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Article ; Online: Peptic Ulcer Disease: An Unusual Presentation of a Common Problem.

Tsoi, Andrew H / Garg, Mayur / Tsoi, Edward H

2021 Volume 162, Issue 3, Page(s) e2–e3

MeSH term(s)	Abdominal Pain/etiology ; Adult ; Endoscopy, Gastrointestinal ; Hematemesis/etiology ; Humans ; Liver Diseases/diagnostic imaging ; Liver Diseases/etiology ; Male ; Melena/etiology ; Peptic Ulcer/complications ; Peptic Ulcer/diagnostic imaging ; Peptic Ulcer/pathology ; Tomography, X-Ray Computed
Language	English
Publishing date	2021-06-26
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	80112-4
ISSN	1528-0012 ; 0016-5085
ISSN (online)	1528-0012
ISSN	0016-5085
DOI	10.1053/j.gastro.2021.06.060
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Article: Management of foreign body ingestion in adults: Time to STOP and rethink endoscopy.

Tambakis, George / Schildkraut, Tamar / Delaney, Isabella / Gilmore, Robert / Loebenstein, Moshe / Taylor, Andrew / Holt, Bronte / Tsoi, Edward H / Cameron, Georgina / Demediuk, Barbara / Miller, Ashley / Connell, William / Wright, Emily / Thompson, Alexander / Holmes, Jacinta

Endoscopy international open

2023 Volume 11, Issue 12, Page(s) E1161–E1167

Abstract: Background and study ... ...

Abstract	Background and study aims
Language	English
Publishing date	2023-12-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722
ISSN (online)	2196-9736
ISSN	2364-3722
DOI	10.1055/a-2201-6928
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Article: Endoscopic features of low-grade dysplastic Barrett's.

He, Tony / Iyer, Kiran Gopinath / Lai, Mark / House, Eloise / Slavin, John L / Holt, Bronte / Tsoi, Edward H / Desmond, Paul / Taylor, Andrew C F

Endoscopy international open

2023 Volume 11, Issue 8, Page(s) E736–E742

Abstract: Background and study ... ...

Abstract	Background and study aims
Language	English
Publishing date	2023-08-07
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722
ISSN (online)	2196-9736
ISSN	2364-3722
DOI	10.1055/a-2102-7726
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Article ; Online: Location and appearance of dysplastic Barrett's esophagus recurrence after endoscopic eradication therapy: no additional yield from random biopsy sampling neosquamous mucosa.

He, Tony / Sundararajan, Vijaya / Clark, Nicholas J / Slavin, John / Tsoi, Edward H / Thompson, Alexander J / Holt, Bronte A / Desmond, Paul V / Taylor, Andrew C F

Gastrointestinal endoscopy

2023 Volume 98, Issue 5, Page(s) 722–732

Abstract: Background and aims: Surveillance after complete remission of intestinal metaplasia (CRIM) is essential. Current recommendations are to sample visible lesions first, followed by random 4-quadrant biopsy sampling of the original Barrett's esophagus (BE) ... ...

Abstract	Background and aims: Surveillance after complete remission of intestinal metaplasia (CRIM) is essential. Current recommendations are to sample visible lesions first, followed by random 4-quadrant biopsy sampling of the original Barrett's esophagus (BE) length. To inform post-CRIM surveillance protocols, we aimed to identify the anatomic location, appearance, and histology of BE recurrences. Methods: We performed an analysis of 216 patients who achieved CRIM after endoscopic eradication therapy for dysplastic BE at a Barrett's Referral Unit between 2008 and 2021. The anatomic location, recurrence histology, and endoscopic appearance of dysplastic recurrences were evaluated. Results: After a median of 5.5 years (interquartile range, 2.9-7.2) of follow-up after CRIM, 57 patients (26.4%) developed nondysplastic BE (NDBE) recurrence and 18 patients (8.3%) developed dysplastic recurrence. From 8158 routine surveillance biopsy samplings of normal-appearing tubular esophageal neosquamous epithelium, the yield for recurrent NDBE or dysplasia was 0%. One hundred percent of dysplastic tubular esophageal recurrences were visible and in BE islands, whereas 77.8% of gastroesophageal junction dysplastic recurrences were nonvisible. Four distinct endoscopic features suspicious for recurrent advanced dysplasia or neoplasia were identified: buried or subsquamous BE, irregular mucosal pattern, loss of vascular pattern, and nodularity or depression. Conclusions: The yield of routine surveillance biopsy sampling of normal-appearing tubular esophageal neosquamous epithelium was zero. BE islands with indistinct mucosal or loss of vascular pattern, nodularity or depression, and/or signs of buried BE should raise clinician suspicion for advanced dysplasia or neoplasia recurrence. We suggest a new surveillance biopsy sampling protocol with a focus on meticulous inspection, followed by targeted biopsy sampling of visible lesions and random 4-quadrant biopsy sampling of the gastroesophageal junction.
Language	English
Publishing date	2023-06-08
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.2023.06.002
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Article ; Online: Factors that predict a poor response to radiofrequency ablation for Barrett's oesophagus with dysplasia.

Tsoi, Edward H / Cameron, Georgina / Williams, Richard / Desmond, Paul / Taylor, Andrew

ANZ journal of surgery

2020 Volume 90, Issue 3, Page(s) 272–276

Abstract: Background: Radiofrequency ablation (RFA) can eradicate dysplasia and intestinal metaplasia in patients with dysplastic Barrett's oesophagus (BO). This study aimed to determine the factors that affect response to RFA for BO with dysplasia in a tertiary ... ...

Abstract	Background: Radiofrequency ablation (RFA) can eradicate dysplasia and intestinal metaplasia in patients with dysplastic Barrett's oesophagus (BO). This study aimed to determine the factors that affect response to RFA for BO with dysplasia in a tertiary metropolitan referral centre. Methods: All patients with dysplastic BO treated with regular proton pump inhibitor twice a day and RFA from November 2008 to July 2019 were identified. These patients were sorted into good responders (GR) (defined as eradication of dysplasia and intestinal metaplasia within three or less treatment sessions) and poor responders (PR) (defined as patients requiring four or more treatment sessions). The following features were compared between the groups: age, gender, presence of hiatus hernia, hiatus hernia size, circumferential and maximal length of BO, grade of dysplasia on histology at referral and presence of endoscopically visible reflux oesophagitis. Results: A total of 152 patients received RFA for dysplastic BO, of whom 125 (82%) patients were classified as GR and 27 (18%) patients were classified as PR. PR had a longer circumferential length of BO compared to GR (mean length of 8.3 versus 3.3 cm, P < 0.0001). PR also had a longer maximal length of BO compared to GR (mean length of 8.7 versus 4.8 cm, P < 0.0001). More patients had reflux oesophagitis identified on gastroscopy in the PR group compared to GR group (12 (44%) versus 20 (16%), P = 0.001). Conclusion: Factors such as circumferential and maximal length of BO and presence of reflux oesophagitis on gastroscopy are associated with poorer response to RFA.
MeSH term(s)	Aged ; Barrett Esophagus/complications ; Barrett Esophagus/pathology ; Barrett Esophagus/surgery ; Esophagus/pathology ; Esophagus/surgery ; Female ; Humans ; Intestines/pathology ; Male ; Metaplasia/complications ; Metaplasia/surgery ; Prospective Studies ; Radiofrequency Ablation ; Treatment Outcome
Language	English
Publishing date	2020-01-23
Publishing country	Australia
Document type	Journal Article ; Observational Study
ZDB-ID	2050749-5
ISSN	1445-2197 ; 1445-1433 ; 0004-8682
ISSN (online)	1445-2197
ISSN	1445-1433 ; 0004-8682
DOI	10.1111/ans.15687
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Article: Diffuse endoscopically visible, predominantly low grade dysplasia in Barrett's esophagus (with video).

Tsoi, Edward H / Fehily, Sasha / Williams, Richard / Desmond, Paul / Taylor, Andrew

Endoscopy international open

2019 Volume 7, Issue 12, Page(s) E1742–E1747

Abstract: ... ...

Abstract	Background
Language	English
Publishing date	2019-12-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722
ISSN (online)	2196-9736
ISSN	2364-3722
DOI	10.1055/a-1031-9327
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Article: Management of foreign body ingestion in adults: Time to STOP and rethink endoscopy

Endoscopy International Open

2023 Volume 11, Issue 12, Page(s) E1161–E1167

Abstract: Background and study aims: Foreign body ingestion is a common cause for Emergency Department presentation. In adults, foreign body ingestion is more common in patients with underlying psychiatric comorbidity, the elderly, alcohol intoxication, and in ... ...

Abstract	Background and study aims: Foreign body ingestion is a common cause for Emergency Department presentation. In adults, foreign body ingestion is more common in patients with underlying psychiatric comorbidity, the elderly, alcohol intoxication, and in prisoners. This study reviewed the management of patients presenting to a tertiary hospital with foreign body ingestion. Patients and methods: A retrospective review of patients presenting with foreign body ingestion to a tertiary hospital in Melbourne, Victoria, was undertaken from January 2017 to December 2021. Data collected included patient demographics, type of foreign body, length of stay, imaging modalities, management strategies, and complications. High-risk ingestion was defined as sharp objects, length >5 cm, diameter >2.5 cm, button battery and/or magnet ingestion or esophageal as per international guidelines. Results: A total of 157 presentations by 63 patients with foreign body ingestion occurred between 2017 and 2021 (50% male; median age 30 years). Of the patients, 56% had underlying psychiatric comorbidities. The majority of presentations occurred in prisoners (65%). The most commonly ingested objects were batteries (23%), alleged drug-containing balloons (17%), razor blades (16%), and miscellaneous (40%). High-risk ingestion occurred in approximately two-thirds of presentations. Conservative management was the most common approach in 55% of patients. Complications, defined as perforation, bowel obstruction or fistula formation, did not occur in this cohort despite more than half presenting with high-risk ingestions. Thirty-day re-presentation rates were high (31%) and that was most common in patients with intentional ingestion, underlying mental health disorders, and a documented history of self-harm. Conclusions: Conservative management for patients presenting with recurrent high-risk foreign body ingestion was safe in appropriately selected cases. Re-presentation is common and poses significant challenges for health care providers.
Keywords	Foreign bodies ; GI surgery
Language	English
Publishing date	2023-10-30
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722 ; 2196-9736
ISSN (online)	2196-9736
ISSN	2364-3722 ; 2196-9736
DOI	10.1055/a-2201-6928
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Article: Endoscopic features of low-grade dysplastic Barrett’s

He, Tony / Iyer, Kiran Gopinath / Lai, Mark / House, Eloise / Slavin, John L / Holt, Bronte / Tsoi, Edward H / Desmond, Paul / Taylor, Andrew C F

Endoscopy International Open

2023 Volume 11, Issue 08, Page(s) E736–E742

Abstract: Background and study aims: Barrett’s esophagus (BE) with low-grade dysplasia (LGD) is considered usually endoscopically invisible and the endoscopic features are not well described. This study aimed to: 1) evaluate the frequency of visible BE-LGD; 2) ... ...

Abstract	Background and study aims: Barrett’s esophagus (BE) with low-grade dysplasia (LGD) is considered usually endoscopically invisible and the endoscopic features are not well described. This study aimed to: 1) evaluate the frequency of visible BE-LGD; 2) compare rates of BE-LGD detection in the community versus a Barrett’s referral unit (BRU); and 3) evaluate the endoscopic features of BE-LGD. Patients and methods: This was a retrospective analysis of a prospectively observed cohort of 497 patients referred to a BRU with dysplastic BE between 2008 and 2022. BE-LGD was defined as confirmation of LGD by expert gastrointestinal pathologist(s). Endoscopy reports, images and histology reports were reviewed to evaluate the frequency of endoscopically identifiable BE-LGD and their endoscopic features. Results: A total of 135 patients (27.2%) had confirmed BE-LGD, of whom 15 (11.1%) had visible LGD identified in the community. After BRU assessment, visible LGD was detected in 68 patients (50.4%). Three phenotypes were observed: (A) Non-visible LGD; (B) Elevated (Paris 0-IIa) lesions; and (C) Flat (Paris 0-IIb) lesions with abnormal mucosal and/or vascular patterns with clear demarcation from regular flat BE. The majority (64.7%) of visible LGD was flat lesions with abnormal mucosal and vascular patterns. Endoscopic detection of BE-LGD increased over time (38.7% (2009–2012) vs. 54.3% (2018–2022)). Conclusions: In this cohort, 50.4% of true BE-LGD was endoscopically visible, with increased recognition endoscopically over time and a higher rate of visible LGD detected at a BRU when compared with the community. BRU assessment of BE-LGD remains crucial; however, improving endoscopy surveillance quality in the community is equally important.
Keywords	Barrett's and adenocarcinoma ; Endoscopy Upper GI Tract ; Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE) ; Endoscopic resection (ESD, EMRc, ...) ; Quality and logistical aspects ; Image and data processing, documentatiton
Language	English
Publishing date	2023-05-30
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722 ; 2196-9736
ISSN (online)	2196-9736
ISSN	2364-3722 ; 2196-9736
DOI	10.1055/a-2102-7726
Database	Thieme publisher's database

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Article ; Online: Not all low grade dysplasia in Barrett's oesophagus is the same: using specific histological criteria in predicting progression to neoplasia.

Tsoi, Edward H / Williams, Richard A / Christie, Michael / Machet, David / Deb, Siddhartha / Sundararajan, Vijaya / Cameron, Georgina R / Desmond, Paul V / Taylor, Andrew C F

Pathology

2021 Volume 53, Issue 6, Page(s) 700–704

Abstract: Barrett's oesophagus with low grade dysplasia (LGD) is a risk factor for progression to high grade dysplasia (HGD) and oesophageal adenocarcinoma (OAC); however, only a subgroup of LGD will progress. We used a combination of specific histological ... ...

Abstract	Barrett's oesophagus with low grade dysplasia (LGD) is a risk factor for progression to high grade dysplasia (HGD) and oesophageal adenocarcinoma (OAC); however, only a subgroup of LGD will progress. We used a combination of specific histological criteria to identify patients with LGD who are more likely to progress to HGD or OAC. LGD slides from 38 patients within the progressor group (PG) and 17 patients from the non-progressor group (NPG) were obtained and reviewed by two expert GI pathologists, to be stratified by the same four specific histological variables identified by Ten Kate et al.: loss of surface maturation, mucin depletion, nuclear enlargement, and increase of mitosis. After review of LGD slides by two expert GI pathologists, 27 suitable patients were identified. Of these 27 patients there was a higher proportion of patients from the PG with all four specific criteria reported, compared to the NPG: 14 (78%) vs 3 (33%) p=0.0394. Patients with all four specific criteria were more likely to progress compared to those who had one or less specific criteria reported (OR 7, 95% CI 1.1848-41.3585, p=0.032). A combination of ≥2 or ≥3 specific histological criteria was not prognostic. Patients with a combination of all four specific histological criteria (loss of surface maturation, mucin depletion, nuclear enlargement, and increase of mitosis) were associated with greater progression from LGD to HGD or OAC in Barrett's oesophagus.
MeSH term(s)	Adenocarcinoma/pathology ; Barrett Esophagus/diagnosis ; Barrett Esophagus/pathology ; Disease Progression ; Esophageal Neoplasms/pathology ; Esophagus/pathology ; Humans ; Hyperplasia/diagnosis ; Hyperplasia/pathology ; Neoplasms/diagnosis ; Neoplasms/pathology ; Precancerous Conditions/pathology ; Prognosis ; Risk Factors
Language	English
Publishing date	2021-08-19
Publishing country	England
Document type	Journal Article
ZDB-ID	7085-3
ISSN	1465-3931 ; 0031-3025
ISSN (online)	1465-3931
ISSN	0031-3025
DOI	10.1016/j.pathol.2021.06.116
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Article: Diffuse endoscopically visible, predominantly low grade dysplasia in Barrett’s esophagus (with video)

Tsoi, Edward H. / Fehily, Sasha / Williams, Richard / Desmond, Paul / Taylor, Andrew

Endoscopy International Open

2019 Volume 07, Issue 12, Page(s) E1742–E1747

Abstract: Background: Low grade dysplasia (LGD) in Barrett’s esophagus (BE) has generally been considered as undetectable endoscopically.: Aim: To describe a phenotype which consists of diffuse, endoscopically visible, predominantly low grade dysplasia in ... ...

Abstract	Background: Low grade dysplasia (LGD) in Barrett’s esophagus (BE) has generally been considered as undetectable endoscopically. Aim: To describe a phenotype which consists of diffuse, endoscopically visible, predominantly low grade dysplasia in Barrett’s esophagus (DEVLB), with often subtle but visible endoscopic changes seen with high definition white light (HDWL) and narrow-band imaging (NBI). Method: A systematic search of a prospectively collected database for patients satisfying predefined criteria for DEVLB and a review of endoscopic and histological features of biopsies and endoscopic mucosal resection (EMR) specimens. Results: Out of a total of 419 patients referred to our expert center for assessment of dysplastic Barrett’s esophagus during the period January 2009 to March 2018, there were 7 patients (1.7 %) who satisfied the criteria defined for DEVLB, identified on their initial assessment endoscopy. All patients were treated by EMR of visible abnormal mucosa during their assessment endoscopy at our tertiary referral center. There was a total of 47 EMR specimens obtained, with a median of 6 (IQR 5–9) EMR resection pieces per patient, of which 36 (77 %) contained LGD, 8 (17 %) high grade dysplasia (HGD), 2 (4 %) non-dysplastic Barrett’s esophagus (NDBE), and 1 (2 %) contained early esophageal adenocarcinoma (EAC). Conclusion: DEVLB is a distinct phenotype seen in a small but significant proportion of individuals with dysplastic Barrett’s esophagus. Patients with DEVLB have widespread LGD, with many having areas of focal HGD or early cancer within this area. We believe these patients are best treated with extensive EMR of the visibly abnormal area.
Language	English
Publishing date	2019-12-01
Publisher	© Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article
ZDB-ID	2761052-4
ISSN	2196-9736 ; 2364-3722 ; 2196-9736
ISSN (online)	2196-9736
ISSN	2364-3722 ; 2196-9736
DOI	10.1055/a-1031-9327
Database	Thieme publisher's database

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