Only 20% of patients with caustic refractory benign esophageal strictures (CRBES) were successfully treated with stepwise endoscopic interventions. The success rate was notably higher in those with the recurrent subtype (73%) versus the refractory subtype (0%). A significant 80% of patients eventually required esophageal reconstruction, which demonstrated a high success rate, achieving nutritional autonomy in […]
Category: Surgical Endoscopy
Pancreatic guidewire-assisted fistulotomy proves more effective
In a trial involving 194 patients facing difficult biliary cannulation, the pancreatic guidewire-assisted fistulotomy method achieved a significantly higher success rate of 93.8%, compared to 81.4% for the transpancreatic biliary sphincterotomy technique (p=0.01). Both techniques exhibited similar rates of adverse events, suggesting that fistulotomy is the preferred choice after failed cannulation attempts. The transpancreatic method […]
Guidance aids decision-making for managing colorectal polyps
Guidelines developed by the BSG/ACPGBI assist clinicians in managing colorectal polyps for patients with a life expectancy of under 10 years. The guidance outlines 33 recommendations drawn from a consensus process involving 28 experts. It includes assessments of life expectancy, polyp characteristics, and risks of polypectomy versus conservative management. A comparative model has been established […]
EMR shows lower mortality and healthcare utilization than surgery
In a comparative study of colon adenomas and early-stage cancers, endoscopic mucosal resection (EMR) significantly outperformed traditional surgery. Among 568 EMR patients and 2,054 surgical patients, EMR was associated with a lower all-cause mortality rate (hazard ratio 0.31) and reduced healthcare utilization over an average follow-up of 4.5 years. These findings suggest EMR is a […]
Fully-covered metal stents outperform plastic for biliary drainage
A comprehensive review of 81 studies with 26,251 patients reveals that fully-covered self-expandable metal stents used during endoscopic retrograde cholangiopancreatography result in fewer adverse events compared to plastic stents, though they carry a higher risk of pancreatitis. Plastic stents resulted in more complications and shorter duration of effectiveness. Internal stents are identified as the best […]
miRNA classifier identifies occult liver metastasis in pancreatic cancer
A miRNA classifier has been developed to detect occult liver metastasis in pancreatic ductal adenocarcinoma (PDAC), revealing significant deregulation of 34 miRNAs in metastatic cases. This classifier, leveraging three key miRNAs (miR-483-5p, miR-6734-5p, and miR-548q), demonstrated high predictive efficacy in identifying metastasis, outperforming CA125 alone while showing comparable results when combined. These findings suggest that […]
Bedside endoscopy may expedite anastomotic leakage diagnosis
A multicenter prospective study aims to evaluate a clinical pathway using routine bedside endoscopy for early detection of anastomotic leakage (AL) following colorectal surgery. Researchers hypothesize that this approach will reduce the median time for AL diagnosis from 15 to 5 days. The pathway includes endoscopic inspection and guided CT scans within the first weeks […]
Reversible endoscopic bypass shows promise for duodenal leaks
A novel procedure, reversible endoscopic gastroduodenal bypass (REGB), demonstrated 100% technical success in six patients with persistent post-surgical duodenal leaks. Patients experienced significant reductions in drain output and resumed oral intake within three days. Following a mean of 52.6 days, five patients successfully underwent REGB reversal, achieving complete healing of ulcers and absence of leaks. […]
Sequential injection-electrocoagulation improves hemostasis in ESD.
A randomized controlled trial involving 69 patients demonstrated that the sequential injection-electrocoagulation method significantly reduced the median time to hemostasis during endoscopic submucosal dissection (17 seconds) compared to traditional electrocoagulation (22 seconds), with p < 0.001. The experimental method also yielded higher visibility scores (3.24 vs. 2.82; p < 0.001) and reduced muscle injuries compared […]
Prophylactic clipping is cost-saving after endoscopic mucosal resection.
A cost-effectiveness analysis involving 4,557 patients found that prophylactic clipping (PC) during endoscopic mucosal resection (EMR) of large non-pedunculated colon polyps is beneficial. For a typical 65-year-old undergoing EMR, PC yielded an incremental cost-effectiveness ratio (ICER) of -$154,706. It proved cost-effective for very large polyps (≥40 mm) and cost-saving for patients on antithrombotic therapy when […]