{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T21:52:14Z","timestamp":1788817934545,"version":"build-2803163510"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Appendiceal orifice lesions are often managed operatively with limited or oncologic resections. The aim is to report the management of appendiceal orifice mucosal neoplasms using advanced endoscopic interventions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Patients with appendiceal orifice mucosal neoplasms who underwent advanced endoscopic resections between 2011 and 2021 with either endoscopic mucosal resection (EMR), endoscopic mucosal dissection (ESD), hybrid ESD, or combined endoscopic laparoscopic surgery (CELS) were included from a prospectively collected dataset. Patient and lesion details and procedure outcomes are reported.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Out of 1005 lesions resected with advanced endoscopic techniques, 41 patients (4%) underwent appendiceal orifice mucosal neoplasm resection, including 39% by hybrid ESD, 34% by ESD, 15% by EMR, and 12% by CELS. The median age was 65, and 54% were male. The median lesion size was 20\u00a0mm. The dissection was completed piecemeal in 49% of patients. Post-procedure, one patient had a complication within 30 days and was admitted with post-polypectomy abdominal pain treated with observation for 2\u00a0days with no intervention. Pathology revealed 49% sessile-serrated lesions, 24% tubular adenomas, and 15% tubulovillous adenomas. Patients were followed up for a median of 8 (0\u201348) months. One patient with a sessile-serrated lesion experienced a recurrence after EMR which was re-resected with EMR.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Advanced endoscopic interventions for appendiceal orifice mucosal neoplasms can be performed with a low rate of complications and early recurrence. While conventionally lesions at the appendiceal orifice are often treated with surgical resection, advanced endoscopic interventions are an alternative approach with promising results which allow for cecal preservation.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00464-024-10726-w","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T21:19:37Z","timestamp":1709587177000},"page":"2267-2272","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The role of advanced endoscopy in appendiceal polyp management and outcomes"],"prefix":"10.1007","volume":"38","author":[{"given":"Carla F.","family":"Justiniano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilker","family":"Ozgur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Liska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Valente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R.","family":"Steele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7725-3522","authenticated-orcid":false,"given":"Emre","family":"Gorgun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,4]]},"reference":[{"key":"10726_CR1","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1053\/j.gastro.2018.01.003","volume":"154","author":"AF Peery","year":"2018","unstructured":"Peery AF, Cools KS, Strassle PD, McGill SK, Crockett SD, Barker A, Koruda M, Grimm IS (2018) Increasing rates of surgery for patients with nonmalignant colorectal polyps in the United States. Gastroenterology 154:1352-1360.e3. https:\/\/doi.org\/10.1053\/j.gastro.2018.01.003","journal-title":"Gastroenterology"},{"key":"10726_CR2","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1097\/SLA.0000000000001511","volume":"264","author":"CK Zogg","year":"2016","unstructured":"Zogg CK, Najjar P, Diaz AJ, Zogg DL, Tsai TC, Rose JA Jr, Scott JW, Gani F, Alshaikh H, Canner JK, Schneider EB, Goldberg JE, Haider AH (2016) Rethinking priorities: cost of complications after elective colectomy. Ann Surg 264:312\u2013322. https:\/\/doi.org\/10.1097\/SLA.0000000000001511","journal-title":"Ann Surg"},{"key":"10726_CR3","doi-asserted-by":"publisher","first-page":"1802","DOI":"10.14309\/ajg.0000000000000407","volume":"114","author":"C Ma","year":"2019","unstructured":"Ma C, Teriaky A, Sheh S, Forbes N, Heitman SJ, Jue TL, Munroe CA, Jairath V, Corley DA, Lee JK (2019) Morbidity and mortality after surgery for nonmalignant colorectal polyps: a 10-year nationwide analysis. Am J Gastroenterol 114:1802\u20131810. https:\/\/doi.org\/10.14309\/ajg.0000000000000407","journal-title":"Am J Gastroenterol"},{"key":"10726_CR4","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.amjsurg.2021.11.030","volume":"223","author":"I Ozgur","year":"2022","unstructured":"Ozgur I, Liska D, Cengiz TB, Sapci I, Valente MA, Holubar SD, Steele SR, Bhatt A, Gorgun E (2022) Colectomy for polyps is associated with high risk for complications and low risk for malignancy: time for endoluminal surgery? Am J Surg 223:463\u2013467. https:\/\/doi.org\/10.1016\/j.amjsurg.2021.11.030","journal-title":"Am J Surg"},{"key":"10726_CR5","doi-asserted-by":"publisher","first-page":"1536","DOI":"10.1002\/bjs.5720","volume":"94","author":"DP Hurlstone","year":"2007","unstructured":"Hurlstone DP, Atkinson R, Sanders DS, Thomson M, Cross SS, Brown S (2007) Achieving R0 resection in the colorectum using endoscopic submucosal dissection. Br J Surg 94:1536\u20131542. https:\/\/doi.org\/10.1002\/bjs.5720","journal-title":"Br J Surg"},{"key":"10726_CR6","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1016\/j.gie.2013.07.033","volume":"78","author":"PV Draganov","year":"2013","unstructured":"Draganov PV, Gotoda T, Chavalitdhamrong D, Wallace MB (2013) Techniques of endoscopic submucosal dissection: application for the Western endoscopist? Gastrointest Endosc 78:677\u2013688. https:\/\/doi.org\/10.1016\/j.gie.2013.07.033","journal-title":"Gastrointest Endosc"},{"key":"10726_CR7","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1053\/j.gastro.2021.02.036","volume":"160","author":"PV Draganov","year":"2021","unstructured":"Draganov PV, Aihara H, Karasik MS, Ngamruengphong S, Aadam AA, Othman MO, Sharma N, Grimm IS, Rostom A, Elmunzer BJ, Jawaid SA, Westerveld D, Perbtani YB, Hoffman BJ, Schlachterman A, Siegel A, Coman RM, Wang AY, Yang D (2021) Endoscopic submucosal dissection in North America: a large prospective multicenter study. Gastroenterology 160:2317-2327.e2. https:\/\/doi.org\/10.1053\/j.gastro.2021.02.036","journal-title":"Gastroenterology"},{"key":"10726_CR8","doi-asserted-by":"publisher","first-page":"262","DOI":"10.4253\/wjge.v11.i4.262","volume":"11","author":"U Kaosombatwattana","year":"2019","unstructured":"Kaosombatwattana U, Yamamura T, Nakamura M, Hirooka Y, Goto H (2019) Colorectal endoscopic submucosal dissection in special locations. World J Gastrointest Endosc 11:262\u2013270. https:\/\/doi.org\/10.4253\/wjge.v11.i4.262","journal-title":"World J Gastrointest Endosc"},{"key":"10726_CR9","doi-asserted-by":"publisher","first-page":"5444","DOI":"10.1007\/s00464-017-5598-6","volume":"31","author":"T Tashima","year":"2017","unstructured":"Tashima T, Ohata K, Nonaka K, Sakai E, Minato Y, Horiuchi H, Matsuhashi N (2017) Endoscopic submucosal dissection for laterally spreading tumors involving the appendiceal orifice. Surg Endosc 31:5444\u20135450. https:\/\/doi.org\/10.1007\/s00464-017-5598-6","journal-title":"Surg Endosc"},{"key":"10726_CR10","doi-asserted-by":"publisher","first-page":"2328","DOI":"10.1007\/s00464-017-5928-8","volume":"32","author":"RV Milano","year":"2018","unstructured":"Milano RV, Viale E, Bartel MJ, Notaristefano C, Testoni PA (2018) Resection outcomes and recurrence rates of endoscopic submucosal dissection (ESD) and hybrid ESD for colorectal tumors in a single Italian center. Surg Endosc 32:2328\u20132339. https:\/\/doi.org\/10.1007\/s00464-017-5928-8","journal-title":"Surg Endosc"},{"key":"10726_CR11","doi-asserted-by":"publisher","first-page":"3114","DOI":"10.1007\/s00464-018-6026-2","volume":"32","author":"E Gorgun","year":"2018","unstructured":"Gorgun E, Benlice C, Abbas MA, Steele S (2018) Experience in colon sparing surgery in North America: advanced endoscopic approaches for complex colorectal lesions. Surg Endosc 32:3114\u20133121. https:\/\/doi.org\/10.1007\/s00464-018-6026-2","journal-title":"Surg Endosc"},{"key":"10726_CR12","doi-asserted-by":"publisher","first-page":"478","DOI":"10.1016\/j.jamcollsurg.2016.05.018","volume":"223","author":"E Gorgun","year":"2016","unstructured":"Gorgun E, Benlice C, Church JM (2016) Does cancer risk in colonic polyps unsuitable for polypectomy support the need for advanced endoscopic resections? J Am Coll Surg 223:478\u2013484. https:\/\/doi.org\/10.1016\/j.jamcollsurg.2016.05.018","journal-title":"J Am Coll Surg"},{"key":"10726_CR13","doi-asserted-by":"publisher","first-page":"3138","DOI":"10.1007\/s10620-017-4760-2","volume":"62","author":"EM Song","year":"2017","unstructured":"Song EM, Yang HJ, Lee HJ, Lee HS, Cha JM, Kim HG, Jung Y, Moon CM, Kim BC, Byeon JS (2017) Endoscopic resection of cecal polyps Involving the appendiceal orifice: a KASID multicenter study. Dig Dis Sci 62:3138\u20133148. https:\/\/doi.org\/10.1007\/s10620-017-4760-2","journal-title":"Dig Dis Sci"},{"key":"10726_CR14","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.gie.2017.03.1550","volume":"87","author":"AF Peery","year":"2018","unstructured":"Peery AF, Shaheen NJ, Cools KS, Baron TH, Koruda M, Galanko JA, Grimm IS (2018) Morbidity and mortality after surgery for nonmalignant colorectal polyps. Gastrointest Endosc 87:243-250.e2. https:\/\/doi.org\/10.1016\/j.gie.2017.03.1550","journal-title":"Gastrointest Endosc"},{"key":"10726_CR15","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/gutjnl-2014-308481","volume":"65","author":"C Hassan","year":"2016","unstructured":"Hassan C, Repici A, Sharma P, Correale L, Zullo A, Bretthauer M, Senore C, Spada C, Bellisario C, Bhandari P, Rex DK (2016) Efficacy and safety of endoscopic resection of large colorectal polyps: a systematic review and meta-analysis. Gut 65:806\u2013820. https:\/\/doi.org\/10.1136\/gutjnl-2014-308481","journal-title":"Gut"},{"key":"10726_CR16","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1016\/j.surg.2017.10.057","volume":"163","author":"M Gamaleldin","year":"2018","unstructured":"Gamaleldin M, Benlice C, Delaney CP, Steele S, Gorgun E (2018) Management of the colorectal polyp referred for resection: a case-matched comparison of advanced endoscopic surgery and laparoscopic colectomy. Surgery 163:522\u2013527. https:\/\/doi.org\/10.1016\/j.surg.2017.10.057","journal-title":"Surgery"},{"key":"10726_CR17","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1055\/s-0042-110396","volume":"48","author":"H Jacob","year":"2016","unstructured":"Jacob H, Toyonaga T, Ohara Y, Tsubouchi E, Takihara H, Baba S, Yoshizaki T, Kawara F, Tanaka S, Ishida T, Hoshi N, Morita Y, Umegaki E, Azuma T (2016) Endoscopic submucosal dissection of cecal lesions in proximity to the appendiceal orifice. Endoscopy 48:829\u2013836. https:\/\/doi.org\/10.1055\/s-0042-110396","journal-title":"Endoscopy"},{"key":"10726_CR18","doi-asserted-by":"publisher","first-page":"362","DOI":"10.5946\/ce.2012.45.4.362","volume":"45","author":"T Toyonaga","year":"2012","unstructured":"Toyonaga T, Nishino E, Man-I M, East JE, Azuma T (2012) Principles of quality controlled endoscopic submucosal dissection with appropriate dissection level and high quality resected specimen. Clin Endosc 45:362\u2013374. https:\/\/doi.org\/10.5946\/ce.2012.45.4.362","journal-title":"Clin Endosc"},{"key":"10726_CR19","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1007\/s12328-013-0443-5","volume":"7","author":"M Kuriyama","year":"2014","unstructured":"Kuriyama M (2014) Acute appendicitis as a rare complication after colonoscopy. Clin J Gastroenterol 7:32\u201335. https:\/\/doi.org\/10.1007\/s12328-013-0443-5","journal-title":"Clin J Gastroenterol"},{"key":"10726_CR20","doi-asserted-by":"publisher","first-page":"8462","DOI":"10.3748\/wjg.v21.i27.8462","volume":"21","author":"Y Nemoto","year":"2015","unstructured":"Nemoto Y, Tokuhisa J, Shimada N, Gomi T, Maetani I (2015) Acute appendicitis following endoscopic mucosal resection of cecal adenoma. World J Gastroenterol 21:8462\u20138466. https:\/\/doi.org\/10.3748\/wjg.v21.i27.8462","journal-title":"World J Gastroenterol"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-024-10726-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-024-10726-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-024-10726-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T18:08:20Z","timestamp":1711649300000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-024-10726-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,4]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10726"],"URL":"https:\/\/doi.org\/10.1007\/s00464-024-10726-w","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,4]]},"assertion":[{"value":"11 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"David Liska is a consultant for Olympus. Emre Gorgun is a consultant for Boston scientific, Olympus, Dilumen. Carla F. Justiniano, Ilker Ozgur, Michael A. Valente, and Scott R have no conflicts of interest or financial ties to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}},{"value":"This study was approved by our institutional review board at the Cleveland Clinic, Cleveland, OH.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}