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. […]
Category: Surgical Endoscopy
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 […]
Visual models enhance prediction of rebleeding risk post-EVL
A retrospective study involving 629 patients evaluated rebleeding rates after endoscopic variceal ligation (EVL). Results revealed rebleeding in 34.8% and 80.1% of patients within 6 weeks and 6 months, respectively. Identified factors included esophageal variceal severity and platelet count, both independent risk predictors. Developed visual nomogram models showed high predictive accuracy, with AUCs of 0.942 […]
Salvage ESD proves effective for previously attempted colorectal lesions
Salvage endoscopic submucosal dissection (ESD) for previously attempted colorectal lesions demonstrated an en bloc rate of 83.4% and curative resection in 73.5% of cases. Among 415 lesions treated, adverse events occurred in 11.8% of patients, with the most frequent being intraprocedural perforation. Notably, there were no procedure-related mortalities. With expert execution, salvage ESD shows high […]
Transoral septotomy and Z-POEM are both effective treatments.
A multicenter study found that transoral septotomy (TS) and Z-POEM treatments for Zenker diverticulum yield similarly high success rates of 96.2%. While TS requires a shorter operative time and has fewer intraoperative complications, both methods resulted in favorable outcomes and significant symptom relief after a median follow-up of 45 to 66 months. The study contributes […]
Single-stage techniques improve outcomes in choledocholithiasis management
Management of choledocholithiasis has evolved towards single-stage techniques, which demonstrate significantly lower 30-day morbidity and shorter hospital stays compared to traditional two-stage laproendoscopic approaches. Intraoperative endoscopic rendezvous procedures show further enhanced patient outcomes by minimizing the risk of post-endoscopic pancreatitis. Additionally, laparoscopic common bile duct exploration offers superior stone clearance rates, reduced costs, and efficient […]
Pocket-creation method outperforms conventional method for gastric cancer
A systematic review indicates that the pocket-creation method of endoscopic submucosal dissection (pcm-esd) offers significant advantages over the conventional method (cm-esd) for treating early gastric cancer. The pcm-esd demonstrated a faster dissection speed (mean difference of 5.57 mm²/min) and resulted in fewer perforations without increasing the risk of delayed bleeding. No significant differences in en […]
Endoscopic resection proves effective for certain esophageal tumors
The study identifies significant clinicopathological differences between esophageal gastrointestinal stromal tumors (e-gist) and gastric gastrointestinal stromal tumors (g-gist), noting e-gist’s stronger male predominance, older median age, and increased tumor size and ulceration. Remarkably, endoscopic resection (ER) is found to be comparably effective to surgical resection for selected e-gist patients (tumors ≤5 cm without ulceration), with […]
Conventional techniques effectively manage previously partially resected colorectal lesions
Findings indicate that conventional endoscopic resection techniques can safely and effectively handle previously partially resected colorectal polyps. Out of 220 such lesions, all were successfully resected with similar recurrence rates (8.2%) compared to lesions without prior resection (7.8%). Notably, previously resected lesions required more advanced methods such as electrocautery and avulsion. Despite trends toward recommending […]