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772 results on '"Thota, Prashanthi N."'

209. Defining the Rates of Missed and Interval High-Grade Lesions in Patients With Barrettʼs Esophagus: Results From a Large Multicenter Study

Author

Parasa, Sravanthi, primary, Vennelaganti, Sreekar, additional, Young, Patrick, additional, Vennalaganti, Prashanth, additional, Bansal, Ajay, additional, Gaddam, Srinivas, additional, Gupta, Neil, additional, Sampliner, Richard, additional, Falk, Gary, additional, Thota, Prashanthi N., additional, Mathur, Sharad, additional, Cash, Brooks D., additional, Fouad, Moawad, additional, Vargo, John, additional, Kennedy, Kevin, additional, Van Olphen, Sophie, additional, Spaander, Manon, additional, Bruno, Marco, additional, and Sharma, Prateek, additional

Published
2017
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212. A nonrandomized trial of vitamin D supplementation for Barrett’s esophagus

Author

Cummings, Linda C., primary, Thota, Prashanthi N., additional, Willis, Joseph E., additional, Chen, Yanwen, additional, Cooper, Gregory S., additional, Furey, Nancy, additional, Bednarchik, Beth, additional, Alashkar, Bronia M., additional, Dumot, John, additional, Faulx, Ashley L., additional, Fink, Stephen P., additional, Kresak, Adam M., additional, Abusneineh, Basel, additional, Barnholtz-Sloan, Jill, additional, Leahy, Patrick, additional, Veigl, Martina L., additional, Chak, Amitabh, additional, and Markowitz, Sanford D., additional

Published
2017
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225. Identification of Genomic Regions Associated with Susceptibility to Barrett’s Esophagus and Esophageal Adenocarcinoma in African Americans: The Cross Betrnet Admixture Study

Author

Sun, Xiangqing, primary, Chandar, Apoorva K., additional, Canto, Marcia I., additional, Thota, Prashanthi N., additional, Brock, Malcom, additional, Shaheen, Nicholas J., additional, Beer, David G., additional, Wang, Jean S., additional, Falk, Gary W., additional, Iyer, Prasad G., additional, Abrams, Julian A., additional, Venkat-Ramani, Medha, additional, Veigl, Martina, additional, miron, Alexander, additional, Willis, Joseph, additional, Patil, Deepa T., additional, Nalbantoglu, Ilke, additional, Guda, Kishore, additional, Markowitz, Sanford D., additional, zhu, Xiaofeng, additional, Elston, Robert, additional, and Chak, Amitabh, additional

Published
2017
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228. Neoplastic Progression in Patients with Short Segment Barrett's Esophagus: Long-Term Follow-up of Over a 1000 Patients in a Multi-Center Consortium

Author

Vennelaganti, Sreekar, primary, Parasa, Sravanthi, additional, Vennalaganti, Prashanth, additional, Gaddam, Srinivas, additional, Spaander, Manon, additional, van Olphen, Sophie H., additional, Thota, Prashanthi N., additional, Kennedy, Kevin F., additional, Moawad, Fouad J., additional, Bruno, Marco J., additional, Vargo, John J., additional, Mathur, Sharad, additional, Cash, Brooks D., additional, Sampliner, Richard, additional, Gupta, Neil, additional, Falk, Gary W., additional, Bansal, Ajay, additional, Young, Patrick E., additional, Lieberman, David A., additional, and Sharma, Prateek, additional

Published
2017
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234. Increased Recognition of HGD/EAC at Index Endoscopy Over the Past 2 Decades: Data from a Multi-Center U.S. Consortium

Author

Desai, Madhav, primary, Parasa, Sravanthi, additional, Bansal, Ajay, additional, Gupta, Neil, additional, Vennelaganti, Sreekar, additional, Vennalaganti, Prashanth, additional, Lieberman, David A., additional, Gaddam, Srinivas, additional, Young, Patrick E., additional, Falk, Gary W., additional, Thota, Prashanthi N., additional, Mathur, Sharad, additional, Cash, Brooks D., additional, Moawad, Fouad J., additional, Vargo, John J., additional, Kennedy, Kevin F., additional, Sampliner, Richard, additional, and Sharma, Prateek, additional

Published
2017
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244. Proposal of high-risk adenoma detection rate as an impactful, complementary quality indicator of colonoscopy

Author

Wadhwa, Vaibhav, Jobanputra, Yash, Al Taii, Haider, Thota, Prashanthi N., Lopez, Rocio, Gurudu, Suryakanth R., and Sanaka, Madhusudhan R.

Abstract

Background and aims: Adenoma detection rate (ADR), a validated quality indicator (QI) of colonoscopy, does not take into account risk stratification of adenomas. Low-risk adenomas are not associated with a significantly increased risk of future colorectal cancer (CRC). On the other hand, high-risk adenomas (HRA) are associated with up to six fold higher risk of future CRC. Therefore, HRA detection rate (HR-ADR) as a QI in addition to ADR may further enhance the efficacy of screening colonoscopy. Our aim was to calculate ADR and HR-ADR in a large cohort of average risk screening colonoscopy patients and propose HR-ADR which correlates with current threshold ADR. Methods: This is a retrospective chart review of all colonoscopies performed in patients aged ≥ 50 years at our institution between 2012 and 2014. Average risk patients who had complete colonoscopy with good, excellent and adequate bowel preparation were included. Overall and gender-specific ADR and HR-ADR were calculated. HR-ADR was defined as proportion of colonoscopies with HRA. Results: Among 4158 colonoscopies included, ADR was 26.4 ± 10.9% overall, 32.7 ± 14.5% in men, and 22.1 ± 12.6% in women. HR-ADR was 8.0 ± 5.7% overall, 10.2 ± 8.6% in men, and 6.1 ± 6% in women. There was only moderate correlation between ADR and HR-ADR [r= 0.57 (0.40–0.70)]. HR-ADR corresponding with minimum threshold ADR of 30% in men and 20% in women were calculated to be 7% in men and 4% in women. Conclusions: HR-ADR correlates only moderately with ADR. Based on the current threshold ADRs, we propose a benchmark HR-ADR of 7% in men and 4% in women as complementary QI to ADR.

Published
2020
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245. Peroral endoscopic myotomy leads to higher rates of abnormal esophageal acid exposure than laparoscopic Heller myotomy in achalasia.

Author

Sanaka, Madhusudhan R., Thota, Prashanthi N., Parikh, Malav P., Hayat, Umar, Gupta, Niyati M., Gabbard, Scott, Lopez, Rocio, Murthy, Sudish, and Raja, Siva

Subjects
*ESOPHAGOGASTRIC junction, *PROPENSITY score matching, *GASTROESOPHAGEAL reflux, *ESOPHAGEAL surgery, *ESOPHAGOSCOPY, *FUNDOPLICATION, *LAPAROSCOPY, *ENDOSCOPY, *ESOPHAGEAL achalasia
Abstract

Background and Aims: Peroral endoscopic myotomy (POEM) may be associated with higher rates of gastroesophageal reflux disease (GERD) than laparoscopic Heller's myotomy with fundoplication (LHM), since POEM is not combined with a fundoplication. However, peri-esophageal anti-reflux barriers are preserved in POEM, which might prevent GERD. Hence, we sought to compare the objective esophageal pH study findings in achalasia patients after POEM and LHM.Methods: Achalasia patients undergoing POEM from 2014 to 2015 at our institution were matched 1:3 with LHM patients using propensity score matching. Demographics, prior interventions, pre-treatment and 2-month post-treatment timed barium esophagram (TBE), high-resolution esophageal manometry (HREM) and 24-h esophageal pH study findings were compared between the two groups.Results: Thirty-one patients in the POEM group and 88 patients in the LHM group were included. Larger proportion of POEM patients had prior interventions for achalasia as compared to LHM patients (overall: 71% vs. 44.3%; p = 0.012). Esophageal acid exposure was significantly higher in POEM as compared to LHM patients (abnormal total acid exposure: 48.4% vs. 13.6%; p < 0.001, abnormal DeMeester score 54.8% vs. 17.4%; p = 0.005 respectively). In sub-group analysis, similar results were noted on 24-h pH study after exclusion of the POEM patients with prior LHM and corresponding matches. There was no significant difference in the rate of GERD symptoms between POEM and LHM. There was no significant correlation between the post-treatment basal lower esophageal sphincter pressure and integrated relaxation pressure with abnormal acid exposure in either POEM or LHM.Conclusions: In patients with achalasia, POEM leads to significantly higher rates of abnormal esophageal acid exposure, without an increase in the rate of GERD symptoms, when compared to LHM with fundoplication. Interestingly, prior LHM has no impact on post-POEM pH study findings. Potential of increased esophageal acid exposure and possible consequences should be discussed with all patients prior to POEM. Further studies are needed to determine the long-term effects of increased acid exposure after POEM. [ABSTRACT FROM AUTHOR]

Published
2019
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246. Lower Annual Rate of Progression of Short-Segment vs Long-Segment Barrett's Esophagus to Esophageal Adenocarcinoma.

Author

Hamade, Nour, Vennelaganti, Sreekar, Parasa, Sravanthi, Vennalaganti, Prashanth, Gaddam, Srinivas, Spaander, Manon C.W., van Olphen, Sophie H., Thota, Prashanthi N., Kennedy, Kevin F., Bruno, Marco J., Vargo, John J., Mathur, Sharad, Cash, Brooks D., Sampliner, Richard, Gupta, Neil, Falk, Gary W., Bansal, Ajay, Young, Patrick E., Lieberman, David A., and Sharma, Prateek

Abstract

Background & Aims European guidelines recommend different surveillance intervals of non-dysplastic Barrett's esophagus (NDBE) based on segment length, as opposed to guidelines in the United States, which do recommend surveillance intervals based on BE length. We studied rates of progression of NDBE to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) in patients with short-segment BE using the definition of BE in the latest guidelines (length ≥1 cm). Methods We collected demographic, clinical, endoscopy, and histopathology data from 1883 patients with endoscopic evidence of NDBE (mean age, 57.3 years; 83.5% male; 88.1% Caucasians) seen at 7 tertiary referral centers. Patients were followed for a median 6.4 years. Cases of dysplasia or EAC detected within 1 year of index endoscopy were considered prevalent and were excluded. Unadjusted rates of progression to HGD or EAC were compared between patients with short (≥1 and <3) and long (≥3) BE lengths using log-rank tests. A subgroup analysis was performed on patients with a documented Prague C&M classification. We used a multivariable proportional hazards model to evaluate the association between BE length and progression. Adjusted hazards ratios were calculated after adjusting for variables associated with progression. Results We found 822 patients to have a short-segment BE (SSBE) and 1061 to have long segment BE (LSBE). We found patients with SSBE to have a significantly lower annual rate of progression to EAC (0.07%) than of patients with LSBE (0.25%) (P =.001). For the combined endpoint of HGD or EAC, annual progression rates were significantly lower among patients with SSBE (0.29%) compared to compared to LSBE (0.91%) (P <.001). This effect persisted in multivariable analysis (hazard ratio, 0.32; 95% CI, 0.18–0.57; P <.001). Conclusion We analyzed progression of BE (length ≥1 cm) to HGD or EAC in a large cohort of patients seen at multiple centers and followed for a median 6.4 years. We found a lower annual rate of progression of SSBE to EAC (0.07%/year) than of LSBE (0.25%/year). We propose lengthening current surveillance intervals for patients with SSBE. [ABSTRACT FROM AUTHOR]

Published
2019
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248. Reintervention After Heller Myotomy for Achalasia: Is It Inevitable?

Author

Raja, Siva, Schraufnagel, Dean P., Blackstone, Eugene H., Murthy, Sudish C., Thota, Prashanthi N., Thuita, Lucy, Lopez, Rocio, Gabbard, Scott L., Ray, Monica N., Wadhwa, Neha, Sanaka, Madhu R., Zanoni, Andrea, and Rice, Thomas W.

Abstract

Background Few studies of reintervention after Heller myotomy for achalasia set patients' expectations, assist therapeutic decision making, and direct follow-up. Therefore, we investigated the frequency and type of symptoms and reinterventions after myotomy based on achalasia type. Methods From January 2006 to March 2013, 248 patients who had preoperative high-resolution manometry and a timed barium esophagram (TBE) underwent Heller myotomy, 62 (25%) for type I, 162 (65%) for type II, and 24 (10%) for type III achalasia. Postoperative surveillance, including TBE, was performed at 8 weeks, then annually. Median follow-up was 36 months. End points were all symptom types and modes of reintervention, endoscopic or surgical. Reintervention was based on both symptoms and objective TBE measurements. Results Eventually most patients (169 of 218; 69%) experienced at least one symptom after myotomy. Fifty patients underwent 85 reinterventions, 41 endoscopic only, 4 surgical only, and 5 both. Five-year freedom from reintervention was 62% for type I, 74% for type II, and 87% for type III, most occurring within 6 months, although later in type III. At 5 years, number of reinterventions per 100 patients was 72 for type I, 51 for type II, and 13 for type III. After each reintervention, there was approximately a 50% chance of another within 2 years. Conclusions Patients' expectations when undergoing Heller myotomy for achalasia must be that symptoms will only be palliated, and patients who have worse esophageal function—achalasia type I—may require one or more postoperative reinterventions. Thus, we recommend that patients with achalasia have lifelong annual surveillance after Heller myotomy that includes TBE. [ABSTRACT FROM AUTHOR]

Published
2019
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