The Experts below are selected from a list of 36 Experts worldwide ranked by ideXlab platform
R J Nicholls - One of the best experts on this subject based on the ideXlab platform.
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assessment of the mucosa of the indefinitely diverted ileo anal Pouch
Colorectal Disease, 2008Co-Authors: J J Smith, A P Lyons, Paris P Tekkis, S K Clark, R J NichollsAbstract:Abstract Objective One surgical option to treat failure afterrestorative proctocolectomy (RPC) is indefinite diversion(ID) without excision of the Pouch. The study aimed toassess the mucosal morphology of the Pouch and ileoanalanastomosis (IAA) over time after ID with particularreference to inflammation, dysplasia and carcinoma.Method Patients with ID were identified from thehospital’s Ileal Pouch Database. Individuals were invitedby mail to attend for flexible Pouchoscopy and biopsyfrom the ileal Pouch and immediately distal to the IAA.Results Of 1822 patients on the database, 28 hadundergone ID. Of these, 20 patients (18 ulcerativecolitis, one familial adenomatous polyposis, one pseudo-obstruction) of median age 42 (18–67) years took part.There were eight males. The median (range) intervalsfrom diagnosis of primary disease, Pouch surgery and IDto the time of study were 221 (63–410), 146 (31–314)and 44 (10–159) months respectively. One patient haddysplasia in the original resection specimen. Five patientsdeveloped type C changes in the Pouch. Of these threewere identified between RPC and ID, one developedbetween ID and the present assessment and one wasidentified for the first time at the present assessment. Nocase of dysplasia or cancer was found in any of thebiopsies. Rectal mucosa was found in biopsies from theIAA in four patients (three stapled; one handsewn); thiswas inflamed in three patients.Conclusion At a median follow-up of 12 years after RPCand 3.6 years after indefinite diversion no instance ofdysplasia or carcinoma in the ileal reservoir or distal to theIAA was found in any of the 20 patients having ID. TypeC changes occurred at some time in five (25%) patients,indicating the importance of continued follow up.Keywords Restorative proctocolectomy, ileal Pouch analanastomosis, ileal reservoir, ulcerative colitis, familialadenomatous polyposis, dysplasia
Francesco Selvaggi - One of the best experts on this subject based on the ideXlab platform.
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non colorectal intestinal tract carcinomas in inflammatory bowel disease results of the 3rd ecco pathogenesis scientific workshop ii
Journal of Crohns & Colitis, 2014Co-Authors: Laurence J Egan, R Dinca, Tine Jess, Gianluca Pellino, Franck Carbonnel, B Bokemeyer, Marcus Harbord, Paula Borralho Nunes, Janneke Van Der Woude, Francesco SelvaggiAbstract:Patients with inflammatory bowel diseases (IBD) have an excess risk of certain gastrointestinal cancers. Much work has focused on colon cancer in IBD patients, but comparatively less is known about other more rare cancers. The European Crohn's and Colitis Organization established a pathogenesis workshop to review what is known about these cancers and formulate proposals for future studies to address the most important knowledge gaps. This article reviews the current state of knowledge about small bowel adenocarcinoma, Ileo-Anal Pouch and rectal cuff cancer, and anal/perianal fistula cancers in IBD patients.
Poonam Beniwalpatel - One of the best experts on this subject based on the ideXlab platform.
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efficacy of vedolizumab for refractory Pouchitis of the ileo anal Pouch results from a multicenter us cohort
Inflammatory Bowel Diseases, 2019Co-Authors: Martin H Gregory, Kimberly N Weaver, Patrick Hoversten, Stephen B Hicks, Devin Patel, Matthew A Ciorba, Alexandra Gutierrez, Poonam BeniwalpatelAbstract:Background and aims Inflammation of the Pouch after ileal Pouch-anal anastomosis (IPAA) can significantly impact quality of life and be difficult to treat. We assessed the effectiveness and safety of vedolizumab in Crohn's disease (CD) of the Pouch and chronic antibiotic-dependent or antibiotic-refractory Pouchitis. Methods This was a retrospective, multicenter cohort study at 5 academic referral centers in the United States. Adult patients with endoscopic inflammation of the Pouch who received vedolizumab were included. The primary outcome was clinical response at any time point. Secondary outcomes included clinical remission, endoscopic response, and remission. Univariate analysis and multivariate analysis were performed for the effect of the following variables on clinical response: fistula, onset of Pouchitis less than 1 year after IPAA, younger than 35 years old, gender, previous tumor necrosis factor inhibitor-alpha use, and BMI >30. Results Eighty-three patients were treated with vedolizumab for inflammation of the Pouch between January 2014 and October 2017. Median follow-up was 1.3 years (interquartile range 0.7-2.1). The proportion of patients that achieved at least a clinical response was 71.1%, with 19.3% achieving clinical remission. Of the 74 patients with a follow-up Pouchoscopy, the proportion of patients with endoscopic response and mucosal healing was 54.1% and 17.6%, respectively. Patients who developed Pouchitis symptoms less than 1 year after undergoing IPAA were less likely to respond to vedolizumab, even after controlling for other risk factors. Conclusions Vedolizumab is safe and effective in the management of CD of the Pouch and chronic Pouchitis. Further studies are needed to compare vedolizumab with other biologic therapies for Pouchitis and CD of the Pouch.
Alexandra Gutierrez - One of the best experts on this subject based on the ideXlab platform.
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efficacy of vedolizumab for refractory Pouchitis of the ileo anal Pouch results from a multicenter us cohort
Inflammatory Bowel Diseases, 2019Co-Authors: Martin H Gregory, Kimberly N Weaver, Patrick Hoversten, Stephen B Hicks, Devin Patel, Matthew A Ciorba, Alexandra Gutierrez, Poonam BeniwalpatelAbstract:Background and aims Inflammation of the Pouch after ileal Pouch-anal anastomosis (IPAA) can significantly impact quality of life and be difficult to treat. We assessed the effectiveness and safety of vedolizumab in Crohn's disease (CD) of the Pouch and chronic antibiotic-dependent or antibiotic-refractory Pouchitis. Methods This was a retrospective, multicenter cohort study at 5 academic referral centers in the United States. Adult patients with endoscopic inflammation of the Pouch who received vedolizumab were included. The primary outcome was clinical response at any time point. Secondary outcomes included clinical remission, endoscopic response, and remission. Univariate analysis and multivariate analysis were performed for the effect of the following variables on clinical response: fistula, onset of Pouchitis less than 1 year after IPAA, younger than 35 years old, gender, previous tumor necrosis factor inhibitor-alpha use, and BMI >30. Results Eighty-three patients were treated with vedolizumab for inflammation of the Pouch between January 2014 and October 2017. Median follow-up was 1.3 years (interquartile range 0.7-2.1). The proportion of patients that achieved at least a clinical response was 71.1%, with 19.3% achieving clinical remission. Of the 74 patients with a follow-up Pouchoscopy, the proportion of patients with endoscopic response and mucosal healing was 54.1% and 17.6%, respectively. Patients who developed Pouchitis symptoms less than 1 year after undergoing IPAA were less likely to respond to vedolizumab, even after controlling for other risk factors. Conclusions Vedolizumab is safe and effective in the management of CD of the Pouch and chronic Pouchitis. Further studies are needed to compare vedolizumab with other biologic therapies for Pouchitis and CD of the Pouch.
Matthew A Ciorba - One of the best experts on this subject based on the ideXlab platform.
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efficacy of vedolizumab for refractory Pouchitis of the ileo anal Pouch results from a multicenter us cohort
Inflammatory Bowel Diseases, 2019Co-Authors: Martin H Gregory, Kimberly N Weaver, Patrick Hoversten, Stephen B Hicks, Devin Patel, Matthew A Ciorba, Alexandra Gutierrez, Poonam BeniwalpatelAbstract:Background and aims Inflammation of the Pouch after ileal Pouch-anal anastomosis (IPAA) can significantly impact quality of life and be difficult to treat. We assessed the effectiveness and safety of vedolizumab in Crohn's disease (CD) of the Pouch and chronic antibiotic-dependent or antibiotic-refractory Pouchitis. Methods This was a retrospective, multicenter cohort study at 5 academic referral centers in the United States. Adult patients with endoscopic inflammation of the Pouch who received vedolizumab were included. The primary outcome was clinical response at any time point. Secondary outcomes included clinical remission, endoscopic response, and remission. Univariate analysis and multivariate analysis were performed for the effect of the following variables on clinical response: fistula, onset of Pouchitis less than 1 year after IPAA, younger than 35 years old, gender, previous tumor necrosis factor inhibitor-alpha use, and BMI >30. Results Eighty-three patients were treated with vedolizumab for inflammation of the Pouch between January 2014 and October 2017. Median follow-up was 1.3 years (interquartile range 0.7-2.1). The proportion of patients that achieved at least a clinical response was 71.1%, with 19.3% achieving clinical remission. Of the 74 patients with a follow-up Pouchoscopy, the proportion of patients with endoscopic response and mucosal healing was 54.1% and 17.6%, respectively. Patients who developed Pouchitis symptoms less than 1 year after undergoing IPAA were less likely to respond to vedolizumab, even after controlling for other risk factors. Conclusions Vedolizumab is safe and effective in the management of CD of the Pouch and chronic Pouchitis. Further studies are needed to compare vedolizumab with other biologic therapies for Pouchitis and CD of the Pouch.
