Category: Surgical Endoscopy

Cryopreserved fibroblast sheets reduce esophageal leakage risk

Cryopreserved allogeneic multilayered fibroblast sheets demonstrated efficacy in preventing esophageal anastomotic leakage in a rat model. The incidence of leakage was significantly lower in the fibroblast sheets group (28%) compared to controls (61%; p = .02). Additionally, the burst pressure was notably higher in the sheet group (124 ± 30 mm Hg) versus controls (78 […]

GNAS droplet digital PCR enhances mucinous cyst diagnosis

A single GNAS droplet digital PCR (ddPCR) analysis improves the diagnostic accuracy for mucinous pancreatic cystic lesions (MPCNs) using endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Among 140 patients, ddPCR increased MPCN detection to 62% while yielding 100% specificity. The method also identified a third of inconclusive lesions as MPCNs. Importantly, GNAS-ddPCR demonstrated a 24% cost reduction […]

Hydrogels may reduce esophageal stricture risk post-ESD.

Innovative hydrogel interventions show promise in significantly reducing stricture rates following endoscopic submucosal dissection for early esophageal cancer. Current methods have limited effectiveness and safety concerns, but hydrogels offer biocompatibility and enhanced therapeutic delivery. They promote epithelial regeneration and reduce fibrosis, potentially improving long-term outcomes. This review highlights the transformative potential of hydrogels in clinical […]

Etomidate-opioids show promising sedation balance for endoscopy

A systematic review and network meta-analysis of 152 trials involving 26,527 patients reveals no pharmacological regimen superior to propofol-opioids for sedation success in gastrointestinal endoscopy. However, etomidate-opioids ranked highest for sedation success, bradycardia, and recovery time, significantly reducing hypoxia risk compared to propofol-opioids. Esketamine-remimazolam exhibited superior hemodynamic stability and faster alertness but lower sedation success. […]

Improving adherence to antithrombotic management in endoscopy

A review highlights that inconsistent adherence to guidelines for peri-endoscopic management of antithrombotic agents poses significant challenges. Identified barriers include insufficient education, delayed updates, and unclear responsibilities. Strategies proposed for improvement encompass enhanced education for healthcare providers and patients, digital clinical decision tools, unified management teams, and international collaboration. These initiatives aim to reduce discrepancies […]

Endoscopic intermuscular dissection shows promise for rectal cancer

A study on endoscopic intermuscular dissection (EID) for deep submucosal invasive rectal cancer (d-smic) reports encouraging three-year outcomes. The procedure achieved a 94.1% en bloc resection and 82.5% R0 resection rates. In low-risk patients under active surveillance, locoregional recurrence rates were low (7%), while intermediate-risk had a 13% rate, all salvageable. Notably, there were no […]

Endoscopic techniques improve outcomes for biliary leak management

Endoscopic management has emerged as a key strategy for treating biliary leakages resulting from surgery or trauma. Researchers emphasize the importance of accurately classifying leaks to choose appropriate treatments, which range from conservative care to surgical intervention. Notably, endoscopic techniques, especially endoscopic retrograde cholangiopancreatography with sphincterotomy and stent placement, are now favored for accessible leaks, […]

AI-assisted system improves biliopancreatic disease detection

A novel AI-assisted endoscopic ultrasound (EUS) system demonstrated superior performance in recognizing biliopancreatic stations and segmenting anatomical structures. Testing with 45,737 EUS images revealed the mean teacher algorithm achieved 95.60% accuracy in internal tests and 92.72% in external validation for station recognition. Additionally, U-Net v2 emerged as the optimal model for segmentation. Notably, the system […]

Glucose assessment outperforms traditional biomarkers in pancreatic cyst differentiation

Mucinous pancreatic cystic lesions (PCLs) significantly increase cancer risk but can be difficult to identify. A study indicates that endoscopic ultrasound-guided intracystic glucose measurement effectively distinguishes mucinous from non-mucinous PCLs, boosting sensitivity to 88-95% and specificity to 76-91%, surpassing traditional carcinoembryonic antigen (CEA) tests. By coupling glucose analysis with DNA-based biomarkers, clinicians can enhance risk […]

AI Model Matches Senior Endoscopists in Esophageal Cancer Treatment

An artificial intelligence model developed for marking detection and incision guidance during esophageal endoscopic submucosal dissection (ESD) demonstrated promising performance. Compared to junior endoscopists, the AI achieved a notable accuracy of 63.21%, precision rates of up to 85.76%, and an average distance error of 0.096, significantly outperforming junior practitioners while matching senior endoscopists. These results […]