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. […]
Category: Surgical Endoscopy
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 […]
ERCP shows high success in managing traumatic pancreatic injuries
A systematic review revealed that endoscopic retrograde cholangiopancreatography (ERCP) achieves an impressive 89% success rate in treating traumatic pancreatic injuries (TPI). The procedure notably enhanced pancreatic duct integrity and led to lower complication rates (4-17%), primarily pancreatitis and bleeding. Mortality remained low at 3-5%, and ERCP significantly reduced hospital stays by an average of 3.1 […]
Advances in Third-Space Endoscopy Improve GI Tumor Management
A review highlighted significant advancements in third-space endoscopy techniques for gastrointestinal tumors. Submucosal tunneling endoscopic resection (STER) was found to be safe and effective, achieving high en bloc resection rates and reduced recovery times. Tunneling endoscopic submucosal dissection (ESD) variants also enhance outcomes for early neoplasms by improving dissection speed and minimizing adverse events. Incorporating […]
AI-assisted system effectively aids esophageal lesion resections
The implementation of an artificial intelligence (AI) lesion-labeling system significantly improved the complete resection rate during endoscopic submucosal dissection (ESD) in low-volume centers. In a study involving 174 patients, 90% achieved negative lateral margins, while the en bloc resection rate stood at 98.5%. Comparatively, no significant difference was found in the lateral resection rates between […]