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Background/Aims Endoscopic submucosal dissection (ESD) of high-grade dysplasia and early esophageal cancer has gained acceptance in the last decade as an effective therapeutic option. Although the short-term results of ESD are promising, a high risk of procedure related complications, including post-procedural stricture remains unresolved. The aim of this study was to assess the effectiveness and safety of mucosal transplantation into esophagus from the stomach and/or other part of the gut in preventing stricture formation after ESD. Methods Six patients who underwent circumferential ESD for early esophageal cancer were enrolled. After the patients underwent ESD, the mucosal patches taken from the posterior wall of the middle part of the gastric body were placed to the ulcer site of esophagus. The guide wire was then inserted into the gastric cavity via flexible endoscopic channel to fix the patches with the stent at the ulcer site. The stent was then removed with media of 7.83 days (range, 7 to 9 days). All of the patients were followed up with endoscopy. Results The graft survival rate was 83.3% with strictures occurring at a mean of 33.67 days (range, 20 to 56 days) after the procedure. The median number of endoscopic balloon dilatation sessions was 5.67 (range, 4 to 7). Conclusions Gastroesophageal mucosal transplantation for stricture prevention after circumferential submucosal dissection for early esophageal cancer and or high-grade dysplasia seems feasible and effective with excellent outcome. This study opens new perspective in this field. [ABSTRACT FROM AUTHOR]

Background/Aims Natural orifice transluminal endoscopic surgery (NOTES) represents an emerging technology, and recently NOTES cholecystectomy has become the hottest area of research. Initial enthusiasm for NOTES cholecystectomy has been partly tempered by the reality that in some instances laparoscopic assistance required. The aim of this study was to evaluate the feasibility and safety of a newly proposed operative method- retrograde cholecystectomy using pure NOTES. Methods An incision was created on the vagina wall, and an endoscope with transparent cap and snare attached on the tip was introduced into the pelvic cavity proceeding upward into peritoneal cavity. After locating the liver and gallbladder (Fig. A), the fundus wall of gallbladder was grasped by forceps and a snare was then released to ligate the funds. The gallbladder was dissected carefully from intrahepatic fossa along the slit to the neck using hook/IT knives (Fig. B). The cystic duct and cystic artery were identified and clipped twice (Fig. C). The cystic duct and artery was then cut off using hook knife (Fig. D). The gallbladder was dragged with snare into vagina, and removed without suturing vaginal crevasse (Fig. E). Results The procedure was successfully performed in all eight porcine models. Average procedure time was 53 minutes (range, 40 to 60 minutes). No severe bleeding or any other complication observed either during or after the procedure in all the animals. Normal diet was given to the animal on the same day after the procedure. All the animal recovered completely without any incident. Conclusions We successfully performed pure NOTES retrograde cholecystectomy. In our experience, pure NOTES retrograde cholecystectomy performed with single channel flexible endoscope is safe and feasible. In addition, this procedure has advantages including no visible scar, and quicker recovery. The translation of this technique to human subjects seems straight forward and provide a new fitting path to pure NOTES. [ABSTRACT FROM AUTHOR]