Browsing by Author "Weusten, Bas L.A.M."
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- Perspectives and awareness of endoscopy healthcare professionals on sustainable practices in gastrointestinal endoscopy: results of the LEAFGREEN surveyPublication . Neves, João A. Cunha; Santiago, Enrique Rodriguez de; Pohl, Heiko; Lorenzo-Zúñiga, Vicente; Cunha, Miguel F.; Voiosu, Andrei M.; Römmele, Christoph; Penman, Douglas G.; Albéniz, Eduardo; Siau, Keith; Donnelly, Leigh; Elli, Luca; Pioche, Mathieu; Beilenhoff, Ulrike; Arvanitakis, Marianna; Weusten, Bas L.A.M.; Bisschops, Raf.; Hassan, Cesare; Messmann, Helmut; Gralnek, Ian M.; Ribeiro, Mário DinisBackground Gastrointestinal (GI) endoscopy is one of healthcare's main contributors to climate change. We aimed to assess healthcare professionals' attitudes and the perceived barriers to implementation of sustainable GI endoscopy. Methods The LEAFGREEN web-based survey was a cross-sectional study conducted by the European Society of Gastrointestinal Endoscopy (ESGE) Green Endoscopy Working Group. The questionnaire comprised 39 questions divided into five sections (respondent demographics; climate change and sustainability beliefs; waste and resource management; single-use endoscopes and accessories; education and research). The survey was available via email to all active members of the ESGE and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) in March 2023. Results 407 respondents participated in the survey (11% response rate). Most participants (86%) agreed climate change is real and anthropogenic, but one-third did not consider GI endoscopy to be a significant contributor to climate change. Improvement in the appropriateness of endoscopic procedures (41%) and reduction in single-use accessories (34%) were considered the most important strategies to reduce the environmental impact of GI endoscopy. Respondents deemed lack of institutional support and knowledge from staff to be the main barriers to sustainable endoscopy. Strategies to reduce unnecessary GI endoscopic procedures and comparative studies of single-use versus reusable accessories were identified as research priorities. Conclusions In this survey, ESGE and ESGENA members acknowledge climate change as a major threat to humanity. Further improvement in sustainability beliefs and professional attitudes, reduction in inappropriate GI endoscopy, and rational use of single-use accessories and endoscopes are critically required.
- Western outcomes of circumferential endoscopic submucosal dissection for early esophageal squamous cell carcinomaPublication . de Santiago, Enrique Rodríguez; van Tilburg, Laurelle; Deprez, Pierre H.; Pioche, Mathieu; Pouw, Roos E.; Bourke, Michael J.; Seewald, Stefan; Weusten, Bas L.A.M.; Jacques, Jeremie; Leblanc, Sara; Barreiro, Pedro; Lemmers, Arnaud; Parra-Blanco, Adolfo; Magalhães, Ricardo Küttner; Libânio, Diogo; Messmann, Helmut; Albéniz, Eduardo; Kaminski, Michal F.; Mohammed, Noor; Ramos-Zabala, Felipe; Herreros-de-Tejada, Alberto; Koecklin, Hugo Huchima; Wallenhorst, Timothée; Antunes, João Santos; Neves, João A. Cunha; Koch, Arjun D.; Ayari, Myriam; Duran, Rodrigo Garces; Ponchon, Thierry; Rivory, Jérôme; Bergman, Jacques J.G.H.M.; Verheij, Eva P.D.; Gupta, Sunil; Groth, Stefan; Lepilliez, Vincent; Franco, Ana Rita; Belkhir, Sanaa; White, Jonathan; Ebigbo, Alanna; Probst, Andreas; Legros, Romain; Pilonis, Nastazja Dagny; de Frutos, Diego; Muñoz González, Raquel; Ribeiro, Mário DinisBackground and Aims: Circumferential endoscopic submucosal dissection (cESD) in the esophagus has been reported to be feasible in small Eastern case series. We assessed the outcomes of cESD in the treatment of early esophageal squamous cell carcinoma (ESCC) in Western countries. Methods: We conducted an international study at 25 referral centers in Europe and Australia using prospective databases. We included all patients with ESCC treated with cESD before November 2022. Our main outcomes were curative resection according to European guidelines and adverse events. Results: A total of 171 cESDs were performed on 165 patients. En bloc and R0 resections rates were 98.2% (95% confidence interval [CI], 95.0-99.4) and 69.6% (95% CI, 62.3-76.0), respectively. Curative resection was achieved in 49.1% (95% CI, 41.7-56.6) of the lesions. The most common reason for noncurative resection was deep submucosal invasion (21.6%). The risk of stricture requiring 6 or more dilations or additional techniques (incisional therapy/stent) was high (71%), despite the use of prophylactic measures in 93% of the procedures. The rates of intraprocedural perforation, delayed bleeding, and adverse cardiorespiratory events were 4.1%, 0.6%, and 4.7%, respectively. Two patients died (1.2%) of a cESD-related adverse event. Overall and disease-free survival rates at 2 years were 91% and 79%. Conclusions: In Western referral centers, cESD for ESCC is curative in approximately half of the lesions. It can be considered a feasible treatment in selected patients. Our results suggest the need to improve patient selection and to develop more effective therapies to prevent esophageal strictures.