Endoscopy International Open最新文献

{"title":"Over-the-scope clips vs standard endoscopic interventions for first-line treatment of NVUGI bleeding: Meta-analysis of randomized trials.","authors":"Paulo Ferreira Mega, Vitor Ottoboni Brunaldi, Alexandre Moraes Bestetti, Angelo So Taa Kum, Igor Valdeir de Sousa, Marcos Eduardo Lera Dos Santos, Eduardo Guimarães Hourneaux de Moura","doi":"10.1055/a-2465-7023","DOIUrl":"10.1055/a-2465-7023","url":null,"abstract":"<p><p><b>Background and study aims</b> Recently, over-the-scope clips (OTSCs) have been extensively studied for hemostasis of nonvariceal upper gastrointestinal bleeding (NVUGIB). Our goal was to compare the efficacy of OTSCs with standard endoscopic interventions (SEIs) as first-line treatments. <b>Patients and methods</b> A comprehensive search of electronic databases was performed to identify randomized clinical trials (RCTs) comparing OTSCs with SEIs as first-line therapy for NVUGIB. This search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. <b>Results</b> Of 819 reviewed studies, five RCTs comprising 555 patients (277 OTSCs vs. 278 SEIs) were included. The OTSC group had a lower 30-day rebleeding rate (risk ratio [RR] 0.43; 95% confidence interval [CI] 0.24-0.77; I² = 0%; <i>P</i> = 0.004) and a higher clinical success rate (RR 1.19; 95% CI 1.11-1.28; I² = 0%; <i>P</i> < 0.00001). There was no significant difference in technical success (RR 1.06; 95% CI 0.98-1.14; I² = 73%; <i>P</i> = 0.13), 30-day all-cause mortality (RR 0.50; 95% CI 0.22-1.14; I² = 0%; <i>P</i> = 0.10), need for further intervention (RR 1.22; 95% CI 0.43-3.47; I² = 0%; <i>P</i> = 0.71), or length of hospital stay (mean difference 0.31; 95% CI: -1.08- 1.70; I² = 0%; <i>P</i> = 0.66). Risk of bias, which was assessed using the Cochrane Risk of Bias 2.0 tool, indicated some concerns about bias. <b>Conclusions</b> OTSCs are more efficient than SEIs as first-line treatment in terms of rebleeding within 30 days and clinical success rates.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24657023"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432623","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":"Chromoendoscopy in colorectal surveillance for primary sclerosing cholangitis and inflammatory bowel disease.","authors":"Rodrigo V Motta, James E East, Emma L Culver","doi":"10.1055/a-2518-9380","DOIUrl":"10.1055/a-2518-9380","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25189380"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499628","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":"Reassessment reveals underestimation of infiltration depth in surgical resection specimens with lymph-node positive T1b esophageal adenocarcinoma.","authors":"Man Wai Chan, Esther A Nieuwenhuis, Sybren L Meijer, Marnix Jansen, Michael Vieth, Mark I van Berge Henegouwen, R E Pouw","doi":"10.1055/a-2509-7208","DOIUrl":"10.1055/a-2509-7208","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic resection (ER) has proven effective and safe for T1 esophageal adenocarcinoma (EAC). However, uncertainty remains concerning risk-benefit return of esophagectomy for submucosal lesions (T1b). Surgical series in past decades have reported significant risk of lymph node metastasis (LNM) in T1b EAC, but these rates may be overestimated due to limitations in histological assessment of surgical specimens. We aimed to test this hypothesis by reassessing histological risk features in surgical specimens from T1b EAC cases with documented LNM.</p><p><strong>Patients and methods: </strong>A retrospective cross-sectional study (1994-2005) was conducted. Patients who underwent direct esophagectomy without prior neoadjuvant therapy for suspected T1b EAC with LNM were included. Additional tissue sections were prepared from archival tumor blocks. A consensus diagnosis on tumor depth, differentiation grade, and lymphovascular invasion (LVI) was established by a panel of experienced pathologists.</p><p><strong>Results: </strong>Specific depth of submucosal invasion (sm1 to sm3) was not specified in 10 of 11 archival case sign-out reports. LVI status was not reported in seven of 11 cases. Following reassessment, one patient was found to have deep tumor invasion into the muscularis propria (T2). The remaining 10 of 11 patients exhibited deep submucosal invasion (sm2-3), with five showing one or more additional risk features (poor differentiation and/or LVI).</p><p><strong>Conclusions: </strong>Our findings highlight the potential for underestimating tumor depth of invasion and other high-risk features in surgical specimens. Despite the limited cohort size, our study confirmed a consistent high-risk histological profile across all cases. Caution is warranted when extrapolating LNM risk data from historic heterogeneous cross-sectional surgical cohorts to the modern ER era.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097208"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499756","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":"Day before late regimen vs standard split dose of low-volume PEG-CS for early morning colonoscopy: Multicenter randomized controlled trial.","authors":"Luigi Pasquale, Giuseppe Grande, Rocco Maurizio Zagari, Paolo Biancheri, Antonio Pisani, Paola Da Massa Carrara, Bastianello Germanà, Enrico Ciliberto, Gianpaolo Cengia, Antonietta Lamazza, Patrizia Lorenzini, Mariavittoria V Carati, Liboria Laterza, Flavia Pigò, Desiree Picascia, Carmelo Stillitano, Matteo Pollastro, Elisabetta Dal Pont, Stefania Maraggi, Rita Conigliaro, Giuseppe Galloro","doi":"10.1055/a-2515-8539","DOIUrl":"10.1055/a-2515-8539","url":null,"abstract":"<p><strong>Background and study aims: </strong>Despite lower patient adherence, the overnight split-dose (SD) intestinal preparation regimen is currently recommended for early morning colonoscopies. Using low-volume preparation, we compared performance of a \"day before late\" (DBL) regimen, with the whole preparation taken between 8.30 pm and midnight on the day before the endoscopic procedure vs the overnight SD regimen for colonoscopies scheduled between 8 am and 10 am.</p><p><strong>Patients and methods: </strong>Patients were randomized to the DBL group (n = 162) or SD group (n = 158). The SD group took the second dose 5 hours before colonoscopy. Successful bowel cleansing, defined as an overall Boston Bowel Preparation Score ≥ 3, safety, compliance and tolerability were assessed in the two groups.</p><p><strong>Results: </strong>The DBL regimen failed to demonstrate non-inferiority compared with the SD regimen in terms of successful bowel cleansing (DBL, 88.2 % vs SD, 98.1%, <i>P</i> < 0.001). Subgroup analysis on colonoscopies before 9 am showed BBPS ≥ 3 rates of 94.6% and 100% in the DBL and SD groups, respectively <i>P</i> = 0.126). The two regimens showed similar compliance and tolerability. Compared with SD patients (25.5%), a lower proportion of DBL patients (13.9%) reported fear of incontinence during the journey to the hospital ( <i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>Albeit more tolerable, the DBL regimen was less effective than the SD regimen with regard to successful bowel cleansing for colonoscopies between 8 am and 10 am. Subgroup analysis on colonoscopies scheduled before 9 am showed that the two regimens have similar efficacy, suggesting that the DBL regimen may be a valuable alternative to the SD regimen for very early morning colonoscopies.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25158539"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499630","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":"Pull-through endoscopic vacuum-assisted closure therapy for complicated leaks of the gastrointestinal tract: Novel technique.","authors":"Carsten Engelke, Yaser Hatem, Carlos Maaß, Martin Kraus, Michael Thomaschewski, Fabian Jacob, Roman Kloeckner, Malte Maria Sieren, Tobias Keck, Jens U Marquardt, Jens Hoeppner, Martha Maria Kirstein","doi":"10.1055/a-2420-0499","DOIUrl":"10.1055/a-2420-0499","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic vacuum-assisted closure (EVAC) of postsurgical leaks is an increasingly applied technique. Precise intracavitary sponge placement is technically challenging. Here, we describe a novel EVAC therapy using a combined external and endoluminal, pull-through technique.</p><p><strong>Patients and methods: </strong>In this retrospective cohort study, we included all patients treated with pull-through EVAC for post-surgery leaks. During endoscopy, the proximal tip of the percutaneous drainage was visualized within the extraluminal abscess cavity, grasped with forceps, and pulled out orally while maintaining the distal end of the drainage above skin level. A foam sponge was fixed to the tip of the percutaneous drainage and sutured to a gastric tube at the other end. The sponge was placed in the cavity by pulling at the percutaneous drainage. Finally, the gastric probe was channeled nasally and suction was applied. Reinterventions comprised pulling the gastric tube, exchanging the sponge, and re-positioning, as described above. Therapy was stopped after closure or complete epithelialization of the leakage.</p><p><strong>Results: </strong>Overall, seven patients were included between 2021 and 2023. Median duration of pull-through EVAC therapy was 30 days (interquartile range [IQR] 11-37 days) and the median number of endoscopic interventions was six (IQR 4-10). Technical and clinical success was achieved in all (100%) and in six of seven patients (85.7%), respectively. In total, one major bleeding complication associated with EVAC therapy occurred (14.3%).</p><p><strong>Conclusions: </strong>Pull-through EVAC therapy is safe and effective in patients with large and challenging postsurgical leaks of the upper gastrointestinal tract.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24200499"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient adherence to surveillance colonoscopy after endoscopic resection of colorectal polyps and factors associated with loss to follow-up.","authors":"Aimen Farooq, BahaAldeen Bani Fawwaz, Arooj Mian, Gurdeep Singh, Yiyang Zhang, Peter Gerges, Kambiz Kadkhodayan, Deepanshu Jain, Natalie Cosgrove, Mustafa A Arain, Muhammad Khalid Hasan, Dennis Yang","doi":"10.1055/a-2409-4916","DOIUrl":"10.1055/a-2409-4916","url":null,"abstract":"<p><strong>Background and study aims: </strong>Post-polypectomy surveillance colonoscopy (SC) plays an integral role in efforts to reduce colorectal cancer risk, but its effectiveness is invariably dependent on patient compliance. This study aimed to evaluate patient adherence to SC after endoscopic resection (ER) of polyps ≥ 20 mm and identify potential barriers associated with loss to follow-up.</p><p><strong>Patients and methods: </strong>This was a single-center retrospective study evaluating adherence to SC after ER of polyps ≥ 20 mm between April 2018 to December 2021. Adherence to SC was defined as the proportion of patients who underwent follow-up colonoscopy. Multivariate logistic regression was performed to identify factors associated with loss to follow-up.</p><p><strong>Results: </strong>A total of 959 patients (mean age 67 years; 47.9% women) underwent endoscopic resection of colorectal polyps ≥ 20 mm (mean size 33.2 ± 13.7 mm). Nearly half of the patients (n = 478; 49.8%) were lost to follow-up. On multivariate analysis, factors associated with a higher likelihood of SC non-adherence were: lack of a primary care physician (odds ratio [OR] 1.7;95% confidence interval [CI] 1.3- 2.3; <i>P</i> < 0.05), American Society of Anesthesiologists grade 3 or 4 (OR 1.4; 95% CI 1.1-1.9; <i>P</i> < 0.05), residence > 60 miles from the endoscopy suite (OR 1.6; 95% CI 1.2-2.3; <i>P</i> = 0.02), being referred by a physician outside of our healthcare system (OR 1.4; 95% CI 1.1-1.8; <i>P</i> = 0.01), and lack of written follow-up recommendations on the colonoscopy report (OR 3.6; 95% CI 1.4-10.2; <i>P</i> = 0.01).</p><p><strong>Conclusions: </strong>Nearly half of patients undergoing ER of colorectal polyps ≥ 20 mm are lost to follow-up. We identified several patient- and healthcare-related factors as barriers to SC adherence. Strategies to address these issues and targeting of high-risk populations are urgently needed to enhance SC programs.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24094916"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448577","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":"Radiographic, fluoroscopic, and endosonographic predictors of failed EUS-guided transgastric stent placement in patients with Roux-en-Y bypass anatomy.","authors":"Benjamin M Moy, Hero Hussain, Jessica X Yu, Kevin D Platt, Jorge D Machicado, Richard S Kwon, Erik-Jan Wamsteker, George M Philips, Allison R Schulman","doi":"10.1055/a-2499-3468","DOIUrl":"10.1055/a-2499-3468","url":null,"abstract":"<p><strong>Background and study aims: </strong>Gastric access temporary for endoscopy (GATE) via endoscopic ultrasound-guided stent placement between the gastric pouch/jejunum and remnant stomach is used in Roux-en-Y gastric bypass (RYGB) to facilitate endoscopic retrograde cholangiopancreatography or other maneuvers. This study aimed to identify radiographic predictors of GATE failure and intraprocedure reasons for aborting.</p><p><strong>Patients and methods: </strong>Patients undergoing GATE were matched 3:1 on procedure success. Features indicating quality of the transgastric window were collected including: 1) gastric pouch/blind limb length; 2) location of remnant stomach relative to pouch or blind/roux limb; 3) pouch orientation; 4) remnant orientation; 5) length of contact; 6) tissue thickness; and 7) presence of poor contact (calcification, surgical material, intervening vasculature). Primary outcome was radiographic criteria associated with GATE failure. Secondary outcomes were endoscopic, endosonographic, and fluoroscopic intraprocedure reasons for aborting GATE.</p><p><strong>Results: </strong>Forty patients (30 successful, 10 aborted, 82.5% female) who underwent GATE were included. Mean (±SD) age and time since RYGB were 62.8±11.9 and 15.1±8.6 years, respectively. There were no group demographic differences. The cumulative number of contact-related risk factors was associated with GATE failure (OR 26.1, 95% CI 0.004-0.337; <i>P</i> =0.004). Two or more factors increased the likelihood of GATE failure ( <i>P</i> <0.05). Echoendoscope angulation/tip deflection, intervening vasculature, distance to remnant stomach, rapid emptying and/or insufficient filling of contrast were reported in cases of GATE failure.</p><p><strong>Conclusions: </strong>Radiographic features may predict GATE failure including intervening vasculature or insufficient contact between gastric pouch/blind limb and remnant. Patients demonstrating these features may benefit from alternative treatment approaches early in management.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24993468"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432644","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":"Surveillance colonoscopy after resection of large polyps: Can we reduce loss to follow up?","authors":"Deepak Madhu, Keith Siau","doi":"10.1055/a-2401-0777","DOIUrl":"10.1055/a-2401-0777","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a24010777"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432650","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":"Use of the mini-forceps traction-assisted cannulation technique when standard ERCP methods fail: Single-center retrospective study.","authors":"Ankit Mishra, Charles Meade, Allison R Schulman, George Philips, Jorge D Machicado","doi":"10.1055/a-2509-7369","DOIUrl":"10.1055/a-2509-7369","url":null,"abstract":"<p><strong>Background and study aims: </strong>There are few salvage techniques for achieving biliary cannulation when no duct can be accessed.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed 10 consecutive cases in which the mini-forceps traction-assisted cannulation technique (MFTAC) was used after failure of any duct access during endoscopic retrograde cholangiopancreatography (ERCP). Outcomes included technical success, use of adjunct techniques; time to biliary access; and adverse events (AEs).</p><p><strong>Results: </strong>Most patients had a native papilla (n = 9) of peri-diverticular location (n = 5) and a benign indication (n = 6). Standard cannulation was unsuccessful over 8:23 mm:ss (interquartile range [IQR] 6:04-19:43). MFTAC had 100% technical success, achieved biliary access after 17:38 mm:ss (IQR 8:52-20:31), and had a 10% incidence of AEs (post-ERCP pancreatitis). MFTAC was sufficient to allow biliary cannulation in three cases and allowed pancreatic duct access in seven cases, which then allowed biliary cannulation with double-wire technique (5/10) and transpancreatic septotomy (2/10).</p><p><strong>Conclusions: </strong>MFTAC is a feasible salvage approach for biliary access when standard cannulation methods fail.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097369"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499760","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":"Optimizing duodenal tissue acquisition for mechanistic studies of duodenal ablation in type 2 diabetes.","authors":"Celine B E Busch, Kim van den Hoek, E Andra Neefjes-Borst, Max Nieuwdorp, Annieke C G van Baar, Jacques J H G M Bergman","doi":"10.1055/a-2503-2135","DOIUrl":"10.1055/a-2503-2135","url":null,"abstract":"<p><strong>Background and study aims: </strong>Histological analysis of regular duodenal biopsies to study morphologic changes after duodenal ablation for type 2 diabetes (T2D) and metabolic syndrome is hampered by variability in tissue orientation. We designed an optimized tissue acquisition protocol using duodenal cold snare resections to create tissue microarrays (TMAs) and to allow for single-cell RNA sequencing (scRNA-seq).</p><p><strong>Patients and methods: </strong>The open-label DIRECT study included patients undergoing an upper gastrointestinal interventional endoscopy for non-duodenal indications. All underwent one ot two single-piece duodenal cold snare resections. Endpoints were safety, adequate histological orientation of specimen and TMA, and tissue dissociation quality for scRNA-seq. The optimized tissue acquisition protocol was validated in a duodenal ablation study, EMINENT-2.</p><p><strong>Results: </strong>In DIRECT, nine patients were included in whom a total of 16 cold snare resections were obtained. No severe adverse events (SAEs) occurred. Eighty percent of specimens and corresponding TMAs showed optimal tissue orientation. Further improvement was achieved by reducing tissue damage during endoscopic retrieval and improving histologic evaluation by eliminating ink use and pinning the tissue on cork. High-quality tissue dissociation scores for scRNA-seq were achieved in 13 of 18 samples (72%). In EMINENT-2, 38 cold snares were obtained without SAEs, histopathologic analysis showed good orientation in all samples, and dissociation scores for scRNA-seq were qualified in 35/38 (92%) samples.</p><p><strong>Conclusions: </strong>Duodenal cold snare resection is safe and can provide high-quality tissue for optimally oriented TMAs and high-quality tissue dissociation scores for scRNA-seq (Clinicaltrials.gov, NCT06333093, NCT05984238). This approach will allow mechanistic studies about the effects of duodenal ablation on metabolic syndrome and T2D.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25032135"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499734","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}