Browsing by Author "Bazerbachi, Fateh"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Impact of COVID-19 on gastroenterology fellowship training: a multicenter analysis of endoscopy volumes
    (Thieme, 2021-09-16) Paleti, Swathi; Sobani, Zain A.; McCarty, Thomas R.; Gutta, Aditya; Gremida, Anas; Shah, Raj; Nutalapati, Venkat; Bazerbachi, Fateh; Jesudoss, Randhir; Amin, Shreya; Okwara, Chinemerem; Kathi, Pradeep Reddy; Ahmed, Ali; Gessel, Luke; Hung, Kenneth; Masoud, Amir; Yu, Jessica; Mony, Shruti; Akshintala, Venkata; Jamil, Laith; Nasereddin, Thayer; Kochhar, Gursimran; Vyas, Neil; Saligram, Shreyas; Garg, Rajat; Sandhu, Dalbir; Benrajab, Karim; Konjeti, Rajesh; Agnihotri, Abhishek; Trivedi, Hirsh; Grunwald, Matthew; Mayer, Ira; Mohanty, Arpan; Rustagi, Tarun; Medicine, School of Medicine
    Abstract Background and study aims The COVID-19 pandemic has had a profound impact on gastroenterology training programs. We aimed to objectively evaluate procedural training volume and impact of COVID-19 on gastroenterology fellowship programs in the United States. Methods This was a retrospective, multicenter study. Procedure volume data on upper and lower endoscopies performed by gastroenterology fellows was abstracted directly from the electronic medical record. The study period was stratified into 2 time periods: Study Period 1, SP1 (03/15/2020 to 06/30/2020) and Study Period 2, SP2 (07/01/2020 to 12/15/2020). Procedure volumes during SP1 and SP2 were compared to Historic Period 1 (HP1) (03/15/2019 to 06/30/2019) and Historic Period 2 (HP2) (07/01/2019 to 12/15/2019) as historical reference. Results Data from 23 gastroenterology fellowship programs (total procedures = 127,958) with a median of 284 fellows (range 273–289; representing 17.8 % of all trainees in the United States) were collected. Compared to HP1, fellows performed 53.6 % less procedures in SP1 (total volume: 28,808 vs 13,378; mean 105.52 ± 71.94 vs 47.61 ± 41.43 per fellow; P < 0.0001). This reduction was significant across all three training years and for both lower and upper endoscopies (P < 0.0001). However, the reduction in volume was more pronounced for lower endoscopy compared to upper endoscopy [59.03 % (95 % CI: 58.2–59.86) vs 48.75 % (95 % CI: 47.96–49.54); P < 0.0001]. The procedure volume in SP2 returned to near baseline of HP2 (total volume: 42,497 vs 43,275; mean 147.05 ± 96.36 vs 150.78 ± 99.67; P = 0.65). Conclusions Although there was a significant reduction in fellows’ endoscopy volume in the initial stages of the pandemic, adaptive mechanisms have resulted in a return of procedure volume to near baseline without ongoing impact on endoscopy training.
  • Thumbnail Image
    Item
    Safety and efficacy of lumen-apposing metal stents versus plastic stents to treat walled-off pancreatic necrosis: systematic review and meta-analysis
    (Thieme, 2020-11) Chandrasekhara, Vinay; Barthet, Marc; Devière, Jacques; Bazerbachi, Fateh; Lakhtakia, Sundeep; Easler, Jeffrey J.; Peetermans, Joyce A.; McMullen, Edmund; Gjata, Ornela; Gourlay, Margaret L.; Abu Dayyeh, Barham K.; Medicine, School of Medicine
    Background and study aims Lumen-apposing metal stents (LAMS) are increasingly used for drainage of walled-off pancreatic necrosis (WON). Recent studies suggested greater adverse event (AE) rates with LAMS for WON. We conducted a systematic review and meta-analysis to compare the safety and efficacy of LAMS with double-pigtail plastic stents (DPPS) for endoscopic drainage of WON. The primary aim was to evaluate stent-related AEs. Methods In October 2019, we searched the Ovid (Embase, MEDLINE, Cochrane) and Scopus databases for studies assessing a specific LAMS or DPPS for WON drainage conducted under EUS guidance. Safety outcomes were AE rates of bleeding, stent migration, perforation, and stent occlusion. Efficacy outcomes were WON resolution and number of procedures needed to achieve resolution. A subanalysis including non-EUS-guided cases was performed. Results Thirty studies including one randomized controlled trial (total 1,524 patients) were analyzed. LAMS were associated with similar bleeding (2.5 % vs. 4.6 %, P = 0.39) and perforation risk (0.5 % vs. 1.1 %, P = 0.35) compared to DPPS. WON resolution (87.4 % vs. 87.5 %, P = 0.99), number of procedures to achieve resolution (2.09 vs. 1.88, P = 0.72), stent migration (5.9 % vs. 6.8 %, P = 0.79), and stent occlusion (3.8 % vs. 5.2 %, P = 0.78) were similar for both groups. Inclusion of non-EUS-guided cases led to significantly higher DPPS bleeding and perforation rates. Conclusions LAMS and DPPS were associated with similar rates of AEs and WON resolution when limiting analysis to EUS-guided cases. Higher bleeding rates were seen in historical studies of DPPS without EUS guidance. Additional high-quality studies of WON treatment using consistent outcome definitions are needed.