ESD achieved a fourfold increase in both en bloc and curative resection rates compared to EMR. Favorable outcomes were particularly noted in differentiated lesions and during long-term follow-up. Consider ESD as the preferred method for selected early gastric cancer patients, keeping in mind the need for advanced skills and longer procedure times. The analysis included […]
Category: Surgical Endoscopy
New tool predicts esophageal stricture risk after ESD
Surgeons can now better predict the risk of esophageal stricture following extensive endoscopic submucosal dissection (ESD) for early esophageal cancer. A nomogram developed from a study of 1,043 patients categorizes stricture risk as low (2.3%), intermediate (48.8%), or high (75%). In a matched cohort of 44 patients, a combination of glucocorticoids and functional exercise reduced […]
Novel approach for complex polyp removal in colon.
Combined endoscopic and robotic-assisted transcolonic polypectomy effectively addresses challenging, benign colonic lesions. Successfully resected a complex polyp that failed endoscopic techniques. Procedure had no significant complications, shorter operative time, and faster recovery than partial colectomy. This method offers a minimally invasive option, reducing the need for more invasive surgery, particularly in high-risk patients. Journal Article […]
Improved Technique Enhances Bile Duct Cannulation Success
Modified endoscopic ultrasound-guided rendezvous shows promise for challenging biliary access in benign cases. Higher technical success rate with modified technique: 95.3% vs. 83.7%, especially effective with CBD diameter ≤ 3 mm (96.9% vs. 61.1%, p=0.002). Reduced procedure time: median of 6.12 minutes vs. 10 minutes (p<0.001) and lower radiation exposure (median 208.93 vs. 345 mGy, […]
Advancing Endoscopic Resection for Colorectal Lesions
A new saline-immersion technique shows promise for complex colorectal resections. 181 lesions treated with an en bloc approach achieved an R0 resection rate of 92.3%. Overall, 4.4% of patients experienced adverse events, with only four needing further intervention. This technique enhances the safety profile of endoscopic procedures, supporting wider use in Western surgical practice. 93.4% […]
Endoscopic Resection Worse for Poorly Differentiated Gastric Cancer
Surgical resection offers better survival outcomes for poorly differentiated early gastric cancer. Surgical resection linked to better cancer-specific survival (CSS) and overall survival (OS) with hazard ratios of 0.61 and 0.56, respectively. Statistically significant differences in CSS and OS observed after propensity score matching (p-values 0.034 and 0.033). Surgeons should favor surgical resection to align […]
Intraoperative Imaging Predicts Gallbladder Cancer Invasion Depth
Intraoperative narrow-band imaging effectively estimates tumor invasion depth in gallbladder cancer, crucial for surgical strategy. 66.7% of patients with suspected disease were diagnosed with gallbladder cancer. Intraoperative NBI had a diagnostic sensitivity of 79.5% for identifying ≥ T2 invasion, outperforming CT and EUS. Surgeons can use NBI for real-time assessment of cancer depth and lymphatic […]
Hybrid Technique Resolves Parastomal Hernias with Low Recurrence
A new hybrid parastomal endoscopic repair (HyPER) demonstrates effectiveness for complex hernia cases. In a study of 200 patients, overall recurrence rate was just 5.5%. Postoperative complications occurred in 12.5%, mainly wound infections. Quality of life significantly improved, with VAS scores rising from 3.15 to 9.15. Stoma relocation necessary in 87% of type IV hernias, […]
Fibrin Sealant Cuts Postoperative Complications in ESD
Applying human-derived fibrin sealant after gastric endoscopic submucosal dissection (ESD) significantly enhances patient outcomes. Delayed hemorrhage rates dropped to 1.7% in the fibrin group versus 6.9% in controls (p < 0.001). One month post-ESD, the fibrin group saw a wound healing rate of 65.4%, compared to 51.1% for controls (p = 0.014). This sealant not […]
Audit Reveals Improved Outcomes in Acute GI Bleeding
A recent UK audit on acute upper gastrointestinal bleeding shows improved patient outcomes despite higher comorbidities and inappropriate transfusion practices. Comorbidities rose from 50% to 67%, with 15% of patients having cirrhosis. Transfusion rates increased to 50%, and 24% of early transfusions were deemed inappropriate, linked to higher adjusted mortality at hemoglobin thresholds above 80 […]