Endoscopy International Open最新文献

{"title":"Endoscopic mucosal resection for Barrett's neoplasia: Long-term outcomes from the largest Canadian single-center experience.","authors":"Yusuke Fujiyoshi, Kareem Khalaf, Daniel Tham, Mary Raina Angeli Fujiyoshi, Catherine J Streutker, Natalia C Calo, Jeffrey D Mosko, Gary R May, Norman E Marcon, Christopher W Teshima","doi":"10.1055/a-2602-8961","DOIUrl":"10.1055/a-2602-8961","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic mucosal resection (EMR) remains an important treatment for high-grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC) in Barrett's esophagus (BE). However, there are limited data regarding long-term recurrence rates. This study aimed to investigate the neoplasia recurrence rate following EMR with long-term follow-up.</p><p><strong>Methods: </strong>This was a retrospective cohort study at a tertiary-referral center in Canada. Patients with Barrett's neoplasia (HGD/EAC) treated with EMR between January 2001 and December 2023 were included. The primary outcome was long-term neoplasia recurrence rate after complete remission of neoplasia (CRN). Secondary outcomes were residual/metachronous neoplasia rate at first follow-up, CRN rate, and long-term rate of patients successfully managed by endoscopy.</p><p><strong>Results: </strong>A total of 552 patients (83.7% male, mean age 66.3 years) were included (HGD: 22.5%, EAC: 77.5%). After EMR, 475 patients were deemed to have had successful endoscopic resection (low lymph-node metastasis risk with tumor-free deep margin), 455 of whom underwent surveillance follow-up. At first follow-up, residual/metachronous neoplasia was observed in 20.9% (95/455), but 95.6% (435/455) eventually achieved CRN after undergoing a median of two EMR sessions (interquartile range: 1-4). As a primary outcome, the 5-year neoplasia recurrence rate was 10.5%, the 10-year rate was 21.6%, and the 15-year rate was 34.9%. During surveillance, neoplasia recurrence was observed in 38 patients, but 68.4% of them (26/38) were managed with endoscopic therapy. The overall rate of patients successfully managed by endoscopy was 93.0% (423/455).</p><p><strong>Conclusions: </strong>While the success rate of EMR for BE is excellent, this study highlights substantial long-term risk of neoplastic recurrence, underscoring the need for indefinite surveillance for patients who had HGD or EAC.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26028961"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559508","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":"Novel application of multi-loop traction device and threaded clip in gastric endoscopic submucosal dissection.","authors":"Hossam El-Din Shaaban, Keisaku Yamada, Masahiro Tajika, Tsutomu Tanaka, Nobuhito Ito, Akihiro Takagi, Yasumasa Niwa","doi":"10.1055/a-2623-4478","DOIUrl":"10.1055/a-2623-4478","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26234478"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559517","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":"Between hype and hard evidence: Are large language models ready for implementation in surveillance colonoscopy?","authors":"Marco Bustamante-Balén","doi":"10.1055/a-2604-7345","DOIUrl":"10.1055/a-2604-7345","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26047345"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559492","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":"Does development of submucosal dissection models influence quality of training? Comparison of existing models.","authors":"Clara Yzet, Jérémie Jacques, Pierre Lafeuille, Jérémie Albouys, Jean-Baptiste Chevaux, Emmanuel Coron, Stanislas Chaussade, Sarah Leblanc, Vincent Lepilliez, Thimothee Wallenhorst, Thierry Ponchon, Jérôme Rivory, Romain Legros, Michel Lefranc, Marion Schaefer, Mathieu Pioche","doi":"10.1055/a-2621-5244","DOIUrl":"10.1055/a-2621-5244","url":null,"abstract":"<p><strong>Background and study aims: </strong>Use of endoscopic submucosal dissection (ESD) is growing, but access to it remains limited. The aim of this study was to compare the performance of various existing models and the progress made by students on them.</p><p><strong>Methods: </strong>Four training models (bovine colon (ex-vivo), ex vivo porcine model, live porcine model, and an artificial model (Endogel)) were evaluated during a 1-week training course. Each participant was evaluated at the beginning (D1) and at the end of the training (D5). Learners performed a standardized ESD of 2 cm on the four models in a randomized order. Experts evaluated the ability of participants to perform ESD using the objective structured assessment of technical skill score (OSATS).</p><p><strong>Results: </strong>Sixteen students were involved, the average age was 35.6 years (+/- 4.6) and they practiced endoscopy for 10 years (+/-5.3). The OSATS significantly increased in each model during the week, with mean scores increasing from 8.6 to 23.3, from 10.7 to 12.9, from 8.8 to 21.3 and from 8.2 to 12.5 for the bovine colon, ex vivo porcine model, live porcine model, and Endogel models, respectively.</p><p><strong>Conclusions: </strong>Ex-vivo models are good models for learning ESD skills. The bovine colon model seems to be the most discriminating. Synthetic models should be reserved for novices.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26215244"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of real-time artificial intelligence-assisted anatomical structure recognition during endoscopic submucosal dissection.","authors":"Markus Wolfgang Scheppach, Hon Chi Yip, Yueyao Chen, Hongzheng Yang, Jianfeng Cao, Tiffany Chua, Qi Dou, Helen Mei Ling Meng, Yeung Yam, Philip W Chiu","doi":"10.1055/a-2615-8008","DOIUrl":"10.1055/a-2615-8008","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic submucosal dissection (ESD) is a challenging minimally invasive resection technique with a long training period and relevant operator-dependent complications. Real-time artificial intelligence (AI) orientation support may improve safety and intervention speed.</p><p><strong>Methods: </strong>A total of 1011 endoscopic still images from 30 ESDs were annotated for relevant anatomical structures and used for training of a deep learning algorithm. After internal and external validation, this algorithm was applied to 12 ESDs performed by either one expert or one novice in ESD using an in vivo porcine model.</p><p><strong>Results: </strong>External validation yielded mean Dice Scores of 88%, 60%, 58%, and 92% for background, submucosal layer, submucosal blood vessels, and muscle layer, respectively. The system was successfully applied during all 12 ESDs. All resections were completed en bloc and without complications.</p><p><strong>Conclusions: </strong>In this proof-of-concept study, feasibility of a real-time AI algorithm for anatomical structure delineation and orientation support during ESD was evaluated. The application proved safe and appropriate for routine procedures in humans. Further studies are needed to elucidate a potential clinical benefit of this new technology.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26158008"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559512","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":"Comparing ChatGPT3.5 and Bard recommendations for colonoscopy intervals: Bridging the gap in healthcare settings.","authors":"Maziar Amini, Patrick W Chang, Rio O Davis, Denis D Nguyen, Jennifer L Dodge, Jennifer Phan, James Buxbaum, Ara Sahakian","doi":"10.1055/a-2586-5912","DOIUrl":"10.1055/a-2586-5912","url":null,"abstract":"<p><strong>Background and study aims: </strong>Colorectal cancer is a leading cause of cancer-related deaths, with screening and surveillance colonoscopy playing a crucial role in early detection. This study examined the efficacy of two freely available large language models (LLMs), GPT3.5 and Bard, in recommending colonoscopy intervals in diverse healthcare settings.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted using data from routine colonoscopies at a large safety-net and a private tertiary hospital. GPT3.5 and Bard were tasked with recommending screening intervals based on colonoscopy reports and pathology data and their accuracy and inter-rater reliability were compared to a guideline-directed endoscopist panel.</p><p><strong>Results: </strong>Of 549 colonoscopies analyzed (N = 268 at safety-net and N = 281 private hospital), GPT3.5 showed better concordance with guideline recommendations (GPT3.5: 60.4% vs. Bard: 50.0%, <i>P</i> < 0.001). In the safety-net hospital, GPT3.5 had a 60.5% concordance rate with the panel compared with Bard's 45.7% ( <i>P</i> < 0.001). For the private hospital, concordance was 60.3% for GPT3.5 and 54.3% for Bard ( <i>P</i> = 0.13). GPT3.5 showed fair agreement with the panel (kappa = 0.324), whereas Bard displayed lower agreement (kappa = 0.219). For the safety-net hospital, GPT3.5 showed fair agreement with the panel (kappa = 0.340) whereas Bard showed slight agreement (kappa = 0.148). For the private hospital, both GPT3.5 and Bard demonstrated fair agreement with the panel (kappa = 0.295 and 0.282, respectively).</p><p><strong>Conclusions: </strong>This study highlights the limitations of freely available LLMs in assisting colonoscopy screening recommendations. Although the potential of freely available LLMs to offer uniformity is significant, the low accuracy, as noted, excludes their use as the sole agent in providing recommendations.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25865912"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559495","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":"Ex vivo evaluation of a novel through-the-scope traction device for endoscopic submucosal dissection.","authors":"Ludovico Alfarone, Roberto De Sire, Boris Rosenbaum, Ali Aidibi, Christophe Cellier, Cesare Hassan, Alessandro Repici, Gabriel Rahmi, Roberta Maselli","doi":"10.1055/a-2576-5837","DOIUrl":"10.1055/a-2576-5837","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopic submucosal dissection (ESD) is a technique used for resection of large neoplastic lesions, providing great oncological outcomes. However, ESD is technically challenging with a long learning curve, high complication rates, and extended procedure times. To address these limitations, various traction-assisted methods have been developed. This study evaluated a novel through-the-scope traction device (TRACMOTION, Fujifilm, Japan), which offers consistent and adjustable traction, in a pilot multicenter randomized ex vivo trial.</p><p><strong>Patients and methods: </strong>The study included six endoscopists with limited ESD experience performing ESD on ex vivo porcine stomach models. Participants were randomized into two groups: those using TRACMOTION-assisted ESD (TM-ESD) and those performing conventional ESD (C-ESD). Each trainee completed six procedures, split equally between both groups. The primary outcome was resection speed, whereas secondary outcomes included en bloc, R0 resection rates, perforation rates, and rates of speedy procedures (>20 mm²/min).</p><p><strong>Results: </strong>The TM-ESD group achieved a higher median resection speed of 20.75 mm²/min (95% confidence interval [CI] 14.56-29.25) in comparison to 15.10 mm²/min (95% CI 12.8-16.6) in the C-ESD group ( <i>P</i> =0.02). Perforation rates were significantly lower in the TM-ESD group (11.1% (95% CI 0.01-0.34) vs. 61.1% (95% CI 0.35-0.82; <i>P</i> =0.0002). No significant differences were observed in en bloc or R0 resection rates between the groups.</p><p><strong>Conclusions: </strong>TRACMOTION significantly improves the efficiency of ESD, reducing procedure time and complication rates. This traction device could potentially facilitate broader adoption of ESD in clinical practice. However, further research in human trials is necessary to validate these findings.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25765837"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559510","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":"Implementing endoscopy video recording in routine clinical practice: Strategies from three tertiary care centers.","authors":"Jonas L Steinhäuser, Tyler M Berzin, Mark E Geissler, Cornelius Weber, Nora Herzog, Maxime Le Floch, Stefan Brückner, Jochen Hampe, Sami Elamin, Joel Troya, Alexander Hann, Franz Brinkmann","doi":"10.1055/a-2592-3338","DOIUrl":"10.1055/a-2592-3338","url":null,"abstract":"<p><strong>Background and study aims: </strong>Endoscopy video recordings are valuable data for training and deploying artificial intelligence (AI) models. However, collecting these data is challenging and time-consuming, demanding new workflows and robust data management strategies.</p><p><strong>Methods: </strong>Here, we outline the challenges associated with routinely recording endoscopy data in clinical practice and share experiences and solutions from three endoscopy centers in Germany and the United States.</p><p><strong>Results: </strong>Each center uses a recording setup tailored to specific needs of that endoscopy unit. Common challenges include integrating with the hospital's electronic health records, automating video recording, and addressing data privacy concerns. In all cases, having dedicated research staff to manage daily operations has proven essential for successful implementation.</p><p><strong>Conclusions: </strong>By describing successful strategies, we aim to inspire gastroenterology divisions worldwide to adapt routine video recording for endoscopy procedures, thereby increasing the volume and diversity of datasets necessary for developing clinically impactful AI applications.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25923338"},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559514","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":"Internal traction in endoscopic full-thickness resection for gastric subepithelial lesions arising from the muscularis propria: Comparative study.","authors":"Jun Li, Xiaojia Hou, Kan Chen, Kangsheng Peng, Chao Huang, Feng Liu","doi":"10.1055/a-2544-2572","DOIUrl":"10.1055/a-2544-2572","url":null,"abstract":"<p><strong>Background and study aims: </strong>Effective tissue traction is crucial for gastric endoscopic full-thickness resection (EFTR) to ensure a clear visual field for the dissection site. We aimed to evaluate the effectiveness of internal traction using a novel clip-with-spring device in assisting gastric EFTR.</p><p><strong>Patients and methods: </strong>Twenty-six patients with gastric subepithelial lesions from the muscularis propria were enrolled for internal traction-assisted EFTR (IT-EFTR) and 26 patients for non-assisted EFTR (NA-EFTR) were enrolled as controls.</p><p><strong>Results: </strong>Average tumor size was 1.5 ± 0.4 cm. All EFTRs were completed successfully with an average total procedure time of 62.4 ± 43.0 minutes and perforation time of 37.2 ± 29.9 minutes. En bloc resection was achieved in 50 patients (96.2%). IT-EFTR significantly improved serosa exposure score (3.4 ± 0.9 vs. 1.9 ± 0.7, <i>P</i> <0.001) and shortened total procedure time (33.0 ± 21.8 vs. 91.8 ± 38.6 min, <i>P</i> <0.001) and perforation time (19.0 ± 18.8 vs. 55.5 ± 27.8 min, <i>P</i> <0.001) compared with NA-EFTR. There were no significant differences in complication rates between the two groups. However, visual analogue score after the procedure was significantly lower (4.2 ± 1.0 vs. 4.7 ± 0.7, <i>P</i> =0.037) and postoperative hospital stay (3.7 ± 2.1 vs. 4.8 ± 1.3, <i>P</i> =0.038) was significantly shorter in the IT-ERTR group than in the NA-EFTR group.</p><p><strong>Conclusions: </strong>Internal traction using the novel clip-with-spring device could significantly improve safety and efficacy of gastric EFTR in the distal stomach.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a25442572"},"PeriodicalIF":2.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648864","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":"Correction: Pilot evaluation of a novel, automated ergonomics assessment tool.","authors":"Bara El Kurdi, Sumbal Babar, Ali Soroush, Jay Bapaye, Reid D Wasserman, Juan Echavarria, Omer Shahab, Cameron Locke, Jamie Yang, Michael Koachman, Klaus Mönkemüller, Aasma Shaukat","doi":"10.1055/a-2625-8430","DOIUrl":"10.1055/a-2625-8430","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2568-9610.].</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"13 ","pages":"a26258430"},"PeriodicalIF":2.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12417779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039346","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}