98 research outputs found
Scissor-type knife improves the safety of endoscopic submucosal dissection (ESD) among endoscopists without experience in ESD: A randomized ex vivo study
Background and study aims Endoscopic submucosal dissection (ESD) is technically challenging, difficult to learn, and carries a substantial risk of perforation, all of which remain significant barriers to its adoptability. We aimed to determine whether use of a novel scissor-type knife improved efficacy and safety among novice performers of ESD.
Materials and methods Following a brief didactic session on ESD, participants performed ESD of two lesions (2 cm diameter) in an ex vivo porcine gastric model. One resection was performed with a conventional knife and the other with the scissor knife (order of knife randomized). We recorded procedure time, successful en bloc resection, and adverse events (including full-thickness perforation and muscle injury) for each dissection. Participants completed a post-study survey.
Results 10 endoscopists (8 trainees, 2 staff) considered novices in ESD participated. Compared with the conventional knife, use of the scissor knife was associated with a significantly shorter time to completion of submucosal dissection (mean 6.2 [SD 5.6] vs. 15.6 [SD 15.6] minutes; P = 0.04) and total procedure time was not significantly different (22.1 [SD 13.3] vs. 24.9 [SD 26.5] minutes; P = 0.65). Scissor knife use was also associated with a significantly lower proportion of perforation and/or muscle injury (10.0 % vs. 70.0 %; P < 0.01) and proportion of muscle injury alone (10.0 % vs. 60.0 %; P  = 0.02).
Conclusions Among novices performing ESD on an ex vivo animal model, use of a scissor knife was associated with a significantly lower proportion of adverse events without prolonging procedure time. Scissor-type knives may improve ESD safety, at least among novices
Overutilization of endoscopic surveillance in nondysplastic Barrett's esophagus: a multicenter study
Guidelines suggest that patients with non-dysplastic BE undergo endoscopic surveillance every 3–5 years, but actual utilization of surveillance endoscopy and the determinants of variation in surveillance intervals are not known
Does performing en bloc versus piecemeal mucosal resections affect outcomes in patients with intramucosal adenocarcinoma?
Sa1829 Irregular Submucosal Glands Imaged on Volume Laser Endomicroscopy in Barrett's Esophagus Are Associated With the Transformed Microenvironment
860 Effects of Inflammation on Senescence in Epithelial Cells Is Mediated by Fibroblasts in Barrett's Esophagus
Sa1835 Tobacco Chewing and Smoking Are Risk Factors for Barrett's Esophagus in Caucasian GERD Patients
Sa1825 Outcomes of Radiofrequency Ablation for Barrett's Esophagus: A 10-Year Assessment
Contribution of stromal and epithelial cells to cyclooxygenase-2 (COX-2) activity in Barrett's esophagus
Combined endoscopic mucosal resection and photodynamic therapy versus esophagectomy for management of early adenocarcinoma in Barrett's esophagus
- …