Background Endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD ) is an invasive treatment for colorectal lesions not resectable by conventional endoscopic techniques. This study presents the first Greek experience of the FTRD  procedure, assessing the efficacy and safety of EFTR. Methods We conducted a retrospective analysis of 17 consecutive patients treated with the FTRD  at 2 referral centers from October 2015 through December 2018. The indications included difficult adenomas (non-lifting and/or at difficult locations), early adenocarcinomas and subepithelial tumors. Primary endpoints were technical success and R0 resection. Results Technical success and R0 resection were achieved in 82.3% procedures (14/17) and in 87.5% of those with difficult adenomas (8 patients). In the subgroup with carcinomas (n=3), the rate of technical success and R0 resection was 66.6%, while in the subgroup with subepithelial tumors (n=6) the rate was 83.3%. Technical success and R0 resection were significantly lower for lesions >20 mm vs. ≤20 mm (P=0.0429). In the 17 patients a total of 3 adverse events occurred (17.6%) and one of the patients underwent laparoscopic appendectomy because of EFTR around the appendix. Conclusions Our study showed favorable results concerning EFTR feasibility, efficacy and safety, especially for lesions ≤20 mm, non-lifting adenomas, and subepithelial tumors. Technical success, R0 resection, and adverse events rates were comparable with previously published data. Larger randomized studies are needed to better define the clinical benefit and long-term outcomes of EFTR in selected patients.

TAE for the treatment of PUB was technically successful in all cases and resulted in high clinical success rate. Minimal re-bleeding rates further highlight the utility of TAE as the second line treatment of choice, after failed endoscopy.

Background Endoscopic full-thickness resection (EFTR) using the full-thickness resection device (FTRD  ) is an invasive treatment for colorectal lesions not resectable by conventional endoscopic techniques. This study presents the first Greek experience of the FTRD  procedure, assessing the efficacy and safety of EFTR. MethodsWe conducted a retrospective analysis of 17 consecutive patients treated with the FTRD  at 2 referral centers from October 2015 through December 2018. The indications included difficult adenomas (non-lifting and/or at difficult locations), early adenocarcinomas and subepithelial tumors. Primary endpoints were technical success and R0 resection.Results Technical success and R0 resection were achieved in 82.3% procedures (14/17) and in 87.5% of those with difficult adenomas (8 patients). In the subgroup with carcinomas (n=3), the rate of technical success and R0 resection was 66.6%, while in the subgroup with subepithelial tumors (n=6) the rate was 83.3%. Technical success and R0 resection were significantly lower for lesions >20 mm vs. ≤20 mm (P=0.0429). In the 17 patients a total of 3 adverse events occurred (17.6%) and one of the patients underwent laparoscopic appendectomy because of EFTR around the appendix. ConclusionsOur study showed favorable results concerning EFTR feasibility, efficacy and safety, especially for lesions ≤20 mm, non-lifting adenomas, and subepithelial tumors. Technical success, R0 resection, and adverse events rates were comparable with previously published data. Larger randomized studies are needed to better define the clinical benefit and long-term outcomes of EFTR in selected patients.

Scale t-score Change at 4 weeks Belly pain 59.07 (56.40-61.74) -5.75 (-8.46 to -3.05) Gas/bloating 62.81 (61.02-64.60) -5.27 (-7.41 to -3.12) Constipation 53.34 (51.04-55.65) -3.66 (-5.47 to -1.85) Reflux 46.67 (44.37-48.96) -1.62 (-3.59-0.35) Nausea/vomiting 49.48 (47.01-51.96) -2.60 (-4.23 to -0.97) S580

Introduction: Baseline impedance (BI) measured during a multichannel intraluminal impedance -pH (MII-pH) study is able to distinguish patients with gastro-esophageal reflux disease (GERD). Limited data suggest BI measured during high resolution esophageal impedance manometry (HRIM) could be helpful in detecting patients with GERD or Barrett's esophagus. Nevertheless, measurement of BI with HRIM is not done routinely. We aim to assess whether BI measured during HRIM (HRIM-BI) could serve to detect patients with GERD, thus eliminating the need for further evaluation. Methods: We retrospectively collected consecutive patients who underwent HRIM and MII-pH study off acid suppression, from May 2021 through May 2022. HRIM-BI measurement was done manually during the landmark period in the beginning of the study, where we measured impedance values at different levels above the LES (0, 5, 10 and 15 cm above LES). Mean nocturnal BI (MNBI) was measured in the MII-pH in the distal sensor (5 cm above the LES) over three 10 minute intervals around 1, 2, and 3 am (Reflux reader 6.1.1 Medronic Inc.). GERD was defined as acid exposure time (AET) .6%, whereas non GERD group included patients without or borderline GERD. Results: We have included 60 patients (31 females) with a mean age 38 6 5.5 years. Of the total cohort, 42 patients had AET, 6% and 18 patients (30%) had MNBI under 1500 Ohm. MNBI and HRIM-BI at the 5 cm proximal to the LES were moderately correlated (Spearman Rho50.439 p, 0.001). This level showed the best correlation to MNBI. A cut-off of MNBI, 1500 ohm had good discriminating properties in detecting GERD with area under the receiver operating characteristics curve AUROC of 0.884 (95% CI0.774-0.995, p, 0.0001). However, HRIM-BI could not discriminate between GERD and non-GERD AUROC of HRIM-BI 5 cm proximal to LES was 0.659 (0.5-0.818, p50.053). None of the levels had adequate discriminating properties. Conclusion: Our results support previously published reports of the usefulness of MII-ph MNBI in detecting GERD. Unfortunately, our data do not support the use of HRIM BI in detecting GERD and obviating the need of 24 hour MII-pH, contrary to prior reports. The HRIM-pH does not correlate well to MNBI and has inadequate discriminatory properties. In conclusion, landmark impedance measurements of HRIM do not discriminate well between GERD and non-GERD patients.