Techniques and Innovations in Gastrointestinal Endoscopy最新文献

英文中文

Real-Life Application of Artificial Intelligence for Automatic Characterization of Biliary Strictures: A Transatlantic Experience 人工智能在胆道狭窄自动表征中的实际应用：跨大西洋经验

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2024-11-17 DOI: 10.1016/j.tige.2024.250902

Mariano González-Haba Ruiz , Pedro Pereira , Jessica Widmer , Tiago Ribeiro , Belén Agudo Castillo , Filipe Vilas-Boas , João Ferreira , Miguel Mascarenhas Saraiva , Guilherme Macedo

引用次数: 0

White Light Imaging to Narrow Band Imaging via Style Transfer: A Feasibility Test for Enhancing Colonoscopic Diagnostics 白光成像到窄带成像通过风格转移：提高结肠镜诊断的可行性测试

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2025-05-11 DOI: 10.1016/j.tige.2025.250927

JUN SEO LEE , DONGHEON LEE , EUN HYO JIN , HAE YEON KANG , JI YEON SEO , JI MIN CHOI

引用次数: 0

Endoscopic Transpapillary Gallbladder Drainage With 2 Stents Versus 1 Stent Reduces Reinterventions: A Multicenter Study 内镜下经乳头胆囊引流2个支架vs 1个支架减少再干预：一项多中心研究

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2024-10-11 DOI: 10.1016/j.tige.2024.09.006

James D. Haddad , Natalie Wilson , Vijay S. Are , Shawn L. Shah , Danny Issa , Tarek Sawas , Mohammad Bilal , Thomas Tielleman

BACKGROUND AND AIMS

Endoscopic transpapillary gallbladder drainage (ETGBD) is a therapeutic option for gallstone-related gallbladder disease in nonsurgical candidates. However, the optimal stenting strategy and follow-up has not been established. We aimed to determine whether there was a decreased need for unplanned reintervention in patients undergoing placement of two transpapillary gallbladder stents compared with that in those undergoing placement of one stent.

METHODS

We performed a multicenter retrospective analysis of patients undergoing ETGBD between June 2013 and October 2022. The primary outcome was clinical success as defined by resolution of symptoms without the need for another drainage strategy. Secondary outcomes included the adverse events of postendoscopic retrograde cholangiopancreatography pancreatitis, cholangitis, bleeding, perforation, or death. Factors associated with placement of two stents, unplanned reintervention, and adverse events were assessed.

RESULTS

We included 75 patients who underwent ETGBD, with a median follow-up of 407 days (IQR: 71-1504 days). Technical and clinical success were 88.2% and 81.3%, respectively. Unplanned reintervention was significantly lower in the double stenting group (0% vs 25.4%; P = 0.02). Use of a 7 French stent (odds ratio [OR]: 15.5; 95% CI: 1.9-125; P = 0.01) and presence of a percutaneous cholecystostomy tube (OR: 10.8; 95% CI: 2.8-41.3; P = 0.001) were associated with placement of two stents. There was no significant difference in adverse events between groups (OR: 0.9; 95% CI: 0.09-8.8; P = 0.94).

CONCLUSION

ETGBD is safe and effective in nonoperative candidates. Single transpapillary gallbladder stenting is associated with more unplanned reinterventions, and 7 French stent diameter and previous percutaneous cholecystostomy tube may be associated with ability to place a second stent. Endoscopists should consider planned exchange of solitary transpapillary gallbladder stents or interval placement of a second stent if placement of two stents was unsuccessful at the index procedure.

背景和目的：内镜下经乳头胆囊引流术（ETGBD）是非手术候选人胆结石相关胆囊疾病的一种治疗选择。然而，最佳支架置入策略和随访尚未确定。我们的目的是确定与放置一个支架的患者相比，放置两个经乳头胆囊支架的患者是否需要减少计划外的再干预。方法：我们对2013年6月至2022年10月期间接受ETGBD的患者进行了多中心回顾性分析。主要结局是临床成功，定义为症状的解决，而不需要另一个引流策略。次要结局包括内镜下逆行胆管造影术后胰腺炎、胆管炎、出血、穿孔或死亡等不良事件。评估与放置两个支架、计划外再干预和不良事件相关的因素。结果我们纳入了75例ETGBD患者，中位随访时间为407天（IQR: 71-1504天）。技术和临床成功率分别为88.2%和81.3%。双支架组的意外再干预率显著降低(0% vs 25.4%；P = 0.02)。使用7 French支架(优势比[OR]: 15.5；95% ci: 1.9-125；P = 0.01)和存在经皮胆囊造瘘管(OR: 10.8；95% ci: 2.8 ~ 41.3；P = 0.001)与放置两个支架相关。两组间不良事件发生率无显著差异(OR: 0.9；95% ci: 0.09-8.8；P = 0.94)。结论etgbd在非手术患者中是安全有效的。单次经乳头胆囊支架植入与更多的意外再介入有关，7 French支架直径和既往经皮胆囊造瘘管可能与放置第二次支架的能力有关。内窥镜医师应考虑计划更换单独的经乳头胆囊支架或间隔放置第二个支架，如果两个支架在索引手术中放置不成功。

{"title":"Endoscopic Transpapillary Gallbladder Drainage With 2 Stents Versus 1 Stent Reduces Reinterventions: A Multicenter Study","authors":"James D. Haddad , Natalie Wilson , Vijay S. Are , Shawn L. Shah , Danny Issa , Tarek Sawas , Mohammad Bilal , Thomas Tielleman","doi":"10.1016/j.tige.2024.09.006","DOIUrl":"10.1016/j.tige.2024.09.006","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Endoscopic transpapillary gallbladder drainage (ETGBD) is a therapeutic option for gallstone-related gallbladder disease in nonsurgical candidates. However, the optimal stenting strategy and follow-up has not been established. We aimed to determine whether there was a decreased need for unplanned reintervention in patients undergoing placement of two transpapillary gallbladder stents compared with that in those undergoing placement of one stent.</div></div><div><h3>METHODS</h3><div>We performed a multicenter retrospective analysis of patients undergoing ETGBD between June 2013 and October 2022. The primary outcome was clinical success as defined by resolution of symptoms without the need for another drainage strategy. Secondary outcomes included the adverse events of postendoscopic retrograde cholangiopancreatography pancreatitis, cholangitis, bleeding, perforation, or death. Factors associated with placement of two stents, unplanned reintervention, and adverse events were assessed.</div></div><div><h3>RESULTS</h3><div>We included 75 patients who underwent ETGBD, with a median follow-up of 407 days (IQR: 71-1504 days). Technical and clinical success were 88.2% and 81.3%, respectively. Unplanned reintervention was significantly lower in the double stenting group (0% vs 25.4%; <em>P</em> = 0.02). Use of a 7 French stent (odds ratio [OR]: 15.5; 95% CI: 1.9-125; <em>P</em> = 0.01) and presence of a percutaneous cholecystostomy tube (OR: 10.8; 95% CI: 2.8-41.3; <em>P</em> = 0.001) were associated with placement of two stents. There was no significant difference in adverse events between groups (OR: 0.9; 95% CI: 0.09-8.8; <em>P</em> = 0.94).</div></div><div><h3>CONCLUSION</h3><div>ETGBD is safe and effective in nonoperative candidates. Single transpapillary gallbladder stenting is associated with more unplanned reinterventions, and 7 French stent diameter and previous percutaneous cholecystostomy tube may be associated with ability to place a second stent. Endoscopists should consider planned exchange of solitary transpapillary gallbladder stents or interval placement of a second stent if placement of two stents was unsuccessful at the index procedure.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150899"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759439","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

Glucagon-like Peptide-1 Receptor Agonists Are Not Associated With Increased Incidence of Pneumonia After Endoscopic Procedures 胰高血糖素样肽-1受体激动剂与内镜手术后肺炎发病率增加无关

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2025-04-15 DOI: 10.1016/j.tige.2025.250925

Natalia Tejada , Ishak Mansi , Silvio W. de Melo Jr

BACKGROUND AND AIMS

Despite their favorable cardiometabolic effects, use of glucagon-like peptide-1 receptor agonists (GLP1-RAs), have raised concerns for increasing the risk of aspiration pneumonia after upper esophagogastroduodenoscopy (EGD)/colonoscopy due to slowing gastrointestinal motility. Such risks are yet to be confirmed. This study aimed to examine the association of GLP1-RA use with risk of aspiration pneumonia or any pneumonia in patients undergoing these procedures.

METHODS

This retrospective, propensity score (PS)–matched cohort study, with active control design, used data from the Veterans Health Administration of veterans who underwent EGD/colonoscopy procedures during fiscal years 2016-2021 while using GLP1-RA or dipeptidyl peptidase 4 inhibitors (DPP4i), as active comparators. A PS was created using 60 baseline characteristics encompassing demographics, laboratory investigations, medication use, and comorbidities that may increase risk of aspiration or infection. Our 2 coprimary outcomes were incidence of any pneumonia and incidence of aspiration pneumonia within 30 days of the procedure.

RESULTS

Of 59,280 EGD/colonoscopy procedures (22,570 GLP1-RA users and 36,710 DPP4i users), we successfully matched 15,943 pairs of patients. Mean (SD) age of patients was 66 (8) years and mean (SD) weighted Charlson comorbidity index was 4.8 (3.2). In the PS-matched cohort, 48 (0.3%) GLP1-RA users had pneumonia vs 57 (0.4%) DPP4i users (odds ratio, 0.84; 95% CI, 0.57-1.23), and 7 (0.04%) GLP1-RA users had aspiration pneumonia vs 9 (0.06%) DPP4i users (odds ratio, 0.78; 95% CI, 0.29-2.09).

CONCLUSION

Risks of aspiration pneumonia or any pneumonia after EGD/colonoscopy procedures were similar in GLP1-RA users and active comparators. Withholding GLP1-RA prior to endoscopic procedures may not be necessary.

背景和目的尽管胰高血糖素样肽-1受体激动剂（GLP1-RAs）具有良好的心脏代谢作用，但由于胃肠道运动减慢，使用胰高血糖素样肽-1受体激动剂（GLP1-RAs）增加了上食管胃十二指肠镜(EGD)/结肠镜检查后吸入性肺炎的风险。这些风险尚未得到证实。本研究旨在检查GLP1-RA的使用与吸入性肺炎或任何肺炎的风险之间的关系。方法：这项回顾性、倾向评分（PS）匹配的队列研究采用主动对照设计，使用退伍军人健康管理局的数据，这些退伍军人在2016-2021财政年度接受EGD/结肠镜检查，同时使用GLP1-RA或二肽基肽酶4抑制剂（DPP4i）作为主动比较物。PS使用60个基线特征创建，包括人口统计学、实验室调查、药物使用和可能增加误吸或感染风险的合并症。我们的两个主要结局是任何肺炎的发病率和手术后30天内吸入性肺炎的发病率。在59,280例EGD/结肠镜检查中（22,570例GLP1-RA使用者和36,710例DPP4i使用者），我们成功匹配了15,943对患者。患者平均（SD）年龄66(8)岁，平均（SD）加权Charlson合并症指数为4.8（3.2）。在ps匹配的队列中，48名（0.3%）GLP1-RA使用者患有肺炎，57名（0.4%）DPP4i使用者(优势比，0.84；95% CI, 0.57-1.23)， GLP1-RA使用者有7例（0.04%）吸入性肺炎，而DPP4i使用者有9例（0.06%）吸入性肺炎(优势比，0.78；95% ci, 0.29-2.09)。结论：GLP1-RA使用者和活性对照者在EGD/结肠镜检查后发生吸入性肺炎或任何肺炎的风险相似。在内窥镜手术前保留GLP1-RA可能没有必要。

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引用次数: 0

Over-the-Scope Clip versus Standard Endoscopic Therapy as First-Line Intervention for Nonvariceal Upper Gastrointestinal Bleeding: A Cost-Effectiveness Analysis 非静脉曲张上消化道出血的内镜下夹与标准内镜治疗的一线干预：成本-效果分析

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2025-06-26 DOI: 10.1016/j.tige.2025.250935

Sneh Sonaiya , Sahib Singh , Tooba Laeeq , Vaishnavi Modi , Magnus Chun , Pranav Patel , Vignan Manne , Babu P. Mohan

BACKGROUND AND AIMS

Recent studies have indicated the superiority of the Over-The-Scope Clip (OTSC) as a first-line treatment compared with standard endoscopic therapy (ST) for nonvariceal upper gastrointestinal bleeding (NVUGIB). Given the high cost of OTSCs, we assessed the cost-effectiveness of OTSCs vs ST for NVUGIB.

METHODS

We conducted an incremental cost-effectiveness analysis comparing OTSCs with ST as the first-line hemostatic intervention for NVUGIB over a 30-day period using a decision tree model based on pooled randomized controlled trial data. All costs were derived from Centers for Medicare & Medicaid Services reimbursement data and published literature. Analysis was performed using TreeAge Pro Healthcare 2024.

RESULTS

Pooled data of 443 patients (216 OTSCs; 227 ST) were analyzed. For the base case of a 69.8-year-old patient with Forrest Ia, Ib, IIa, or IIb NVUGIB, OTSCs resulted in an incremental cost-effectiveness ratio (ICER) of −$45,454 per quality-adjusted life year (QALY), indicating cost savings. For NVUGIB with stigmata of active bleeding (Forrest Ia or Ib), OTSCs yielded an ICER of −$85,046 per QALY. For acute NVUGIB with high risk of rebleeding (complete Rockall score ≥ 7), OTSCs yielded an ICER of −$112,960 per QALY. OTSCs remained cost-effective compared with ST when the per-OTSC cost was ≤$927 or when ≤2.3 OTSCs were utilized.

CONCLUSION

At a willingness-to-pay of $100,000 per QALY, OTSCs are cost-saving compared with ST for Forrest Ia, Ib, IIa, or IIb NVUGIB, as well as NVUGIB with stigmata of active bleeding or high rebleeding risk. Reducing OTSC costs (≤$927) and optimizing usage (≤2 clips) further improve the economic viability of OTSCs. Our findings support OTSCs as a first-line hemostatic intervention for high-risk NVUGIB to improve clinical and economic outcomes.

背景和目的最近的研究表明，与标准内镜治疗（ST）相比，超镜夹（OTSC）作为治疗非静脉曲张性上消化道出血（NVUGIB）的一线治疗方法具有优势。考虑到OTSCs的高成本，我们评估了OTSCs与ST治疗NVUGIB的成本效益。方法：我们采用基于合并随机对照试验数据的决策树模型，对30天内OTSCs与ST作为NVUGIB一线止血干预进行了增量成本-效果分析。所有费用均来自医疗保险中心；医疗补助服务报销数据和已发表文献。使用TreeAge Pro Healthcare 2024进行分析。结果443例患者(216例OTSCs；227 ST)进行分析。对于69.8岁的Forrest Ia， Ib， IIa或IIb NVUGIB患者的基本病例，OTSCs导致每个质量调整生命年（QALY）的增量成本-效果比（ICER）为- 45,454美元，表明成本节省。对于伴有活动性出血（Forrest Ia或Ib）的NVUGIB， OTSCs的ICER为- 85,046美元/ QALY。对于再出血风险高的急性NVUGIB（完全Rockall评分≥7），OTSCs的ICER为- 112,960美元/ QALY。当每个otsc成本≤927美元或使用≤2.3个ottsc时，与ST相比，OTSCs仍具有成本效益。结论：在每个QALY支付意愿为10万美元的情况下，对于Forrest Ia， Ib， IIa或IIb NVUGIB，以及有活动性出血或高再出血风险的NVUGIB，与ST相比，OTSCs节省了成本。降低OTSC成本（≤927美元）和优化使用（≤2夹子）进一步提高了OTSC的经济可行性。我们的研究结果支持OTSCs作为高风险NVUGIB的一线止血干预措施，以改善临床和经济结果。

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引用次数: 0

Role of Endoscopic Ultrasound–Guided Gastrointestinal Anastomosis for Gastric Outlet Obstruction, Endoscopic Access, and Enteric Decompression 超声内镜下胃肠道吻合在胃出口梗阻、内镜下进入及肠道减压中的作用

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2025-02-05 DOI: 10.1016/j.tige.2025.250915

Michiel Bronswijk , Giuseppe Vanella , Roy L.J. van Wanrooij , Paolo Giorgio Arcidiacono , Schalk Van der Merwe

Endoscopic ultrasound (EUS)-guided gastrointestinal anastomosis techniques using lumen-apposing metal stents are increasingly being used in expert centers throughout the world and have already found their way into day-to-day practice. For patients with gastric outlet obstruction, EUS-guided gastroenterostomy has the potential to become the new reference standard given the most recent prospective data of long-term effectiveness in the setting of oncologic palliation, as well as the promising evidence regarding benign obstruction in poor surgical candidates. For patients with surgically altered anatomy, EUS-directed transgastric or transenteric endoscopic retrograde cholangiopancreatography (ERCP) seems to provide more effective and less invasive alternative to enteroscopy-assisted ERCP and laparoscopy-assisted ERCP. Besides access or management of gastric outlet obstruction, EUS-guided gastrointestinal anastomosis is furthermore increasingly being used for the palliation of afferent loop syndrome, showing high clinical success rates and acceptable safety profile. This also pertains to EUS-directed enterocolostomy, where small series have suggested a potential benefit for patients with malignant intestinal obstruction, although more data are required regarding patient selection and safety. In this review, we discuss the most recent evidence, technical approaches, and future directions for these techniques.

内镜超声（EUS）引导下使用腔内金属支架的胃肠道吻合技术在世界各地的专家中心越来越多地使用，并且已经进入日常实践。对于胃出口梗阻患者，eus引导下的胃肠造口术有可能成为新的参考标准，因为最新的前瞻性数据表明，在肿瘤姑息的情况下，eus引导下的胃肠造口术长期有效，而且在不良手术候选人中，良性梗阻的证据也很有希望。对于手术解剖改变的患者，eus引导的经胃或经肠内镜逆行胆管胰胆管造影（ERCP）似乎比肠镜辅助的ERCP和腹腔镜辅助的ERCP更有效，侵入性更小。除了进入或处理胃出口梗阻外，eus引导下的胃肠道吻合越来越多地用于缓解传入环路综合征，具有较高的临床成功率和可接受的安全性。这也适用于eus导向的肠结肠造口术，尽管需要更多关于患者选择和安全性的数据，但小系列研究表明，恶性肠梗阻患者可能受益。在这篇综述中，我们讨论了这些技术的最新证据，技术方法和未来的发展方向。

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引用次数: 0

Cost-effectiveness of Endoscopic Sleeve Gastroplasty for Obesity: Sufficient Evidence Supporting a Higher Utilization? 内镜下套管胃成形术治疗肥胖症的成本效益：充分证据支持更高的使用率？

IF 0.9 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2025-06-03 DOI: 10.1016/j.tige.2025.250933

JIANRONG ZHANG

引用次数: 0

Training in Colorectal Endoscopic Submucosal Dissection: US Perspectives 结肠内镜下粘膜下剥离训练：美国视角

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2025-06-20 DOI: 10.1016/j.tige.2025.250934

Fredy Nehme , Phillip S. Ge

Endoscopic submucosal dissection (ESD) was established in Japan in the early 2000s for the removal of early neoplastic gastrointestinal lesions with high en bloc and curative resection rates. Although ESD has gained widespread use in Asia, its adoption in the West has been gradual. The procedural complexity, steep learning curve, and limited training resources have been major obstacles. Nonetheless, ESD has been gaining popularity in the United States. The growing body of evidence on the efficacy and safety of ESD, technological advancements in endoscopy, and the establishment of effective training systems are contributing to increased adoption of ESD in the West. More endoscopists are showing interest and have started to adopt this technique, with excellent clinical outcomes. Although there is currently no standardized approach for ESD training in the United States, several pathways and training opportunities have emerged to facilitate broader adoption. These programs aim to bridge the proficiency gap by enhancing the trainee’s cognitive and technical skills. This article aimed to review the current state of colorectal ESD training in the West.

内镜下粘膜夹层（ESD）于21世纪初在日本建立，用于早期胃肠道肿瘤病变的切除，具有很高的整体切除率和治愈率。尽管ESD在亚洲得到了广泛的应用，但在西方的采用却是渐进的。程序的复杂性、陡峭的学习曲线和有限的培训资源一直是主要障碍。尽管如此，ESD在美国越来越受欢迎。越来越多的证据表明ESD的有效性和安全性，内窥镜技术的进步以及有效培训系统的建立正在促进ESD在西方的采用。越来越多的内窥镜医生表现出兴趣，并开始采用这种技术，并取得了良好的临床效果。虽然目前在美国没有标准化的可持续发展教育培训方法，但已经出现了几种途径和培训机会，以促进更广泛的采用。这些项目旨在通过提高受训者的认知和技术技能来弥合熟练程度的差距。本文旨在综述西方国家结肠直肠ESD培训的现状。

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引用次数: 0

Advanced Machine Learning Voice-Based Biomarkers for Characterization of Barrett's Esophagus 先进的机器学习语音为基础的生物标志物表征巴雷特食管

IF 1.2 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2024-12-20 DOI: 10.1016/j.tige.2024.250903

AMRIT K. KAMBOJ , MANOJ K. YARLAGADDA , MAYO CLINIC BARRETT'S ESOPHAGUS AND VOICE WORKING GROUP , KEIKO ISHIKAWA , DIANA M. ORBELO , MARY PIETROWICZ , CADMAN L. LEGGETT

引用次数: 0

Proper Management and Prevention of Bleeding and Perforation in Endoscopic Submucosal Dissection 内镜下粘膜剥离术中出血和穿孔的正确处理和预防

IF 0.9 Q4 GASTROENTEROLOGY & HEPATOLOGY

Techniques and Innovations in Gastrointestinal Endoscopy

Pub Date : 2025-01-01 Epub Date: 2025-06-04 DOI: 10.1016/j.tige.2025.250930

Jay Bapaye , Saurabh Chandan , Sagar Pathak , Peter V. Draganov , Dennis Yang

Endoscopic submucosal dissection (ESD) has become widely accepted as a minimally invasive technique for the management of superficial neoplasia throughout the gastrointestinal tract. Despite its therapeutic benefits, ESD is technically demanding, with a steep learning curve and can be associated with serious adverse events (AEs). The most common and clinically significant AEs include intraprocedural or delayed bleeding and perforation. With prompt recognition and intervention, most of these AEs can be safely and adequately managed endoscopically. This review focuses on best practices for the prevention, early identification, and management of ESD-related bleeding and perforation. We aimed to provide insight into the tools, techniques, and general approach on how to mitigate and manage AEs that may arise with the goal of optimizing patient safety and the ongoing adoption of this therapeutic modality.

内镜下粘膜剥离术（ESD）已被广泛接受为一种微创技术，用于整个胃肠道的浅表肿瘤的治疗。尽管具有治疗效果，但ESD在技术上要求很高，具有陡峭的学习曲线，并可能与严重的不良事件（ae）相关。最常见和临床意义重大的ae包括术中或延迟出血和穿孔。通过及时识别和干预，大多数ae可以在内窥镜下安全、充分地处理。这篇综述的重点是预防、早期识别和处理esd相关出血和穿孔的最佳实践。我们的目的是提供关于如何减轻和管理可能出现的ae的工具、技术和一般方法的见解，以优化患者安全性和持续采用这种治疗方式。

引用次数: 0

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