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Surveillance colonoscopy in PSC-IBD: Some answers but more questions remain. PSC-IBD的监测结肠镜检查:一些答案,但更多的问题仍然存在。
IF 2.2
Endoscopy International Open Pub Date : 2025-02-06 eCollection Date: 2025-01-01 DOI: 10.1055/a-2514-9742
Nilanga Nishad, Mo Thoufeeq, Sreedhar Subramanian
{"title":"Surveillance colonoscopy in PSC-IBD: Some answers but more questions remain.","authors":"Nilanga Nishad, Mo Thoufeeq, Sreedhar Subramanian","doi":"10.1055/a-2514-9742","DOIUrl":"10.1055/a-2514-9742","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25149742"},"PeriodicalIF":2.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499758","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}
引用次数: 0
Gender disparity in hepatobiliary endoscopy training and delivery: Results of a nationwide survey. 在肝胆内窥镜培训和分娩中的性别差异:一项全国性调查的结果。
IF 2.2
Endoscopy International Open Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1055/a-2505-6019
Sreelakshmi Kotha, Matthew Long, Philip Berry
{"title":"Gender disparity in hepatobiliary endoscopy training and delivery: Results of a nationwide survey.","authors":"Sreelakshmi Kotha, Matthew Long, Philip Berry","doi":"10.1055/a-2505-6019","DOIUrl":"10.1055/a-2505-6019","url":null,"abstract":"<p><strong>Background and study aims: </strong>There are far fewer female, independent endoscopic retrograde cholangiopancreatography (ERCP) practitioners than men in the UK. This study aimed to explore what lies behind the disparity by examining the current state of training, attitudes, and other factors that may influence trainees' decision to pursue ERCP training, with a view to identifying modifiable factors.</p><p><strong>Methods: </strong>Anonymized responses to an electronic survey distributed to gastroenterology trainees and independent ERCP practitioners in the UK were collected and analyzed.</p><p><strong>Results: </strong>Of 214 respondents 45% were female. Whereas gender distribution in non-hepatobiliary therapeutic endoscopy was balanced, only 29% of ERCP trainees were female. Eighty percent of those who worked less than full time (LTFT) were female, but 32% felt that LTFT was incompatible with ERCP training. Concerningly, one-quarter of female respondents reported that they had been discouraged. It was noted that females are often treated differently within endoscopy units, including by patients. Fifty percent of females indicated that radiation exposure affected their decision to train in ERCP, compared with 22% of males. A question specific to trainers revealed that 95% felt that male gender was associated with increased confidence. In free-text responses, valuable insights into trainees' personal experiences were provided, and a selection is presented. Finally, strategies to redress the gender imbalance are proposed.</p><p><strong>Conclusions: </strong>Gender disparity in HPB endoscopy exists and is stark. Underlying this are attitudes, assumptions, and environmental factors that will require systemic and sustained correction. Ideas about how to address this challenge need to be explored.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25056019"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499730","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}
引用次数: 0
Over-the-scope clips vs standard endoscopic interventions for first-line treatment of NVUGI bleeding: Meta-analysis of randomized trials. 超镜夹与标准内窥镜干预在一线治疗NVUGI出血:随机试验的荟萃分析
IF 2.2
Endoscopy International Open Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1055/a-2465-7023
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
{"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}
引用次数: 0
Chromoendoscopy in colorectal surveillance for primary sclerosing cholangitis and inflammatory bowel disease. 彩色内镜在原发性硬化性胆管炎和炎症性肠病的结肠直肠监测中的应用。
IF 2.2
Endoscopy International Open Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1055/a-2518-9380
Rodrigo V Motta, James E East, Emma L Culver
{"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}
引用次数: 0
Novel device for blunt dissection in third space endoscopy: Preliminary animal study (with video). 新型第三空间内窥镜钝性解剖装置:初步动物实验(附视频)。
IF 2.2
Endoscopy International Open Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1055/a-2514-5464
Takashi Yokouchi, Teppei Masunaga, Kurato Miyazaki, Motohiko Kato, Shota Fujii, Kota Momose, Kotaro Yamashita, Takuro Saito, Koji Tanaka, Kazuyoshi Yamamoto, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Hidetoshi Eguchi, Yuichiro Doki, Kiyokazu Nakajima
{"title":"Novel device for blunt dissection in third space endoscopy: Preliminary animal study (with video).","authors":"Takashi Yokouchi, Teppei Masunaga, Kurato Miyazaki, Motohiko Kato, Shota Fujii, Kota Momose, Kotaro Yamashita, Takuro Saito, Koji Tanaka, Kazuyoshi Yamamoto, Tomoki Makino, Tsuyoshi Takahashi, Yukinori Kurokawa, Hidetoshi Eguchi, Yuichiro Doki, Kiyokazu Nakajima","doi":"10.1055/a-2514-5464","DOIUrl":"10.1055/a-2514-5464","url":null,"abstract":"<p><strong>Background and study aims: </strong>Blunt dissection is not commonly performed in flexible endoscopic procedures. We developed a novel blunt dissection device and evaluated its feasibility, safety, and potential effectiveness in third space endoscopy procedures.</p><p><strong>Materials and methods: </strong>The device consists of a cotton swab and a flexible shaft. To evaluate its functionality, creation of 4-cm submucosal tunnels in live swine stomachs was attempted by either blunt dissection using our device or sharp dissection using a standard monopolar knife. Data on factors such as completion rate, operating time, adverse events, necessity of submucosal injection, and dissected submucosal thickness were collected.</p><p><strong>Results: </strong>Eighteen submucosal tunnels were successfully created (sharp: 9, blunt: 9) by two experienced endoscopists and one novice endoscopist. Median operating time was significantly shorter in the blunt dissection group (239 vs. 429 s, <i>P</i> = 0.008). In the sharp dissection group, the experienced endoscopists did not cause any muscle layer injuries, but the novice endoscopist caused muscle layer injuries in all cases. In the blunt dissection group, neither experienced nor novice endoscopists caused muscle layer injuries. The blunt dissection group required significantly fewer submucosal injections (0 vs. 5, <i>P</i> < 0.001). Median dissected submucosal thickness was similar between the groups.</p><p><strong>Conclusions: </strong>Blunt dissection using our device was feasible, safe, and potentially effective in third space endoscopy procedures by shortening operating time, reducing submucosal injections, and potentially minimizing muscle layer injury.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25145464"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499732","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}
引用次数: 0
Endoscopic blind limb reduction with septotomy for the treatment of candy cane syndrome after Roux-en-Y gastric bypass: Pilot feasibility study. Roux-en-Y胃旁路术后盲肢复位联合鼻中隔切开术治疗糖手杖综合征的初步可行性研究。
IF 2.2
Endoscopy International Open Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1055/a-2509-7573
Kambiz Kadkhodayan, Zubair Khan, Shayan Irani, Artur Viana, Saurabh Chandan, Sagar Pathak, Abdullah Abassi, Mustafa A Arain, Maham Hayat, Deepanshu Jain, Dennis Yang, Muhammad Khalid Hasan, Gustavo Bello Vincentelli
{"title":"Endoscopic blind limb reduction with septotomy for the treatment of candy cane syndrome after Roux-en-Y gastric bypass: Pilot feasibility study.","authors":"Kambiz Kadkhodayan, Zubair Khan, Shayan Irani, Artur Viana, Saurabh Chandan, Sagar Pathak, Abdullah Abassi, Mustafa A Arain, Maham Hayat, Deepanshu Jain, Dennis Yang, Muhammad Khalid Hasan, Gustavo Bello Vincentelli","doi":"10.1055/a-2509-7573","DOIUrl":"10.1055/a-2509-7573","url":null,"abstract":"<p><strong>Background and study aims: </strong>Candy cane syndrome (CCS) refers to patients with a long and symptomatic blind afferent roux limb (BARL) after Roux-en-Y gastric bypass (RYGB). Revisional surgery is efficacious but can be cost prohibitive.</p><p><strong>Patients and methods: </strong>We describe endoscopic blind limb reduction (EBLR), that converts the BARL into a \"common channel\" and eliminates food pooling, thereby improving symptoms. Patients that did not have a complete symptomatic response underwent a repeat EBLR or EBLR with septotomy (EBLR-S) based on residual BARL length.</p><p><strong>Results: </strong>Five patients with CCS underwent the EBLR procedure. Mean age was 60.4 years, average BARL length 5.8 cm, and median Charlson comorbidity index was 3. Technical success was achieved in all five patients (100%). Symptom resolution was achieved in all five patients (100%). Two patients required a second procedure.</p><p><strong>Conclusions: </strong>EBLR may be a potentially safe, efficacious, and cost-effective alternative to surgery in patients with CCS. Further prospective studies are needed.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097573"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499771","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}
引用次数: 0
EUS-guided rendezvous is a viable salvage technique for failed billiary cannulation in patients with Roux-en-Y gastric bypass undergoing BAE-ERCP. 在Roux-en-Y胃旁路术行BAE-ERCP的患者中,eus引导的汇合是一种可行的挽救胆道插管失败的技术。
IF 2.2
Endoscopy International Open Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1055/a-2509-7500
Kambiz Kadkhodayan, Sagar Pathak, Saurabh Chandan, Abdullah Abassi, Artur Viana, Maham Hayat, Mustafa A Arain, Natalie Cosgrove, Deepanshu Jain, Dennis Yang, Muhammad Khalid Hasan, Shayan Irani
{"title":"EUS-guided rendezvous is a viable salvage technique for failed billiary cannulation in patients with Roux-en-Y gastric bypass undergoing BAE-ERCP.","authors":"Kambiz Kadkhodayan, Sagar Pathak, Saurabh Chandan, Abdullah Abassi, Artur Viana, Maham Hayat, Mustafa A Arain, Natalie Cosgrove, Deepanshu Jain, Dennis Yang, Muhammad Khalid Hasan, Shayan Irani","doi":"10.1055/a-2509-7500","DOIUrl":"10.1055/a-2509-7500","url":null,"abstract":"<p><strong>Background and study aims: </strong>Biliary cannulation via balloon-assisted-ERCP (BAE-ERCP) can be challenging. Patients with Roux-en-Y gastric bypass (RYGB) have among the lowest reported BAE-ERCP success rates when compared with other types of surgically altered anatomy. We explored the role of EUS-guided rendezvous (EUS-RV) as a rescue technique when BAE-ERCP fails.</p><p><strong>Patients and methods: </strong>Consecutive patients with RYGB underwent BAE-ERCP for both benign and malignant indications. Among them, patients in whom BAE-ERCP failed despite use of conventional advanced biliary cannulation techniques underwent EUS-RV if the ampulla could be reached.</p><p><strong>Results: </strong>Forty-three consecutive patients with RYGB underwent BAE-ERCP. The procedure was successful in 30 patients (69.7%). Among the 13 patients with failed ERCP, EUS-RV was performed in five. Technical success was achieved in all five patients (100%), thereby increasing the overall BAE-ERCP success to 35 patients (81.3%). There were no major procedure-related adverse events on immediate and 3-month follow-up. Average total procedure time for failed BAE-ERCP followed by EUS-RV was 129 minutes (range 47-205 minutes).</p><p><strong>Conclusions: </strong>EUS-RV in patients with RYGB has high technical and clinical success and can be a viable alternative to more invasive options when BAE-ERCP fails using traditional cannulation techniques.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25097500"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11855226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499814","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}
引用次数: 0
Reassessment reveals underestimation of infiltration depth in surgical resection specimens with lymph-node positive T1b esophageal adenocarcinoma. 重新评估发现淋巴结阳性T1b食管腺癌手术切除标本浸润深度低估。
IF 2.2
Endoscopy International Open Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1055/a-2509-7208
Man Wai Chan, Esther A Nieuwenhuis, Sybren L Meijer, Marnix Jansen, Michael Vieth, Mark I van Berge Henegouwen, R E Pouw
{"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}
引用次数: 0
Day before late regimen vs standard split dose of low-volume PEG-CS for early morning colonoscopy: Multicenter randomized controlled trial. 清晨结肠镜检查的前一天晚期方案与标准分剂量小容量PEG-CS:多中心随机对照试验
IF 2.2
Endoscopy International Open Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI: 10.1055/a-2515-8539
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
{"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}
引用次数: 0
Pull-through endoscopic vacuum-assisted closure therapy for complicated leaks of the gastrointestinal tract: Novel technique. 内镜下真空辅助封闭治疗复杂胃肠道渗漏:新技术。
IF 2.2
Endoscopy International Open Pub Date : 2025-01-30 eCollection Date: 2025-01-01 DOI: 10.1055/a-2420-0499
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
{"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}
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