Non-exposed endoscopic wall-inversion surgery with one-step nucleic acid amplification for early gastrointestinal tumors - Personal experience and literature review

Sep 24, 2026

Uploaded by Connor

Laparoscopic and endoscopic cooperative surgery can achieve full-thickness resection with adequate margins, but tumor and mucosa exposure to the peritoneal cavity may permit cancer cell seeding and spillage of gastric or enteric fluids. Non-exposed endoscopic wall-inversion surgery (NEWS) aims to prevent intraperitoneal contamination by inverting the tumor into the visceral lumen. This study assesses NEWS safety and feasibility in early gastric and colon cancers and evaluates adding rapid intraoperative lymph node assessment using OSNA.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Abstract

Background

Aim

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| W | J | G | World Journal of
Gastroenterology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2023 June 28; 29(24): 3883-3898 DOI: 10.3748/wjg.v29.i24.3883 ISSN 1007-9327 (print) ISSN 2219-2840 (online) ORIGINAL ARTICLE Observational Study Non-exposed endoscopic wall-inversion surgery with one-step nucleic acid amplification for early gastrointestinal tumors: Personal experience and literature review Francesco Crafa, Serafino Vanella, Aristide Morante, Onofrio A Catalano, Kelsey L Pomykala, Mario Baiamonte, Maria Godas, Alexandra Antunes, Joaquim Costa Pereira, Valentina Giaccaglia Specialty type: Surgery Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s scientific quality classification Grade A (Excellent): 0 Grade B (Very good): 0 Grade C (Good): C, C Grade D (Fair): 0 Grade E (Poor): 0 P-Reviewer: Goto O, Japan; Guo X, China Received: March 25, 2023 Peer-review started: March 25, 2023 First decision: April 21, 2023 Revised: May 11, 2023 Accepted: May 31, 2023 Article in press: May 31, 2023 Published online: June 28, 2023 Francesco Crafa, Serafino Vanella, Mario Baiamonte, Maria Godas, Division of General and Surgical Oncology, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, Avellino 83100, Italy Aristide Morante, Division of Gastorenterology and Endoscopy, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, Avellino 83100, Italy Onofrio A Catalano, Department of Radiology, Athinoula A Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States Kelsey L Pomykala, Department of Nuclear Medicine, Department of Radiological Sciences, University Hospital Essen, University of Duisburg-Essen, Essen 45141, Germany Alexandra Antunes, Joaquim Costa Pereira, Department of General Surgery, Braga Hospital, Braga 4710-243, Portugal Valentina Giaccaglia, Department of Surgery, Medclinic City Hospital, Dubai 505004, United Arab Emirates Corresponding author: Serafino Vanella, MD, PhD, Doctor, Surgeon, Surgical Oncologist, Division of General and Surgical Oncology, St. Giuseppe Moscati Hospital, Center of National Excellence and High Specialty, C/da Amoretta, Avellino 83100, [Italy.](Italy. nekroma@yahoo.it)[ nekroma@yahoo.it](Italy. nekroma@yahoo.it) Abstract BACKGROUND Laparoscopic and endoscopic cooperative surgery is a safe, organ-sparing surgery that achieves full-thickness resection with adequate margins. Recent studies have demonstrated the safety and efficacy of these procedures. However, these techniques are limited by the exposure of the tumor and mucosa to the peritoneal cavity, which could lead to viable cancer cell seeding and the spillage of gastric juice or enteric liquids into the peritoneal cavity. Non-exposed endoscopic wallinversion surgery (NEWS) is highly accurate in determining the resection margins to prevent intraperitoneal contamination because the tumor is inverted into the visceral lumen instead of the peritoneal cavity. Accurate intraoperative asse- WJG [https://www.wjgnet.com](https://www.wjgnet.com) 3883 June 28, 2023 Volume 29 Issue 24 Crafa F et al. NEWS-OSNA for early gastrointestinal tumors ssment of the nodal status could allow stratification of the extent of resection. One-step nucleic acid amplification (OSNA) can provide a rapid method of evaluating nodal tissue, whilst nearinfrared laparoscopy together with indocyanine green can identify relevant nodal tissue intraoperatively. AIM To determine the safety and feasibility of NEWS in early gastric and colon cancers and of adding rapid intraoperative lymph node (LN) assessment with OSNA. METHODS The patient-based experiential portion of our investigations was conducted at the General

FAQs

What problem does NEWS address in early gastrointestinal tumor surgery?

NEWS aims to reduce intraperitoneal contamination by preventing tumor and mucosa exposure to the peritoneal cavity, using tumor inversion into the visceral lumen rather than direct exposure.

What was the aim of this observational study?

To determine the safety and feasibility of NEWS in early gastric and colon cancers and to assess feasibility of adding rapid intraoperative lymph node evaluation with OSNA.

What were the main outcomes regarding lymph nodes and resection completeness?

OSNA detected no lymph node metastases in any patient, and histologically complete (R0) resection was achieved in 9 of 10 patients, with no recurrence during follow-up.

Sep 24, 2026

Uploaded by Connor