Oral Full Papers
Bibliographic record
Abstract
The number of patients with endoscopically irresectable colonic polyps or Stage I cancer is increasing due to the introduction of bowel cancer screening programs. These patients usually undergo hemicolectomy when localised full thickness excision would be adequate. To address this and improve clinical outcomes, we have further developed a previously reported full thickness laparo-endoscopic excision (FLEX) technique. Methods: Following a series of ex-vivo experiments to standardise procedural steps, the procedure was performed in five 70-kg pigs. A simulated colonic polyp was created by endoscopic ink injection and a clearance margin was delineated by circumferential placement of mucosal argon plasma coagulator (APC) marks. Full thickness eversion of the bowel wall was achieved using endoscopically placed BraceBars and the 'pseudopolyp' was excised using a laparoscopic stapler. The first pig was terminated immediately thereafter; the others were sacrificed 8 days after surgery. Results: The median procedure duration from placement of mucosal APC marks to specimen excision was 26 min (range 20-31 min). Excised specimens had a median diameter of 51 cm (range 45-63 cm). Postoperative recovery in survival animals was uneventful. Post-mortem and histological evaluation demonstrated well-healed resection sites with no evidence of intra-abdominal infection or inadvertent organ damage. Endoscopic evaluation of anastomoses at post-mortem demonstrated a patent lumen in all animals with no evidence of stenosis. Histological examination showed a primary closure by mucosal abbutal and regeneration, with repair and restoration of continuity of the submucosa at anastomotic sites. Conclusions: This is the first full thickness resection technique described to date suitable for translational to clinical practice, as an alternative to hemicolectomy. The ability to preserve mesenteric vasculature and colonic length is likely to result in less morbidity and mortality, better functional outcomes and reduced treatment costs.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".