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Article ; Online: Management of high risk T1 esophageal adenocarcinoma following endoscopic resection.

Leclercq, Philippe / Bisschops, Raf / Bergman, Jacques J G H M / Pouw, Roos E

Best practice & research. Clinical gastroenterology

2024 Volume 68, Page(s) 101882

Abstract: High-risk T1 esophageal adenocarcinoma (HR-T1 EAC) is defined as T1 cancer, with one or more of the following histological criteria: submucosal invasion, poorly or undifferentiated cancer, and/or presence of lympho-vascular invasion. Esophagectomy has ... ...

Abstract	High-risk T1 esophageal adenocarcinoma (HR-T1 EAC) is defined as T1 cancer, with one or more of the following histological criteria: submucosal invasion, poorly or undifferentiated cancer, and/or presence of lympho-vascular invasion. Esophagectomy has long been the only available treatment for these HR-T1 EACs and was considered necessary because of a presumed high risk of lymph node metastases up to 46%. However, endoscopic submucosal disscection have made it possible to radically remove HR-T1 EAC, irrespective of size, while leaving the esophageal anatomy intact. Parallel to this development, new publications demonstrated that the risk of lymph node metastases for HR-T1 EAC may be even <24%. Therefore, indications for endoscopic treatment of HR-T1 EAC are being reconsidered and current research aims at finding the optimal management strategy for this indication, where watchful waiting may proof to be an acceptable strategy in selected patients. In this review, we will discuss the latest developments in this field.
MeSH term(s)	Humans ; Lymphatic Metastasis ; Esophageal Neoplasms/surgery ; Esophageal Neoplasms/pathology ; Adenocarcinoma/surgery ; Adenocarcinoma/pathology ; Esophagoscopy ; Esophagectomy/adverse effects ; Barrett Esophagus/pathology
Language	English
Publishing date	2024-02-03
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2048181-0
ISSN	1532-1916 ; 1521-6918
ISSN (online)	1532-1916
ISSN	1521-6918
DOI	10.1016/j.bpg.2024.101882
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Article ; Online: Role of the Intestine and Its Gut Microbiota in Metabolic Syndrome and Obesity.

Busch, Celine B E / Bergman, Jacques J G H M / Nieuwdorp, Max / van Baar, Annieke C G

The American journal of gastroenterology

2024

Abstract: The metabolic syndrome (MetSyn) is currently one of the biggest global health challenges because of its impact on public health. MetSyn includes the cluster of metabolic disorders including obesity, high blood pressure, hyperglycemia, high triglyceride ... ...

Abstract	The metabolic syndrome (MetSyn) is currently one of the biggest global health challenges because of its impact on public health. MetSyn includes the cluster of metabolic disorders including obesity, high blood pressure, hyperglycemia, high triglyceride levels, and hepatic steatosis. Together, these abnormalities increase the cardiovascular risk of individuals and pose a threat to healthcare systems worldwide. To better understand and address this complex issue, recent research has been increasingly focusing on unraveling the delicate interplay between metabolic disorders and the intestines and more specifically our gut microbiome. The gut microbiome entails all microorganisms inhabiting the gastrointestinal tract and plays a pivotal role in metabolic processes and overall health of its host. Emerging evidence proves an association between the gut microbiome composition and aspects of MetSyn, such as obesity. Understanding these relationships is crucial because they offer valuable insights into the mechanisms underlying development and progression of metabolic disorders and possible treatment options. Yet, how should we interpret this relationship? This review focuses on the interplay between the gut and MetSyn. In addition, we have reviewed the existing evidence of the gut microbiome and its association with and impact on metabolic disorders, in an attempt to understand the complex interactions and nature of this association. We also explored potential therapeutic options targeting the gut to modify metabolic disorders and obesity.
Language	English
Publishing date	2024-03-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	390122-1
ISSN	1572-0241 ; 0002-9270
ISSN (online)	1572-0241
ISSN	0002-9270
DOI	10.14309/ajg.0000000000002730
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Article ; Online: Comments on "TSP-9: A Barrett's Esophagus Biomarker Better Than Pathologists?"

Duits, Lucas C / Critchley-Thorne, Rebecca J / Bergman, Jacques J G H M

Gastroenterology

2023 Volume 166, Issue 4, Page(s) 714–715

MeSH term(s)	Humans ; Barrett Esophagus/diagnosis ; Pathologists ; Esophageal Neoplasms ; Biomarkers
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-12-17
Publishing country	United States
Document type	Letter
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2023.12.012
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Article ; Online: Response.

van Baar, Annieke C G / Bergman, Jacques J G H M

Gastrointestinal endoscopy

2022 Volume 96, Issue 5, Page(s) 875–876

Language	English
Publishing date	2022-10-18
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/j.gie.2022.07.032
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Zs.B 283: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Re-Cellularization via Electroporation Therapy of the duodenum combined with GPL-1 receptor agonist to replace insulin therapy in patients with type 2 diabetes; 12 months results of a first-in-human study.

Busch, Celine B E / Meiring, Suzanne / van Baar, Annieke C G / Holleman, Frits / Nieuwdorp, Max / Bergman, Jacques J G H M

Gastrointestinal endoscopy

2024

Abstract: Background and aims: Studies have shown that hydrothermal duodenal mucosal ablation results in improved glycemic control. Re-Cellularization via Electroporation Therapy (ReCET) is a novel endoscopic procedure that uses electroporation to induce cellular ...

Abstract	Background and aims: Studies have shown that hydrothermal duodenal mucosal ablation results in improved glycemic control. Re-Cellularization via Electroporation Therapy (ReCET) is a novel endoscopic procedure that uses electroporation to induce cellular apoptosis and subsequent reepithelization. In this study, we aimed to eliminate exogenous insulin treatment in T2D patients through a single ReCET procedure combined with a GLP-1 receptor agonist (GLP-1RA). Feasibility, safety, and (dose) efficacy of ReCET were assessed. Methods: First-in-human study including patients with T2D on basal insulin (28-75years; BMI 24-40kg/m Results: Fourteen patients underwent endoscopic ReCET. Median procedure time was 58 (IQR 49-73) minutes. ReCET demonstrated a technical success rate of 100%. No device related SAEs or severe hypoglycemic events were observed. At 12 months follow up, 12 (86%) patients remained off exogenous insulin therapy with significant improvements in glycemic control, metabolic parameters. The 2 patients in whom insulin therapy was reintroduced both received ReCET at the lowest voltage (single 600V). Conclusion: These results suggest that ReCET is feasible and safe. In combination with semaglutide, ReCET may be a promising therapeutic option to replace insulin therapy in selected T2D patients, while improving glycemic control and metabolic health.
Language	English
Publishing date	2024-04-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/j.gie.2024.04.2904
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Article ; Online: Screening for Barrett's esophagus: Ready for prime time or still hard to swallow?

Frei, Nicola F / Bergman, Jacques J G H M / Pouw, Roos E

Gastrointestinal endoscopy

2021 Volume 94, Issue 3, Page(s) 506–508

MeSH term(s)	Barrett Esophagus/diagnosis ; Esophageal Neoplasms/diagnosis ; Esophagoscopy ; Humans ; Mass Screening
Language	English
Publishing date	2021-07-16
Publishing country	United States
Document type	Editorial ; Comment
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/j.gie.2021.06.004
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Zs.B 283: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 519: Show issues

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Article: Vacuum-stent: A combination of endoscopic vacuum therapy and an intraluminal stent for treatment of esophageal transmural defects.

Pattynama, Lisanne M D / Eshuis, Wietse J / van Berge Henegouwen, Mark I / Bergman, Jacques J G H M / Pouw, Roos E

Frontiers in surgery

2023 Volume 10, Page(s) 1145984

Abstract: Introduction: Endoscopic vacuum therapy (EVT) has gained a greater role in management of transmural defects in the upper gastrointestinal (GI) tract, including anastomotic leakage and esophageal perforation (e.g. Boerhaave syndrome and iatrogenic causes) ...

Abstract	Introduction: Endoscopic vacuum therapy (EVT) has gained a greater role in management of transmural defects in the upper gastrointestinal (GI) tract, including anastomotic leakage and esophageal perforation (e.g. Boerhaave syndrome and iatrogenic causes). The vacuum-stent is a new treatment modality, combining the benefits of EVT and an intraluminal stent. Patients and methods: This prospective case series describes the first ten cases of a transmural defect in the upper GI tract treated with a vacuum-stent in a tertiary referral center. All patients signed informed consent for prospective registration of relevant data on treatment and outcomes in a specially designed database. Outcome parameters were successful closure of the defect, number of endoscopies, duration of treatment and adverse events. Results: In total, ten patients treated with a vacuum-stent were included. Eight patients had anastomotic leakage after esophageal resection, of whom six were treated with vacuum-sponge and vacuum-stent, and two with vacuum-stent only. One patient had Boerhaave syndrome, treated with vacuum-sponge and vacuum-stent, and one had an iatrogenic perforation during pneumodilation for achalasia, treated with vacuum-stent only. Success rate was 100%, requiring a median of 5 (IQR 3-12) EVT-related endoscopies with a treatment course of median 18 (IQR 12-59) days. One patient developed an esophageal stricture, but no other vacuum-stent related adverse events were observed. Conclusion: The vacuum-stent, which combines benefits of EVT and an intraluminal stent, shows great feasibility and efficacy in treatment of transmural defects in the upper GI tract. Future studies should point out whether this device can prevent major (re-)surgery in these patients.
Language	English
Publishing date	2023-02-22
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2023.1145984
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Article ; Online: Endoscopic vacuum therapy for anastomotic leakage after upper gastrointestinal surgery.

Pattynama, Lisanne M D / Pouw, Roos E / Henegouwen, Mark I van Berge / Daams, Freek / Gisbertz, Suzanne S / Bergman, Jacques J G H M / Eshuis, Wietse J

Endoscopy

2023 Volume 55, Issue 11, Page(s) 1019–1025

Abstract: Background: Recently, endoscopic vacuum therapy (EVT) was introduced as treatment for anastomotic leakage after upper gastrointestinal (GI) surgery. The aim of this study was to describe the initial experience with EVT for anastomotic leakage after ... ...

Abstract	Background: Recently, endoscopic vacuum therapy (EVT) was introduced as treatment for anastomotic leakage after upper gastrointestinal (GI) surgery. The aim of this study was to describe the initial experience with EVT for anastomotic leakage after upper GI surgery in a tertiary referral center. Methods: Patients treated with EVT for anastomotic leakage after upper GI surgery were included retrospectively (January 2018-June 2021) and prospectively (June 2021-October 2021). The primary end point was the EVT success rate. Secondary end points included mortality and adverse events. Results: 38 patients were included (31 men; mean age 66 years): 27 had undergone an esophagectomy with gastric conduit reconstruction and 11 a total gastrectomy with esophagojejunal anastomosis. EVT was successful in 28 patients (74 %, 95 %CI 57 %-87 %). In 10 patients, EVT failed: deceased owing to radiation pneumonitis (n = 1), EVT-associated complications (n = 2), and defect closure not achieved (n = 7). Mean duration of successful EVT was 33 days, with a median of six EVT-related endoscopies. Median hospital stay was 45 days. Conclusion: This initial experience with EVT for anastomotic leakage after upper GI surgery demonstrated a success rate of 74 %. EVT is a promising therapy that could prevent further major surgery. More experience with the technique and its indications will likely improve success rates in the future.
MeSH term(s)	Male ; Humans ; Aged ; Anastomotic Leak/etiology ; Anastomotic Leak/surgery ; Retrospective Studies ; Negative-Pressure Wound Therapy/methods ; Endoscopy/adverse effects ; Gastrectomy/adverse effects ; Esophagectomy/adverse effects
Language	English
Publishing date	2023-05-30
Publishing country	Germany
Document type	Clinical Trial ; Journal Article
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/a-2102-1691
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Zs.MO 162: Show issues

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Article ; Online: Insulin sensitivity and beta cell function after Duodenal Mucosal Resurfacing (DMR): An Open-Label, Mechanistic, Pilot Study.

Busch, Celine B E / Meiring, Suzanne / van Baar, Annieke C G / Gastaldelli, Amalia / DeFronzo, Ralph / Mingrone, Geltrude / Hagen, Moira / White, Kelly / Rajagopalan, Harith / Nieuwdorp, Max / Bergman, Jacques J G H M

Gastrointestinal endoscopy

2024

Abstract: Background and aims: The duodenum has been shown to play a key role in glucose homeostasis. Duodenal mucosal resurfacing (DMR) is an endoscopic procedure for patients with type 2 diabetes (T2D) in which the duodenal mucosa is hydrothermally ablated. DMR ...

Abstract	Background and aims: The duodenum has been shown to play a key role in glucose homeostasis. Duodenal mucosal resurfacing (DMR) is an endoscopic procedure for patients with type 2 diabetes (T2D) in which the duodenal mucosa is hydrothermally ablated. DMR improves glycemic control, but the underlying mechanisms remain unclear. Here, we report changes in glucoregulatory hormones and indices of insulin sensitivity and beta cell function after DMR. Methods: We included 28 patients on non-insulin glucose lowering medications who underwent open-label DMR and a mixed meal test (MMT) in Revita-1 or Revita-2. Inclusion criteria were hemoglobin A1c (HbA1c) 7.6-10.4% and BMI 24-40kg/m Results: Fasting insulin, glucagon, and C-peptide decreased significantly. Insulin sensitivity (HOMA-IR, MI, and HIR) and beta cell function (DI and ISR) all improved significantly. Decline in postprandial glucose, mainly driven by a decrease in fasting levels, was observed, as well as a decline in postprandial glucagon whereas GLP-1 and GIP did not change. Conclusions: Insulin sensitivity and insulin secretion improved 3 months after DMR. It is unlikely that incretin changes are responsible for improved glucose control after DMR. These data add to the growing evidence validating the duodenum as a therapeutic target for patients with T2D.
Language	English
Publishing date	2024-01-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	391583-9
ISSN	1097-6779 ; 0016-5107
ISSN (online)	1097-6779
ISSN	0016-5107
DOI	10.1016/j.gie.2024.01.031
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Article ; Online: Endoscopic submucosal dissection for early esophageal squamous cell carcinoma: long-term results from a Western cohort.

Beaufort, Ilse N / Frederiks, Charlotte N / Overwater, Anouk / Brosens, Lodewijk A A / Koch, Arjun D / Pouw, Roos E / Bergman, Jacques J G H M / Weusten, Bas L A M

Endoscopy

2024 Volume 56, Issue 5, Page(s) 325–333

Abstract: Background: Although endoscopic submucosal dissection (ESD) is established as first-choice treatment for early esophageal squamous cell carcinoma (ESCC) worldwide, most data are derived from Asian studies. We aimed to evaluate the long-term outcomes of ... ...

Abstract	Background: Although endoscopic submucosal dissection (ESD) is established as first-choice treatment for early esophageal squamous cell carcinoma (ESCC) worldwide, most data are derived from Asian studies. We aimed to evaluate the long-term outcomes of ESD for patients with early ESCC in a Western cohort. Methods: In this retrospective cohort study, patients with early ESCC amenable to ESD were included from four tertiary referral hospitals in the Netherlands between 2012 and 2017. All ESD procedures were performed by experienced endoscopists, after which the decision for additional treatment was made on a per-patient basis. Outcomes were curative resection rate, ESCC-specific survival, and overall survival. Results: Of 68 included patients (mean age 69 years; 34 males), ESD was technically successful in 66 (97%; 95%CI 93%-100%), with curative resection achieved in 34/66 (52%; 95%CI 39%-64%). Among patients with noncurative resection, 15/32 (47%) underwent additional treatment, mainly esophagectomy (n = 10) or definitive chemoradiation therapy (n = 4). Endoscopic surveillance was preferred in 17/32 patients (53%), based on severe comorbidities or patient choice. Overall, 31/66 patients (47%) died during a median follow-up of 66 months; 8/31 (26%) were ESCC-related deaths. The 5-year overall and ESCC-specific survival probabilities were 62% (95%CI 52%-75%) and 86% (95%CI 77%-96%), respectively. Conclusion: In this Western cohort with long-term follow-up, the effectiveness and safety of ESD for early ESCC was confirmed, although the rate of noncurative resections was substantial. Irrespective of curative status, the long-term prognosis of these patients was limited mainly due to competing mortality.
MeSH term(s)	Humans ; Endoscopic Mucosal Resection/methods ; Endoscopic Mucosal Resection/adverse effects ; Male ; Female ; Aged ; Esophageal Neoplasms/surgery ; Esophageal Neoplasms/mortality ; Esophageal Neoplasms/pathology ; Retrospective Studies ; Esophageal Squamous Cell Carcinoma/surgery ; Esophageal Squamous Cell Carcinoma/mortality ; Esophageal Squamous Cell Carcinoma/pathology ; Middle Aged ; Netherlands ; Esophagectomy/methods ; Esophagectomy/adverse effects ; Treatment Outcome ; Survival Rate ; Aged, 80 and over ; Neoplasm Staging
Language	English
Publishing date	2024-02-07
Publishing country	Germany
Document type	Journal Article ; Multicenter Study
ZDB-ID	80120-3
ISSN	1438-8812 ; 0013-726X
ISSN (online)	1438-8812
ISSN	0013-726X
DOI	10.1055/a-2245-7235
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