Techniques and Innovations in Gastrointestinal Endoscopy最新文献

{"title":"Safety and Efficacy of Transoral Incisionless Fundoplication for Post–Esophageal Peroral Endoscopic Myotomy Gastroesophageal Reflux Disease With Esophagitis: A Meta-Analysis","authors":"Yusuf Kagzi,&nbsp;Abuzar Asif,&nbsp;Srinivas Reddy Puli","doi":"10.1016/j.tige.2025.250953","DOIUrl":"10.1016/j.tige.2025.250953","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Esophageal peroral endoscopic myotomy (E-POEM) is a gold-standard, minimally invasive treatment for achalasia and related esophageal motility disorders. However, gastroesophageal reflux disease (GERD) is a common complication after E-POEM, potentially compromising patient outcome. Transoral incisionless fundoplication (TIF) is an endoscopic technique designed to restore the competency of the gastroesophageal junction and reduce GERD symptoms. This meta-analysis evaluates the safety and efficacy of TIF in managing GERD with esophagitis following E-POEM.</div></div><div><h3>METHODS</h3><div>We performed a comprehensive, systematic search of multiple electronic databases, including conference proceedings, from inception through November 2024 to identify studies that evaluated the efficacy and safety of TIF in patients with GERD post E-POEM. Pooled proportions were calculated using both Mantel-Haenszel method (fixed effects model) and Der Simonian Laird method (random effects model). The heterogeneity among studies was tested using Cochran's Q test based on inverse variance weights. Primary outcomes were technical success, reduction in daily proton-pump inhibitor (PPI) and improvement in esophagitis. Secondary outcomes included procedure time, adverse event rates, and improvement in the GERD Health-Related Quality of Life (GERD-HRQL) Questionnaire.</div></div><div><h3>Results</h3><div>Seven studies comprising 212 patients with post-E-POEM GERD with esophagitis were included, with 59 undergoing TIF. Pooled mean interval between E-POEM and TIF was 16 months (95% CI, 8.00-24.00). Pooled technical success was 100% (95% CI, 91.07-100). GERD Health-Related Quality of Life scores improved from 39.82 ± 11.18 to 14.61 ± 4.6 post-TIF. The pooled odds ratio for esophagitis post-TIF vs pre-TIF was 0.28 (95% CI, 0.10-0.79). Proton pump inhibitor discontinuation was achieved in 69.45% (95% CI, 55.44-81.83). Mean procedure time was 60.17 minutes, and the adverse event rate was 13.87%, with all events being mild, self-limited, and no mortality was reported.</div></div><div><h3>CONCLUSION</h3><div>TIF is a safe and effective treatment for GERD with esophagitis following E-POEM, improving symptoms and reducing proton pump inhibitor dependence. Additional studies are needed to confirm long-term benefits.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"28 1","pages":"Article 250953"},"PeriodicalIF":0.9,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576946","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":"Percutaneous Endoscopic Vacuum Therapy for Patients With Postoperative Enterocutaneous Fistulas: A Retrospective Study","authors":"Marcus Kantowski ,&nbsp;Nathaniel Melling ,&nbsp;Thomas Roesch ,&nbsp;Chengcheng Christine Zhang","doi":"10.1016/j.tige.2025.250947","DOIUrl":"10.1016/j.tige.2025.250947","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Enterocutaneous fistulas following intestinal surgery are a feared complication with high morbidity and mortality. The therapeutic management of these fistulas is challenging. Percutaneous endoscopic vacuum therapy may be a new promising approach. Therefore, we aimed to evaluate the feasibility, effectiveness, and safety of percutaneous endoscopic vacuum therapy in patients with postoperative enterocutaneous fistulas.</div></div><div><h3>METHODS</h3><div>Patients with postoperative enterocutaneous fistulas treated with percutaneous endoscopic vacuum therapy were included and analyzed retrospectively. The primary endpoint was successful fistula closure using percutaneous endoscopic vacuum therapy.</div></div><div><h3>RESULTS</h3><div>This study included 44 patients, with a median follow-up of 5.9 months. Most patients (n = 35 of 44, 79.5%) received combined endoscopic treatments. The median duration of percutaneous endoscopic therapy was 37 days (range, 1-370 days), with a median of 6 endoscopic interventions (range, 1-15). Percutaneous endoscopic vacuum therapy was successful in 30 patients (68.2%). The remaining 14 patients (31.8%) required surgical revision, and of these, 10 (71.4%) achieved complete healing postoperatively. The overall success rate was 90.1% (n = 40 of 44). Procedure-related complications (anastomotic stenosis and duodenal ulcer bleeding) occurred in 6 patients (n = 6 of 44, 13.6%); 4 were treated endoscopically, while 2 required reoperation. The 30-day mortality rate was 20.5% (n = 9 of 44), and none of the deaths were treatment-related.</div></div><div><h3>CONCLUSIONS</h3><div>Percutaneous endoscopic vacuum therapy is feasible, effective, and safe for endoscopic treatment of postoperative enterocutaneous fistulas. Given the complexity of this severe condition, developing an individualized, multidisciplinary therapeutic concept based on clinical conditions and fistula morphology is crucial for the successful treatment.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"28 1","pages":"Article 250947"},"PeriodicalIF":0.9,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384188","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":"The Rise of Peroral Endoscopic Myotomy: Achalasia Treatment Trends, Institutional Adoption Patterns, and Current Procedural Terminology Coding in a Nationwide Cohort (2014-2024)","authors":"Mohammad Abuassi ,&nbsp;Kobina Essilfie-Quaye ,&nbsp;Ashraf Almomani ,&nbsp;Carson Creamer ,&nbsp;Harsimran Kalsi ,&nbsp;Tony Brar ,&nbsp;Yaseen Perbtani","doi":"10.1016/j.tige.2025.250946","DOIUrl":"10.1016/j.tige.2025.250946","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Achalasia is a chronic esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and absent peristalsis. The emergence of peroral endoscopic myotomy (POEM) has significantly altered achalasia treatment paradigms, although variation in adoption remain. This study evaluated nationwide trends in achalasia management, the impact of the 2022 Current Procedural Terminology (CPT) coding change for POEM, and institutional differences in procedure adoption.</div></div><div><h3>METHODS</h3><div>A retrospective cohort analysis using the TriNetX database was conducted on adult patients diagnosed with achalasia from 2014 to 2024. Annual incidence and prevalence, treatment patterns, and institutional (academic vs nonacademic) utilization trends were analyzed. Interrupted time series analysis assessed the effect of the 2022 CPT code implementation on POEM adoption.</div></div><div><h3>RESULTS</h3><div>Achalasia incidence proportion increased from 8.36 to 16.1 per 100,000 over the study period. POEM utilization increased substantially (0.42%-3.21%), whereas utilization rates of laparoscopic Heller myotomy and pneumatic dilation remained relatively stable, with Heller myotomy demonstrating a decline in recent years (from a peak of 1.46% in 2019 to 0.94% in 2024). Botulinum toxin injection use also increased significantly (0.33%-1.38%). Interrupted time series analysis showed no significant immediate (<em>P</em> = 0.337) or trend-altering (<em>P</em> = 0.150) effects from CPT coding changes. Academic institutions consistently demonstrated higher and earlier POEM adoption than nonacademic centers.</div></div><div><h3>CONCLUSION</h3><div>POEM adoption has steadily increased over the past decade, driven primarily by clinical efficacy rather than reimbursement policy. Differences in adoption persist between academic and nonacademic institutions, underscoring the need for expanded training and equitable access to advanced therapeutic options.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"28 1","pages":"Article 250946"},"PeriodicalIF":0.9,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420374","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":"Outcomes of Invisible Dysplasia Found on Random Biopsy Referred for Chromoendoscopy in a Community Practice","authors":"Suvithan Rajadurai ,&nbsp;Samir A. Shah","doi":"10.1016/j.tige.2025.250945","DOIUrl":"10.1016/j.tige.2025.250945","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"28 1","pages":"Article 250945"},"PeriodicalIF":0.9,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384187","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":"Raising the BARS: First US Experience of the Bariatric Anastomotic Reduction System (BARS) for Endoscopic Gastrojejunal Anastomosis Revision","authors":"Stephen A. Firkins ,&nbsp;Leandro Sierra ,&nbsp;Akash Khurana ,&nbsp;Arjun Chatterjee ,&nbsp;Roma Patel ,&nbsp;Bailey Flora ,&nbsp;Erika Staneff ,&nbsp;Roberto Simons-Linares","doi":"10.1016/j.tige.2025.250944","DOIUrl":"10.1016/j.tige.2025.250944","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"28 1","pages":"Article 250944"},"PeriodicalIF":0.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420448","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":"Concurrent Colonoscopy Does Not Affect Results of Wireless Ambulatory pH Monitoring","authors":"Chasen Cottle ,&nbsp;Manar Al Jawish ,&nbsp;Swathi Eluri ,&nbsp;Maoyin Pang ,&nbsp;Andree Koop","doi":"10.1016/j.tige.2025.250943","DOIUrl":"10.1016/j.tige.2025.250943","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"28 1","pages":"Article 250943"},"PeriodicalIF":0.9,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420447","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":"International Survey Assessing Gender Disparities in Advanced Therapeutic Endoscopy","authors":"Katarzyna M. Pawlak ,&nbsp;Kareem Khalaf ,&nbsp;Erin Brennand ,&nbsp;Andrei Voiosu ,&nbsp;Theodor Voiosu ,&nbsp;Giulio Antonelli ,&nbsp;Sharan B. Malipatil ,&nbsp;Caleb Na ,&nbsp;Ahmed H. Mokhtar ,&nbsp;Balqis Alabdulkarim ,&nbsp;Maryam Mahjoob ,&nbsp;Arjun Kundra ,&nbsp;Jeanin van Hooft ,&nbsp;Uzma Siddiqui ,&nbsp;Roberta Maselli ,&nbsp;Jeffrey D. Mosko ,&nbsp;Jennifer Telford ,&nbsp;Nauzer Forbes ,&nbsp;Natalia Causada Calo","doi":"10.1016/j.tige.2025.250917","DOIUrl":"10.1016/j.tige.2025.250917","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Underrepresentation of women in advanced therapeutic endoscopy is a multifactorial issue. We aim to evaluate the concerns about fluoroscopy use across genders and assess its impact on the representation of women in advanced therapeutic endoscopy.</div></div><div><h3>METHODS</h3><div>An international survey was distributed in August of 2023 to endoscopic retrograde cholangiopancreatography (ERCP)–performing physicians. The primary outcome was the frequency of concerns related to fluoroscopy exposure. Secondary outcomes included the reasons or implication of these concerns. Subgroup analyses were performed across gender.</div></div><div><h3>RESULTS</h3><div>ERCP-performing physicians revealed a gender disparity in therapeutic endoscopy, with 72.8% male respondents and 27.2% female respondents. Most participants were staff (67.6%), predominantly men (70.6%). The average age was 38.2 years, with a median institutional ERCP volume of 550 cases. Awareness of fluoroscopy safety standards was 56.1%, but only 51.6% received formal training. Concerns about radiation included cancer risk (73.4%) and fertility (43.9%). Usage of protective equipment was inadequate: thyroid dosimeters (21.9% always used), pelvic dosimeters (13.1%), and leaded goggles (8.4%). Female respondents specifically noted delayed family planning (27.6%) and fear of working while pregnant (40.4%), whereas male respondents focused on general health risks. Additionally, 68.4% of institutions recorded fluoroscopy time, but only 56.1% reported dosimeter use.</div></div><div><h3>CONCLUSION</h3><div>Gender disparities in fluoroscopy exposure concerns warrant the need for improved training and safety standards to foster equity in therapeutic endoscopy. Addressing these issues through targeted education and policy changes will not only enhance awareness of radiation risks but also promote a more inclusive environment for both male and female practitioners.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250917"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783683","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":"Endoscopic Band Ligation With Sclerotherapy Versus Milligan–Morgan Hemorrhoidectomy for the Treatment of Mixed Hemorrhoids","authors":"Minghua Ai ,&nbsp;Weizheng Wang ,&nbsp;Jie Li ,&nbsp;Xiaoping Tan ,&nbsp;Qing Zhang","doi":"10.1016/j.tige.2025.250914","DOIUrl":"10.1016/j.tige.2025.250914","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>To compare the clinical efficacy of endoscopic band ligation with sclerotherapy (EBS) with that of Milligan–Morgan hemorrhoidectomy (MMH) in the treatment of mixed hemorrhoids.</div></div><div><h3>METHODS</h3><div>This study was a retrospective, single-center investigation conducted at the First Hospital of Yangtze University. From September 2022 to March 2023, 46 patients who underwent EBS for mixed hemorrhoids were selected in an observation group, whereas 32 patients who underwent MMH for mixed hemorrhoids were allocated to a control group. Surgical-related parameters and adverse events were compared between the 2 groups, and the relationship between the number of endoscopic bands used and pain levels was analyzed.</div></div><div><h3>RESULTS</h3><div>The observation group demonstrated significantly shorter surgical and hospitalization durations than the control group (<em>P &lt;</em> 0.05). Furthermore, the 2 groups showed decreased postoperative visual analog scale scores, with the observation group exhibiting consistently lower scores at 24 hours, 48 hours, and 1 week postoperatively (<em>P &lt;</em> 0.05). Additionally, visual analog scale scores in the observation group at 4 hour postsurgery were correlated with the number of endoscopic ligation bands applied (<em>R</em>² = 0.1253; <em>P</em> = 0.0158). No significant differences in postoperative anal swelling, overall efficacy, or patient satisfaction were observed between the 2 groups (all <em>P &gt;</em> 0.05). However, the observation group experienced significantly less intraoperative (0% vs 84.4%; <em>P</em> = 0.000) and postoperative bleeding (6.5% vs 34.4%; <em>P</em> = 0.002) and a lower postoperative infection rate (0% vs 9.4%; <em>P</em> = 0.034) than the control group.</div></div><div><h3>CONCLUSION</h3><div>EBS provides clinical efficacy comparable with that of MMH in the treatment of mixed hemorrhoids. Moreover, the EBS approach is a potentially less invasive and shorter surgical procedure with relatively reduced hospitalization time, lower complication risk, and faster recovery.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250914"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687023","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":"Endoscopic Assessment of Large Colorectal Lesions","authors":"Naoto Tamai,&nbsp;Kazuki Sumiyama","doi":"10.1016/j.tige.2025.250931","DOIUrl":"10.1016/j.tige.2025.250931","url":null,"abstract":"<div><div>Endoscopic submucosal dissection (ESD) has emerged as an important therapeutic strategy for colorectal lesions that cannot be resected en bloc using endoscopic mucosal resection or underwater endoscopic mucosal resection, enabling en bloc resection with precise histopathologic evaluation. However, the determination of appropriate indications for ESD of large colorectal lesions remains a significant challenge. This article aimed to provide a comprehensive summary of the indications for colorectal ESD and the role of endoscopic evaluation in formulating optimal treatment strategies. Colorectal lesions with deep submucosal invasion are often associated with extensive submucosal fibrosis, presenting considerable technical difficulties during ESD. Performing ESD on such lesions has been linked to an increased additional surgical intervention and a heightened risk of procedure-related complications. Therefore, thorough preoperative assessment of the lesion is essential to ensure an appropriate treatment strategy while minimizing unnecessary risks. Accurate evaluation of colorectal lesions through white-light imaging, advanced imaging modalities such as narrow-band imaging, and chromoendoscopy are critical for assessing lesion characteristics. Furthermore, the application of artificial intelligence in lesion characterization has shown potential as a supportive tool in facilitating clinical decision-making regarding the indications for ESD. Artificial intelligence may assist endoscopists by enhancing the accuracy of lesion assessment and contributing to improved treatment planning. A comprehensive understanding of the morphologic and pathologic features of large colorectal lesions is vital to identify patients who would benefit most from ESD, while minimizing the risk of complications. This review highlights the necessity of meticulous endoscopic evaluation to enable appropriate lesion selection, ensuring the safe and effective application of ESD for large colorectal lesions and ultimately contributing to improved patient outcomes.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 4","pages":"Article 250931"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686087","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":"Traction-Assisted Endoscopic Submucosal Dissection of Colonic Lesions: A North American Experience","authors":"Farid Abushamat,&nbsp;Fares Ayoub,&nbsp;Mai A. Khalaf,&nbsp;Tara Keihanian,&nbsp;Salmaan Jawaid,&nbsp;Mohamed O. Othman","doi":"10.1016/j.tige.2024.250900","DOIUrl":"10.1016/j.tige.2024.250900","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Traction-assisted endoscopic submucosal dissection (TA-ESD) is a proposed technique to improve the efficiency of endoscopic submucosal dissection (ESD). Multiple studies primarily from Asian centers yielded mixed results in terms of procedure time, en bloc resection rate, and R0 resection rate of TA-ESD in comparison with those of conventional endoscopic submucosal dissection (C-ESD). We performed the first comparison of TA-ESD with C-ESD at a high-volume North American center.</div></div><div><h3>METHODS</h3><div>This was a retrospective cohort-matched study of all patients who underwent colonic ESD at a single center in the United States by a single operator. The study group were patients who underwent TA-ESD and were matched with a C-ESD case on a 1:1 basis based upon location within the colon, lesion size, and scope stabilization device usage. The baseline characteristics and procedure-related outcomes were compared between the groups.</div></div><div><h3>RESULTS</h3><div>In total, 138 colonic ESD cases were included (69 TA-ESD and 69 C-ESD). There were no significant differences in the baseline characteristics between the groups. Mean procedure time was 91.0 minutes (SD: 32.5) for TA-ESD and 85.4 minutes (SD: 39.3) for C-ESD (<em>P</em> = 0.36). En bloc resection was achieved in 69 (100%) of the TA-ESDs and 67 (97.1%) of the C-ESDs (<em>P</em> = 0.15). R0 resection was achieved in 52 (75.4%) of the TA-ESDs and 48 (69.6%) of the C-ESDs (<em>P</em> = 0.45).</div></div><div><h3>CONCLUSION</h3><div>We did not show a significant difference in procedure time, en bloc resection, R0 resection, or adverse events. Further randomized prospective studies that are sufficiently powered and stratified by operator experience level are needed to further elucidate the utility of the technique.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250900"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158124","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}