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Current Issue July 2015

Safety and efficacy of carbon dioxide cryotherapy for treatment of neoplastic Barrett's esophagus   (FREE ACCESS)

Marcia Irene Canto, Eun Ji Shin, Mouen A. Khashab, Daniela Molena, Patrick Okolo,Elizabeth Montgomery, Pankaj Pasricha

Outcomes of CO2 cryotherapy in patients with neoplastic Barrett's esophagus (n=68) were assessed at 1 year. The overall complete remission rate was 77% for cancer, 89% for dysplasia, and 55% for intestinal metaplasia. Serious adverse events were noted in two patients (3%) and post-cryoablation pain occurred in four (6 %). Buried Barrett's was detected in 7%. CO2 cryotherapy seems a safe and effective therapy for Barrett's neoplasia but comparative studies with other ablative treatments are required. Read more.

Randomized multicenter study of multiple plastic stents vs. covered self-expandable metallic stent in the treatment of biliary stricture in chronic pancreatitis (FREE ACCESS)

Carola Haapamäki, Leena Kylänpää, Marianne Udd, Outi Lindström, Juha Grönroos, Arto Saarela, Harri Mustonen, Jorma Halttunen

Covered self-expandable metallic stents (cSEMS) are increasingly used for the treatment of benign biliary strictures, but their efficacy in strictures due to chronic pancreatitis is unclear. A group from Finland randomized 60 patients to placement of either one covered self-expandable metallic stent for 6 months or three plastic stents followed by three additional plastic stents 3 months later, for a total of 6 months. The 2-year stricture-free success rate was not different between the metal and plastic stents (92% vs. 90%, respectively). If one considers the number of procedures and patient comfort, the covered self-expandable metallic stent seems preferable to plastic stents for this indication.  Read more.

Thienopyridine derivatives as risk factors for bleeding following high risk endoscopic treatments: Safe Treatment on Antiplatelets (STRAP) study  (FREE ACCESS)

Satoshi Ono, Mitsuhiro Fujishiro, Naohiro Yoshida, Hisashi Doyama, Toshiro Kamoshida, Shinji Hirai, Teruhito Kishihara, Yorimasa Yamamoto, Hiroyuki Sakae, Atsushi Imagawa, Masaaki Hirano, Kazuhiko Koike


Patients at high risk of thromboembolism who were treated by thienopyridinederivatives and aspirin, underwent gastric endoscopic submucosal dissection with continuation of aspirin only. No bleeding occurred during the procedure. However, subsequent postoperative administration of thienopyridine derivatives was associated with a high risk of postoperative bleeding (25% of patients). Cautious postoperative care is required in such conditions. Read more.