A multicenter study involving 890 patients evaluated hybrid endoscopic submucosal dissection (ESD) against conventional ESD for treating laterally spreading tumors (LSTs). Hybrid ESD demonstrated significantly reduced procedure times and hospitalization costs, particularly for lesions sized 10-30 mm. However, it yielded lower R0 resection rates and lifting sign positivity. For larger lesions, conventional ESD maintained better […]
Category: Surgical Endoscopy
Primary needle-knife fistulotomy is safer for biliary access.
A randomized clinical trial involving 260 patients revealed that primary needle-knife fistulotomy (PNKF) significantly outperforms standard transpapillary (STP) techniques for cannulating long-size papilla. PNKF achieved a biliary cannulation success rate of 96.2% compared to STP’s 87.7% (p = 0.01). Moreover, post-endoscopic retrograde cholangiopancreatography pancreatitis was markedly lower in the PNKF group (2.4%) versus STP (9.6%, […]
Modified apprenticeship models could enhance esophageal ESD training.
Endoscopic resection techniques, like ESD, offer safer alternatives to esophagectomy for esophageal cancer. While ESD provides complete histopathological assessment, a consensus on training models remains elusive. The effectiveness of Japan’s apprenticeship model contrasts with the West’s comprehensive methods that combine various training approaches. Researchers suggest adapting a modified apprenticeship model to optimize ESD training outcomes. […]
Endoscopic Submucosal Tunneling Techniques outperform Flexible Endoscopic Septotomy
A systematic review and meta-analysis involving 759 patients revealed that endoscopic submucosal tunneling techniques (ESTT) provide a higher probability of clinical success for treating Zenker’s diverticulum compared to flexible endoscopic septotomy (FES). While both methods showed similar rates of technical success, operative time, and hospital stay, ESTT had a tendency toward lower recurrence rates. These […]
AI surpasses human endoscopists in detecting colorectal lesions
A deep learning algorithm based on the yolov7 model demonstrated exceptional performance in identifying laterally spreading tumors (LSTs) with an accuracy of 99.34%. Sensitivity was recorded at 96.88%, while specificity reached 99.8%. This algorithm outperformed both novice and senior endoscopists, achieving diagnostic capabilities comparable to expert professionals. The study utilized a substantial dataset of 7985 […]
EUS outperforms MCE in detecting colorectal cancer invasion depth
A meta-analysis of 26 studies encompassing 12,586 lesions revealed that endoscopic ultrasonography (EUS) demonstrates superior sensitivity for identifying massively submucosal invasion in early colorectal cancers compared to magnifying chromoendoscopy (MCE). Specifically, EUS had a sensitivity of 88% versus MCE’s 78%, while MCE showed greater specificity (95% versus EUS’s 87%). This distinction is critical as accurate […]
Endoscopic resection offers safe alternative to colectomy.
Endoscopic techniques, including mucosal resection and submucosal dissection, provide effective treatment for dysplastic lesions in patients with inflammatory bowel disease (IBD). This retrospective analysis of 50 IBD patients revealed that endoscopic resection results in favorable short-term outcomes and organ preservation, presenting a safe alternative to colectomy. The cohort consisted of predominantly middle-aged males, with diverse […]
Endoscopic stenting shows comparable outcomes with lower costs for gastric outlet obstruction
Endoscopic stenting (ES) and gastrojejunostomy (GJ) result in similar short-term morbidity and mortality rates for malignant gastric outlet obstruction. However, patients who underwent GJ faced higher costs exceeding $15,800 and longer hospital stays by over 6.9 days. Analysis revealed that while GJ increased the likelihood of blood transfusions and postoperative total parenteral nutrition usage, the […]
Additional surgery improves outcomes for early colorectal cancer patients
A meta-analysis involving 3,508 early colorectal cancer patients reveals that those undergoing additional surgery post non-curative endoscopic resection experience significantly enhanced overall survival and recurrence-free survival compared to those under surveillance alone. Specifically, the additional surgery group demonstrated better recurrence and local recurrence rates, with odds ratios of 1.96 and 2.35, respectively. Findings suggest that […]
Early surgery outperforms endoscopy in chronic pancreatitis patients
A long-term follow-up study reveals that early surgery significantly reduces pain and enhances patient satisfaction compared to an endoscopy-first approach in chronic pancreatitis patients. After an average of 98 months, the early surgery group reported lower pain scores (33 vs. 51) and a higher rate of complete pain relief (45% vs. 20%). Additionally, satisfaction with […]