Ikponmwosa Enofe

All Publications

• Adverse events associated with full-thickness resection devices in gastrointestinal endoscopy: National postmarketing surveillance study. Endoscopy international open Shahzil, M., Kashif, T. B., Qureshi, A. A., Shehzadi, M., Razjouyan, H., Enofe, I. 2026; 14: a28203777

  Abstract

  Endoscopic full-thickness resection (EFTR) using dedicated full-thickness resection devices (FTRDs) offers a minimally invasive option for complex gastrointestinal lesions involving the muscularis propria. Despite growing use, safety data remain limited, which constrains guidelines and uptake.We performed a retrospective analysis of FDA MAUDE reports from January 2014 to March 2025. Reports involving FTRDs were reviewed to classify device malfunctions and patient adverse events (AEs). Variables were analyzed using SPSS software.Sixty-eight FTRD cases were identified. Colonic FTRD was used in 79.4% and gastroduodenal and diagnostic sets in 10.3% each. Device issues (n = 69) included clip non-deployment (79.7%), snare malfunctions (10.1%), and clip detachment (5.8%); grasper malfunctions (2.9%), improper clip placement (1.5%), and thread rupture (1.5%) were also reported. Patient AEs (n = 77) were dominated by colonic perforations (69.5%). Delayed gastric and delayed colonic perforations occurred in three cases each (3.9%). Other events included duodenal perforation (2.6%), hemorrhage (2.6%), and esophageal perforation with mediastinitis (2.6%). Four deaths (5.2%) occurred, two from unrecognized esophageal perforation with mediastinitis and sepsis and two after surgery in patients with significant comorbidities. Surgery was required in 78.7%. Endoscopic clipping alone succeeded in 3.3%. Endoscopic or over the scope clipping followed by surgery was used in 16.4%.EFTR with FTRD is associated with device malfunctions and patient complications, with colonic perforation being the most frequently reported complication. Careful patient selection and procedural expertise are critical to reduce risk.

  View details for DOI 10.1055/a-2820-3777

  View details for PubMedID 41970670

  View details for PubMedCentralID PMC13063300

• Adverse events associated with full-thickness resection devices in gastrointestinal endoscopy: National postmarketing surveillance study ENDOSCOPY INTERNATIONAL OPEN Shahzil, M., Kashif, T., Qureshi, A., Shehzadi, M., Razjouyan, H., Enofe, I. 2026; 14

  View details for DOI 10.1055/a-2820-3777

  View details for Web of Science ID 001712627900001

• EUS-guided enterocolostomy with lumen-apposing metal stents for palliative management of malignant bowel obstruction: a systematic review and meta-analysis. Therapeutic advances in gastrointestinal endoscopy Shahzil, M., Saleem, A., Kazmi, S. K., Bhattarai, B., Faisal, M. S., Faisal, M. H., Ali, H., Ofosu, A., Razjouyan, H., Enofe, I. 2025; 18: 26317745251400665

  Abstract

  Malignant bowel obstruction (MBO) is a frequent and debilitating complication in advanced abdominal cancers, particularly ovarian, colorectal, and gastric malignancies associated with peritoneal carcinomatosis. Surgery is often not feasible, and conventional decompression carries substantial morbidity. Endoscopic ultrasound-guided enterocolostomy (EUS-EC) with lumen-apposing metal stents (LAMS) has emerged as a minimally invasive alternative, but the evidence remains limited.To systematically evaluate the feasibility, safety, and clinical outcomes of EUS-EC with LAMS for the palliation of MBO.Systematic review and meta-analysis.A comprehensive literature search was performed across PubMed, Embase, Cochrane Library, and Web of Science from database inception through August 2025. Studies were eligible for inclusion if they involved patients with MBO undergoing EUS-EC using LAMS. Statistical analysis was performed using a random-effects model with Hartung-Knapp adjustments. Primary outcomes were technical success (defined as successful stent deployment) and clinical success (defined as relief of obstruction and restoration of bowel function).Twenty-three studies (78 patients) were included. Pooled technical and clinical success rates were 96.1% and 88.4%, respectively. The mean hospital stay was 10.6 days, and oral intake resumed after a mean of 3.1 days. Mean post-procedure survival was 91 days, consistent with the advanced disease stage of most included patients. Adverse events were uncommon: diarrhea (6.4%), perforation (3.8%), bleeding (2.5%), and aspiration (1.2%). Stent misdeployment occurred in one cohort (26.6%), but all cases were managed endoscopically without major sequelae. Among 33 deaths reported, most (78.8%) were due to disease progression, with only 6.1% procedure-related.EUS-EC with LAMS demonstrates high technical and clinical success, rapid symptom relief, and low procedure-related morbidity, supporting its potential as an emerging palliative option for carefully selected patients with MBO. Evidence remains limited to small retrospective cohorts and case reports, highlighting the need for prospective comparative trials with patient-centered outcomes.

  View details for DOI 10.1177/26317745251400665

  View details for PubMedID 41458317

  View details for PubMedCentralID PMC12739100

• Development and validation of a prognostic model based on RNA binding proteins in patients with esophageal cancer. Journal of thoracic disease Du, H., Li, Y., Pang, S., Enofe, I., Pallante, P., Zhu, L., Hang, J., Chen, L. 2023; 15 (11): 6178-6191

  Abstract

  RNA-binding proteins (RBPs) play a crucial role in regulating RNA turnover and are associated with cancer development. However, little is known about the role of RBPs in esophageal cancer (ESCA). The present study focuses on the association between RBP gene expression and survival in ESCA, addressing the clinical relevance of an RBPs-based prediction model for prognosis.RNA-sequencing data and clinical information of patients with ESCA were obtained from The Cancer Genome Atlas (TCGA) database. We identified differentially expressed genes in ESCA and intersected them with RBP-encoding genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed with the identified differentially expressed RBPs. Then, a protein-protein interaction (PPI) network was constructed through the STRING database to determine the hub RBPs. Univariate Cox regression analysis and multivariate Cox regression analysis were applied to construct a novel prognostic model based on RBPs. Based on the R package "Caret", we divided patients into the training set and validation set. The efficacy of the prognostic model was evaluated by the area under the receiver operating characteristic (ROC) curve. A nomogram was developed for the prediction of patient survival outcomes.A total of 158 ESCA patients from the TCGA database were included in our analysis. We screened out five prognostic RBPs (CLK1, CIRBP, MRPL13, TNRC6A, and TYW3) through univariate and multivariate Cox regression analysis. CLK1, CIRBP, TNRC6A and TYW3 were downregulated in tumor samples, while MRPL13 was upregulated. A prognostic model constructed with these five RBPs in the training data set accurately stratified ESCA patients into high- and low-risk groups. When the same prognostic model was applied to the test data set and entire cohort, the 5-RBP signature remained an independent prognostic factor in multivariate analysis. The areas under the time-dependent ROC curve of the prognostic model for predicting one-year survival in the training data set, test data set, and entire cohort were 0.789, 0.753, and 0.764, respectively, confirming that this model is a good prognostic model. The nomogram based on the five RBPs and clinical variables could improve individualized outcome predictions and highlight the importance of RBPs in the outcomes of patients with ESCA.Our study provides a potential prognostic model for predicting the prognosis of ESCA patients. The prognostic nomogram could improve individualized outcome predictions for patients with ESCA, therefore providing novel insights into future diagnosis and treatment.

  View details for DOI 10.21037/jtd-23-1307

  View details for PubMedID 38090289

  View details for PubMedCentralID PMC10713301

• Response. Gastrointestinal endoscopy Ramai, D., Enofe, I., Deliwala, S. S., Mozell, D., Facciorusso, A., Gkolfakis, P., Mohan, B. P., Chandan, S., Previtera, M., Maida, M., Anderloni, A., Adler, D. G., Ofosu, A. 2023; 98 (2): 268-269

  View details for DOI 10.1016/j.gie.2023.03.027

  View details for PubMedID 37455059

• Esophageal carcinoma cuniculatum: a narrative review to understand this rare and commonly misdiagnosed variant of well-differentiated esophageal squamous cell carcinoma. Translational gastroenterology and hepatology Enofe, I., Venkataraj, H., Hong, P., Ding, X., Haseeb, A. 2023; 8: 20

  Abstract

  Esophageal carcinoma cuniculatum (CC) is a rare variant of a well-differentiated squamous cell carcinoma (SCC). Unlike other forms of esophageal cancers, CC of the esophagus is difficult to diagnose on endoscopic biopsies. This can lead to a delay in the diagnosis and increases morbidity. We reviewed the available literature to shed light on the etiopathogenesis, diagnosis, treatment, and outcomes of this disease. Our aim is to create a better understanding of this rare disease entity and contribute to a timely diagnosis to reduce the associated morbidity and mortality.Extensive review of PubMed, Embase, Scopus, Google Scholar was conducted. We identified the published literature on Esophageal CC from inception till date. We report epidemiological trends, clinical presentation, diagnostic and treatment strategies to correctly identify the cases to reduce the likelihood of a missed diagnosis of esophageal CC.Associated risk factors for esophageal CC are chronic reflux esophagitis, smoking, alcohol consumption, immunosuppression, and achalasia. Dysphagia is the most common presentation. Primary diagnostic modality is an esophagogastroduodenoscopy (EGD), but diagnosis can be easily missed. To favor an early diagnosis, a histological scoring system has been proposed by Chen et al. where authors describe specific histological features that appear to be common based on the numerous mucosal biopsies examined from patients with CC.A high clinical suspicion for the disease along with close endoscopic follow-up with repeat biopsies is needed for an early diagnosis. Surgery remains the gold standard for treatment and is associated with a favorable prognosis when the patients are diagnosed early.

  View details for DOI 10.21037/tgh-22-37

  View details for PubMedID 37197255

  View details for PubMedCentralID PMC10184030

• Early (<4 weeks) versus standard (≥4 weeks) endoscopic drainage of pancreatic walled-off fluid collections: a systematic review and meta-analysis. Gastrointestinal endoscopy Ramai, D., Enofe, I., Deliwala, S. S., Mozell, D., Facciorusso, A., Gkolfakis, P., Mohan, B. P., Chandan, S., Previtera, M., Maida, M., Anderloni, A., Adler, D. G., Ofosu, A. 2023; 97 (3): 415-421.e5

  Abstract

  Previous studies have demonstrated that the ideal time for drainage of walled-off pancreatic fluid collections is 4 to 6 weeks after their development. However, some pancreatic collections, notably infected pancreatic fluid collections, require earlier drainage. Nevertheless, the optimal timing of the first intervention is unclear, and consensus data are sparse. The aim of this study was to evaluate the clinical efficacy and safety of EUS-guided drainage of pancreatic fluid collections <4 weeks after development compared with ≥4 weeks after development.Search strategies were developed for PubMed, Embase, and Cochrane Library databases from inception. Outcomes of interest were technical success, defined as successful endoscopic placement of a lumen-apposing metal stent; clinical success, defined as a reduction in cystic collection size; and procedure-related adverse events. A random-effects model was used for analysis, and results are expressed as odds ratio (OR) with 95% confidence interval (CI).Six studies (630 patients) were included in our final analysis, in which 182 patients (28.9%) were enrolled in the early drainage cohort and 448 patients (71.1%) in the standard drainage cohort. The mean fluid collection size was 143.4 ± 18.8 mm for the early cohort versus 128 ± 19.7 mm for the standard cohort. Overall, technical success was equal in both cohorts. Clinical success did not favor either standard drainage or early drainage (OR, .39; 95% CI, .13-1.22; P = .11). No statistically significant differences were found in overall adverse events (OR, 1.67; 95% CI, .63-4.45; P = .31) or mortality (OR, 1.14; 95% CI, .29-4.48; P = .85). Hospital stay was longer for patients undergoing early drainage compared with standard drainage (23.7 vs 16.0 days, respectively).Both early (<4 weeks) and standard (≥4 weeks) drainage of walled-off pancreatic fluid collections offer similar technical and clinical outcomes. Patients requiring endoscopic drainage should not be delayed for 4 weeks.

  View details for DOI 10.1016/j.gie.2022.11.003

  View details for PubMedID 36395824

• Estimating the optimum number of colon biopsies for diagnosing microscopic colitis: a systematic review. European journal of gastroenterology & hepatology Malik, A., Nadeem, M., Javaid, S., Malik, M. I., Enofe, I., Abegunde, A. T. 2022; 34 (7): 733-738

  Abstract

  Microscopic colitis (MC) is an inflammatory disease of the colon characterized by persistent watery, nonbloody diarrhea. Subtypes of MC include collagenous and lymphocytic MC. Microscopic examination of colon tissue is crucial to confirming the diagnosis because the colonic mucosa often appears normal during flexible sigmoidoscopy or colonoscopy. We aim to determine the optimal sites and minimum number of colon biopsies required to diagnose MC from published studies. We systematically searched PubMed, Web of Science, Scopus, and Cochrane databases from inception until October 2020 using the following keywords: microscopic, lymphocytic, collagenous, colitis, biopsy, and biopsies. We screened the search results for eligibility and extracted data from the included studies. We pooled the numbers of biopsies provided by each study to calculate the mean number of biopsies, SD, and SEM. We included three retrospective cohort studies with 356 patients (148 collagenous, 192 lymphocytic, and 16 mixed), and the total number of biopsies were 1854. The mean number of biopsies that were recommended by the included studies are 4, 4, and 9, respectively. The pooled mean ± SD is 5.67 ± 2.89. The included studies reported that biopsies from the ascending colon (AC) and descending colon (DC) had the highest diagnostic rates. To ensure a high level of certainty in diagnosing MC, a total of six biopsies should be taken from the AC and DC (3 AC and 3 DC). However, special care should be directed toward differentiating MC from other forms of colitis. In addition, detailed and comparative studies are needed to provide stronger recommendations to diagnose MC.

  View details for DOI 10.1097/MEG.0000000000002355

  View details for PubMedID 35170530

• Device failures associated with gastric pacemakers: A MAUDE database analysis. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver Ramai, D., DeLuca, M., Enofe, I., Mozell, D., Facciorusso, A. 2021; 53 (11): 1529-1530

  View details for DOI 10.1016/j.dld.2021.05.024

  View details for PubMedID 34134943