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Resecting pituitary microadenomas and macroadenomas with extrasellar extensions through the endoscopic endonasal route often requires adjunctive tools to assess the anatomy, maximize resection, and preserve the functional integrity of the gland. Intraoperative ultrasound (IOUS) is a cost-effective tool that is routinely used in neuro-oncology. With the advancement of this technique, smaller and slender probes have been developed that are useful in endoscopic approaches. The aim of this study was to assess the usefulness of IOUS in the endoscopic resection of pituitary adenomas and evaluate its effect on lesion localization, residual detection, and clinical outcome. This is a retrospective study on 79 cases (83 surgeries) between January 2023 and December 2024 that underwent endoscopic endonasal resection for pituitary adenomas using IOUS. The performance of IOUS in detecting residual disease was compared with postoperative MRI. Gross total resection (GTR) was achieved in 77.1% cases and average residue volume was 2.9 cc. IOUS prevented early termination of resection in 10 cases and thus helped achieve GTR in each of them. A total of 13 residual disease (15.6%) was missed on IOUS, average residue volume missed was 0.7 cc, and the lateral compartment of the cavernous sinus was the most common site that alluded detection. The specificity of IOUS in detecting residual disease was 98.5%, while the sensitivity was 27.8%. Disease extension into both cavernous sinus and suprasellar sellar cistern significantly affected the ability of the IOUS to identify residual disease (P = .002), and it was more likely to miss residual diseases in cases of giant adenomas than smaller pituitary adenomas. IOUS helps achieve GTR without compromising clinical outcomes.

The benefit of endoscopy for non-cardia gastric cancer (GC) prevention lacks evidence from randomized controlled trials (RCTs). This study aimed to evaluate the effect of endoscopic screening for non-cardia GC through an RCT. We conducted a cluster RCT in rural Hua County, northern China (ClinicalTrials.gov, NCT01688908). A total of 668 villages were randomly selected and assigned to either undergo upper gastrointestinal endoscopic screening (screening group) or no screening (control group). Permanent residents aged 45-69 years were enrolled from January 2012 to September 2016. Non-cardia GC mortality between the two groups was compared in intention-to-treat, per-protocol, and subgroup analyses. Poisson regression fitted with generalized estimating equations was used, adjusting for baseline characteristics and accounting for village clustering. The study enrolled 17,104 participants in the screening group, of whom 15,165 (88.7%) underwent endoscopy, and 16,743 in the control group. After a maximum follow-up of 12 years, non-cardia GC mortality was 13.1 per 100,000 person-years in the screening group and 13.5 per 100,000 person-years in the control group. Intention-to-treat analysis showed a 15% lower non-cardia GC mortality in the screening group compared with the control group (adjusted rate ratio [aRR], 0.85 [95% CI: 0.49-1.50]), although the difference was statistically non-significant. In the per-protocol analysis, the aRR for non-cardia GC mortality was 0.70 (95% CI: 0.38-1.29). A subgroup analysis of the screening group restricted to participants who complied with screening protocol and received timely treatment for detected malignancies yielded similar results, with an aRR of 0.66 (95% CI: 0.35-1.22); neither of these analyses reached statistical significance. In this trial, endoscopic screening was associated with a non-significant reduction in non-cardia GC mortality; larger trials in higher-incidence settings are needed to confirm a benefit.

The operative link on gastritis assessment (OLGA) and operative link on gastritis assessment based on intestinal metaplasia (OLGIM) are established tools for stratifying the risk of gastric neoplasm development. This study evaluated whether OLGA and OLGIM staging can predict metachronous gastric neoplasms (adenoma or cancer) after endoscopic submucosal dissection (ESD) in patients with early gastric cancer (EGC) without current Helicobacter pylori infection. This retrospective cohort study enrolled 494 patients with EGC without current H. pylori infection who underwent ESD between 2004 and 2015. The primary endpoint was the incidence of metachronous gastric neoplasms. High risk was defined as OLGA or OLGIM stage III-IV. Of the included patients, 55.4% (250/451) and 55.9% (276/494) were classified as high risk according to OLGA and OLGIM staging, respectively. During a median follow-up of 6.8 years, the incidence of metachronous gastric neoplasm was 26.6 cases per 1,000 person-years. According to OLGA staging, the high-risk group had a significantly higher incidence of metachronous neoplasms than the low-risk group (33.3 vs. 17.8 cases per 1,000 person-years, log-rank test P=0.012). Similarly, according to OLGIM staging, the high-risk group demonstrated a significantly higher incidence than the low-risk group (35.2 vs. 16.6 cases per 1,000 person-years, P=0.002). In patients with EGC without current H. pylori infection, OLGA and OLGIM staging are useful for assessing the risk of metachronous gastric. The current 5-year endoscopic surveillance interval after ESD may be further optimized according to patient risk stratified by OLGA or OLGIM stages.

We compared the long-term outcomes of endoscopic submucosal dissection (ESD) with those of surgery in late older adult patients aged &#x2265;75 years with early gastric cancer (EGC) who met the curative resection criteria. This multicenter retrospective study included 4,241 older adults with EGC who were treated with either ESD (n=4,083) or surgery (n=158) at 22 hospitals between 2010 and 2020. Overall survival (OS) and gastric cancer (GC) recurrence were investigated in the overall cohort and a 4-to-1 propensity score (PS)-matched cohort. During a median follow-up of 6.6 years, the 5-year OS rates were 84.8% and 82.9% in the ESD and surgery groups, respectively, and OS did not differ between the 2 groups in the overall (P=0.396) and PS-matched cohorts (P=0.248). In the PS-matched cohort, the multivariate analyses showed that overall mortality after ESD (adjusted hazard ratio, 0.77; 95% confidence interval, 0.57-1.04) did not increase compared to that after surgery. The GC recurrence rate after ESD was higher than that after surgery (6.1% [248/4,083] vs. 0.6% [1/158]; 5-year rate: 9.3% vs. 0.7%, respectively; P<0.001 for the overall and PS-matched cohorts). However, approximately 77% (190/248) of the recurrences in the ESD group were metachronous, most of which were successfully managed with endoscopic treatment. The ESD group had fewer adverse events (AEs, 7.6% vs. 12.0%; P=0.044) than the surgery group, and no ESD treatment-related deaths were observed. In late older adult patients (aged &#x2265;75 years) with EGC, long-term outcomes after ESD were comparable to those after surgery for EGC meeting the curative resection criteria, with acceptable treatment-related AEs.

"Underwater" endoscopic techniques have gained traction given its potential advantages. The aim of this multicenter randomized trial was to compare the effect of saline immersion (U-POEM) vs. carbon dioxide insufflation during peroral endoscopic myotomy (CO2-POEM) on post-procedural pain. Consecutive patients with achalasia subtype I and II were randomized in a 1:1 ratio to U-POEM or CO2-POEM during the study period between February 2025 to November 2025. Pain was assessed using the validated numeric pain rating (NPRS) on a scale of 0 (none) to 10 (most severe). Primary outcome was immediate post-procedure pain. Secondary outcomes included: post-procedure pain at different time periods, requirement of analgesics, and clinical response (defined as a post-POEM Eckardt score <3). Thirty-six patients were randomized to U-POEM (n=18) and CO2-POEM (n=18). Technical and clinical success were 100% in both groups with no immediate and delayed adverse events. There were no differences in dissection speed or procedural time between the two groups. The immediate post-POEM mean NPRS score was significantly lower in the U-POEM vs. CO2-POEM group (1.6 &#xb1; 1.6 vs. 3.3 &#xb1; 2.6; 95% CI: 0.23-3.16; p=0.02). When compared to CO2-POEM, patients who underwent U-POEM reported less moderate-severe pain (16.7% vs. 55.5%; 95% CI: 0.04-0.64; p=0.04) and a lower number required opioids for post-operative pain management (5.5% vs. 50%; 95% CI: 0.11-0.68; p=0.007). Mean NPRS score remained lower in the U-POEM vs. CO2-POEM group at 72-hours after the procedure (1.13&#xb1;1.36 vs. 2.26&#xb1;1.78; 95% CI: 0.06-2.20; p=0.04). U-POEM was safe, effective, and associated with lower post-procedure pain scores when compared to CO2-POEM (U-POEM trial:NCT06918730).

Endoscopic full-thickness resection (EFTR) and laparoscopic and endoscopic cooperative surgery (LECS) are minimally invasive treatments for gastric submucosal tumors (SMTs). Because comparative data of both methods are lacking, we aimed to compare the clinical outcomes between EFTR and LECS for gastric SMT. This multicenter study included patients who underwent EFTR or LECS for gastric SMT in four Japanese institutions. A 1:1 propensity score matching (PSM) analysis was performed with a caliper width of 0.2. Covariates included age; sex; body mass index; history of abdominal surgery, cardiovascular disease, or cerebrovascular disease; comorbidities; smoking and drinking habits; antiplatelet and anticoagulant intake; along with tumor location, type, and size. We enrolled 38 patients treated with EFTR and 59, with LECS. After PSM, 21 patients were selected. The histological R0 resection rate was comparable between EFTR and LECS before (95% vs. 100%) and after&#xa0;(91% vs. 100%) PSM. In the EFTR group, median operation time was shorter (93&#x2009;min vs. 161&#x2009;min, p&#x2009;<&#x2009;0.001), median numbers of attending doctors were fewer (5 vs. 3, p&#x2009;<&#x2009;0.001), with procedure (&#xa5;305,330 vs. &#xa5;434,700, p&#x2009;=&#x2009;0.017) and total hospitalization costs (&#xa5;676,400 vs. &#xa5;861,420) lower than those in the LECS group after PSM. Adverse event rates were low (5% vs. 14%, p&#x2009;=&#x2009;0.606) in both groups. EFTR and LECS provide efficacious oncological outcomes for patients with small (&#x2264;&#x2009;3&#x2009;cm) intraluminal type gastric SMT. EFTR demonstrated favorable operative efficiency and economic outcomes, suggesting it may be a potentially cost-effective alternative.

Descending necrotizing mediastinitis (DNM) is a severe complication of deep neck infection when the mediastinum is involved. Currently, the optimal surgical treatment for DNM, especially for Endo IIA DNM, has not been defined. We aimed to describe a standardized ETMD procedure emphasizing safe catheter placement into the main mediastinal abscess cavities and to evaluate its association outcomes compared with non-ETMD approaches in patients with DNM. This multicenter retrospective cohort study included adult patients (&#x2265;&#x2009;18 years) diagnosed with descending necrotizing mediastinitis (DNM) secondary to deep neck infection between 2008 and 2024. Patients who received incomplete treatment or were unable to undergo surgery were excluded. Clinical, laboratory, and imaging data were collected. Surgical management was classified as endoscopic transcervical mediastinal drainage (ETMD) or non-ETMD. The primary outcome was the requirement for secondary drainage. Secondary outcomes included hospital stay, drainage duration, and major complications. Statistical analyses were performed using t-tests, Mann-Whitney U tests, chi-square tests, and multivariable models where appropriate. Multivariable regression and supplementary inverse probability of treatment weighting (IPTW) analyses were performed to adjust for potential confounding. Among 95 patients enrolled, 49 received ETMD. The secondary drainage rate was significantly lower in patients who received ETMD (10.2% vs. 43.5%; risk difference, -33.3%; 95% CI, -49.9% to -16.6%; P&#x2009;<&#x2009;0.001). After IPTW adjustment, ETMD remained associated with a lower risk of secondary drainage (OR&#x2009;=&#x2009;0.184; 95% CI, 0.050-0.677; P&#x2009;=&#x2009;0.013). In the exploratory Endo IIA subgroup analysis, ETMD reduced secondary drainage rate and shortened selected perioperative recovery measures. In this multicentre retrospective cohort, ETMD reduced the requirement for secondary drainage in patients with DNM, particularly in the exploratory Endo IIA subgroup analysis. These findings suggest that ETMD may be a potential minimally invasive approach for selected patients, but further prospective studies are needed to validate its role. Level III.

Functioning pituitary adenomas (FPAs) account for 63% to 85% of pituitary adenomas. Although endoscopic endonasal surgery targets biochemical remission and reduced recurrence, cavernous sinus medial wall (CSMW) invasion often leads to incomplete resection and persistent disease. This retrospective study evaluated the clinical value of combining tumor excision with CSMW resection in patients with FPAs. We compared 60 patients who underwent tumor excision plus CSMW resection with contemporaneous controls who underwent tumor excision alone. Propensity scores based on age, sex, body mass index, Knosp grade, hormone subtype, and tumor size/volume were used for 1:1 nearest-neighbor matching, yielding 60 pairs. In the matched cohort, the CSMW resection group achieved higher sustained biochemical cure (&#x2265;6 months) (85.0% vs 61.7%) and clinical symptom relief (83.3% vs 56.7%), and a higher magnetic resonance imaging-defined gross total resection rate (95.0% vs 81.7%), with a lower recurrence rate (3.3% vs 15.0%) (all P&#x2005;<&#x2005;.05). After multivariable adjustment (age, sex, body mass index, and Knosp grade), CSMW resection remained independently associated with sustained biochemical cure (odds ratio [OR]&#x2005;=&#x2005;4.77, 95% confidence interval [CI] 1.83-12.43), symptom relief (OR&#x2005;=&#x2005;4.68, 95% CI 1.79-12.21), and gross total resection (OR&#x2005;=&#x2005;4.55, 95% CI 1.04-19.95), and with reduced recurrence (OR&#x2005;=&#x2005;0.16, 95% CI 0.03-0.78). Postoperative cerebrospinal fluid leakage and intracranial infection were less frequent with CSMW resection (both 3.3% vs 18.3%; OR&#x2005;=&#x2005;0.13, 95% CI 0.03-0.54), whereas length of stay and other sinonasal complications did not differ materially. Tumor excision combined with CSMW resection may improve key clinical outcomes in FPAs and warrants consideration in appropriately selected patients.

The current expanded criteria for endoscopic resection (ER) of early gastric cancer (EGC) include a non-negligible risk of lymph node metastasis (LNM) in submucosal (SM) disease. We had previously proposed revised criteria incorporating the SM invasion width to better stratify LNM risk. In the present study, we aimed to validate whether these revised criteria improved the identification of truly node-negative, differentiated-type pT1b EGC. This multicenter retrospective study included 712 patients with differentiated-type SM invasive EGC who underwent gastrectomy at 2 tertiary centers between 2016 and 2023. The SM invasion depth and width were re-evaluated, and the diagnostic performance of the conventional, expanded, and revised criteria (tumor size &#x2264;3 cm, SM depth &#x2264;1,000 &#xb5;m, SM width &#x2264;4 mm, and no lymphovascular/perineural invasion) for predicting LNM was compared. LNM was identified in 16.9% of the patients. An SM invasion width >4 mm was a strong independent predictor of LNM (P<0.001) and demonstrated superior discriminatory ability (area under the receiver operating characteristic curve [AUC], 0.79) in comparison with SM depth (AUC, 0.68) and tumor size (AUC, 0.59). Although the conventional criteria classified 54 cases as curative, the revised criteria classified 83 cases as curative, and no LNM events were observed in both sets of cases. Thus, the revised criteria expanded the potential candidate pool for curative ER by approximately 54% without compromising nodal safety. SM invasion width can be a significant independent predictor of LNM. The revised criteria, which incorporated SM width, safely expanded the indications for curative ER in patients with differentiated-type SM gastric cancer.

To evaluate the radiographic and clinical outcomes of unilateral biportal endoscopic lumbar interbody fusion (ULIF) in patients with grade I lumbar spondylolisthesis, 30 patients underwent ULIF between January 2023 and January 2024. Clinical and radiographic outcomes were analyzed, including operative time, intraoperative blood loss, hospital stay, fusion rate, and laboratory indices (Hb, CRP, CPK). All procedures were successfully completed without intraoperative complications. The mean operative time was 199.7&#x2005;&#xb1;&#x2005;36.5 minutes, blood loss 60.7&#x2005;&#xb1;&#x2005;29.6&#x2009;mL, and hospital stay 9.2&#x2005;&#xb1;&#x2005;3.7 days. Low back pain Visual Analogue Scale decreased from 6.63&#x2005;&#xb1;&#x2005;1.00 to 0.83&#x2005;&#xb1;&#x2005;0.80, leg pain Visual Analogue Scale from 6.47&#x2005;&#xb1;&#x2005;1.41 to 0.63&#x2005;&#xb1;&#x2005;0.67, and Oswestry Disability Index from 58.47&#x2005;&#xb1;&#x2005;12.86 to 18.87&#x2005;&#xb1;&#x2005;7.67 at 12 months. The fusion rate at final follow-up was 100%. Laboratory findings indicated a transient decrease in Hb and increases in CRP and CPK on POD1, with recovery by POD3. ULIF is a promising short-term option for grade I lumbar spondylolisthesis, demonstrating effective reduction, spinal decompression, minimal soft tissue injury, and high short-term fusion success.

Endoscopic instruments are vulnerable to structural damage due to frequent reuse. This study aimed to evaluate the effectiveness of quality control circle (QCC) activities in reducing instrument damage. A multidisciplinary QCC team was established to implement interventions including enhanced staff training, standardized maintenance protocols, and peer-reviewed inspections. Instrument damage rates were compared before and after the intervention using chi-square analysis. The damage rate declined significantly from 2.33% to 0.27% (P&#x2005;<.001). Common issues such as missing parts and assembly confusion were markedly reduced, achieving a target improvement rate of 137.33%. Implementation of QCC activities in instrument management effectively reduced equipment damage, improved workflow, and enhanced patient safety. These findings suggest that QCC methods have potential for broader application in hospital quality-improvement initiatives.

Dysthyroid optic neuropathy (DON) is a vision-threatening complication of Graves' ophthalmopathy, and insufficient orbital decompression may result in persistent or irreversible visual impairment. While endoscopic transnasal orbital decompression (ETOD) has become a mainstream surgical approach for orbital decompression, the optimal extent of ETOD remains incompletely defined, particularly regarding reproducible anatomical landmarks and safe surgical boundaries. This retrospective study evaluated patients with DON who underwent an extended ETOD procedure at a tertiary medical center. The surgical technique involved decompression of the medial, inferior, and superior orbital walls, with standardized anterior, posterior, superior, and inferior anatomical landmarks. Clinical characteristics, imaging findings, treatment outcomes were reviewed before surgery and during postoperative follow-up. Factors associated with improvement in visual acuity and exophthalmos were further explored. Most affected eyes showed postoperative improvement in visual acuity, accompanied by reductions in exophthalmos, intraocular pressure, and lagophthalmos. The extended procedure did not result in major surgical complications or new-onset diplopia. Younger age, poorer preoperative visual acuity, and shorter duration of visual impairment were associated with greater visual recovery, while more severe baseline exophthalmos was associated with greater reduction in exophthalmos. By contrast, diabetes appeared to be associated with less exophthalmos improvement. Extended ETOD appears to be a safe and effective surgical strategy for DON. By defining clear anatomical boundaries, this standardized decompression approach may provide clinicians with effective and reproducible surgical guidance and thereby improving patients' prognosis and psychosocial well-being.

Western data to help guide surveillance recommendations following colorectal endoscopic submucosal dissection (ESD) remains scarce. In this multicenter study, we evaluate and stratify the risk of local recurrence following colorectal ESD. Retrospective analysis of colorectal ESD at 13 centers between January 2015 to September 2025. Local recurrence was defined as neoplasia at the ESD site during surveillance colonoscopy (SC). Recurrence risk was calculated for the following groups: category 1 (R0 resection of low-grade dysplasia [LGD]), category 2 (R0 resection of high-grade dysplasia), category 3 (R1/Rx resection of non-invasive neoplasia), and category 4 (curative resection of T1a cancer). Multivariable logistic regression was performed to identify factors associated with recurrence. 2182 patients underwent colorectal ESD (median lesion size of 34 mm). En-bloc and R0 resection rates were 93.6% and 81.1%, respectively. SC was available in 1478 out of the 2182 patients. Local recurrence occurred in 1.5% (22/1478) at a median of 14 months: 1.5% (12/775) in category 1, 0.9% (3/330) in category 2, 2.2% (6/279) in category 3, and 1.1% (1/94) in category 4. Recurrence in very low-risk lesions (defined as <40 mm in size with only LGD on histology) was 0.8% (4/478). Severe fibrosis was a risk factor for local recurrence (OR:2.40; 95%CI:1.12-4.89; p=0.019) whereas R0 resection was associated with a lower likelihood (OR:0.30; 95%CI:0.15-0.58; p<0.001). In this multicenter non-Asian study, local recurrence after colorectal ESD was 1.5% and 0.8% for very low-risk lesions. Severe submucosal fibrosis and R1/Rx resection were independently associated with local recurrence. Our data support current recommendations for SC at 12 months after ESD and raises the possibility of a longer interval for very low-risk lesions.

With the aging population, the number of older adult patients undergoing endoscopic resections (ERs) for early gastric cancer (EGC) has increased. However, data on the long-term outcomes in these patients remain limited. We evaluated long- and short-term outcomes and identified factors associated with outcomes in older adult patients with EGC after ERs. Data from older patients (aged &#x2265;75 years) who underwent ERs for EGC between 2011 and 2019 were collected from the Korean National Health Insurance database. Baseline characteristics, clinical outcomes, and outcome-associated risk factors were investigated. In total, 7,331 patients (mean age: 79.0 years) were included. During the 74.7-month median follow-up, 2,436 (33.2%) patients died, of whom 291 (4.0%) died of gastric cancer. The 3-, 5-, and 10-year overall survival rates were 91.3%, 82.1%, and 53.3%, respectively. The 3-, 5-, and 10-year cancer-specific survival rates were 98.3%, 96.9%, and 94.0%, respectively. Within 90 days after ER, 1,900 (25.9%) patients were readmitted, and 32 (0.4%) died. Risk factors associated with all-cause mortality were age &#x2265;80 years, lower baseline hemoglobin level, higher baseline creatinine level, being underweight, current smoking, and a medical history of myocardial infarction, congestive heart failure, dementia, or renal disease. A body mass index &#x2265;25 kg/m&#xb2; was associated with lower overall mortality. When deciding on ER for EGC in late-older adult patients (aged &#x2265;75 years), incorporating risk factors may be useful for risk stratification and prognostic counseling.

Patients with cirrhosis may have acute kidney injury (AKI) after receiving endoscopic retrograde cholangiopancreatography (ERCP). This study aimed to identify determinants of AKI that require dialysis following ERCP in patients with cirrhosis. Data from the US Nationwide Inpatient Sample from 2016 to 2020 were retrospectively reviewed. Patients aged &#x2265;20 years with liver cirrhosis who underwent ERCP were identified. The primary outcome was AKI requiring dialysis. Logistic regression with stepwise selection was used to identify factors associated with dialysis-requiring AKI among demographic variables, comorbidities, and hospital characteristics. Data from 6748 patients with liver cirrhosis who underwent ERCP were analyzed, and 2.2% (n=148) developed AKI that required dialysis. After adjustment, the results showed that decompensated liver cirrhosis (adjusted odds ratio [aOR] 4.73, 95% CI 3.12-7.15; P<.001), chronic kidney disease (aOR 5.93, 95% CI 4.00-8.79; P<.001), obesity (aOR 1.65, 95% CI 1.05-2.59; P=.03), and sepsis (aOR 3.57, 95% CI 2.44-5.23; P<.001) were significant factors associated with AKI that required dialysis. The developed model demonstrated good calibration and discrimination (c-index: 0.826 for derivation cohort, 0.824 for validation cohort). Decompensated liver cirrhosis, preexisting chronic kidney disease, obesity, and sepsis are significant factors associated with AKI that require dialysis following ERCP in patients with liver cirrhosis. These findings can inform risk stratification and management strategies to improve outcomes in this high-risk population.

Sellar chondromas are extremely rare benign cartilaginous tumors, representing less than 0.3% of intracranial tumors. Their occurrence in the pediatric population is exceptionally rare and their clinical and radiological presentation frequently mimics that of more common sellar lesions, making preoperative diagnosis particularly challenging. The authors present the case of a 16-year-old female patient with a sellar chondroma treated via a transsphenoidal endoscopic approach and adjuvant radiosurgery. The patient presented with headache, bitemporal hemianopsia, and hormonal alterations. Preoperative imaging suggested craniopharyngioma as the leading diagnosis. Subtotal resection was performed due to firm tumor adherence to the medial wall of the right cavernous sinus, and histopathological examination confirmed the diagnosis of chondroma. Adjuvant radiosurgery was subsequently initiated for the residual tumor. This case highlights the importance of considering sellar chondroma in the differential diagnosis of heterogeneous sellar lesions in the pediatric population even when imaging suggests a more common entity. When gross-total resection is not achievable due to neurovascular involvement, adjuvant radiosurgery represents a safe complementary strategy. Definitive diagnosis relies on histopathological confirmation. https://thejns.org/doi/10.3171/CASE26226.

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Subepithelial lesions (SELs) in the lower gastrointestinal tract are rare, and diagnosis and treatment of colorectal SELs are often challenging. Although endoscopic ultrasound-guided tissue acquisition (EUS-TA) is useful for minimally invasive histological diagnosis, few reports have described its use for right-sided colonic SELs because advancing an oblique-viewing echoendoscope into the right colon is difficult. A 30-year-old woman was referred to our hospital after colonoscopy revealed a protruding cecal lesion suggestive of an SEL. Contrast-enhanced computed tomography showed a 37-mm contrast-enhancing mass and an adjacent lesion, thought to be an enlarged lymph node, and gastrointestinal stromal tumor was suspected. A forward-viewing echoendoscope was inserted transanally and advanced successfully to the cecum in 4&#xa0;min. EUS-TA of the cecal mass was performed using a 19-gauge fine-needle biopsy needle, and EUS-TA of the adjacent lesion was performed using a 25-gauge fine-needle biopsy needle. Histopathological and immunohistochemical examinations showed endometrial glands and stroma with positivity for estrogen receptor, progesterone receptor, and CD10, leading to a definitive diagnosis of endometriosis. This diagnosis enabled initial non-surgical management without immediate surgery.

This corrects the article on p. 279 in vol. 26, PMID: 41942360.