Browsing by Author "Sharp, Allan"

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    Clinical features and prognosis of malignant small bowel tumors: Experience from a university hospital in Chile
    (2024) Silva, Felipe; Bustamante, Miguel; Latorre, Gonzalo; Flandez, Jorge; Montero, Isabella; Dukes, Eitan; Gandara, Vicente; Robles, Camila; Uribe, Javier; Iglesias, Andres; Bellolio, Felipe; Molina, Maria Elena; Migueles, Rodrigo; Urrejola, Gonzalo; Larach, Tomas; Besser, Nicolas; Sharp, Allan; Aguero, Carlos; Riquelme, Arnoldo; Vargas, Jose Ignacio; Candia, Roberto; Monrroy, Hugo; De Simone, Federico; Espino, Alberto
    Background: Small bowel tumors (SBT) are infrequent and represent a small proportion of digestive neoplasms. There is scarce information about SBT in Latin America. Aim: To describe the epidemiology, clinical characteristics, diagnostic methods, and survival of malignant SBTs. Methods: Retrospective observational study of adult patients with histopathological diagnosis of SBT between 2007 and 2021 in a university hospital in Chile. Results: A total of 104 patients [51.9% men; mean age 57 years] with SBT. Histological type: neuroendocrine tumor (NET) (43.7%, n = 38), gastrointestinal stromal tumors (GIST) (21.8%, n = 19), lymphoma (17.2%, n = 15) and adenocarcinoma (AC) (11.5%, n = 10). GIST was more frequent in duodenum (50%; n = 12) and NET in the ileum (65.8%; n = 25). Metastasis was observed in 17 cases, most commonly from colon and melanoma. Nausea and vomiting were significantly more often observed in AC ( p = 0.035), as well as gastrointestinal bleeding in GIST ( p = 0.007). The most common diagnostic tools were CT and CT enteroclysis with an elevated diagnostic yield (86% and 94% respectively). The 5 -year survival of GIST, NET, lymphoma and AC were 94.7% (95%CI: 68.1 - 99.2), 82.2% (95%CI: 57.6 - 93.3), 40.0% (95%CI: 16.5 - 82.8) and 25.9% (95%CI: 4.5 - 55.7%), respectively. NET (HR 6.1; 95%CI: 2.1 - 17.2) and GIST (HR 24.4; 95%CI: 3.0 - 19.8) were independently associated with higher survival compared to AC, adjusted for age and sex. Conclusions: Malignant SBT are rare conditions and NETs are the most common histological subtype. Clinical presentation at diagnosis, location or complications may suggest a more probable diagnosis. GIST and NET are associated with better survival compared to other malignant subtypes. (c) 2024 Elsevier Espana, S.L.U. All rights reserved.
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    Long-term Results of Endoscopic Submucosal Dissection (ESD) for the Treatment of Early Gastric Cancer (EGC) in a High-volume Latin American Center
    (2021) Mejía, Ricardo; Sáez, Josefina; Norero, Enrique; Briones, Pamela; Ceroni, Marco; Martínez, Cristian; Díaz, Alfonso; Calvo, Alfonso; Sharp, Allan
    Background: Gastric cancer is the second leading cause of death by cancer worldwide. Endoscopic submucosal dissection (ESD) is a technique that allows en bloc resection of early lesions of the digestive tract. It has curative potential in selected patients and benefits over gastrectomy for the treatment of early gastric cancer (EGC). The aim of this study is to present the results of ESD for EGC in a high-volume center in Chile. Materials and Methods: Retrospective descriptive study of patients who underwent ESD for EGC at the Doctor Sótero del Río Hospital. Results: A total of 100 ESDs were performed in 96 patients between 2008 and 2020. Fifty-five percent were female patients, the average age was 68 years (range, 45 to 89 y). En bloc resection was achieved in 98% of cases and the rate of complications Clavien grade III or higher was 8.3%. There were no cases of perioperative mortality. Ninety-three percent of the dissections were classified as R0 and 83% met curative standards according to expanded criteria. The mean follow-up was 42 months (range, 1 to 144 mo). Overall survival was 97%. Cancer-specific survival was 100% and recurrence-free survival was 97%. Conclusions: The present study describes the largest series of ESD for the treatment of EGC reported in Latin America. Our results support the feasibility of implementing ESD in Chile and indicate good oncological outcomes comparable to those reported in the large Asian series published to date.
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    Weight Loss and Metabolic Improvement in Morbidly Obese Subjects Implanted for 1 Year With an Endoscopic Duodenal-Jejunal Bypass Liner
    (LIPPINCOTT WILLIAMS & WILKINS, 2012) Escalona, Alex; Pimentel, Fernando; Sharp, Allan; Becerra, Pablo; Slako, Milenko; Turiel, Dannae; Munoz, Rodrigo; Bambs, Claudia; Guzman, Sergio; Ibanez, Luis; Gersin, Keith
    Objective: To evaluate safety, weight loss, and cardiometabolic changes in obese subjects implanted with the duodenal-jejunal bypass liner (DJBL) for 1 year.