Endorobotic submucosal dissection (ERSD) using the da Vinci SP system is a safe and effective option for resecting distal colorectal lesions. En-bloc resection rate was 96%, with a median procedure time of 73 minutes. Patients had a median hospital stay of 0 days and minimal long-term complications. This indicates ERSD could expand surgical options for […]
Category: Surgical Endoscopy
Endoscopic Necrosectomy: No Major Differences Found
Upfront endoscopic necrosectomy (UEN) and step-up endoscopic necrosectomy (SUEN) show similar outcomes for walled-off pancreatic necrosis, impacting how you approach patient management. No significant difference in clinical success (RR: 1.04) or technical success (RR: 1.27) between UEN and SUEN. Patient safety outcomes, including post-procedural bleeding (RR: 0.66) and recurrence (RR: 0.71), were comparable. Individualized treatment […]
Biliary Stents for Bile Leaks After Fenestrated Cholecystectomy Show No Difference
This study examines the effectiveness of different biliary stents for treating bile leaks post-fenestrated cholecystectomy, revealing significant implications for patient management. PCBL resolution rates were similar across stent types: 93.8% for 10 fr stents, 92.3% for 7 fr stents, and 88.9% for fully covered self-expanding metal stents. Plastic stents, including single and double pigtail options, […]
Effective Strategies for Malignant Gastric Outlet Obstruction
Endoscopic ultrasound-guided gastrojejunostomy (eus-gj) outperforms surgical methods for malignant gastric outlet obstruction, impacting patient outcomes. EUS-gj shows a clinical success rate significantly higher than surgical gastrojejunostomy (rr 0.82) and enteral stents (rr 0.91). Surgical options are linked to longer hospital stays and increased reintervention rates compared to EUS-gj. Consider recommending EUS-gj as the primary treatment […]
Guidelines for EUS-Guided Gastroenterostomy Standardized
A consensus among experts highlights vital technical practices for EUS-guided gastroenterostomy (EUS-GE) that can improve patient outcomes in gastric outlet obstruction. 31 key statements were approved, showing strong agreement on essentials like fluoroscopy and managing complications. Over 90% consensus on sedation, patient positioning, and saline use as a distension solution. Surgeons should adopt these recommendations […]
Immediate Endoscopic Necrosectomy Cuts Recovery Time in Pancreatitis
Immediate endoscopic necrosectomy (den) after drainage significantly speeds recovery in patients with necrotizing pancreatitis. Time to clinical success was 29 days with immediate den, compared to 44 days with the step-up approach (p = .009). Adverse events were similar between groups: 24% for immediate den vs. 22% for step-up (p = .79). Consider immediate den […]
Laparoscopic choledocholithotripsy lower recurrence, costs than ERCP
A meta-analysis of 1,576 patients shows outcomes for managing common bile duct stones. Preoperative endoscopic sphincterotomy (est) has a higher CBD clearance rate (OR 1.72). Laparoscopic choledocholithotripsy (lcbde) shows lower stone recurrence (OR 0.27) and reduced costs ($2,059 savings). Both methods have similar safety profiles; tailor treatment based on expertise and patient factors. Hospital stays […]
Long-term outcomes after endoscopic resection for esophageal cancer show low recurrence risk.
In a study of 540 patients with pt1a-muscularis mucosa esophageal squamous cell carcinoma, 485 were monitored without intervention. The 5-year cumulative recurrence rates were low at 4.9% for observation, 2.2% for chemoradiotherapy, and 10.0% for surgery. Given the data, observation may be a viable strategy for these patients. Overall survival rates were high, reaching 100% […]
Flexible Endoscopy Surpasses Rigid Endoscopy for Zenker Repair
Flexible endoscopy achieves better outcomes than rigid endoscopy for Zenker diverticulum repair, making it a strong first-line option. Clinical success rates: flexible endoscopy 84.6% vs. rigid endoscopy 55.6% (p = 0.032); comparable to open surgery 88.9% (p = 0.712). Adverse event rates are lowest for flexible endoscopy at 4.5%, with a trend towards fewer complications […]
Stenosis Risk High After Circumferential Colorectal Dissection
Post-resection stenosis significantly impacts surgical outcomes for colorectal lesions treated with endoscopic submucosal dissection when over 90% of the circumference is involved. Stenosis rates reached 34.2%, higher for rectal lesions (38.2%) compared to colonic (11.6%). Complete resection was achieved in 85.1% of cases, with oncological resection rates of 80.3%. Effective endoscopic treatments resolved all stenosis […]