Endoscopy International Open最新文献

{"title":"Bridging the gap in gastrointestinal healthcare in a resource-limited setup: Feasibility study of weekend endoscopy services in Southwest Ethiopia.","authors":"Guda Merdassa Roro, Elias Merdassa Roro, Tsegaye Melaku, Esayas Kebede Gudina","doi":"10.1055/a-2625-6225","DOIUrl":"10.1055/a-2625-6225","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopy is essential for diagnosis and management of gastrointestinal disorders. However, its accessibility in Africa is limited by the need for extensive training and costly equipment. This study aimed to assess the feasibility of a weekend outreach endoscopy service led by a trained gastroenterologist in southwest Ethiopia, where endoscopy services were previously unavailable.</p><p><strong>Patients and methods: </strong>A weekend outreach endoscopy service was launched in 2019 at a primary hospital in Jimma City, located 360 km from Addis Ababa. Procedures were performed using the Fujinon EPX-2500-HD system. Demographic data, endoscopy findings, and histology results were documented electronically. Findings were compared with those from four Ethiopian referral hospitals offering full-time endoscopy services.</p><p><strong>Results: </strong>A total of 2165 esophagogastroduodenoscopies (EGDs) were performed with a diagnostic yield of 93.3%. The most common indications for EGD were dyspepsia (53.7%) and dysphagia (17.0%). Patients who underwent endoscopy for alarm symptoms as an indication had a 77% to 83% chance of having a major finding compared with those with dyspepsia without an alarm symptom (24%). Squamous cell carcinoma (40.2%), adenocarcinoma (29.6%), and chronic nonspecific inflammation (16.2%) were the predominant histologic findings among those who had a biopsy (n = 425).</p><p><strong>Conclusions: </strong>The study demonstrates the feasibility and effectiveness of a weekend outreach endoscopy service led by a trained gastroenterologist in a rural Ethiopian setting. The unexpectedly high prevalence of upper gastrointestinal disorders, including cancers, and the long duration of symptoms before endoscopy likely reflect delayed diagnoses due to limited access to endoscopy. Moreover, presence of alarm symptoms predicted major endoscopic findings. Expanding endoscopy services, increasing public awareness, and further research into risk factors and preventive strategies for these diseases are recommended.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26256225"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559494","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":"Effectiveness and safety of endoscopic submucosal dissection for residual or recurrent colorectal neoplasia: Meta-analysis.","authors":"Maximilian Eisele, Alessandra Ceccacci, Mehul Gupta, Emily Heer, Sherif Elhanafi, Saowanee Ngamruengphong, Nirav Thosani, Jordan Iannuzzi, Puja Kumar, Paul Belletrutti, Richdeep Gill, Nauzer Forbes","doi":"10.1055/a-2606-0982","DOIUrl":"10.1055/a-2606-0982","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic submucosal dissection (ESD) is a potentially surgery-sparing technique for colorectal neoplasia resection. Outcomes of ESD for residual or recurrent colorectal neoplasia are not well described. This meta-analysis aimed to evaluate the effectiveness and safety of ESD in treating residual or recurrent colorectal neoplasia.</p><p><strong>Patients and methods: </strong>We searched MEDLINE and Embase up to July 24, 2023 for studies on ESD for residual or recurrent colorectal neoplasia at prior surgery or endoscopic resection sites. The primary outcome of the meta-analysis was R0 resection; secondary outcomes included recurrence, adverse events (AEs), procedure time, and hospitalization length. Pooled effect sizes were obtained using inverse variance random effects models. Subgroup analyses were based on study location, lesion size, and endoscopist experience.</p><p><strong>Results: </strong>From 1,133 abstracts, data from 25 observational studies were included, reporting on 863 residual or recurrent lesions treated with ESD. R0 resection was achieved in 80.7% of patients (95% confidence interval 72.7-86.7%, I ² = 81%) of patients, whereas recurrence occurred in 2.0% (0.7-5.1%, I ² = 0%). Incidence of delayed bleeding and delayed perforation were 1.8% (0.7-4.2%, I ² = 0%) and 1.9% (0.6-6.3%, I ² = 35%), respectively. The former was independent of country of study, recurrent lesion size, or endoscopist experience. Mean procedure duration was 80.4 minutes (66.6-94.2, I ² = 96%) and hospitalization length was 4.2 days (2.0-6.4, I ² = 98%).</p><p><strong>Conclusions: </strong>This meta-analysis suggests that ESD is effective and safe for treating residual or recurrent colorectal neoplasia after previous resection, with further prospective validation studies needed to compare ESD with other endoscopic resection methods and surgery in this context.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26060982"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559498","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":"Retrospective study comparing rectal endoscopic submucosal dissection with and without Foley catheter drainage tube placement.","authors":"Yuka Kagaya, Hiroaki Ishii, Yoshikazu Hayashi, Hiroki Hayashi, Satoshi Sato, Stefano Kayali, Kohei Suzuki, Takaaki Morikawa, Masahiro Okada, Takahito Takezawa, Ayman Qawasmi, Keijiro Sunada, Hirotsugu Sakamoto, Tomonori Yano, Hironori Yamamoto","doi":"10.1055/a-2631-7694","DOIUrl":"10.1055/a-2631-7694","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic submucosal dissection (ESD) is a minimally invasive and effective treatment for rectal tumors but maintaining a clear surgical field during the procedure is challenging, especially for novice operators. This study aimed to investigate whether continuous drainage using a Foley catheter could enhance efficiency and safety of rectal ESD performed by novice endoscopists under expert supervision.</p><p><strong>Patients and methods: </strong>This retrospective study involved 26 patients who underwent rectal ESD between March 2023 and October 2024. Patients were divided into two groups: those who received continuous drainage with Foley catheter placement (n = 12) and those who did not (n = 14). Key outcomes evaluated were dissection speed, total procedure time, R0 resection rates (complete tumor resection with clear margins), and occurrence of any adverse events (AEs) during or after the procedure. All procedures were performed by novice endoscopists under expert guidance.</p><p><strong>Results: </strong>The results showed that dissection speed was significantly higher in the Foley catheter group, with a median of 18.6 mm²/min compared with 10.5 mm²/min in the non-catheter group ( <i>P</i> = 0.027). Although total procedure time and sodium hyaluronate usage were lower in the catheter group, these differences were not statistically significant. Importantly, no AEs were reported in either group.</p><p><strong>Conclusions: </strong>Foley catheter placement notably improved efficiency of rectal ESD performed by novice endoscopists, particularly by increasing dissection speed. This technique may contribute to safer and more effective ESD. However, larger studies are needed to confirm these findings and further assess their benefits.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26317694"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559530","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":"Exegesis on using a customized GPT to provide guideline-based recommendations for the management of pancreatic cystic lesions.","authors":"Ilker Sengul, Demet Sengul","doi":"10.1055/a-2605-1215","DOIUrl":"10.1055/a-2605-1215","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26051215"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559511","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":"Mobile health technology in quality assessment of pediatric ileocolonoscopy: Results of the SIGENP national program.","authors":"Salvatore Oliva, Giusy Russo, Lucia Cococcioni, Francesca Destro, Marco Deganello Saccomani, Claudia Banzato, Barbara Parma, Giulia Franchino, Giovanni Di Nardo, Emanuele Nicastro, Paolo Orizio, Emanuele Dabizzi, Giorgio Raffaele Fava, Andrea Chiaro, Maristella Pellegrino, Fabiola Fornaroli, Antonio Pizzol, Caterina Strisciuglio, Caterina Pacenza, Sara Renzo, Cosimo Ruggiero, Francesco Morotti, Lorenzo Norsa","doi":"10.1055/a-2592-2914","DOIUrl":"10.1055/a-2592-2914","url":null,"abstract":"<p><strong>Background and study aims: </strong>Currently, there is no formal quality assessment of pediatric gastrointestinal endoscopy. We innovatively used mobile health (mHealth) technology to determine the quality of pediatric ileocolonoscopy (IC) in Italy.</p><p><strong>Methods: </strong>Between April 2019 and March 2021, we prospectively collected data (demographics, procedure information, pre/intra/post-procedure indicators, patient satisfaction questionnaires) from the Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition using the ENDO-PED mobile app.</p><p><strong>Results: </strong>Of 3410 registered procedures, 827 ICs were analyzed. Mean patient age was 11.1 ± 4.7 years. The most frequent indication was IBD follow-up or diagnosis (57.9%). Therapeutic ICs accounted for 11%, with polypectomy being the most common procedure. Among pre-procedure indicators, waiting time < 30 days was reported in 70.7%, informed consent was signed in 99.8% of cases, and 90.8% of patients completed > 90% of bowel preparation. In terms of intra-procedure indicators, deep sedation was the most commonly used method (77.8%). A high level of bowel cleansing was achieved in 87.4% of patients, with a terminal ileal (TI) intubation rate of 91.6%. Mean IC time with and without TI intubation was 24.2 ± 15.5 and 22.6 ± 15.6 minutes, respectively ( <i>P</i> =0.2). Regarding post-procedure indicators, late complications occurred in three children (0.4%), and a final report was issued in 96% of cases, with 67.2% being completed after more than 15 days.</p><p><strong>Conclusions: </strong>mHealth was effective in assessing the quality of pediatric endoscopy. Levels of bowel preparation, sedation, TI intubation rate, and safety were adequate in Italy, whereas waiting time and post-procedure communication seemed to be the most critical areas of concern.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25922914"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559515","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":"Positive provocative testing and symptom evaluation for detecting upper extremity repetitive use injuries among endoscopists.","authors":"Gregory Toy, Elizabeth Cardell, John C Fang, Jamie Latham, Natalie Mudrow, Kathryn Byrne, Daryl Ramai","doi":"10.1055/a-2606-1076","DOIUrl":"10.1055/a-2606-1076","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopists have reported experiencing musculoskeletal pain, yet a comprehensive and objective investigation into repetitive use symptoms or injuries has not been conducted. We aimed to evaluate a cohort of endoscopists for upper extremity repetitive use injury.</p><p><strong>Methods: </strong>We employed a 43 author-developed questionnaire as well as the validated QuickDASH (Disability of Arm, Shoulder, Hand) questionnaire. Subjects were evaluated by occupational therapists to identify clinical evidence of injury. Demographic factors, reported symptoms, and signs of injury were then analyzed.</p><p><strong>Results: </strong>Overall, 34.3% reported experiencing pain while 17.1% reported numbness. In the prior week, 48.5% of participants had been bothered by pain, 11.4% felt tingling, 17.1% experienced interrupted sleep, and 17.1% reported limitations in work duties. Physical testing revealed that many endoscopists had below-normal strength in their right grip (48.6%) and left grip (42.9%), and 88.6% had below-normal pinch strengths for their age and gender. In addition, 71.4% of the group had at least one abnormal positive provocative test. Participants who reported numbness at night ( <i>P</i> = 0.015) and those who reported current pain ( <i>P</i> < 0.001) reported higher DASH disability scores. Current pain was also associated with performing 20+ procedures per week ( <i>P</i> = 0.007). Those with a positive provocative test of the neck or elbow were likely to have below-normal pinch ( <i>P</i> < 0.05) and grip strength ( <i>P</i> < 0.05). Performing ERCP 20% to 60% of the week was more likely to result in decreased bilateral pinch strength.</p><p><strong>Conclusions: </strong>Our study found a high prevalence of repetitive use injury symptoms among endoscopists, corroborated by objective physical examination and testing.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26061076"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559518","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":"Radiofrequency ablation: Solution for a long-time therapeutic dilemma of chronic radiation proctitis?","authors":"Katharina Esswein, Marijana Ninkovic, Veronika Kröpfl, Elisabeth Gasser, Christoph Profanter","doi":"10.1055/a-2605-1079","DOIUrl":"10.1055/a-2605-1079","url":null,"abstract":"<p><strong>Background and study aims: </strong>Chronic radiation proctitis is a prevalent condition following pelvic radiation therapy, occasionally leading to significant blood loss. Although medical treatment and argon plasma coagulation (APC) are well-established options, endoscopic radiofrequency ablation (RFA) is an emerging treatment that has shown promising results in smaller studies. However, further research, particularly on long-term outcomes, is necessary. This study aimed to evaluate the treatment outcome of endoscopic RFA in patients with chronic radiation proctitis, with a particular focus on long-term outcome.</p><p><strong>Patients and methods: </strong>This retrospective study included all patients treated with RFA for radiation-induced chronic proctitis suffering from hematochezia at the Medical University of Innsbruck, Department of Visceral, Transplant and Thoracic Surgery, between 2018 and 2023.</p><p><strong>Results: </strong>Thirteen patients were included in the study, with RFA being the initial treatment in five cases. RFA sessions were performed once in nine patients, twice in three patients, and three times in one patient. After a median follow-up period of 58 months, 69.2% (n= 9) remained still symptom-free and 30.8% (n= 4) reported only mild rectal bleeding after hard stools.</p><p><strong>Conclusions: </strong>These data indicate that RFA is a highly effective and safe treatment option for chronic radiation proctitis, providing excellent long-term results.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26051079"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559528","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 retrograde cholangiopancreatography services in Sudan during wartime: Innovations in crisis.","authors":"Abdelmounem Abdo, Salah Dafalla, Mohammed Bushra, Rodwan Mustafa, Reem Hamad, Ahmed Rafei, Mohamed Jaafer, Rawan Bidab, Waleed Gamus Ojan, Mohammed Ganim, Hala Abdalla","doi":"10.1055/a-2621-5666","DOIUrl":"10.1055/a-2621-5666","url":null,"abstract":"<p><p>​Endoscopic retrograde cholangiopancreatography (ERCP) services in Africa have expanded in recent years, aiming to enhance healthcare infrastructure. ERCP, combining endoscopy and fluoroscopy, diagnoses and treats biliary and pancreatic ductal system conditions. Expanding these services addresses healthcare access disparities between urban and rural populations. ERCP services are well-established primarily in South Africa and Egypt. Countries like Nigeria, Uganda, Rwanda, Ethiopia, and Kenya have sustained ERCP services over the past 5 years. This paper examines the need to expand ERCP services as a step toward health equity in Africa. In Sudan, ERCP services began in 1982 at Soba University Hospital, followed by Ibnsina Specialized Hospital. Before the conflict, only seven centers in Khartoum offered ERCP services. The war that started in April 2023 severely disrupted healthcare services, including ERCP. The National Center for Gastrointestinal and Liver Diseases relocated to Madani City in June 2023, resuming ERCP services by July. By December 2023, 375 procedures were performed. Following further conflict, services moved to Kassala City, where 420 ERCP cases were completed between March and December 2024.​ Innovative solutions addressed challenges such as equipment compatibility and accessory availability. A fluoroscopy machine was adapted from a non-functional urology lithotripsy system, and locally designed tables improved procedural efficiency. Development of a local scoring system for trainee assessment after 50 supervised procedures aims to establish a sustainable ERCP fellowship program, addressing the shortage of specialists. These efforts highlight resilience and innovation in delivering ERCP services during conflict.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26215666"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559509","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":"Reply to: Exegesis on using a customized GPT to provide guideline-based recommendations for management of pancreatic cystic lesions.","authors":"Yuri Gorelik","doi":"10.1055/a-2605-1278","DOIUrl":"10.1055/a-2605-1278","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26051278"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559529","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":"Gastroesophageal reflux disease over time in endoscopic versus surgical myotomy for treatment of achalasia: Systematic review and meta-analysis.","authors":"Angelo So Taa Kum, Beanie Conceição Medeiros Nunes, Eduardo Turiani Hourneaux Moura, Matheus Cavalcante Franco, Eduardo Guimarães Hourneaux de Moura","doi":"10.1055/a-2621-5421","DOIUrl":"10.1055/a-2621-5421","url":null,"abstract":"<p><strong>Background and study aims: </strong>Achalasia, a motor disorder of the esophagus, is treated with peroral endoscopic myotomy (POEM) or Heller myotomy with fundoplication (HMF). Although POEM lacks an antireflux mechanism, potentially increasing postoperative gastroesophageal reflux disease (GERD), limiting the endoscopic approach, this difference in GERD tends to diminish over time. The objective of this study was to compare GERD over time, the need for regular gastric acid suppression therapy (GAST), effectiveness, and safety between POEM and HMF in treating achalasia.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted by searching mainly in MEDLINE, EMBASE, and ClinicalTrials.gov. Primary outcomes included early (< 12 months) and late (≥ 12 months) evaluations of postoperative GERD based on endoscopic criteria of the Lyon Consensus 2.0, and GAST. Secondary outcomes included clinical success (Eckardt score ≤ 3), procedure time, length of stay, and major adverse events (AEs) (Clavien-Dindo classification ≥ 2).</p><p><strong>Results: </strong>Thirty-two observational studies and two randomized trials were included, totaling 14,125 patients. GERD was higher in POEM in early evaluation (risk ratio [RR] = 3.03; <i>P</i> P < 0.01). GERD occurrence was similar between POEM and HMF in the late evaluation ( <i>P</i> = 0.30). Higher GAST was observed in POEM (RR = 1.35; <i>P</i> = 0.02). Secondly, clinical success was higher in POEM (RR = 1.06; <i>P</i> = 0.01), with shorter procedure time (median 39.53 minutes; <i>P</i> < 0.01) and shorter length of stay (mean different = -0.51 day; <i>P</i> = 0.03), with similar major AEs ( <i>P</i> = 0.81) compared with HMF.</p><p><strong>Conclusions: </strong>A higher rate of early GERD is observed in POEM compared with HMF, with the difference waning over time and reaching equivalence after 12 months, despite a higher rate of GAST in the endoscopic group. POEM also exhibited effectiveness and safety comparable to the surgical approach.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26215421"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559513","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}