A meta-analysis of 1,576 patients shows outcomes for managing common bile duct stones. Preoperative endoscopic sphincterotomy (est) has a higher CBD clearance rate (OR 1.72). Laparoscopic choledocholithotripsy (lcbde) shows lower stone recurrence (OR 0.27) and reduced costs ($2,059 savings). Both methods have similar safety profiles; tailor treatment based on expertise and patient factors. Hospital stays […]
Category: Surgical Endoscopy
Long-term outcomes after endoscopic resection for esophageal cancer show low recurrence risk.
In a study of 540 patients with pt1a-muscularis mucosa esophageal squamous cell carcinoma, 485 were monitored without intervention. The 5-year cumulative recurrence rates were low at 4.9% for observation, 2.2% for chemoradiotherapy, and 10.0% for surgery. Given the data, observation may be a viable strategy for these patients. Overall survival rates were high, reaching 100% […]
Flexible Endoscopy Surpasses Rigid Endoscopy for Zenker Repair
Flexible endoscopy achieves better outcomes than rigid endoscopy for Zenker diverticulum repair, making it a strong first-line option. Clinical success rates: flexible endoscopy 84.6% vs. rigid endoscopy 55.6% (p = 0.032); comparable to open surgery 88.9% (p = 0.712). Adverse event rates are lowest for flexible endoscopy at 4.5%, with a trend towards fewer complications […]
Stenosis Risk High After Circumferential Colorectal Dissection
Post-resection stenosis significantly impacts surgical outcomes for colorectal lesions treated with endoscopic submucosal dissection when over 90% of the circumference is involved. Stenosis rates reached 34.2%, higher for rectal lesions (38.2%) compared to colonic (11.6%). Complete resection was achieved in 85.1% of cases, with oncological resection rates of 80.3%. Effective endoscopic treatments resolved all stenosis […]
Transanal Surgery Offers R0 Resection for Rectal GISTs
Transanal endoscopic microsurgery (TEM) provides promising outcomes for rectal gastrointestinal stromal tumors (GISTs) while preserving function. High rates of R0 resection were achieved in 13 patients with rectal GIST, underscoring the technique’s efficacy. Tumor size should not automatically disqualify candidates for en-bloc excision with negative margins. Neoadjuvant imatinib may help select borderline cases, but more […]
EUS-Guided Biopsy for Pancreatic Cysts: Key Outcomes and Risks
EUS-guided through-the-needle biopsy (EUS-TTNB) offers valuable diagnostic insights for pancreatic cysts but carries significant risks that surgeons must navigate. Diagnostic adequacy is high at 80.3%, with changes in management seen in 16.3% of cases. Adverse events (AEs) occurred in 20.9% of procedures, predominantly acute pancreatitis (15%). Intraductal papillary mucinous neoplasm (IPMN) significantly raises AE risk […]
ESD outperforms TEM for early rectal tumors in cost-effectiveness.
ESD showed a significant net monetary benefit of €1,797 for complete resection at one year. The en-bloc excision rate was higher with ESD (99%) compared to TEM (92.5%). Choosing ESD could enhance surgical outcomes while managing costs effectively. Disease-free survival was better with ESD at 94.3%, versus 84.6% for TEM. Journal Article by Beyer-Berjot L, […]
Diagnostic insights for colorectal laterally spreading tumors
Magnifying endoscopy offers limited guidance for treating non-granular laterally spreading tumors (lst-ng), crucial for surgical decisions. Pseudodepressed lesions show significantly higher rates of high-grade dysplasia (78.1% vs. 31.2%) and T1 carcinoma (34.4% vs. 2%). All T1b carcinomas were found in pseudodepressed lesions, emphasizing the need for en bloc resection. Surgeons should prioritize technical feasibility for […]
Myotomy Methods Equal for Type III Achalasia Patients
Both per oral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) deliver similar outcomes for treating Type III achalasia, suggesting flexibility in surgical approach. Success rates post-procedure were nearly identical: 88% for POEM (14 of 16) vs. 87% for LHM (26 of 30), with p=0.94. Re-intervention rates were also similar: 25% for POEM and 16.7% […]
Enhanced Biliary Brush Cytology Boosts Detection of Cholangiocarcinoma
Updated protocols for biliary brush cytology significantly improve sensitivity in diagnosing perihilar and intrahepatic cholangiocarcinoma. Sensitivity jumped from 50.5% to 88.3% after protocol changes, with first sample sensitivity reaching 78%. Specificity remained high at 100% across both prospective and historical cohorts. These results suggest that adopting optimized protocols can enhance diagnostic accuracy, potentially improving patient […]