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.

Clinical features of atlantoaxial rotatory fixation among children with Kawasaki disease.

More than 50% of Kawasaki disease patients exhibit cervical lymphadenopathy, which can lead to atlantoaxial rotatory fixation (AARF). Yet, the incidence and clinical features of AARF in Kawasaki disease (KD-AARF) have been poorly documented. This study explored the symptomatic incidence of AARF in patients with Kawasaki disease.

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.

Spinal Cord Herniation After Posterior Cervical Spine Surgery in a Middle-Aged Man.

Spinal cord herniation is a rare condition arising from idiopathic or traumatic dural defects or fragility. Here we present a case of early-onset spinal cord herniation following cervical posterior decompression and fusion surgery for ossification of the posterior longitudinal ligament (OPLL). The patient, a 55-year-old male, presented with upper and lower extremity weakness and gait disturbance.

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.

Angiography-Based Blood Flow Quantification After Revascularization in Acute Coronary Syndromes.

Background: In patients presenting with acute coronary syndromes (ACS), impaired coronary blood flow (CBF) after percutaneous coronary interventions (PCI) is linked to mortality. We developed a novel angiography-based approach for blood flow quantification using automatic contrast bolus tracking. Therefore, this study aimed to investigate the clinical impact of angiography-based blood flow quantification on major adverse cardiovascular events (MACE) after PCI in patients with ACS.

Usefulness of a One-step Semi-deployment Flushing and Stenting Technique in Endoscopic Transpapillary Gallbladder Drainage for Acute Cholecystitis (With Video).

Objectives: Endoscopic transpapillary gallbladder stenting (EGBS) has demonstrated high technical and clinical success rates in endoscopic transpapillary gallbladder drainage (ETGBD) for acute cholecystitis. The effectiveness of a 5-Fr endoscopic naso-gallbladder drainage (ENGBD) tube for flushing and the internal fistula technique after tube cutting has also been reported. We developed an alternative one-step semi-deployed flushing and stenting technique for EGBS using a 7-Fr pigtail stent that avoids tube resection and evaluated its effectiveness and safety compared with that of endoscopic nasogastric gallbladder drainage.

Esophageal Contrast Transesophageal Echocardiography for Mitral Valve Transcatheter Edge-to-Edge Repair in Severe Esophageal Achalasia.

Image: Severe esophageal achalasia complicates transesophageal echocardiography (TEE), particularly in patients requiring mitral valve transcatheter edge-to-edge repair. We developed an innovative imaging technique called esophageal contrast TEE (ECTE), specifically designed for optimal imaging in complex conditions.

Case Summary: An 80-year-old man with chronic atrial fibrillation and severe mitral regurgitation was referred for mitral transcatheter valve edge-to-edge repair.

Aspirin vs Clopidogrel 1 Month After Acute Coronary Syndrome With High-Bleeding Risk or ST-Segment Elevation.

Background: High bleeding risk (HBR) and acute coronary syndrome (ACS) subtypes (ST-segment elevation myocardial infarction [STEMI] and non-ST-segment elevation ACS [NSTE-ACS]) might be key determinants of appropriate antiplatelet strategies.

Objectives: The aim of this study was to investigate the effects of aspirin versus clopidogrel within 1 year after percutaneous coronary intervention in patients with ACS, on the basis of HBR or non-HBR and STEMI or NSTE-ACS.

Methods: Patients with ACS in the STOPDAPT-3 (Short and Optimal Duration of Dual Antiplatelet Therapy-3) trial were included.

Feasibility of optical coherence tomography-guided primary percutaneous coronary intervention for STEMI: all-comer ATLAS-OCT trial.

Intravascular imaging for acute coronary syndrome is recommended in the guidelines; however, the actual rate of patients with ST-segment elevation myocardial infarction (STEMI) who successfully undergo optical coherence tomography (OCT)-guided primary percutaneous coronary intervention (PCI) is unclear. This study aimed to determine the feasibility of OCT-guided primary PCI and identify the patient population that would benefit most from OCT guidance in STEMI. The ATLAS-OCT trial was a prospective, single-arm, all-comers study conducted at 16 institutions.

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.

Significant Stenosis Without Thrombus: Is It the Third Most Common Morphology of Acute Coronary Syndrome?

Background: Significant stenosis without thrombus (SSWT) is sometimes observed in patients with acute coronary syndrome (ACS). However, its incidence and clinical features remains unclear.

Method: This substudy of the TACTICS registry included patients with ACS (n = 702) undergoing emergency percutaneous coronary intervention using optical coherence tomography.

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.].

Antireflux myoplasty: Endoscopic myoplasty with bilateral sling fiber plication for refractory gastroesophageal reflux disease.

Endoscopic antireflux therapy is a novel endoscopic treatment for refractory gastroesophageal reflux disease. We developed antireflux myoplasty (AR-MP), a modified version of antireflux mucoplasty (ARM-P), in which exposed bilateral sling fibers are sutured directly via endoscopic hand-suturing. AR-MP was performed on a 60-year-old man, resulting in symptomatic improvement and allowing discontinuation of acid-suppressive medication 3 months after the procedure.

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).