Endoscopy International Open最新文献

{"title":"Endoscopic submucosal dissection for proximal colonic lesions: An effective therapeutic option.","authors":"Ludovico Alfarone, Roberta Maselli, Cesare Hassan, Paola Spaggiari, Marco Spadaccini, Antonio Capogreco, Davide Massimi, Roberto De Sire, Elisabetta Mastrorocco, Alessandro Repici","doi":"10.1055/a-2443-1609","DOIUrl":"10.1055/a-2443-1609","url":null,"abstract":"<p><strong>Background and study aims: </strong>Due to the greater risks of adverse events (AEs) and the lower rate of submucosal invasive cancer (SMIC), large proximal colonic polyps are frequently treated by piecemeal endoscopic mucosal resection (EMR) in the West. However, this implies the risk of surgery to radicalize non-curative endoscopic resection in case of early colorectal cancer (CRC). We evaluated procedure outcomes in patients undergoing ESD for proximal colonic lesions at risk of SMIC.</p><p><strong>Patients and methods: </strong>All consecutive patients with lesions at risk of SMIC proximal to splenic flexure referred for ESD at a tertiary center were prospectively included from 2019 to 2021. En bloc, R0, and curative resection rates were primary outcomes, while length of hospitalization, AEs, need for surgery due to AEs, and recurrence rates were secondary outcomes.</p><p><strong>Results: </strong>A total of 116 patients (mean age: 68.4±10.91 years; men: 69.8%) were included. En bloc, R0, and curative resection rates were 84.5%, 78.4%, and 72.4%, respectively. T1 adenocarcinoma was reported in 25% of lesions (29/116). Eleven patients (9.5%) underwent secondary surgery due to non-curative resections; residual disease was found in one patient. Most frequent AE was intra-procedural perforation (9.9%); no AE required surgery. Median follow-up was 36 months; three of 97 recurrences (3.1%) at 6 months and one of 85 recurrence (1.2%) at 36 months were reported, which were all endoscopically treated.</p><p><strong>Conclusions: </strong>In expert hands, ESD is effective and safe for proximal colonic lesions at risk of SMIC for the favorable balance between risk of AEs and benefit of avoiding unnecessary surgery, even for early CRC.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24431609"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662690","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":"Transanal endoscopic cooperative surgery as a less invasive resection technique for anorectal tumors extending beyond the dentate line: Case series.","authors":"Kohei Shigeta, Kazunori Takada, Kinichi Hotta, Kenichiro Imai, Sayo Ito, Junya Sato, Yoichi Yamamoto, Masao Yoshida, Yuki Maeda, Noboru Kawata, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Akio Shiomi, Hiroyasu Kagawa, Manabe Shoichi, Yusuke Yamaoka, Shunsuke Kasai, Yusuke Tanaka, Yasuyuki Hirashima, Ayako Mochizuki, Shusuke Yoshikawa, Arata Tsutsumida, Wataru Omata, Takuma Oishi, Hiroyuki Ono","doi":"10.1055/a-2503-1815","DOIUrl":"10.1055/a-2503-1815","url":null,"abstract":"<p><p>Endoscopic submucosal dissection (ESD) and surgical local excision pose particular challenges for anorectal tumors extending beyond the dentate line, making technique selection difficult. We hypothesized that combining ESD and local excision (transanal endoscopy cooperative surgery; TaECS) can effectively resect such tumors. TaECS was performed for three patients with anorectal tumors extending beyond the dentate line between January and December 2022. TaECS was indicated for local resection of tumors extending beyond the dentate line with a low risk of lymph node metastases. TaECS was performed in an operating room after ensuring adequate bowel preparation. The oral side of the tumor was dissected endoscopically with resection margins precisely evaluated using magnifying endoscopy. The anal side was surgically dissected above the internal anal sphincter. The defect was repaired wtih bilateral V-Y advancement flap reconstruction. All three tumors were successfully resected in en bloc fashion without intraprocedural adverse events. No postoperative stricture and bleeding occurred. A postoperative abscess around the anastomosis was observed in one case. The anal sphincter was preserved in all cases. No recurrences were recorded at the 17- to 27-month follow-up. TaECS may be a viable treatment for minimally invasive local resection of anorectal tumors extending beyond the dentate line.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25031815"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12142567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247023","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":"On-site ERCP availability and cholangitis outcomes: Retrospective cohort study.","authors":"Rishad Khan, Kayley-Jasmin Marchena-Romero, Marwa F Ismail, Surain B Roberts, Nikko Gimpaya, Michael A Scaffidi, Nasruddin Sabrie, Kareem Khalaf, Jeffrey Mosko, Paul James, Nauzer Forbes, Fahad Razak, Amol A Verma, Samir C Grover","doi":"10.1055/a-2494-7333","DOIUrl":"10.1055/a-2494-7333","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is important in acute cholangitis (AC) management but is not available at all hospitals. The association between on-site ERCP availability and cholangitis outcomes is unknown.</p><p><strong>Patients and methods: </strong>We included adults diagnosed with AC at 27 hospitals in Ontario through the GEMINI network. We collected data on demographics, clinical and laboratory values, and interventions. The primary outcome was in-hospital mortality. Secondary outcomes were length of stay, intensive care unit (ICU) admission, readmission rates, and requirement for percutaneous or surgical decompression. We used multivariable regression analyses to assess the impact of on-site ERCP availability on the primary and secondary outcomes with adjustment for relevant variables.</p><p><strong>Results: </strong>Our cohort included 4492 patients with a median age of 75. Patients at ERCP sites had higher unadjusted rates of undergoing ERCP (55.7% at ERCP sites, 40.8% at non-ERCP sites). Patients at ERCP sites compared with non-ERCP sites did not have significantly different in-hospital mortality (adjusted odds ratio [aOR] = 2.19, 95% confidence interval [CI] = 0.86-5.55). Compared with non-ERCP sites, patients at ERCP sites with underlying stricturing biliary disease or pancreaticobiliary malignancy (aOR = 1.94, 95% CI = 1.14-13.58) or severe cholangitis (aOR = 2.17, 95% CI = 1.17-4.02) had higher odds of in-hospital mortality. In a post-hoc propensity score-based analysis, there was no significant difference between patients at ERCP sites compared with those at non-ERCP sites for in-hospital mortality.</p><p><strong>Conclusions: </strong>Patients at ERCP sites compared with non-ERCP sites did not have significantly different mortality. Subgroups of patients with underlying stricturing biliary disease or pancreaticobiliary malignancy and severe cholangitis, who have higher mortality at ERCP sites, warrant further study.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24947333"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432444","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":"Improved outcomes of endoscopic treatment for delayed perforation following endoscopic submucosal dissection for gastric epithelial neoplasms.","authors":"Daiki Kitagawa, Noriya Uedo, Noboru Hanaoka, Takashi Kanesaka, Yasuhiro Tani, Yuki Okubo, Yuya Asada, Tomoya Ueda, Atsuko Kizawa, Takehiro Ninomiya, Yoshiaki Ando, Gentaro Tanabe, Yuta Fujimoto, Mori Hitoshi, Minoru Kato, Shunsuke Yoshii, Satoki Shichijo, Sachiko Yamamoto, Koji Higashino, Tomoki Michida, Ryu Ishihara, Yasuhiro Fujiwara","doi":"10.1055/a-2451-7835","DOIUrl":"10.1055/a-2451-7835","url":null,"abstract":"<p><strong>Background and study aims: </strong>Emergency surgery is usually required for patients with delayed perforation after gastric endoscopic submucosal dissection (ESD); however, cases of successful endoscopic treatment recently have been reported. Here, we elucidated the usefulness of endoscopic intervention for patients with delayed perforation.</p><p><strong>Patients and methods: </strong>Patients who underwent gastric ESD from 2005 to 2022 were assessed for eligibility. Delayed perforation was defined as no intraprocedural perforation after the ESD but subsequent development of peritoneal irritation and free air on computed tomography scan. Participants were divided into early- and late-period groups based on time (October 2015) of implementation of the polyglycolic acid (PGA) sheet and the over-the-scope clip (OTSC) in clinical practice. We evaluated changes in incidence of required surgery.</p><p><strong>Results: </strong>Among the 5,048 patients who underwent gastric ESD, delayed perforation occurred in 28 patients (0.6%, 95% confidence interval [CI] 0.4%-0.8%). Incidence of delayed perforation did not differ significantly between the early- and late-period groups (0.5% vs. 0.6%). The proportion of patients who underwent surgery was significantly smaller in the late-period group than in the early-period group (54% vs. 13%, odds ratio [OR] 0.14, 95% CI 0.02-0.83; <i>P</i> = 0.042); this was confirmed by multivariate analysis (adjusted OR 0.04, 95% CI 0.002-0.9; <i>P</i> = 0.043) after adjustment for age, sex, Charlson's comorbidity index, tumor location, and size.</p><p><strong>Conclusions: </strong>Endoscopic intervention using PGA sheets and OTSC was associated with a low incidence of required surgery for delayed perforation after gastric ESD and is recommended.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24517835"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432501","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":"Predictive factors for long-term patency in duodenal stenting for malignant gastric outlet obstruction.","authors":"David Razzaz, Stefan Linder, Alexander Waldthaler, Marcus Holmberg, Poya Ghorbani","doi":"10.1055/a-2487-2722","DOIUrl":"10.1055/a-2487-2722","url":null,"abstract":"<p><strong>Background and study aims: </strong>Malignant gastric outlet obstruction (GOO) occurs often late during disseminated disease, requiring palliation. Placement of duodenal self-expandable metal stents (SEMS) is a common method for relieving malignant GOO but recurrent obstruction is common, warranting reintervention. The aim of the present study was to identify predictive factors for stent patency at 3 months and survival. Also, stent patency rate and adverse events after duodenal stenting were analyzed.</p><p><strong>Patients and methods: </strong>This was a retrospective observational single-center study including all patients with malignant GOO receiving duodenal SEMS for palliation (2008-2021). Logistic regression for stent patency (3 months) and Cox regression for survival were undertaken.</p><p><strong>Results: </strong>Overall, 198 patients were included. The most common malignancies were pancreatic adenocarcinoma (40%), gastric adenocarcinoma (18%), and cholangiocarcinoma (13%). Uncovered SEMS were used in 88% of patients and the reintervention rate was 44%. The stent patency rate was 63% in 188 patients with clinical success. Predictors of stent patency at 3 months were jaundice, semi- or fully-covered stents, and chemotherapy prior to stenting. Median survival was 81 days (interquartile range 40-241) after stenting. In Cox regression, predictors for overall survival at 6 months were absence of jaundice and stent patency at 3 months. Stent dysfunction was the most common cause of reintervention and was managed by repeated stent (76%) or dilation (11%).</p><p><strong>Conclusions: </strong>Treatment of malignant GOO with duodenal SEMS is effective but the reintervention rate is high. Predictors of stent patency were jaundice, semi- or fully-covered SEMS, and chemotherapy. Survival was impaired by jaundice and stent dysfunction.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24872722"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432632","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":"EUS-guided gallbladder drainage vs dual stent transpapillary gallbladder drainage for management of acute cholecystitis.","authors":"Dhruval Amin, Katherine M Cooper, Prashanth Rau, Lea Sayegh, Nouran Mostafa, Ikechukwu Achebe, Zachary DeVore, Daniella Gonzalez, Stephanie Stephanie, Jaroslav Zivny, Savant Mehta, Christopher Marshall, Navine Nasser-Ghodsi, Andrew C Storm, Neil B Marya","doi":"10.1055/a-2509-7076","DOIUrl":"10.1055/a-2509-7076","url":null,"abstract":"<p><strong>Background and study aims: </strong>Cholecystectomy (CCY) is the standard treatment for acute cholecystitis. For non-surgical patients, percutaneous cholecystostomy tube (PT-GBD) is recommended but is associated with high readmission rates and poor quality of life. Endoscopic gallbladder decompression techniques, including endoscopic transpapillary gallbladder drainage (ET-GBD) and endoscopic ultrasound-guided gallbladder drainage (EUS-GBD), are alternatives. Studies comparing ET-GBD and EUS-GBD have shown EUS-GBD to have superior outcomes. However, these studies assessed ET-GBD mostly via single transcystic stent placement (SSET-GBD). This study aimed to compare outcomes of dual transcystic stents (DSET-GBD) and EUS-GBD in non-surgical candidates with acute cholecystitis.</p><p><strong>Patients and methods: </strong>A multicenter analysis was conducted on patients who underwent ET-GBD or EUS-GBD between January 2019 and January 2023. Data were extracted from electronic medical records and outcomes including technical success, success, adverse events (AEs), and recurrence rates of cholecystitis were measured.</p><p><strong>Results: </strong>Of 129 procedures (56 EUS-GBD; 73 ET-GBD), technical success was achieved in 87.5% of EUS-GBD and 86.3% of ET-GBD attempts. Immediate clinical success was achieved in 98.1% for EUS-GBD and 100% for DSET-GBD. AE rates were similar between the groups. Recurrent cholecystitis rates were 5.3% for EUS-GBD and 8.2% for DSET-GBD ( <i>P</i> = 0.692).</p><p><strong>Conclusions: </strong>This study demonstrates that DSET-GBD has similarly low rates of recurrent acute cholecystitis compared with EUS-GBD. DSET-GBD should be considered as an alternative management strategy for management of acute cholecystitis in patients who are unable to undergo CCY.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097076"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499791","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":"Novel submucosal injection material comprising fully synthetic and self-assembling peptide solution in endoscopic submucosal dissection: A pilot study.","authors":"Kengo Kasuga, Keigo Sato, Ko Nakata, Hirohito Tanaka, Hiroko Hosaka, Shiko Kuribayashi, Yoji Takeuchi, Toshio Uraoka","doi":"10.1055/a-2487-2823","DOIUrl":"10.1055/a-2487-2823","url":null,"abstract":"<p><p>Endoscopic submucosal dissection (ESD) requires an injection solution to create a submucosal cushion for safe endoscopic resection. This study evaluated the safety and feasibility of a new injection solution (PuraLift) in ESD for early-stage gastrointestinal tumors. This prospective, single-arm, single-center pilot study included 11 patients with gastrointestinal neoplasms of the stomach (n = 5) or colorectum (n = 6) who underwent ESD. All patients underwent outpatient follow-up at week 4 to confirm presence or absence of adverse events (AEs). All underwent protocol treatment and post-treatment follow-up. None of the AEs were judged to have a cause-and-effect relationship with the study. Questionnaires to the operators who performed the protocol treatment and assistants who performed submucosal injections were evaluated in comparison with saline, and maintenance of mucosal lifting was long, comparable, and short (9/2/0). En bloc and R0 resections were achieved in all patients without intraprocedural AEs. Median size of the specimens was 40 mm (range, 20-70). Median excision time was 52 minutes (range, 22-130). Median volume of PuraLift was 32 mL (range, 22-130). No postoperative bleeding or delayed perforation was observed in any patient. The novel injectable material, PuraLift, can potentially ensure safe and feasible ESD.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24872823"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432510","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 closure using a dedicated device following gastric endoscopic submucosal dissection: Multicenter, prospective, observational pilot study.","authors":"Kazuo Shiotsuki, Kohei Takizawa, Yohei Nose, Yuki Kondo, Hitoshi Homma, Taisuke Inada, Mao Daikaku, Kosuke Maehara, Shin-Ichiro Fukuda, Hironori Aoki, Yorinobu Sumida, Hirotada Akiho, Jiro Watari, Kiyokazu Nakajima","doi":"10.1055/a-2503-1684","DOIUrl":"10.1055/a-2503-1684","url":null,"abstract":"<p><strong>Background and study aims: </strong>Development of a simple, optimized closure method for mucosal defects left by gastric endoscopic submucosal dissection (ESD) is warranted. Herein, we developed a novel and dedicated closure device called FLEXLOOP and aimed to assess feasibility and safety of the closure using FLEXLOOP following gastric ESD.</p><p><strong>Patients and methods: </strong>This multicenter, prospective, observational study enrolled patients clinically diagnosed with gastric neoplasms < 30 mm in size. Following gastric ESD, closure of the mucosal defect was performed using a FLEXLOOP with standard clips. The primary outcome was the complete closure rate. The secondary outcomes were procedure time, number of clips, sustained closure rate on second-look endoscopy on postoperative days (PODs) 5 to 7, and rate of post-ESD bleeding.</p><p><strong>Results: </strong>Overall, 35 patients were included in this study. The median specimen size was 32 mm. The mucosal defect was completely closed in 31 patients (89%; 95% confidence interval, 73%-99%) and incompletely closed in four patients (11%). Median closure time was 11 minutes and median number of clips was 10. Second-look endoscopy performed on PODs 5 to 7 demonstrated sustained, partially sustained, and unsustained closures in seven (20%), 22 (63%), and six patients (17%), respectively. Post-ESD bleeding and complications related to FLEXLOOP were not observed.</p><p><strong>Conclusions: </strong>Closure using FLEXLOOP is feasible and safe. Our technique using this new device can be an attractive option for more easily closing mucosal defects. However, further clinical research is warranted to confirm that this technique can prevent delayed complications.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25031684"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432521","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":"Real-time visualization of the gastrointestinal tract during nasogastric tube placement: Pilot study of new video-Assisted system.","authors":"Yi-Ning Lo, Jui-Wen Kang, Chih-Cheng Hsieh, Chiung-Zuei Chen, Kai-Chun Yang, Wei-Chu Tsai, Hsueh-Chien Chiang, Chien-Cheng Chen, I-Cheng Shih, Po-Jun Chen, Er-Hsiang Yang, Hsin-Yu Kuo, Chiung-Yu Chen, Chen-Ju Chen, Chiao-Hsiung Chuang","doi":"10.1055/a-2494-7454","DOIUrl":"10.1055/a-2494-7454","url":null,"abstract":"<p><strong>Background and study aims: </strong>Nasogastric (NG) tubes are commonly inserted blindly, leading to complications. Existing NG tube placement-assisting systems face safety and cost-effectiveness issues. This study aimed to evaluate a new assisting system using a camera probe inserted into the NG tube to provide real-time visualization.</p><p><strong>Patients and methods: </strong>Thirty patients requiring nasogastric tube placement were prospectively included. The primary objective was to determine the success rate of NG tube placement, while the secondary objectives included assessment of usability and safety of this system.</p><p><strong>Results: </strong>Our findings revealed a high success rate of 96.7%. Median time to complete NG tube placement was 3.8 minutes. No serious complications were observed during the 7-day follow-up period. Operator feedback indicated this system helps facilitate NG tube placement, identify the gastric mucosa and safety landmark, and ease of camera wire removal. However, image visibility received a slightly lower score due to gastrointestinal secretions entering the NG tube through the side hole. To address this, air insufflation was used to enhance visibility in 13 patients.</p><p><strong>Conclusions: </strong>The video-assisted system provides real-time visualization of the gastrointestinal tract during tube insertion and has been shown to enhance the safety and effectiveness of NG tube placement.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24947454"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12132707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215302","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":"Glasgow-Blatchford and Rockall score utility in predicting findings on video capsule endoscopy in patients admitted with overt small bowel bleeding.","authors":"Raquel Ballester, James O'Connell, Conor Costigan, Shreyashee Sengupta, Thilagaraj Manoharan, Monserrat Martinez, Deirdre Mc Namara","doi":"10.1055/a-2452-1219","DOIUrl":"10.1055/a-2452-1219","url":null,"abstract":"<p><strong>Background and study aims: </strong>Glasgow-Blachford (GBS) and Rockall scores are recognized tools to prioritize patients with upper gastrointestinal bleeding. Their utility in predicting findings on capsule endoscopy (CE) in patients with overt small bowel bleeding (OSBB) remains unclear. The aim was to assess use of these scores in predicting relevant findings on CE and outcome among patients with suspected OSBB.</p><p><strong>Patients and methods: </strong>A retrospective analysis was performed from January 2019 to June 2022. Clinical parameters and scores were collected at presentation and at 24 hours. Univariate analysis used simple logistic regression, chi-squared test or Mann-Whitney as needed. ROC analysis was performed selecting the optimal cut-off point maximized by the Youden index.</p><p><strong>Results: </strong>Seventy-nine patients were included, 62% of whom had relevant findings. The predictor showing the highest discrimination ability was the initial GBS (area under the curve [AUC] 0.625; 95% confidence interval [CI] 0.49-0.76). The optimal cut-off point was at least 4, with sensitivity 98%, specificity 30%, and accuracy 72%. Multivariable regression analysis showed inpatient status on CE (odds ratio [OR] 117.27; 95% CI 11.32-4492.93; <i>P</i> = 0.001), shorter time to CE (OR 1.02; CI 1.01-1.04; <i>P</i> = 0.018), higher initial GBS (OR 1.22; CI 1.06-1.43; <i>P</i> = 0.009), and higher GBS within 24 hours (OR 1.19; CI 1.04-1.37; <i>P</i> = 0.013) were predictive factors for relevant findings on CE, with a model AUC 0.802, sensitivity 91.8%, and specificity 63.3%.</p><p><strong>Conclusions: </strong>GBS and Rockall scores were useful in predicting relevant findings on CE in this cohort of patients with suspected OSBB. In patients with GBS 5 or higher, early CE during the same admission is warranted.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24521219"},"PeriodicalIF":2.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432244","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}