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This article discusses the clinical outcomes of endoscopic submucosal dissection (ESD) for superficial esophageal neoplasia (SEN) in patients with cirrhosis and esophageal varices. The study found that ESD was safe and effective in achieving complete resection of SEN in these patients, with high rates of successful removal. The results suggest that ESD may be a viable treatment option for this patient population. Another study discussed in the document found that ESD was feasible and safe in cirrhotic patients with SEN near esophageal varices, with high rates of successful removal and low rates of complications. The study suggests that ESD can be a potential treatment option for cirrhotic patients with SEN, even in the presence of esophageal varices. [Extracted from the article]

BACKGROUND : This study aimed to assess the feasibility and efficacy of the novel loop 9 method of gastrointestinal (GI) defect closure. METHODS : 20 patients underwent a GI procedure that required defect closure. Loop 9 can be delivered through a single instrument channel (3.2 mm) and released at the defect site. After it has been anchored by two clips positioned on opposite sides of the defect edge, the loop 9 is tightened by pulling the end of the suture intraluminally using biopsy forceps. Additional clips are placed to achieve complete closure. The primary outcome was complete closure rate. The secondary outcomes were closure time, sustained closure rate, and adverse events. RESULTS : Complete closure was achieved in 100 % of cases. The mean size of the mucosal defects was 17.5 mm (range 10-55 mm). The median closure time was 14 minutes. The sustained closure rate was 90 %. No adverse events were noted. CONCLUSIONS : The loop 9 technique is feasible and effective in achieving complete and sustained closure of therapeutic endoscopy-related GI defects. [ABSTRACT FROM AUTHOR]

Background and study aims: Intrapapillary capillary loops (IPCLs) have been used to estimate histopathological atypia and the invasion depth of squamous cell carcinoma (SCC). The aim of this study was to evaluate the clinical significance of IPCLs. Patients and methods: A total of 358 consecutive patients with esophageal neoplasia on magnifying narrow-band imaging (M-NBI) were studied. The lesions were categorized according to the IPCL classification of Inoue et al. and were subsequently resected. Resected specimens were histopathologically analyzed to determine the invasion depth. The inter- and intraobserver agreements in the interpretation of IPCL images were also investigated. Results: A total of 446 lesions were diagnosed on M-NBI as IPCL type V lesions, which were further classified as 185 IPCL type V1, 109 type V2, 104 type V3, and 48 type Vn. Sensitivity and specificity of IPCL type V1-2 for invasion confined to the epithelium or lamina propria mucosa (m1-2) were 89.5% (95% confidence interval [CI] 85.4%- 92.7 %) and 79.6% (95 %CI 72.3%-85.7 %), respectively. Sensitivity and specificity of IPCL type V3 for invasion confined to the muscularis mucosa or slight submucosal invasion (m3-sm1) were 58.7% and 83.8 %, respectively. Sensitivity and specificity of IPCL type Vn for deeper invasion (sm2-3) were 55.8% and 98.6 %, respectively. Interobserver agreement was substantial (?=0.609, 0.641, and 0.705), as was intraobserver agreement (?=0.705 and ?=0.819). Conclusion: Changes in the morphology of IPCLs on M-NBI correlated with the depth of SCC invasion, and results were reproducible and reliable among observers. Identification of IPCL type V1- 2 proved useful for the intraprocedural identification of m1-2 lesions, which are considered an absolute indication for endoscopic resection. [ABSTRACT FROM AUTHOR]