VideoGIE最新文献_第2页

EUS-guided rendezvous fistula creation for complete anastomotic stenosis after low anterior resection eus引导下吻合口狭窄低位前切除术后交会造瘘术

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.06.001

Pavlos Kaimakliotis MBBS , Nicole Saur MD , Galen Leung MD

{"title":"EUS-guided rendezvous fistula creation for complete anastomotic stenosis after low anterior resection","authors":"Pavlos Kaimakliotis MBBS , Nicole Saur MD , Galen Leung MD","doi":"10.1016/j.vgie.2025.06.001","DOIUrl":"10.1016/j.vgie.2025.06.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Complete luminal stenosis at the colorectal anastomosis after low anterior resection is a rare adverse event.</div></div><div><h3>Methods</h3><div>We present a novel case with rendezvous via a diverting ileostomy and a retrograde EUS-guided formation of a new colorectal anastomosis for recanalization.</div></div><div><h3>Results</h3><div>A 52-year-old previously healthy man presented with rectal bleeding and was found to have locally advanced (T3N1) adenocarcinoma. The patient received neoadjuvant chemoradiation and then underwent an uncomplicated low anterior resection with a diverting loop ileostomy. During surveillance sigmoidoscopy 6 months later, complete stenosis of his anastomosis was seen, and he was referred to advanced endoscopy. He underwent dual-operator colonoscopy and ileoscopy with confirmation of complete stenosis of the anastomosis. Using EUS, we deployed a lumen-apposing metal stent for de novo colorectal fistula formation. The patient was discharged home and has since undergone successful takedown of his ileostomy. He has remained without recurrent anastomotic narrowing on routine follow-up.</div></div><div><h3>Conclusions</h3><div>Although complete stenosis of colorectal anastomosis is rare, we argue for the role and safety profile of EUS-guided lumen-apposing metal stent insertion given the ability to distend the proximal aspect of the colon with water to create an accessible target for fistula creation, which offers a minimally invasive alternative to major surgery.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 548-551"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242404","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}

引用次数: 0

Peroral endoscopic tumor resection of recurrent hypopharyngeal fibrovascular polyp 经口内镜下复发性下咽纤维血管息肉切除术

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.06.003

Yohei Nishikawa MD, PhD , Koji Otsuka MD, PhD , Kei Ushikubo MD , Kazuki Yamamoto MD, PhD , Ippei Tanaka MD , Mayo Tanabe MD, PhD , Takashi Suzuki MD, PhD , Haruhiro Inoue MD, PhD

{"title":"Peroral endoscopic tumor resection of recurrent hypopharyngeal fibrovascular polyp","authors":"Yohei Nishikawa MD, PhD , Koji Otsuka MD, PhD , Kei Ushikubo MD , Kazuki Yamamoto MD, PhD , Ippei Tanaka MD , Mayo Tanabe MD, PhD , Takashi Suzuki MD, PhD , Haruhiro Inoue MD, PhD","doi":"10.1016/j.vgie.2025.06.003","DOIUrl":"10.1016/j.vgie.2025.06.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Fibrovascular polyps (FVPs) are rare benign submucosal tumors of the pharynx and cervical esophagus that can cause dysphagia and airway obstruction. We report the successful endoscopic resection of a recurrent FVP in the hypopharynx using peroral endoscopic tumor resection techniques in combination with pharyngeal endoscopic treatment strategies. A 56-year-old woman presented with a recurrent FVP in the right arytenoid region after an incomplete resection. Because of tumor growth and worsening dysphagia, we opted to perform the endoscopic resection after thorough evaluation.</div></div><div><h3>Methods</h3><div>The procedure was performed with the patient under general anesthesia. Intra- and postoperative airway management was secured with temporary percutaneous cricothyrotomy. Laryngeal expansion was performed with a curved rigid laryngoscope to enhance visualization. Endoscopic resection was performed with a minimal mucosal incision, followed by enucleation of the tumor, and closure of the mucosa. En bloc enucleation of the tumor was achieved without damaging its surface using string-clip traction.</div></div><div><h3>Results</h3><div>The patient was discharged on postoperative day 6 without adverse events. Pathologic examination confirmed complete resection of the FVP.</div></div><div><h3>Conclusions</h3><div>Endoscopic resection using combined peroral endoscopic tumor resection techniques and pharyngeal endoscopic treatment strategies offers a safe and minimally invasive treatment option for hypopharyngeal FVPs.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 552-556"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242405","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}

引用次数: 0

Endoscopic closure of full-thickness transverse colon perforation with sequential over-the-scope clips including retroflexed deployment 内镜下用连续的镜外夹包括后屈曲部署闭合全层横结肠穿孔

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.008

Vanisha Patel MD, Suraj Pai MD, Erica Park MD, Raj Shah MD, Somashekar G. Krishna MD, Georgios I. Papachristou MD, Jordan Burlen MD

{"title":"Endoscopic closure of full-thickness transverse colon perforation with sequential over-the-scope clips including retroflexed deployment","authors":"Vanisha Patel MD, Suraj Pai MD, Erica Park MD, Raj Shah MD, Somashekar G. Krishna MD, Georgios I. Papachristou MD, Jordan Burlen MD","doi":"10.1016/j.vgie.2025.05.008","DOIUrl":"10.1016/j.vgie.2025.05.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopic mucosal resection (EMR) poses a risk of iatrogenic colonic perforation. In this case, we discuss the endoscopic closure of a colonic perforation with sequential over-the-scope clips (OTSCs), one of which was deployed in retroflexion.</div></div><div><h3>Methods</h3><div>A 61-year-old patient presented for EMR of a transverse colon polyp. Lifting agent injection provided inadequate lift, so underwater EMR was performed with a hot snare. After en bloc polypectomy, a full-thickness perforation was found. We review our perforation closure technique, including an unsuccessful attempt with through-the-scope clips followed by successful closure with sequential OTSCs.</div></div><div><h3>Results</h3><div>Approximation of defect edges with through-the-scope clips was technically challenging because of location and width of the defect. Ultimately, the perforation was closed with 2 OTSCs. A retroflexed examination of the defect with gastroscope found a persistent defect along the posterior aspect. The remaining area was closed with a third OTSC deployed in retroflexion.</div></div><div><h3>Conclusions</h3><div>This case highlights use of sequential OTSCs, including one deployed in retroflexion to successfully close a large, full-thickness transverse colonic perforation following an EMR. We describe modified positioning of the OTSC that enabled more tissue acquisition with clip deployment. The patient did well postprocedurally, without need for surgical intervention.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 544-547"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242403","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}

引用次数: 0

Endoscopic resection of gastric subepithelial lesions: techniques and tips 胃上皮下病变的内镜切除：技术和提示

VideoGIE Pub Date : 2025-06-02 DOI: 10.1016/j.vgie.2025.05.003

Michael Lajin MD , Fateh Bazerbachi MD , Helen Sohn MD , Octavio Armas MD

{"title":"Endoscopic resection of gastric subepithelial lesions: techniques and tips","authors":"Michael Lajin MD , Fateh Bazerbachi MD , Helen Sohn MD , Octavio Armas MD","doi":"10.1016/j.vgie.2025.05.003","DOIUrl":"10.1016/j.vgie.2025.05.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>In the past, endoscopic resection of gastric subepithelial lesions (SELs) was restricted to small lesions confined to the submucosa. Larger and deeper lesions were resected surgically. Recent innovations in endoscopy have yielded multiple techniques for extending the boundaries and providing minimally invasive resection of larger and deeper lesions.</div></div><div><h3>Methods</h3><div>This article presents the different endoscopic modalities for resecting gastric SELs. The video illustrates, through clinical examples, how to choose the appropriate resection method and provides technical tips for these techniques.</div></div><div><h3>Results</h3><div>In this case series, we implemented different endoscopic resection modalities on the basis of endoscopic and endosonographic evaluation of the tumor and patient anatomical factors. Successful en bloc resection of gastric SELs was achieved in all patients without adverse events.</div></div><div><h3>Conclusions</h3><div>Multiple techniques made endoscopic resection of larger and deeper gastric SELs feasible. Successful resection requires familiarity with these techniques' tips and tricks.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 9","pages":"Pages 493-498"},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810281","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}

引用次数: 0

Circumferential endoscopic submucosal dissection of a 14-cm long-segment Barrett’s esophagus with multifocal adenocarcinoma: a case report 14cm长段Barrett食管合并多灶性腺癌的环周内镜粘膜下剥离1例

VideoGIE Pub Date : 2025-05-27 DOI: 10.1016/j.vgie.2025.05.001

Aida Saad MD , Joyce Arnouk MD , Arshia Khorasani-Zadeh MD , Monika Seth MD , Kais Zakharia MD

{"title":"Circumferential endoscopic submucosal dissection of a 14-cm long-segment Barrett’s esophagus with multifocal adenocarcinoma: a case report","authors":"Aida Saad MD , Joyce Arnouk MD , Arshia Khorasani-Zadeh MD , Monika Seth MD , Kais Zakharia MD","doi":"10.1016/j.vgie.2025.05.001","DOIUrl":"10.1016/j.vgie.2025.05.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Barrett's esophagus (BE) is a recognized precursor to esophageal adenocarcinoma (EAC), with an annual progression risk of up to 7% in cases involving high-grade dysplasia (HGD). Endoscopic therapy is the standard treatment for dysplastic BE and early-stage EAC, typically involving ablation techniques, such as radiofrequency ablation and cryotherapy, for flat BE and endoscopic resection methods, including EMR and more recently endoscopic submucosal dissection (ESD), for nodular lesions.</div></div><div><h3>Methods</h3><div>This article describes the case of a patient with an ultralong segment of BE (14 cm) and multifocal EAC who was successfully treated with circumferential ESD.</div></div><div><h3>Results</h3><div>A complete en bloc resection of a 16-cm segment was achieved. Histopathologic analysis confirmed the presence of BE with HGD and multifocal EAC (T1b). Although the patient developed an esophageal stricture postprocedure, it was effectively managed endoscopically.</div></div><div><h3>Conclusions</h3><div>The patient is currently doing well and remains under routine endoscopic and radiographic surveillance. Circumferential ESD represents a safe and effective approach for the endoscopic resection of extensive BE and early EAC and should be considered a viable alternative to surgical intervention.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 9","pages":"Pages 448-451"},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810401","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}

引用次数: 0

Palliative use of lumen-apposing metal stents in tandem to alleviate malignant bowel obstructions in a patient with small-bowel adenocarcinoma with carcinomatosis 姑息性使用管腔旁置金属支架串联缓解恶性肠梗阻的小肠腺癌伴癌变患者

VideoGIE Pub Date : 2025-05-02 DOI: 10.1016/j.vgie.2025.04.009

Smriti Kochhar DO , Ibrahim Yaghnam MD , Abraham Mathew MD

{"title":"Palliative use of lumen-apposing metal stents in tandem to alleviate malignant bowel obstructions in a patient with small-bowel adenocarcinoma with carcinomatosis","authors":"Smriti Kochhar DO , Ibrahim Yaghnam MD , Abraham Mathew MD","doi":"10.1016/j.vgie.2025.04.009","DOIUrl":"10.1016/j.vgie.2025.04.009","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Duodenal stents or endoscopic gastrojejunostomy with lumen-apposing metal stents (LAMSs) are commonly used to treat small-bowel obstruction. However, endoscopic therapy for many regions of obstruction is less well-established. We describe a patient case with multiple areas of obstruction that was relieved with LAMS placement, creating gastroenteric and enteroenteric anastomosis.</div></div><div><h3>Methods</h3><div>Direct endoscopy with EUS was used to place gastroenteric LAMSs. A multimodal imaging approach, including EUS, fluoroscopy, and transabdominal ultrasound, was used to identify the area of the enteroenteric LAMS. Lastly, a venting percutaneous jejunostomy tube was placed using the transluminal technique.</div></div><div><h3>Results</h3><div>Tandem LAMS placement successfully decompressed the small bowel with improved oral intake. The patient did not require any hospital readmissions related to the stents.</div></div><div><h3>Conclusions</h3><div>LAMS placement may be helpful for patients with multiple small-bowel obstructions, especially for patients who are not candidates for surgical intervention to alleviate their symptoms.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 9","pages":"Pages 483-486"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810279","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}

引用次数: 0

Minimizing bleeding risks during gastric neuroendocrine tumor endoscopic submucosal dissection by pre-emptive EUS-guided epinephrine injection 先发制人eus引导下注射肾上腺素降低胃神经内分泌肿瘤内镜下粘膜下夹层出血风险

VideoGIE Pub Date : 2025-05-02 DOI: 10.1016/j.vgie.2025.04.010

Radhika Chavan MD, DNB, FISG, FASGE , Vishal Seth MD, DM , Zaheer Nabi MD, DNB, FISG, FASGE , Dadasaheb Maindad MD, DNB , Harshwardhan Dongre DNB , Sanjay Rajput MD, DM , Akhil Nagpal MD, DM

{"title":"Minimizing bleeding risks during gastric neuroendocrine tumor endoscopic submucosal dissection by pre-emptive EUS-guided epinephrine injection","authors":"Radhika Chavan MD, DNB, FISG, FASGE , Vishal Seth MD, DM , Zaheer Nabi MD, DNB, FISG, FASGE , Dadasaheb Maindad MD, DNB , Harshwardhan Dongre DNB , Sanjay Rajput MD, DM , Akhil Nagpal MD, DM","doi":"10.1016/j.vgie.2025.04.010","DOIUrl":"10.1016/j.vgie.2025.04.010","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric neuroendocrine tumors (NETs), although rare, are highly vascular subepithelial lesions that can pose significant bleeding risks during endoscopic submucosal dissection (ESD). Traditionally, bleeding is managed intraoperatively with mechanical or thermal hemostasis, but pre-emptive strategies remain underexplored. Here, we report the use of EUS-guided pre-emptive epinephrine injection to minimize the bleeding risk during gastric NET ESD.</div></div><div><h3>Methods</h3><div>To minimize the risk of bleeding during ESD of large gastric NETs, a pre-emptive EUS-guided epinephrine injection was administered at the base of the lesion near the feeder vessel.</div></div><div><h3>Results</h3><div>A 38-year-old female was diagnosed with a large gastric subepithelial lesion during evaluation for upper gastrointestinal bleeding. EUS revealed a large hypoechoic tumor confined to the submucosa with a prominent feeding vessel. Given the predominantly submucosal location, ESD was planned. However, significant bleeding was anticipated due to the large feeder vessel. Therefore, a pre-emptive EUS-guided adrenaline injection (5 mL of 1:10,000 diluted epinephrine) was administered at the base of the lesion after confirming absence of blood return on fine-needle aspiration. Instantaneous pallor of the lesion was observed. ESD was subsequently completed successfully without any bleeding.</div></div><div><h3>Conclusions</h3><div>This case highlights a novel, effective, and safe use of EUS-guided pre-emptive epinephrine injection to minimize bleeding during ESD of vascular gastric NETs. This approach could enhance procedural safety and warrants further prospective evaluation.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 9","pages":"Pages 464-468"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810285","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}

引用次数: 0

Counter mucosal incision with Zenker's peroral endoscopic myotomy: an innovative approach for mucosal decompression in Zenker’s diverticulum and mucosal webs 反粘膜切口与Zenker的经口内窥镜肌切开术：在Zenker憩室和粘膜网中进行粘膜减压的一种创新方法

VideoGIE Pub Date : 2025-05-02 DOI: 10.1016/j.vgie.2025.04.011

Boldbaatar Gantuya MD, PhD , Haruhiro Inoue MD, PhD , Kazuki Yamamoto MD, PhD , Ippei Tanaka MD , Yohei Nishikawa MD , Kei Ushikubo MD , Mayo Tanabe MD

{"title":"Counter mucosal incision with Zenker's peroral endoscopic myotomy: an innovative approach for mucosal decompression in Zenker’s diverticulum and mucosal webs","authors":"Boldbaatar Gantuya MD, PhD , Haruhiro Inoue MD, PhD , Kazuki Yamamoto MD, PhD , Ippei Tanaka MD , Yohei Nishikawa MD , Kei Ushikubo MD , Mayo Tanabe MD","doi":"10.1016/j.vgie.2025.04.011","DOIUrl":"10.1016/j.vgie.2025.04.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Zenker’s diverticulum (ZD) is a pouch of the mucosa arising from the Killian triangle. Any size of symptomatic ZD or medium to large (2-3 cm or more) ZD needs intervention. Zenker's peroral endoscopic myotomy (Z-POEM) is the ideal first-line therapy for making the reliable myotomy. We aimed to demonstrate the latest Z-POEM techniques and counter mucosal incision (CMI) for a patient with larger-sized ZD and pre-existing esophageal mucosal webs near ZD.</div></div><div><h3>Methods</h3><div>The CMI technique recently was developed by our hospital for antireflux intervention. It is a novel tension-relief technique of the mucosal plasty for enhancing closure stability. This time we performed esophageal mucosal incision on the opposite side of the Z-POEM defect closure part to relieve the mucosal tension and alleviate a postoperative stricture resulting from the tight clip closure in the background of the stiff surrounding mucosa and webs near the ZD.</div></div><div><h3>Results</h3><div>We obtained complete eradication of ZD pouch without creating a stricture.</div></div><div><h3>Conclusions</h3><div>CMI is the ideal approach for preventing a stricture related to the use of tight clip closure of the Z-POEM for a larger-sized ZD with a background of the surrounding mucosal webs.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 9","pages":"Pages 443-447"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144810400","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}

引用次数: 0

ENDOSCOPIC TRUNCAL VAGOTOMY. A TECHNICAL FESABILITY STUDY 内窥镜迷走神经截切术。技术可行性研究

VideoGIE Pub Date : 2025-05-01 DOI: 10.1016/j.vgie.2025.03.006

Kambiz S. Kadkhodayan, Shayan S. Irani

引用次数: 0

TREATMENT OF REFRACTORY CYSTIC DUCT STUMP LEAKS WITH VASCULAR COILS 血管线圈治疗难治性囊管残端渗漏

VideoGIE Pub Date : 2025-05-01 DOI: 10.1016/j.vgie.2025.03.010

Prashanth Rau, Rohan Rau, Ikechukwu Achebe, Neil B. Marya

引用次数: 0