The Experts below are selected from a list of 11310 Experts worldwide ranked by ideXlab platform
Kenneth K. Wang - One of the best experts on this subject based on the ideXlab platform.
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combined endoscopic mucosal resection and photodynamic therapy for esophageal neoplasia within barrett s esophagus
Gastrointestinal Endoscopy, 2001Co-Authors: Navtej Buttar, Kenneth K. Wang, Lori S Lutzke, Krishnawatie K Krishnadath, Marlys AndersonAbstract:Abstract Background: Endoscopic mucosal resection (EMR) and photodynamic therapy have been proposed as treatments for early stage Cancers. EMR is limited by its focal nature whereas photodynamic therapy is dependent on precise staging. The combination of EMR and photodynamic therapy were studied in the treatment of Superficial Cancer in patients with Barrett's esophagus. Methods: Seventeen consecutive nonsurgical patients with Superficial Cancers underwent EMR followed by photodynamic therapy with a porphyrin photosensitizer. Photoradiation was performed at 630 nm for a total dose of 200 J/cm of diffuser. Results: Seventeen patients (15 men; mean age 69 ± 13 years) underwent EMR. The mean diameter of mucosal resection was 1 cm. The margins were involved by Cancer in 3 cases. EMR improved staging in 8 patients (47%). Sixteen (94%) patients remained in remission (median follow-up 13 months). Complications included minor bleeding after EMR in 1 patient (6%), stricture in 5 (30%), cutaneous phototoxicity in 2 (12%), and supraventricular tachycardia in 1 patient (6%). Conclusions: Combined EMR and photodynamic therapy appears to be an effective and safe therapy for Superficial esophageal Cancer within Barrett's esophagus. This combination improves Cancer staging, removes the Superficial Cancer, and eliminates remaining mucosa at risk for Cancer development. (Gastrointest Endosc 2001;54:682-8.)
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endoscopic mucosal resection for lesions with endoscopic features suggestive of malignancy and high grade dysplasia within barrett s esophagus
Gastrointestinal Endoscopy, 2000Co-Authors: Pardeep K Nijhawan, Kenneth K. WangAbstract:Abstract Background: Endoscopic mucosal resection has been used in the treatment of Superficial squamous cell Cancers and gastric malignancies. Our aim was to determine whether endoscopic mucosal resection can be used in the diagnosis of lesions within Barrett's esophagus whose endoscopic appearances raise suspicion of carcinoma or high-grade dysplasia. Methods: Twenty-five patients with such lesions within Barrett's esophagus underwent endoscopic mucosal resection for diagnostic and therapeutic purposes. All patients underwent endoscopic ultrasound to determine the feasibility of endoscopic resection. Only lesions found to be uT0 or uT1 underwent EMR. The lift and cut technique was used in 23 patients and a variceal ligating device was used on 2 patients. Results: Endoscopic mucosal resection was performed because of a nodule or polyp within Barrett's esophagus in 11 patients (44%) and suspected Superficial Cancer or high-grade dysplasia in 14 patients (56%). Endoscopic mucosal resection diagnosed Superficial adenocarcinoma in 13 patients (52%) and high-grade dysplasia in 4 (16%); it confirmed lesions in 8 patients (40%) to be of lower neoplastic risk. No complications occurred due to the procedure itself. Conclusions: Endoscopic mucosal resection is a technique with low morbidity and mortality. It has led to a change in diagnosis in patients with Barrett's esophagus and lesions with endoscopic features that suggest neoplasia. Its major advantages include simplicity and retrieval of the specimen en bloc. (Gastrointest Endosc 2000;52:328–32.)
Stephen F. Badylak - One of the best experts on this subject based on the ideXlab platform.
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esophageal preservation in five male patients after endoscopic inner layer circumferential resection in the setting of Superficial Cancer a regenerative medicine approach with a biologic scaffold
Tissue Engineering Part A, 2011Co-Authors: Stephen F. Badylak, Thomas W. Gilbert, Toshitaka Hoppo, Alejandro Nieponice, Jon M Davison, Blair A JobeAbstract:As a result of injury caused by chronic gastroesophageal reflux, Barrett's esophagus with high-grade dysplasia and esophageal adenocarcinoma are rapidly increasing problems in the United States. The current standard of care involves esophagectomy, a procedure associated with a high morbidity, a negative impact on long term quality of life, and a mortality rate of 1–6 percent. An entirely endoscopic technique for circumferential, long segment en bloc removal of the mucosa and submucosa with subsequent placement of a biologic scaffold material that promotes a constructive remodeling response and minimizes stricture is described herein. The results of this approach are reported for five patients with 4–24-month follow-up. Restoration of normal mature, K4+/K14+, squamous epithelium, and return to a normal diet without significant dysphagia is reported for all patients. Two of five patients show a small focus of recurrent Barrett's esophagus at the gastroesophageal junction, but the entire length and circumfer...
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transoral endoscopic inner layer esophagectomy management of high grade dysplasia and Superficial Cancer with organ preservation
Journal of Gastrointestinal Surgery, 2009Co-Authors: Bart P L Witteman, Toshitaka Hoppo, Alejandro Nieponice, Tyler Foxwell, Sandy Monsheimer, Andres Gelrud, George M Eid, Robert W Orourke, Nicole D Bouvy, Stephen F. BadylakAbstract:Introduction Limitations of endoscopic therapies for Barrett’s esophagus and Superficial Cancer include a compromised histological assessment, the need for surveillance, subsequent procedures, and stricture formation. Circumferential en bloc resection of the mucosa–submucosa complex followed by deployment of a biologic scaffold onto the remaining muscularis propria may address these concerns. The objective of this study was to determine technical feasibility of transoral resection of the esophageal lining.
Alejandro Nieponice - One of the best experts on this subject based on the ideXlab platform.
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esophageal preservation in five male patients after endoscopic inner layer circumferential resection in the setting of Superficial Cancer a regenerative medicine approach with a biologic scaffold
Tissue Engineering Part A, 2011Co-Authors: Stephen F. Badylak, Thomas W. Gilbert, Toshitaka Hoppo, Alejandro Nieponice, Jon M Davison, Blair A JobeAbstract:As a result of injury caused by chronic gastroesophageal reflux, Barrett's esophagus with high-grade dysplasia and esophageal adenocarcinoma are rapidly increasing problems in the United States. The current standard of care involves esophagectomy, a procedure associated with a high morbidity, a negative impact on long term quality of life, and a mortality rate of 1–6 percent. An entirely endoscopic technique for circumferential, long segment en bloc removal of the mucosa and submucosa with subsequent placement of a biologic scaffold material that promotes a constructive remodeling response and minimizes stricture is described herein. The results of this approach are reported for five patients with 4–24-month follow-up. Restoration of normal mature, K4+/K14+, squamous epithelium, and return to a normal diet without significant dysphagia is reported for all patients. Two of five patients show a small focus of recurrent Barrett's esophagus at the gastroesophageal junction, but the entire length and circumfer...
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esophageal preservation in five male patients after endoscopic inner layer circumferential resection in the setting of Superficial Cancer a regenerative medicine approach with a biologic scaffold
Tissue Engineering Part A, 2011Co-Authors: Stephe F Adylak, Toshitaka Hoppo, Alejandro Nieponice, Thomas W Gilbe, Jo M Daviso, Lai A JobeAbstract:As a result of injury caused by chronic gastroesophageal reflux, Barrett's esophagus with high-grade dysplasia and esophageal adenocarcinoma are rapidly increasing problems in the United States. The current standard of care involves esophagectomy, a procedure associated with a high morbidity, a negative impact on long term quality of life, and a mortality rate of 1-6 percent. An entirely endoscopic technique for circumferential, long segment en bloc removal of the mucosa and submucosa with subsequent placement of a biologic scaffold material that promotes a constructive remodeling response and minimizes stricture is described herein. The results of this approach are reported for five patients with 4-24-month follow-up. Restoration of normal mature, K4+/K14+, squamous epithelium, and return to a normal diet without significant dysphagia is reported for all patients. Two of five patients show a small focus of recurrent Barrett's esophagus at the gastroesophageal junction, but the entire length and circumference of the reconstituted esophageal mucosa remains free of disease. This experience provides evidence that a regenerative medicine approach may, for the first time, enable aggressive endoscopic resection of early stage neoplasia without the need for esophagectomy and its associated complications.
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transoral endoscopic inner layer esophagectomy management of high grade dysplasia and Superficial Cancer with organ preservation
Journal of Gastrointestinal Surgery, 2009Co-Authors: Bart P L Witteman, Toshitaka Hoppo, Alejandro Nieponice, Tyler Foxwell, Sandy Monsheimer, Andres Gelrud, George M Eid, Robert W Orourke, Nicole D Bouvy, Stephen F. BadylakAbstract:Introduction Limitations of endoscopic therapies for Barrett’s esophagus and Superficial Cancer include a compromised histological assessment, the need for surveillance, subsequent procedures, and stricture formation. Circumferential en bloc resection of the mucosa–submucosa complex followed by deployment of a biologic scaffold onto the remaining muscularis propria may address these concerns. The objective of this study was to determine technical feasibility of transoral resection of the esophageal lining.
Toshitaka Hoppo - One of the best experts on this subject based on the ideXlab platform.
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esophageal preservation in five male patients after endoscopic inner layer circumferential resection in the setting of Superficial Cancer a regenerative medicine approach with a biologic scaffold
Tissue Engineering Part A, 2011Co-Authors: Stephen F. Badylak, Thomas W. Gilbert, Toshitaka Hoppo, Alejandro Nieponice, Jon M Davison, Blair A JobeAbstract:As a result of injury caused by chronic gastroesophageal reflux, Barrett's esophagus with high-grade dysplasia and esophageal adenocarcinoma are rapidly increasing problems in the United States. The current standard of care involves esophagectomy, a procedure associated with a high morbidity, a negative impact on long term quality of life, and a mortality rate of 1–6 percent. An entirely endoscopic technique for circumferential, long segment en bloc removal of the mucosa and submucosa with subsequent placement of a biologic scaffold material that promotes a constructive remodeling response and minimizes stricture is described herein. The results of this approach are reported for five patients with 4–24-month follow-up. Restoration of normal mature, K4+/K14+, squamous epithelium, and return to a normal diet without significant dysphagia is reported for all patients. Two of five patients show a small focus of recurrent Barrett's esophagus at the gastroesophageal junction, but the entire length and circumfer...
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esophageal preservation in five male patients after endoscopic inner layer circumferential resection in the setting of Superficial Cancer a regenerative medicine approach with a biologic scaffold
Tissue Engineering Part A, 2011Co-Authors: Stephe F Adylak, Toshitaka Hoppo, Alejandro Nieponice, Thomas W Gilbe, Jo M Daviso, Lai A JobeAbstract:As a result of injury caused by chronic gastroesophageal reflux, Barrett's esophagus with high-grade dysplasia and esophageal adenocarcinoma are rapidly increasing problems in the United States. The current standard of care involves esophagectomy, a procedure associated with a high morbidity, a negative impact on long term quality of life, and a mortality rate of 1-6 percent. An entirely endoscopic technique for circumferential, long segment en bloc removal of the mucosa and submucosa with subsequent placement of a biologic scaffold material that promotes a constructive remodeling response and minimizes stricture is described herein. The results of this approach are reported for five patients with 4-24-month follow-up. Restoration of normal mature, K4+/K14+, squamous epithelium, and return to a normal diet without significant dysphagia is reported for all patients. Two of five patients show a small focus of recurrent Barrett's esophagus at the gastroesophageal junction, but the entire length and circumference of the reconstituted esophageal mucosa remains free of disease. This experience provides evidence that a regenerative medicine approach may, for the first time, enable aggressive endoscopic resection of early stage neoplasia without the need for esophagectomy and its associated complications.
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transoral endoscopic inner layer esophagectomy management of high grade dysplasia and Superficial Cancer with organ preservation
Journal of Gastrointestinal Surgery, 2009Co-Authors: Bart P L Witteman, Toshitaka Hoppo, Alejandro Nieponice, Tyler Foxwell, Sandy Monsheimer, Andres Gelrud, George M Eid, Robert W Orourke, Nicole D Bouvy, Stephen F. BadylakAbstract:Introduction Limitations of endoscopic therapies for Barrett’s esophagus and Superficial Cancer include a compromised histological assessment, the need for surveillance, subsequent procedures, and stricture formation. Circumferential en bloc resection of the mucosa–submucosa complex followed by deployment of a biologic scaffold onto the remaining muscularis propria may address these concerns. The objective of this study was to determine technical feasibility of transoral resection of the esophageal lining.
Lai A Jobe - One of the best experts on this subject based on the ideXlab platform.
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esophageal preservation in five male patients after endoscopic inner layer circumferential resection in the setting of Superficial Cancer a regenerative medicine approach with a biologic scaffold
Tissue Engineering Part A, 2011Co-Authors: Stephe F Adylak, Toshitaka Hoppo, Alejandro Nieponice, Thomas W Gilbe, Jo M Daviso, Lai A JobeAbstract:As a result of injury caused by chronic gastroesophageal reflux, Barrett's esophagus with high-grade dysplasia and esophageal adenocarcinoma are rapidly increasing problems in the United States. The current standard of care involves esophagectomy, a procedure associated with a high morbidity, a negative impact on long term quality of life, and a mortality rate of 1-6 percent. An entirely endoscopic technique for circumferential, long segment en bloc removal of the mucosa and submucosa with subsequent placement of a biologic scaffold material that promotes a constructive remodeling response and minimizes stricture is described herein. The results of this approach are reported for five patients with 4-24-month follow-up. Restoration of normal mature, K4+/K14+, squamous epithelium, and return to a normal diet without significant dysphagia is reported for all patients. Two of five patients show a small focus of recurrent Barrett's esophagus at the gastroesophageal junction, but the entire length and circumference of the reconstituted esophageal mucosa remains free of disease. This experience provides evidence that a regenerative medicine approach may, for the first time, enable aggressive endoscopic resection of early stage neoplasia without the need for esophagectomy and its associated complications.