iGIE最新文献

{"title":"Impact of novel lightweight disposable gastroscope and duodenoscope on endoscopist muscle activation: a comparative study","authors":"Veronica Bessone PhD ,&nbsp;Robin Rusnak MSc ,&nbsp;Sven Adamsen MD, FASGE","doi":"10.1016/j.igie.2024.08.008","DOIUrl":"10.1016/j.igie.2024.08.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Musculoskeletal injuries are common among endoscopists, and reducing the endoscope weight is considered to be a preventive measure. We aimed to assess the impact on muscle activation of recently developed lightweight gastroscopes and duodenoscopes, compared with standard endoscopes in a 2-part study.</div></div><div><h3>Methods</h3><div>In the first part, 14 participants performed a protocol using a lightweight disposable and a standard reusable gastroscope in a random order. The protocol constituted of 3 equal working blocks with repetitive and standardized movements. In the second part, 15 endoscopists used a lightweight disposable and a reusable duodenoscope in an artificial model and at rest. For both protocols, the subjects wore a sleeve with embedded superficial electromyographic sensors on the left arm.</div></div><div><h3>Results</h3><div>Wrist flexor muscle activation was significantly lower when using the lightweight single-use endoscopes during the protocol tasks (<em>P</em> &lt; .05). The extensor muscles were also significantly less activated while using the single-use gastroscope (<em>P</em> &lt; .05), but there was no difference when using the duodenoscopes.</div></div><div><h3>Conclusions</h3><div>Standardized operation with lightweight endoscopes reduces the load on the left forearm muscles and favors muscle rest compared with heavier standard endoscopes. These improvements in user ergonomics may aid in preventing or delaying the development of tremor, fatigue, and injuries.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 6-10"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of quality performance metrics in screening and surveillance colonoscopy: a single-center experience","authors":"James Stephen Love MD ,&nbsp;Michael Siegel DO ,&nbsp;Meredith Yellen MD ,&nbsp;Jeffrey Rebhun MD ,&nbsp;Asim Shuja MD","doi":"10.1016/j.igie.2024.08.007","DOIUrl":"10.1016/j.igie.2024.08.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Screening colonoscopy guidelines recommend a minimum adenoma detection rate (ADR) of 35%. There are no established benchmarks for surveillance colonoscopies, and data surrounding the utility of other quality metrics are limited. We aimed to define the relationship between ADR and alternative quality measures in the setting of screening and surveillance colonoscopies and to determine whether validated screening quality benchmarks can be extrapolated to surveillance procedures.</div></div><div><h3>Methods</h3><div>A retrospective review of outpatient screening and surveillance colonoscopies at a tertiary health center was performed. ADR, adenomas per colonoscopy, adenomas per positive participant, polyp detection rate, right-sided polyp detection rate, and colonoscopy withdrawal times (CWTs) were analyzed for screening and surveillance colonoscopies.</div></div><div><h3>Results</h3><div>In total, 2646 procedures (1884 screening, 762 surveillance) were analyzed. Surveillance ADR (CADR) was higher than screening ADR (65.6% ± 0.02% vs 47.0% ± 0.01%; <em>P</em> &lt; .001). All alternate quality measures except CWT were higher in surveillance procedures. Among surveillance procedures, there was a strong correlation between CADR and polyp detection rate (<em>r</em> = .956, <em>P</em> &lt; .01) and right-sided polyp detection rate (r = .771, <em>P</em> = .003); correlations between CADR and other alternate quality measures were not significant.</div></div><div><h3>Conclusions</h3><div>Colonoscopy quality measures were significantly higher in surveillance procedures compared with screening procedures despite similar CWTs. Higher benchmarks should be considered to ensure quality surveillance colonoscopies.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 26-30"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser-assisted endoscopic removal of a foreign body impacted in the esophagus","authors":"Rohit Gupta MD, DM ,&nbsp;Sugata Narayan Biswas MD, DM","doi":"10.1016/j.igie.2025.01.004","DOIUrl":"10.1016/j.igie.2025.01.004","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 63-65"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the clinical effectiveness of a novel rigidizing overtube in completing difficult colonoscopies and for challenging colorectal polyp resection","authors":"Eleazar E. Montalvan-Sanchez MD ,&nbsp;Dalton A. Norwood MD ,&nbsp;Diego Izquierdo-Veraza MD ,&nbsp;Renato Beas MD ,&nbsp;Mirian Ramirez-Rojas MILS ,&nbsp;Sergio A. Sánchez-Luna MD ,&nbsp;Shajan Peter MD ,&nbsp;Douglas R. Morgan MD ,&nbsp;Douglas K. Rex MD","doi":"10.1016/j.igie.2025.01.010","DOIUrl":"10.1016/j.igie.2025.01.010","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Completing colonoscopy in redundant colons and resecting complex precancerous lesions are 2 challenging areas in the technical performance of colonoscopy. In this study, we conducted a systematic review to assess the clinical success of a rigidizing overtube (ROT) to facilitate completion of difficult colonoscopy insertions and challenging polyp resections.</div></div><div><h3>Methods</h3><div>We used multiple electronic databases from August 2019 through June 2024 to identify studies evaluating the use of the novel ROT for colonoscopies.</div></div><div><h3>Results</h3><div>Five studies were included with a total of 163 patients. Three studies evaluated the ROT system in challenging colonoscopies, with a combined cecal intubation rate of 100%. There were no adverse events. Four studies evaluated ROT for challenging colorectal polyp resection. The overall clinical success was 94.7%. Procedure facilitation was reported in 3 studies, with an average of 92.5% facilitation. One study compared endoscopic submucosal dissection (ESD) with and without ROT and reported similar en-bloc resection and curative rates with the use of ROT (92% and 88%, respectively) compared with conventional ESD (96% and 92%, respectively). In other studies that evaluated ROT in the removal of challenging polyps (60 patients), technical success was achieved in all cases.</div></div><div><h3>Conclusions</h3><div>ROT is safe, shows potential in enhancing the clinical success of completing difficult colonoscopies, and may be useful for facilitating ESD and endoscopic mucosal resection of some colonic lesions. The mechanism of any benefit is likely in reducing looping in the case of previous incomplete colonoscopies and providing stability in the case of the complex resections. Further controlled studies are warranted and needed to confirm benefit.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 68-74"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of a multi-degree-of-freedom articulating forceps for endoscopic submucosal dissection and closure of large mucosal defects in a porcine model","authors":"Shunsuke Kamba MD, PhD,&nbsp;Manus Rugivarodom MD,&nbsp;Louis M. Wong Kee Song MD,&nbsp;Nayantara Coelho-Prabhu MBBS,&nbsp;Andrew C. Storm MD,&nbsp;Elizabeth Rajan MD","doi":"10.1016/j.igie.2025.01.006","DOIUrl":"10.1016/j.igie.2025.01.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Multi-degree-of-freedom (MDOF) articulating forceps for flexible endoscopy feature a unique device combining rotating and bending articulation to provide active traction. This study aimed to evaluate the efficacy and safety of the MDOF articulating forceps for endoscopic submucosal dissection (ESD) and closure of large post-ESD mucosal defects using a linearized closure technique.</div></div><div><h3>Methods</h3><div>Four rectal sites (20-50 mm) and 3 gastric sites (20-40 mm) were resected in explanted porcine models. ESD was performed by applying active traction of the articulating forceps to the mucosal flap. After ESD, the articulating forceps were used for defect closure by grasping an edge of the mucosal defect and pulling it toward the luminal cavity, allowing submucosal tissue apposition within the defect and configuration of the linear defect for easy through-the-scope clip closure.</div></div><div><h3>Results</h3><div>The mean procedure times of the gastric and rectal ESD were 16.1 ± 8.7 minutes and 20.7 ± 4.3 minutes, respectively. The mean sizes of the post-ESD gastric and rectal mucosal defects were 38.0 ± 12.6 mm and 43.8 ± 10.2 mm. No injury to the muscularis propria or perforations occurred. Complete clip closure was achieved in all mucosal defects. The mean procedure time for defect closure was 29.3 ± 5.4 minutes in the stomach and 15.5 ± 5.2 minutes in the rectum. The mean combined procedure times for ESD and clip closure were 45.4 ± 13.5 minutes in the stomach and 36.3 ± 7.9 minutes in the rectum.</div></div><div><h3>Conclusions</h3><div>The MDOF articulating forceps seem to be an effective and safe adjunct traction tool for ESD and closure of large mucosal defects. Future clinical studies are needed to validate the efficiency, safety, and durability of this approach.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 11-15"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overall survival and margin status in resected gastric stromal tumors","authors":"Fiyinfoluwa O. Abraham MD ,&nbsp;Tarrant McPherson PhD ,&nbsp;Leslie Blackshear MD ,&nbsp;Yuan Liu PhD ,&nbsp;Theresa Gillespie PhD ,&nbsp;Preeyanka Sundar MD ,&nbsp;Vaishali Patel MD ,&nbsp;Jordan Orr MD ,&nbsp;Saurabh Chawla MD ,&nbsp;Steven A. Keilin MD ,&nbsp;Field F. Willingham MD, MPH, FASGE","doi":"10.1016/j.igie.2025.01.013","DOIUrl":"10.1016/j.igie.2025.01.013","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Studies assessing gastrointestinal stromal tumors (GISTs) have found no survival differences based on margin status; however, small sample sizes, merged anatomic locations, and limited follow-up have been limitations. This study examined the impact of margin status on overall survival in a large national cohort of patients with resected gastric GISTs.</div></div><div><h3>Methods</h3><div>Data on patients with gastric GISTs were abstracted from the National Cancer Database, with data collected over a 16-year period (2004-2020). Exclusion criteria included the presence of other primary tumors, unknown patient/tumor characteristics, macroscopic residual margins, metastasis at diagnosis, and prior chemotherapy. The cohort was stratified according to tumor size. R0 is defined as microscopically negative margin, and R1 is microscopically positive margin.</div></div><div><h3>Results</h3><div>After exclusions, there were 8448 patients in the analysis cohort: 8221 (97.3%) had R0 resections, and 227 (2.7%) had R1 resections. On univariate analysis, tumor size ≤5 cm (<em>P</em> &lt; .001), T1 stage (<em>P</em> &lt; .001), low grade (<em>P</em> &lt; .001), and low mitotic index (<em>P</em> &lt; .001) were associated with a decreased risk of death. Margin status (R0 vs R1) did not have an impact on survival in the combined (<em>P</em> = .249), ≤5 cm (<em>P</em> = .961), ≤3 cm (<em>P</em> = .595), or ≤2 cm (<em>P</em> = .614) cohorts. There was also no difference in the risk of death based on the resection margin, in which the hazard ratio (R1 vs R0) with a 95% confidence interval was 1.206 (.862-1.633). In multivariate analysis, the resection margin status did not affect overall survival (<em>P</em> = .666).</div></div><div><h3>Conclusions</h3><div>Congruent with prior studies, there was no difference in survival when comparing R0 with R1 resections in gastric GIST patients without metastasis over an extended follow-up period. These data may be helpful in assessing suitability for endoscopic resection for patients with gastric GISTs.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 48-60"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lumen-apposing metal stent placement in severe sepsis secondary to afferent limb syndrome","authors":"Nicholas Noverati MD,&nbsp;Faisal Kamal MD","doi":"10.1016/j.igie.2025.01.003","DOIUrl":"10.1016/j.igie.2025.01.003","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 61-62"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful endoscopic therapy for esophagotracheal fistula using polyglycolic acid sheets","authors":"Zhenkai Wang PhD,&nbsp;Xiang Liu MD,&nbsp;Wanzhen Chen PhD,&nbsp;Quanzhao Di MD,&nbsp;Xiaoqian Yang BSN,&nbsp;Dan Liu BSN","doi":"10.1016/j.igie.2025.01.007","DOIUrl":"10.1016/j.igie.2025.01.007","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 66-67"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for endoscopy and sedation in the lactating patient","authors":"Lauren D. Feld MD ,&nbsp;Katherine M. Cooper MD ,&nbsp;Shara I. Feld MD, PhD ,&nbsp;Sarah Gray MD ,&nbsp;Amy S. Oxentenko MD","doi":"10.1016/j.igie.2025.01.008","DOIUrl":"10.1016/j.igie.2025.01.008","url":null,"abstract":"<div><div>Lactation is common amongst patients of childbearing age, providing a valuable nutrition source for their infants. There are several concerns to balance with lactating patients in the procedural setting, including interrupted lactation, milk supply, and child safety. However, clinicians have variable comfort with and training in counseling regarding periprocedural lactation. Anecdotally, the authors have noted many endoscopy centers do not use a standardized or guideline-based approach with lactating patients. In this article, we will (1) briefly review the safety and impact of periendoscopy medications on breastmilk and breastmilk supply, and (2) describe our approach for the lactating patient undergoing endoscopy.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 75-77.e2"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic ultrasound–guided gastroenterostomy for managing gastroparesis refractory to gastric peroral endoscopic pylorotomy: a promising new therapeutic option","authors":"Jean-Michel Gonzalez MD, PhD,&nbsp;Juliette Phelip MD,&nbsp;Mohamed Gasmi MD,&nbsp;Véronique Vitton MD, PhD,&nbsp;Marc Barthet MD, PhD","doi":"10.1016/j.igie.2025.01.011","DOIUrl":"10.1016/j.igie.2025.01.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric peroral endoscopic myotomy (G-POEM) reaches an efficacy rate around 65% for gastroparesis. Endoscopic ultrasound (EUS)–guided gastroenteroanastomosis (EUS-GEA) has demonstrated efficacy in gastric outlet obstruction. We evaluated it for refractory gastroparesis.</div></div><div><h3>Methods</h3><div>We undertook a single-center retrospective study enrolling patients with gastroparesis treated with G-POEM with failure or symptoms recurrence managed with EUS-GEA. The drain-assisted EUS-GEA technique with 20-mm lumen-apposing stent was applied. End points were clinical efficacy at 6 months, adverse events, and recurrence rate.</div></div><div><h3>Results</h3><div>Twelve patients were included, median age 46 years (interquartile range [IQR], 16-78 y). Patients had an abnormal gastric emptying or bezoar, and 50% never improved from baseline. Median follow-up was 11.5 months (IQR, 6-26 mo). Clinical efficacy rate was 75% at 6 months. The median preoperative Gastroparesis Cardinal Symptoms Index was 4.1 (IQR, 1.6-5) versus 1.6 (IQR, 0-2.6; <em>P</em> &lt; .05). No severe periprocedural adverse events occurred.</div></div><div><h3>Conclusions</h3><div>EUS-GEA demonstrated promising results in improving patients with gastroparesis refractory to G-POEM. Prospective evaluation is required to confirm these results.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 16-20"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}