Endoscopic Diagnosis Research Articles

Role of Stool for H. Pylori Antigen and Upper GI Endoscopy in Diagnosis Among Patients with Dyspepsia – A Single Centre Study

Objective: The objective of our study was to compare the efficacy of stool for H. pylori antigen test with endoscopic biopsy in patients with dyspepsia. Methodology: The study was conducted at the department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi during the time period of 10 months i.e. from August 2023 to May 2024. It was a prospective observational study. Sampling was done via non- probability consecutive sampling technique. Our study consisted of 202 patients. We included all the dyspeptic patients over 18 years of age while excluding those above 60 years of age, with comorbidities or taking PPIs and antibiotics. Demographic variables like age, gender and socioeconomic status were recorded. Data was be analysed by using statistical package for social sciences version 23 (SPSS ver 23). Quantitative variables were summarized as mean ± SD and qualitative variables were summarized as frequency and percentages. Sensitivity, specificity, Positive predictive value (PPV) and Negative predictive value (NPV) were calculated using Chi-square test. Values with P< 0.05 were considered significant at Confidence Interval (CI) 95%. Results: The results of our study showed that the sensitivity of the H.Pylori Antigen test was 86.86%, specificity was 81.54 %, positive predictive value (PPV) was 90. 84% and negative predictive value (NPV) was 74. 65%. The diagnostic accuracy of the test came out to be >85%. Conclusion: The test proved to be a beneficial diagnostic tool in terms of cost - effectiveness, with an additional benefit of being non-invasiveness. It can be used in the centers where endoscopy is not available and can also decrease the workload of endoscopy setups. Key Words: H. pylori antigen test, endoscopic biopsy, sensitivity, specificity, stool test

Endoscopic diagnosis and management of gallbladder carcinoma in minimally invasive era: New needs, new models

Endoscopic diagnosis and management of gallbladder carcinoma in minimally invasive era: New needs, new models

Combination of artificial intelligence endoscopic diagnosis and Kimura-Takemoto classification determined by endoscopic experts may effectively evaluate the stratification of gastric atrophy in post-eradication status.

Since it is difficult for expert endoscopists to diagnose early gastric cancer in post-eradication status, it may be critical to evaluate the stratification of high-risk groups using the advance of gastric atrophy or intestinal metaplasia. We tried to determine whether the combination of endoscopic artificial intelligence (AI) diagnosis for the evaluation of gastric atrophy could be a useful tool in both pre- and post-eradication status. 270 Helicobacter pylori-positive outpatients (Study I) were enrolled and Study II was planned to compare patients (n=72) with pre-eradication therapy with post-eradication therapy. Assessment of endoscopic appearance was evaluated by the Kyoto classification and Kimura-Takemoto classification. The trained neural network generated a continuous number between 0 and 1 for gastric atrophy. There were significant associations between the severity of gastric atrophy determined by AI endoscopic diagnosis and not having a regular arrangement of collecting venules in angle, visibility of vascular pattern, and mucus using Kyoto classification in H. pylori-positive gastritis. There were significant differences (p=0.037 and p=0.014) in the severity of gastric atrophy between the high-risk group and low-risk group based on the combination of Kimura-Takemoto classification and endoscopic AI diagnosis in pre- and post-eradication status. The area under the curve values of the severity of gastric atrophy (0.674) determined by the combination of Kimura-Takemoto classification and gastric atrophy determined by AI diagnosis was higher than that determined by Kimura-Takemoto classification alone in post-eradication status. A combination of gastric atrophy determined by AI endoscopic diagnosis and Kimura-Takemoto classification may be a useful tool for the prediction of high-risk groups in post-eradication status.

Endoscopic resection for esophageal granular cell tumors: report of 62 cases.

To analyze the clinical manifestations, endoscopic features, pathological features, endoscopic resection, and prognosis of esophageal granular cell tumors (GCTs). The present study retrospectively analyzed and followed up the clinical data of 62 patients diagnosed with esophageal GCTs who underwent endoscopic resection at Zhongshan Hospital of Fudan University between July 2007 and March 2022. The clinicopathological features, endoscopic diagnosis, and treatment experience of esophageal GCT patients were summarized. Among the 62 patients with esophageal GCT, there were 34 males and 28 females, with an average age of 49.3 ± 11.7 years. Only 11 patients had symptoms, such as epigastric discomfort, regurgitation or dysphagia. One patient had multiple lesions, and the rest had single lesions, totaling 63 lesions. Most lesions (53/63) were located in the median and lower esophagus, the diameters ranged from 3 to 22mm. The endoscopic morphology of the GCTs was molar, flat, hemispherical, or irregular submucosal protuberance. Endoscopic ultrasound (EUS) was performed in 38 cases, most cases (31/38) were hypoechoic, and 32 cases were appeared as homogeneous lesions. There were no complications during or after the endoscopic operations, and the en bloc resection rate was 100%. The negative rate of microscopic incisional margin was 63.5% (40/63). No patients developed recurrence during the follow-up period. The follow-up duration was 21-197 months (100.5 months for average). Esophageal GCT is a rare disease with no obvious symptoms and a good prognosis. Endoscopic resection is a safe and effective method of diagnosis and treatment for esophageal GCTs. A microscopic positive tumor margin may not increase the rate of recurrence.

Diagnostic Techniques for Infantile Subglottic Hemangiomas: A Scoping Review.

Infantile subglottic hemangioma (SGH) poses a risk of airway compromise if untreated. Traditionally, operative endoscopy (OH) diagnoses SGH, but since the discovery of beta-blockers' efficacy in treating infantile hemangiomas (IHs) in 2008, and advances in endoscopic technology, nonoperative methods have emerged. This review identifies endoscopic practices for diagnosing and monitoring infantile SGH during the oral beta-blocker treatment era. A comprehensive literature search in October 2022 and August 2023 covered PubMed, Embase, Cochrane Library, SCOPUS, and Web of Science. The search was limited to English-language studies published since 2008, considering this when propranolol was demonstrated as an effective treatment option for IH. The articles were screened for relevance based on predefined inclusion and exclusion criteria. After inclusion and exclusion criteria, sixty final studies were identified, describing 240 cases of infantile SGH. Most children were diagnosed using OE alone (73.3%; n = 176/240), 23.3% (n = 56/240) using office-based laryngoscopy procedures (OBPs) followed by OE, 3.3% using OBP alone (n = 8/240). There were no reported diagnostic endoscopy-related complications. Twenty-nine studies described using endoscopy plus diagnostic imaging to either confirm an SGH lesion, characterize the extent of disease spread, or rule out other causes of presenting symptoms. The proportion of infants diagnosed with OE alone decreased from 2008 to 2023. Operative endoscopy remains the SGH diagnostic standard, but OBP adoption is increasing. Further research is needed to determine the optimal SGH diagnosis and management approach. NA Laryngoscope, 2024.

Endoscopic characteristics to differentiate SSLs and microvesicular hyperplastic polyps from goblet cell-rich hyperplastic polyps.

Background and study aims Among colorectal serrated polyps (SPs), sessile serrated lesions (SSLs) and hyperplastic polyps (HPs) have a similar endoscopic appearance. However, the endoscopic distinctions between those two categories, microvesicular HPs (MVHPs) and goblet cell-rich HPs (GCHPs), are not well understood. Therefore, we compared the endoscopic features of SSLs, MVHPs, and GCHPs. Methods This retrospective, cross-sectional study was conducted at the Toyoshima Endoscopy Clinic. We examined polyp size, location, Paris classification type, mucus cap, indistinct border, expanded crypt opening, varicose microvascular vessels, and JNET classification type. Multivariable analysis of each endoscopic finding using a binomial logistic regression model determined the factors that predicted SP histology. Results A total of 670 SPs were enrolled in this study, comprising 159 SSLs, 361 MVHPs, and 150 GCHPs. On comparing the SSL + MVHP group and the GCHP group, a mucus cap (partial regression coefficient 1.705), expanded crypt opening (1.828), and varicose microvascular vessels (1.270) were more often observed in the SSL + MVHP group compared with the GCHP group. In the comparison between MVHPs and GCHPs, a mucus cap (1.564), expanded crypt opening (1.802), and varicose microvascular vessels (1.288) were more often found in MVHPs in contrast to GCHPs. When comparing SSLs and MVHPs, SSLs were more likely to be in the proximal colon (0.662) and were larger (0.198) than the MVHPs. No significant differences were observed in other endoscopic findings. Conclusions SSLs and MVHPs have endoscopic appearances that differ from those of GCHPs. Considering MVHPs and GCHPs as distinct entities may aid in endoscopic diagnosis of SPs.

Endoscopic diagnosis and treatment of recurrent acute pancreatitis after pancreaticojejunostomy: A case report

Endoscopic diagnosis and treatment of recurrent acute pancreatitis after pancreaticojejunostomy: A case report

Peroral endoscopic myotomy as a new approach in the treatment of patients with achalasia cardia

Background. Achalasia cardia is a disease characterized by an esophageal motility disorder in which the lower esophageal sphincter fails to fully relax in response to swallo-wing and esophageal motility progressively decreases. The aim of the work is to improve the outcomes of endoscopic treatment for esophageal achalasia by modifying peroral endoscopic myotomy (POEM) in stage II–III achalasia cardia. Materials and methods. In 2019–2023, 35 (100.0 %) patients with stage II–III achalasia cardia were examined and underwent POEM at the multidisciplinary surgical department in the Educational and Scientific Medical Center “University Clinic” of the Zaporizhzhia State Medical and Pharmaceutical University. The diagnosis was made based on the following data: complaints, clinical course, esophagram, endoscopic diagnosis, and computed tomography. The average age of the patients was 50.0 ± 15.7 years. Analyzing the frequency of this disease according to the WHO age classification, there were 16 (45.7 %) young, 8 (22.9 %) middle-aged, 10 (28.6 %) elderly, and 1 (2.8 %) senile patient. The group was equal in terms of gender: 16 men (45.7 %) and 19 women (54.3 %), p = 0.9654. Inclusion criteria: age over 18 years, stage II–III achalasia cardia, informed consent of a patient. Exclusion criteria: achalasia cardia stage I, as we believe that at this stage only conservative treatment and balloon dilatation are indicated; achalasia cardia stage IV for which only Heller myotomy with Dor fundoplication are indicated. Results. All patients of the study group were operated by the method of POEM under total intravenous ane-sthesia with artificial lung ventilation. Esophageal myotomy was performed along the posterior wall, considering the risk of recurrence and preservation of the anterior wall for repeated peroral myotomy or laparoscopic Heller myotomy. The length of the myotomy was determined depending on the stage of achalasia. So, for stage II, the beginning of the endoscopic tunnel formation and myotomy was determined from the first persistent esophageal spasm, which most often corresponded to a distance of 25.0 ± 2.0 cm from the incisors and, accordingly, myotomy of the esophagus, lower esophageal sphincter, and gastric myotomy averaged 15.0 ± 3.0 cm. We noted that in all operated patients six months after the operation, a propulsive activity appeared during contrast X-ray of the esophagus, and its volume decreased from 5.6 ± 0.4 cm at stage II to 2.3–4.1 cm (p = 0.0324) and from 7.4 ± 0.2 cm at stage III to 3.6 ± 0.8 cm (p = 0.0267), which indicates a decreased pressure in the lower esophageal sphincter after surgery. Based on the evaluation of the results of multichannel esophageal gastric pH monitoring, reflux was confirmed in 1 (6.7 %) patient with achalasia stage II and in 1 (5.0 %) case with achalasia stage III. Conclusions. Peroral endoscopic myotomy is an effective minimally invasive method of treating patients with achalasia cardia stage II–III. According to the Eckardt symptom score, reliable results were achieved already one month after surgery: 7.6 ± 1.1 points before surgery and 2.1 ± 0.4 points when evaluated one month after surgical treatment (p < 0.0001, U = 475.0). Given the effectiveness and minimal trauma, the low risk of postoperative complications, a significant reduction in hospital stay and rapid postoperative rehabilitation, POEM can be an alternative to laparoscopic Heller myotomy.

A convolutional neural network-based system for identifying neuroendocrine neoplasm and multiple types of lesions in the pancreas via endoscopic ultrasound (with videos)

Background and aimsEndoscopic ultrasound (EUS) is sensitive in detecting pancreatic neuroendocrine neoplasm (pNEN). However, the endoscopic diagnosis of pNEN is operator-dependent and time-consuming since pNEN mimics normal pancreas and other pancreatic lesions. We intended to develop a convolutional neural network (CNN)-based system named iEUS for identifying pNEN and multiple types of pancreatic lesions via EUS. MethodsRetrospective data of 12,200 EUS images obtained from pNEN and non-pNEN pancreatic lesions, including pancreatic ductal adenocarcinoma (PDAC), autoimmune pancreatitis (AIP), and pancreatic cystic neoplasm (PCN), were used to develop iEUS. It was composed of a two-category (pNEN/ non-pNEN pancreatic lesion) classification model (CNN1) and a four-category (pNEN/ PDAC/ AIP/ PCN) classification model (CNN2). Videos from consecutive patients were prospectively collected for a human-iEUS contest to evaluate the performance of iEUS. ResultsA total of 573 patients were enrolled in this study. In the human-iEUS contest containing 203 videos, CNN1 and CNN2 showed an accuracy of 84.2% and 88.2% for diagnosing pNEN, respectively, which were significantly higher than that of novices (75.4%) and comparable with intermediate endosonographers (85.5%) and experts (85.5%). In addition, CNN2 showed an accuracy of 86.2%, 97.0%, and 97.0% for diagnosing PDAC, AIP, and PCN, respectively. With the assistance of iEUS, the sensitivity of endosonographers at all three levels in diagnosing pNEN has significantly improved (64.6% vs. 44.8%, 87.5% vs. 71.9%, 74.0% vs. 57.6%, respectively). ConclusionsThe iEUS precisely diagnosed pNEN and other confusing pancreatic lesions, thus could assist endosonographers in achieving more accessible and accurate endoscopic diagnoses via EUS.

Cost-effectiveness of universal esophageal cancer screening for newly diagnosed oral cancer patients.

Oral and esophageal cancers are globally prevalent, especially in East Asia. Over half of head and neck cancer patients developing second primary esophageal cancer (SPEC) were initially diagnosed with oral cavity cancer (OCC). This study assessed the cost-effectiveness of universal endoscopic screening for early SPEC prevention in newly diagnosed OCC patients at different stages. This study employed Markov cohort models to evaluate the cost-effectiveness of endoscopic SPEC screening post-OCC diagnosis (stages 0 to IV) between screened and non-screened groups. Four surveillance frequencies were assessed: (i) one time, (ii) annual for 3years, (iii) annual for 10years, and (iv) annual for life. A hypothetical cohort of 100000 cases across stages was compared for costs and quality-adjusted life-years (QALYs), discounted annually at 3%. All four screening strategies were beneficial for all OCC stages, especially for early-stage patients, resulting in higher QALYs. Lifetime/annual screening from the payer's perspective proved most favorable, with incremental QALYs of 1.23 at stage 0 and 0.06 at stage IV. Incremental costs for this strategy ranged from NTD 121331 (USD 4044) at stage 0 to NTD 13032 (USD 434) at stage IV. Both incremental costs and incremental cost-effectiveness ratio (ICER) values indicated cost savings from a societal perspective. The ICER values ranged from NTD -626440 (USD -20881) at stage 0 and NTD -475021 (USD -15834) at stage IV. Overall, our study provided cost-effectiveness evidences to understanding the cost-effectiveness of endoscopic screening in OCC patients, particularly emphasizing the benefits of early and consistent screening.

Role of Liquid-Based Cytology in the Endoscopic Diagnosis of Pancreatic Ductal Adenocarcinoma

Recently, endoscopic ultrasound-guided tissue acquisition (EUS-TA) has been widely used to diagnose pancreatic ductal adenocarcinoma (PDAC). The histological examination of core tissues acquired using novel biopsy needles is the primary diagnostic approach for patients with PDAC. However, in patients with early-stage PDAC, such as Stages 0 and I, EUS-TA can be challenging, and its diagnostic accuracy may be limited. This presents a clinical dilemma: The earlier that clinicians attempt to accurately diagnose PDAC, the more difficult it becomes to do so using EUS-TA. Liquid-based cytology (LBC) is a technique for preparing pathological specimens from liquefied cytology specimens by placing the collected material in a special fixative preservative fluid. LBC offers advantages, such as specimen optimization with reduced blood interference, a high cell-collection rate, and the simplicity of the procedure in the endoscopy room. The use of LBC may improve diagnostic accuracy, particularly for early-stage PDAC. Therefore, we emphasize that cytology remains a valuable tool for the endoscopic diagnosis of PDAC. In this review, we discuss the role of LBC in the endoscopic diagnosis of PDAC.

Correlation between White Globe Appearance and Clinicopathologic Characteristics in Early Gastric Cancer.

Magnifying endoscopy with narrow-band imaging (ME-NBI) enables the visualization of detailed microsurface (MS) and microvascular (MV) structures in the gastrointestinal tract. White globe appearance (WGA) is a small whitish lesion with a globular shape identified during ME-NBI for early gastric cancer (EGC). This study aimed to investigate the associations between WGA, clinicopathological characteristics, and other ME-NBI findings in patients with EGC. The presence or absence of WGA in 122 patients (126 lesions) with an endoscopic diagnosis of EGC who underwent ME-NBI before endoscopic or surgical resection was prospectively collected and retrospectively analyzed. During ME-NBI, the MS and MV patterns and the presence of WGA and white opaque substances (WOS) were investigated. EGC cases were categorized as differentiated or undifferentiated type, and mucosal, submucosal, or advanced. Of 126 lesions, WGA was observed in 25 (19.8%). WGA was associated with tumor size (≤2 cm [17/63, 27.0%] vs >2 cm [8/63, 12.7%]; p=0.044), histologic type (differentiated type [22/89, 24.7%] vs undifferentiated type [3/37. 8.1%]; p=0.033), and tumor location (upper third [1/11, 9.1%] vs middle third [18/58, 31.0%] and lower third [6/57, 10.5%]; p=0.017). Although WGA was observed more frequently in lesions with an oval/tubular MS pattern, a fine-network MV pattern, and the absence of WOS, the difference was not statistically significant (MS pattern, p=0.358; MV pattern, p=0.212; WOS, p=0.121, respectively). WGA was associated with small tumor size, differentiated-type histology, and middle-third tumor location, and was more frequently observed in lesions with an oval/tubular MS and fine-network MV patterns and the absence of WOS.

6666 Asymptomatic Fasting Hypoglycemia After Sleeve Gastrectomy

Abstract Disclosure: K. Mitrollari: None. H.K. Deveaux: None. A. Gundeti: None. A.P. Calimag: None. T. Yasmeen: None. Introduction: Post-bariatric surgery hypoglycemia (PBSH), though previously considered rare, is increasingly recognized, occurring not only after Roux-en-Y gastric bypass (RYGB,) but also following various bariatric procedures. PBSH can manifest as postprandial or fasting hypoglycemia, requiring thorough investigation and prevention due to potential asymptomatic presentations that may lead to severe consequences, including coma and death. Case Report A 45-year-old female with a history of type 2 DM, ESRD on HD, gastric sleeve surgery, bilateral trans-metatarsal amputations, coronary artery disease, and congestive heart failure presented with bilateral lower extremity wounds. On admission her venous blood glucose was 71 mg/dL. Glycohemoglobin was 3.9% and fructosamine was 225 (205-285 umol/L). Her glycohemoglobin levels consistently remained below 6.4% status post sleeve gastrectomy off diabetes medications. Throughout admission, she experienced almost daily episodes of fasting asymptomatic hypoglycemia correlated with venous sample with lowest blood glucose reading 38 mg/dL. Initially, these episodes were attributed to NPO status for procedures or decreased PO intake. Her diet consisted of fast food brought by her family, which she reported was similar to her diet at home. Workup during a hypoglycemic episode (glucose 51 mg/dL,) revealed insulin 4 mUnits/L, proinsulin 7.1 pmol/L (<=7.2 pmol/L), C-peptide 25.7 ng/mL (0.8-3.9 ng/mL), and beta-hydroxybutyrate 0.5 mmol/L (0.0-0.3 mmol/L). Negative insulin antibodies and sulfonylurea panel, normal cortisol, and ACTH levels were noted. The patient was placed on a 10% dextrose infusion to avoid further episodes of hypoglycemia. However, she continued to experience hypoglycemia and was started on oral diazoxide. A CT pancreas with and without contrast was unremarkable, and endoscopic ultrasonography only revealed a 10 mm accessory spleen. The patient was discharged with counseling on glucose monitoring, dietary changes, and follow-up with endocrinology. Conclusion: PBSH should be considered as a differential diagnosis in patients with unexplained hypoglycemia and a history of bariatric surgery. PBSH mimics insulinoma or non-insulinoma pancreatogenous hypoglycemia syndrome (NIPHS) with elevated insulin, proinsulin, C-peptide, and low beta-hydroxybutyrate during hypoglycemia, however NIPHS is exclusive to non-bariatric patients. Imaging is crucial to rule out insulinoma, and invasive tests such as endoscopic ultrasound aid diagnosis. PBSH is a diagnosis of exclusion; therefore, workup involves ruling out other causes of hypoglycemia. First-line treatment involves diet modification, with medications like diazoxide or acarbose considered if dietary changes prove insufficient. This case underscores the complexity of hypoglycemia, implicating bariatric surgery as a contributing factor. Presentation: 6/3/2024

Risk of metachronous colorectal cancer associated with polypectomy during endoscopic diagnosis of colorectal cancer

Background and aimThere are conflicting reports regarding the risk of metachronous colorectal cancer (CRC) subsequent to colonoscopy with polypectomy or biopsy performed concurrently with diagnostic biopsies for CRC. We aimed to establish the 5-year risk of CRC in patients who had synchronous polypectomy or biopsies during the colonoscopy at which CRC was diagnosed.MethodsThis is a single-centre retrospective case–control study of adults who underwent surgical resection for CRC over a 2-year period (January 2016 to December 2017). Colonoscopy details of interest were the location of the CRC, polypectomy and non-CRC biopsy sites. In patients with CRC at index colonoscopy, we sought associations between the occurrence of metachronous CRC and the sites from which endoscopic specimens had been obtained.ResultsOur study population comprised 225 patients with a median (IQR) age of 71 (60–77) years. Polypectomy or biopsy at a non-CRC site had been performed during the index colonoscopy in 108 patients (48%), including 83 (37%) polypectomies outside the surgical resection field. There were 8 (3.6%) metachronous CRCs: 1 (0.4%) at the site of endoscopic mucosal resection for a 15-mm sessile serrated lesion, 3 (1.3%) anastomotic site CRCs and 4 (1.8%) at other sites within the colon. There was no significant difference in the prevalence of metachronous CRC in patients who underwent polypectomy/biopsy at the index colonoscopy compared with those who did not (1.9% vs. 5.1%, p = 0.283).ConclusionThere was no significant increased risk of metachronous CRC subsequent to synchronous polypectomy or biopsy during the colonoscopy at which CRC was diagnosed.

S4792 Endoscopic Diagnosis and Management of a Rare Case of T-Cell Associated Enteropathy

S4792 Endoscopic Diagnosis and Management of a Rare Case of T-Cell Associated Enteropathy

S2733 A Challenging Endoscopic Diagnosis of an Intraductal Papillary Neoplasm of the Bile Ducts: A Case Report

S2733 A Challenging Endoscopic Diagnosis of an Intraductal Papillary Neoplasm of the Bile Ducts: A Case Report

Development and application of an artificial intelligence-assisted endoscopy system for diagnosis of Helicobacter pylori infection: a multicenter randomized controlled study

BackgroundThe early diagnosis and treatment of Heliobacter pylori (H.pylori) gastrointestinal infection provide significant benefits to patients. We constructed a convolutional neural network (CNN) model based on an endoscopic system to diagnose H. pylori infection, and then examined the potential benefit of this model to endoscopists in their diagnosis of H. pylori infection.Materials and methodsA CNN neural network system for endoscopic diagnosis of H.pylori infection was established by collecting 7377 endoscopic images from 639 patients. The accuracy, sensitivity, and specificity were determined. Then, a randomized controlled study was used to compare the accuracy of diagnosis of H. pylori infection by endoscopists who were assisted or unassisted by this CNN model.ResultsThe deep CNN model for diagnosis of H. pylori infection had an accuracy of 89.6%, a sensitivity of 90.9%, and a specificity of 88.9%. Relative to the group of endoscopists unassisted by AI, the AI-assisted group had better accuracy (92.8% [194/209; 95%CI: 89.3%, 96.4%] vs. 75.6% [158/209; 95%CI: 69.7%, 81.5%]), sensitivity (91.8% [67/73; 95%CI: 85.3%, 98.2%] vs. 78.6% [44/56; 95%CI: 67.5%, 89.7%]), and specificity (93.4% [127/136; 95%CI: 89.2%, 97.6%] vs. 74.5% [114/153; 95%CI: 67.5%, 81.5%]). All of these differences were statistically significant (P < 0.05).ConclusionOur AI-assisted system for diagnosis of H. pylori infection has significant ability for diagnostic, and can improve the accuracy of endoscopists in gastroscopic diagnosis.Trial registrationThis study was approved by the Ethics Committee of Daping Hospital (10/07/2020) (No.89,2020) and was registered with the Chinese Clinical Trial Registration Center (02/09/2020) (www.chictr.org.cn; registration number: ChiCTR2000037801).

Endoscopic diagnosis of asymptomatic appendicitis in a pediatric patient

Endoscopic diagnosis of asymptomatic appendicitis in a pediatric patient

Endoscopic interventions in patients with bronchial tumors

Analysis of the results of endoscopic diagnosis and treatment of patients with bronchial tumors. Material and methods. Endoscopic diagnosis and interventions were perfomed in 56 patients with benign - 39 (70.7%) and malignant - 17 (29.3%) bronchial tumors. There were 38 men and 18 women aged from 17 to 70 years (average age of patients 52.1 ± 14.6 years). Results. In patients with benign bronchial tumors, mechanical removal or excision by using polypectomy share was more often performed. In cases malignant tumors (10 patients) stent insertion was performed to ensure long-term maintenance of the bronchial lumen. In two cases - silicone stents were inserted; in eight cases - metal self-expanding stents were inserted. There were no complications during the intervention or in the postoperative period. Repeated interventions due to tumor recurrence were performed in 3 (5.4%) patients. Conclusion. Endoscopic interventions in patients with benign and malignant bronchial tumors can effectively and relatively safely restore and maintain airway patency. The choice of tumor removal method is multifactorial. It depends on the equipment of the medical institution and the endoscopist preference. To maintain bronchial patency in patients with malignant bronchial tumors, stenting is indicated, which avoids staged endoscopic interventions, each of which can be potentially dangerous due to possible complications.

Endoscopic diagnosis and evaluation of the effectiveness of treatment of small cell lung cancer

This publication examines the possibilities of bronchoscopy in the diagnosis of primary small cell lung cancer and the assessment of the effectiveness of treatment. Endoscopic semiotics of small cell lung cancer is considered. A clinical observation of a patient with widespread small cell lung cancer is presented: primary diagnosis and assessment of the effectiveness of the course of chemotherapy.