosis. The overall accuracy of the optical criteria was 92.0 % (95 % CI, 89.8 %-94.2 %). Conclusions The Hazewinkel's optical criteria are not reliable for a positive diagnosis of SSL, particularly for diminutive lesions., Competing Interests: Competing interests The authors declare that they have no conflict of interest., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
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- 2021
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36. Upper gastrointestinal bleeding as a complication of Brunner's gland adenoma. An unusual presentation.
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Herreras J, Giner F, Cordon G, Roca MJ, and Bustamante-Balén M
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- Adenoma pathology, Brunner Glands blood supply, Duodenal Neoplasms pathology, Dyspepsia etiology, Female, Gastroscopy, Humans, Melena etiology, Middle Aged, Adenoma complications, Brunner Glands pathology, Duodenal Neoplasms complications, Gastrointestinal Hemorrhage etiology
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- 2019
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37. Non-guided self-learning program for high-proficiency optical diagnosis of diminutive and small colorectal lesions: A single-endoscopist pilot study.
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Bustamante-Balén M, Satorres C, Puchades L, Navarro B, García-Morales N, Alonso N, Ponce M, Argüello L, and Pons-Beltrán V
- Subjects
- Aged, Clinical Competence, Colon diagnostic imaging, Colon pathology, Colonoscopy methods, Colorectal Neoplasms pathology, Female, Humans, Male, Middle Aged, Pilot Projects, Predictive Value of Tests, Program Evaluation, Prospective Studies, Rectum diagnostic imaging, Rectum pathology, Sensitivity and Specificity, Colonoscopy education, Colorectal Neoplasms diagnostic imaging, Early Detection of Cancer methods, Narrow Band Imaging methods, Self-Directed Learning as Topic
- Abstract
Background: The implementation of optical diagnosis (OD) of diminutive colorectal lesions in clinical practice has been hampered by differences in performance between community and academic settings. One possible cause is the lack of a standardized learning tool. Since the factors related to better learning are not well described, strong evidence upon which a consistent learning tool could be designed is lacking. We hypothesized that a self-designed learning program may be enough to achieve competency in OD of diminutive lesions of the colon., Aim: To assess the accuracy of OD of diminutive lesions in real colonoscopies after application of a self-administered learning program., Methods: This was a single-endoscopist prospective pilot study, in which an experienced endoscopist followed a self-designed, self-administered learning program in OD of colorectal lesions. An assessment phase divided in two halves with a 6-mo period in between without performance of OD was developed in a population-based colorectal cancer screening program. The accomplishment of the Preservation and Incorporation of Valuable Endoscopic Innovations criteria and performance measures were calculated overall and in the two halves of the assessment phase, assessing their response to the 6-mo stopping period. The evolution of performance through blocks of 50 lesions was also assessed., Results: Overall, 152 patients and 522 lesions (≤ 5 mm: 399, and 6-9 mm: 123) were included. The negative predictive value for the OD of adenoma in rectosigmoid lesions diagnosed with high confidence was 91.7% [95% confidence interval (CI): 87.3-96.6]. The proportion of agreement on surveillance interval between OD and pathological diagnosis was higher than 95%. Overall accuracy for diminutive lesions diagnosed with high confidence was 89.5% (95%CI: 86.3-92.7). The overall accuracy of OD was similar in the two halves of the assessment phase [90.1 (95%CI: 85.6-94.7) vs 88.2 (95%CI: 87.9-95.9)]. All the other performance parameters were also equivalent, except for specificity. Specificity, negative predictive value and accuracy were the parameters most affected by the stopping period between the two halves. Upon analyzing trends on blocks of 50 lesions, an improvement on sensitivity ( P = 0.02) was detected only in the first half and an improvement on accuracy ( P = 0.01) was detected only in the second half., Conclusion: A self-administered learning program is sufficient to achieve expert-level OD. To maintain performance, continuous practice is needed, with a refresher course following any long non-practice period., Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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- 2019
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38. Accuracy of the Narrow-Band Imaging International Colorectal Endoscopic Classification System in Identification of Deep Invasion in Colorectal Polyps.
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Puig I, López-Cerón M, Arnau A, Rosiñol Ò, Cuatrecasas M, Herreros-de-Tejada A, Ferrández Á, Serra-Burriel M, Nogales Ó, Vida F, de Castro L, López-Vicente J, Vega P, Álvarez-González MA, González-Santiago J, Hernández-Conde M, Díez-Redondo P, Rivero-Sánchez L, Gimeno-García AZ, Burgos A, García-Alonso FJ, Bustamante-Balén M, Martínez-Bauer E, Peñas B, and Pellise M
- Subjects
- Adenocarcinoma classification, Adenocarcinoma surgery, Adenomatous Polyps classification, Adenomatous Polyps surgery, Aged, Clinical Decision-Making, Colonic Polyps classification, Colonic Polyps surgery, Colorectal Neoplasms classification, Colorectal Neoplasms surgery, Female, Humans, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Predictive Value of Tests, Prospective Studies, Reproducibility of Results, Risk Factors, Spain, Tumor Burden, Adenocarcinoma pathology, Adenomatous Polyps pathology, Colonic Polyps pathology, Colonoscopy methods, Colorectal Neoplasms pathology, Narrow Band Imaging methods
- Abstract
Background & Aims: T1 colorectal polyps with at least 1 risk factor for metastasis to lymph node should be treated surgically and are considered endoscopically unresectable. Optical analysis, based on the Narrow-Band Imaging International Colorectal Endoscopic (NICE) classification system, is used to identify neoplasias with invasion of the submucosa that require endoscopic treatment. We assessed the accuracy of the NICE classification, along with other morphologic characteristics, in identifying invasive polyps that are endoscopically unresectable (have at least 1 risk factor for metastasis to lymph node)., Methods: We performed a multicenter, prospective study of data collected by 58 endoscopists, from 1634 consecutive patients (examining 2123 lesions) at 17 university and community hospitals in Spain from July 2014 through June 2016. All consecutive lesions >10 mm assessed with narrow-band imaging were included. The primary end point was the accuracy of the NICE classification for identifying lesions with deep invasion, using findings from histology analysis as the reference standard. Conditional inference trees were fitted for the analysis of diagnostic accuracy., Results: Of the 2123 lesions analyzed, 89 (4.2%) had features of deep invasion and 91 (4.3%) were endoscopically unresectable. The NICE classification system identified lesions with deep invasion with 58.4% sensitivity (95% CI, 47.5-68.8), 96.4% specificity (95% CI, 95.5-97.2), a positive-predictive value of 41.6% (95% CI, 32.9-50.8), and a negative-predictive value of 98.1% (95% CI, 97.5-98.7). A conditional inference tree that included all variables found the NICE classification to most accurately identify lesions with deep invasion (P < .001). However, pedunculated morphology (P < .007), ulceration (P = .026), depressed areas (P < .001), or nodular mixed type (P < .001) affected accuracy of identification. Results were comparable for identifying lesions that were endoscopically unresectable., Conclusions: In an analysis of 2123 colon lesions >10 mm, we found the NICE classification and morphologic features identify those with deep lesions with >96% specificity-even in non-expert hands and without magnification. ClinicalTrials.gov number NCT02328066., (Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved.)
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- 2019
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39. Calcium and vitamin D in the serrated neoplastic pathway: Friends or foes?
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García-Morales N, Satorres C, and Bustamante-Balén M
- Abstract
Sessile serrated adenoma/polyps (known as SSA/Ps) may play an important role in the development of interval colorectal cancer (CRC). These lesions are more difficult to detect with conventional endoscopy and they may quickly turn into CRC, especially when dysplasia has developed. Therefore, primary or secondary chemoprevention may be an appealing strategy at a population level. Calcium and vitamin D have been shown in epidemiological studies to reduce the risk of CRC and conventional adenomas, but the evidence regarding their effect on SSA/Ps is controversial. In this editorial we comment on the results of a recent randomized controlled trial investigating the effect of calcium and vitamin D on the development of serrated lesions, summarizing the possible antineoplastic mechanisms of calcium and vitamin D, and discussing the differences found with previous observational reports., Competing Interests: Conflict-of-interest statement: The authors have no conflicts of interest to declare.
- Published
- 2018
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40. Primary chancre in the rectum: an underdiagnosed cause of rectal ulcer.
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Díaz-Jaime F, Satorres Paniagua C, and Bustamante Balén M
- Subjects
- Adult, Anti-Bacterial Agents therapeutic use, Chancre diagnostic imaging, Chancre drug therapy, Homosexuality, Male, Humans, Male, Penicillin G therapeutic use, Rectal Diseases diagnostic imaging, Rectal Diseases drug therapy, Ulcer diagnostic imaging, Ulcer drug therapy, Chancre complications, Rectal Diseases etiology, Ulcer etiology
- Abstract
We report the case of a 35-year-old homosexual man with previous history of HIV, with primary chacre in the rectum. We believe this paper is significant because the diagnosis of rectal ulcer is more common in recent years, however rectal syphilis is a poorly recognized entity, especially with primary chancre formation.
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- 2017
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41. Endoscopic resection of colorectal polyps in patients on antiplatelet therapy: an evidence-based guidance for clinicians.
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Plumé Gimeno G, Bustamante-Balén M, Satorres Paniagua C, Díaz Jaime FC, and Cejalvo Andújar MJ
- Subjects
- Evidence-Based Medicine, Gastrointestinal Hemorrhage chemically induced, Gastrointestinal Hemorrhage prevention & control, Guidelines as Topic, Humans, Medication Therapy Management, Platelet Aggregation Inhibitors therapeutic use, Colonic Polyps surgery, Endoscopy, Gastrointestinal methods, Platelet Aggregation Inhibitors adverse effects, Polyps surgery, Rectal Neoplasms surgery
- Abstract
Due to the rising prevalence of coronary heart disease, endoscopists are more frequently performing a polypectomy in patients on antiplatelet therapy (APT) and dual antiplatelet therapy (DATP). Despite the availability of several guidelines with regard to the management of antiplatelet drugs during the periprocedure period, there is still variability in the current clinical practice. This may be influenced by the low quality of the evidence supporting recommendations, because most of the studies dealing with APT and polypectomy are observational and retrospective, and include mainly small (< 10 mm) polyps. However, some recommendations can still be made. An estimation of the bleeding and thrombotic risk of the patient should be made in advance. In the case of DAPT the procedure should be postponed, at least until clopidogrel can be safely withheld. If possible, non-aspirin antiplatelet drugs should be withheld 5-7 days before the procedure. Polyp size is the main factor related with post-polypectomy bleeding and it is the factor that should drive clinical decisions regarding the resection method and the use of endoscopic prophylactic measures. Non-aspirin antiplatelet agents can be reintroduced 24-48 hours after the procedure. In conclusion, there is little data with regard to the management of DAPT in patients with a scheduled polypectomy. Large randomized controlled trials are needed to support clinical recommendations.
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- 2017
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42. Knotting of Duodopa® duodenal infusion system.
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del-Hoyo-Francisco J, Bustamante-Balén M, Martínez-Torres I, Barrios-Barrios A, Satorres-Paniagua C, and Pons-Beltrán V
- Subjects
- Aged, Antiparkinson Agents therapeutic use, Carbidopa therapeutic use, Catheterization instrumentation, Catheterization methods, Drug Combinations, Duodenum, Female, Humans, Levodopa therapeutic use, Male, Middle Aged, Antiparkinson Agents administration & dosage, Carbidopa administration & dosage, Catheters, Equipment Failure, Infusion Pumps, Levodopa administration & dosage, Parkinson Disease drug therapy
- Published
- 2015
43. Role of hemostatic powders in the endoscopic management of gastrointestinal bleeding.
- Author
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Bustamante-Balén M and Plumé G
- Abstract
Acute gastrointestinal bleeding (AGIB) is a prevalent condition with significant influence on healthcare costs. Endoscopy is essential for the management of AGIB with a pivotal role in diagnosis, risk stratification and management. Recently, hemostatic powders have been added to our endoscopic armamentarium to treat gastrointestinal (GI) bleeding. These substances are intended to control active bleeding by delivering a powdered product over the bleeding site that forms a solid matrix with a tamponade function. Local activation of platelet aggregation and coagulation cascade may be also boosted. There are currently three powders commercially available: hemostatic agent TC-325 (Hemospray(®)), EndoClot™ polysaccharide hemostatic system, and Ankaferd Bloodstopper(®). Although the available evidence is based on short series of cases and there is no randomized controlled trial yet, these powders seem to be effective in controlling GI bleeding from a variety of origins with a very favorable side effects profile. They can be used either as a primary therapy or a second-line treatment, and they seem to be especially indicated in cases of cancer-related bleeding and lesions with difficult access. In this review, we will comment on the mechanism of action, efficacy, safety and technical challenges of the use of powders in several clinical scenarios and we will try to define the main current indications of use and propose new lines of research in this area.
- Published
- 2014
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44. Prevalence of nonpolypoid colorectal neoplasms in symptomatic patients scheduled for colonoscopy: a study with total colonic chromoscopy.
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Bustamante-Balén M, Bernet L, Cano R, Pertejo V, and Ponce J
- Subjects
- Adenoma diagnosis, Adenoma epidemiology, Adenoma pathology, Adult, Aged, Aged, 80 and over, Carcinoma diagnosis, Carcinoma epidemiology, Carcinoma pathology, Cohort Studies, Colorectal Neoplasms diagnosis, Colorectal Neoplasms pathology, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Precancerous Conditions epidemiology, Precancerous Conditions pathology, Prevalence, Young Adult, Colonoscopy, Colorectal Neoplasms epidemiology, Colorectal Neoplasms physiopathology
- Abstract
Objectives: (i) To determine the prevalence of nonpolypoid colorectal neoplasms (NP-CRNs) in a prospective cohort of patients of a Mediterranean area; (ii) to compare the characteristics of NP-CRNs with those of polypoid adenomas, focusing on the rate of high-grade dysplasia (HGD) and carcinoma; (iii) to evaluate the characteristics of patients harboring NP-CRNs versus patients with protruding adenomas (P-CRNs)., Patients and Methods: A prospective, cross-sectional observational study was made in which consecutive unselected patients were scheduled for colonoscopy and pancolonic chromoendoscopy. The Paris Classification of Superficial Neoplastic Lesions was used to classify the detected lesions, and the revised Vienna criteria were applied to describe the grade of dysplasia. All examinations were performed by the same endoscopist, and all samples were reviewed by the same pathologist., Results: A total of 290 patients were included, and 613 neoplasms were detected-26% of them being NP-CRNs. The prevalence of NP-CRNs was 34.1% [95% confidence interval (CI): 28.8%-39.7%]. The proportion of HGD or carcinoma in NP-CRNs was 2.5% (95% CI: 0.8%-5.9%), versus 2.9% in P-CRNs (95% CI: 1.6%-4.7%). Size larger than 10 mm [odds ratio: 22.7 (95% CI: 5.2-99.2)] and a pedunculated morphology [odds ratio: 5.7 (95% CI: 1.3-24.3)] were related to the presence of HGD or carcinoma. A relationship between increased size and HGD or carcinoma was found for all morphologies. Patients harboring only NP-CRNs and patients harboring only P-CRNs were similar for all the variables collected., Conclusions: NP-CRNs have a high prevalence in our region, but show a proportion of HGD and carcinoma similar to that seen in P-CRNs. No patient variable is predictive of the presence of a NP-CRN.
- Published
- 2010
- Full Text
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