Endoscopy International Open最新文献

{"title":"Author reply to letter to the editor: Beyond the ruler: Measuring what truly matters in EUS-guided pancreatic cancer genomics.","authors":"Junya Sato, Hirotoshi Ishiwatari, Kazuma Ishikawa, Hiroki Sakamoto, Masahiro Yamamura, Takuya Doi, Kazunori Takada, Yoichi Yamamoto, Masao Yoshida, Sayo Ito, Noboru Kawata, Kenichiro Imai, Kinichi Hotta, Hiroyuki Ono","doi":"10.1055/a-2677-0491","DOIUrl":"10.1055/a-2677-0491","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26770491"},"PeriodicalIF":2.3,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946510","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 and safety of endoscopic resection for duodenal gastrointestinal stromal tumors.","authors":"Shao-Bin Luo, Zu-Qiang Liu, Li Wang, Yi-Qun Zhang, Ming-Yan Cai, Quan-Lin Li, Ping-Hong Zhou","doi":"10.1055/a-2655-1439","DOIUrl":"10.1055/a-2655-1439","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic resection for duodenal gastrointestinal stromal tumors (GISTs) is still considered a great challenge with a high risk of complications. This study aimed to evaluate effectiveness and safety of endoscopic resection for duodenal GIST.</p><p><strong>Patients and methods: </strong>Between June 2013 and August 2024, we performed a retrospective study of patients with duodenal GISTs who underwent endoscopic resection at Zhongshan Hospital. Data on patient characteristics, clinical outcome, and follow-up were collected.</p><p><strong>Results: </strong>A total of 73 patients with duodenal GISTs were enrolled, including 31 patients who underwent endoscopic submucosal dissection (ESD) and 42 who underwent endoscopic full-thickness resection (EFTR). Mean lesion size was 1.2 ± 0.5 cm and 1.9 ± 0.9 cm, respectively. En bloc resection rates were 96.8% and 95.2%, respectively. Rates of R0 resection were 45.2% and 42.9%, respectively. Rates of R1 resection were 54.8% and 57.1%, respectively. No patient transferred to open surgery. Postoperative adverse events included delayed bleeding (1 case), delayed perforation (1 case), delayed wall edema (2 cases), hydrothorax (1 case), and retroperitoneal infection (1 case). Mean hospital stays were 4.1 ± 2.8 days and 6.2 ± 4.9 days, respectively. No metastasis or duodenal stenosis were detected during the follow-up period (64.8 ± 43.6 months and 61.3 ± 40.2 months, respectively). Local recurrence occurred in one patient with high recurrence risk at 56 months after EFTR.</p><p><strong>Conclusions: </strong>ESD and EFTR are safe, minimally invasive treatments for duodenal GISTs. Moreover, the EFTR technique may have advantages of completely resecting lesions originating from the deep muscularis propria layer, particularly lesions with extraluminal growth.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26551439"},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947272","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":"Safety and efficacy of peroral endoscopic myotomy with endoscopic fundoplication compared with POEM alone: International multicenter cohort study.","authors":"Michel Kahaleh, Vera Hapshy, Juan A Alcívar, Jorge Baquerizo-Burgos, Hannah Lukashok, Monica R Gaidhane, Iman Andalib, Amy Tyberg, Avik Sarkar, Haroon Shahid, Abid Allehibi, Resheed Alkhiari, Magda L Rodriguez, Carmen Bautista-Altamirano, Sarbelio Rodriguez, Maria G Porfilio, Mine Carames, Juan Carlos Carames, Amol Bapaye, Carlos Robles-Medranda","doi":"10.1055/a-2655-6550","DOIUrl":"10.1055/a-2655-6550","url":null,"abstract":"<p><strong>Background and study aims: </strong>Gastroesophageal reflux (GERD) can occur in a significant number of achalasia patients undergoing post-peroral endoscopic myotomy (POEM). POEM with endoscopic fundoplication (POEM-F) is a new endoscopic technique to treat post- POEM GERD. We conducted a multicenter cohort study to compare outcomes between POEM and POEM-F.</p><p><strong>Patients and methods: </strong>We included patients who underwent POEM or POEM-F from six tertiary centers. Primary outcomes were: 1) clinical success, defined as post-procedure cessation or reduction of proton-pump inhibitors; 2) post procedure percent time pH < 4 and DeMeester score; and 3) post-procedure Eckardt scores. Secondary outcomes included adverse events, procedure time, and hospital stay duration.</p><p><strong>Results: </strong>Sixty-four patients were included: 31 patients underwent POEM-F (mean age 51, 48% male), whereas 33 patients POEM (mean age 56, 58% male). Technical success was 100% in both groups. POEM-F patients achieved reduction/cessation in proton pump inhibitor use in 25 of 31 patients (80%); POEM patients in eight of 33 (24%) ( <i>P</i> ≤ 0.00001). Percent time with pH < 4 was significantly lower in the POEM-F group (2.75 +/- 2.53 vs 9.3 +/- 3.6 min, <i>P</i> ≤ 0.0001). Post-procedure DeMeester scores were lower (< 14.7) in POEM-F (mean 9.6) than POEM (mean 15.8) ( <i>P</i> ≤ 0.0011). There were three mucosal injuries in the POEM-F group and four in the POEM group. Hospital stay duration and procedure time did not differ between groups. In the POEM group, four patients required Dor fundoplication. No repeat interventions were recommended for the POEM- F group at 6-month follow-up.</p><p><strong>Conclusions: </strong>POEM-F achieves statistically significant improvement in post- POEM GERD compared with POEM alone.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26556550"},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947327","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":"Direct visualization endoscopic retrograde appendicitis therapy versus laparoscopic appendectomy for management of acute uncomplicated appendicitis.","authors":"Jun-Yu Pan, Hui-Xin Zhi, Jie-Li Chen, Hao-Xin Chen, De-Feng Li, Jun Yao, Li-Sheng Wang","doi":"10.1055/a-2638-6177","DOIUrl":"10.1055/a-2638-6177","url":null,"abstract":"<p><strong>Background and study aims: </strong>Direct visualization endoscopic retrograde appendicitis therapy (ERAT), an advanced technique building upon conventional ERAT, represents a novel endoscopic approach for managing acute uncomplicated appendicitis. This study aimed to assess clinical efficacy and safety of employing cholangioscope-guided endoscopic intervention as a therapeutic approach.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on 656 patients presenting with suspected acute appendicitis between February 2024 and November 2024. To minimize baseline differences, propensity score matching was applied, resulting in a final study population of 34 patients undergoing direct visualization ERAT and 68 patients treated with laparoscopic appendectomy (LA). Key outcome measures included technical and clinical success rates, operative time, time to postoperative pain resolution, length of hospital stay, recurrence rate, incidence of adverse events (AEs), and overall patient satisfaction.</p><p><strong>Results: </strong>The technical success rate was 97.06% (33/34) in the ERAT group and 100% in the LA group ( <i>P</i> = 0.333), while clinical success was achieved in 94.12% (32/34) of ERAT cases compared with 100% in the LA cohort ( <i>P</i> = 0.109). Notably, ERAT was associated with a significantly shorter operative time (37 vs 50 minutes; <i>P</i> < 0.001) and more rapid postoperative pain relief ( <i>P</i> = 0.001), with a greater proportion of patients reporting complete symptom resolution within 2 days of the procedure. There were no significant differences between the two groups in terms of AEs, length of hospital stay, or patient satisfaction. During follow-up, a recurrence of appendicitis was observed in one ERAT patient (2.94%, 1/34).</p><p><strong>Conclusions: </strong>Direct visualization ERAT demonstrated high feasibility and effectiveness as a diagnostic and therapeutic modality for acute uncomplicated appendicitis, offering a promising alternative to conventional approaches.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26386177"},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947111","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":"Capnography monitoring reduces incidence of hypoxia in older patients undergoing gastrointestinal endoscopy under propofol sedation.","authors":"Qiuyue Lian, Jianbo Wu, Jie Zhang, Yizhe Zhang, Xiangyang Cheng, Xiaomei Yang, Renlong Zhou, Yue Chen, Weiwei Ding, Guangzhi Wang, Weifeng Yu, Jiaqiang Zhang, Diansan Su","doi":"10.1055/a-2663-6372","DOIUrl":"10.1055/a-2663-6372","url":null,"abstract":"<p><strong>Background and study aims: </strong>Whether routine capnography monitoring during gastrointestinal endoscopy sedation can reduce occurrence of hypoxia is controversial. Older patients are more prone to hypoxia. This study aimed to determine the effect of additional capnography monitoring on incidence of hypoxia in older patients undergoing gastrointestinal endoscopy under propofol sedation.</p><p><strong>Patients and methods: </strong>A multicenter, randomized, single-blind, two-arm, parallel-group, controlled with an active comparator, interventional superiority clinical trial was performed at three teaching hospitals in China between September 1, 2021, and September 1, 2022. This study compared additional capnography monitoring (intervention group) and standard monitoring (control group) among older patients (aged 65-79 years) undergoing gastrointestinal endoscopy under propofol sedation. The primary outcome was incidence of hypoxia (75%-89% for < 60s). Secondary outcomes were incidence of subclinical hypoxia (90%-94%), incidence of severe hypoxia (< 75% for any duration or 75%-89% for ≥ 60s), and other adverse events (AEs).</p><p><strong>Results: </strong>Data from 1777 participants (888 intervention, 889 control group) were analyzed. Additional capnography monitoring reduced incidence of hypoxia in older patients from 19% to 12% ( <i>P</i> < 0.001). Incidence of subclinical hypoxia in the additional capnographymonitoring group was 23% and in the standard monitoring group was 15% ( <i>P</i> < 0.001). There was no significant difference in incidence of severe hypoxia ( <i>P</i> = 0.070) and other AEs between the two groups ( <i>P</i> = 0.374).</p><p><strong>Conclusions: </strong>Additional capnography monitoring during gastrointestinal endoscopy for older patients who were sedated with propofol reduces incidence of hypoxia.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26636372"},"PeriodicalIF":2.3,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144946693","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":"Please stay seated - the specialist AI will see you shortly.","authors":"Keith Siau","doi":"10.1055/a-2655-6281","DOIUrl":"10.1055/a-2655-6281","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26556281"},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947302","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":"GastroGPT: Development and controlled testing of a proof-of-concept customized clinical language model.","authors":"Cem Simsek, Mete Ucdal, Enrique de-Madaria, Alanna Ebigbo, Petr Vanek, Omar Elshaarawy, Theodor Alexandru Voiosu, Giulio Antonelli, Román Turró, Javier P Gisbert, Olga P Nyssen, Cesare Hassan, Helmut Messmann, Rajiv Jalan","doi":"10.1055/a-2637-2163","DOIUrl":"10.1055/a-2637-2163","url":null,"abstract":"<p><strong>Background and study aims: </strong>Current general-purpose artificial intelligence (AI) large language models (LLMs) demonstrate limited efficacy in clinical medicine, often constrained to question-answering, documentation, and literature summarization roles. We developed GastroGPT, a proof-of-concept specialty-specific, multi-task, clinical LLM, and evaluated its performance against leading general-purpose LLMs across key gastroenterology tasks and diverse case scenarios.</p><p><strong>Methods: </strong>In this structured analysis, GastroGPT was compared with three state-of-the-art general-purpose LLMs (LLM-A: GPT-4, LLM-B: Bard, LLM-C: Claude). Models were assessed on seven clinical tasks and overall performance across 10 simulated gastroenterology cases varying in complexity, frequency, and patient demographics. Standardized prompts facilitated structured comparisons. A blinded expert panel rated model outputs per task on a 10-point Likert scale, judging clinical utility. Comprehensive statistical analyses were conducted.</p><p><strong>Results: </strong>A total of 2,240 expert ratings were obtained. GastroGPT achieved significantly higher mean overall scores (8.1 ± 1.8) compared with GPT-4 (5.2 ± 3.0), Bard (5.7 ± 3.3), and Claude (7.0 ± 2.7) (all <i>P</i> < 0.001). It outperformed comparators in six of seven tasks ( <i>P</i> < 0.05), except follow-up planning. GastroGPT demonstrated superior score consistency (variance 34.95) versus general models (97.4-260.35) ( <i>P</i> < 0.001). Its performance remained consistent across case complexities and frequencies, unlike the comparators ( <i>P</i> < 0.001). Multivariate analysis revealed that model type significantly predicted performance ( <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>This study pioneered development and comparison of a specialty-specific, clinically-oriented AI model to general-purpose LLMs. GastroGPT demonstrated superior utility overall and on key gastroenterology tasks, highlighting the potential for tailored, task-focused AI models in medicine.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26372163"},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947356","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":"Hyperbaric oxygen and steroids for preventing stricture after large esophageal endoscopic submucosal dissection.","authors":"Haotian Zeng, Jiaxing Yang, Ximin Lin, Zhenglei Xu","doi":"10.1055/a-2637-1928","DOIUrl":"10.1055/a-2637-1928","url":null,"abstract":"<p><strong>Background and study aims: </strong>Treatment of esophageal mucosal lesions by endoscopic submucosal dissection (ESD) may lead to the formation of esophageal strictures. This trial was designed to clarify efficacy of hyperbaric oxygen therapy (HBOT)-assisted steroids in preventing postoperative strictures after ESD for large and long-segment esophageal mucosal lesions.</p><p><strong>Patients and methods: </strong>Between October 2020 and July 2023, patients who underwent esophageal ESD with a remained mucosal defect of more than three-quarters of the esophageal circumference and longer than 50 mm in diameter were retrospectively analyzed. Patients in the control group were administered one injection of triamcinolone acetonide in the submucosal layer and oral prednisone, whereas patients in the experimental group underwent HBOT along with the abovementioned steroid therapy. Furthermore, differences in postoperative stricture incidence and related adverse events between the two groups were evaluated.</p><p><strong>Results: </strong>A total of 35 patients were included in this study. Patients in the experimental group had a significantly lower stricture incidence compared with those in the control group (6.7%, 1/15 patients vs 40%, 8/20 patients; <i>P</i> = 0.048). Stricture incidence of circumferential mucosal defects was significantly lower in the experimental group than in the control group (0.0%, 0/6 patients vs 71.4%, 5/7 patients; <i>P</i> = 0.021). Incidence of post-ESD complications was similar in both groups (6.7%, 1/15 patients vs 25%, 5/20 patients; <i>P</i> = 0.207). No HBOT-related AEs were observed.</p><p><strong>Conclusions: </strong>HBOT-assisted steroid therapy might be a safe and effective way to prevent postoperative strictures after ESD for large and long-segment esophageal mucosal lesions.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26371928"},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of endoscopic intermuscular dissection vs. endoscopic submucosal dissection in treating rectal neuroendocrine tumors < 10 mm.","authors":"Guang Yang, Jingsong Wang, Bo Li, Xiaolong Xian, Jianzhen Ren, Qiuping Qiu, Xiaoping Hong, Longbin Huang, Suhuan Liao, Silin Huang","doi":"10.1055/a-2641-5725","DOIUrl":"10.1055/a-2641-5725","url":null,"abstract":"<p><strong>Background and study aims: </strong>Rectal neuroendocrine tumors (r-NETs) exhibit significant heterogeneity and malignant potential. Currently, endoscopic resection is the preferred treatment for r-NETs < 10 mm. However, traditional endoscopic resection carries a risk of positive vertical margins. This study aimed to compare clinical efficacy of endoscopic intermuscular dissection (EID) and endoscopic submucosal dissection (ESD) in treating small r-NETs (< 10 mm).</p><p><strong>Patients and methods: </strong>This retrospective study included 56 patients with r-NETs < 10 mm who underwent endoscopic treatment between April 2017 and September 2024 at Shenzhen University Affiliated South China Hospital and Shenzhen Hospital of Southern Medical University. All procedures were performed by the same surgeon. Patients were divided into two groups based on type of endoscopic treatment: the EID group (n = 16) and the ESD group (n = 40). We compared operative time, technical success rates, resection outcomes, adverse event (AE) rates, and histopathological findings between the two groups.</p><p><strong>Results: </strong>Median lesion size in the EID group (7.5 mm) was significantly larger than in the ESD group (6.0 mm) ( <i>P</i> = 0.001). Although operative time in the EID group was longer (39 vs 28.5 minutes), the difference was not statistically significant ( <i>P</i> = 0.137). The complete resection rate was 100% in the EID group and 97.5% in the ESD group, with no statistically significant difference. There were no significant differences in general characteristics, technical success rates (100% vs 100%), or incidence of AEs (bleeding, perforation, infection) (0% vs 0%) between groups ( <i>P</i> > 0.05).</p><p><strong>Conclusions: </strong>Endoscopic intermuscular dissection offers a better option for preventing positive basal margins and demonstrates good safety and feasibility.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26415725"},"PeriodicalIF":2.3,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947161","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":"Characterization of biomechanical risk factors during endoscopic submucosal dissection: Ergonomic pilot study.","authors":"Clara Yzet, Léa Leroy, Sylvain Chamot, Mathieu Pioche, Franck Brazier, Jean-Phillippe Le Mouel, Jérôme Rivory, Romain Gerard, Alexandru Lupu, Julien Branche, Stéphane Delanaud, Mathurin Fumery, Frederic Telliez","doi":"10.1055/a-2655-1195","DOIUrl":"10.1055/a-2655-1195","url":null,"abstract":"<p><strong>Background and study aims: </strong>Musculoskeletal disorders (MSDs) are prevalent among endoscopists. The aim of this study was to evaluate biomechanical risk factors for MSDs in gastroenterologists performing ESD.</p><p><strong>Methods: </strong>An observational study was performed among interventional endoscopists performing ESD in three French centers. Physical constraints were assessed using an analog scale of perceived physical effort intensity and physiological sensors to measure joint angulation kinematics and muscle activity levels (flexor and extensor carpi radialis muscles) during diagnostic colonoscopy and ESD. High muscle strain was defined as any muscle activation exceeding 10% of maximum voluntary contraction (MVC). Two distinct sub-tasks of ESD were identified: lesion marking and circumferential incision phase (ESD-1) and dissection phase (ESD-2).</p><p><strong>Results: </strong>Six interventional gastroenterologists participated in the study. Perceived physical effort was significantly greater for ESD compared with colonoscopy ( <i>P</i> = 0.03). Time spent at more than 10% MVC for the right extensor carpi radialis was significantly higher during ESD-1 than during colonoscopy (+15%, <i>P</i> = 0.04). The greatest strain was observed in the left extensor carpi radialis. This muscle was particularly exposed because more than 50% of the time was spent at more than 10% of MVC during colonoscopy and up to more than 80% during ESD-1 and -2. Time spent in the neck flexion risk zone was significantly higher during ESD-2 than during colonoscopy (+42%, <i>P</i> = 0.046).</p><p><strong>Conclusions: </strong>ESD increased the risk of musculoskeletal strain. It is crucial to develop prevention programs to reduce risk of MSD in the population of gastroenterologists.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26551195"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039410","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}