Publications by authors named "Francesco Di Matteo"

Background: Guidelines recommend leaving in situ rectosigmoid polyps diagnosed during colonoscopy that are 5 mm or smaller if the endoscopist optically predicts them to be non-neoplastic. However, no randomised controlled trial has been done to examine the efficacy and safety of this strategy.

Methods: This open-label, multicentre, non-inferiority, randomised controlled trial enrolled adults age 18 years or older undergoing colonoscopy for screening, surveillance, or clinical indications across four Italian centres.

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Background And Aims: The outcome of Crohn's Disease (CD) patients with entero-enteric anastomosis (EEA) after small bowel resection is undefined. The primary aim of the present case-control study was to compare the clinical recurrence rate within the first 5 years after surgery in CD patients with small bowel EEA (Cases) versus age-matched patients with ileo-colonic anastomosis (ICA, Controls).

Methods: All CD patients with EEA were matched for age at diagnosis (±5years) and smoking habits with 2 Controls with ICA.

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Background:  Endoscopic ultrasound (EUS)-guided gallbladder drainage (GBD) and EUS-guided choledochoduodenostomy (CDS) with lumen-apposing metal stents are alternative approaches to endoscopic retrograde cholangiopancreatography. We compared EUS-GBD and EUS-CDS as first-line therapies in the management of distal malignant biliary obstruction (MBO).

Methods:  This was an international, multicenter, retrospective, observational study at 28 tertiary care centers from April 2017 to August 2024.

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Background And Study Aims: Underwater ESD (UESD) has recently emerged as a less complex technical alternative to standard endoscopic submucosal dissection (SESD), but only small retrospective data are currently available. Our aim was to evaluate the effectiveness and safety of UESD, as compared to the current standard of care.

Patients And Methods: We performed a 1-to-4 nearest-neighbor retrospective propensity-score-matched-analysis between all UESD cases and all SESD cases performed and collected prospectively in a Western and an Eastern interventional endoscopy referral center, respectively.

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Background And Study Aims: Endoscopic submucosal dissection (ESD) has emerged as the standard treatment for colorectal lesions. Considering aging of the global population, we aimed to assess effectiveness and safety of colorectal ESD in patients aged ≥ 80 years compared with those aged 65 to 79 years in a large Western cohort.

Patients And Methods: We retrospectively enrolled patients aged > 64 years undergoing colorectal ESD, classifying them into a very elderly group (VE-Group, aged > 80 years) and elderly group (E-Group, 65-79 years).

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Malignant bowel obstruction (MBO) is a critical complication occurring in patients with advanced malignancy. Current treatments are both surgical and non-surgical, the latter including medical, endoscopic, and percutaneous approaches. Surgery is still the treatment of choice for MBO.

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Objectives: Endoscopic papillectomy (EP) is the gold standard treatment for ampullary adenomas. However, EP is still burdened by a nonnegligible rate of incomplete resections (IR). Different predictors have been linked to higher rates of IR, but the interaction between these factors is still unclear.

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This multicenter retrospective study included patients undergoing EUS-guided GI anastomoses from 2016 to 2023. Indications for EUS-guided anastomosis were GOO, ALS or patients with altered anatomy needing endoscopic interventions. The primary outcome was technical success, while secondary outcomes included clinical success, safety, lumen-apposing metal stent (LAMS) patency, and the need for reinterventions.

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Background And Study Aims: Hybrid argon plasma coagulation (H-APC) is a novel technique for ablation of neoplastic Barrett's esophagus (BE), consisting in submucosal fluid injection and subsequent APC of visible BE. The aim of this study was to assess H-APC efficacy, safety, and tolerability.

Patients And Methods: We prospectively included patients undergoing H-APC ablation at four Italian Hospitals from September 2022 to March 2024.

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Periventricular heterotopia (PH), a common form of gray matter heterotopia associated with developmental delay and drug-resistant seizures, poses a challenge in understanding its neurophysiological basis. Human cerebral organoids (hCOs) derived from patients with causative mutations in FAT4 or DCHS1 mimic PH features. However, neuronal activity in these 3D models has not yet been investigated.

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Background:  Patients with inflammatory bowel disease (IBD) have an increased risk of colorectal cancer. High-risk colorectal colitis-associated neoplasia (HR-CAN) can be difficult to treat using traditional endoscopic resection methods. This study evaluated the outcomes of endoscopic submucosal dissection (ESD) in patients with IBD and HR-CANs.

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Article Synopsis
  • - Ex vivo fluorescence laser scanning microscopy (FCM) enables real-time imaging of fresh tissue samples without traditional slide preparation, and this study specifically investigates its application in evaluating biopsy samples from endoscopic procedures for lung lesions and lymph nodes.
  • - The study involved 32 patients, showing that the FCM Vivascope 2500 could accurately assess sample adequacy and malignancy, with a perfect agreement noted between its evaluations and final histological results.
  • - The findings suggest that FCM could significantly improve the speed of diagnostic information during endoscopic biopsies, potentially enhancing patient management by reducing the time needed to diagnose lung cancer.
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  • - The study evaluated the safety and effectiveness of PuraStat, a topical hemostatic agent, for treating active gastrointestinal bleeding and preventing bleeding in patients undergoing endoscopic procedures.
  • - Data from 401 patients across ten Italian centers showed PuraStat achieved hemostasis in nearly all cases of active bleeding (98.9%) and had a low follow-up bleeding rate (3.9%) for preventive uses.
  • - No adverse events related to PuraStat were reported, indicating it is a safe option that could be used for broader applications than currently recommended.
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Article Synopsis
  • The text refers to a correction made to a previously published article.
  • The specific article mentioned can be identified by its DOI, which is 10.1055/a-2411-1814.
  • Corrections like this are common in academic publishing to address errors or inaccuracies in research.
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Background: EUS-guided gastroenterostomy (EUS-GE) is a novel and effective procedure for the management of malignant gastric outlet obstruction (GOO) with more durable results when compared to enteral stenting (ES). However, data comparing EUS-GE to ES in patients already treated with EUS-guided choledocoduodenostomy (EUS-CDS) for distal malignant biliary obstruction (DMBO) are lacking. We aimed to compare outcomes of EUS-GE and ES for the palliation of GOO in this specific population of patients.

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Article Synopsis
  • - The study investigated outcomes of lumen-apposing metal stents (LAMS) placement in patients with surgically altered anatomy (SAA), which is not well-documented in existing literature, involving 270 patients across 25 tertiary care centers up to November 2023.
  • - Technical success of the procedures was very high at 98%, with clinical success at 97%, although there was a notable adverse event rate of 12%, with various degrees of severity recorded.
  • - The results suggest that while LAMS placement in SAA is effective, due to the risk of complications, these procedures should only be performed by experienced endoscopists in specialized centers.
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Background: Surgery is the first-choice treatment for malignant intestinal obstruction (MIO); however, many patients are deemed unfit for surgery. Endoscopic ultrasound-guided entero-colostomy (EUS-EC) with a lumen-apposing metal stent (LAMS) could represent a new treatment option.

Methods: Consecutive patients undergoing EUS-EC for MIO from November 2021 to September 2023 at four European tertiary referral centers were retrospectively enrolled.

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  • Recent advancements in technology aim to standardize pathology lab processes, especially in automating tissue paraffin embedding, which enhances sample preservation.
  • The study tested a new polymer matrix to facilitate automatic paraffin embedding for cytological specimens, which previously lacked suitable tools.
  • Results showed that this automated process effectively prepares and preserves cytological samples without manual handling, improving laboratory efficiency and patient diagnosis.
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Background:  Endoscopic full-thickness resection (EFTR) is an effective and safe technique for nonlifting colorectal lesions. Technical issues or failures with the full-thickness resection device (FTRD) system are reported, but there are no detailed data. The aim of our study was to quantify and classify FTRD technical failures.

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The optimal number of needle passes during endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is not yet established. We aimed to perform a per-pass analysis of the diagnostic accuracy of EUS-FNB of solid pancreatic lesions using a 22G Franseen needle. Consecutive patients with solid pancreatic lesions referred to 11 Italian centers were prospectively enrolled.

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Background: Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumen apposing metal stent has emerged as a minimally invasive treatment for the management of malignant gastric outlet obstruction (mGOO). We aimed to compare EUS-GE with enteral stenting (ES) for the treatment of mGOO.

Methods: Patients who underwent EUS-GE or ES for mGOO between June 2017 and June 2023 at two Italian centers were retrospectively identified.

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Per-Oral Endoscopic Myotomy (POEM) is recognized as the first-line therapy for achalasia, considering its high clinical efficacy and safety. Among the most important adverse events, bleeding or hematoma in the submucosal tunnel has incidence of approximately 1%. We describe the case of woman affected by type II achalasia, treated with POEM, who presented delayed bleeding with submucosal hematoma after starting anticoagulant therapy with subcutaneous low molecular weight heparin (LMWH).

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Article Synopsis
  • Lumen-apposing metal stents (LAMSs) are crucial for ultrasonography-guided gallbladder drainage (EUS-GBD) in patients who are not fit for surgery, especially those with acute cholecystitis.
  • A retrospective study of 54 patients showed a 100% technical success rate for LAMS placement, with 76.67% of patients achieving clinical success and only 5.6% experiencing adverse events.
  • Patients typically left the hospital after about 5 days, highlighting EUS-GBD as a safe and effective option for high-risk surgical patients.
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