Magnifying endoscopy offers limited guidance for treating non-granular laterally spreading tumors (lst-ng), crucial for surgical decisions. Pseudodepressed lesions show significantly higher rates of high-grade dysplasia (78.1% vs. 31.2%) and T1 carcinoma (34.4% vs. 2%). All T1b carcinomas were found in pseudodepressed lesions, emphasizing the need for en bloc resection. Surgeons should prioritize technical feasibility for […]
Category: Surgical Endoscopy
Myotomy Methods Equal for Type III Achalasia Patients
Both per oral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) deliver similar outcomes for treating Type III achalasia, suggesting flexibility in surgical approach. Success rates post-procedure were nearly identical: 88% for POEM (14 of 16) vs. 87% for LHM (26 of 30), with p=0.94. Re-intervention rates were also similar: 25% for POEM and 16.7% […]
Enhanced Biliary Brush Cytology Boosts Detection of Cholangiocarcinoma
Updated protocols for biliary brush cytology significantly improve sensitivity in diagnosing perihilar and intrahepatic cholangiocarcinoma. Sensitivity jumped from 50.5% to 88.3% after protocol changes, with first sample sensitivity reaching 78%. Specificity remained high at 100% across both prospective and historical cohorts. These results suggest that adopting optimized protocols can enhance diagnostic accuracy, potentially improving patient […]
Endoscopic Therapy Shows 16.1% Recurrence in Appendicitis
Endoscopic retrograde appendicitis therapy (ERAT) is effective but carries a 16.1% risk of recurrence within a year. Technical success was 100%, with a 92.4% clinical improvement rate in 435 patients. Key predictors of recurrence include age over 60 (OR=2.981), previous appendicitis, and the presence of appendicoliths. Surgeons should prioritize ERAT for low-risk patients and utilize […]
Effective Therapies Cut Esophageal Stricture After ESD
Oral hydrocortisone sodium succinate with aluminum phosphate gel significantly reduces postoperative esophageal stricture after endoscopic submucosal dissection (ESD). This combination therapy lowers stricture risk by 92.5% compared to standard care (relative risk = 0.075). Using polyglycolic acid sheets with fibrin glue minimizes the need for endoscopic balloon dilatation, reducing sessions by an average of 6.4. […]
Gastric partitioning cuts complications in gastric outlet obstruction
Stomach-partitioning gastrojejunostomy (SPGJ) outperforms conventional gastrojejunostomy (CGJ) in managing gastric outlet obstruction (GOO). SPGJ reduces delayed gastric emptying by 76% (relative risk = 0.24). Major postoperative complications drop by 74% (relative risk = 0.26). SPGJ offers a strong alternative to CGJ with similar survival rates and length of stay. No significant difference in reintervention rates […]
Endoscopic Dissection Transforms Early Upper GI Carcinoma Care
Endoscopic Submucosal Dissection (ESD) provides an advanced local treatment option for early upper gastrointestinal carcinomas, enabling complete tumor removal and improved patient outcomes. ESD allows for en bloc resection of early GI neoplasia, aiding in precise pathology and risk assessment. Key candidates for ESD include high-grade intraepithelial neoplasia and superficial early carcinomas without visible deep […]
Impact of Lipid Levels on Recurrent CBD Stones Post-ERCP
Higher cholesterol and HbA1c levels increase the risk of recurrent bile duct stones after ERCP. Cholesterol and HbA1c >6.5% are key risk factors for recurrence. Triglycerides and HDL levels are protective against stone formation. Consider lipid management and medications like statins and aspirin in patient care to potentially lower recurrence rates. Study involved 5,132 patients; […]
Mobile Endoscopy Expands GI Access in Rural South Africa
A mobile endoscopy outreach program significantly improves access to essential gastrointestinal diagnostic services in resource-limited settings. 515 procedures performed, including 94% esophagogastroduodenoscopies. Common diagnoses: gastritis (76%), hiatal hernia (70%), and esophagitis (69%). This model reduces patient travel from 102 km to an average of just 13.6 km to receive care. Easily replicable in similar resource-limited […]
Endoscopic ultrasound enhances gallbladder tumor diagnosis
Endoscopic ultrasound (EUS) effectively distinguishes between malignant and benign gallbladder wall thickening, improving surgical decision-making. EUS achieved a sensitivity of 79.31% and specificity of 92.86% for diagnosing gallbladder tumors. Key indicators of malignancy included wall thickness greater than 14 mm and disrupted wall layers; both are highly significant (p < 0.001). Surgeons should consider EUS […]