Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Endoscopic Papillary Balloon Dilation Versus Small Endoscopic Sphincterotomy for Endoscopic Retrograde Cholangiopancreatography-Related Adverse Events in Patients With Non-Dilated Distal Bile Duct.","authors":"Lili Gao, Huafang Yan, Limei Bu, Hao Zhang","doi":"10.1097/SLE.0000000000001200","DOIUrl":"10.1097/SLE.0000000000001200","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic papillary balloon dilation (EPBD), small endoscopic sphincterotomy (EST), and small EST plus EPBD are commonly used as rescue techniques to remove bile duct stones. However, we often encountered challenging cases with non-dilated distal bile ducts, especially in those undergoing EPBD. We aimed to explore the reasons by assessing whether patients without the dilated bile duct had a higher risk of early complications and whether it was impacted by the rescue techniques.</p><p><strong>Methods: </strong>We performed a retrospective cohort study by frequency matching design in patients diagnosed with stones in non-dilated distal bile duct who received rescue techniques from July 2016 to June 2022. Besides, patients with stones and without dilatation of the distal bile duct (DDBD) were divided into 3 subgroups according to the rescue technique received. Outcomes were compared between the subgroups.</p><p><strong>Results: </strong>The non-DDBD group was more likely to develop post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) and hyperamylasemia (HP) than the DDBD group ( P < 0.05). Some cases had mild or moderate pancreatitis, but no one in either group developed severe pancreatitis. For subgroup analysis, each technique resulted in complete stone removal; the EPBD group had a higher HP rate than the other subgroups and reached statistical significance: the EPBD group versus the small EST group ( P = 0.013) and the EPBD group versus the EPBD plus small EST group ( P = 0.008). Although there was no statistical significance, PEP incidence in the EPBD group was 13.7% higher than in other subgroups ( P > 0.05/3).</p><p><strong>Conclusion: </strong>Non-DDBD patients have a higher risk for endoscopic retrograde cholangiopancreatography-related pancreatic inflammation. EPBD should be used cautiously due to the significant association with increased rates of PEP and HP. Conversely, small EST and combination therapy are suitable for non-dilated bile duct stones because of their high safety profile and efficacy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Robotic Valvuloplastic Esophagogastrostomy Technique After Proximal Gastrectomy: A Safety and Feasibility Study.","authors":"Neda Amini, Takahiro Kinoshita, Manuel Arrieta, Mitsumasa Yoshida, Hiromi Nagata, Takumi Habu, Masaru Komatsu, Masahiro Yura","doi":"10.1097/SLE.0000000000001322","DOIUrl":"10.1097/SLE.0000000000001322","url":null,"abstract":"<p><strong>Background: </strong>Esophagogastrostomy is one of the reconstruction techniques after proximal gastrectomy, but reflux and esophagitis are significant concerns. We introduced a new robotic valvuloplasty technique (single-flap), taking advantage of robotic surgery to address these issues and simplify the technique, especially for tumors with esophageal invasion.</p><p><strong>Methods: </strong>Between March 2022 and March 2024, patients who underwent robotic proximal gastrectomy with the single-flap technique were included. Based on the difficulty of the surgery, patients were divided into 2 groups: one with esophageal invasion requiring anastomosis in the mediastinum and the second group with tumors in the upper third of the stomach requiring anastomosis in the abdomen.</p><p><strong>Results: </strong>A total of 22 patients were included: 13 in the esophageal invasion group and 9 in the upper stomach group. The median size of esophageal invasion was 2 cm (1 to 3 cm). The median operative time was 320 minutes (esophageal invasion 326 vs. upper stomach 280 min, P =0.51), with a median blood loss of 35 g (31 vs. 38 g, P =0.19). No postoperative mortality, anastomotic leaks, reflux symptoms, or pancreatic fistulas were observed. Eighteen patients underwent endoscopic evaluation, and no sign of esophagitis was detected. Five patients (22.7%) developed grade III strictures requiring endoscopic balloon dilation (esophageal invasion 32.1% vs. upper stomach 22.2%; P =0.96).</p><p><strong>Conclusions: </strong>Robotic proximal gastrectomy with single-flap valvuloplastic esophagogastrostomy is a safe and feasible option for gastroesophageal junction tumors with up to 3 cm of esophageal invasion.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of a Quantitative Early Activity Program on Gastrointestinal Function Following Laparoscopic Pancreaticoduodenectomy: A Single-Center Retrospective Analysis.","authors":"Ling Zhang, Fan Zhang, Chen-Jie Xiao, Yue-Fen Shu, Zheng Li, Jun Wang, Wen-Jie Tang","doi":"10.1097/SLE.0000000000001357","DOIUrl":"10.1097/SLE.0000000000001357","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to assess the impact of a quantitative early activity program, integrated into the Enhanced Recovery After Surgery (ERAS) protocol on gastrointestinal function in patients undergoing laparoscopic pancreatoduodenectomy (LPD).</p><p><strong>Methods: </strong>Perioperative data from 203 patients who underwent LPD at the Department of Comprehensive Treatment of Pancreatic Cancer, Fudan University Shanghai Cancer Center, between January 2021 and December 2022 were analyzed retrospectively. The patients were categorized into 2 groups based on their nursing plans. Group A received the standard perioperative ERAS nursing plan, while group B followed the ERAS plan supplemented with a quantitative early activity program. We assessed postoperative outcomes including bowel sound recovery time, time to first anal exhaust, time to first mobilization, activity compliance 1-week postsurgery, and incidence of postoperative breakthrough pain.</p><p><strong>Result: </strong>We compared several postoperative metrics between group A and group B. Specifically, the time to bowel sound recovery was 62.39±17.89 hours in group A versus 56.45±22.85 hours in group B. The time to first anal exhaust was 78.88±71.99 hours in group A compared with 63.62±24.73 hours in group B. The time to first mobilization was 56.98±18.66 hours in group A versus 49.85±20.48 hours in group B. In addition, activity compliance 1-week postsurgery and the incidence of postoperative breakthrough pain (1.55±2.01 times in group A vs. 0.94±1.16 times in group B) were also compared. All these differences were statistically significant ( P <0.05). Conversely, the incidence of postoperative complications and the length of hospital stay (11.20±5.69 d in group A vs. 12.47±6.67 d in group B) did not reveal any significant differences ( P >0.05).</p><p><strong>Conclusion: </strong>The quantitative early activity program for LPD, based on the ERAS protocol, enhances the adherence to postoperative activity and decreases the incidence of breakthrough pain, thereby facilitating gastrointestinal function recovery in patients. This approach merits clinical adoption.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Intraoperative CO 2 Pneumoperitoneum Pressure in Gastrointestinal Surgery: A Systematic Review.","authors":"Roy Mahapatra, Matthew Fok, Nicola Manu, Maria Cameron, Aimee Johnson, Aaron Kler, Hayley Fowler, Rachael Clifford, Dale Vimalachandran","doi":"10.1097/SLE.0000000000001325","DOIUrl":"10.1097/SLE.0000000000001325","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumoperitoneum is widely used in gastrointestinal surgery, particularly for laparoscopic or robotic procedures, with suggested advantages associated with low pressure. While existing data predominantly focuses on laparoscopic cholecystectomy, the assessment of intra-abdominal pressures in other gastrointestinal surgeries remains unexplored.</p><p><strong>Methods: </strong>This study conducted an electronic literature search for randomized control trials comparing low-pressure pneumoperitoneum to standard or high-pressure counterparts.</p><p><strong>Results: </strong>Out of 26 articles meeting inclusion criteria, encompassing 2077 patients, 15 demonstrated positive associations with low-pressure pneumoperitoneum. No significant difference in postoperative pain was found in the remaining papers. Methodological variations, diverse outcome reporting, and a prevalent high risk of bias precluded meta-analysis.</p><p><strong>Conclusions: </strong>The study highlights substantial outcome variability, urging cautious interpretation of aggregated results. Despite positive associations in specific cases, insufficient evidence was found to support the superiority of low-pressure pneumoperitoneum. The study recommends future research employing validated patient-reported outcome measures and standardized reporting to help guide the development of evidence-based guidelines and optimize patient care in abdominal surgeries.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Knives With Versus Without Integrated Water-jet Function During Peroral Endoscopic Myotomy for Patients With Achalasia: A Meta-analysis.","authors":"Abdul-Rahman F Diab, Joseph A Sujka, Muhammad Nashit, Ameen Abdel-Khalek, Sukriti Seth, Salvatore Docimo, Christopher G DuCoin","doi":"10.1097/SLE.0000000000001356","DOIUrl":"10.1097/SLE.0000000000001356","url":null,"abstract":"<p><strong>Background: </strong>Peroral endoscopic myotomy (POEM) is a well-established endoscopic treatment for achalasia, utilizing an endoscopic knife for dissection. Recently, new knives with an integrated water-jet (WJ) function have been introduced. This study aims to compare the technical, perioperative, and late postoperative outcomes between WJ knives and conventional (C) knives, which lack the WJ function, through a pairwise meta-analysis of published comparative studies.</p><p><strong>Methods: </strong>We conducted a systematic literature review following PRISMA guidelines to identify studies directly comparing knives with versus without a WJ function in POEM for achalasia. A random-effects model was employed, using odds ratios for dichotomous data and mean differences for continuous data as effect size metrics.</p><p><strong>Results: </strong>The use of WJ knives demonstrated statistically significant reductions in the mean number of intraoperative instrument exchanges, mean intraoperative use of coagulation forceps, and operative times compared to the use of C knives. There were no significant differences in terms of the incidence of adverse events, subcutaneous emphysema, or mean hospital length of stay (LOS). Clinical success, defined as a postoperative Eckardt score <3, mean postoperative Eckardt scores, and the incidence of GERD requiring proton pump inhibitors (PPI) also showed no significant differences.</p><p><strong>Conclusions: </strong>The use of water-jet (WJ) knives demonstrates comparable efficacy to conventional (C) knives, with superior efficiency reflected in reduced operative time and fewer intraoperative instrument exchanges. In addition, in terms of safety, the lower use of coagulation forceps with WJ knives suggests reduced intraoperative bleeding. However, no significant differences were observed between the groups in terms of length of stay (LOS) and adverse events, despite a trend toward reduction. A larger number of studies with greater sample sizes is required to better assess potential differences in safety between the use of WJ and C knives.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Ultrasound-guided Pancreatic Duct Drainage: A Systematic Review and Meta-analysis.","authors":"Ruixia Wang, Tong Su, Changqin Xu, Tong Xiao, Hongwei Xu, Xiuju Shi, Shulei Zhao","doi":"10.1097/SLE.0000000000001359","DOIUrl":"10.1097/SLE.0000000000001359","url":null,"abstract":"<p><strong>Background and objectives: </strong>Endoscopic ultrasound-guided pancreatic duct drainage (EUS-PD) has emerged as a minimally invasive therapeutic option for patients who cannot undergo traditional retrograde access to the pancreatic duct due to difficulties in cannulation or surgically altered anatomy. This meta-analysis aimed to evaluate the overall outcomes and safety of EUS-PD.</p><p><strong>Methods: </strong>We conducted a comprehensive search of major databases, including PubMed, EMBASE, Cochrane Library, and Science Citation Index, up until October 2023. The meta-analysis focused on technical and clinical success rates, as well as the overall adverse event (AE) rate.</p><p><strong>Results: </strong>A total of 27 trials involving 902 patients were included in the study. The cumulative rate of technical success is 89%, and the clinical success is 88%, whereas the AE rate was 17%. The most common AE observed was post-EUS-PD acute pancreatitis, with a rate of 3%. In addition, the cumulative rates of bleeding, perforation, pancreatic leak, and infection were 2%, 2%, 1%, and 1%, respectively.</p><p><strong>Conclusion: </strong>EUS-PD demonstrates highly favorable technical and clinical success rates, alongside acceptable AE rates, making it a highly effective procedure.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Feasibility and Safety of Autologous Skin Flap-supported Loop Stomas.","authors":"Wei-Bin Li, Yi Zhang, Ruo-Chong He, Ji Li, Nan Kang, Jie An","doi":"10.1097/SLE.0000000000001360","DOIUrl":"10.1097/SLE.0000000000001360","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the benefits of utilizing autologous flap-supported loop stomas in comparison to conventional rod-supported loop stomas regarding feasibility, safety, convenience, and satisfaction among doctors and patients.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 98 patients who underwent ileostomy at the Gastrointestinal Department of Shanxi Bethune Hospital Affiliated to Shanxi Medical University from July 2017 to January 2021. On the basis of the ileostomy methods used, the patients were categorized into 2 groups: the autologous flap loop ileostomy group (intervention group, 48 cases) and the traditional loop ileostomy group (traditional group, 50 cases). The analysis focused on assessing the quality of the stoma, short-term and long-term complications associated with postoperative stoma, and differences in feasibility, safety, convenience, and economic factors between the 2 groups.</p><p><strong>Results: </strong>The intervention group exhibited lower rates of short-term postoperative complications compared with the traditional group, especially in peristomal dermatitis ( P =0.002) and stoma leakage ( P =0.001). In addition, the frequency of stoma appliance replacement and the average cost within a 2-week period were also superior to those of the traditional group (all P <0.001). Long-term complications were not significantly different between the 2 groups ( P ≥ 0.05). Moreover, the intervention group had a shorter operating time ( P =0.01) and less blood loss ( P =0.006) than the traditional group for the ostomy closure surgery.</p><p><strong>Conclusions: </strong>Autologous flap-supported loop stoma shows a notable decrease in postoperative stoma-related short-term complications, offering superior feasibility, safety, convenience, with favorable economic aspects as well.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Efficacy and Complications Between One-stage Transcystic Common Bile Duct Exploration and Two-stage ERCP Plus Laparoscopic Cholecystectomy for Treatment of Choledocholithiasis: A Systematic Review and Meta-analysis.","authors":"Zachary Malaussena, Brody Smith, Ila Sethi, Paige DeBlieux, Rahul Mhaskar, Joseph Sujka, Christopher DuCoin, Salvatore Docimo","doi":"10.1097/SLE.0000000000001364","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001364","url":null,"abstract":"<p><strong>Background: </strong>Early and effective management of choledocholithiasis is imperative to decrease patient morbidity. Despite the widespread use of ERCP, advancements in laparoscopy and choledochoscopy have renewed interest in laparoscopic CBD exploration (LCBDE). This meta-analysis compares outcomes of 2-stage ERCP followed by laparoscopic cholecystectomy (LC) versus one-stage transcystic LCBDE plus LC.</p><p><strong>Methods: </strong>A comprehensive literature search was performed in PubMed, CENTRAL, and Embase databases according to PRISMA guidelines. Studies were selected based on specific criteria. Data on stone clearance, postoperative pancreatitis, bleeding, mortality, and length of stay were extracted.</p><p><strong>Results: </strong>Seven comparative non-randomized studies enrolling 669 \"one-stage LCBDE patients\" and 724 \"two-stage ERCP patients\" were included. Overall, there were no statistically significant differences regarding the rates of stone clearance, pancreatitis, bleeding, and mortality between the 2 groups.</p><p><strong>Conclusion: </strong>One-stage transcystic LCBDE is noninferior to the 2-stage ERCP + LC approach, supporting its use as a first-line treatment for choledocholithiasis.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiation of \"Polyp\" and \"Pseudo Polyp\" in Gallbladder Polyps, Single-center Experience.","authors":"Deniz Tazeoglu, Ahmet Cem Esmer","doi":"10.1097/SLE.0000000000001363","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001363","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of gallbladder polyps is 0.3% to 9.5%. Gallbladder polyps are divided into polyps and pseudo polyps. We aim to determine the rate of polyps after histopathologic examination in patients who were operated on for gallbladder polyps and to choose the factors affecting the diagnosis of polyps.</p><p><strong>Patients and methods: </strong>Patients who underwent cholecystectomy between January 2012 and January 2022 were analyzed retrospectively. Demographic data of the patients, anthropometric measurements, preoperative radiologic imaging methods, characteristics (size and number of polyps), and histopathologic results of the gallbladder after cholecystectomy were recorded. After histopathologic examination, the patients were grouped as gallbladder polyp and pseudo polyp and compared.</p><p><strong>Result: </strong>A total of 162 (4.7%) patients were included in the study. 109 (67.3%) of the patients were in the polyp group, and 53 (32.7%) were in the pseudo polyp group. Polyp size and number were larger in the polyp group than in the pseudo polyp group and were odd in number (P = 0.03, P < 0.001). The radiologic polyp size cut-off value to identify the polyp was >8 mm (sensitivity: 84.2%, specificity: 66.0%).</p><p><strong>Conclusion: </strong>Gallbladder polyps are a common pathology. The distinction between true and pseudo polyp is critical. Therefore, it is essential to distinguish between polyps and pseudo polyps for cholecystectomy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Different Endoscopic Treatment Methods on Bleeding Complications in Pedunculated Colorectal Polyps.","authors":"Xuan Li, Liang Bu, Xin Ye, Qing Han, Xi Yang, Lei Chen, Mingliang Yuan","doi":"10.1097/SLE.0000000000001362","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001362","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic resection of colorectal polyps offers several advantages, including ease of performance, reduced surgical time, and preservation of anatomic structures. However, bleeding remains a common complication of the endoscopic treatment of colorectal polyps, particularly with a higher incidence of postprocedural bleeding in pedunculated colorectal polyps. Currently, there is no optimal method for the resection of pedunculated colorectal polyps. The aim of this study was to compare the postresection bleeding outcomes of 3 different techniques for the removal of pedunculated colorectal polyps.</p><p><strong>Methods: </strong>A retrospective analysis of postresection bleeding following the use of 3 techniques-endoscopic mucosal resection, endoscopic submucosal dissection (ESD), and prophylactic clips was conducted on pedunculated colorectal polyps.</p><p><strong>Results: </strong>The incidence of delayed hemorrhage after endoscopic mucosal resection resection of pedunculated colorectal polyps was highest (18.9%). In contrast, the incidence rates of delayed bleeding in the ESD and prophylactic clip groups were 4.3% and 5.9%, respectively (P<0.05). The intraoperative bleeding rate was highest in the ESD group (6.5%), while no intraoperative bleeding occurred in the other 2 groups, indicating a statistically significant difference among the 3 groups (P<0.05). However, the need for endoscopic hemostasis due to delayed bleeding was not significantly different among the groups (P>0.05).</p><p><strong>Conclusion: </strong>Employing endoscopic submucosal dissection (ESD) and clamping the stalk of pedunculated polyps before removal can effectively reduce the risk of postpolypectomy bleeding. Furthermore, ESD offers distinct advantages for the removal of larger polyps, both at the stalk and the head.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}