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Background and Aim: Endoscopic submucosal dissection (ESD) is commonly employed in the treatment of epithelial gastrointestinal tumors, but few studies have explored ESD for treatment of duodenal papillary adenomas (PAs). In this study, we aim to evaluate the feasibility of a modified ESD method as an alternative modality in the resection of PAs. Methods: We evaluated potential advantages of modified ESD for resection of sporadic duodenal PAs through retrospective analysis of 10 PAs resected via ESD compared to paired lesions undergoing endoscopic papillectomy (EP). Results: All lesions undergoing ESD were resected en bloc with negative margins, compared to 60% of lesions undergoing EP. Within the experimental group, there was one case each of melena and pancreatitis compared to four bleeds and one case of pancreatitis in the control group. No recurrence was detected within the ESD group after a mean follow‐up time of 11.2 months compared to three recurrences within a mean follow‐up time of 27.7 months. Conclusions: From our preliminary experience, ESD is a promising alternative in the treatment of superficial duodenal PAs; however, further investigation is needed. [ABSTRACT FROM AUTHOR]

DDWC (Directional Drilling with Casing) is an effective wellbore construction technique, particularly suitable for soft marine formations. In DDWC, the casing replaces the drill pipe for sliding drilling operations, and the passability of the drill string through the casing has become one of the primary challenges in applying DDWC. This study uses ANSYS Workbench to simulate the strain and bending behavior of the casing under various geological conditions. Simulations were conducted for different wellbore trajectories, casing specifications, and materials to evaluate the feasibility of the drill string passing through the casing under different conditions. The results show that, when the dogleg severity reaches 18°/30 m and the casing's inner diameter is 315 mm, the maximum radial strain of the casing is 4.2 mm, which cannot guarantee the successful passage of a drill string assembly with a 311 mm outer diameter. For other casing specifications, with a minimum inner diameter of 317 mm, the drill string can pass through under the maximum dogleg severity. Additionally, since the elastic modulus and Poisson's ratio of the casing materials are identical, the strain behavior is consistent across different materials, meaning that the material does not affect the passability of the casing. Moreover, the study optimized the selection of casing specifications and materials. From the perspective of ensuring drill string passability and resource conservation, a casing with an inner diameter of 319.4 mm was chosen. To ensure the longevity of the casing and the stability of the wellbore, N80 steel was selected as the material. A sensitivity analysis was conducted on the factors affecting casing strain, and the results aligned with the simulation findings, showing that wellbore trajectory and casing specifications have a significant impact on casing strain. Verifying the passability of the drill string through the casing is critical for the development and application of DDWC technology. [ABSTRACT FROM AUTHOR]

Background There are no data comparing a regular diet with a restricted diet after endoscopic polypectomy in patients with colorectal polyps. The current guidelines also did not provide the detailed information of dietary patterns after polypectomy. In this study, we aimed to evaluate the safety and efficacy of different diets on post-polypectomy outcomes. Methods A total of 302 patients with colorectal polyps who underwent polypectomy were prospectively enrolled between March 2019 and December 2019 in Nanfang Hospital (Guangzhou, China). Enrolled patients were then randomly assigned to a regular diet group or a restricted diet group after polypectomy. The study is a non-inferior design and the primary end point was the post-operative adverse events (AE) rate. Secondary end points included length of stay (LOS) and hospitalization cost. Results Among all the included patients, 148 patients received a restricted diet and 154 patients received a regular diet after polypectomy. A total of 376 polyps were removed, with 183 polyps in the restricted diet group and 193 polyps in the regular diet group. Shorter LOS (4.0 ± 1.4 vs 4.8 ± 1.7, P  < 0.001) and lower hospitalization costs (7,701.63 ± 2,579.07 vs 8,656.05 ± 3,138.53, P  = 0.001) were observed in the regular diet group. In particular, there was no significant difference in 3-day AE rates between the restricted diet and the regular diet group (1.35% [2/148] vs 2.60% [4/154], P  = 0.685). Subgroup analysis looking at the number of polyps removed in each patient and different treatment modalities also showed similar findings. Conclusion Regular diet should be recommended after polypectomy for polyps <20 mm as it can shorten LOS and save hospitalization costs. [ABSTRACT FROM AUTHOR]

Background: In our previous work, we developed a modified method for the removal of gastric submucosal tumors (SMTs), called endoscopic mucosa-sparing lateral dissection (EMSLD). This prospective study aimed to evaluate the efficacy and postoperative outcomes of EMSLD.Methods: We prospectively enrolled 25 consecutive patients with gastric SMTs, who received EMSLD treatment. Clinicopathological characteristics and operation-related outcomes were analyzed.Results: The mean age of patients was 49.3 ± 9.7 years, and the mean tumor size was 14.6 ± 6.1 mm. En bloc resection was achieved in all cases. The mean procedure time was 47.3 ± 25.9 minutes, and the estimated blood loss was 4.8 ± 3.5 mL. Endoscopic full-thickness resection was performed in six patients (24 %) because the tumors originated from the deep muscularis propria layer. All perforations and resection defects were successfully closed by the retained mucosa and endoclips. No serious complications related to EMSLD were encountered during or after the procedure.Conclusions: EMSLD was reliable and effective for the removal of gastric SMTs. However, large-scale randomized controlled trials are needed. [ABSTRACT FROM AUTHOR]