Endoscopy International Open最新文献

{"title":"Precision vs. cost: Endoscopic ultrasound-guided vs. conventional pancreatic cyst drainage in a resource-limited setting.","authors":"Abeer Altaf, Javeria Salman, Muhammad Asim, Muhammad Umair Tahseen, Bushra Ayub, Arif Siddiqui, Shanil Kadir, Mehreen Siyal, Asma Yaseen, Noval Zakaria, Naseer Ahmed, Fahad Kakar, Marwan Elaqaad, Saad Niaz","doi":"10.1055/a-2821-8219","DOIUrl":"10.1055/a-2821-8219","url":null,"abstract":"<p><strong>Background and study aims: </strong>Pancreatic pseudocyst is a frequent complication of pancreatitis. Endoscopic ultrasound (EUS) being the standard approach for drainage, along with conventional transgastric (CTG) remains an alternative, but comparative real-world data from resource-limited settings remain scarce.</p><p><strong>Patients and methods: </strong>A retrospective review was conducted at a tertiary-care center in Pakistan from 2015 to 2025. Patients undergoing pseudocyst drainage via CTG or EUS were compared for demographic variables, technical success, complications, and procedure costs. Logistic regression was used to identify predictors of either modality for drainage.</p><p><strong>Results: </strong>A total of 164 patients underwent pseudocyst drainage, including 96 (58.5%) treated with EUS-guided drainage and 68 (41.5%) with CTG. Mean age was 32.76 ± 16.65 years (range 4-77), with 42 pediatric patients. Abdominal pain was the most common presenting symptom. Pseudocysts treated with CTG were significantly larger than those treated with EUS (15.02 ± 8.20 mm vs. 8.49 ± 2.53 mm; <i>P</i> < 0.001). Technical success rates were comparable between groups (EUS 96.9% vs. CTG 98.5%; <i>P</i> = 0.499), with no significant difference in complications or 6-month clinical outcomes. EUS-guided procedures incurred higher instrument costs (PKR 330,500 vs. PKR 197,500). Larger cyst size was independently associated with CTG selection, whereas EUS was more commonly used in hospitalized patients.</p><p><strong>Conclusions: </strong>EUS-guided and conventional transgastric drainage demonstrate comparable safety and efficacy. In resource-limited settings, CTG remains a cost-effective option in appropriately selected patients.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28218219"},"PeriodicalIF":2.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13062678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671524","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 sleeve gastroplasty: Prospective assessment of weight loss and metabolic impact.","authors":"Marc Barthet, Geoffroy Vanbiervliet, Jean-Michel Gonzalez, Maxime Thobois, Yoann Poher, Marion Blin, Shani Diai, Nathalie Lesavre, Sandrine Boullu","doi":"10.1055/a-2819-0356","DOIUrl":"https://doi.org/10.1055/a-2819-0356","url":null,"abstract":"<p><strong>Background and study aims: </strong>Recent international guidelines (American Society for Gastrointestinal Endoscopy and European Society of Gastrointestinal Endoscopy) suggest endoscopic treatment plus lifestyle management for management of obesity class I and II. The aim of this prospective study was to assess results of Endosleeve gastroplasty (ESG) plus lifestyle management (LSM).</p><p><strong>Patients and methods: </strong>Twenty-nine patients (mean age 44 years) were included in a longitudinal prospective cohort study in two experienced centers. Mean weight at inclusion was 91.13 kg (± 8.4) and mean body mass index (BMI) was 34.08 (± 2.43) kg/m ² . ESG was performed using Endomina (Endo Tools Therapeutics S.A., Gosselies, Belgium) 6 months after LSM and patients were followed for 1 year with continuous LSM.</p><p><strong>Results: </strong>Twenty-eight patients completed 12-month follow-up. Total body weight loss (TBWL) was 11.05% ( <i>P</i> < 0.001, 81.2% of cases with TBWL decrease > 5 %). EWL was significantly reached in 40.98% ( <i>P</i> < 0.001). Final BMI was significantly decreased (30.52 kg/m ² ; <i>P</i> < 0.001). Glucose control and HbA1c level were significantly improved at 1 year ( <i>P</i> = 0.01 and <i>P</i> = 0.003). Liver function tests (gamma-glutamyl transferase, alanine aminotransferase) were significantly decreased ( <i>P</i> = 0.006 and <i>P</i> = 0.009). Diastolic arterial pressure significantly decreased at 1 year ( <i>P</i> < 0.001). Quality of life (QoL) score (sf12) for physical activity was significantly improved ( <i>P</i> = 0.05). Only one adverse event was noted (sustained pain; AGREE II). No nutritional deficiency assessed by biological measurements appeared during follow-up.</p><p><strong>Conclusions: </strong>ESG combined with LSM resulted in significant improvement in TBWL, EWL, BMI, and QoL. Metabolic improvements were also observed without leading to nutritional deficiency.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28190356"},"PeriodicalIF":2.3,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671444","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":"Diagnostic value of non-magnifying gastroscopy followed by targeted biopsy for detection of early gastric cancer: Multicenter prospective study.","authors":"Fumei Yin, Qinwei Xu, Lianjun Di, Xin Wang, Lang Yang, Shan Hu, Mingjie Zhang, Yilin Wang, Heng Zhang, Changwei Duan, Jianqiu Sheng, Rui Xie, Xiao Hu, Peng Jin","doi":"10.1055/a-2781-6191","DOIUrl":"https://doi.org/10.1055/a-2781-6191","url":null,"abstract":"<p><strong>Background and study aims: </strong>Non-magnifying endoscopy remains the most essential tool for detecting early gastric cancer (EGC), but there is still a lack of widely accepted diagnostic methods. We established an optimized EGC detection protocol using non-magnifying gastroscopy-guided targeted biopsy of morphological suspicious lesions and evaluated its effectiveness.</p><p><strong>Methods: </strong>This study included 5738 participants across four medical centers in China. Targeted biopsies were performed on the following suspicious lesions for high-grade neoplasia (HGN) under screening non-magnifying gastroscopy: 1) ulcerative lesions; 2) esophagogastric junction reddish lesions outside the atrophic area; 3) pale or well-demarcated lesions outside the atrophic area, except polypoid lesions smaller than 5 mm; 4) elevated lesions with clear borders or uneven top within the atrophic area; and 5) flat/depressed lesions with irregular borders or uneven surface or ocher color under narrow-band imaging (NBI) within the atrophic area. Sensitivity for detecting gastric HGN and the positive predictive value (PPV) of targeted biopsy were calculated.</p><p><strong>Results: </strong>The targeted biopsy method demonstrated a sensitivity of 90.9% (50/55, 95% confidence interval [CI] 83.1%-98.8%) and a PPV of 5.4% (50/931, 95% CI 3.9%-6.8%) for diagnosing HGN on per-lesion assessment. Lesions that met the suspicious morphological criteria carried a significant risk to be HGNs, even after adjusting for age, sex, and other risk factors associated with gastric cancer (adjusted odds ratio = 42.03, 95% CI 11.14-158.63, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Targeted biopsy of suspicious lesions for HGN with non-magnifying gastroscopy can be used as a primary clue for detecting EGC.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a27816191"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671409","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":"Post-inflammatory polyps and risk of dysplasia in inflammatory bowel disease: Wolves in sheep's clothing?","authors":"Elena De Cristofaro, Antonio Fonsi, Giovanni Monteleone, Irene Marafini","doi":"10.1055/a-2818-9346","DOIUrl":"https://doi.org/10.1055/a-2818-9346","url":null,"abstract":"<p><p>Patients with longstanding and extensive inflammatory bowel disease (IBD) have an enhanced risk of colorectal cancer (CRC), which accounts for up to 10% of all IBD-related deaths. Chronicity of bowel inflammation, co-existence of primary sclerosing cholangitis, and a family history of sporadic colorectal cancer represent further risk factors for development of CRC. Colon post-inflammatory polyps are believed to be another risk factor for IBD-associated CRC, even though it remains unclear how presence of such lesions could influence CRC development. Although earlier observational studies suggested an association between post-inflammatory polyps and colorectal neoplasia, more recent studies have indicated that these lesions do not independently increase neoplasia risk. However, they may, nonetheless, complicate surveillance by obscuring dysplastic lesions, particularly when numerous, and they are best regarded as markers of chronic and recurrent mucosal inflammation. Moreover, emerging evidence suggests that a minority of post-inflammatory-like lesions may conceal or coexist with dysplasia, underscoring the diagnostic challenge posed by polypoid lesions in chronically inflamed mucosa. In this article, we review the available data about the association between post-inflammatory polyps and development of CRC in IBD and discuss how advances in technology, particularly development of artificial intelligence models integrated with endoscopy, may contribute to their appropriate management.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28189346"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671545","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":"Flexible spectral imaging color enhancement in colon capsule endoscopy: Scoping review of evidence for lesion detection and characterization.","authors":"Pablo Cortegoso Valdivia, Ervin Toth, Anastasios Koulaouzidis","doi":"10.1055/a-2821-8380","DOIUrl":"https://doi.org/10.1055/a-2821-8380","url":null,"abstract":"<p><strong>Background and study aims: </strong>Second-generation colon capsule endoscopy (CCE) has achieved high diagnostic accuracy for polyp detection. However, its widespread adoption as a filter test is hampered by major cost-effectiveness concerns, due to significant follow-up endoscopy rates (FER), quantified as high as 42%, thus revealing a potential paradox: CCE superior detection of un-characterized lesions may worsen the economic problem. Flexible spectral imaging color enhancement (FICE) is a standard virtual chromoendoscopy tool, but its role in CCE has been considered uncertain. This scoping review aimed to evaluate available evidence on FICE in addressing CCE limitations in lesion detection and characterization.</p><p><strong>Methods: </strong>A systematic literature search identified studies investigating use of FICE in CCE, focusing on studies analyzing FICE performance in improving detection rates and differentiating polyp histology.</p><p><strong>Results: </strong>Two key studies representing complementary evidence were analyzed. Regarding detection, a prospective trial demonstrated that FICE significantly improved overall per-lesion sensitivity compared with white light (WL) (79% vs. 61%). Specifically, FICE outperformed WL for 6-9-mm polyps (93% vs. 65%), flat/non-protruding lesions (75% vs. 53%), and serrated polyps (74% vs. 57%). Regarding characterization, a quantitative colorimetric analysis identified that the color difference between polyps and mucosa in FICE reliably discriminates histology, yielding a 0.928 area-under-the-curve (AUC), with 91.2% sensitivity and 88.2% specificity.</p><p><strong>Conclusions: </strong>FICE may play a complementary role in CCE, significantly improving detection of high-risk flat/serrated lesions and providing objective data for differentiating adenomas from hyperplastic polyps. Integrating FICE into diagnostic workflows could provide a smart solution to address CCE high FER and cost-effectiveness barriers.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28218380"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671364","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":"Evaluation of time to endosonographic creation route after endoscopic ultrasound-guided hepaticogastrostomy.","authors":"Yuki Uba, Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Jun Sakamoto, Jun Matsuno, Mitsuki Tomita, Nobuhiro Hattori, Junichi Nakamura, Takafumi Kanadani, Kimi Bessho, Naoto Aoyama, Kouji Kawakami, Ahmad Fikry Aboelezz, Hiroki Nishikawa","doi":"10.1055/a-2817-1109","DOIUrl":"https://doi.org/10.1055/a-2817-1109","url":null,"abstract":"<p><strong>Background and study aims: </strong>Recently, antegrade procedures via the endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) have been developed as an alternative technique for failed endoscopic retrograde cholangiopancreatography However, time required for formation of endosonography-created route (ESCR) after EUS-HGS is still unknown. To prevent adverse events (AEs) after stent removal, stent removal using the through mesh technique might be useful. The aim of this study was to evaluate time to ESCR formation.</p><p><strong>Patients and methods: </strong>Consecutive patients who underwent EUS-HGS using self-expandable metal stents (SEMSs) and EUS-HGS stent removal for performing antegrade procedures were retrospectively enrolled. The primary endpoint was evaluation of the rate of ESCR formation. In the present study, EUS-HGS stent removal was attempted at approximately 14 days.</p><p><strong>Results: </strong>A total of 104 patients were enrolled in this study. EUS-HGS was performed using by partially covered SEMSs (n = 82) or fully covered SEMSs (n = 22). EUS-HGS stent removal was successfully performed in 102 patients (98.1%). Median interval prior to EUS-HGS stent removal in the study subjects was 13 days (range 12-14 days). Among patients who underwent EUS-HGS stent removal, ESCR formation was confirmed in all cases. Mean procedure time was 24.0 minutes. The rate of AEs was 2.9% (3/104)and all AEs were successfully treated conservatively.</p><p><strong>Conclusions: </strong>In conclusion, ESCR may have been established by a median of 13 days following EUS-HGS using SEMS; however, time to ESCR formation should be evaluated in a future study.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28171109"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671413","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":"Development of a national root cause analysis system for post-endoscopy upper gastrointestinal cancer.","authors":"Amar Srinivasa, Rebeca Fiadeiro, Tim Gentry, Shilpi Goel, Tameera Rahman, Karen Clements, Warren Chapman, Nicholas Burr, Dipankar Mukherjee, Matthew Banks, Mimi McCord, Anjan Dhar, Roland Valori, Nigel Trudgill","doi":"10.1055/a-2788-3285","DOIUrl":"https://doi.org/10.1055/a-2788-3285","url":null,"abstract":"<p><strong>Background and study aims: </strong>Post-endoscopy upper gastrointestinal cancer (PEUGIC) is a key performance indicator for endoscopy. PEUGIC represents a delay in diagnosis: a patient has an endoscopy that did not diagnose cancer, and another investigation, usually endoscopy, 3 to 36 months later that diagnoses upper gastrointestinal (UGI) cancer. We describe a national system to identify PEUGIC and undertake root cause analysis.</p><p><strong>Methods: </strong>This retrospective national study was undertaken in the English National Health Service (NHS) and consisted of: 1) identification of PEUGIC; 2) development of an online platform for root cause analysis; and 3) pooled national analysis of PEUGIC. Two national datasets--Hospital Episode Statistics and National Cancer Registration and Analysis Service's cancer registry--enabled identification of people diagnosed with UGI cancer who had endoscopy in the previous 3 to 36 months without a cancer diagnosis (PEUGIC). The online portal informed every endoscopy provider of their PEUGIC and enabled a comprehensive root cause analysis.</p><p><strong>Results: </strong>This methodology was successful in identifying 3907 PEUGIC from January 1, 2017 to October 30, 2023. Root cause analysis was completed for 2666 PEUGIC during the study period and represents the world's largest cohort of PEUGIC. 664 (17%) PEUGIC were ineligible on local review as they did not meet study criteria.</p><p><strong>Conclusions: </strong>A process to identify PEUGIC across a national healthcare system and to perform root cause analysis is described. The methodology is transferable to other healthcare systems with large national datasets, but even without such datasets, the root cause analysis process developed allows identification of learning from PEUGIC for local endoscopy quality improvement.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a27883285"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671406","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 sphincterotomy using a rotatable sphincterotome in a patient with situs inversus totalis.","authors":"Kenshin Tamura, Yuki Kawasaki, Hisaki Kato, Kazuya Sumi, Jun Ushio, Noboru Yokoyama, Haruhiro Inoue","doi":"10.1055/a-2817-4568","DOIUrl":"https://doi.org/10.1055/a-2817-4568","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28174568"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688856","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":"Esophageal myotomy and risk of esophageal cancer and mortality in achalasia: Real-world cohort study.","authors":"Fouad Jaber, Mohamad Ali Ibrahim, Mohammed Jaber, Youssef Soliman, Mai A Khalaf, Tara Keihanian, Fares Ayoub, Mohamed O Othman, Salmaan Jawaid","doi":"10.1055/a-2801-4957","DOIUrl":"https://doi.org/10.1055/a-2801-4957","url":null,"abstract":"<p><strong>Background and study aims: </strong>Achalasia is associated with increased risk of esophageal cancer, particularly squamous cell carcinoma. Although esophageal myotomy improves dysphagia, its impact on cancer risk and mortality remains unclear.</p><p><strong>Patients and methods: </strong>We conducted a retrospective cohort study using the TriNetX research network, including adults (≥ 18 years) with achalasia confirmed by esophageal manometry. Patients were categorized based on treatment of those undergoing esophageal myotomy (peroral endoscopic myotomy [POEM] or laparoscopic Heller myotomy [LHM]) and those managed without myotomy. Patients with prior esophagectomy or malignancies associated with increased esophageal cancer risk were excluded. The primary outcome was incident esophageal cancer; secondary outcomes included all-cause mortality. Propensity score matching balanced baseline characteristics. Associations were assessed using adjusted odds ratios (aORs) and Cox proportional hazards models. Overall survival was assessed using Kaplan-Meier analysis and compared with the log-rank test.</p><p><strong>Results: </strong>Among 18,186 patients with achalasia, 3,758 underwent esophageal myotomy and 14,428 were managed without myotomy. After matching, esophageal cancer incidence was low and did not differ significantly between the myotomy and non-myotomy cohorts (0.29% vs 0.27%; aOR 1.1, 95% confidence interval [CI] 0.47-2.6). In contrast, myotomy was associated with significantly lower all-cause mortality (3.25% vs 7.22%; aOR 0.43, 95% CI 0.35-0.54). Independent predictors of esophageal cancer included male sex, older age, and personal history of gastrointestinal malignancy.</p><p><strong>Conclusions: </strong>In short-term follow-up, esophageal myotomy in achalasia was associated with lower all-cause mortality and similar esophageal cancer incidence. These findings suggest benefits beyond symptom control, including a potential survival advantage.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28014957"},"PeriodicalIF":2.3,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671361","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":"Adverse events associated with full-thickness resection devices in gastrointestinal endoscopy: National postmarketing surveillance study.","authors":"Muhammad Shahzil, Talha Bin Kashif, Ali Akram Qureshi, Minahel Shehzadi, Hadie Razjouyan, Ikponmwosa Enofe","doi":"10.1055/a-2820-3777","DOIUrl":"https://doi.org/10.1055/a-2820-3777","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic full-thickness resection (EFTR) using dedicated full-thickness resection devices (FTRDs) offers a minimally invasive option for complex gastrointestinal lesions involving the muscularis propria. Despite growing use, safety data remain limited, which constrains guidelines and uptake.</p><p><strong>Patients and methods: </strong>We performed a retrospective analysis of FDA MAUDE reports from January 2014 to March 2025. Reports involving FTRDs were reviewed to classify device malfunctions and patient adverse events (AEs). Variables were analyzed using SPSS software.</p><p><strong>Results: </strong>Sixty-eight FTRD cases were identified. Colonic FTRD was used in 79.4% and gastroduodenal and diagnostic sets in 10.3% each. Device issues (n = 69) included clip non-deployment (79.7%), snare malfunctions (10.1%), and clip detachment (5.8%); grasper malfunctions (2.9%), improper clip placement (1.5%), and thread rupture (1.5%) were also reported. Patient AEs (n = 77) were dominated by colonic perforations (69.5%). Delayed gastric and delayed colonic perforations occurred in three cases each (3.9%). Other events included duodenal perforation (2.6%), hemorrhage (2.6%), and esophageal perforation with mediastinitis (2.6%). Four deaths (5.2%) occurred, two from unrecognized esophageal perforation with mediastinitis and sepsis and two after surgery in patients with significant comorbidities. Surgery was required in 78.7%. Endoscopic clipping alone succeeded in 3.3%. Endoscopic or over the scope clipping followed by surgery was used in 16.4%.</p><p><strong>Conclusions: </strong>EFTR with FTRD is associated with device malfunctions and patient complications, with colonic perforation being the most frequently reported complication. Careful patient selection and procedural expertise are critical to reduce risk.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a28203777"},"PeriodicalIF":2.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13063300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147671426","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}