Endoscopy International Open最新文献

{"title":"Correction: Longitudinal mucosal incision prior to balloon dilation: Novel and advanced approach for severe esophageal stenosis.","authors":"Ippei Tanaka, Gantuya Boldbaatar, Kei Ushikubo, Kazuki Yamamoto, Yohei Nishikawa, Mayo Tanabe, Haruhiro Inoue","doi":"10.1055/a-2616-2611","DOIUrl":"https://doi.org/10.1055/a-2616-2611","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2569-8517.].</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26162611"},"PeriodicalIF":2.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127028","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":"Patient- and endoscopist-related risk factors and etiological categorization of post-colonoscopy colorectal cancer.","authors":"Esly Lemmen, Judith Sluiter-Post, Karlijn van Stralen, Ellert van Soest","doi":"10.1055/a-2566-3380","DOIUrl":"10.1055/a-2566-3380","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colonoscopy is considered to be the gold standard for detecting colorectal cancer. However, this technique is not flawless and post-colonoscopy colorectal cancers (PCCRCs) can occur. Therefore, we investigated the association between patient- and endoscopist-related risk factors and occurrence of PCCRC.</p><p><strong>Patients and methods: </strong>A matched case-control study design was employed. Data from the national colorectal cancer screening program, along with medical records, were used to identify patients diagnosed with colorectal cancer from 2012 until 2022 who had a negative colonoscopy in the 4 years preceding the diagnosis. Patients with colorectal cancer (cases) were matched in a 1:2 ratio with patients without colorectal cancer (controls) based on the date of the negative index colonoscopy of the cases. Analyses at the patient and endoscopist level were conducted to assess factors associated with PCCRC occurrence. Root cause analysis, using the World Endoscopy Organization categorization, was performed to identify possible PCCRC causes.</p><p><strong>Results: </strong>Of 72,975 colonoscopies, 61 PCCRC cases (62% male, mean age 77 years) were found, resulting in an incidence of 22 per 100,000 patient years. Root cause analysis showed that over 75% of PCCRCs could be classified as a possibly missed lesion during index colonoscopy. Endoscopists with a higher mean number of adenomas per colonoscopy had significantly lower PCCRC incidence.</p><p><strong>Conclusions: </strong>Endoscopists detecting more adenomas had a substantially lower PCCRC incidence in their patients. Therefore, endoscopist performance is a crucial marker of PCCRC and may serve as a quality control measure for colonoscopy.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25663380"},"PeriodicalIF":2.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110228","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":"Red dichromatic imaging enhances submucosal visibility during endoscopic submucosal dissection: Pilot study.","authors":"Tsubasa Ishikawa, Tomoaki Tashima, Tomonori Kawasaki, Kankei Fujimoto, Kei Sugimoto, Takahiro Shin, Takahiro Muramatsu, Yumi Mashimo, Shomei Ryozawa","doi":"10.1055/a-2592-3546","DOIUrl":"10.1055/a-2592-3546","url":null,"abstract":"<p><strong>Background and study aims: </strong>In 2020, Olympus Medical Systems Corporation introduced red dichromatic imaging (RDI) as a novel image-enhanced endoscopy (IEE) technology. However, clinical evidence regarding its practical applications and the lesions for which RDI is beneficial remains limited. Endoscopic submucosal dissection (ESD) is an essential therapeutic option for gastrointestinal tumors, yet achieving clear visualization of the dissecting layer remains a significant challenge. This study aimed to evaluate the efficacy of RDI in enhancing visualization of the dissecting layer during ESD.</p><p><strong>Methods: </strong>A total of 86 images from 43 gastrointestinal tumors (esophagus, stomach, duodenum, colon, and rectum) were evaluated by eight endoscopists. Visibility of the dissecting layer was assessed using a scale ranging from -2 (poor) to 2 (excellent) under white light imaging (WLI) and RDI. In addition, the color difference between the submucosal and muscular layers was analyzed using the International Commission on Illumination Lab color space system.</p><p><strong>Results: </strong>RDI significantly improved visibility of the dissecting layer compared with WLI. Moreover, RDI showed a significantly greater color difference between the submucosal and muscular layers than WLI.</p><p><strong>Conclusions: </strong>RDI enhances visualization during ESD by improving visibility of the dissecting layer and increasing color differentiation compared with conventional WLI. These findings suggest that incorporating RDI into routine endoscopic practice could lead to more precise and efficient ESD procedures, ultimately improving patient outcomes.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25923546"},"PeriodicalIF":2.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110269","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":"Comparative analysis of gastric emptying between patients undergoing EUS-guided gastroenterostomy and enteral stent placement: Pilot analysis.","authors":"Sridhar Sundaram, Ameya Puranik, Akhil Mahajan, Kiran Mane, Rahul Puri, Aditya Kale, Prachi Patil, Shaesta Mehta","doi":"10.1055/a-2586-6153","DOIUrl":"10.1055/a-2586-6153","url":null,"abstract":"<p><strong>Background and study aims: </strong>Previous studies show that endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is better than enteral stents (ESs) in terms of clinical success and need for reintervention in the long term. Gastric atony and stent placement across a tumor can lead to poor gastric emptying after ES placement. We aimed to compare gastric emptying across ES and EUS-GE to assess the benefit of EUS-GE over ES in the short-term.</p><p><strong>Patients and methods: </strong>In this pilot study, patients who underwent ES or EUS-GE for palliation of gastric outlet obstruction were included. A gastric emptying study was performed 2 weeks after the procedure after consumption of a semisolid test-meal (Indian porridge) labelled with Tc-Sulphur. The primary outcome was gastric emptying t1/2 between ES and EUS-GE.</p><p><strong>Results: </strong>Forty patients were included in this study (21 ES, 19 EUS-GE; mean age 54 years, 27 males). EUS-GE had a faster emptying t1/2 as compared with ES (72 mins vs 118 mins) ( <i>P</i> = 0.02). Abnormal emptying was seen in fewer patients undergoing EUS-GE (5.3% vs 47.6% [ES]; <i>P</i> = 0.004). Clinical success at 2 weeks and reintervention at 6 months was no different.</p><p><strong>Conclusions: </strong>EUS-GE was associated with better gastric emptying compared with ES, suggesting a benefit that may translate into clinical benefit even in the short term.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25866153"},"PeriodicalIF":2.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110141","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":"Epithelium-preserving stricturotomy is effective for improving postoperative benign anastomotic stricture associated with colorectal surgery.","authors":"Xiaoling Hong, Dezheng Lin, Dejun Fan, Xutao Lin, Junguo Chen, Jiancong Hu","doi":"10.1055/a-2592-3133","DOIUrl":"10.1055/a-2592-3133","url":null,"abstract":"<p><strong>Background and study aims: </strong>We analyzed a large sample of patients with colorectal cancer (CRC) treated with endoscopic stricturotomy (ESt) for postoperative benign anastomotic stricture (POBAS) and explored risk factors for stricture recurrence (restricture). We aimed to provide data on the long-term outcomes of ESt and support for optimizing ESt in treating and preventing POBAS recurrence.</p><p><strong>Patients and methods: </strong>This retrospective study included 152 consecutive patients with CRC diagnosed with POBAS and treated by ESt at our center from April 2013 to April 2023. The primary outcome was stricture recurrence. Secondary outcomes were the technical success rate, postoperative adverse events (AEs), and restricture-free survival (RFS). Risk factors for stricture recurrence were explored.</p><p><strong>Results: </strong>Of the 152 patients, 94.1% (143/152) achieved technical success after the first ESt. Twenty-two patients (17.5%) were diagnosed with recurrent stricture among 126 initial successful patients with follow-up. Anastomotic stricture length ≥ 1 cm and non-preservation of intestinal epithelium during ESt were independent risk factors for recurrence ( <i>P</i> < 0.05). The cumulative RFS rate was 82.53%.</p><p><strong>Conclusions: </strong>Anastomotic stricture length ≥ 1 cm and non-epithelium preservatoin at ESt were independent risk factors for restricture after ESt in POBAS patients. These two factors may help predict risk of POBAS recurrence and provide reliable evidence for developing personalized treatment plans for patients.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25923133"},"PeriodicalIF":2.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110184","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":"Benefits of macroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling.","authors":"Junya Sato, Hirotoshi Ishiwatari, Kazuma Ishikawa, Hiroki Sakamoto, Takuya Doi, Masahiro Yamamura, Kazunori Takada, Yoichi Yamamoto, Masao Yoshida, Sayo Ito, Noboru Kawata, Kenichiro Imai, Kinichi Hotta, Hiroyuki Ono","doi":"10.1055/a-2593-4172","DOIUrl":"10.1055/a-2593-4172","url":null,"abstract":"<p><strong>Background and study aims: </strong>Matched therapy based on comprehensive genomic profiling is a potential treatment option for patients with inoperable pancreatic cancer; however, the optimal method for obtaining tissue samples suitable for comprehensive genomic profiling using endoscopic ultrasound-guided tissue acquisition remains unclear. This study aimed to determine the optimal endoscopic ultrasound-guided tissue acquisition method to obtain samples for comprehensive genomic profiling.</p><p><strong>Patients and methods: </strong>This retrospective study included 86 consecutive patients with pancreatic cancer who underwent comprehensive genomic profiling using FoundationOne CDx (Foundation Medicine Inc.) and endoscopic ultrasound-guided tissue acquisition between June 2019 and January 2023. Macroscopic visible core length was measured using on-site macroscopic evaluation in all patients. Foundation Medicine Inc. reported analysis results categorized as passed (successful FoundationOne CDx), qualified, or failed. We investigated factors predicting successful FoundationOne CDx treatment.</p><p><strong>Results: </strong>Needles sized 22, 20, and 19 gauge were used in 63, one, and 23 patients, respectively. The stylet slow-pull and suction techniques were performed in 43 and 41 patients, respectively. Median total macroscopic visible core length in the formalin-fixed paraffin-embedded blocks subjected to FoundationOne CDx was 41 mm. The success rate for FoundationOne CDx was 66%. Multiple linear regression analysis revealed that macroscopic visible core length independently affected successful FoundationOne CDx ( <i>P</i> = 0.0019).</p><p><strong>Conclusions: </strong>In tissue specimens obtained using endoscopic ultrasound-guided tissue acquisition, macroscopic visible core length can be associated with an appropriate sample for FoundationOne CDx.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25934172"},"PeriodicalIF":2.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110133","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":"Effectiveness and safety of endoscopic ultrasound-guided radiofrequency ablation for pancreatic metastases of renal cell carcinoma.","authors":"Morgane Stouvenot, Stephane Koch, Alexandre Frontzcak, Christelle D'Engremont, Aurélien Boinette, Alexandre Doussot, Tristan Maurina, Lucine Vuitton","doi":"10.1055/a-2566-7350","DOIUrl":"https://doi.org/10.1055/a-2566-7350","url":null,"abstract":"<p><strong>Background and study aims: </strong>Pancreatic metastases from renal cell carcinoma (RCC) are usually managed surgically but with significant morbidity. As an alternative, endoscopic ultrasound-guided radiofrequency ablation (EUS-RFA) has shown promising results in treatment of pancreatic neuroendocrine tumors. The aim of our study was to assess technical success, effectiveness, and safety of EUS-RFA in patients with pancreatic metastases of RCC.</p><p><strong>Patients and methods: </strong>This retrospective, observational study included consecutive patients referred for EUS-RFA of pancreatic RCC metastases. EUS-RFA was performed through 18G or 19G dedicated RFA needles. Effectiveness of EUS-RFA treatment was defined by necrosis with no contrast enhancement or lesion disappearance, determined by contrast-enhanced computed tomography (CT) scan, at 2 to 5 months post procedure, 1 year, and at the end of follow-up. Safety was assessed per and post procedure.</p><p><strong>Results: </strong>Between January 2015 and January 2021, eight patients with 11 lesions were treated and median time from RCC diagnosis to pancreatic metastases RFA was 8.5 years (1-15). Mean lesion size was 13.9 mm (± 3.9). Technical success assessed by immediate post procedure contrast-enhanced CT or Doppler was 100%. At the first CT scan follow-up, complete response was 45.4% and partial response was 27.3%. At 1 year, complete response was 45.4% and partial response was 27.3%. Three patients had multiple EUS-RFAs. Adverse events occurred in 3 patients (mild acute pancreatitis, abdominal pain, and pancreatic fistula with retro-gastric pseudocyst).</p><p><strong>Conclusions: </strong>Our study demonstrated the feasibility and safety of EUS-RFA for patients with pancreatic metastases of RCC.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25667350"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076639","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":"Medicolegal aspects of digestive endoscopy: Results of a Chilean national survey.","authors":"Oscar Corsi, María Jesús Fuenzalida, José Ignacio Vargas, Verónica Silva, Maximiliano Figueroa, Juan Andrés Prato, Andrea Künsemüller, Alberto Espino","doi":"10.1055/a-2570-6490","DOIUrl":"https://doi.org/10.1055/a-2570-6490","url":null,"abstract":"<p><strong>Background and study aims: </strong>Medical professional liability (MPL) is a significant concern for gastrointestinal physicians, yet there are limited data available from Latin America. We aimed to assess frequency of complaints and lawsuits related to digestive endoscopy among gastrointestinal endoscopists in Chile and to identify associated factors.</p><p><strong>Methods: </strong>An online survey collected sociodemographic data, information about endoscopy unit characteristics, and MPL-related experiences. Invitations were sent to 525 gastrointestinal endoscopists in Chile between August and September 2022. Associations between categorical variables were analyzed using the Chi-square test.</p><p><strong>Results: </strong>In total, 140 endoscopists participated (response rate: 26.7%). Mean age was 48.8 years; 68.6% were gastroenterologists, 70.7% were male, and 95% had MPL insurance. Written complaints were reported by 55% of participants, with an average of 1.5 complaints per year. The most common causes were procedure costs, adverse events (AEs), and sedation issues. Colonoscopy was the procedure most frequently associated with complaints (63.2%). Complaints related to AEs included perforation (48.7%), hemorrhage (23.7%), pancreatitis (21.1%), and death (13.2%). Factors associated with complaints included years of endoscopic practice ( <i>P</i> = 0.047), therapeutic procedures ( <i>P</i> < 0.001), and patient satisfaction assessments ( <i>P</i> = 0.048). Of respondents, 14.5% reported at least one lawsuit. Factors associated with lawsuits included age ( <i>P</i> = 0.0047), male gender ( <i>P</i> = 0.0033), Chilean nationality ( <i>P</i> = 0.0257), therapeutic procedures ( <i>P</i> = 0.004), and patient satisfaction assessments ( <i>P</i> = 0.002).</p><p><strong>Conclusions: </strong>Gastrointestinal endoscopists are frequently exposed to complaints and lawsuits. Key factors include procedure costs, AEs, sedation practices, years of experience, type of endoscopic procedure, and communication. Proactive strategies to address these factors could mitigate medico-legal risks and improve patient outcomes.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25706490"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076709","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":"Retrospective case-control study of the impact of dialysis on bowel preparation scores.","authors":"Sébastien Kindt, Michele Vanhooren, Pieter Jan Poortmans, Karlien François","doi":"10.1055/a-2565-8022","DOIUrl":"https://doi.org/10.1055/a-2565-8022","url":null,"abstract":"<p><strong>Background and study aims: </strong>Inadequate bowel preparation (BP) negatively affects diagnostic performance of colonoscopy. Most trials assessing adequacy of bowel preparation regimens have excluded patients affected by chronic kidney disease (CKD), especially patients on dialysis. This study aimed to assess the impact of dialysis on BP quality and adenoma detection rate (ADR) and identify factors related to quality of BP.</p><p><strong>Patients and methods: </strong>We retrospectively compared patient-specific, preparation-specific (preparation solution, preparation regimen (split-dose vs. 1-day preparation, outpatient preparation), and colonoscopy-specific data (indication, Boston Bowel Preparation Score [BBPS], sedation type, presence of adenoma or cancer) between 79 patients on dialysis and 158 matched controls. Adequate BP was defined as a BBPS score ≧2 in every colonic segment. Significant contributors to BP were assessed by logistic regression.</p><p><strong>Results: </strong>Despite matching, dialysis patients were significantly older (69.0 ± 11.9 vs 64.2 ± 14.6, <i>P</i> = 0.008) and less frequently women (30% vs 52%, <i>P</i> = 0.002). There was no significant difference in BP or ADR between patients on dialysis and controls (85% vs 89%, <i>P</i> = 0.39 and 35% vs 35%, <i>P</i> = 1.00, respectively). Older age ( <i>P</i> = 0.03), lower body mass index ( <i>P</i> = 0.03), type of BP regimen ( <i>P</i> <0.001), outpatient preparation ( <i>P</i> = 0.03), and residency in residential care ( <i>P</i> = 0.05) were significantly associated with BP adequacy. According to the logistic regression model, split-dose regimen was the main predictor of adequate BP ( <i>P</i> <0.001, odds ratio 3.1 [1.65-5.81]).</p><p><strong>Conclusions: </strong>Safe and adequate BP is achievable in dialysis patients. Bowel preparation regimen rather than treatment with dialysis influences BP quality. Split-dose preparation remains the most important determinant of adequate BP for colonoscopy, irrespective of regimen.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25658022"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076713","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":"Environmental footprint of a colonoscopy procedure: Life cycle assessment.","authors":"Paulina Lämmer, Dorien Oomkens, Tim Stobernack, Marjolijn Duijvestein","doi":"10.1055/a-2570-6599","DOIUrl":"https://doi.org/10.1055/a-2570-6599","url":null,"abstract":"<p><strong>Background and study aims: </strong>Gastroenterology is a specialty that has evolved rapidly over time, especially in terms of advancements in endoscopic procedures. However, these advancements also present challenges, given the substantial resource demands associated with endoscopy procedures. Numerous actions could be taken to develop a resilient healthcare system that consumes as few resources as possible, but recommendations are needed to prioritize which processes could be improved. We aimed to evaluate the environmental footprint of a colonoscopy procedure, and to identify the main contributing impact process categories.</p><p><strong>Methods: </strong>A single-center observational study was conducted at a Dutch university hospital. No clinical patient data were collected, but the colonoscopy procedure was studied. Data were collected during 13 colonoscopies. Life cycle assessment (LCA) was used to calculate environmental impact.</p><p><strong>Results: </strong>Damage to human health from one colonoscopy was 11.3·10 ^-5 disability-adjusted life-years, equivalent to 1 hour. A single colonoscopy resulted in emission of 56.4 kg of CO ₂ -equivalent (CO ₂ eq), equal to driving a car for 255 km or 55 days of emissions for an average European household. Transportation of patients and staff (76.5%) and disposables (13.5%) were the greatest contributors to damage to human health.</p><p><strong>Conclusions: </strong>Among the 13 colonoscopies studied, the environmental impact was mainly attributable to transportation of patients and staff, and disposables. Therefore, raising awareness about the impact of transportation by car, and reducing resource consumption, particularly of disposable products, should be prioritized. Implementing alternatives to colonoscopy, such as intestinal ultrasound, could reduce the environmental footprint of the healthcare system.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25706599"},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076718","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}