A146 UNDERWATER EMR WITHOUT SUBMUCOSAL INJECTION FOR COLONIC ANGIODYSPLASIA
Bibliographic record
Abstract
Abstract Background Angiodysplasia is a common source of overt or occult colonic bleeding. Lesions are amenable to endoscopic thermal treatment such as APC, which requires a dedicated device and carries a small risk of perforation. Underwater EMR without submucosal injection (UEMR) is safe and effective for colorectal polyps, and requires no special equipment. Aims This study explores the use of UEMR to treat colonic angiodysplasia. We endeavoured to assess the effectiveness of treatment with UEMR in patients with this unique condition and further quantify the safety and adequacy of the obtained sample to achieve diagnosis. Further analyses were undertaken to determine the cost-burden of this method compared to comparable methods of treatment. Methods Retrospective review of clinical database for patients who underwent UEMR for colonic angiodysplasia between 2021 and 2023. Indications for treatment were iron deficiency anemia (N=4), Hematochezia (N=2), and melena (N=1). Lesions were excised en bloc using standard UEMR technique without submucosal injection and soft-coagulation electrosurgical settings. Results Six patients (5 females, mean age 76 ± 10) underwent colonoscopy with UEMR for treatment of angiodysplasia. One patient with extensive lesions required two endoscopic sessions; the others were treated during a single procedure. The median number of lesions was two; range, 1 to 13). A total of 24 lesions (size 7 ± 2 mm) were treated with UEMR. All lesions were located in the proximal colon (cecum, 14; ascending colon, 10). Histology of excised specimens confirmed a diagnosis of angiodysplasia. There were no procedural complications. Overt bleeding and anemia resolved in all patients. Conclusions In this series of patients, UEMR without submucosal injection was simple, safe and effective for treatment of proximal colon angiodysplasia. Advantages of this approach over conventional therapy with APC include reduced equipment needs, lower cost and histologic diagnosis. Further study comparing UEMR to conventional thermal modalities is warranted. Funding Agencies None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".