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Simple Summary: High-resolution anoscopy (HRA) is crucial for spotting and treating early signs of anal cancer. The researchers created an artificial intelligence (AI) system to analyze HRA images and identify high-grade and low-grade lesions accurately. They trained a computer program with thousands of images, achieving a remarkable accuracy of 94.6%. The AI system proved effective across different examination methods, such as using acetic acid or lugol iodine, and even after treatment. This advancement could improve the early detection of anal cancer precursors, potentially saving lives. High-resolution anoscopy (HRA) plays a central role in the detection and treatment of precursors of anal squamous cell carcinoma (ASCC). Artificial intelligence (AI) algorithms have shown high levels of efficiency in detecting and differentiating HSIL from low-grade squamous intraepithelial lesions (LSIL) in HRA images. Our aim was to develop a deep learning system for the automatic detection and differentiation of HSIL versus LSIL using HRA images from both conventional and digital proctoscopes. A convolutional neural network (CNN) was developed based on 151 HRA exams performed at two volume centers using conventional and digital HRA systems. A total of 57,822 images were included, 28,874 images containing HSIL and 28,948 LSIL. Partial subanalyses were performed to evaluate the performance of the CNN in the subset of images acetic acid and lugol iodine staining and after treatment of the anal canal. The overall accuracy of the CNN in distinguishing HSIL from LSIL during the testing stage was 94.6%. The algorithm had an overall sensitivity and specificity of 93.6% and 95.7%, respectively (AUC 0.97). For staining with acetic acid, HSIL was differentiated from LSIL with an overall accuracy of 96.4%, while for lugol and after therapeutic manipulation, these values were 96.6% and 99.3%, respectively. The introduction of AI algorithms to HRA may enhance the early diagnosis of ASCC precursors, and this system was shown to perform adequately across conventional and digital HRA interfaces. [ABSTRACT FROM AUTHOR]

Copyright of Hépato-Gastro & Oncologie Digestive is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Hépato-Gastro & Oncologie Digestive is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Hépato-Gastro & Oncologie Digestive is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Résumé: Les maladies proctologiques constituent un motif fréquent de consultation en gastro-entérologie. Elles relèvent parfois de gestes instrumentaux simples, réalisables en consultation et indispensables à connaître par tout gastroentérologue. La maladie hémorroïdaire de grade II ou III peut ainsi bénéficier d'un traitement instrumental par photocoagulation infrarouge ou ligature élastique. Le traitement d'une thrombose hémorroïdaire externe est avant tout médical mais, en cas de persistance d'un thrombus non œdémateux gênant et/ou de l'évacuation spontanée mais partielle d'un thrombus responsable de saignements tachant les sous-vêtements, une excision (et non pas une incision !) peut être pratiquée sous anesthésie locale. Elle permet en effet l'exérèse de tout le sac thrombotique évitant ainsi la formation d'une marisque résiduelle. Les abcès ano-périnéaux dus à une fistule anale, un sinus pilonidal infecté ou une maladie de Verneuil nécessitent une incision en urgence pour soulager la douleur et éviter la propagation de l'infection. Les antibiotiques seuls sont inefficaces en cas de fistule anale. Les condylomes de la marge anale et endocanalaires peuvent parfois être traités sous anesthésie locale par électrocoagulation au bistouri électrique et/ou par photocoagulation infrarouge. Enfin, une marisque hypertrophique gênante peut être réséquée aux ciseaux froids ou au bistouri électrique sous anesthésie locale. Dans tous les cas, il faut respecter les précautions d'utilisation, le déroulement de la procédure et surtout informer les patients au préalable des suites et des complications potentielles même si elles sont exceptionnelles. Proctological diseases are a frequent reason for consultation in gastroenterology. They are sometimes treated with simple instrumental procedures, which can be carried out in consultation and are essential for all gastroenterologists to know. Grade II or III hemorrhoidal disease can thus benefit from instrumental treatment by infrared photocoagulation or rubber band ligation. The treatment of an external hemorrhoidal thrombosis is above all medical but, in the case of persistence of a non-edematous thrombus and/or spontaneous but partial evacuation of a thrombus responsible for bleeding staining the underwear, an excision (and not an incision!) can be performed under local anaesthesia. This allows the entire thrombus sac to be removed, thus avoiding the formation of a residual skin tag. Ano-perineal abscesses due to an anal fistula, a pilonidal disease or Verneuil's disease require an emergency incision to relieve the pain and avoid the spread of the infection. Antibiotics alone are ineffective for anal fistula. Anal margin and endoanal condylomas can sometimes be treated under local anesthesia by electrocoagulation with an electric scalpel and/or infrared photocoagulation. Finally, an hypertrophic skin tag can be resected with cold scissors or electric scalpel under local anaesthesia. In all cases, the precautions for use and the procedure must be respected and, above all, patients must be informed beforehand of the consequences and potential complications, even if they are exceptional. [ABSTRACT FROM AUTHOR]