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Pietro Familiari

Publications and source records attributed to Pietro Familiari.

6 recordsLinked to original sources
PubMed2006

Optical coherence tomography evaluation of ulcerative colitis: the patterns and the comparison with histology.

HYPOTHESIS: The optical coherence tomography (OCT) is an imaging modality based on infrared light backscattering properties of tissues. OCT studies documented the disappearance of crypts and the alteration in light backscattering as features of ulcerative colitis (UC) in human colon. This technique should be more and more able to identify tissue microstructures with a resolution that is nearly that of histology (optical biopsy). AIM: To evaluate whether there are OCT patterns specific for UC and to compare the overall technique performance with the histology. METHODS: A total of 27 patients (20-76 yr) with UC underwent OCT imaging during a total colonoscopy. The OCT images were collected both from affected and normal sites in active UC or disease in remission. Two biopsies of the same sites were acquired. The OCT images were separately scored. Two pathologists blinded to the endoscopic and OCT patterns scored the samples. RESULTS: Three OCT patterns were identified: the mucosal backscattering alteration (MBA), the delimited dark areas (DDA), and the layered colonic wall (LCW). In colon affected segments of active and UC in remission, these patterns showed a good correspondence with the histology. Moreover, in 14/25 (56%) normal sites above the affected segment, the OCT documented the pathological features, confirmed only in 10/14 by the histology. Thus, the assessed sensitivity and specificity of OCT in normal segments of UC patients have been 100% and 69%, respectively. CONCLUSIONS: The in vivo OCT correctly detected disease features in endoscopically affected colon segments, but even in apparently normal segments of UC patients.

Adult↗
PubMed2005

Endoscopic removal of malfunctioning biliary self-expandable metallic stents.

BACKGROUND: Endoscopic removal of malfunctioning self-expandable metallic biliary stents (SEMS) is difficult and not well described. The aim of this study is to review the indications, the techniques, and the results of SEMS removal in a cohort of patients with malfunctioning stents. METHODS: All patients who underwent an attempt at endoscopic removal of biliary SEMS over a 5-year period were retrospectively identified. The main indications for SEMS removal were the following: distal migration of the stent or impaction to the duodenum, impaction into the bile-duct wall, tissue ingrowth, and inappropriate length of the stent causing occlusion of intrahepatic ducts. SEMS were removed by using foreign-body forceps or polypectomy snares. RESULTS: Endoscopic removal of 39 SEMS (13 uncovered and 26 covered) was attempted in 29 patients (17 men; mean age, 66 years). SEMS extraction was attempted after a mean of 7.5 months (8.75 months standard deviation) post-SEMS insertion. Removal was successful in 20 patients (68.9%) and in 29 SEMS (74.3%). Covered SEMS were effectively removed more frequently than uncovered ones: 24 of 26 (92.3%) and 5 of 13 (38.4%), respectively (p < 0.05). No major complications were recorded. Multivariate analysis showed that the time interval between insertion and removal, SEMS length, stent-mesh design (zigzag vs. interlaced), and indication for removal were not predictive of success at stent removal. CONCLUSIONS: Endoscopic removal of biliary SEMS is feasible and safe in more than 70% of cases. Because only 38% of uncovered SEMS were removable, the presence of a stent covering is the only factor predictive of successful stent extraction. The presence of diffuse and severe ingrowth was the main feature limiting SEMS removal.

Aged↗
PubMedDate not supplied

Staging of esophageal carcinoma: endoscopic ultrasonography.

Endoscopic ultrasonography (EUS) has gained ground in the staging of esophageal cancer because of its high accuracy in determining depth of tumor invasion (greater than 80%) and lymph node metastases. The accuracy of EUS increases with increasing stage. However within T1 tumors, EUS performance in distinguishing mucosal (T1m) form submucosal invasion (T1sm) is poor. In this context high-frequency ultrasonography probes can play a major role. The advent of EUS-guided fine-needle aspiration (EUS-FNA) has dramatically changed the impact of EUS on nodal staging, providing cytological confirmation of malignancy from peritumoral and celiac lymph nodes. Especially celiac node metastases, have a major clinical impact on patient management. Widespread use of EUS in the staging of esophageal cancer should be encouraged. However, EUS should not be considered as first line test for evaluation of these patients and should always be performed after negative CT or PET/CT.

Biopsy, Needle↗