Endoscopy International Open最新文献

{"title":"Radiofrequency ablation: Solution for a long-time therapeutic dilemma of chronic radiation proctitis?","authors":"Katharina Esswein, Marijana Ninkovic, Veronika Kröpfl, Elisabeth Gasser, Christoph Profanter","doi":"10.1055/a-2605-1079","DOIUrl":"10.1055/a-2605-1079","url":null,"abstract":"<p><strong>Background and study aims: </strong>Chronic radiation proctitis is a prevalent condition following pelvic radiation therapy, occasionally leading to significant blood loss. Although medical treatment and argon plasma coagulation (APC) are well-established options, endoscopic radiofrequency ablation (RFA) is an emerging treatment that has shown promising results in smaller studies. However, further research, particularly on long-term outcomes, is necessary. This study aimed to evaluate the treatment outcome of endoscopic RFA in patients with chronic radiation proctitis, with a particular focus on long-term outcome.</p><p><strong>Patients and methods: </strong>This retrospective study included all patients treated with RFA for radiation-induced chronic proctitis suffering from hematochezia at the Medical University of Innsbruck, Department of Visceral, Transplant and Thoracic Surgery, between 2018 and 2023.</p><p><strong>Results: </strong>Thirteen patients were included in the study, with RFA being the initial treatment in five cases. RFA sessions were performed once in nine patients, twice in three patients, and three times in one patient. After a median follow-up period of 58 months, 69.2% (n= 9) remained still symptom-free and 30.8% (n= 4) reported only mild rectal bleeding after hard stools.</p><p><strong>Conclusions: </strong>These data indicate that RFA is a highly effective and safe treatment option for chronic radiation proctitis, providing excellent long-term results.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26051079"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559528","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 retrograde cholangiopancreatography services in Sudan during wartime: Innovations in crisis.","authors":"Abdelmounem Abdo, Salah Dafalla, Mohammed Bushra, Rodwan Mustafa, Reem Hamad, Ahmed Rafei, Mohamed Jaafer, Rawan Bidab, Waleed Gamus Ojan, Mohammed Ganim, Hala Abdalla","doi":"10.1055/a-2621-5666","DOIUrl":"10.1055/a-2621-5666","url":null,"abstract":"<p><p>​Endoscopic retrograde cholangiopancreatography (ERCP) services in Africa have expanded in recent years, aiming to enhance healthcare infrastructure. ERCP, combining endoscopy and fluoroscopy, diagnoses and treats biliary and pancreatic ductal system conditions. Expanding these services addresses healthcare access disparities between urban and rural populations. ERCP services are well-established primarily in South Africa and Egypt. Countries like Nigeria, Uganda, Rwanda, Ethiopia, and Kenya have sustained ERCP services over the past 5 years. This paper examines the need to expand ERCP services as a step toward health equity in Africa. In Sudan, ERCP services began in 1982 at Soba University Hospital, followed by Ibnsina Specialized Hospital. Before the conflict, only seven centers in Khartoum offered ERCP services. The war that started in April 2023 severely disrupted healthcare services, including ERCP. The National Center for Gastrointestinal and Liver Diseases relocated to Madani City in June 2023, resuming ERCP services by July. By December 2023, 375 procedures were performed. Following further conflict, services moved to Kassala City, where 420 ERCP cases were completed between March and December 2024.​ Innovative solutions addressed challenges such as equipment compatibility and accessory availability. A fluoroscopy machine was adapted from a non-functional urology lithotripsy system, and locally designed tables improved procedural efficiency. Development of a local scoring system for trainee assessment after 50 supervised procedures aims to establish a sustainable ERCP fellowship program, addressing the shortage of specialists. These efforts highlight resilience and innovation in delivering ERCP services during conflict.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26215666"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559509","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":"Reply to: Exegesis on using a customized GPT to provide guideline-based recommendations for management of pancreatic cystic lesions.","authors":"Yuri Gorelik","doi":"10.1055/a-2605-1278","DOIUrl":"10.1055/a-2605-1278","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26051278"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559529","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":"Gastroesophageal reflux disease over time in endoscopic versus surgical myotomy for treatment of achalasia: Systematic review and meta-analysis.","authors":"Angelo So Taa Kum, Beanie Conceição Medeiros Nunes, Eduardo Turiani Hourneaux Moura, Matheus Cavalcante Franco, Eduardo Guimarães Hourneaux de Moura","doi":"10.1055/a-2621-5421","DOIUrl":"10.1055/a-2621-5421","url":null,"abstract":"<p><strong>Background and study aims: </strong>Achalasia, a motor disorder of the esophagus, is treated with peroral endoscopic myotomy (POEM) or Heller myotomy with fundoplication (HMF). Although POEM lacks an antireflux mechanism, potentially increasing postoperative gastroesophageal reflux disease (GERD), limiting the endoscopic approach, this difference in GERD tends to diminish over time. The objective of this study was to compare GERD over time, the need for regular gastric acid suppression therapy (GAST), effectiveness, and safety between POEM and HMF in treating achalasia.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted by searching mainly in MEDLINE, EMBASE, and ClinicalTrials.gov. Primary outcomes included early (< 12 months) and late (≥ 12 months) evaluations of postoperative GERD based on endoscopic criteria of the Lyon Consensus 2.0, and GAST. Secondary outcomes included clinical success (Eckardt score ≤ 3), procedure time, length of stay, and major adverse events (AEs) (Clavien-Dindo classification ≥ 2).</p><p><strong>Results: </strong>Thirty-two observational studies and two randomized trials were included, totaling 14,125 patients. GERD was higher in POEM in early evaluation (risk ratio [RR] = 3.03; <i>P</i> P < 0.01). GERD occurrence was similar between POEM and HMF in the late evaluation ( <i>P</i> = 0.30). Higher GAST was observed in POEM (RR = 1.35; <i>P</i> = 0.02). Secondly, clinical success was higher in POEM (RR = 1.06; <i>P</i> = 0.01), with shorter procedure time (median 39.53 minutes; <i>P</i> < 0.01) and shorter length of stay (mean different = -0.51 day; <i>P</i> = 0.03), with similar major AEs ( <i>P</i> = 0.81) compared with HMF.</p><p><strong>Conclusions: </strong>A higher rate of early GERD is observed in POEM compared with HMF, with the difference waning over time and reaching equivalence after 12 months, despite a higher rate of GAST in the endoscopic group. POEM also exhibited effectiveness and safety comparable to the surgical approach.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26215421"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559513","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 mucosal resection for Barrett's neoplasia: Long-term outcomes from the largest Canadian single-center experience.","authors":"Yusuke Fujiyoshi, Kareem Khalaf, Daniel Tham, Mary Raina Angeli Fujiyoshi, Catherine J Streutker, Natalia C Calo, Jeffrey D Mosko, Gary R May, Norman E Marcon, Christopher W Teshima","doi":"10.1055/a-2602-8961","DOIUrl":"10.1055/a-2602-8961","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic mucosal resection (EMR) remains an important treatment for high-grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC) in Barrett's esophagus (BE). However, there are limited data regarding long-term recurrence rates. This study aimed to investigate the neoplasia recurrence rate following EMR with long-term follow-up.</p><p><strong>Methods: </strong>This was a retrospective cohort study at a tertiary-referral center in Canada. Patients with Barrett's neoplasia (HGD/EAC) treated with EMR between January 2001 and December 2023 were included. The primary outcome was long-term neoplasia recurrence rate after complete remission of neoplasia (CRN). Secondary outcomes were residual/metachronous neoplasia rate at first follow-up, CRN rate, and long-term rate of patients successfully managed by endoscopy.</p><p><strong>Results: </strong>A total of 552 patients (83.7% male, mean age 66.3 years) were included (HGD: 22.5%, EAC: 77.5%). After EMR, 475 patients were deemed to have had successful endoscopic resection (low lymph-node metastasis risk with tumor-free deep margin), 455 of whom underwent surveillance follow-up. At first follow-up, residual/metachronous neoplasia was observed in 20.9% (95/455), but 95.6% (435/455) eventually achieved CRN after undergoing a median of two EMR sessions (interquartile range: 1-4). As a primary outcome, the 5-year neoplasia recurrence rate was 10.5%, the 10-year rate was 21.6%, and the 15-year rate was 34.9%. During surveillance, neoplasia recurrence was observed in 38 patients, but 68.4% of them (26/38) were managed with endoscopic therapy. The overall rate of patients successfully managed by endoscopy was 93.0% (423/455).</p><p><strong>Conclusions: </strong>While the success rate of EMR for BE is excellent, this study highlights substantial long-term risk of neoplastic recurrence, underscoring the need for indefinite surveillance for patients who had HGD or EAC.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26028961"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559508","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 application of multi-loop traction device and threaded clip in gastric endoscopic submucosal dissection.","authors":"Hossam El-Din Shaaban, Keisaku Yamada, Masahiro Tajika, Tsutomu Tanaka, Nobuhito Ito, Akihiro Takagi, Yasumasa Niwa","doi":"10.1055/a-2623-4478","DOIUrl":"10.1055/a-2623-4478","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26234478"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559517","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":"Between hype and hard evidence: Are large language models ready for implementation in surveillance colonoscopy?","authors":"Marco Bustamante-Balén","doi":"10.1055/a-2604-7345","DOIUrl":"10.1055/a-2604-7345","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26047345"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559492","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":"Does development of submucosal dissection models influence quality of training? Comparison of existing models.","authors":"Clara Yzet, Jérémie Jacques, Pierre Lafeuille, Jérémie Albouys, Jean-Baptiste Chevaux, Emmanuel Coron, Stanislas Chaussade, Sarah Leblanc, Vincent Lepilliez, Thimothee Wallenhorst, Thierry Ponchon, Jérôme Rivory, Romain Legros, Michel Lefranc, Marion Schaefer, Mathieu Pioche","doi":"10.1055/a-2621-5244","DOIUrl":"10.1055/a-2621-5244","url":null,"abstract":"<p><strong>Background and study aims: </strong>Use of endoscopic submucosal dissection (ESD) is growing, but access to it remains limited. The aim of this study was to compare the performance of various existing models and the progress made by students on them.</p><p><strong>Methods: </strong>Four training models (bovine colon (ex-vivo), ex vivo porcine model, live porcine model, and an artificial model (Endogel)) were evaluated during a 1-week training course. Each participant was evaluated at the beginning (D1) and at the end of the training (D5). Learners performed a standardized ESD of 2 cm on the four models in a randomized order. Experts evaluated the ability of participants to perform ESD using the objective structured assessment of technical skill score (OSATS).</p><p><strong>Results: </strong>Sixteen students were involved, the average age was 35.6 years (+/- 4.6) and they practiced endoscopy for 10 years (+/-5.3). The OSATS significantly increased in each model during the week, with mean scores increasing from 8.6 to 23.3, from 10.7 to 12.9, from 8.8 to 21.3 and from 8.2 to 12.5 for the bovine colon, ex vivo porcine model, live porcine model, and Endogel models, respectively.</p><p><strong>Conclusions: </strong>Ex-vivo models are good models for learning ESD skills. The bovine colon model seems to be the most discriminating. Synthetic models should be reserved for novices.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26215244"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559497","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":"Feasibility of real-time artificial intelligence-assisted anatomical structure recognition during endoscopic submucosal dissection.","authors":"Markus Wolfgang Scheppach, Hon Chi Yip, Yueyao Chen, Hongzheng Yang, Jianfeng Cao, Tiffany Chua, Qi Dou, Helen Mei Ling Meng, Yeung Yam, Philip W Chiu","doi":"10.1055/a-2615-8008","DOIUrl":"10.1055/a-2615-8008","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic submucosal dissection (ESD) is a challenging minimally invasive resection technique with a long training period and relevant operator-dependent complications. Real-time artificial intelligence (AI) orientation support may improve safety and intervention speed.</p><p><strong>Methods: </strong>A total of 1011 endoscopic still images from 30 ESDs were annotated for relevant anatomical structures and used for training of a deep learning algorithm. After internal and external validation, this algorithm was applied to 12 ESDs performed by either one expert or one novice in ESD using an in vivo porcine model.</p><p><strong>Results: </strong>External validation yielded mean Dice Scores of 88%, 60%, 58%, and 92% for background, submucosal layer, submucosal blood vessels, and muscle layer, respectively. The system was successfully applied during all 12 ESDs. All resections were completed en bloc and without complications.</p><p><strong>Conclusions: </strong>In this proof-of-concept study, feasibility of a real-time AI algorithm for anatomical structure delineation and orientation support during ESD was evaluated. The application proved safe and appropriate for routine procedures in humans. Further studies are needed to elucidate a potential clinical benefit of this new technology.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26158008"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559512","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":"Comparing ChatGPT3.5 and Bard recommendations for colonoscopy intervals: Bridging the gap in healthcare settings.","authors":"Maziar Amini, Patrick W Chang, Rio O Davis, Denis D Nguyen, Jennifer L Dodge, Jennifer Phan, James Buxbaum, Ara Sahakian","doi":"10.1055/a-2586-5912","DOIUrl":"10.1055/a-2586-5912","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colorectal cancer is a leading cause of cancer-related deaths, with screening and surveillance colonoscopy playing a crucial role in early detection. This study examined the efficacy of two freely available large language models (LLMs), GPT3.5 and Bard, in recommending colonoscopy intervals in diverse healthcare settings.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted using data from routine colonoscopies at a large safety-net and a private tertiary hospital. GPT3.5 and Bard were tasked with recommending screening intervals based on colonoscopy reports and pathology data and their accuracy and inter-rater reliability were compared to a guideline-directed endoscopist panel.</p><p><strong>Results: </strong>Of 549 colonoscopies analyzed (N = 268 at safety-net and N = 281 private hospital), GPT3.5 showed better concordance with guideline recommendations (GPT3.5: 60.4% vs. Bard: 50.0%, <i>P</i> < 0.001). In the safety-net hospital, GPT3.5 had a 60.5% concordance rate with the panel compared with Bard's 45.7% ( <i>P</i> < 0.001). For the private hospital, concordance was 60.3% for GPT3.5 and 54.3% for Bard ( <i>P</i> = 0.13). GPT3.5 showed fair agreement with the panel (kappa = 0.324), whereas Bard displayed lower agreement (kappa = 0.219). For the safety-net hospital, GPT3.5 showed fair agreement with the panel (kappa = 0.340) whereas Bard showed slight agreement (kappa = 0.148). For the private hospital, both GPT3.5 and Bard demonstrated fair agreement with the panel (kappa = 0.295 and 0.282, respectively).</p><p><strong>Conclusions: </strong>This study highlights the limitations of freely available LLMs in assisting colonoscopy screening recommendations. Although the potential of freely available LLMs to offer uniformity is significant, the low accuracy, as noted, excludes their use as the sole agent in providing recommendations.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25865912"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559495","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}