Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"What is the Impact of Comorbidities in the Outcomes of Minimally Invasive Surgery for Elderly Patients With Colorectal Cancer?","authors":"Yu Sato, Anjelli Wignakumar, Peter Rogers, Cesar Valdivieso, Michelle Hambleton, Mohammed Moola, Matthew Bilotti, Spencer Barnes, Cameron Perrone, Samantha Sipe, Abel Abraham, Christopher Lopez, Giovanna da Silva, Steven D Wexner","doi":"10.1097/SLE.0000000000001474","DOIUrl":"10.1097/SLE.0000000000001474","url":null,"abstract":"<p><strong>Background: </strong>Comorbidity burden may influence perioperative outcomes in elderly patients undergoing minimally invasive resection for colorectal cancer (CRC). This study evaluated the association between the Charlson Weighted Comorbidity Index (CCI) and short-term postoperative outcomes in this population.</p><p><strong>Methods: </strong>A retrospective review of 894 consecutive patients aged 65 years or older who underwent curative minimally invasive resection for CRC at a single institution between January 2014 and August 2023. Surgical approaches included pure laparoscopic, robotic-assisted, and converted-to-open procedures. Comorbidity burden was quantified using the CCI, excluding age and the index colorectal malignancy from score calculation. Patients with and without postoperative complications were compared, and multivariable logistic regression was performed to identify independent factors associated with complications. Patients were divided into 2 groups [low CCI (≤2; n=637) and high CCI (≥3; n=257)] to investigate the relationship between an increased CCI score and the patients' short-term outcomes.</p><p><strong>Results: </strong>Postoperative complications occurred in 319 patients (36%). Age, American Society of Anesthesiologists Physical Status (ASA) score, conversion to open surgery, rectal tumor location, and CCI score were significantly higher in patients with postoperative complications. On multivariable analysis, age 75 years or older, ASA score ≥4, conversion to open surgery, rectal tumor location, and CCI ≥3 were independently associated with an increased risk of postoperative complications. The discriminatory ability of CCI alone was modest (AUC: 0.578). Compared with the low-CCI group, the high-CCI group had higher rates of transfusion (13% vs. 8%, P =0.016), overall complications (46% vs. 31%, P <0.001), and 30-day mortality (2% vs. 1%, P =0.024), as well as a longer postoperative length of stay (6.4 vs. 5.2 days, P <0.001).</p><p><strong>Conclusion: </strong>Higher comorbidity burden, as measured by CCI, was associated with worse short-term postoperative outcomes after minimally invasive CRC surgery in elderly patients. Although CCI alone showed limited discriminatory performance for individual prediction, a CCI score ≥3 identified a subgroup with substantially higher postoperative risk and may potentially be useful as a simple adjunct in preoperative risk assessment.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240422","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":"Sac Excision at the Time of Surgery Can Predict Hernia Recurrences and a Need for Reoperation in Patients.","authors":"Iris Levine, Joshua Lyons, Hamza Nasir Chatha, Christina Boutros, Saher-Zahra Khan, Jamie Benson, Guy Katz, Christine Alvarado, Patrick Wieland, Jeffrey Marks","doi":"10.1097/SLE.0000000000001470","DOIUrl":"10.1097/SLE.0000000000001470","url":null,"abstract":"<p><strong>Background: </strong>Paraesophageal hernias are a prevalent medical condition often treated with surgical intervention, and decisions regarding hernia sac management are involved. Sac excision during PEH repair has emerged as a viable and safe management strategy, with potential implications for patient outcomes. This study aimed to assess the impact of sac excision on hernia recurrence, reoperation rates, and postoperative gastroesophageal reflux disease (GERD) in patients undergoing hernia repair.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients who underwent paraesophageal hernia repair between 2014 and 2022. Data on patient demographics, preoperative evaluation, surgical technique, and long-term follow-up were collected and analyzed. Primary outcomes included hernia recurrence, reoperation rates, and postoperative GERD assessed over a mean follow-up of 1.8 years.</p><p><strong>Results: </strong>Analysis of a 1154-patient cohort revealed that sac excision during paraesophageal hernia repair did not significantly affect hernia recurrence ( P =0.27). Notably, the reoperation rate was similar between patients with and without sac excision ( P =0.28), indicating no significant difference in the need for reoperation. However, sac excision was associated with a lower incidence of persistent postoperative gastroesophageal reflux disease (GERD) ( P =0.03).</p><p><strong>Conclusions: </strong>Sac excision during paraesophageal hernia repair does not significantly impact hernia recurrence or reoperation rates but may be associated with a lower incidence of persistent postoperative GERD.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309556","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 Obesity on Outcomes of Laparoscopic Adrenalectomy: A Single-Center Retrospective Study.","authors":"Mehmet T Unlu, Ozan Caliskan, Isik Cetinoglu, Yasin Cakir, Nurcihan Aygun, Mehmet Uludag","doi":"10.1097/SLE.0000000000001450","DOIUrl":"10.1097/SLE.0000000000001450","url":null,"abstract":"<p><strong>Aim: </strong>Obesity is a well-known risk factor for surgical complications. Laparoscopic adrenalectomy is now preferred over open surgery for adrenal masses of <6 cm without high malignancy suspicion. This study evaluates the impact of obesity on surgical complication rates in laparoscopic adrenalectomy.</p><p><strong>Materials and methods: </strong>Patients who underwent laparoscopic transabdominal adrenalectomy between 2013 and 2024 were retrospectively analyzed. They were divided into two groups: obese (BMI ≥30 kg/m 2 ) and nonobese (BMI <30 kg/m 2 ). Demographic data, perioperative, and postoperative outcomes were compared.</p><p><strong>Results: </strong>A total of 110 patients (75 females, 35 males) were included, with 40 in the obese group and 70 in the nonobese group. The mean age was 46.6±12.4 years, and the mean BMI was 28.7±5.5 kg/m 2 . Surgery was performed on the right side in 58 patients (52.7%), left side in 51 (46.4%), and bilaterally in 1 (0.9%). The most common indications were Cushing syndrome (38 patients), pheochromocytoma (31), Conn syndrome (11), and incidentaloma (28). There were no significant differences between groups in terms of operative time, blood loss, tumor size, pathology, and hospital stay. Postoperative complications occurred in 6/40 obese (15.0%) and 3/70 nonobese (4.3%) patients, without a statistically significant difference ( P =0.07). Complications in the obese group included wound infection (4 cases), toxic hepatitis (1), atrial fibrillation (1), and respiratory infection (1).</p><p><strong>Conclusion: </strong>Obesity was associated with a trend toward higher postoperative complication rates, while operative time and length of stay were not significantly different. These findings emphasize the importance of surgical expertise and careful perioperative planning in obese patients.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220558","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 Treatment of Biliary Anastomotic Strictures After Liver Transplantation: Algorithmic Approach of a Single Tertiary Center.","authors":"Bülent Ödemiş, Kerem Kenarli, Mustafa Özdemir, Muharrem Tola, Derya Ari, Çağdaş Erdoğan, Osman Aydin, Erdal B Bostanci","doi":"10.1097/SLE.0000000000001442","DOIUrl":"10.1097/SLE.0000000000001442","url":null,"abstract":"<p><strong>Background: </strong>The optimal endoscopic strategy for postliver transplantation anastomotic strictures remains undefined. This study aimed to evaluate an algorithmic, stepwise approach based on stricture severity over a 13-year period.</p><p><strong>Methods: </strong>This retrospective study included 78 patients treated between 2011 and 2024. Standard endoscopic passage of the anastomotic stricture using a guidewire was attempted in all cases. When this was unsuccessful, a percutaneous-endoscopic rendezvous procedure was performed; if the stricture remained impassable, a magnetic compression anastomosis was applied.</p><p><strong>Results: </strong>A total of 613 procedures were performed. The proximal side of the stricture was successfully traversed by standard endoscopy in 55 patients (70.5%), by rendezvous in 15 (19.2%), and by magnetic compression in 8 (10.3%). Stent-free follow-up was achieved in 55 patients (70.5%), with a mean treatment duration of 12.3 months. Recurrence occurred in 10 patients (18.2%), and complications developed in 8.2% of procedures, most commonly stent migration.</p><p><strong>Conclusion: </strong>A structured algorithm incorporating rendezvous and magnetic compression techniques can enhance overall success in complex post-transplant biliary strictures.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012366","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":"Conversion Rates From Initial Consultation to Bariatric Surgery: A Single-Center Community Practice Experience.","authors":"Will McDonough, Jonathon Gevorkian, Daniela Wong, Benjamin Clapp","doi":"10.1097/SLE.0000000000001443","DOIUrl":"10.1097/SLE.0000000000001443","url":null,"abstract":"<p><strong>Background: </strong>As part of the accreditation process for bariatric surgery, patients must go through a preoperative pathway. There will inevitably be patients who are seen in the clinic but never undergo surgery. This rate of attrition is different for every practice. Our objective was to evaluate the percentage of patients who eventually undergo bariatric surgery at a community practice.</p><p><strong>Methods: </strong>A single private practice was evaluated. Patients initially seen in the clinic were followed to surgery completion or until they dropped out. A period of 21 months was evaluated. Patients with at least a 6-month follow-up were included.</p><p><strong>Results: </strong>There were 479 patients who underwent evaluation during that time. Forty-three percent of these patients went on to have surgery. There were 216 patients who did not have surgery, with most of those patients never progressing past the first visit. One patient became pregnant and dropped out, 2 did not achieve medical clearance, one moved out of town, and one obtained surgery at a different program. There was a significant increase in the rate of attrition if the wait period was 6 months or longer ( P <0.05).</p><p><strong>Conclusion: </strong>There are no national benchmarks as to what percentage of patients complete the preoperative process at accredited bariatric centers and undergo surgery. This solo private practice has a conversion rate of 43%. Longer waiting times appear to increase the rate of attrition. Mandated wait times function as barriers to patients undergoing surgery and should be abandoned.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107166","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":"Preliminary Experience of Circular Stapler-based Lower Mediastinal Reconstruction in Robotic Total and Proximal Gastrectomy.","authors":"Shinsuke Usui, Kenichi Iwasaki, Ryota Sakon, Kimihiko Nakamura, Yusuke Abe, Kenta Kitamura, Tomonori Matsumura, Takeshi Natori, Motoi Koyama, Kazuhiro Karikomi, Tatsushi Suwa","doi":"10.1097/SLE.0000000000001457","DOIUrl":"10.1097/SLE.0000000000001457","url":null,"abstract":"<p><strong>Background: </strong>In minimally invasive surgery for upper gastric and esophagogastric junction cancers, linear staplers are commonly used, and reports of circular‑stapled reconstruction have declined in parallel with the decrease in open surgery. Lower mediastinal reconstruction during robot‑assisted gastrectomy also remains technically challenging. This study describes our surgical technique and preliminary experience with transhiatal lower mediastinal anastomosis using a circular stapler.</p><p><strong>Methods: </strong>Twelve patients who underwent robot‑assisted total or proximal gastrectomy with lower mediastinal reconstruction between March 2023 and December 2025 were included. Total operative time, blood loss, reconstruction time, length of hospital stay, postoperative complications, and esophageal transection length were evaluated separately for robot‑assisted total gastrectomy (RTG) and robot‑assisted proximal gastrectomy (RPG).</p><p><strong>Results: </strong>No patient required conversion to open surgery.In the RTG group (n=6), the operative time, reconstruction time, blood loss, and hospital stay were 498.0 ± 61.1 minutes, 36.2 ± 8.4 minutes, 175 ± 117.3 g, and 14.3 ± 2.7 days, respectively.In the RPG group (n=6), these values were 345.8 ± 51.5 minutes, 75.6 ± 14.0 minutes, 75.0 ± 98.7 g, and 14.3 ± 2.7 days.Postoperative complications included one anastomotic stricture and one Grade B pancreatic fistula, both in the RPG group. No anastomotic leakage occurred in either group. The esophageal transection length was 35.2 ± 14.0 mm in the RTG group and 25.5 ± 7.9 mm in the RPG group, and all resection margins were negative.</p><p><strong>Conclusion: </strong>Circular staplers are feasible and safe for lower mediastinal reconstruction in robot‑assisted total and proximal gastrectomy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842971","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 Complexities of Reoperative Metabolic and Bariatric Surgery-A Retrospective Review of Outcomes at a Single Large Institution.","authors":"Sara Bocchinfuso, Jack W Sample, Noura Jawhar, Tala Abedalqader, Nour El Ghazal, Simon Laplante, Kabir Mehta, Omar M Ghanem","doi":"10.1097/SLE.0000000000001455","DOIUrl":"10.1097/SLE.0000000000001455","url":null,"abstract":"<p><strong>Background: </strong>Reoperative metabolic and bariatric surgery (MBS), consisting of revision and conversion surgery, carries higher morbidity and mortality compared with primary procedures, yet robust long-term data are limited.</p><p><strong>Methods: </strong>A retrospective review was conducted of all patients 18 years of age or older who underwent first-time reoperative MBS between 2000 and 2024 at a single large quaternary referral center. Data were stored securely and analyzed in R (v4.4.2) using standard descriptive statistics and group tests ( t tests/Wilcoxon/Kruskal-Wallis; χ²/Fisher). Sparse late-complication data precluded pairwise tests.</p><p><strong>Results: </strong>Three hundred sixty patients, 86% female, mean age 50 years, underwent reoperative MBS. Conversion to Roux-en-Y gastric bypass (49%) was the most common surgery. The majority were performed for weight recidivism (37%). Length of stay, estimated blood loss, length of surgery, complication rates, readmission rates, and reintervention rates varied by type of reoperative MBS performed and indication. Most early complications were Clavien-Dindo 2, and most late complications were Clavien-Dindo 3b for all approaches. There was one procedure-related death in the study following an open conversion.</p><p><strong>Conclusion: </strong>In this 24-year single-center cohort, weight recidivism was the most frequent indication for reoperation and was associated with improved perioperative outcomes and durable long-term weight loss. As the landscape of bariatric surgery continues to evolve, we recommend early referral to centers with reoperative MBS expertise.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378558","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":"Routine or Selective Intraoperative Cholangiography?: A Single-Center Analysis of 1506 Laparoscopic Cholecystectomies.","authors":"Josefina Principe, Nicolas H Dreifuss, Pablo Capitanich, Lucas McCormack, Francisco Schlottmann","doi":"10.1097/SLE.0000000000001453","DOIUrl":"10.1097/SLE.0000000000001453","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) helps to clarify the biliary anatomy, detect common bile duct (CBD) stones, and prevent or promptly detect bile duct injuries (BDI). However, the indication for routine or selective cholangiography remains controversial. We aimed to compare the results of a routine versus selective IOC policy during LC in an urban teaching hospital.</p><p><strong>Methods: </strong>A prospective cohort study was designed, including a consecutive series of patients undergoing LC with either routine IOC (RC) or selective IOC (SC). SC was performed in emergent LC for cholecystitis and in patients with preoperative risk factors for CBD stones. The primary outcomes of interest were CBD stones, BDI, and anatomic variations of the biliary tract rates. Secondary outcomes of interest were the IOC success rate and readmission for residual CBD stones.</p><p><strong>Results: </strong>A total of 1506 patients were analyzed: 1003 (66.6%) with RC and 503 (33.4%) with SC. Demographic variables were comparable between groups. Emergent LC was more frequent in SC (RC: 29.7% vs. SC: 36.2%, P =0.01). The IOC success rate was higher in RC (RC: 93.5% vs. SC: 82.6%, P <0.001). LC with SC had higher rates of positive IOC (RC: 6.7% vs. SC: 11%, P =0.04) and CBD stones detection (RC: 6.3% vs. SC: 10.4%, P =0.05). BDI was comparable between groups (RC: 0.5% vs. SC: 0%, P =0.3%), and none of them were detected by IOC. Residual CBD stones were similar between groups (RC: 0.4% vs. SC: 0.2%, P =0.5). Overall morbidity (RC: 4.5% vs. SC: 4.9%, P =0.6), readmissions (RC: 1.2% vs. SC: 1.7%, P =0.4), and reoperations (RC: 0.7% vs. SC: 0.2%, P =0.3) were comparable between groups.</p><p><strong>Conclusion: </strong>Selective use of IOC appears to be a safe and effective strategy with comparable BDI and residual CBD stone rates, compared with routine IOC. However, as selective IOC was associated with a lower success rate of IOC, surgical training for its performance should not be neglected.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378506","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":"Acute Appendicitis as a Harbinger of Colorectal Neoplasms in Patients Aged 40 or Older: A Scoping Review.","authors":"Andrea Spota, Marina Englesakis, Sami Chadi, David Gomez, Eisar Al-Sukhni","doi":"10.1097/SLE.0000000000001451","DOIUrl":"10.1097/SLE.0000000000001451","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines on follow-up for acute appendicitis (AA) neglect the risk of colorectal cancer after AA. Heterogeneous and low-level evidence hinders drawing recommendations on follow-up of 40-year-old or older patients after AA, looking for colorectal neoplasms. This study aims to summarize existing research and identify gaps for future studies.</p><p><strong>Methods: </strong>This scoping review was conducted following the 5-stage framework described by Arksey and O'Malley, and is based on the JBI (Joanna Briggs Institute) guidelines. The searching process followed the Cochrane Handbook and the Cochrane Methodological Expectations of Cochrane Intervention Reviews (MECIR) for conducting the search and the PRISMA 2020 for reporting. Protocol registration on Open Science Framework.</p><p><strong>Results: </strong>Seventeen of 3778 studies met the inclusion criteria, all retrospective: 4 population-based and 13 cohort studies. Half focused on patients 40 years of age or older, while others analyzed older patients or performed a subanalysis by age. Seven studies had a 36-month follow-up, 2 had 24 months, and one had 12 months. Remaining studies provided subclassifications. The rate of colorectal neoplasms found at follow-up ranged from 0.5% to 34.6%, while the increased risk varied from 1.2 to 38.5 times, reflecting marked heterogeneity in study design and follow-up modality. Neoplasms were detected in all colorectal regions. Thirteen studies supported follow-up after AA, 3 expressed conditional favor, and one opposed it.</p><p><strong>Conclusions: </strong>Many retrospective studies suggest an increased risk of colorectal neoplasms in AA patients aged 40 years or older. However, current evidence does not support solid recommendations for standard follow-up. This scoping review highlighted a gap in the literature, and a prospective study framework has been outlined to improve evidence quality on this topic.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146221388","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":"Balloon-Assisted Versus Conventional Endoscopic Submucosal Dissection for Management of Large Colorectal Polyps: A Systematic Review and Meta-Analysis.","authors":"Aamir Saeed, Saira Yousuf, Marc Hersh, Katherine Duffey, Muhammad Hamza Sadiq, Waleed Razzaq Chaudhry, Muhammad Talha Bajwa, Ghulam Ali Hasnan, Yasi Xiao, Anand Kumar, Alexander Schlachterman, Thomas Kowalski, Mark Radlinski, Sultan Mahmood, Faisal Kamal","doi":"10.1097/SLE.0000000000001444","DOIUrl":"10.1097/SLE.0000000000001444","url":null,"abstract":"<p><strong>Background: </strong>Balloon-assisted endoscopic submucosal dissection (BA-ESD) can improve endoscopic maneuverability by stabilizing the tip of the scope. Studies have compared BA-ESD with conventional ESD (C-ESD) and reported conflicting results. We conducted a meta-analysis to compare BA-ESD with C-ESD in the management of colorectal polyps.</p><p><strong>Methods: </strong>Several databases were reviewed from 1985 to December 16, 2024, to identify studies comparing BA-ESD with C-ESD for colorectal polyps. Our outcomes of interest were en bloc resection and R0 resection, procedure time, dissection speed, and adverse events such as perforation and bleeding. We calculated the pooled odds ratio (OR) with 95% CI for categorical variables and the standardized mean difference (SMD) with 95% CI for continuous variables.</p><p><strong>Results: </strong>We included 8 studies with 1449 patients (BA-ESD 420 and C-ESD 1029). We found no significant difference in the rate of en bloc resection, OR (95% CI): 1.00 (0.51-1.99) and R0 resection, OR (95% CI): 1.24 (0.51-3.02) between groups. We found no significant difference in bleeding and perforation between groups. We found no significant difference in procedure time, SMD (95% CI): -0.15 (-0.56 to 0.26) and dissection speed, SMD (95% CI): 0.18 (-0.28 to 0.63) between groups. Subgroup analysis of RCTs showed that the procedure time was significantly shorter in the BA-ESD group.</p><p><strong>Conclusions: </strong>Our meta-analysis demonstrated comparable outcomes between BA-ESD and C-ESD, although analysis of RCTs demonstrated shorter procedure time with BA-ESD. Large-scale multicenter RCTs are required to further evaluate these findings.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012330","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}