Surgical Endoscopy And Other Interventional Techniques最新文献

{"title":"Appropriate use of tissue sampling and somatostatin receptor PET imaging in the diagnosis of pancreatic neuroendocrine tumors: results of an International Delphi Consensus.","authors":"Megan Casey, Francesca Tozzi, Jaeyun Wang, Keon Min Park, Emily Bergsland, Thomas Hope, Hagen F Kennecke, J Bart Rose, Michele Babicky, Shayan S Irani, Kevin M El-Hayek, Mohammad Abu Hilal, Horacio J Asbun, Sean Cleary, Peter Smeets, Frederik Berrevoet, Mohamed Adam, Niki Rashidian, Adnan Alseidi","doi":"10.1007/s00464-025-11667-8","DOIUrl":"10.1007/s00464-025-11667-8","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines lack clarity regarding the appropriate use of preoperative ultrasound-guided (EUS) biopsy and receptor positron emission tomography (SSTR PET) imaging for pancreatic neuroendocrine tumors (PNETs). This study aims to reach expert consensus on the optimal sequencing of SSTR PET and EUS biopsy in the diagnostic workup and management of patients with suspected PNETs.</p><p><strong>Methods: </strong>A three-round modified Delphi process was used. A multidisciplinary panel of experts was recruited via snowball sampling. A set of 22 baseline statements pertaining to diagnostic workup, imaging, and biopsy was developed based on literature review and feedback obtained through a focus group. Survey rounds were conducted electronically and anonymously. A panel of international experts was asked to indicate whether they agreed, disagreed, or lacked the appropriate background to answer each statement. Of the 55 experts invited, 38 (69%) accepted to participate. Consensus was achieved with > 80% agreement.</p><p><strong>Results: </strong>Response rates were 97%, 100%, and 100% in rounds 1, 2, and 3, respectively. Following rounds 1 and 2, 29 final statements achieved consensus in the following three domains: diagnostic workup (15 statements), imaging (nine statements), and tissue sampling (five statements). Cronbach's alpha value, a measure of internal consistency, was 0.91 and 0.85 for rounds 1 and 2, respectively. The final set of statements achieved a 95% approval rate in round 3.</p><p><strong>Conclusion: </strong>This international Delphi study provides expert consensus-based guidance on the appropriate use of EUS biopsy in the diagnostic workup of PNETs in the era of SSTR PET imaging.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3435-3446"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the endoscopic snare to facilitate two-port laparoscopic appendectomy.","authors":"Mohamed Farid, Azza Baz, Mohamed Riad, Ashraf Abdelmonem Elsayed, Ahmed Salah Arafa, Rasha S Elsayed, Alaaedin Ramadan, Ibrahim A Heggy, Mostafa M Elaidy","doi":"10.1007/s00464-025-11743-z","DOIUrl":"10.1007/s00464-025-11743-z","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic appendectomy is now the gold-standard treatment for acute appendicitis, requiring three ports for a classic procedure. Recent laparoscopy improvements aim to minimize surgical trauma and improve cosmetic quality through smaller, fewer portal incisions, such as two-port laparoscopic appendectomy, resulting in reduced postoperative pain. We aimed in this study to describe a novel technique to facilitate two-port laparoscopic appendectomy using the endoscopic snare.</p><p><strong>Patients and methods: </strong>The data for a total of 85 patients, who underwent the two-port laparoscopic appendectomy using the endoscopic snare, at two research centers in Zagazig city, Egypt, from July 2022 till July 2023, is retrospectively analyzed. Overall length of hospital stay was the primary outcome, and the duration of operation and patient cosmetic satisfaction were secondary endpoints.</p><p><strong>Results: </strong>All the 85 laparoscopic procedures were completed without difficulty. The mean operative time was 43.78 ± 8.46 min (minimum: 34 min, maximum: 57 min). Length of hospitalization was 1.12 ± 0.74 days (min: 1 day, max: 2 days). No major complications were encountered. Four cases of minor postoperative complication occurred, in which the patient developed port site infection, which was completely resolved at one week postoperatively.</p><p><strong>Conclusion: </strong>Laparoscopic appendectomy, using only two ports and endoscopic snare, is generally feasible and has been linked to high patient satisfaction and excellent cosmetic outcomes.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3814-3820"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defect closure after endoscopic submucosal dissection decreased the adverse events in patients with large rectal neoplasms: a propensity score matching analysis.","authors":"Jiancong Feng, Yaqi Zhai, Ke Han, Wengang Zhang, Zhenyu Liu, Ningli Chai, Enqiang Linghu","doi":"10.1007/s00464-025-11705-5","DOIUrl":"10.1007/s00464-025-11705-5","url":null,"abstract":"<p><strong>Background and aims: </strong>The effectiveness of defect closure in preventing postoperative complications in rectal lesions exceeding 30 mm in size following endoscopic submucosal dissection (ESD) remains uncertain; this study aimed to assess the effectiveness of defect closure in reducing postoperative complications after ESD in patients with large rectal neoplasms.</p><p><strong>Methods: </strong>A retrospective review was conducted on consecutive patients with large rectal neoplasms who underwent ESD at our center from January 2013 to December 2024. Patients were divided into two groups: the closure group and the non-closure group. Propensity score matching (PSM) was used to minimize selection bias. The study compared adverse events, postoperative fever, and postoperative hospital stay between the two matched groups.</p><p><strong>Results: </strong>A total of 215 patients were enrolled in the study and included in the analysis. The baseline characteristics of the 83 matched patient pairs were comparable after PSM. The incidence of adverse events was significantly lower in the closure group than in the non-closure group (1.2% vs. 9.6%, P = 0.040). While no statistically significant differences were observed between the two groups in terms of postoperative fever and prolonged postoperative hospital stay, the rates were lower in the closure group compared to the non-closure group (9.6% vs. 10.8%, P = 0.798; 22.9% vs. 33.7%, P = 0.121, respectively). Moreover, defect closure was independently associated with a reduced risk of delayed bleeding (OR, 0.181; 95% CI, 0.035-0.932; P = 0.041).</p><p><strong>Conclusion: </strong>Defect closure after ESD decreased the adverse events in patients with large rectal neoplasms. Moreover, defect closure was independently associated with a reduced risk of delayed bleeding. Future prospective studies with larger samples are needed to provide more definitive guidance for clinical practice.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3504-3513"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual prediction models for predicting rebleeding events after the first esophageal variceal ligation.","authors":"Bingbing Li, Yong Li, Yu Peng, Jun Yi, Lei Gu, Shizhe Li, Xiaowei Liu, Fujun Li, Yu Wu","doi":"10.1007/s00464-025-11714-4","DOIUrl":"10.1007/s00464-025-11714-4","url":null,"abstract":"<p><strong>Background: </strong>Sequential endoscopic variceal ligation (EVL) is a standard therapy for esophageal variceal bleeding, yet poor compliance often compromises its efficacy. This study aimed to identify high-risk factors for rebleeding after initial EVL and establish a visual predictive model to improve patient follow-up and education.</p><p><strong>Methods: </strong>In this retrospective study, we enrolled patients who underwent first-time EVL for esophageal variceal bleeding at Xiangya Hospital, Central South University, between January 2017 and January 2023. Patients were allocated to training and validation cohorts. Clinical data were systematically collected, and rebleeding incidence rates within 6 weeks and 6 months post-EVL were analyzed. Logistic regression was used to explore high-risk factors influencing postoperative rebleeding and to establish visual models, evaluated with a validation set.</p><p><strong>Results: </strong>The study involved 629 patients in the training set and 312 in the validation set. Rebleeding occurred in 34.8% (219/629) and 80.1% (504/629) of patients within 6 weeks and 6 months after initial EVL, respectively. Esophageal variceal severity and platelet count emerged as shared independent risk factors for both 6-week and 6-month rebleeding. The nomogram models demonstrated robust predictive accuracy in the validation cohort, with areas under the curve (AUC) of 0.942 (95% CI 0.901-0.983) for 6-week rebleeding risk and 0.852 (95% CI 0.759-0.945) for 6-month rebleeding risk.</p><p><strong>Conclusion: </strong>This study proposes a visual prediction model designed to assess the risk of rebleeding following initial EVL in patients with esophageal variceal hemorrhage to optimize clinical decision-making and improve patient management strategies.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3576-3586"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the use of EUS-guided hepaticogastrostomy combined with antegrade stenting for malignant biliary obstruction and comparing to EUS-guided hepaticogastrostomy alone for patients who failed ERCP: a pairwise and single-arm meta-analysis.","authors":"Otavio Cosendey Martins, Vanio Antunes, Marcelo Cristalli Pacheco da Costa, Cynthia Florêncio de Mesquita, Tulio L Correa, Matheus Vanzin Fernandes, Natália Junkes Milioli, Stefano Baraldo","doi":"10.1007/s00464-025-11760-y","DOIUrl":"10.1007/s00464-025-11760-y","url":null,"abstract":"<p><strong>Background and aims: </strong>When ERCP is not feasible in the management of malignant biliary obstruction (MBO), endoscopic ultrasound-guided biliary drainage has been proven to be a valuable alternative. EUS-guided hepaticogastrostomy (EUS-HGS) carries a relatively high risk of complications. To mitigate these risks, EUS-guided antegrade stenting combined with EUS-HGS (EUS-HGAS) has been explored. We aimed to conduct a pairwise and a single-arm meta-analysis comparing both techniques and analyzing the efficacy and safety of HGAS for MBO, respectively.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane Library. We included randomized controlled trials or observational studies enrolling patients who underwent EUS-HGAS placement with or without a control group of EUS-HGS without antegrade stenting. We used R statistical software, version 4.4.1.</p><p><strong>Results: </strong>Eight studies were included in the pairwise meta-analysis, and 11 studies were included in the single-arm meta-analysis. Analysis of the need for reintervention showed a significant difference between HGAS and HGS groups, favoring HGAS (p = 0.005), but this group also had a significantly higher rate of pancreatitis (p = 0.027). For HGAS, the pooled analyses demonstrated high technical and clinical success rates (94.06% and 98.05%, respectively); a need for reintervention rate of 8.03%, an overall adverse events rate of 11.67%, mean survival time of 118.53 days, and mean time to stent dysfunction or patient death of 134.61 days.</p><p><strong>Conclusion: </strong>The performance of HGAS in patients who failed ECRP for MBO showed lower need for reintervention rates but higher pancreatitis rates compared to HGS alone. Performing HGAS is associated with high technical and clinical success rates and a low overall adverse event occurrence.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3786-3796"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review, meta-analysis and GRADE assessment of the evidence on complete mesocolic excision for right-sided colon cancer with SAGES and ESCP participation.","authors":"Alexander A Tzanis, Francesco Maria Carrano, Konstantinos Perivoliotis, Sunjay S Kumar, Christos Christogiannis, Dimitris Mavridis, Bright Huo, Nicole Bouvy, Niki Christou, Suzanne Dore, Audrius Dulskas, Christos Kontovounisios, Tim Lubbers, Francesco Palazzo, Philip Quirke, Dimitra Repana, Monica Terlizzo, Bethany J Slater, Ivan D Florez, Monica Ortenzi, Tan Arulampalam, Stavros A Antoniou","doi":"10.1007/s00464-025-11749-7","DOIUrl":"10.1007/s00464-025-11749-7","url":null,"abstract":"<p><strong>Background: </strong>Complete mesocolic excision (CME) is a surgical approach for right-sided colon cancer, involving the resection of the primary tumour along with an intact mesocolon, central vascular ligation, and exposure of the superior mesenteric vein. It has been postulated to improve oncologic outcomes such as disease-free survival and reduce local recurrence compared to standard right colectomy. However, the clinical benefits are still debated.</p><p><strong>Objective: </strong>This systematic review and meta-analysis, sponsored by the European Association for Endoscopic Surgery, aims to compare the oncologic outcomes of CME with standard right colectomy for right-sided colon cancer, with the ultimate objective to inform clinical practice recommendations.</p><p><strong>Methods: </strong>We followed the PRISMA 2020 reporting standards. A comprehensive literature search was conducted to identify relevant studies published from 2008 onwards, focusing on randomised trials and matched cohort studies comparing CME with standard right hemicolectomy. The GRADE methodology was used to assess the certainty of evidence, and minimal important differences were calculated to inform clinical relevance.</p><p><strong>Results: </strong>Thirteen studies, amongst which three randomised trials, were included. No difference was found between CME and standard colectomy in terms of 30-day mortality, major peri-operative morbidity, or major blood loss. However, patients who underwent CME showed improved overall survival (HR = 0.67, 95%CI [0.48 - 0.93], low certainty of evidence) and disease-free survival (HR = 0.78, 95% CI [0.63 - 0.96], low certainty of evidence) compared to those who underwent standard colectomy, though certainty of the evidence was low due to the high risk of bias in the observational studies.</p><p><strong>Conclusion: </strong>Complete mesocolic excision may offer survival benefits over standard right colectomy for right-sided colon cancer. However, the evidence remains of low certainty, mainly due to the predominance of observational data with significant risk of bias. Future high-quality randomized trials are needed to confirm these findings and standardize surgical techniques to reduce heterogeneity and improve clinical outcomes.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3466-3473"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automatic gesture recognition and evaluation in peg transfer tasks of laparoscopic surgery training.","authors":"Shujun Ju, Penglin Jiang, Yutong Jin, Yaoyu Fu, Xiandi Wang, Xiaomei Tan, Ying Han, Rong Yin, Dan Pu, Kang Li","doi":"10.1007/s00464-025-11730-4","DOIUrl":"10.1007/s00464-025-11730-4","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic surgery training is gaining increasing importance. To release doctors from the burden of manually annotating videos, we proposed an automatic surgical gesture recognition model based on the Fundamentals of Laparoscopic Surgery (FLS) and the Chinese Laparoscopic Skills Testing and Assessment (CLSTA) tools. Furthermore, statistical analysis was conducted based on a gesture vocabulary that had been designed to examine differences between groups at different levels.</p><p><strong>Methods: </strong>Based on the CLSTA, the training process of peg transfer can be represented by a standard sequence of seven surgical gestures defined in our gesture vocabulary. The dataset used for model training and testing included eighty videos recorded at 30 fps. All videos were rated by senior medical professionals from our medical training center. The dataset was processed using cross-validation to ensure robust model performance. The model applied is 3D ResNet-18, a convolutional neural network (CNN). An LSTM neural network was utilized to refine the output sequence.</p><p><strong>Results: </strong>The overall accuracy for the recognition model was 83.8% and the F1 score was 84%. The LSTM network improved model performance to 85.84% accuracy and an 85% F1 score. Every operative process starts with Gesture 1 (G1) and ends with G5, with wrong placement is labeled as G6. The average training time is 92 s (SD = 36). Variance was observed between groups for G1, G3, and G6, indicating that trainees may benefit from focusing their efforts on these relevant operations, while assisting doctors also in more effectively analyzing the training outcome.</p><p><strong>Conclusion: </strong>An automatic surgical gesture recognition model was developed for the peg transfer task. We also defined a gesture vocabulary along with the artificial intelligence model to sequentially describe the training operation. This provides an opportunity for artificial intelligence-enabled objective and automatic evaluation based on CLSTA in the clinic implementation.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3749-3759"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence-assisted endoscopic ultrasound diagnosis of esophageal subepithelial lesions.","authors":"Ai-Meng Zhang, Dai-Min Jiang, Shu-Peng Wang, Wen Liu, Bei-Bei Sun, Zhe Wang, Guo-Yi Zhou, Yao-Fu Wu, Qing-Yun Cai, Jin-Tao Guo, Si-Yu Sun","doi":"10.1007/s00464-025-11767-5","DOIUrl":"10.1007/s00464-025-11767-5","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound (EUS) is one of the most accurate methods for determining the originating layer of subepithelial lesions (SELs). However, the accuracy is greatly influenced by the expertise and proficiency of the endoscopist. In this study, we aimed to develop an artificial intelligence (AI) model to identify the originating layer of SELs in the esophagus and evaluate its efficacy.</p><p><strong>Methods: </strong>A total of 1445 cases of esophageal SELs were used to develop the model. An AI model stemming from YOLOv8s-seg and MobileNetv2 was developed to detect esophageal lesions and identify the originating layer. Two seniors and two junior endoscopists independently diagnosed the same test set.</p><p><strong>Results: </strong>The precision, recall, mean average precision @ 0.5, and F1-score of the AI model were 92.2%, 73.6%, 0.832, and 81.9%, respectively. The overall accuracy of the originating layer recognition model was 55.2%. The F1-scores of the second, third, and fourth layers were 47.1%, 51.7%, and 66.1%, respectively. The accuracy of the AI system in differentiating layers 2 and 3 from four was 76.5% and was similar to that of senior endoscopists (74.9-79.8%, P = 0.585) but higher than that of junior endoscopists (65.6-66.7%, P = 0.045).</p><p><strong>Conclusions: </strong>The EUS-AI model has shown high diagnostic potential for detecting esophageal SELs and identifying their originating layers. EUS-AI has the potential to enhance the diagnostic ability of junior endoscopists in clinical practice.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3821-3831"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 indocyanine green and near-infrared fluorescence in the detection of metastatic lymph nodes during oesophageal and gastric cancer resection: a systematic review and meta-analysis.","authors":"Naim Slim, Deepika Anbu, Ara Darzi, Daniel S Elson, Christopher J Peters","doi":"10.1007/s00464-025-11703-7","DOIUrl":"10.1007/s00464-025-11703-7","url":null,"abstract":"<p><strong>Background: </strong>Lymph node status is one of the most important prognosticating factors for patients afflicted by oesophageal cancer (OC) and gastric cancer (GC), and lymphadenectomy during surgery is therefore an essential step to ensure complete oncological resection and accurate disease staging. Intraoperative lymph node visualisation using near-infrared fluorescence (NIRF) and indocyanine green (ICG) tracing has been postulated to improve the overall lymph node yield, and to ensure the appropriate radicality, but its usefulness in the detection of metastatic lymph nodes remains unclear.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of the relevant literature to ascertain the accuracy of ICG-guided lymphadenectomy in the detection of metastatic nodes in OC and GC. The primary outcomes were the sensitivity, specificity and diagnostic odds ratio of ICG-guided lymphadenectomy. Secondary outcomes included measurement of the effect of prior neoadjuvant chemotherapy (NAC), tumour characteristics and method of ICG administration. Summary receiver operator characteristic (SROC) curves were built to illustrate the relationship between the sensitivity of ICG and false positive rate.</p><p><strong>Results: </strong>From an initial search of 6,302 articles, 15 studies met the criteria for inclusion, incorporating 4,004 patients. The pooled sensitivity for metastatic node detection was 69.1% (95% CI 56.5-79.3%), specificity 47.4% (38.0-56.9%), and DOR 2.02 (1.40-2.92). The SROC curve for diagnostic test accuracy yielded an area under the curve of 0.60. The use of NAC adversely affected the sensitivity of ICG 74.7% [59.2-85.8%] without NAC; 52.8% [43.6-61.9%] with NAC, p = 0.018). No significant difference in efficacy was demonstrated between pathological 'T' stage, or ICG administration method.</p><p><strong>Conclusion: </strong>Our findings suggest that the oncological benefits of NIRF and ICG in the context of lymphadenectomy in OC and GC are limited, and that surgeons risk omitting a significant proportion of metastatic nodes if this technique is solely relied upon.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3525-3538"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Color differences of intraprocedural bleeding between white light and red dichromatic imaging during endoscopic submucosal dissection: a post hoc analysis of a multicenter, open-label, randomized controlled trial (with videos).","authors":"Mai Makiguchi, Seiichiro Abe, Ai Fujimoto, Ryosuke Kawagoe, Takeshi Uozumi, Mitsunori Kusuhara, Yasuhiko Mizuguchi, Naoya Toyoshima, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Issay Kitabayashi, Hiroyuki Daiko, Yutaka Saito, Naohisa Yahagi","doi":"10.1007/s00464-025-11809-y","DOIUrl":"https://doi.org/10.1007/s00464-025-11809-y","url":null,"abstract":"<p><strong>Background: </strong>Red dichromatic imaging (RDI) is an image-enhanced endoscopy expected to improve the visibility of bleeding source. We aimed to analyze color difference and hemostasis time between white light imaging (WLI) and RDI during endoscopic submucosal dissection (ESD).</p><p><strong>Methods: </strong>This was a single-center post hoc analysis of a multicenter randomized controlled trial (RCT) to verify the efficacy and safety of RDI in hemostasis during ESD. We included patients with intraprocedural bleeding enrolled in an RCT at our institution. We extracted videos of intraoperative bleeding and annotated bleeding source in each frame. We calculated the mean color difference (ΔE) between the bleeding source and eight surrounding areas for each frame. We also evaluated the visibility score of the bleeding source.</p><p><strong>Results: </strong>Thirty-nine and 63 hemostasis were performed among 30 patients in WLI (n = 16) and RDI (n = 14) groups. The ΔE ± standard error (SE) was significantly higher in RDI than in WLI (14.2 ± 0.5 and 11.7 ± 0.8, p = 0.01). The ΔE ± SE for spurting and oozing hemorrhage was 9.3 ± 0.9 and 13.6 ± 0.7 (p = 0.02) and 12.4 ± 1.0 and 14.5 ± 0.5 (p = 0.47), and mean hemostasis time ± SE (seconds) was 44.5 ± 7.9 and 25.9 ± 3.8 (p = 0.04) in WLI and RDI, respectively. The mean visibility score was significantly higher in RDI than in WLI (3.36 ± 0.7 vs 2.78 ± 1.0, p < 0.01).</p><p><strong>Conclusion: </strong>RDI demonstrated a higher color difference in the bleeding source than WLI. This could improve the visibility of a bleeding source, particularly spurting hemorrhage.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}