Therapeutic Advances in Gastrointestinal Endoscopy最新文献

{"title":"Palliative therapy for malignant gastric outlet obstruction: how does the endoscopic ultrasound-guided gastroenterostomy compare with surgery and endoscopic stenting? A systematic review and meta-analysis.","authors":"Rafael Krieger Martins, Vitor Ottoboni Brunaldi, André Luis Fernandes, José Pinhata Otoch, Everson Luiz de Almeida Artifon","doi":"10.1177/26317745221149626","DOIUrl":"10.1177/26317745221149626","url":null,"abstract":"<p><strong>Introduction: </strong>The gold-standard procedure to address malignant gastric outlet obstruction (MGOO) is surgical gastrojejunostomy (SGJJ). Two endoscopic alternatives have also been proposed: the endoscopic stenting (ES) and the endoscopic ultrasound-guided gastroenterostomy (EUS-G). This study aimed to perform a thorough and strict meta-analysis to compare EUS-G with the SGJJ and ES in treating patients with MGOO.</p><p><strong>Materials and methods: </strong>Studies comparing EUS-G to endoscopic stenting or SGJJ for patients with MGOO were considered eligible. We conducted online searches in primary databases (MEDLINE, EMBASE, Lilacs, and Central Cochrane) from inception through October 2021. The outcomes were technical and clinical success rates, serious adverse events (SAEs), reintervention due to obstruction, length of hospital stay (LOS), and time to oral intake.</p><p><strong>Results: </strong>We found similar technical success rates between ES and EUS-G but clinical success rates favored the latter. The comparison between EUS-G and SGJJ demonstrated better technical success rates in favor of the surgical approach but similar clinical success rates. EUS-G shortens the LOS by 2.8 days compared with ES and 5.8 days compared with SGJJ. Concerning reintervention due to obstruction, we found similar rates for EUS-G and SGJJ but considerably higher rates for ES compared with EUS-G. As to AEs, we demonstrated equivalent rates comparing EUS-G and SGJJ but significantly higher ones compared with ES.</p><p><strong>Conclusion: </strong>Despite being novel and still under refinement, the EUS-G has good safety and efficacy profiles compared with SGJJ and ES.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"16 ","pages":"26317745221149626"},"PeriodicalIF":3.0,"publicationDate":"2023-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/42/8b/10.1177_26317745221149626.PMC9869232.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10622312","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":"Multimodal necrosectomy with full combined endoscopic necrosectomy in the management of acute necrotizing pancreatitis","authors":"S. Ouazzani, M. Gasmi, M. Barthet, J.M. Gonzalez","doi":"10.1177/26317745231182595","DOIUrl":"https://doi.org/10.1177/26317745231182595","url":null,"abstract":"Transgastric and transduodenal endoscopic drainages and necrosectomy are minimally invasive and effective way for the treatment of infected necrosis in the setting of acute pancreatitis (AP), but are limited in case of large and distant collections or in case of altered anatomy. We present an exclusively endoscopic approach consisting of multimodal endoscopic necrosectomy. We included consecutive patients with severe AP and presenting with large and infected necrosis requiring one transgastric and at least one extra-gastric access, among which are percutaneous, transcolonic, and/or transgrelic access. All accesses and necrosectomy sessions were performed endoscopically with CO2 insufflation. Six consecutive patients were treated. The location of infected collections were perigastric (100%), right and left paracolonic (67% and 67%), and paraduodenal (33%). All patients had transgastric or transduodenal access, all had at least one percutaneous access (total: 7 accesses), one had one transcolonic access, and one had one transjejunal access. A median of 4 necrosectomy sessions (2–5) were performed. All patients recovered without additional surgical necrosectomy. Full endoscopic multimodal management of infected necrosis with step-up approach seems feasible, safe, and effective in very large collections.","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"258 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135505495","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":"Unconventional treatment of inoperable biliary IPMN with an oesophageal stent in the common bile duct: case report.","authors":"Antti Siiki,&nbsp;Anne Antila,&nbsp;Yrjö Vaalavuo,&nbsp;Johanna Ronkainen,&nbsp;Irina Rinta-Kiikka,&nbsp;Johanna Laukkarinen","doi":"10.1177/26317745231183311","DOIUrl":"https://doi.org/10.1177/26317745231183311","url":null,"abstract":"Biliary intraductal papillary mucinous neoplasm (IPMN) is a rare biliary neoplasia preferably treated with oncologic resection. Endoscopic radio frequency (RF) ablation may be used as a palliative measure. We present a rare case, where heavy co-morbidities prevented surgery. Continuous mucus production caused recurrent episodes of severe cholangitis. Several ERCPs (endoscopic retrograde cholangio pancretography) were necessary due to recurrent biliary obstruction. RF ablation was not effective in the dilated common bile duct without a stricture. Standard biliary stents failed due to either migration or occlusion. When other options failed, an exceptional decision was made: a covered large diameter oesophageal stent was inserted in ERCP into the bile duct to secure bile flow and stop mucus production. Digital cholangioscopy was crucial adjunct to standard ERCP in endoscopic management. The palliative treatment method was successful: there were no stent-related adverse events or readmissions for cholangitis. The follow-up in the palliative care lasted until patient’s last 10 months of lifetime.","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"16 ","pages":"26317745231183311"},"PeriodicalIF":2.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10392209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10290010","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":"Peroral-cholangioscopy to plan surgery for protruding biliary lesions: report of four cases.","authors":"Andrea Tringali,&nbsp;Sebastian Manuel Milluzzo,&nbsp;Francesco Ardito,&nbsp;Andrea Laurenzi,&nbsp;Giuseppe Maria Ettorre,&nbsp;Brunella Barbaro,&nbsp;Riccardo Ricci,&nbsp;Felice Giuliante,&nbsp;Ivo Boškoski,&nbsp;Guido Costamagna","doi":"10.1177/26317745221139735","DOIUrl":"https://doi.org/10.1177/26317745221139735","url":null,"abstract":"<p><p>Intraductal biliary lesions can involve the main hepatic confluence. Assessment of the extension of pedunculated biliary lesions during per-oral cholangioscopy (POCS) can optimize and personalize the surgical strategy. Four consecutive cases of pedunculated biliary lesions were analysed. Cholangioscopy was performed with a disposable single-operator cholangioscope. POSC was successfully performed in four patients (three female, mean age 50 years), showing involvement of the main biliary confluence in three of four pedunculated biliary lesions; direct biopsy sampling was diagnostic in two of three cases (in one patient, biopsy were not performed due to the smooth appearance of the intrabiliary lesion). No adverse events occurred after POCS. Surgery required excision of the main hepatic confluence in two of three cases (one patient was not resectable). POCS can diagnose intrabiliary extension of protruding biliary lesions, providing important information to plan the surgical intervention.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":" ","pages":"26317745221139735"},"PeriodicalIF":2.6,"publicationDate":"2022-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/78/10.1177_26317745221139735.PMC9709184.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35343429","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":"Safety and efficacy of endoscopic ultrasound as a diagnostic and therapeutic tool in pediatric patients: a multicenter study.","authors":"Khalid Mohamed Ragab,&nbsp;Mohamed El-Kassas,&nbsp;Ahmad Madkour,&nbsp;Hussein Hassan Okasha,&nbsp;Ramy Hassan Agwa,&nbsp;Elsayed Awad Ghoneem","doi":"10.1177/26317745221136767","DOIUrl":"https://doi.org/10.1177/26317745221136767","url":null,"abstract":"<p><strong>Background: </strong>Despite the well-established diagnostic and therapeutic applications of endoscopic ultrasound (EUS) in adults, data about its use in children are limited. In this study, we tried to assess the feasibility, safety, and clinical impact of EUS in pediatric patients.</p><p><strong>Methods: </strong>Data of pediatric patients (<18 years) referred for EUS over a 3-year period to the endoscopy units of four Egyptian tertiary centers were retrospectively analyzed. Significant impact was defined as a new diagnosis or treatment attributed to the EUS procedure.</p><p><strong>Results: </strong>Twenty-four diagnostic and five therapeutic EUS procedures were conducted in 29 children with a median age of 9 years. Indications for EUS included assessment of solid pancreatic mass (<i>n</i> = 3), pancreatic cyst (<i>n</i> = 2), suspected chronic pancreatitis (<i>n</i> = 9), pancreatic pseudocyst (PPC) (<i>n</i> = 5), recurrent hypoglycemia (<i>n</i> = 1), bile duct mass (<i>n</i> = 1), subepithelial lesion (esophageal, duodenal or anorectal) (<i>n</i> = 4), mediastinal mass (<i>n</i> = 1), pelvic mass (<i>n</i> = 3), and mass at splenic hilum (<i>n</i> = 1). Therapeutically, five patients underwent cystogastrostomy for symptomatic PPC with 100% technical and clinical success. EUS was able to diagnose 21 out of the other 24 patients. EUS-guided tissue acquisition was performed in 11 patients with definitive histopathological diagnosis in 10 patients (91%). There was no procedure-related major complication, while minor complications occurred in two cases (transient pain in one case, temporary fever, and vomiting in two cases).</p><p><strong>Conclusion: </strong>Standard linear EUS equipment and accessories can be used safely and effectively in selected pediatric patients for diagnostic and therapeutic purposes.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":" ","pages":"26317745221136767"},"PeriodicalIF":2.6,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/32/10.1177_26317745221136767.PMC9669673.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40477363","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":"Metallic stent insertion to relieve malignant bowel obstruction in a child: a case report.","authors":"Sundus Bilal,&nbsp;Saad M Saeed,&nbsp;Muhammad Z Sidique,&nbsp;Muhammed A Yusuf","doi":"10.1177/26317745221111942","DOIUrl":"https://doi.org/10.1177/26317745221111942","url":null,"abstract":"<p><p>Self-expandable metallic stents (SEMS) have been widely used in adults to relieve obstruction secondary to colorectal tumours. However, there is a paucity of literature about their use in children, with only a few case reports describing stent insertion in children with benign colonic conditions. There is one case report on a malignant colonic condition in a child by Hussain <i>et al</i>. in the literature. However, due to the rarity of the condition, there are currently no guidelines from learned societies on colorectal SEMS placement in paediatric patients. We share our experience of using a fully covered SEMS to relieve malignant colonic obstruction in a 6 year-old-child, who was on treatment for T cell lymphoma. This was done as a bridge to surgery, thereby allowing planned surgery, and avoiding colostomy in this child, who went on to have colonic resection with primary anastomosis.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":" ","pages":"26317745221111942"},"PeriodicalIF":2.6,"publicationDate":"2022-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/a7/10.1177_26317745221111942.PMC9290144.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40524546","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":"Management of biliary stones in bariatric surgery.","authors":"Francisco Tustumi,&nbsp;João Emílio Lemos Pinheiro Filho,&nbsp;Lucas Cata Preta Stolzemburg,&nbsp;Leonardo Carvalho Serigiolle,&nbsp;Thiago Nogueira Costa,&nbsp;Denis Pajecki,&nbsp;Marco Aurélio Santo,&nbsp;Sérgio Carlos Nahas","doi":"10.1177/26317745221105087","DOIUrl":"https://doi.org/10.1177/26317745221105087","url":null,"abstract":"<p><p>Morbidly obese and post-bariatric surgery patients are at increased risk for biliary stones formation. The complications related to biliary stones may impose complexity on their management. This study aimed to review the management of biliary conditions in obese and bariatric patients. In this study, a narrative review was performed of the medical, surgical, and endoscopic procedures for the management of biliary stones and their related complications. Knowing the main prophylactic and therapeutic interventions options is essential for clinicians to properly manage the biliary stones in patients candidates or submitted to bariatric surgery.</p><p><strong>Plain language summary: </strong><b>Management of biliary stones in bariatric surgery</b> The complications related to biliary stones may impose complexity on their management. Knowing the main prophylactic and therapeutic intervention options is essential for clinicians to properly manage the biliary stones in patient candidates or submitted to bariatric surgery. This study reviewed the main tools clinicians can handle to properly manage candidates for bariatric surgery or patients submitted to bariatric surgery.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":" ","pages":"26317745221105087"},"PeriodicalIF":2.6,"publicationDate":"2022-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/09/10.1177_26317745221105087.PMC9664186.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40709290","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":"Predictors of postoperative recurrence in a cohort of Tunisian patients with Crohn's disease.","authors":"Aya Hammami,&nbsp;Raida Harbi,&nbsp;Nour Elleuch,&nbsp;Khaled Ben Meddeb,&nbsp;Wafa Ben Ameur,&nbsp;Wafa Dahmani,&nbsp;Ahlem Braham,&nbsp;Salem Ajmi,&nbsp;Mehdi Ksiaa,&nbsp;Aida Ben Slama,&nbsp;Hanen Jaziri,&nbsp;Ali Jmaa","doi":"10.1177/26317745211060689","DOIUrl":"https://doi.org/10.1177/26317745211060689","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study was to evaluate the frequency and risk factors of clinical postoperative recurrence in Tunisian patients with Crohn's disease (CD).</p><p><strong>Methods: </strong>Clinical data of 86 patients with CD who underwent ileocolonic resection at University Hospital of Sahloul in Tunisia were retrospectively reviewed. Continuous data are expressed as median (interquartile range), and categorical data as frequencies and percentages. Multivariate Cox proportional hazard regression analysis was conducted to identify the risk factors of postoperative clinical recurrence.</p><p><strong>Results: </strong>A total of 86 patients with CD were included in this study. During follow-up, 21 patients (24.4%) had clinical recurrence. The cumulative clinical recurrence rate was 9.3% at 1 year and 20.9% at 5 years. In univariate analysis, predictive factors of postoperative clinical recurrence were active preoperative smoking (<i>p</i> = 0.008), ileal location of the disease (<i>p</i> = 0.01), active CD [Crohn's Disease Activity Index (CDAI) > 150] (<i>p</i> = 0.04), duration of disease before first surgery <9.5 months (<i>p</i> = 0.027), and limited resection margins (<2 cm) from macroscopically diseased bowel (<i>p</i> = 0.005). In multivariate analysis, only smoking (<i>p</i> = 0.012), duration of disease before first surgery <9.5 months (<i>p</i> = 0.048), and limited resection margins (<2 cm) from macroscopically diseased bowel (<i>p</i> = 0.046) were confirmed to be independent factors of clinical relapse.</p><p><strong>Conclusion: </strong>Smoking, duration of disease before first surgery <9.5 months, and limited resection margins (<2 cm) from macroscopically diseased bowel were independent risk factors for clinical recurrence. Based on these factors, patients could be stratified in order to guide postoperative therapeutic options.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":" ","pages":"26317745211060689"},"PeriodicalIF":2.6,"publicationDate":"2022-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/f8/10.1177_26317745211060689.PMC8935554.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40314607","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":"Therapeutic utility of percutaneous cecostomy in adults: an updated systematic review.","authors":"Yasir Mohammed Khayyat","doi":"10.1177/26317745211073411","DOIUrl":"https://doi.org/10.1177/26317745211073411","url":null,"abstract":"<p><strong>Objective: </strong>Percutaneous cecostomy is a minimally invasive procedure that provides access to the colon for therapeutic interventions. This review aimed to update and summarize the existing information on the use and application of percutaneous endoscopic cecostomy in the field of therapeutic gastroenterology.</p><p><strong>Data sources: </strong>A systematic review of the literature was performed without any restrictions on the year of publication from the date of inception in 1986 to January 2021.</p><p><strong>Methods: </strong>The review was performed using the medical subject heading keywords in the following search engines: MEDLINE, EMBASE, Cochrane, and Google Scholar.</p><p><strong>Results: </strong>A total of 29 articles were subjected to final data extraction. The review included a total of 174 patients who underwent percutaneous cecostomy. Most of the included studies were conducted in the United States (<i>n</i> = 14). The most common comorbidity was cancer (<i>n</i> = 10) and the major indication for performing percutaneous cecostomy was colonic pseudo-obstruction or Ogilvie's syndrome (<i>n</i> = 15). The main technique for performing percutaneous cecostomy was endoscopy (17 studies), followed by fluoroscopy- (five studies), computed-tomography- (three studies), laparoscopy- (two studies), and ultrasound- (one study) guided procedures. The procedure was technically successful in 153 (88%) cases. The total cumulative rates of major and minor complications were 47.5%. These complications included tube malfunction, local wound site infections, and bleeding and rare complications of peritonitis and death.</p><p><strong>Conclusion: </strong>Percutaneous cecostomy is a safe and effective option for managing acute colonic pseudo-obstruction. It leads to durable symptom relief with low to minimal risk.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":" ","pages":"26317745211073411"},"PeriodicalIF":2.6,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/12/64/10.1177_26317745211073411.PMC8819810.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39767389","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":"Serrated polyp detection rate in colonoscopies performed by gastrointestinal fellows.","authors":"Matthew Heckroth,&nbsp;Michael Eiswerth,&nbsp;Mohamed Elmasry,&nbsp;Khushboo Gala,&nbsp;Wenjing Cai,&nbsp;Scott Diamond,&nbsp;Amal Shine,&nbsp;David Liu,&nbsp;Nanlong Liu,&nbsp;Sudaraka Tholkage,&nbsp;Maiying Kong,&nbsp;Dipendra Parajuli","doi":"10.1177/26317745221136775","DOIUrl":"https://doi.org/10.1177/26317745221136775","url":null,"abstract":"<p><strong>Background: </strong>Clinically significant serrated polyp detection rate (CSSDR) and proximal serrated polyp detection rate (PSDR) have been suggested as the potential quality benchmarks for colonoscopy (CSSDR = 7% and PSDR = 11%) in comparison to the established benchmark adenoma detection rate (ADR). Another emerging milestone is the detection rate of lateral spreading lesions (LSLs).</p><p><strong>Objectives: </strong>This study aimed to evaluate CSSDR, PSDR, ADR, and LSL detection rates among gastrointestinal (GI) fellows performing a colonoscopy. A secondary aim was to evaluate patient factors associated with the detection rates of these lesions.</p><p><strong>Design and methods: </strong>A retrospective review of 799 colonoscopy reports was performed. GI fellow details, demographic data, and pathology found on colonoscopy were collected. Multiple logistic regression analysis was performed to identify the factors associated with CSSDR, PSDR, ADR, and LSL detection rates. A <i>p</i> value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>For our patient population, the median age was 58 years; 396 (49.8%) were male and 386 (48.6%) were African American. The 15 GI fellows ranged from first (F1), second (F2), or third (F3) year of training. We found an overall CSSDR of 4.4%, PSDR of 10.5%, ADR of 42.1%, and LSL detection rate of 3.2%. Female gender was associated with CSSDR, while only age was associated with PSDR. GI fellow level of training was associated with LSL detection rate, with the odds of detecting them expected to be four times higher in F2/F3s than F1s.</p><p><strong>Conclusion: </strong>Although GI fellows demonstrated an above-recommended ADR and nearly reached target PSDR, they failed to achieve target CSSDR. Future studies investigating a benchmark for LSL detection rate are needed to quantify if GI fellows are detecting these lesions at adequate rates.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"15 ","pages":"26317745221136775"},"PeriodicalIF":2.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/4c/10.1177_26317745221136775.PMC9749503.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10392048","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}