Endoscopy

Background and Aims Cold snare polypectomy (CSP) is safer and equi-efficacious to hot snare polypectomy (HSP) for the removal of small (<10mm) colorectal polyps. The upper limit of polyp size that can be effectively managed by piecemeal CSP (p-CSP) without an excessive burden of recurrence is unknown. Methods Resection error rate (RER) for CSP and HSP were calculated based on the rate of incomplete resection in the literature. Polyp area, snare size, estimated number of resections and optimal resection defect area were modelled...

BACKGROUND: Cold snare defect protrusions (CSDPs) that occur after cold snare polypectomy (CSP) are considered indicators of incomplete polyp resection (IPR). We have sometimes experienced difficult polyp resection with snaring alone; in such cases, a forcible pull on the snare by the endoscopist is necessary. We call this procedure "forced CSP (FCSP)." However, no previous studies have addressed this point. METHODS: This is a prospective observational study (UMIN000041718)...

BACKGROUND:  Cold snare endoscopic mucosal resection (CS-EMR) can reduce the risks associated with electrocautery during colon polyp resection. Data on efficacy are variable. This systematic review and meta-analysis aimed to estimate the pooled efficacy and safety rates of CS-EMR. METHODS:  We conducted a comprehensive literature search of multiple databases, from inception to March 2023, for studies addressing outcomes of CS-EMR for colon polyps. The weighted pooled estimates with 95 %CIs were calculated using the random effects model...

No abstract text is available yet for this article.

BACKGROUND AND AIMS Despite advances in understanding and reducing risk of endoscopic procedures, there is little consideration of the safety of the wider endoscopy service. Patient safety incidents (PSIs) still occur. We sought to identify non-procedural PSIs (nPSIs) and their causative factors from a human factors perspective and generate ideas for safety improvement. METHODS Endoscopy-specific PSI reports were extracted from the National Reporting and Learning System (NRLS). A retrospective, cross-sectional human factors analysis of data was performed...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

BACKGROUND: Prior studies have demonstrated that existing guidelines to predict choledocholithiasis have limited accuracy, leading to overutilization of ERCP. Improved stratification may allow for appropriate patient selection for ERCP and the use of lower-risk modalities (i.e. EUS and MRCP). METHODS: A machine learning model was developed using patient information from two published cohort studies originally used to evaluate performance of published guidelines in predicting choledocholithiasis...

BACKGROUND AND AIMS: Large (20mm) adenomatous Anastomotic Polyps (LAPs) are uncommon. Data pertaining to prevalence, characteristics and efficacy of endoscopic resection (ER) is absent. A safe and effective strategy for ER would reduce morbidity and healthcare costs. PATIENTS AND METHODS: Large non-pedunculated colorectal polyps 20mm (LNPCPs) referred for ER were prospectively studied. Multiple data points were recorded including anastomotic location, polyp morphology, resection modality, complications, and technical success...

No abstract text is available yet for this article.

BACKGROUND:  Texture and color enhancement imaging (TXI) was recently proposed as a substitute for standard high definition white-light imaging (WLI) to increase lesion detection during colonoscopy. This international, multicenter randomized trial assessed the efficacy of TXI in detection of colorectal neoplasia. METHODS:  Consecutive patients aged ≥ 40 years undergoing screening, surveillance, or diagnostic colonoscopies at five centers (Italy, Germany, Japan) between September 2021 and May 2022 were enrolled...

BACKGROUND: Walled-off necrosis (WON) is highly morbid disease most effectively managed by endoscopic drainage with lumen-apposing metal (LAMS) or plastic stents with or without necrosectomy. This meta-analysis compared clinical outcomes of patients included in randomized trials treated using LAMS or plastic stents. METHODS: MEDLINE and EMBASE databases were searched to identify all data collected from randomized trials comparing LAMS and plastic stents for treatment of WON...

BACKGROUND:  The primary obesity surgery endoluminal 2.0 (POSE 2.0) procedure involves full-thickness gastric body plications to narrow the stomach using durable suture anchor pairs. We evaluated POSE 2.0 as a treatment strategy for nonalcoholic fatty liver disease (NAFLD) in patients with obesity. METHODS:  Adults with obesity and NAFLD were prospectively allocated based on their preference to undergo POSE 2.0 with lifestyle modification or lifestyle modification alone (control)...

BACKGROUND: There is limited data on the feasibility of ESD for superficial esophageal neoplasia[SEN] located at or adjacent to esophageal varices [EV]. We aimed to evaluate the outcomes of ESD in these patients. METHODS: This multicenter, retrospective study included cirrhotic patients with history of EV with SEN, located at or adjacent to EV and underwent ESD. RESULTS: 23 patients with SEN [median lesion size 30mm], 16 squamous cell neoplasia, or 7 Barrett's esophagus related neoplasia were included...

BACKGROUND AND AIMS: There is limited evidence on the comparative diagnostic performance of endoscopic tissue sampling techniques of subepithelial lesions (SELs). We performed a systematic review with network meta-analysis to compare these techniques. METHODS: A systematic literature review was conducted for randomized-controlled trials (RCTs) comparing the sample adequacy and diagnostic accuracy of bite-on-bite biopsy, mucosal incision-assisted biopsy (MIAB), endoscopic ultrasound fine-needle aspiration (EUS-FNA), or EUS fine-needle biopsy (FNB)...

All endoscopic procedures are invasive and carry risk. Accordingly, all endoscopists should involve the patient in the decision-making process about the most appropriate endoscopic procedure for that individual, in keeping with a patient's right to self-determination and autonomy. Recognition of this has led to detailed guidelines on informed consent for endoscopy in some countries, but in many no such guidance exists; this may lead to variations in care and exposure to risk of litigation. In this document, the European Society of Gastrointestinal Endoscopy (ESGE) sets out a series of statements that cover best practice in informed consent for endoscopy...

BACKGROUND:  As endoscopic mucosal resection (EMR) of large (≥ 20 mm) adenomatous nonpedunculated colonic polyps (LNPCPs) becomes widely practiced outside expert centers, appropriate training is necessary to avoid failed resection and inappropriate surgical referral. No EMR-specific tool guides case selection for endoscopists learning EMR. This study aimed to develop an EMR case selection score (EMR-CSS) to identify potentially challenging lesions for "EMR-naïve" endoscopists developing competency...

BACKGROUND AND STUDY AIMS: Esophageal stenting (ES) is an important intervention for the management of malignant and benign dysphagia, with migration representing a common drawback. This systematic review with meta-analysis aimed to assess the benefit of ES fixation over non-fixated stenting. PATIENTS METHODS: A systematic research was performed in MEDLINE, Cochrane, Scopus and ClinicalTrials.gov databases until January 2023 for comparative studies evaluating the migration rates of ES after anchoring or not...

BACKGROUND AND STUDY AIMS: Artificial intelligence based computer-aided polyp detection (CADe) systems receive regular updates and occasionally offer customizable detection thresholds which impact their performance, but little is known about these effects. This study aimed to compare the performance of different CADe systems on the same benchmark dataset. METHODS: 101 colonoscopy videos were used as benchmark. Each video frame with a visible polyp was manually annotated with bounding boxes resulting in 129,705 polyp images...

BACKGROUND AND AIMS: Goals of therapy for patients with nonalcoholic fatty liver disease (NAFLD) and compensated advanced chronic liver disease (cACLD) include weight loss and reduction of the portosystemic pressure gradient (PPG) to decrease the risk of hepatic decompensation. Endoscopic gastric plication (EGP) is an effective endoscopic weight loss procedure. This study aims to assess the effect of EGP on PPG. PATIENTS AND METHODS: In this prospective pilot study, patients with NAFLD and cACLD underwent endoscopic ultrasound-guided PPG determination prior to and at 6 months following EGP...