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Background and study aims Apart from mucosal healing as an established treatment goal in inflammatory bowel diseases (IBD), recent evidence suggests that histologic healing may become another key prognostic parameter in IBD patients. We aimed to evaluate whether magnification endoscopy with optical chromoendoscopy can accurately assess histologic inflammation in IBD patients. Patients and methods In this prospective study, 82 patients with IBD (30 UC, 52 CD) were included. In all patients, magnification endoscopy in conjunction with optical chromoendoscopy was performed and rated on a novel magnification endoscopy score by three independent endoscopists. Targeted biopsies of the imaged areas were obtained and results were compared against two histological scores in UC (Robarts Histopathology Index, RHI; Nancy Histology Index, NHI) and one score in CD (modified Riley index, mRI). Moreover, interobserver agreement was calculated. Results Magnification endoscopy showed strong correlation with histopathologic scoring in both UC (RHI: r = 0.83, NHI: r = 0.78, P 0.7). Conclusion Magnification endoscopy in combination with optical chromoendoscopy shows strong correlation with histologic inflammation in patients with IBD. This approach has potential to reduce physical biopsies for monitoring of inflammatory activity in patients with IBD during colonoscopy.

Background and study aims Although several endoscopic techniques have been described for Zenker’s diverticulotomy, no standardized endoscopic approach has been established in clinical routine to date. This study aimed to assess the efficacy and safety of endoscopic diverticulotomy using the Clutch Cutter. Patients and methods Cricopharyngeal myotomy was performed in six prospectively enrolled patients with symptomatic Zenker’s diverticulum, using the Clutch Cutter. Procedural details such as duration, complications, and technical success were recorded and compared to the outcomes of 15 patients who received needle-knife-based myotomy. Results Myotomy with the Clutch Cutter was feasible in all six patients with complete diverticulotomy in a single session in all patients. Mean procedure time of the Clutch Cutter myotomy was 19 minutes without major complications. During follow-up, one patient had diverticulum recurrence after 10 months, which was successfully re-treated. Mean procedure time with the needle-knife was 43 minutes and a mean of 2.7 myotomy sessions was required for complete diverticulotomy. Conclusion Endoscopic diverticulotomy using the Clutch Cutter is safe, effective, and fast. Larger studies comparing myotomy using the Clutch Cutter with other endoscopic techniques are highly warranted.

Background and study aims The full-thickness resection device (FTRD) represents a novel endoscopic treatment method for lesions unresectable with conventional endoscopic techniques. The overall aim of this study was to evaluate technical success and in toto resection rates, recurrence rates, as well as immediate or late complications in patients who underwent polyp removal with the FTRD. Patients and methods Data from a prospectively collected database of 12 patients who underwent 13 over-the-scope clip-based full-thickness resections between June 2015 and June 2017 were analyzed. Follow-up endoscopy was performed in 11 out of 12 patients. Results 13 full-thickness resections were performed in 7 males and 5 females (mean age 64.3 ± 6.3 years). Mean size of the lesions removed with FTRD was 17 ± 4 mm. Location was rectum (n = 6), cecum (n = 2), ascending colon (n = 2), left flexure (n = 1) and right flexure (n = 2). Mean procedure time was 68 ± 35 minutes and mean hospital stay was 2.5 ± 1.2 days. 2 patients developed post-polypectomy syndrome, which resolved after conservative treatment. No perforations and no immediate surgical revision were needed. Histology of the 13 lesions removed with FTRD showed 5 adenomas with low grade intraepithelial neoplasia (IEN), 4 high grade IEN, 1 fibrosis, 1 fibrosis without dysplasia and 2 adenocarcinomas. Technical success was achieved in all procedures (13/13, 100 %). R0 resection was achieved in 10/12 patients (83.3 %). 2 patients underwent surgery because of recurrence or not evaluable margins. In 1 patient no residual malignancy was proven in histological examination, in the other patient residual low grade IEN adenoma. Conclusion FTRD is a minimally invasive approach with good success rate of complete resection and minimal side effects.