Techniques and Innovations in Gastrointestinal Endoscopy最新文献

{"title":"Traction-Assisted Endoscopic Submucosal Dissection of Colonic Lesions: A North American Experience","authors":"Farid Abushamat,&nbsp;Fares Ayoub,&nbsp;Mai A. Khalaf,&nbsp;Tara Keihanian,&nbsp;Salmaan Jawaid,&nbsp;Mohamed O. Othman","doi":"10.1016/j.tige.2024.250900","DOIUrl":"10.1016/j.tige.2024.250900","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Traction-assisted endoscopic submucosal dissection (TA-ESD) is a proposed technique to improve the efficiency of endoscopic submucosal dissection (ESD). Multiple studies primarily from Asian centers yielded mixed results in terms of procedure time, en bloc resection rate, and R0 resection rate of TA-ESD in comparison with those of conventional endoscopic submucosal dissection (C-ESD). We performed the first comparison of TA-ESD with C-ESD at a high-volume North American center.</div></div><div><h3>METHODS</h3><div>This was a retrospective cohort-matched study of all patients who underwent colonic ESD at a single center in the United States by a single operator. The study group were patients who underwent TA-ESD and were matched with a C-ESD case on a 1:1 basis based upon location within the colon, lesion size, and scope stabilization device usage. The baseline characteristics and procedure-related outcomes were compared between the groups.</div></div><div><h3>RESULTS</h3><div>In total, 138 colonic ESD cases were included (69 TA-ESD and 69 C-ESD). There were no significant differences in the baseline characteristics between the groups. Mean procedure time was 91.0 minutes (SD: 32.5) for TA-ESD and 85.4 minutes (SD: 39.3) for C-ESD (<em>P</em> = 0.36). En bloc resection was achieved in 69 (100%) of the TA-ESDs and 67 (97.1%) of the C-ESDs (<em>P</em> = 0.15). R0 resection was achieved in 52 (75.4%) of the TA-ESDs and 48 (69.6%) of the C-ESDs (<em>P</em> = 0.45).</div></div><div><h3>CONCLUSION</h3><div>We did not show a significant difference in procedure time, en bloc resection, R0 resection, or adverse events. Further randomized prospective studies that are sufficiently powered and stratified by operator experience level are needed to further elucidate the utility of the technique.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250900"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reopenable Clip-Over-the-Line Method for Troubleshooting Iatrogenic Gastrointestinal Perforations","authors":"Takeshi Yasuda,&nbsp;Narutoshi Ando,&nbsp;Tamae Hashimoto,&nbsp;Yoshiaki Kanai,&nbsp;Yoichi Sakamoto,&nbsp;Yuki Endo,&nbsp;Tomohiro Soda,&nbsp;Takako Akazawa,&nbsp;Tsuguhiro Matsumoto,&nbsp;Norihito Yamauchi,&nbsp;Akira Muramatsu,&nbsp;Hiromu Kutsumi","doi":"10.1016/j.tige.2024.250901","DOIUrl":"10.1016/j.tige.2024.250901","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250901"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Patients’ Current Acceptability of Artificial Intelligence During Colonoscopy for Polyp Detection: A Single-Center Study","authors":"Kathryn A. Schmidt ,&nbsp;Shubham Sood ,&nbsp;Saam Dilmaghani ,&nbsp;Cadman Leggett ,&nbsp;Ross Dierkhising ,&nbsp;Mayank Goyal ,&nbsp;Barbara A. Barry ,&nbsp;Xuan Zhu ,&nbsp;Nayantara Coelho-Prabhu","doi":"10.1016/j.tige.2024.250905","DOIUrl":"10.1016/j.tige.2024.250905","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Research into potential applications of artificial intelligence (AI) in healthcare have witnessed a meteoric rise. A primary application in gastroenterological care is colonoscopy. Before AI tools become ubiquitous in healthcare, it is critical to appreciate the perspective of the potential beneficiaries, particularly patients. This study evaluated patient acceptability of AI in colonoscopy, particularly for polyp detection and diagnosis.</div></div><div><h3>METHODS</h3><div>In this cross-sectional survey study, patients undergoing outpatient colon cancer screening or surveillance colonoscopies at Mayo Clinic, Rochester, from September 2023 to February 2024 completed an electronic self-administered survey via tablet computer including questions regarding AI in colonoscopy. The primary outcome was patient perspectives on AI, and secondary outcomes included patient factors influencing their perspective. Statistical analyses were performed using Pearson's chi-square test and ordinal logistic regression.</div></div><div><h3>RESULTS</h3><div>Five hundred eight participants completed the survey. Younger age, male gender, and higher education were associated with higher AI familiarity and perceived importance, while males and those who believed in AI's positive outcomes were more comfortable with AI-assisted polyp detection.</div></div><div><h3>CONCLUSION</h3><div>This study is the first to assess patient perceptions of AI in colonoscopy. While patients generally believe AI can improve health outcomes, there is uncertainty about its current use, indicating a gap in knowledge and awareness. Key findings highlight that beliefs in AI's efficacy are linked to increased comfort with AI-assisted procedures, with significant demographic variations in perceptions, particularly across gender, age, and education. Addressing disparities through targeted education and transparent communication is crucial for fostering patient acceptance and trust in AI-assisted colonoscopy.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250905"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143349020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Surveillance Patterns and Management of Helicobacter pylori in Newly Diagnosed Gastric Intestinal Metaplasia","authors":"SHIVRAM CHANDRAMOULI ,&nbsp;ANNIE L. WANG ,&nbsp;DAVID A. LEIMAN","doi":"10.1016/j.tige.2024.250904","DOIUrl":"10.1016/j.tige.2024.250904","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250904"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Life Application of Artificial Intelligence for Automatic Characterization of Biliary Strictures: A Transatlantic Experience","authors":"Mariano González-Haba Ruiz ,&nbsp;Pedro Pereira ,&nbsp;Jessica Widmer ,&nbsp;Tiago Ribeiro ,&nbsp;Belén Agudo Castillo ,&nbsp;Filipe Vilas-Boas ,&nbsp;João Ferreira ,&nbsp;Miguel Mascarenhas Saraiva ,&nbsp;Guilherme Macedo","doi":"10.1016/j.tige.2024.250902","DOIUrl":"10.1016/j.tige.2024.250902","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250902"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Machine Learning Voice-Based Biomarkers for Characterization of Barrett's Esophagus","authors":"AMRIT K. KAMBOJ ,&nbsp;MANOJ K. YARLAGADDA ,&nbsp;MAYO CLINIC BARRETT'S ESOPHAGUS AND VOICE WORKING GROUP ,&nbsp;KEIKO ISHIKAWA ,&nbsp;DIANA M. ORBELO ,&nbsp;MARY PIETROWICZ ,&nbsp;CADMAN L. LEGGETT","doi":"10.1016/j.tige.2024.250903","DOIUrl":"10.1016/j.tige.2024.250903","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250903"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Repair for Sleeve Gastrectomy Leaks Is Associated With a High Rate of Leak Resolution","authors":"Khalid Fahoum ,&nbsp;Tamara Kahan ,&nbsp;Olivia Delau ,&nbsp;Matthew Fasullo ,&nbsp;Ki-Yoon Kim ,&nbsp;Lauren Khanna ,&nbsp;Gregory Haber ,&nbsp;Paresh C. Shah ,&nbsp;Tamas Gonda","doi":"10.1016/j.tige.2024.09.004","DOIUrl":"10.1016/j.tige.2024.09.004","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Staple line leaks following sleeve gastrectomy have significant morbidity and mortality. Endoscopic repair approaches are increasingly being used and studied, but follow-up time is limited, and more data are needed. Our primary aim was to describe long-term outcomes following repair; secondary aims were to compare repair approaches and assess factors associated with clinical success.</div></div><div><h3>METHODS</h3><div>We conducted an observational cohort study of patients who underwent endoscopic repair of a sleeve gastrectomy leak from 2017 to 2023 at our tertiary care center. Patients without available follow-up were excluded. Electronic medical records were reviewed to obtain baseline and clinical characteristics; long-term outcomes were ascertained from the electronic medical record and telephonic conversations with patients. Repairs were classified as drainage when transmural stents were placed and as closure when clips, sutures, and/or an intraluminal stent was placed.</div></div><div><h3>RESULTS</h3><div>A total of 30 patients were included. The majority were females (77%) and Whites (74%), with a median age of 41.0 years (IQR, 35.1-51.8 years). The majority of patients (70%) initially underwent drainage, while the rest underwent closure. Median follow-up time was 1.2 years (IQR, 0.6 -1.6 years). Success rates for the initial repair approach without crossover or requiring surgical repair were 71.4% for drainage and 22.2% for closure (<em>P</em> = 0.02). Overall, 24 (80%) patients had leak resolution at the last follow-up, and the median number of endoscopies was 3 (IQR, 2-4).</div></div><div><h3>CONCLUSION</h3><div>Our study demonstrates a high rate of long-term leak resolution following endoscopic repair of sleeve gastrectomy leaks. An initial drainage approach may be associated with higher clinical success, although this was not noted in the multivariable analysis. Prospective randomized multicenter studies are needed to further evaluate and compare repair approaches.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150897"},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Endoscopic Role and Indications of Through-the-Scope Tack and Suture System for Gastrointestinal Closure","authors":"Andrew Canakis ,&nbsp;Abdulhameed Al-Sabban ,&nbsp;Shayan S. Irani","doi":"10.1016/j.tige.2024.09.005","DOIUrl":"10.1016/j.tige.2024.09.005","url":null,"abstract":"<div><div>The development of endoscopic closure devices has revolutionized management options for gastrointestinal defects. The endoscopists’ toolbox has expanded from through-the-scope clips to over-the-scope clips and over-the-scope suturing. The over-the-scope devices are somewhat limited by the target location, maneuverability, and need for device withdrawal for application. The introduction of a novel through-the-scope helix tack suture system enhances the toolbox for defect closure as this device can provide closure throughout the gastrointestinal tract without the need for endoscope withdrawal. Its user-friendly design and compatibility with standard endoscopes allows for complex tissues approximation in challenging locations. Since its approval by the Federal Drug Agency in December 2020, studies have investigated its utility for all types of defects, including perforations, leaks, fistulas, endoscopic resections sites, and even stent fixation. In this review, we will investigate the versatility of this device to understand its role in primary defect closure.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150898"},"PeriodicalIF":1.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Transpapillary Gallbladder Drainage With 2 Stents Versus 1 Stent Reduces Reinterventions: A Multicenter Study","authors":"James D. Haddad ,&nbsp;Natalie Wilson ,&nbsp;Vijay S. Are ,&nbsp;Shawn L. Shah ,&nbsp;Danny Issa ,&nbsp;Tarek Sawas ,&nbsp;Mohammad Bilal ,&nbsp;Thomas Tielleman","doi":"10.1016/j.tige.2024.09.006","DOIUrl":"10.1016/j.tige.2024.09.006","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Endoscopic transpapillary gallbladder drainage (ETGBD) is a therapeutic option for gallstone-related gallbladder disease in nonsurgical candidates. However, the optimal stenting strategy and follow-up has not been established. We aimed to determine whether there was a decreased need for unplanned reintervention in patients undergoing placement of two transpapillary gallbladder stents compared with that in those undergoing placement of one stent.</div></div><div><h3>METHODS</h3><div>We performed a multicenter retrospective analysis of patients undergoing ETGBD between June 2013 and October 2022. The primary outcome was clinical success as defined by resolution of symptoms without the need for another drainage strategy. Secondary outcomes included the adverse events of postendoscopic retrograde cholangiopancreatography pancreatitis, cholangitis, bleeding, perforation, or death. Factors associated with placement of two stents, unplanned reintervention, and adverse events were assessed.</div></div><div><h3>RESULTS</h3><div>We included 75 patients who underwent ETGBD, with a median follow-up of 407 days (IQR: 71-1504 days). Technical and clinical success were 88.2% and 81.3%, respectively. Unplanned reintervention was significantly lower in the double stenting group (0% vs 25.4%; <em>P</em> = 0.02). Use of a 7 French stent (odds ratio [OR]: 15.5; 95% CI: 1.9-125; <em>P</em> = 0.01) and presence of a percutaneous cholecystostomy tube (OR: 10.8; 95% CI: 2.8-41.3; <em>P</em> = 0.001) were associated with placement of two stents. There was no significant difference in adverse events between groups (OR: 0.9; 95% CI: 0.09-8.8; <em>P</em> = 0.94).</div></div><div><h3>CONCLUSION</h3><div>ETGBD is safe and effective in nonoperative candidates. Single transpapillary gallbladder stenting is associated with more unplanned reinterventions, and 7 French stent diameter and previous percutaneous cholecystostomy tube may be associated with ability to place a second stent. Endoscopists should consider planned exchange of solitary transpapillary gallbladder stents or interval placement of a second stent if placement of two stents was unsuccessful at the index procedure.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150899"},"PeriodicalIF":1.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic Cancer Screening: A Narrative Review","authors":"Jihane Meziani,&nbsp;Gwenny M. Fuhler,&nbsp;Marco J. Bruno,&nbsp;Djuna L. Cahen,&nbsp;Kasper A. Overbeek","doi":"10.1016/j.tige.2024.08.001","DOIUrl":"10.1016/j.tige.2024.08.001","url":null,"abstract":"<div><div>Pancreatic cancer (PC) is one of the most lethal cancer types. Despite advancements that have led to some modest improvements in survival rates over the past decade, PC still has a dismal prognosis. Patients diagnosed with early-stage disease have higher survival rates. Unfortunately, PC seldom manifests itself early, and symptoms prompting diagnostic investigations usually develop when the disease is already advanced. PC screening may lead to better patient outcomes through detection of asymptomatic early-stage cancers and precursor lesions. Population-based screening is deemed unfeasible because of the low incidence of PC. However, screening of individuals with an inherited lifetime risk of ≥5%-10% for developing PC may prove beneficial. In the context of high-risk individuals, screening is referred to as surveillance. Yet, critical aspects such as suitable candidates for surveillance, the ideal time to initiate and discontinue surveillance, as well as the most effective surveillance method, preferred surveillance modalities, and optimal surveillance interval remain unclear. Herein, we summarize the current state of knowledge regarding PC surveillance by reviewing current expert consensus statements and guidelines. In addition, we review the management of identified lesions, the yield in different cohorts, and future directions to improve the outcomes of individuals at high-risk of developing PC.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"26 4","pages":"Pages 323-334"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142533795","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}