VideoGIE最新文献_第4页

Technical considerations for endoscopic submucosal dissection of a large rectal laterally spreading tumor 内镜下粘膜下解剖直肠大肿瘤的技术考虑

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-27 DOI: 10.1016/j.vgie.2026.03.007

Abdulrahman Qatomah MBBS, Daryl Ramai MD, MSc, MPH, Sulaiman Almushir MD, Leander Heisterberg MS, Christopher C. Thompson MD, MSc, Hiroyuki Aihara MD, PhD

{"title":"Technical considerations for endoscopic submucosal dissection of a large rectal laterally spreading tumor","authors":"Abdulrahman Qatomah MBBS, Daryl Ramai MD, MSc, MPH, Sulaiman Almushir MD, Leander Heisterberg MS, Christopher C. Thompson MD, MSc, Hiroyuki Aihara MD, PhD","doi":"10.1016/j.vgie.2026.03.007","DOIUrl":"10.1016/j.vgie.2026.03.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopic submucosal dissection (ESD) is an established technique for the management of large colorectal lesions, offering high en bloc and R0 resection rates. Although traction-assisted and tunneling ESD techniques are individually established, each may have limitations in achieving dissection efficiency. We describe important technical considerations in managing large rectal lesions using a combination of both techniques.</div></div><div><h3>Methods</h3><div>A 42-year-old man with mucous stools was found to have a 12-cm rectal laterally spreading tumor, granular type with a dominant nodule. Careful lesion assessment excluded deep submucosal invasion. ESD was performed using both techniques.</div></div><div><h3>Results</h3><div>Initial oral and anal incisions were performed, followed by tunneling dissection. Because of the limited submucosal plane, 2 sequential tractions were applied to enhance exposure. The procedure was completed with en bloc resection, without deep mural injury, and the specimen was successfully retrieved manually to avoid fragmentation. The specimen measured 12 cm, and final pathology showed tubulovillous adenoma, with high-grade dysplasia and R0 resection.</div></div><div><h3>Conclusions</h3><div>The use of tunneling and traction-assisted ESD aids in maintaining an optimal dissection plane and minimizing deep mural injury. Strategic traction placement and gravity-assisted patient positioning are critical for procedural efficiency. Finally, manual specimen extraction can be considered to preserve specimen integrity.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 359-362"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647436","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}

引用次数: 0

Endoscopic ultrasound—guided coil embolization and glue injection of bleeding bile duct varices causing gastrointestinal hemorrhage 内镜下超声引导下线圈栓塞加注胶治疗消化道出血的胆管静脉曲张出血

VideoGIE Pub Date : 2026-08-01 Epub Date: 2025-11-17 DOI: 10.1016/j.vgie.2025.11.003

Hassan Allahrakha DO, Syed Hamaad Rahman DO, Sarah Ramzan Unar MD, Prashant Kedia MD

{"title":"Endoscopic ultrasound—guided coil embolization and glue injection of bleeding bile duct varices causing gastrointestinal hemorrhage","authors":"Hassan Allahrakha DO, Syed Hamaad Rahman DO, Sarah Ramzan Unar MD, Prashant Kedia MD","doi":"10.1016/j.vgie.2025.11.003","DOIUrl":"10.1016/j.vgie.2025.11.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Bleeding bile duct varices are rare vascular communications between the portal venous system and the biliary tree. They may arise from portal vein thrombosis, malignancy, or endoscopic injury and often present with life-threatening hemobilia. We describe a case of choledochal varices bleeding in a patient with hepatocellular carcinoma (HCC) successfully managed with endoscopic ultrasound–guided coil embolization and glue injection.</div></div><div><h3>Methods</h3><div>A 62-year-old man with hepatitis C virus cirrhosis and portal vein tumor thrombus presented with hematochezia and right upper quadrant pain. He underwent prior stereotactic body radiation and was not a transplant candidate. Initial laboratory tests showed hemoglobin of 12 g/dL. CT angiogram revealed portal venous collateralization; esophagogastroduodenoscopy and colonoscopy were unrevealing. After a postcolonoscopy episode of brisk hematochezia and hemodynamic instability, small-bowel enteroscopy showed active bleeding from the ampulla.</div></div><div><h3>Results</h3><div>Endoscopic retrograde cholangiopancreatography revealed hemobilia from the bile duct, and a covered metal stent was placed. EUS identified a large portal-system varix encasing the bile duct, which was successfully obliterated using coil and glue embolization.</div></div><div><h3>Conclusions</h3><div>Biliovenous fistulas are a rare but serious cause of hemobilia in HCC. EUS-guided embolization offers effective, definitive therapy after initial stabilization with biliary stenting. Timely diagnosis and intervention are critical.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 329-332"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647240","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}

引用次数: 0

Salvage reconstruction of an endoscopic ultrasound–guided gastroenterostomy using a tubular enteral stent after inadvertent transcolonic lumen-apposing metal stent deployment 超声内镜引导下经结肠置管金属支架置入后使用管状肠内支架进行胃肠造口术的抢救重建

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-28 DOI: 10.1016/j.vgie.2026.03.006

Miguel Martins MD, Joana Mota MD, Filipe Vilas-Boas MD, PhD, Pedro Moutinho-Ribeiro MD, PhD, Susana Lopes MD, PhD, Tiago Bouça-Machado MD, PhD, Guilherme Macedo MD, PhD

{"title":"Salvage reconstruction of an endoscopic ultrasound–guided gastroenterostomy using a tubular enteral stent after inadvertent transcolonic lumen-apposing metal stent deployment","authors":"Miguel Martins MD, Joana Mota MD, Filipe Vilas-Boas MD, PhD, Pedro Moutinho-Ribeiro MD, PhD, Susana Lopes MD, PhD, Tiago Bouça-Machado MD, PhD, Guilherme Macedo MD, PhD","doi":"10.1016/j.vgie.2026.03.006","DOIUrl":"10.1016/j.vgie.2026.03.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>EUS-guided gastroenterostomy (EUS-GE) is effective for palliating malignant gastric outlet obstruction (GOO). Inadvertent gastrocolostomy, although rare, can be a serious adverse event. We present an endoscopic rescue strategy in a case of gastrocolonic and colojejunal fistula after EUS-GE.</div></div><div><h3>Methods</h3><div>A 59-year-old woman with duodenal adenocarcinoma underwent EUS-GE with a 20- × 10-mm lumen-apposing metal stent (LAMS) because of GOO. One week later, the patient presented with postprandial diarrhea, nausea, and halitosis. Imaging and endoscopy revealed a gastrocolonic fistula and a mature colojejunal fistula.</div></div><div><h3>Results</h3><div>Under endoscopic and fluoroscopic guidance, a partially covered self-expandable metal stent was deployed transcolonically through the LAMS into the jejunum. The procedure was uneventful. The patient resumed oral intake within 24 hours, and follow-up confirmed correct stent positioning and clinical improvement.</div></div><div><h3>Conclusions</h3><div>Transcolonic stent placement through the LAMS appears to be a feasible rescue solution for managing inadvertent gastrocolostomy after EUS-GE in the presence of a concurrent colojejunal fistula.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 346-349"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647431","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}

引用次数: 0

Bridging the gap: intraoperative esophageal stent used as a scaffold for the treatment of complete postsurgical gastroesophageal anastomosis dehiscence 弥合差距：术中食管支架作为支架治疗完全性术后胃食管吻合口破裂

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-27 DOI: 10.1016/j.vgie.2026.03.004

Patricia Ziegler MD, Agnieszka Maniak MD, John Aversa MD, Christopher Chapman MD, Ajaypal Singh MD, Irving Waxman MD, Nicole Geissen MD, Neal Mehta MD

{"title":"Bridging the gap: intraoperative esophageal stent used as a scaffold for the treatment of complete postsurgical gastroesophageal anastomosis dehiscence","authors":"Patricia Ziegler MD, Agnieszka Maniak MD, John Aversa MD, Christopher Chapman MD, Ajaypal Singh MD, Irving Waxman MD, Nicole Geissen MD, Neal Mehta MD","doi":"10.1016/j.vgie.2026.03.004","DOIUrl":"10.1016/j.vgie.2026.03.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Esophagogastric (EG) anastomotic leaks are serious adverse events after esophagectomy. Endoscopic stent placement has become an effective, minimally invasive option that promotes healing. While esophageal stents maintain luminal continuity, technical success rates are as high as 90.9%. A 62-year-old man with esophageal adenocarcinoma presented 12 days after McKeown esophagectomy with dyspnea and empyema. Imaging and chest tube output suggested an anastomotic leak. The aim of this study was to display the utility of esophageal stent placement even in cases of complete EG dehiscence.</div></div><div><h3>Methods</h3><div>Intraoperative exploration revealed complete EG dehiscence. Using robotic surgical guidance, we advanced a gastroscope through the mediastinum into the stomach, and a guidewire was passed to facilitate placement of a 20- × 100-mm fully covered self-expandable metal stent. Given the emergent intraoperative nature of the case and the use of a travel cart, endoscopic images are limited or mostly unavailable.</div></div><div><h3>Results</h3><div>The stent provided a scaffold for reapproximation and repair with interrupted sutures and biological mesh. The patient recovered uneventfully, resumed tube feeds, and advanced to oral intake within 2 months. The stent was removed 4 months after placement without stricture or need for dilation.</div></div><div><h3>Conclusions</h3><div>Complete EG dehiscence typically necessitates high-risk surgical repair. In this case, endoscopic stent placement enabled luminal restoration and guided repair, demonstrating a novel multidisciplinary approach to a complex adverse event. Intraoperative endoscopic stent placement can successfully manage complete anastomotic dehiscence, emphasizing the value of coordinated surgical/endoscopic strategies to preserve function.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 321-324"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647440","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}

引用次数: 0

Advanced endoscopic rescue after failed endoscopic ultrasound–guided choledochoduodenostomy 超声内镜引导胆总管十二指肠吻合术失败后的先进内镜抢救

VideoGIE Pub Date : 2026-08-01 Epub Date: 2026-03-12 DOI: 10.1016/j.vgie.2026.02.015

Stefan Michaelis MD, Ulrich Rosien MD, Alexander Arlt MD, PhD

{"title":"Advanced endoscopic rescue after failed endoscopic ultrasound–guided choledochoduodenostomy","authors":"Stefan Michaelis MD, Ulrich Rosien MD, Alexander Arlt MD, PhD","doi":"10.1016/j.vgie.2026.02.015","DOIUrl":"10.1016/j.vgie.2026.02.015","url":null,"abstract":"<div><h3>Background and Aims</h3><div>EUS-guided choledochoduodenostomy (EUS-CDS) has become an established alternative to percutaneous or surgical approaches in cases of failed or predicted difficult ERCP.</div></div><div><h3>Methods</h3><div>We report a case of complex endoscopic management of biliary obstruction in a 46-year-old woman with inoperable pancreatic adenocarcinoma. Because of tumor-related deformation of the papillary region, primary transpapillary drainage was not feasible.</div></div><div><h3>Results</h3><div>EUS-CDS using a 6- × 8-mm electrocautery-enhanced lumen-apposing metal stent (LAMS) (Hot AXIOS stent; Boston Scientific, Marlborough, Mass, USA) was performed. Misdeployment of the distal flange led to bile leakage and stent dysfunction. Subsequent placement of a fully covered self-expandable metal stent (8 mm × 6 cm) (BONASTENT; MTW, Wesel, Germany) resulted in secondary stent dislocation into the paraduodenal space. The dislocated stent was successfully retrieved endoscopically through the original access using a 3-mm cholangioscope (Scivita, Boston Scientific). The duodenal defect was closed with 2 closure clips (MANTIS Clip, Boston Scientific). The patient recovered uneventfully and remained asymptomatic at 2-month follow-up.</div></div><div><h3>Conclusions</h3><div>This case illustrates the feasibility of endoscopic rescue in a challenging scenario after LAMS misdeployment using advanced ERCP and closure techniques.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 8","pages":"Pages 337-341"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148647435","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}

引用次数: 0

Endoscopic ultrasound—directed transduodenal endoscopic retrograde cholangiopancreatography in a patient with a duodenal switch for complex stone management 内镜超声引导下经十二指肠内镜逆行胆管造影治疗十二指肠结石患者1例。

VideoGIE Pub Date : 2026-07-01 Epub Date: 2026-02-05 DOI: 10.1016/j.vgie.2026.01.006

Zane Gouda MD, Ali Lahooti MD, Kate Solpari BA, Sean Rangwani MD, Muhammad Usman Baig MBBS, Anam Rizvi MD, Adeyinka Adejumo MD, Reem Z. Sharaiha MD, MSc

{"title":"Endoscopic ultrasound—directed transduodenal endoscopic retrograde cholangiopancreatography in a patient with a duodenal switch for complex stone management","authors":"Zane Gouda MD, Ali Lahooti MD, Kate Solpari BA, Sean Rangwani MD, Muhammad Usman Baig MBBS, Anam Rizvi MD, Adeyinka Adejumo MD, Reem Z. Sharaiha MD, MSc","doi":"10.1016/j.vgie.2026.01.006","DOIUrl":"10.1016/j.vgie.2026.01.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>A 69-year-old male patient with a previous duodenal switch surgery presented with choledocholithiasis and cholangitis. Initially, interventional radiology (IR) performed biliary stent placement with a metal stent left in situ. One year later, the patient presented again with cholangitis, now requiring definitive treatment via EUS-directed transduodenal ERCP (EDDE).</div></div><div><h3>Methods</h3><div>An anastomosis was created between the first portion (superior portion) of the duodenum (D1) and the excluded second portion (descending portion) of the duodenum (D2) using a lumen-apposing metal stent (LAMS). After anastomosis maturation, the patient returned for ERCP and removal of the IR-placed stent. The previously placed stent initially could not be removed, so a metal stent was placed within the IR-placed stent for later removal via stent-in-stent technique. Three months later, the stents were removed, and the bile duct was swept with a balloon. Stones and debris were extracted from the duct. The duodenoduodenal LAMS was removed, leaving a patent fistula in place.</div></div><div><h3>Results</h3><div>An EDDE was successfully performed between the D1 and D2 portions of the duodenal switch. The patient was asymptomatic and stent-free.</div></div><div><h3>Conclusions</h3><div>The successful completion of this procedure indicates that it may be safe and effective to perform an EDDE in patients with duodenal switch anatomy.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 7","pages":"Pages 292-297"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413860","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}

引用次数: 0

Modified gastric peroral endoscopic myotomy for helical stenosis after sleeve gastrectomy 改良经口胃内窥镜切开术治疗袖胃切除术后螺旋型狭窄。

VideoGIE Pub Date : 2026-07-01 Epub Date: 2026-03-03 DOI: 10.1016/j.vgie.2026.02.011

Michael Lajin MD, Helen Sohn MD, Jon Ellison MD, Scott Honowitz MD

{"title":"Modified gastric peroral endoscopic myotomy for helical stenosis after sleeve gastrectomy","authors":"Michael Lajin MD, Helen Sohn MD, Jon Ellison MD, Scott Honowitz MD","doi":"10.1016/j.vgie.2026.02.011","DOIUrl":"10.1016/j.vgie.2026.02.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric sleeve stenosis (GSS) occurs in 0.7% to 4% of cases after laparoscopic sleeve gastrectomy and can lead to leaks, fistulas, refractory reflux, regurgitation, and diet intolerance. It is classified into 2 subtypes: helical and nonhelical. Although stent placement and pneumatic dilation may help with nonhelical stenosis, they often do not produce sufficient results for helical stenosis. Recently, a modified gastric peroral endoscopic myotomy (G-POEM) technique (tunneling stricturotomy) has been introduced as a salvage treatment for GSS.</div></div><div><h3>Methods</h3><div>In this case series, we present 3 cases of patients with helical sleeve stenosis treated with modified G-POEM as the initial approach. All patients in this series underwent under–saline solution tunneling, which helped navigate a swirling, challenging submucosal space. The article offers techniques and tips for successfully completing the procedure.</div></div><div><h3>Results</h3><div>The procedure was successfully performed in all patients, who experienced significant clinical improvement and were able to tolerate a low-residue diet. No adverse events were reported.</div></div><div><h3>Conclusions</h3><div>Although our case series demonstrates that tunneling stricturotomy was safe and effective as a primary treatment for gastric sleeve helical stenosis, additional data are needed to evaluate its safety and long-term effectiveness compared with other endoscopic treatments.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 7","pages":"Pages 313-320"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414017","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}

引用次数: 0

Robotic-assisted traction and closure during colorectal endoscopic submucosal dissection 结肠内镜下粘膜下剥离术中机器人辅助牵引和闭合。

VideoGIE Pub Date : 2026-07-01 Epub Date: 2026-03-03 DOI: 10.1016/j.vgie.2026.02.008

Carlos Bertran-Rodriguez MD, Maham Hayat MD, Zubair Khan MD, Abdul Sattar Shariq Mohammed MD, Muhammad K. Hasan MD, Kambiz K. Kadkhodayan MD, Joo Ha Hwang MD, Dennis Yang MD

{"title":"Robotic-assisted traction and closure during colorectal endoscopic submucosal dissection","authors":"Carlos Bertran-Rodriguez MD, Maham Hayat MD, Zubair Khan MD, Abdul Sattar Shariq Mohammed MD, Muhammad K. Hasan MD, Kambiz K. Kadkhodayan MD, Joo Ha Hwang MD, Dennis Yang MD","doi":"10.1016/j.vgie.2026.02.008","DOIUrl":"10.1016/j.vgie.2026.02.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endoscopic submucosal dissection (ESD) is a technically challenging procedure that can be associated with a lengthy procedure duration and high risk of adverse events. A robotic gripper device for tissue traction and closure during endoscopic procedures was recently approved by the U.S. Food and Drug Administration. In this video, we demonstrate the use of this device to assist with traction during ESD.</div></div><div><h3>Methods</h3><div>The robotic platform consists of an operating driver unit, a controller, and the robotic gripper arm. The robotic arm is mounted on the distal tip of the endoscope. The robotic arm's multidegree range of motion is directed through the controller and adjusted to provide tissue tension during ESD.</div></div><div><h3>Results</h3><div>A 60-year-old man underwent flexible sigmoidoscopy for a 60-mm granular mixed laterally spreading tumor in the rectum. A circumferential mucosal incision was made with a water-pressure injection ESD knife. After this, the robotic gripper arm was used to provide traction throughout the procedure to optimize tissue tension and visualization during dissection. The en bloc–resected specimen measured 75 × 70 mm in size. Final histopathology was a tubulovillous adenoma with high-grade dysplasia.</div></div><div><h3>Conclusions</h3><div>We demonstrate the use of a robotic arm to assist with traction during ESD. This robotic platform allowed real-time tissue manipulation and dynamic adjustment, optimizing tissue tension and visualization during ESD and tissue apposition during mucosal closure.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 7","pages":"Pages 310-312"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413977","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}

引用次数: 0

Multitraction point strategy for endoscopic submucosal dissection in managing difficult colorectal lesions 内镜下粘膜下剥离的多牵引点策略在处理疑难结直肠病变中的应用。

VideoGIE Pub Date : 2026-07-01 Epub Date: 2026-02-20 DOI: 10.1016/j.vgie.2026.02.005

Abdulrahman Qatomah MBBS, Daryl Ramai MD, MSc, MPH, Aishah Qatomah MBBS, Talal Alenezi MD, Christopher C. Thomson MD, MSc, Hiroyuki Aihara MD, PhD

{"title":"Multitraction point strategy for endoscopic submucosal dissection in managing difficult colorectal lesions","authors":"Abdulrahman Qatomah MBBS, Daryl Ramai MD, MSc, MPH, Aishah Qatomah MBBS, Talal Alenezi MD, Christopher C. Thomson MD, MSc, Hiroyuki Aihara MD, PhD","doi":"10.1016/j.vgie.2026.02.005","DOIUrl":"10.1016/j.vgie.2026.02.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Colorectal endoscopic submucosal dissection (ESD) enables en bloc resection and comprehensive histopathologic assessment; however, it can be technically challenging, particularly with large or unfavorably located lesions. The traction method has shown superior outcomes compared with the conventional technique, yet a single-point traction may be inadequate in bulky lesions. This study aimed to report the outcomes of the multitraction point (MTP) technique in a video series.</div></div><div><h3>Methods</h3><div>This video presents a case series of 3 patients in whom MTP was successfully performed, achieving en bloc resection without adverse events.</div></div><div><h3>Results</h3><div>We present 3 cases of large laterally spreading tumors in the ascending colon and/or cecum, where a MTP strategy was performed. In each case, the traction points were strategically placed to optimize submucosal plane exposure, facilitating dissection without risk of deep mural injury. All lesions were completely resected en bloc with R0 margins, and final pathology confirmed tubulovillous adenomas on all lesions.</div></div><div><h3>Conclusions</h3><div>These cases highlight the safety and efficacy of MTP in achieving curative resection in anatomically challenging colorectal ESD. The MTP approach may serve as a valuable technique, particularly when other methods are not feasible. Further studies are warranted to assess its generalizability and long-term outcomes.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"11 7","pages":"Pages 304-306"},"PeriodicalIF":0.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13343416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414008","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}

引用次数: 0

Failed endoscopic ultrasound–guided hepaticogastrostomy: do not give up–endoscopic ultrasound–guided rendezvous-hepaticogastrostomy can rescue you 超声内镜下肝胃造口术失败：不要放弃，超声内镜下肝胃造口术可以拯救你。

VideoGIE Pub Date : 2026-07-01 Epub Date: 2025-12-24 DOI: 10.1016/j.vgie.2025.10.012

Amar Vedamurthy MD, Shayan Irani MBBS, MD

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