Outcomes of endoscopic submucosal dissection for treatment of superficial anal squamous cell carcinoma: Multicenter international experience.

Background And Study Aims: Data on feasibility of endoscopic submucosal dissection (ESD) for treatment of superficial anal squamous cell carcinoma are limited. This study aimed to evaluate outcomes of ESD in this anatomical location.

Patients And Methods: This was a multicenter retrospective study including patients who underwent ESD for treatment of superficial ASCC.

Counter mucosal incision with Zenker's peroral endoscopic myotomy: an innovative approach for mucosal decompression in Zenker's diverticulum and mucosal webs.

Background And Aims: Zenker's diverticulum (ZD) is a pouch of the mucosa arising from the Killian triangle. Any size of symptomatic ZD or medium to large (2-3 cm or more) ZD needs intervention. Zenker's peroral endoscopic myotomy (Z-POEM) is the ideal first-line therapy for making the reliable myotomy.

Complications of Endoscopic Pressure Study Integrated System: Review of 1205 Cases in 10 Years' Experience.

Background And Aims: The Endoscopic Pressure Study Integrated System (EPSIS) is a novel endoscopic tool to assess lower esophageal sphincter (LES) function by monitoring intragastric pressure (IGP) through insufflation. While previous studies have confirmed its diagnostic utility for LES dysfunction-related disorders such as gastroesophageal reflux disease and achalasia, there have been no reports evaluating its safety. Thus, this study aimed to assess its complication rates and detailed characteristics.

Endoscopic closure of 5-cm long esophageal perforation in an elderly patient with achalasia.

Chronic esophageal achalasia can lead to significant morphological changes in the esophagus, posing challenges during endoscopic examinations. Here, we report a case of iatrogenic esophageal perforation in an elderly patient with achalasia. An 80-year-old woman presented with severe dysphagia and marked weight loss, indicating chronic malnutrition.

Clinical Characteristics and Outcomes of Incomplete Cardia Reconstruction Cases Following Multiple Anti-reflux Mucosectomy/Anti-reflux Mucosal Ablation Treatments.

Introduction: Anti-reflux mucosectomy (ARMS) and anti-reflux mucosal ablation (ARMA) are novel endoscopic treatments for proton pump inhibitor or potassium-competitive acid blocker-refractory gastroesophageal reflux disease. These procedures induce scarring of the artificial ulcer at the gastric cardia, which tightens the enlarged cardiac opening. However, we encountered patients with unresolved symptoms due to insufficient cardiac shrinkage despite multiple ARMS/ARMA treatments.

Wave height fluctuations in the waveforms of an endoscopic pressure study integrated system have the potential to predict acid reflux in gastroesophageal reflux disease (with video).

Objectives: The endoscopic pressure study integrated system (EPSIS) is a useful diagnostic tool for gastroesophageal reflux disease (GERD). Although wave height fluctuations have been observed in EPSIS waveforms, their clinical significance remains unclear. We hypothesized that the magnitude of these fluctuations may reflect lower esophageal sphincter functionality.

Correction: Longitudinal mucosal incision prior to balloon dilation: Novel and advanced approach for severe esophageal stenosis.

[This corrects the article DOI: 10.1055/a-2569-8517.].

A pilot study on anti-reflux mucoplasty with valve as novel endoscopic therapy for gastroesophageal reflux disease.

Background And Aims: Endoscopic anti-reflux therapies like anti-reflux mucosectomy (ARMS) and anti-reflux mucosal ablation have shown efficacy for gastroesophageal reflux disease (GERD) in systematic reviews and meta-analyses. Anti-reflux mucoplasty (ARM-P), a refinement of ARMS, incorporates immediate closure of the resection site to reduce complications. Recently, anti-reflux mucosal valvuloplasty (ARMV), which employs endoscopic submucosal dissection to create a mucosal valve, was introduced but retains ARMS's limitations, requiring extensive incisions (three-quarters to four-fifths circumference).

Peroral endoscopic myotomy in spastic esophageal disorders: Clinical outcomes and optimal approaches.

Objectives: The efficacy and safety of peroral endoscopic myotomy (POEM) for spastic esophageal disorders (SED), including type III achalasia, distal esophageal spasm (DES), and jackhammer esophagus (JE), remain uncertain due to its rarity. This study aimed to evaluate the clinical outcomes and optimal strategies for managing SED.

Methods: A retrospective analysis was conducted on patients who underwent POEM for SED between March 2014 and December 2023.

Utility of endoscopic pressure study integrated system for gastroesophageal reflux disease after endoscopic antireflux therapy.

Objectives: The endoscopic pressure study integrated system (EPSIS) measures intragastric pressure (IGP) during esophagogastroduodenoscopy. Previous research demonstrated that EPSIS correlates with the 24-h impedance-pH (MII-pH) test and shows lower maximum IGP (IGP-Max) and a flatter waveform gradient in gastroesophageal reflux disease (GERD) patients, attributed to lower esophageal sphincter dysfunction. Although endoscopic antireflux therapy (EARTh) is effective for GERD, the MII-pH monitoring, the gold standard for assessing treatment outcomes, requires hospitalization and can be a burden.

Role of balloon dilation test in identifying suitable candidates for gastric peroral endoscopic myotomy.

Background: Predicting successful outcomes of gastric peroral endoscopic myotomy (G-POEM) is essential for identifying patients who are most likely to benefit from the procedure. This study aimed to evaluate the utility of the balloon dilation test (BDT) in optimizing patient selection for G-POEM.

Methods: A retrospective study was conducted from February 2021 to December 2023, including patients with refractory gastroparesis unresponsive to conventional medical treatments.

Phase concept: Novel dynamic endoscopic assessment of intramural antireflux mechanisms (with video).

Objectives: The gastroesophageal junction (GEJ) consists of various anatomical components that together form a barrier to prevent reflux of gastric content. This study introduces a novel phase concept to dynamically evaluate the antireflux barrier (ARB) during endoscopy and analyzes its functionality.

Methods: We reviewed previously the recorded endoscopic videos of subjects who underwent the endoscopic pressure study integrated system (EPSIS) from February to April 2024 for indications other than gastroesophageal reflux disease symptoms.

Rectal perforation following SpaceOAR placement combined with permanent prostate brachytherapy.

Introduction: We report a case of rectal perforation following SpaceOAR placement utilized with iodine-125 low-dose-rate brachytherapy for prostate cancer.

Case Presentation: A 65-year-old patient with localized prostate cancer underwent SpaceOAR placement following LDR-BT. No significant issues occurred with the SpaceOAR procedure, and no abnormalities were found on the next day's T2-weighted magnetic resonance imaging.

Loop9 closure technique for mucosal defects after colorectal endoscopic submucosal dissection (with video).

Mucosal defect closure after colorectal endoscopic submucosal dissection (ESD) has the potential to reduce the occurrence of delayed adverse events (AEs) such as bleeding and perforation. This study aimed to assess the feasibility and effectiveness of the Loop9 method for closing mucosal defects following colorectal ESD. A retrospective single-center study was conducted using prospectively collected data from May 2020 to March 2023.

Impact of peroral endoscopic myotomy on the endoscopic pressure study integrated system.

Objectives: The endoscopic pressure study integrated system (EPSIS) is an endoscopic diagnostic system utilized for evaluation of lower esophageal sphincter function. Although previous studies have determined that EPSIS was effective as a tool for the diagnosis of achalasia, it remains uncertain if EPSIS can detect significant changes before and after peroral endoscopic myotomy (POEM), which is the premier treatment for achalasia. This study aimed to evaluate the effectiveness of EPSIS as an objective diagnostic tool for assessing the clinical effect of POEM.

Endoscopic resection for gastric submucosal tumors: A single-center experience in Japan.

Objectives: Endoscopic resection (ER) for gastric submucosal tumors (SMTs) has gained prominence in recent years, with studies emerging from various countries. However, there is a paucity of reports from Japan. We aimed to elucidate the efficacy and safety of ER for gastric SMT in Japan.

Unified Magnifying Endoscopic Classification (UMEC) of Gastrointestinal Lesions: A North American Validation Study.

Background And Study Aim: Magnifying endoscopy enables the diagnosis of advanced neoplasia throughout the gastrointestinal tract. The unified magnifying endoscopic classification (UMEC) framework unifies optical diagnosis criteria in the esophagus, stomach, and colon, dividing lesions into three categories: non-neoplastic, intramucosal neoplasia, and deep submucosal invasive cancer. This study aims to ascertain the performance of North American endoscopists when using the UMEC.