Endoscopy International Open最新文献

{"title":"Reducing applied force in colonoscopy using a novel soft robotic colonoscope: Head-to-head study.","authors":"Jabed Foyez Ahmed, Korn Borvorntanajanya, Jialei Shi, Enrico Franco, Ara Darzi, Ferdinando Rodriguez Baena, Nisha Patel","doi":"10.1055/a-2641-5827","DOIUrl":"10.1055/a-2641-5827","url":null,"abstract":"<p><strong>Background and study aims: </strong>Current colonoscopies have a recognized limitation. Manual pushing and pulling required by operators provides gross movement in the bowel. Reported pain, therefore, is likely due to the manual force applied. Implementing novel steering techniques with a soft growing robotic system can potentially overcome challenges such as fine control, precise steering, and capability to expand treatment options for complex therapies. This study assessed a novel controlled-growing soft robot compared with a standard colonoscope in terms of force exhibited on a model bowel wall and its clinical implications.</p><p><strong>Methods: </strong>A head-to-head study using a hybrid colon phantom of the left colon was undertaken. Both the novel soft-robot and standard colonoscope were passed through the phantom by endoscopists. Multiple passes were undertaken in the phantom with both colonoscopy methods with force values recorded at two points (rectum and sigmoid) with pressure sensors.</p><p><strong>Results: </strong>Nine clinical endoscopists (4M:5F, 5 non-expert, 4 expert) were recruited. Average force with the novel robot was 0.25N (rectum) and 0.19N (sigmoid). Average force applied with standard colonoscopy was 2.82N (rectum) and 1.45N (sigmoid).</p><p><strong>Conclusions: </strong>This study demonstrated an improvement in force with the novel soft robot compared with a standard colonoscope. This suggests the possibility of more comfortable colonoscopy for patients. Currently time taken is longer with the novel robot, which is attributable to the learning curve and improves in subsequent passes. Further work will be undertaken in a complete colon model with aspirations to reach in-vivo experiments.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26415827"},"PeriodicalIF":2.3,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144947367","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":"Colon capsule endoscopy today: Brief overview of leading UK and Danish initiatives.","authors":"Jakob Frederik Frokjaer Justsen, Niels Gellert Olesen, Gunnar Baatrup, Anastasios Koulaouzidis","doi":"10.1055/a-2641-5952","DOIUrl":"10.1055/a-2641-5952","url":null,"abstract":"<p><strong>Background and study aims: </strong>In recent years, several large national studies have been published reporting on outcomes of colon capsule endoscopy (CCE) in both symptomatic and screening settings, significantly contributing to the expanding body of real-world evidence on CCE. Therefore, we have compiled these studies to provide an overview of key developments, current challenges, and valuable insights they offer into the evolving role of CCE.</p><p><strong>Patients and methods: </strong>We examined three multicenter studies reporting on outcomes of CCE including the NHS England study with 4,878 symptomatic patients; the ScotCap pilot with 316 symptomatic patients; the ScotCap registry with 1,087 predominantly symptomatic patients (95.9%); and the CareForColon 2015 study with 1,790 patients in a screening setting. For the ScotCap pilot study, only symptomatic patients were included.</p><p><strong>Results: </strong>ScotCap pilot reported the highest rate of adequate bowel preparation (79.4%) without using prucalopride. CareForColon2015 achieved a significantly higher rate of complete tests (91.7%) compared with other studies. NHS England reported a notably lower rate of follow-up endoscopy (46.7%), indicating effective patient selection. ScotCap pilot reported one case of missed colorectal cancer. Sensitivity of CCE for detecting polyps ≥ 10 mm ranged from 93.8% to 97.0% on a per-patient basis and from 75.0% to 95.8% on a per-polyp basis in the NHS England and ScotCap trials.</p><p><strong>Conclusions: </strong>These national CCE programs reveal the complexity of large-scale implementation, driven by variations in definitions and protocols. Harmonized quality metrics and shared definitions of success are essential. Efforts should focus on reducing downstream procedures and fostering cross-system learning.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26415952"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728756","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":"Do all trainers think the same? Exploring use of the Think Aloud method to understand colonoscopy trainer thought processes.","authors":"Amy Whitehead, Joe Causer, Melissa Rankin, Kristin McGinty-Minister, Paul O'Toole","doi":"10.1055/a-2633-9032","DOIUrl":"10.1055/a-2633-9032","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colonoscopy is a complex skill to teach. Understanding trainer cognition is an important factor in determining the level of trainer competence. This study aimed to explore colonoscopy trainer thoughts as they observed trainee performance using the Think Aloud method (TA).</p><p><strong>Methods: </strong>Eleven trainers verbalized their thoughts (TA) while watching three video recordings of trainees performing a colonoscopy procedure. TA audio was transcribed verbatim and content was analyzed to determine valence of verbalizations, frequency of verbalized themes, and level of verbalizations in relation to depth of response.</p><p><strong>Results: </strong>Descriptive differences were observed between trainers, highlighting a lack of consistency in relation to their thoughts while observing a trainee perform colonoscopy.</p><p><strong>Conclusions: </strong>This study provides support for use of TA as a method to understand trainer cognition in colonoscopy. It suggests the need for further research to explore consistency of training across trainers.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26339032"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728757","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":"Outcomes and complications of biliary drainage for malignant biliary obstruction: National prospective study.","authors":"Philip R Harvey, Richard Rj Wilkin, Shahd A Mohamed, Sarah Powell-Brett, Siobhan C McKay, Georgia R Layton, Keith Roberts, Nigel Trudgill","doi":"10.1055/a-2558-6754","DOIUrl":"10.1055/a-2558-6754","url":null,"abstract":"<p><strong>Background and study aims: </strong>National data suggest that biliary drainage for malignant obstruction is associated with high complication rates and early mortality. This study examined factors associated with poor outcomes.</p><p><strong>Patients and methods: </strong>RICOCHET was a national, prospective audit of patients with pancreatic cancer or malignant biliary obstruction between April and August 2018. This analysis reviewed outcomes including complications within 7 days and 30-day mortality following biliary drainage and associated factors.</p><p><strong>Results: </strong>Biliary drainage was attempted in 773 patients, of which, 78.7% were successful at first attempt; but if unsuccessful, only 37% of subsequent attempts succeeded. Complications occurred following 11% of endoscopic retrograde cholangiopancreatographies (ERCPs) (including pancreatitis, 5%) and 12% of percutaneous transhepatic biliary drainages (PTBDs) (including cholangitis, 8%). Complications were associated with: potentially resectable cancer (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.23-3.03); more than one biliary drainage attempt (OR 1.69, 95% CI 1.04-2.74); cholangiocarcinoma (OR 2.20, 95% CI 1.20-4.05), or radiological cancer diagnosis (OR 2.02, 95% CI 1.13-3.60). Thirty-day mortality rates following ERCP and PTBD were 21.4% and 21.4%, respectively, in unresectable cancer and 6% and 6.3%, respectively, in potentially resectable cancer. Increased 30-day mortality in patients with unresectable disease was associated with a performance status of 2 or more (HR 3.14 (1.65-5.97)). Thirty-day mortality was significantly higher in patients with unresectable cancer if a multidisciplinary team meeting had not reviewed and advised drainage prior to the procedure 50% vs 20.4% ( <i>P</i> = 0.028).</p><p><strong>Conclusions: </strong>Careful multidisciplinary consideration of risks and potential benefits should be undertaken prior to attempting malignant biliary drainage due to the high risk of complications and early mortality.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25586754"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728763","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":"Effective closure of post-gastric endoscopic submucosal dissection defect using anchor-pronged clip, string-clip, and detachable snare.","authors":"Shoichi Tanaka, Nanami Yamasaki, Kentaro Hamada, Kenji Ota, Yoshiaki Matsumura, Yukiteru Yanabe, Tsuyoshi Fujimoto","doi":"10.1055/a-2633-9122","DOIUrl":"10.1055/a-2633-9122","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26339122"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728758","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":"Interval colorectal cancer: Lesson from looking back.","authors":"Giovanni Aldinio, Helmut Neumann, Luigi Boni, Emanuele Dabizzi, Luca Elli, Marco Maggioni, Gian Eugenio Tontini","doi":"10.1055/a-2638-6322","DOIUrl":"10.1055/a-2638-6322","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26386322"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728761","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 ultrasound-guided gallbladder drainage for distal malignant biliary obstruction: Outcomes from a multicenter cohort.","authors":"Michael Chieng, Tara Fox, Jerry Yung-Lun Chin, Estella Johns, Rees Cameron, Frank Weilert","doi":"10.1055/a-2631-7857","DOIUrl":"10.1055/a-2631-7857","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is described as salvage therapy for patients with distal malignant biliary obstruction (DMBO). However, there is a paucity of data reporting on clinical outcomes for this indication.</p><p><strong>Patients and methods: </strong>A multicenter retrospective review of 26 EUS-GBD cases was performed between 2017 and 2023 at two centers in New Zealand. Efficacy outcomes of technical success (TS), clinical success (CS), length of stay (LOS), and resumption of cancer therapy were recorded. Adverse events (AEs), reinterventions, time to reintervention, and survival also were examined. Reinterventions were categorized into early (< 7 days) or delayed procedures (≥ 7 days).</p><p><strong>Results: </strong>Mean age was 74 years. Pancreatic cancer was the most common diagnosis. All included cases were unresectable and eight of 26 (30.8%) were chemotherapy candidates. TS and CS were achieved in all patients. At 14 days, bilirubin decreased from a mean of 139 to 55 μmol/L, a 60.4% reduction from baseline value. Mean LOS was 3 days. Of eligible patients, 87.5% were able to resume chemotherapy post-procedure. There were no intra-procedural complications nor early reinterventions. Four serious AEs (15.4%) required reintervention; the remaining nine were treated conservatively. Median survival was 103 days.</p><p><strong>Conclusions: </strong>EUS-GBD is a clinically effective salvage therapy for DMBO that may be positioned after unsuccessful endoscopic retrograde cholangiopancreatography or EUS-BD in a single anesthetic session. Most patients have a short LOS and few serious AEs. Furthermore, oncologic therapy can be successfully resumed post-procedure. EUS-GBD, therefore, should be considered an effective, safe, and durable addition to the treatment armamentarium for DMBO.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26317857"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728759","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":"Minor papilla approach improves technical success of nasopancreatic drainage-based pancreatic juice cytology for early pancreatic cancer diagnosis.","authors":"Tatsunori Satoh, Shinya Kawaguchi, Haruna Takahashi, Yuichi Masui, Masanori Matsuda, Asami Kawai, Shinya Endo, Takafumi Kurokami, Naofumi Shirane, Kazuya Ohno","doi":"10.1055/a-2631-7957","DOIUrl":"10.1055/a-2631-7957","url":null,"abstract":"<p><strong>Background and study aims: </strong>Early detection of pancreatic cancer (PC) is vital for improving survival, yet it often relies on indirect imaging findings rather than detection of distinct masses. Recently, pancreatic juice cytology obtained via nasopancreatic drainage (NPD-PJC) has emerged as a valuable diagnostic approach for early-stage disease. However, technical challenges associated with NPD placement remain a significant limitation. This study aimed to assess whether incorporating a minor papilla approach improves the technical success rate for NPD-PJC in patients with suspected early-stage PC.</p><p><strong>Patients and methods: </strong>We conducted a retrospective study of patients scheduled for NPD placement for NPD-PJC between January 2015 and November 2024. Demographic and procedural data were collected, including endoscopic retrograde pancreatography (ERP) findings and outcomes associated with major and minor papilla approaches. Potential risk factors for technical failure and post-ERP pancreatitis (PEP) were evaluated.</p><p><strong>Results: </strong>A total of 81 cases were planned for NPD-PJC within the study period to differentiate early-stage PC. The success rate of the major papilla approach alone was 81.5%, which significantly increased to 93.8% ( <i>P</i> = 0.00157) with the addition of the minor papilla approach. Abnormal ductal configurations were associated with failure of the conventional approach (odds ratio 23.4). The minor papilla approach was not a significant risk factor for PEP, whereas younger age (≤ 70 years) and high body mass index (≥ 25) were identified as PEP risk factors.</p><p><strong>Conclusions: </strong>Incorporating the minor papilla approach substantially improves technical success of NPD-PJC without increasing PEP risk, underscoring the importance of individualized ERP strategies for early-stage PC diagnosis.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26317957"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728762","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":"Utility of a novel tapered-tip sheath system for preoperative mapping biopsy of biliary tract cancers.","authors":"Tomoaki Matsumori, Norimitsu Uza, Kazuhiro Okada, Masahiro Shiokawa, Takahisa Maruno, Yoshihiro Nishikawa, Takeshi Kuwada, Yuya Muramoto, Muneji Yasuda, Hajime Yamazaki, Kojiro Taura, Etsuro Hatano, Yuzo Kodama, Hiroshi Seno","doi":"10.1055/a-2631-7538","DOIUrl":"10.1055/a-2631-7538","url":null,"abstract":"<p><strong>Background and study aims: </strong>Preoperative evaluation of biliary tract cancer progression plays a critical role in assessing resectability and in selecting the appropriate surgical procedure. This study aimed to evaluate the utility of a novel tapered-tip sheath system for mapping biopsy to assess the extent of biliary tract cancer.</p><p><strong>Patients and methods: </strong>This observational, comparative study included 32 patients who were diagnosed with biliary tract cancers and underwent mapping biopsies with the novel tapered-tip sheath system and 21 patients using the conventional methods before the period. Technical success, total biopsy time, number of biopsy specimens, appropriate tissue sampling, adverse events (AEs), and negative surgical margin in case of surgical resection were evaluated.</p><p><strong>Results: </strong>The following were the respective results for the novel system and conventional methods groups: technical success rates, 73.3% and 48.4% ( <i>P</i> = 0.027); total biopsy times, 11.4 and 23.5 minutes ( <i>P</i> = 0.043); median number of specimens obtained per procedure, 6 and 3 ( <i>P</i> < 0.001); appropriate tissue sampling rates, 86.1% and 67.2% ( <i>P</i> < 0.001); AE rates, 2.1% and 0%; and negative surgical margin rates, 90.4% and 78.6%.</p><p><strong>Conclusions: </strong>Preoperative mapping biopsy using the novel tapered-tip sheath system is a promising option for assessing the extent of biliary tract cancers.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26317538"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728765","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":"Pathologic complete response after neoadjuvant therapy for resectable esophageal squamous cell carcinoma: Endoscopic characteristics and implications.","authors":"Peng Yuan, Zongchao Liu, Liang Dai, Yan Yan, Yaya Wu, Keneng Chen, Wenqing Li, Qi Wu","doi":"10.1055/a-2625-5884","DOIUrl":"10.1055/a-2625-5884","url":null,"abstract":"<p><strong>Background and study aims: </strong>This study aimed to identify endoscopic characteristics and develop predictive models for detecting a pathologic complete response (pCR) after neoadjuvant therapy in patients with esophageal squamous cell carcinoma (ESCC).</p><p><strong>Patiens and methods: </strong>This study enrolled 220 patients including a retrospective cohort (n = 158) and a prospective cohort (n = 62), from May 2018 to March 2023 with ESCC who received neoadjuvant chemoimmunotherapy (nCIT) or neoadjuvant chemotherapy (nCT) followed by surgery. Predictive capability of the endoscopic characteristics for pCR was developed and validated using machine learning.</p><p><strong>Results: </strong>All patients underwent endoscopic examinations before surgery but after neoadjuvant therapy. Cohort I was divided into a training set (n = 112) and an internal validation set (n = 46) at a 7:3 ratio. Seven endoscopic features were assessed: scarring; intraepithelial papillary capillary loop (IPCL) type B; depressed mucosa post-tumor disappearance; eroding mucosal changes with an uneven surface; nonsuperficial neoplastic lesions; protruded changes; and presence of cancer cells in biopsy specimens. Using these characteristics as predictors, a multivariate logistic regression model was trained to predict pCR. For further validation, data from prospective Cohorts II and III were incorporated. The model achieved 96.43% accuracy (95% confidence interval [CI] 91.11%-99.02%) in the training set, 93.48% (95% CI 82.10%-98.63%) for internal validation of Cohort I, and 96.77% (95% CI 88.83%-99.61%) in the prospective validation set.</p><p><strong>Conclusions: </strong>Endoscopic characteristics are significant predictors of pCR in patients with ESCC receiving nCIT or nCT. The predictive model demonstrated high accuracy in both derivation and validation cohorts.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26255884"},"PeriodicalIF":2.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728764","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}