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1. Effect of optical diagnosis training on recognition and treatment of submucosal invasive colorectal cancer in community hospitals: a prospective multicenter intervention study.

Author

Meulen, Lonne W.T., Haasnoot, Krijn J.C., Vlug, Marije S., Wolfhagen, Frank H.J., Baven-Pronk, Martine A.M.C., van der Voorn, Michael P.J.A., Schwartz, Matthijs P., Vogelaar, Lauran, de Vos tot Nederveen Cappel, Wouter H, Seerden, Tom C.J., Hazen, Wouter L., Schrauwen, Ruud W.M., Alvarez-Herrero, Lorenza, Schreuder, Ramon-Michel, van Nunen, Annick B., Stoop, Esther, de Bruin, Gijs J., Bos, Philip, Marsman, Willem A., and Kuiper, Edith

Subjects
CANCER hospitals, COLORECTAL cancer, CANCER invasiveness, WESTERN countries, ODDS ratio
Abstract

Background Recognition of submucosal invasive colorectal cancer (T1 CRC) is difficult, with sensitivities of 35 %–60 % in Western countries. We evaluated the real-life effects of training in the OPTICAL model, a recently developed structured and validated prediction model, in Dutch community hospitals. Methods In this prospective multicenter study (OPTICAL II), 383 endoscopists from 40 hospitals were invited to follow an e-learning program on the OPTICAL model, to increase sensitivity in detecting T1 CRC in nonpedunculated polyps. Real-life recognition of T1 CRC was then evaluated in 25 hospitals. Endoscopic and pathologic reports of T1 CRCs detected during the next year were collected retrospectively, with endoscopists unaware of this evaluation. Sensitivity for T1 CRC recognition, R0 resection rate, and treatment modality were compared for trained vs. untrained endoscopists. Results 1 year after e-learning, 528 nonpedunculated T1 CRCs were recorded for endoscopies performed by 251 endoscopists (118 [47 %] trained). Median T1 CRC size was 20 mm. Lesions were mainly located in the distal colorectum (66 %). Trained endoscopists recognized T1 CRCs more frequently than untrained endoscopists (sensitivity 74 % vs. 62 %; mixed model analysis odds ratio [OR] 2.90, 95 %CI 1.54–5.45). R0 resection rate was higher for T1 CRCs detected by trained endoscopists (69 % vs. 56 %; OR 1.73, 95 %CI 1.03–2.91). Conclusion Training in optical recognition of T1 CRCs in community hospitals was associated with increased recognition of T1 CRCs, leading to higher en bloc and R0 resection rates. This may be an important step toward more organ-preserving strategies. [ABSTRACT FROM AUTHOR]

Published
2024
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2. Standardised training for endoscopic mucosal resection of large non-pedunculated colorectal polyps to reduce recurrence (*STAR-LNPCP study): a multicentre cluster randomised trial

Author

MS MDL 1, Cancer, Meulen, Lonne W T, Bogie, Roel M M, Siersema, Peter D, Winkens, Bjorn, Vlug, Marije S, Wolfhagen, Frank H J, Baven-Pronk, Martine, van der Voorn, Michael, Schwartz, Matthijs P, Vogelaar, Lauran, de Vos Tot Nederveen Cappel, Wouter H, Seerden, Tom C J, Hazen, Wouter L, Schrauwen, Ruud W M, Alvarez Herrero, Lorenza, Schreuder, Ramon-Michel M, van Nunen, Annick B, Stoop, Esther, de Bruin, Gijs J, Bos, Philip, Marsman, Willem A, Kuiper, Edith, de Bièvre, Marc, Alderlieste, Yasser A, Roomer, Robert, Groen, John, Bargeman, Marloes, van Leerdam, Monique E, Roberts-Bos, Linda, Boersma, Femke, Thurnau, Karsten, de Vries, Roland S, Ramaker, Jos M, Vleggaar, Frank P, de Ridder, Rogier J, Pellisé, María, Bourke, Michael J, Masclee, Ad A M, Moons, Leon M G, MS MDL 1, Cancer, Meulen, Lonne W T, Bogie, Roel M M, Siersema, Peter D, Winkens, Bjorn, Vlug, Marije S, Wolfhagen, Frank H J, Baven-Pronk, Martine, van der Voorn, Michael, Schwartz, Matthijs P, Vogelaar, Lauran, de Vos Tot Nederveen Cappel, Wouter H, Seerden, Tom C J, Hazen, Wouter L, Schrauwen, Ruud W M, Alvarez Herrero, Lorenza, Schreuder, Ramon-Michel M, van Nunen, Annick B, Stoop, Esther, de Bruin, Gijs J, Bos, Philip, Marsman, Willem A, Kuiper, Edith, de Bièvre, Marc, Alderlieste, Yasser A, Roomer, Robert, Groen, John, Bargeman, Marloes, van Leerdam, Monique E, Roberts-Bos, Linda, Boersma, Femke, Thurnau, Karsten, de Vries, Roland S, Ramaker, Jos M, Vleggaar, Frank P, de Ridder, Rogier J, Pellisé, María, Bourke, Michael J, Masclee, Ad A M, and Moons, Leon M G

Published
2024

3. Standardised training for endoscopic mucosal resection of large non-pedunculated colorectal polyps to reduce recurrence (*STAR-LNPCP study): a multicentre cluster randomised trial

Author

Meulen, Lonne W T, Bogie, Roel M M, Siersema, Peter D, Winkens, Bjorn, Vlug, Marije S, Wolfhagen, Frank H J, Baven-Pronk, Martine, van der Voorn, Michael, Schwartz, Matthijs P, Vogelaar, Lauran, de Vos Tot Nederveen Cappel, Wouter H, Seerden, Tom C J, Hazen, Wouter L, Schrauwen, Ruud W M, Alvarez Herrero, Lorenza, Schreuder, Ramon-Michel M, van Nunen, Annick B, Stoop, Esther, de Bruin, Gijs J, Bos, Philip, Marsman, Willem A, Kuiper, Edith, de Bièvre, Marc, Alderlieste, Yasser A, Roomer, Robert, Groen, John, Bargeman, Marloes, van Leerdam, Monique E, Roberts-Bos, Linda, Boersma, Femke, Thurnau, Karsten, de Vries, Roland S, Ramaker, Jos M, Vleggaar, Frank P, de Ridder, Rogier J, Pellisé, María, Bourke, Michael J, Masclee, Ad A M, Moons, Leon M G, Meulen, Lonne W T, Bogie, Roel M M, Siersema, Peter D, Winkens, Bjorn, Vlug, Marije S, Wolfhagen, Frank H J, Baven-Pronk, Martine, van der Voorn, Michael, Schwartz, Matthijs P, Vogelaar, Lauran, de Vos Tot Nederveen Cappel, Wouter H, Seerden, Tom C J, Hazen, Wouter L, Schrauwen, Ruud W M, Alvarez Herrero, Lorenza, Schreuder, Ramon-Michel M, van Nunen, Annick B, Stoop, Esther, de Bruin, Gijs J, Bos, Philip, Marsman, Willem A, Kuiper, Edith, de Bièvre, Marc, Alderlieste, Yasser A, Roomer, Robert, Groen, John, Bargeman, Marloes, van Leerdam, Monique E, Roberts-Bos, Linda, Boersma, Femke, Thurnau, Karsten, de Vries, Roland S, Ramaker, Jos M, Vleggaar, Frank P, de Ridder, Rogier J, Pellisé, María, Bourke, Michael J, Masclee, Ad A M, and Moons, Leon M G

Abstract

OBJECTIVE: Endoscopic mucosal resection (EMR) is the preferred treatment for non-invasive large (=20?mm) non-pedunculated colorectal polyps (LNPCPs) but is associated with an early recurrence rate of up to 30%. We evaluated whether standardised EMR training could reduce recurrence rates in Dutch community hospitals. DESIGN: In this multicentre cluster randomised trial, 59 endoscopists from 30 hospitals were randomly assigned to the intervention group (e-learning and 2-day training including hands-on session) or control group. From April 2019 to August 2021, all consecutive EMR-treated LNPCPs were included. Primary endpoint was recurrence rate after 6 months. RESULTS: A total of 1412 LNPCPs were included; 699 in the intervention group and 713 in the control group (median size 30 mm vs 30 mm, 45% vs 52% size, morphology, site and access (SMSA) score IV, 64% vs 64% proximal location). Recurrence rates were lower in the intervention group compared with controls (13% vs 25%, OR 0.43; 95% CI 0.23 to 0.78; p=0.005) with similar complication rates (8% vs 9%, OR 0.93; 95% CI 0.64 to 1.36; p=0.720). Recurrences were more often unifocal in the intervention group (92% vs 76%; p=0.006). In sensitivity analysis, the benefit of the intervention on recurrence rate was only observed in the 20-40?mm LNPCPs (5% vs 20% in 20-29?mm, p=0.001; 10% vs 21% in 30-39?mm, p=0.013) but less evident in =40?mm LNPCPs (24% vs 31%; p=0.151). In a post hoc analysis, the training effect was maintained in the study group, while in the control group the recurrence rate remained high. CONCLUSION: A compact standardised EMR training for LNPCPs significantly reduced recurrences in community hospitals. This strongly argues for a national dedicated training programme for endoscopists performing EMR of =20?mm LNPCPs. Interestingly, in sensitivity analysis, this benefit was limited for LNPCPs =40?mm. TRIAL REGISTRATION NUMBER: NTR7477.

Published
2024

4. Standardised training for endoscopic mucosal resection of large non-pedunculated colorectal polyps to reduce recurrence (*STAR-LNPCP study): a multicentre cluster randomised trial.

Author

Meulen, Lonne W. T., Bogie, Roel M. M., Siersema, Peter D., Winkens, Bjorn, Vlug, Marije S., Wolfhagen, Frank H. J., Baven-Pronk, Martine, van der Voorn, Michael, Schwartz, Matthijs P., Vogelaar, Lauran, de Vos tot Nederveen Cappel, Wouter H., Seerden, Tom C. J., Hazen, Wouter L., Schrauwen, Ruud W. M., Herrero, Lorenza Alvarez, Schreuder, Ramon-Michel M., van Nunen, Annick B., Stoop, Esther, de Bruin, Gijs J., and Bos, Philip

Subjects
POLYPECTOMY, COLON polyps, ENDOSCOPIC surgery, CLUSTER randomized controlled trials
Published
2024
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5. Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry

Author

Zwager, Liselotte W, Zwager, Liselotte W, Bastiaansen, Barbara A J, van der Spek, Bas W, Heine, Dimitri N, Schreuder, Ramon M, Perk, Lars E, Weusten, Bas L A M, Boonstra, Jurjen J, van der Sluis, Hedwig, Wolters, Hugo J, Bekkering, Frank C, Rietdijk, Svend T, Schwartz, Matthijs P, Nagengast, Wouter B, Ten Hove, W Rogier, Terhaar Sive Droste, Jochim S, Rando Munoz, Francisco J, Vlug, Marije S, Beaumont, Hanneke, Houben, Martin H M G, Seerden, Tom C J, de Wijkerslooth, Thomas R, Gielisse, Eric A R, Hazewinkel, Yark, de Ridder, Rogier, Straathof, Jan-Willem A, van der Vlugt, Manon, Koens, Lianne, Fockens, Paul, Dekker, Evelien, Dutch eFTR Grp, Zwager, Liselotte W, Zwager, Liselotte W, Bastiaansen, Barbara A J, van der Spek, Bas W, Heine, Dimitri N, Schreuder, Ramon M, Perk, Lars E, Weusten, Bas L A M, Boonstra, Jurjen J, van der Sluis, Hedwig, Wolters, Hugo J, Bekkering, Frank C, Rietdijk, Svend T, Schwartz, Matthijs P, Nagengast, Wouter B, Ten Hove, W Rogier, Terhaar Sive Droste, Jochim S, Rando Munoz, Francisco J, Vlug, Marije S, Beaumont, Hanneke, Houben, Martin H M G, Seerden, Tom C J, de Wijkerslooth, Thomas R, Gielisse, Eric A R, Hazewinkel, Yark, de Ridder, Rogier, Straathof, Jan-Willem A, van der Vlugt, Manon, Koens, Lianne, Fockens, Paul, Dekker, Evelien, and Dutch eFTR Grp

Abstract

BACKGROUND: Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) are critical in determining subsequent treatment. Endoscopic full-thickness resection (eFTR) is a new treatment option for T1 CRC < 2 cm. We aimed to report clinical outcomes and short-term results.METHODS: Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analyzed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk assessment, curative resection, adverse events, and short-term outcomes.RESULTS: We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection, and curative resection rates were 87.0 % (95 % confidence interval [CI] 82.7 %-90.3 %), 85.6 % (95 %CI 81.2 %-89.2 %), and 60.3 % (95 %CI 54.7 %-65.7 %). Curative resection rate was 23.7 % (95 %CI 15.9 %-33.6 %) for primary resection of T1 CRC and 60.8 % (95 %CI 50.4 %-70.4 %) after excluding deep submucosal invasion as a risk factor. Risk stratification was possible in 99.3 %. The severe adverse event rate was 2.2 %. Additional oncological surgery was performed in 49/320 (15.3 %), with residual cancer in 11/49 (22.4 %). Endoscopic follow-up was available in 200/242 (82.6 %), with a median of 4 months and residual cancer in 1 (0.5 %) following an incomplete resection.CONCLUSIONS: eFTR is relatively safe and effective for resection of small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes.

Published
2022

6. Endoscopic full-thickness resection of T1 colorectal cancers: a retrospective analysis from a multicenter Dutch eFTR registry.

Author

Zwager, Liselotte W., Bastiaansen, Barbara A. J., van der Spek, Bas W., Heine, Dimitri N., Schreuder, Ramon M., Perk, Lars E., Weusten, Bas L. A. M., Boonstra, Jurjen J., van der Sluis, Hedwig, Wolters, Hugo J., Bekkering, Frank C., Rietdijk, Svend T., Schwartz, Matthijs P., Nagengast, Wouter B., ten Hove, W. Rogier, Terhaar sive Droste, Jochim S., Rando Munoz, Francisco J., Vlug, Marije S., Beaumont, Hanneke, and Houben, Martin H. M. G.

Subjects
RESEARCH, CLINICAL trials, CARCINOGENESIS, RESEARCH methodology, RETROSPECTIVE studies, ACQUISITION of data, EVALUATION research, COLORECTAL cancer, TREATMENT effectiveness, COMPARATIVE studies, MENTAL health surveys
Abstract

Background: Complete endoscopic resection and accurate histological evaluation for T1 colorectal cancer (CRC) are critical in determining subsequent treatment. Endoscopic full-thickness resection (eFTR) is a new treatment option for T1 CRC < 2 cm. We aimed to report clinical outcomes and short-term results.Methods: Consecutive eFTR procedures for T1 CRC, prospectively recorded in our national registry between November 2015 and April 2020, were retrospectively analyzed. Primary outcomes were technical success and R0 resection. Secondary outcomes were histological risk assessment, curative resection, adverse events, and short-term outcomes.Results: We included 330 procedures: 132 primary resections and 198 secondary scar resections after incomplete T1 CRC resection. Overall technical success, R0 resection, and curative resection rates were 87.0 % (95 % confidence interval [CI] 82.7 %-90.3 %), 85.6 % (95 %CI 81.2 %-89.2 %), and 60.3 % (95 %CI 54.7 %-65.7 %). Curative resection rate was 23.7 % (95 %CI 15.9 %-33.6 %) for primary resection of T1 CRC and 60.8 % (95 %CI 50.4 %-70.4 %) after excluding deep submucosal invasion as a risk factor. Risk stratification was possible in 99.3 %. The severe adverse event rate was 2.2 %. Additional oncological surgery was performed in 49/320 (15.3 %), with residual cancer in 11/49 (22.4 %). Endoscopic follow-up was available in 200/242 (82.6 %), with a median of 4 months and residual cancer in 1 (0.5 %) following an incomplete resection.Conclusions: eFTR is relatively safe and effective for resection of small T1 CRC, both as primary and secondary treatment. eFTR can expand endoscopic treatment options for T1 CRC and could help to reduce surgical overtreatment. Future studies should focus on long-term outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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7. Endoscopic full-thickness resection (eFTR) of colorectal lesions: results from the Dutch colorectal eFTR registry

Author

Zwager, Liselotte W., Zwager, Liselotte W., Bastiaansen, Barbara A. J., Bronzwaer, Maxime E. S., van der Spek, Bas W., Heine, G. Dimitri N., Haasnoot, Krijn J. C., van der Sluis, Hedwig, Perk, Lars E., Boonstra, Jurjen J., Rietdijk, Svend T., Wolters, Hugo J., Weusten, Bas L. A. M., Gilissen, Lennard P. L., Ten Hove, W. Rogier, Nagengast, Wouter B., Bekkering, Frank C., Schwartz, M. P., Droste, Jochim S. Terhaar Sive, Vlug, Marije S., Houben, Martin H. M. G., Munoz, Francisco J. Rando, Seerden, Tom C. J., Beaumont, Hanneke, de Ridder, Rogier, Dekker, Evelien, Fockens, Paul, Dutch eFTR Grp, Zwager, Liselotte W., Zwager, Liselotte W., Bastiaansen, Barbara A. J., Bronzwaer, Maxime E. S., van der Spek, Bas W., Heine, G. Dimitri N., Haasnoot, Krijn J. C., van der Sluis, Hedwig, Perk, Lars E., Boonstra, Jurjen J., Rietdijk, Svend T., Wolters, Hugo J., Weusten, Bas L. A. M., Gilissen, Lennard P. L., Ten Hove, W. Rogier, Nagengast, Wouter B., Bekkering, Frank C., Schwartz, M. P., Droste, Jochim S. Terhaar Sive, Vlug, Marije S., Houben, Martin H. M. G., Munoz, Francisco J. Rando, Seerden, Tom C. J., Beaumont, Hanneke, de Ridder, Rogier, Dekker, Evelien, Fockens, Paul, and Dutch eFTR Grp

Abstract

Background Endoscopic full-thickness resection (eFTR) is a minimally invasive resection technique that allows definite diagnosis and treatment for complex colorectal lesionsMethods Consecutive patients undergoing eFTR in 20 hospitals were prospectively included. The primary outcome was technical success, defined as macroscopic complete en bloc resection. Secondary outcomes were: clinical success, defined as tumor-free resection margins (R0 resection); full-thickness resection rate; and adverse events.Results Between July 2015 and October 2018, 367 procedures were included. Indications were difficult polyps (non-lifting sign and/or difficult location; n = 133), primary resection of suspected T1 colorectal cancer (CRC; n = 71), reresection after incomplete resection of T1 CRC (n = 150), and subepithelial tumors (n = 13). Technical success was achieved in 308 procedures (83.9%). In 21 procedures (5.7 %), eFTR was not performed because the lesion could not be reached or retracted into the cap. In the remaining 346 procedures, R0 resection was achieved in 285 (82.4%) and full-thickness resection in 288 (83.2%). The median diameter of resected specimens was 23mm. Overall adverse event rate was 9.3% (n = 34/367): 10 patients (2.7 %) required emergency surgery for five delayed and two immediate perforations and three cases of appendicitis.Conclusion eFTR is an effective and relatively safe en bloc resection technique for complex colorectal lesions with the potential to avoid surgery. Further studies assessing the role of eFTR in early CRC treatment with long-term outcomes are needed.

Published
2020

9. Automatic optical diagnosis of small colorectal lesions by laser-induced autofluorescence.

Author

Kuiper, Teaco, Alderlieste, Yasser A., Tytgat, Kristien M. A. J., Vlug, Marije S., Nabuurs, Joyce A., Bastiaansen, Barbara A. J., Löwenberg, Mark, Fockens, Paul, and Dekker, Evelien

Subjects
COLON cancer, BIOFLUORESCENCE, ENDOSCOPY, COLONOSCOPY, DIAGNOSTIC imaging, COLON examination
Abstract

Background and study aims: Endoscopic optical diagnosis can potentially replace histopathological evaluation of small colorectal lesions. The aim of this study was to evaluate diagnostic performance of WavSTAT, a novel system for automatic optical diagnosis based on laser-induced autofluorescence spectroscopy. Patients and methods: Consecutive patients who were scheduled for colonoscopy were included in the study. Each detected lesion with a size of ⩽9mm was differentiated using high resolution endoscopy (HRE) by the endoscopist, who then reported this as a low or high confidence call. Thereafter, all lesions were analyzed using Wav- STAT. Histopathology was used as the reference standard. The primary outcome measures were the accuracy of WavSTAT to differentiate between adenomatous and nonadenomatous lesions, and the accuracy of an algorithm combining HRE (lesions differentiated with high confidence) and WavSTAT (all remaining lesions). The secondary outcome measure was the accuracy of on-site recommended surveillance intervals. Results: At total of 87 patients with 207 small colorectal lesions were evaluated. Accuracy and negative predictive value of WavSTAT were 74.4% and 73.5 %, respectively. The corresponding figures for the algorithm were 79.2% and 73.9 %, respectively. Accuracy of on-site recommended surveillance interval was 73.7% for WavSTAT alone and 77.2% for the algorithm of HRE and WavSTAT. Conclusions: Both accuracy of WavSTAT alone and the algorithm combining HRE with WavSTAT proved to be insufficient for the in vivo differentiation of small colorectal lesions, and do not fulfill American Society for Gastrointestinal Endoscopy performance thresholds for assessment of diminutive lesions. Future studies should assess whether combining WavSTAT with more advanced imaging techniques could result in a higher accuracy. [ABSTRACT FROM AUTHOR]

Published
2015
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10. Optical assessment of scars after endoscopic mucosal resection of large colorectal polyps in a multicenter, community hospital setting: is routine biopsy still necessary?

Author

Meulen LWT, Bogie RMM, Siersema PD, Winkens B, Vlug MS, Wolfhagen FHJ, Baven-Pronk MAMC, van der Voorn MPJA, Schwartz MP, Vogelaar L, Seerden TCJ, Hazen WL, Schrauwen RWM, Alvarez Herrero L, Schreuder RM, van Nunen AB, de Bruin GJ, Marsman WA, de Bièvre M, Roomer R, de Ridder R, Pellisé M, Bourke MJ, Masclee A, and Moons LM

Abstract

Background and Study Aims: Piecemeal EMR of large (≥20mm) non-pedunculated colorectal polyps (LNPCPs) is succeeded by a 6-month surveillance endoscopy to evaluate the post-EMR scar for recurrence. Data from expert centers suggest that routine tattoo placement and scar biopsies can be omitted, but data from community hospitals are lacking., Patients and Methods: In a post-hoc analysis of the STAR-LNPCP study (NTR7477), containing prospective data on 6-month post-pEMR scar assessments in 30 Dutch community hospitals (October 2019 to May 2022), the agreement between optical assessment and histological confirmation by routine biopsies was evaluated. Documentation of optical characteristics, imaging, and biopsies of the post-EMR scar were performed according to a standardized protocol., Results: In 1277 post-EMR scar assessments, identification of the scar was achieved in 1215/1277 (95%). Tattoo placement did not influence scar identification. Scar biopsy was performed in 1050/1215 cases (86%). Recurrences were seen in 200/1050 cases (19%). There was a good agreement between optical assessment of recurrence and histological confirmation (Cohen's kappa 0.78 [0.73-0.83]). The NPV was 98% [97-99%] and the PPV was 74% [68-80%]. Higher false positive rate was seen after prior use of clips (11% vs. 5%, p=0.017). Dedicated endoscopists identified the scar more often (96% vs. 88%, p<0.001), and showed a lower optical recurrence miss rate (1%vs. 3%, p=0.111) compared to non-dedicated endoscopists., Conclusion: Based on this multicenter community hospital study, routine tattoo placement and scar biopsies of the post-EMR scar can be omitted. Assessment of post-EMR scars by dedicated endoscopists is advised., Competing Interests: P. Siersema received grants or speaker’s fees from Pentax Japan, The E-Nose Company The Netherlands, Microtech China, Lucid Diagnostics USA, Magentiq Eye Israel, Norgine UK/The Netherlands, and Motus GI USA. M. Pellisé has received speaker’s fees from Norgine Iberia (2018-2023), Casen Recordati (2016 – 2019), Olympus (2018, 2022), Jansen (2018), Medtronic (2022), Fujifilm (2022); a consultancy fee GI Supply (2019), Fujifilm Europe (2022) and research funding from Fujifilm (2019-2021), Casen Recordati (2020); Ziuz (2021); 3-DMatrix (2021); her department has received loan material from Fujifilm (2017- ongoing), a consultancy service with Olympus (2022-ongoing); She is Board member of ESGE and AEG; and has received a fee from Thieme as an Endoscopy Co-Editor (2015-2021). She has shared actions of MiWendo. M. Bourke received research support for ethics-approved studies from Boston Scientific, Cook Medical, and Olympus Medical. A. Masclee received research grants from the Dutch Cancer Society (KWF) and the Dutch Organization for Health Research and Innovation (ZonMW). L. Moons acts as a consultant for Boston Scientific. The other authors disclose no competing interests., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Published
2024
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