Gastrointestinal Endoscopy

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BACKGROUND AND AIMS: The American Society for Gastrointestinal Endoscopy (ASGE) advanced endoscopy fellowship (AEF) match offers a structured application process for AEF training in the United States. Our aim was to describe recent trends in AEF match, trainee experience, and postfellowship employment. METHODS: ASGE AEF match data from 2012 to 2020 were reviewed. Online surveys were sent to advanced endoscopy trainees in 2019 and 2020 to explore their perceptions about AEF training and postfellowship jobs...

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No abstract text is available yet for this article.

BACKGROUND AND AIMS: Colorectal neoplasms with submucosal fibrosis are the most challenging targets of endoscopic resection. Water pressure endoscopic submucosal dissection (WP-ESD) is a recently introduced procedure that has several advantages over conventional endoscopic submucosal dissection (C-ESD). This study aimed to assess the efficacy and safety of WP-ESD for fibrotic colorectal neoplasms. METHODS: This retrospective observational study investigated 133 colorectal neoplasms expected to have submucosal fibrosis, which were resected by WP-ESD or C-ESD between April 2012 and April 2020...

BACKGROUND AND AIMS: Patients with primary sclerosing cholangitis (PSC) and dominant biliary strictures carry increased risk for the development of cholangiocarcinoma. Although ERCP-based techniques including brush cytology and intraductal biopsies represent first-line tissue sampling methods for dominant strictures, sensitivity is low. Probe-based confocal laser endomicroscopy (pCLE) offers microscopic level imaging of subepithelial biliary mucosa. As data regarding the use of pCLE in PSC are limited, we aimed to investigate its diagnostic performance in dominant strictures...

BACKGROUND AND AIMS: Select patients with acute cholecystitis (AC) are poor candidates for cholecystectomy. Endoscopic retrograde cholangiopancreatography (ERCP)-guided transpapillary gallbladder drainage (ERGD) is one modality for nonoperative management of AC in these patients. The primary aim was to evaluate long-term success of destination ERGD. Secondary aims include rate of technical and clinical success, number of repeat procedures, adverse event rate, and risk factors for recurrent AC...

BACKGROUND AND AIMS: Endoscopic ultrasound fine-needle biopsy (EUS-FNB) is the standard procedure for the diagnosis of pancreatic lesions. Fluorescence confocal microscopy (FCM) allows imaging of tissues in the fresh state, requiring minimal preparation without damage or loss of tissue. Up to now, no data exist on FCM in the field of microhistological specimens. We aimed at assess the diagnostic performance of FCM in predicting histological adequacy of EUS-FNB samples in pancreatic solid lesions and to assess the agreement between FCM evaluation and final histology...

BACKGROUND AND AIMS: Now that the debate about the safety and effectiveness of laparoscopic versus open surgery is over, attention has turned to innovations that can verify whether minimizing the impact of laparoscopy on the abdominal wall can further reduce pain, improve patient comfort, lead to superior cosmesis, and reduce morbidity. The aim of this study was to further explore the application value of totally laparoscopic right hemicolectomy with transcolonic natural orifice specimen extraction (NOSE) and to evaluate the short-term efficacy of transcolonic NOSE surgery for resecting specimens of ascending colon cancer...

BACKGROUND AND AIMS: Colorectal cancer rates are increasing in young people, and new guidelines recommend screening should begin at age 45. We aimed to evaluate colorectal cancer detection rates in a large integrated healthcare system, to assess treatment outcomes in younger colorectal cancer patients, and to determine factors that could aid in identifying these individuals. METHODS: We analyzed confirmed cases of colorectal cancer using a cancer database spanning 1985 to 2017 from a large integrated health care system comprised of 15 hospitals, 150 outpatient clinics, and 20 outpatient oncology clinics...

BACKGROUND AND AIMS: Several reports have validated endoscopic ultrasound-guided liver biopsy (EUS-LB) as safe and effective. Nineteen-gauge EUS aspiration (fine-needle aspiration [FNA]) or core (fine-needle biopsy [FNB]) needles are used, but different needle techniques can yield variable outcomes. Some data shows 1 pass (single liver puncture) with 1 actuation (one to-and-fro needle movement) may be enough to obtain a satisfactory specimen. However, there has not been a head-to-head comparison of single versus multiple needle actuations for EUS-LB...

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BACKGROUND AND AIMS: Frailty is a known predictor of mortality and adverse events in the inpatient setting; however, it has not been studied as a modality to assess risk among patients undergoing endoscopy for gastrointestinal bleeding (GIB). We aimed to determine the association between frailty status and risk of adverse events in hospitalized patients with GIB who underwent endoscopy. METHODS: We performed a cohort study using the 2016 and 2017 National Inpatient Sample (NIS) database, using International Classification of Diseases (ICD) diagnostic codes to identify adult patients with GIB who underwent endoscopic procedures within 2 days of admission and the Hospital Frailty Risk Score (HFRS) to classify patients as frail or non-frail...

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No abstract text is available yet for this article.

BACKGROUND AND AIMS: In July 2019, fecal immunochemistry testing (FIT) replaced fecal occult blood test (FOBt) in England as the Bowel Cancer Screening Program (BCSP) screening tool. We aimed to assess the impact of this on healthcare resources at our BCSP center. METHODS: Two 6-month periods were initially analyzed for stool sample return and positivity rates. Subsequent comparative analysis of patient screening episodes assessed utilization of Specialist Screening Practitioner (SSP) time, endoscopy, histology, radiology, surgical, and oncology service usage...

BACKGROUND AND AIMS: Gastric precancerous conditions, including gastric atrophy (GA) and intestinal metaplasia (IM), play an important role in the development of gastric cancer. Image-enhanced endoscopy (IEE) shows great potential in diagnosing gastric precancerous conditions and adenocarcinoma. In this study, a deep convolutional neural network (DCNN) system, named ENDOANGEL, was constructed to detect gastric precancerous conditions by IEE. METHODS: Endoscopic images were retrospectively obtained from 5 hospitals in China for the development, validation, internal and external test of the system...