World Journal of Gastrointestinal Endoscopy最新文献

{"title":"Endoscopic ultrasonography as a comprehensive tool in the evaluation of pancreatic lesions.","authors":"Rodrigo Mansilla-Vivar, Eduardo Segovia-Vergara","doi":"10.4253/wjge.v17.i9.111000","DOIUrl":"10.4253/wjge.v17.i9.111000","url":null,"abstract":"<p><p>This article expands upon of endoscopic ultrasound's (EUS) role in the evaluation of pancreatic lesions, building on findings presented by Ayesha <i>et al</i> and Tasneem <i>et al</i> regarding neuroendocrine tumors. We emphasize the diagnostic and therapeutic utility of EUS not only in solid pancreatic tumors but also in the increasingly prevalent cystic lesions, highlighting its particular relevance in resource-limited settings. By integrating high-resolution imaging, tissue acquisition, biomarker analysis, and minimally invasive interventions into a single platform, EUS addresses key diagnostic and therapeutic challenges, reducing the need for multiple costly procedures and enabling effective management even when access to advanced technologies is limited.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"111000"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic ultrasound in the management of complications related to cirrhosis- recent evidence.","authors":"Drew T Castleberry, Rupinder Mann, Benjamin Tharian, Ragesh Babu Thandassery","doi":"10.4253/wjge.v17.i9.108549","DOIUrl":"10.4253/wjge.v17.i9.108549","url":null,"abstract":"<p><p>Advanced endoscopic methods like endoscopic ultrasound (EUS) have recently been applied for the management of complications related to cirrhosis. This includes novel techniques to measure portal pressure gradients, esophageal, gastric, and ectopic varices management, and EUS-assisted treatment of liver tumors. Management of liver tumors has seen significant changes in recent years, and many minimally invasive procedures have been approved, especially in the management of liver cell carcinoma. These are specialized procedures and are performed only in patients with cirrhosis in specialized centers. There are concerns for complications in patients with cirrhosis due to their increased risk of bleeding and the altered hemostatic milieu. This minireview summarizes the recent evidence on using EUS in the management of cirrhosis-related complications.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"108549"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114214","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":"Effect of prehabilitation in patients undergoing hepatobiliary and pancreatic cancer resections: A systematic review and meta-analysis.","authors":"Omar Lubbad, Wajeeh Ullah Mahmood, Shehram Shafique, Krishna K Singh, Goldie Khera, Muhammad Shafique Sajid","doi":"10.4253/wjge.v17.i9.109029","DOIUrl":"10.4253/wjge.v17.i9.109029","url":null,"abstract":"<p><strong>Background: </strong>Hepatobiliary and pancreatic cancers are often associated with high morbidity and mortality. Surgical intervention remains the cornerstone for curative treatment. However, Due to the complexity of these procedures, patients often experience postoperative complications. Prehabilitation has been suggested as a tool to decrease postoperative morbidity and improve recovery by optimising patients preoperatively to handle the stress of surgery.</p><p><strong>Aim: </strong>To evaluate the effectiveness of prehabilitation in patients undergoing hepatobiliary and pancreatic cancer resections.</p><p><strong>Methods: </strong>Standard medical databases such as MEDLINE, EMBASE, PubMed, and Cochrane Library were searched to find randomised, controlled trials comparing prehabilitation <i>vs</i> no-prehabilitation before hepatic, biliary, or pancreatic cancer resections. All data were analysed using Review Manager Software 5.4, and the meta-analysis was performed with a random-effect model analysis.</p><p><strong>Results: </strong>A total of 8 studies were included (<i>n</i> = 568), recruiting adult patients undergoing hepatic, biliary, or pancreatic cancer resections. In the random effect model analysis, prehabilitation was associated with fewer postoperative complications compared to no prehabilitation [risk ratio (RR): 0.79, 95%CI: 0.66-0.95, <i>Z</i> = 2.52, <i>P</i> = 0.01]. No statistically significant difference was found in postoperative readmission rate (RR: 1.31, 95%CI: 0.79-2.17, <i>Z</i> = 1.05, <i>P</i> = 0.29), major complications (RR: 1.08; 95%CI: 0.61-1.92, <i>Z</i> = 0.28, <i>P</i> = 0.78), length of stay (standardised mean difference: -0.11, 95%CI: -0.31 to 0.1, <i>Z</i> = 1.05, <i>P</i> = 0.29), or mortality (RR: 0.28, 95%CI: 0.01-6.51, <i>Z</i> = 0.79, <i>P</i> = 0.43).</p><p><strong>Conclusion: </strong>Prehabilitation was found to be effective in reducing postoperative complications following surgical intervention for hepatobiliary or pancreatic cancer.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"109029"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic submucosal dissection for early gastrointestinal malignancies: Current state and future perspectives.","authors":"Sandip Pal, Gourab Bhaduri","doi":"10.4253/wjge.v17.i9.109144","DOIUrl":"10.4253/wjge.v17.i9.109144","url":null,"abstract":"<p><p>Endoscopic submucosal dissection (ESD) has emerged as a pivotal therapeutic modality for early gastrointestinal (GI) cancers, providing a minimally invasive approach with curative potential. This technique enables the <i>en bloc</i> resection of neoplastic lesions confined to the mucosa and submucosa, thereby preserving organ function and reducing the need for more radical surgical interventions. ESD provides diagnostic clarity and enhances patient survival rates when performed by skilled practitioners in the early stages of GI cancers such as esophageal, gastric, and colorectal carcinomas. This article examines the indications, procedural advancements, technical considerations, and outcomes associated with ESD in early GI cancers. The challenges and complications that can arise are also highlighted. Additionally, we discuss the evolving role of novel techniques and adjunctive therapies to improve safety and efficacy. As the field progresses, ESD remains a cornerstone in managing early GI cancers, offering patients a promising option for organ preservation and long-term survival.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"109144"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114143","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":"Effect of prehabilitation in patients undergoing gastric or oesophageal cancer resections: A systematic review and meta-analysis.","authors":"Omar Lubbad, Wajeeh Ullah Mahmood, Shehram Shafique, Krishna K Singh, Goldie Khera, Muhammad Shafique Sajid","doi":"10.4253/wjge.v17.i9.109033","DOIUrl":"10.4253/wjge.v17.i9.109033","url":null,"abstract":"<p><strong>Background: </strong>Gastric and oesophageal cancers are among the leading causes of cancer-related mortality globally. Treatment in the form of surgical resection and neoadjuvant therapy is considered the gold standard; however, these procedures are associated with significant postoperative morbidity and prolonged recovery times. Prehabilitation aims to combat this by physically and psychologically optimising patients preoperatively to handle the stress of surgery and improve postoperative outcomes.</p><p><strong>Aim: </strong>To evaluate the effectiveness of prehabilitation in patients undergoing gastric or oesophageal cancer resections.</p><p><strong>Methods: </strong>Standard medical databases such as MEDLINE, EMBASE, PubMed, and Cochrane Library were searched to find randomised, controlled trials comparing prehabilitation <i>vs</i> no-prehabilitation in patients undergoing gastric or oesophageal cancer resections. All data were analysed using Review Manager Software 5.4, and the meta-analysis was performed with a random-effect model analysis.</p><p><strong>Results: </strong>A total of 16 studies were included (<i>n</i> = 1479), recruiting adult patients undergoing gastric or oesophageal cancer resections. In the random effect model analysis, prehabilitation was associated with fewer postoperative complications compared to no prehabilitation (Odds ratio: 0.43, 95%CI: 0.31-0.58, <i>Z</i> = 25.28, <i>P</i> < 0.00001). Additionally, prehabilitation was associated with a lower postoperative readmission rate (risk ratio: 0.58, 95%CI: 0.35-0.96, <i>Z</i> = 2.10, <i>P</i> = 0.04) and a shorter length of stay [standardised mean difference (SMD): -0.19, 95%CI: -0.37 to -0.02, <i>Z</i> = 2.21, <i>P</i> = 0.03] compared to no-prehabilitation. Prehabilitation was also found to improve preoperative 6-minute walking distance (6-MWD) compared to no-prehabilitation (SMD: 0.72, 95%CI: 0.21-1.23, <i>Z</i> = 2.75, <i>P</i> = 0.006). No statistical difference was found in postoperative 6-MWD, mortality, and severe complications.</p><p><strong>Conclusion: </strong>Prehabilitation was found to be effective in reducing postoperative morbidity and improving preoperative physical health in patients undergoing gastric or oesophageal cancer resections.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"109033"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113883","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":"Unsuspected efficacy of starch-based polysaccharide <i>vs</i> crystalloid-oil emulsion for lifting in colonic endoscopic resections.","authors":"Sartajdeep Kahlon, Amer Alsamman, Jiten Desai, Shiro Urayama","doi":"10.4253/wjge.v17.i9.109396","DOIUrl":"10.4253/wjge.v17.i9.109396","url":null,"abstract":"<p><strong>Background: </strong>In endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), submucosal lifting agents such as crystalloid-oil emulsion solution (COES) are used for improved effect. Starch-based polysaccharide solution (SPS), which in powder form acts as effective hemostatic agent, are now available as an alternative lifting agent.</p><p><strong>Aim: </strong>To compare SPS to COES outcomes as lifting agents in colonic EMR and ESD.</p><p><strong>Methods: </strong>This is a retrospective study of patients who underwent colonic EMR or ESD and received submucosal injection of either SPS or COES at a single academic center from March 2021 to November 2023. A total of 79 patients were included in the COES group and 99 patients in the SPS group from chart review. Intraprocedural bleeding was defined as bleeding during a procedure requiring hemostatic intervention. Adverse events included were perforation or post-procedure gastrointestinal bleed within the first 30-day period. Data were analyzed using <i>t</i>-test and <i>χ</i> ² test.</p><p><strong>Results: </strong>Successful resection was achieved in all 178 patients. Average lesion size in SPS group was 2.6 cm <i>vs</i> 2.4 cm in COES group. Average procedure time was 22 minutes shorter in the SPS group (<i>P</i> < 0.05). Intraprocedural bleeding was 24.1% more frequent in COES group (<i>P</i> < 0.01). The 30-day adverse events were 9.37% more frequent in the COES group (<i>P</i> < 0.01). <i>En bloc</i> resection was achieved 22.2% more frequently in patients receiving SPS submucosal injection (<i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>SPS colonic submucosal injection appears to be beneficial over COES, as it is associated with lower intraprocedural bleeding, less adverse events, shorter procedures, and more frequent <i>en bloc</i> resections.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"109396"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114281","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":"Intersection of medicine and nursing in endoscopic sedation: Understanding roles and responsibilities.","authors":"Maria Kapritsou","doi":"10.4253/wjge.v17.i9.110664","DOIUrl":"10.4253/wjge.v17.i9.110664","url":null,"abstract":"<p><p>The effective delivery of healthcare in procedural settings, particularly during endoscopic sedation, requires seamless collaboration between medical and nursing professionals. This necessity has become increasingly significant as healthcare systems strive to improve patient safety and quality of care during minimally invasive procedures, which have gained traction due to their benefits in diagnosis and treatment. The findings indicate significant discrepancies in how roles are perceived by medical and nursing staff, with over 60% of participants reporting confusion about specific responsibilities during sedation processes. This uncertainty has been associated with inconsistent patient outcomes and potential safety issues. Additionally, the research highlights the need for interprofessional education and collaborative practice models to promote effective communication and mutual understanding between medical and nursing teams.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"110664"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114330","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":"Transpapillary drainage of pancreatic fluid leakage <i>via</i> a rigid trans-tumoral tract using a drill dilator: A case report.","authors":"Makomo Makazu, Kazuya Koizumi, Jun Kubota, Karen Kimura, Sakue Masuda","doi":"10.4253/wjge.v17.i9.110424","DOIUrl":"10.4253/wjge.v17.i9.110424","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic fluid leakage is a rare complication of pancreatic cancer and often requires drainage when conservative therapy fails. Endoscopic, percutaneous, and surgical drainage are options. Minimally invasive endoscopic procedures are generally considered the first-line treatment, with either a transpapillary approach or an endoscopic ultrasound-guided transmural approach selected depending on the case. Various dilators are used to dilate tracts to the leakage site. However, reports of dilation through a rigid trans-tumoral tract using a drill dilator remain extremely rare.</p><p><strong>Case summary: </strong>A 74-year-old woman with pancreatic body and tail cancer developed fever and left-sided chest pain after multiple courses of chemotherapy. Computed tomography revealed fluid accumulation around the pancreatic tail and spleen along with a left pleural effusion. The effusion was diagnosed as reactive secondary to pancreatic fluid leakage. Endoscopic retrograde cholangiopancreatography identified irregular stenosis of the main pancreatic duct in the pancreatic body. Distal to the stenosis, the main ductal structure was nearly obliterated by the tumor. The contrast medium had leaked into the pancreatic fluid leakage area through several fine, disrupted ductal structures. The guidewire was successfully advanced through an extremely fine tract that was not the main contrast-filling route. Standard dilators failed to expand the rigid trans-tumoral tract. A second endoscopic retrograde cholangiopancreatography using a drill dilator successfully expanded the trans-tumoral tract, enabling endoscopic nasopancreatic drainage tube placement. Subsequently, the pancreatic fluid leakage and pleural effusion resolved.</p><p><strong>Conclusion: </strong>Even in rigid trans-tumoral tracts, the use of a drill dilator can facilitate successful tract expansion, enabling effective drainage.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"110424"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114243","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":"Addressing gastrointestinal disorders in rural Ethiopia: Success of a weekend outreach colonoscopy service.","authors":"Guda M Roro, Elias M Roro, Dabessa M Abebe","doi":"10.4253/wjge.v17.i9.110476","DOIUrl":"10.4253/wjge.v17.i9.110476","url":null,"abstract":"<p><strong>Background: </strong>Colonoscopy is essential for screening, diagnosing, and treating lower gastrointestinal diseases; however, access is limited in resource-constrained areas. Barriers to endoscopy services include a shortage of trained specialists and inadequate equipment and infrastructure. Most gastroenterologists in Ethiopia work in major cities, leaving the 80% rural population with limited access to endoscopy due to economic and logistical challenges. Such inequitable access negatively impacts optimal patient care and outcomes and potentially skews data on disease prevalence. To address these issues we implemented weekend outreach endoscopy program in Southwest Ethiopia where such services were previously unavailable. Findings were documented electronically and stored safely.</p><p><strong>Aim: </strong>To evaluate the findings, success, and impact of weekend outreach colonoscopy services in predominantly rural Southwest Ethiopia.</p><p><strong>Methods: </strong>In partnership with Jimma Awetu Hospital, a senior gastroenterologist from Addis Ababa University established an outreach endoscopy service in 2019, training local nursing staff as coordinators. Physicians selected and referred patients for colonoscopy, and informed consent was obtained before the procedure. A total of 1612 procedures were performed using a portable Fujinon EPX-2500-HD system, and findings were documented electronically. Data were analyzed using descriptive statistics on Statistical Package for the Social Sciences 29.</p><p><strong>Results: </strong>From 2019 to 2024 1612 colonoscopy procedures were performed, achieving an 83.0% diagnostic yield. The cohort was predominantly male (70.6%) with a mean age of 44 years; 61% were under 50. Ninety-one percent of patients were referred by 21 hospitals across three regions. Primary indications included abdominal pain (26.8%) and lower gastrointestinal bleeding (25.3%). Abnormal findings included inflammation (39.5%), colorectal masses (13.2%), and hemorrhoid (11.8%). Histology confirmed inflammatory bowel disease in 11.5%, cancers in 11.0%, and polyps in 10.0%. In this study half of colorectal cancer cases occurred in patients under 50 with prevalence rates of 18.8% in females and 10.8% in males, challenging the global trend that shows this disease predominantly affects older individuals and males.</p><p><strong>Conclusion: </strong>This weekend outreach colonoscopy service implemented standard diagnostics, improved the existing service, and generated vital evidence on local disease patterns with the potential to positively impact clinical practice and policy-making.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"110476"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113482","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":"Efficacy and safety of pretraction-assisted endoscopic submucosal dissection for treating rectal neuroendocrine tumors.","authors":"Xiao-Xiong Guo, Si-Han Zhang, Ai-Jin Chen, Yan-Ling Chen, Feng-Lin Chen","doi":"10.4253/wjge.v17.i9.111734","DOIUrl":"10.4253/wjge.v17.i9.111734","url":null,"abstract":"<p><strong>Background: </strong>Conventional endoscopic submucosal dissection (c-ESD) is a widely used technique for rectal neuroendocrine tumors (NETs), but it poses certain challenges. To address these, we developed a pretraction-assisted endoscopic submucosal dissection (p-ESD) technique.</p><p><strong>Aim: </strong>To compare the efficacy and safety of p-ESD and c-ESD for rectal NETs.</p><p><strong>Methods: </strong>This retrospective study included consecutive patients with rectal NETs measuring less than 15 mm who underwent either pESD or cESD at Fujian Medical University Union Hospital between January 2019 and December 2023. The study aimed to evaluate differences in dissection time, <i>en bloc</i> resection rate, R0 resection rate, and adverse event rates between the pESD and cESD groups.</p><p><strong>Results: </strong>In total, 103 patients were enrolled (49 in the p-ESD group and 54 in the c-ESD group). The p-ESD group exhibited a significantly shorter median dissection time (9.3 minutes <i>vs</i> 14.9 minutes; <i>P</i> < 0.001) and a higher R0 resection rate (100% <i>vs</i> 88.9%; <i>P</i> = 0.028), while <i>en bloc</i> resection rates were comparable. Rates of minor intraoperative bleeding (10.2% <i>vs</i> 25.9%; <i>P</i> = 0.040) and major intraoperative bleeding (4.1% <i>vs</i> 18.5%; <i>P</i> = 0.030) were lower in the p-ESD group. No muscularis propria injuries occurred in the p-ESD group <i>vs</i> 16.7% in the c-ESD group (<i>P</i> = 0.003). Other adverse events did not differ significantly.</p><p><strong>Conclusion: </strong>p-ESD is safe and effective for treating rectal NETs. Compared with c-ESD, it is technically easier, requires less dissection time, achieves higher R0 resection rates, reduces intraoperative bleeding, and lowers the risk of muscularis propria injury.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 9","pages":"111734"},"PeriodicalIF":1.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12444259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114148","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}