Article
Gastroenterology & Hepatology
Li-Yun Ma, Zu-Qiang Liu, Lu Yao, Mei-Dong Xu, Shi-Yao Chen, Yun-Shi Zhong, Yi-Qun Zhang, Wei-Feng Chen, Li-Li Ma, Wen-Zheng Qin, Jian-Wei Hu, Ming-Yan Cai, Li-Qing Yao, Quan-Lin Li, Ping-Hong Zhou
Summary: In this study, the safety and efficacy of endoscopic resection for extraluminal tumors in the upper GI tract were assessed. The results showed that endoscopic resection is a safe and feasible therapeutic approach, but tumor size, shape, and location impact the difficulty and safety of the procedure.
GASTROINTESTINAL ENDOSCOPY
(2022)
Article
Surgery
Jin Hee Noh, Do Hoon Kim, Kwangbeom Park, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Summary: This study compared the outcomes of endoscopic treatment for different sizes of duodenal neuroendocrine tumors (DNET). The study found that in lesions smaller than 10 mm, both conventional EMR and modified EMR had similar histologic complete resection rates, but the modified EMR group had a higher risk of perforation. Overall, endoscopic treatment is feasible and effective for nonampullary DNET sized less than 10 mm and limited to mucosal and submucosal layer.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2023)
Article
Gastroenterology & Hepatology
Hiroyuki Aihara, Vladimir Kushnir, Gobind S. Anand, Lisa Cassani, Prabhleen Chahal, Sunil Dacha, Anna Duloy, Sahar Ghassemi, Christopher Huang, Thomas E. Kowalski, Emad Qayed, Sunil G. Sheth, C. Roberto Simons-Linares, Jason R. Taylor, Sarah B. Umar, Stacie A. F. Vela, Catharine M. Walsh, Renee L. Williams, Mihir S. Wagh
Summary: This document is part of a series prepared by the American Society for Gastrointestinal Endoscopy Training Committee, offering recommendations for a training curriculum focusing on endoscopic mucosal resection (EMR). It serves as an overview of favored techniques and a guide to resources for training directors, endoscopists, and trainees.
GASTROINTESTINAL ENDOSCOPY
(2021)
Article
Gastroenterology & Hepatology
David J. Tate, Lobke Desomer, Maria Eva Argenziano, Neha Mahajan, Mayenaaz Sidhu, Sergei Vosko, Neal Shahidi, Eric Lee, Stephen J. Williams, Nicholas G. Burgess, Michael J. Bourke
Summary: This study investigated the efficacy of endoscopic retreatment for residual or recurrent adenoma after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal polyps (LNPCPs) of >= 20mm. The results showed that endoscopic retreatment is an effective treatment method, with long-term adenoma remission of over 90%.
Article
Gastroenterology & Hepatology
Chang Kyo Oh, Young-Seok Cho, Sung Hak Lee, Bo-In Lee
Summary: The study found that anchoring-endoscopic mucosal resection (A-EMR) is superior to conventional endoscopic mucosal resection (C-EMR) for the complete resection of large colorectal polyps.
Article
Gastroenterology & Hepatology
Xue-Qun Zhang, Jian-Zhong Sang, Lei Xu, Xin-Li Mao, Bo Li, Wan-Lin Zhu, Xiao-Yun Yang, Chao-Hui Yu
Summary: EMR-P is superior to CEMR in removing sessile colorectal polyps sized 10-20 mm, particularly polyps > 15 mm in diameter, with higher R0 and en bloc resection rates and without increasing adverse events.
WORLD JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Surgery
Chang Kyo Oh, Bo-In Lee, Sung Hak Lee, Seung-Jun Kim, Han Hee Lee, Chul-Hyun Lim, Jin Su Kim, Yu Kyung Cho, Jae Myung Park, Young-Seok Cho, In Seok Lee, Myung-Gyu Choi
Summary: The study found that the use of CSI-EMR does not increase the complete or en bloc resection rate of colorectal lesions with SSL endoscopic features, but does increase the R0 resection rate. Although the procedure time is longer for CSI-EMR, there is no significant difference in adverse events or recurrence rate compared to EMR. Further evaluation is needed to assess the association of CSI-EMR with R0 resection and non-recurrence.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Medicine, General & Internal
Su Jin Kim, Tae Un Kim, Cheol Woong Choi, Hyung Wook Kim, Su Bum Park, Dae Gon Ryu
Summary: Underwater endoscopic mucosal resection (UW-EMR) is a safe and effective treatment for upper gastrointestinal subepithelial tumors (SETs) embedded in the submucosal layer. In this study, 17 SETs were successfully resected using UW-EMR, with no complications and no recurrence observed.
Article
Medicine, General & Internal
Masahiro Okada, Satoshi Shinozaki, Eriko Ikeda, Yoshikazu Hayashi, Takahito Takezawa, Hisashi Fukuda, Takaaki Morikawa, Masafumi Kitamura, Munefumi Arita, Tatsuma Nomura, Hirotsugu Sakamoto, Keijiro Sunada, Noriyoshi Fukushima, Alan Kawarai Lefor, Hironori Yamamoto
Summary: UEMR achieves similar resection quality with shorter procedure time and lower costs compared to ESMR-L. We recommend using UEMR for the resection of rectal NET < 10 mm.
FRONTIERS IN MEDICINE
(2022)
Article
Gastroenterology & Hepatology
Naohisa Yoshida, Ken Inoue, Hikaru Hashimoto, Reo Kobayashi, Yuri Tomita, Satoshi Sugino, Ryohei Hirose, Osamu Dohi, Yukiko Morinaga, Yutaka Inada, Takaaki Murakami, Yoshito Itoh
Summary: The efficacy of precutting endoscopic mucosal resection with SOUTEN (PEMR-S) for colorectal lesions was analyzed. The results showed that PEMR-S achieved high en bloc resection rates for colorectal lesions of 20-30 mm, although it led to longer procedure times.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Article
Gastroenterology & Hepatology
Eduardo Rodrigues-Pinto, Pedro Pereira, Bernardo Sousa-Pinto, Hany Shehab, Rolando Pinho, Michael C. Larsen, Shayan Irani, Richard A. Kozarek, Antonio Capogreco, Alessandro Repici, Ealaf Shemmeri, Brian E. Louie, Pawel Rogalski, Andrzej Baniukiewicz, Andrzej Dabrowski, Joao Correia de Sousa, Silvia Barrias, Yervant Ichkhanian, Vivek Kumbhari, Mouen A. Khashab, Nicole Bowers, Allison R. Schulman, Guilherme Macedo
Summary: This retrospective study evaluated the effectiveness of endoscopic therapy for UGI postsurgical leaks in 206 patients between 2014 and 2019. It found that multimodal therapeutic endoscopy can achieve leak closure in a significant proportion of patients with a low rate of severe adverse events.
GASTROINTESTINAL ENDOSCOPY
(2021)
Article
Oncology
Catherine G. Tran, Scott K. Sherman, Mohammed O. Suraju, Apoorve Nayyar, Henning Gerke, Rami G. El Abiad, Chandrikha Chandrasekharan, Po Hien Ear, Thomas M. O'Dorisio, Joseph S. Dillon, Andrew M. Bellizzi, James R. Howe
Summary: The management of duodenal neuroendocrine tumors (DNETs) varies depending on the size of the lesion, with smaller ones typically treated by endoscopic mucosal resection (EMR) and larger ones by surgical resection (SR). A study comparing outcomes between patients who underwent EMR and SR showed that there was no significant difference in survival rates, particularly in 1-2 cm DNETs. However, surgically resected DNETs had improved progression-free survival (PFS) and overall survival (OS) compared to jejunoileal NETs.
ANNALS OF SURGICAL ONCOLOGY
(2022)
Article
Surgery
Peiwen Li, Bin Ma, Shulei Gong, Xinyu Zhang, Wenya Li
Summary: The study evaluated the feasibility and safety of Underwater Endoscopic Mucosal Resection (UEMR) for colorectal lesions, finding that UEMR could achieve a high en bloc resection rate and low adverse event rate compared to conventional methods. UEMR may be considered as an effective and safe alternative for treating colorectal lesions.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Surgery
Yoshinori Sato, Shun-ichiro Ozawa, Hiroshi Yasuda, Masaki Kato, Hirofumi Kiyokawa, Masaki Yamashita, Yasumasa Matsuo, Hiroyuki Yamamoto, Fumio Itoh
Summary: Tip-in endoscopic mucosal resection (EMR) is a potential alternative for treating large colorectal sessile polyps of >= 20 mm, showing a high en bloc resection rate in polyps of < 30 mm.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Gastroenterology & Hepatology
Masau Sekiguchi, Ataru Igarashi, Yasuhiko Mizuguchi, Hiroyuki Takamaru, Masayoshi Yamada, Taku Sakamoto, Henrik Maltzman, Ylva Falken, Minoru Esaki, Takahisa Matsuda, Yutaka Saito
Summary: The cost-effectiveness analysis of endoscopic submucosal dissection (ESD) and piecemeal endoscopic mucosal resection (pEMR) for colorectal laterally spreading tumors (LSTs) showed that ESD yielded lower number of recurrences and surgeries but required higher costs compared to pEMR. The incremental cost-effectiveness ratios for avoiding a recurrence and surgery were favorable for ESD over pEMR, with a probability for ESD being a more cost-effective option being over 50% at certain willingness-to-pay values. The scenario analysis also demonstrated lower required costs for ESD.
DIGESTIVE ENDOSCOPY
(2022)
Article
Surgery
Anirban Ghosh, Adam Hussein, Alan Askari, Vigyan Jain, Md Tanveer Adil
Summary: This study found that two-stage DS can lead to sustained weight loss, resolution of comorbidities, and improvement in quality of life in patients with BMI over 60 kg/m(2).
Article
Gastroenterology & Hepatology
Rawen Kader, Anton Cid-Mejias, Patrick Brandao, Shahraz Islam, Sanjith Hebbar, Juana Gonzalez-Bueno Puyal, Omer F. Ahmad, Mohamed Hussein, Daniel Toth, Peter Mountney, Ed Seward, Roser Vega, Danail Stoyanov, Laurence B. Lovat
Summary: CNN can effectively classify polyps as adenomatous or nonadenomatous using NBI and NBI-NF, and can differentiate adenomas from SSLs and hyperplastic polyps. The CNN achieved high sensitivity and specificity in distinguishing different types of polyps.
DIGESTIVE ENDOSCOPY
(2023)
Article
Public, Environmental & Occupational Health
Jacob Salmonsmith, Andrea Ducci, Ramanarayanan Balachandran, Liwei Guo, Ryo Torii, Catherine Houlihan, Ruth Epstein, John Rubin, Manish K. Tiwari, Laurence B. Lovat
Summary: SARS-CoV-2 has impacted the NHS, increasing waiting lists due to longer downtime between patient consultations. Portable air cleaners (PAC) were investigated as a low-cost alternative to reduce aerosol concentration. Using PAC can significantly reduce aerosol clearance time by 82% and maintain lower aerosol concentrations compared to no ventilation. This technology could help reduce downtime in NHS departments.
EPIDEMIOLOGY AND INFECTION
(2023)
Article
Gastroenterology & Hepatology
Mohamed Hussein, David Lines, Juana Gonzalez-Bueno Puyal, Rawen Kader, Nicola Bowman, Vinay Sehgal, Daniel Toth, Omer F. Ahmad, Martin Everson, Jose Miguel Esteban, Raf Bisschops, Matthew Banks, Michael Haefner, Peter Mountney, Danail Stoyanov, Laurence B. Lovat, Rehan Haidry
Summary: This study developed a computer-aided characterization system to support the diagnosis of dysplasia in Barrett's esophagus (BE) on magnification endoscopy. By training a neural network with high-definition images and videos, the system showed high accuracy and speed in characterizing dysplasia in BE, making a step towards real-time automated diagnosis.
GASTROINTESTINAL ENDOSCOPY
(2023)
Article
Gastroenterology & Hepatology
Omer F. Ahmad, Evangelos Mazomenos, Francois Chadebecq, Rawen Kader, Mohamed Hussein, Rehan J. Haidry, Juana Gonzalez-Bueno Puyal, Patrick Brandao, Daniel Toth, Peter Mountney, Ed Seward, Roser Vega, Danail Stoyanov, Laurence B. Lovat
Summary: This study aimed to evaluate visual recognition errors in colorectal polyps and explore the underlying mechanisms. The findings showed that cognitive errors were the main reason for visual recognition errors, while gaze errors were less common. Artificial intelligence performed better in identifying colorectal polyps compared to trainees and medical students.
JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
(2023)
Review
Gastroenterology & Hepatology
Francois Chadebecq, Laurence B. Lovat, Danail Stoyanov
Summary: Modern endoscopy relies on digital technology to capture detailed information of surgical procedures, and advances in artificial intelligence have the potential to assist in computer-assisted interventions, improving the effectiveness and accuracy of surgeries.
NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY
(2023)
Article
Surgery
Antonio S. Soares, Neil T. Clancy, Sophia Bano, Imran Raza, Michelle Diana, Laurence B. Lovat, Danail Stoyanov, Manish Chand
Summary: This study assessed the interobserver variability in the selection of the transection point during fluorescence angiography before anastomosis. The results showed no significant difference among the raters in choosing the optimal bowel transection point based on static fluorescence angiography images. The agreement between different pre-planned rater cohorts was also poor.
SURGICAL INNOVATION
(2023)
Article
Biochemical Research Methods
Juana Gonzalez-Bueno Puyal, Patrick Brandao, Omer F. Ahmad, Kanwal K. Bhatia, Daniel Toth, Rawen Kader, Laurence Lovat, Peter Mountney, Danail Stoyanov
Summary: Colonoscopy is still the best method for colorectal cancer screening, as it can detect and remove pre-cancerous polyps. Computer-aided polyp characterisation can determine which polyps need to be removed, and recent deep learning approaches have shown promising results as clinical decision support tools. However, the appearance of polyps during a procedure can vary, making automatic predictions unstable. In this paper, the use of spatio-temporal information is investigated to improve the performance of classifying lesions as adenoma or non-adenoma. Two methods are implemented and extensive experiments on benchmark datasets show an increase in performance and robustness.
BIOMEDICAL OPTICS EXPRESS
(2023)
Article
Medicine, General & Internal
Mohammad Farhad Peerally, Clare Jackson, Pradeep Bhandari, Krish Ragunath, Hugh Barr, Clive Stokes, Rehan Haidry, Laurence B. Lovat, Howard Smart, John De Caestecker
Summary: This study investigated the feasibility of a multicenter randomized controlled trial for the management of early Barrett's neoplasia, and identified factors influencing patient participation and their views on a potential future trial comparing surgery with endotherapy. Four main influences were identified, highlighting the importance of qualitative research in informing the design of larger randomized controlled trials.
Article
Gastroenterology & Hepatology
Kai Man Alexander Ho, Avi Rosenfeld, Aine Hogan, Hazel McBain, Margaret Duku, Paul B. D. Wolfson, Ashley Wilson, Sharon M. Y. Cheung, Laura Hennelly, Lester Macabodbod, David G. Graham, Vinay Sehgal, Amitava Banerjee, Laurence B. Lovat
Summary: The study used a machine learning approach to predict oesophageal cancer based on questionnaire responses. The model showed high accuracy and sensitivity in detecting oesophageal cancer. The findings suggest that this questionnaire approach could help prioritize high-risk patients for endoscopy, addressing endoscopic backlogs caused by the COVID-19 pandemic.
CLINICS AND RESEARCH IN HEPATOLOGY AND GASTROENTEROLOGY
(2023)
Article
Medicine, General & Internal
Katerina-Vanessa Savva, Michal Kawka, Bhamini Vadhwana, Rahul Penumaka, Imogen Patton, Komal Khan, Claire Perrott, Saranya Das, Maxime Giot, Stella Mavroveli, George B. Hanna, Melody Zhifang Ni, Christopher J. Peters
Summary: This study aims to create a Biomarker Toolkit to bridge the gap between biomarker discovery and clinical use by identifying clinically promising biomarkers. A validated checklist of attributes linked with successful biomarker implementation was generated through mixed-methodology, including systematic literature search, interviews, and a Delphi survey. The toolkit can be used to detect biomarkers with the highest clinical potential and shape the design and execution of biomarker studies.
Article
Multidisciplinary Sciences
Stefania Manetti, Emanuele Lettieri, Melody Zhifang Ni
Summary: This study aims to develop and validate an evidence-based framework that helps innovators assess their readiness for successful medical device development and deployment. Through a key-informant process and Delphi method, a checklist for small and large enterprises was constructed and validated. The study found that early Health Technology Assessment plays a pivotal role in the success of the medical device industry.
Review
Biotechnology & Applied Microbiology
Rossella Di Bidino, Davide Piaggio, Martina Andellini, Beatriz Merino-Barbancho, Laura Lopez-Perez, Tianhui Zhu, Zeeshan Raza, Melody Ni, Andra Morrison, Simone Borsci, Giuseppe Fico, Leandro Pecchia, Ernesto Iadanza
Summary: Artificial intelligence and machine learning are increasingly important in the field of medical devices, but the Health Technology Assessment process still lacks a common methodology for assessing AI/ML-based devices. A meta-review conducted by the International Federation of Medical and Biological Engineering collected existing evidence on methods used to assess AI-based devices, with a focus on heart failure management. The findings showed that deep learning is commonly used, and electronic health records and registries are prevalent data sources for AI/ML algorithms.
BIOENGINEERING-BASEL
(2023)
Article
Primary Health Care
James Lewis, Alan Askari, Arihant Mehta, Yasmin Razak, Prash Patel, Ravi Misra, Henry Tilney, Tanveer Ahmed, Mooyad Ahmed, Adnan Syeed, John Camilleri-Brennan, Ralph John Nicholls, James Macalister Kinross
Summary: This study evaluated the feasibility, acceptability, and safety of digital rectoscopy in primary care. The results showed that it is a feasible and acceptable method, with no serious adverse events reported. It also demonstrated the potential to reduce referrals and save costs.
Article
Surgery
T. S. Hettiarachchi, A. Askari, E. Rudge, L. T. Hao, S. Sarwar, D. Dowsett, A. El Hadi, Irshad Shaikh
Summary: This study compares the surgical outcomes of robotic assisted surgery and laparoscopic surgery for left sided colorectal resections. The results show that robotic surgery has shorter length of stay, lower rate of conversion to open surgery, and lower complication rates compared to laparoscopic surgery. There is no significant difference between the two groups in terms of anastomotic leak rates and complete resection.
JOURNAL OF ROBOTIC SURGERY
(2023)