Untutored learning curve for endoscopic submucosal dissection in New Zealand.

Introduction: Endoscopic submucosal dissection (ESD) is a specialised endoscopic technique in the treatment of large pre-cancerous and early cancerous gastrointestinal lesions that avoids the need for surgical resections. The objective of this study was to assess the feasibility, efficacy and safety of learning ESD in an untutored approach in a prevalence-based setting within New Zealand.

Methods: Over a 4-year period, 80 ESD procedures were performed at a single tertiary centre within New Zealand.

Traction-Assisted Endoscopic Submucosal Dissection of a Gastric Subepithelial Tumor: A Case Report.

Endoscopic submucosal dissection (ESD) is considered curative for patients with early gastrointestinal cancers. However, it is a technically challenging procedure that can be time-consuming and associated with complications such as bleeding and perforation. Traction devices and techniques have been developed to mitigate these risks and reduce procedure times.

Quality of life after oesophageal stenting in patients with palliative oesophageal cancer.

Aim: Patients with incurable oesophageal cancer have poor outcomes, with disabling symptoms and a poor quality of life (QOL), which may be improved by oesophageal stenting. We aimed to measure change in symptoms related specifically to oesophageal cancer and overall QOL before and 30 days after stent insertion, to measure adverse effects and to define any patient factors that may be significant in predicting patients who may benefit most.

Methods: We prospectively enrolled patients in an observational study at Middlemore Hospital, New Zealand, and administered validated QOL- and symptomatology-based questionnaires before and 30 days after stent insertion.

Complications of endoscopically placed duodenal stents for malignant duodenal outlet obstruction.

Background: Endoscopically placed duodenal stents are commonly performed procedures for palliation of obstruction due to malignancy. A relatively small number of studies highlight the potential complications of this procedure, and to date no data have been published in New Zealand specifically addressing this issue. We aimed to retrospectively review complications from duodenal stents at our center and factors associated with the complications.

Chromoendoscopy versus standard colonoscopy for detection of nonpolypoid dysplasia in patients with inflammatory bowel disease.

Aim: Inflammatory bowel disease (IBD) is associated with an increased risk of colorectal cancer. Studies show that chromoendoscopy (CE) can increase the detection of dysplasia at surveillance colonoscopy, compared to standard white light endoscopy (WLE). We performed a retrospective cohort study to compare standard WLE to CE with targeted biopsies in detecting nonpolypoid dysplasia in IBD patients undergoing surveillance colonoscopy at a single tertiary centre.

Urban rickettsiosis in the Waikato region of New Zealand.

Murine typhus is the only endemic rickettsia that has been shown to cause human disease in New Zealand (NZ). We present a case report of a rickettsial infection in the Waikato region which was not typical for murine typhus. We outline the features which made this case unusual, and discuss the diagnostic uncertainty in assessing rickettsial disease.