Objective To develop expert consensus on the environment and layout of digestive endoscopy center.The overall layout, area partition and the configuration of medical equipment, protective equipment and fire facilities were designed according to the principle of "definite function, matched quantity, safe specification, reasonable layout". To avoid the risk of infection control and improve operation safety and patient satisfaction.

A compilation team was established to conduct article search on several databases such as China National Knowledge Infrastructure (CNKI) according to relevant domestic and foreign guidelines and consensus to screen and grade evidence.The preliminary draft of the consensus was completed, and was discussed through two rounds of expert demonstration meetings to carry out adjustment and modification before the consensus was developed.

The consensus suggest the digestive endoscopy center consist six functional area: appointment waiting area, diagnosis and treatment area, cleaning and disinfection area, resuscitation area, office and public living area and medical auxiliary area. The contents cover the layout and environmental requirements and standards of the relevant functional areas of the digestive endoscopy center, as well as how to do a good job in the relevant medical care of the digestive endoscopy center.

The consensus item is simple, clear and easy to implement. The new content can complement and improve the existing norms and standards to a certain extent. It can provide reference standards for new, rebuilt and expanded endoscopic diagnosis and treatment centers and guide clinical practice.

In recent years, many hospitals both home and abroad have performed a series of surgeries under the concept of super minimally invasive surgery (SMIS), which highlights the advantages of SMIS.However, there is no expert consensus on wound pretreatment and antibiotic application for this type of surgery.This consensus aims to discuss the issues of wound pretreatment and antibiotic application in digestive endoscopic SMIS based on the best available scientific evidence.

Experts were recruited from the Super Minimally Invasive Surgery Group, ERCP Group, Ultrasound Endoscopy Group, Endoscopic Surgery Group, Early Gastrointestinal Cancer Collaborative Group, Esophageal Disease Collaborative Group, Gastric Disease Collaborative Group, Pancreatic Disease Collaborative Group and Endoscopic Tunneling Technology Group of Chinese Society of Digestive Endoscopology to form the expert group and a clinical question list was created.Each question was assigned to experts to form the statements which were then discussed and revised to reach agreement in 3 online and offline meetings between November 2022 and April 2023. Finally, the full statement collection was sent to all expert group members to grade the evidence, classify the statements, and vote on the strength of the statements.

Sixteen statements on surgical wound pretreatment and antibiotic application in four surgical channels of digestive endoscopic SMIS were formulated, including 5 statements on surgical wound pretreatment and 11 statements on antibiotic application.

The consensus on wound pretreatment and antibiotic application for digestive endoscopic SMIS is the first published among all societies. This consensus recommends that in the clinical practice of SMIS, endoscopists should fully consider the characteristics of different surgical channels, choose different wound pretreatment and antibiotic application methods, formulate isolation measures, strictly disinfect the endoscope, and use disposable sterile instruments to minimize the incidence of infection. In addition, multi-cavity channels involve the field of minimally invasive surgery, so surgical procedures should be followed at the same time.

To investigate the feasibility and safety of linaclotide capsule combined with low-dose compound polyethylene glycol electrolyte powder (PEG) as intestinal detergent before colonoscopy.

A total of 300 subjects who planned to undergo colonoscopy in the outpatient department of Baoding First Central Hospital from March 2022 to May 2022 were selected as the research objects. The subjects were randomly divided into three groups with 100 patients in each group by random number table. Group A was treated with 3 boxes of PEG alone, group B with 2 boxes of linaclotide capsules (290 μg/capsules) combined with 2 boxes of PEG intestinal cleanse, and group C with 3 boxes of linaclotide capsules combined with 2 boxes of PEG intestinal cleanse. The degree of intestinal cleanliness and the incidence of adverse events were compared among the three groups.

There were no significant differences in left colon, transverse colon, right colon and total Boston bowel Preparation Scale (BBPS) between group B and group A (P> 0.05). The left colon, transverse colon, right colon and total BBPS of group C were higher than those of group A, with statistical significance (P< 0.05). The left colon, transverse colon, right colon and total BBSP scores of group B were lower than those of group A, with statistical significance (P< 0.05). The incidence of adverse events in groups B and C was lower than that in group A, and the difference was statistically significant (P< 0.05). There was no significant difference between groups B and C (P> 0.05).

The intestinal cleanliness of 2 linaclotide capsules combined with 2 boxes of PEG is similar to that of 3 boxes of PEG alone. The intestinal cleansing effect of 3 linaclotide capsules combined with 2 boxes of PEG is better than that of 3 boxes of PEG alone. The incidence of adverse events was lower in the two drug combinations than in the three-box PEG alone.

To compare the efficacy of two different endoscopic resection methods in the treatment of rectal neuroendocrine tumors (NET) less than 10mm in diameter.

A total of 43 cases of rectal submucosal tumors from September 2019 to September 2022 were retrospectively collected. After relevant examination and treatment in our hospital, postoperative pathological findings of rectal neuroendocrine tumors were confirmed.27 cases were resected by ESD and 16 cases by CS-EMR. The size of lesion, resection area, resection time and postoperative pathological evaluation were compared between the two groups.

The surgical resection area of CS-EMR group and ESD group was (46.75±14.65) mm² and (185.96±117.33)mm², respectively P<0.05, operation time (13.69±3.95)min compared with (40.26±8.93) min, P<0.05, there were significant differences.There were no significant differences in R0 resection, vertical resection margin, vascular, lymphatic, nerve invasion, incidence of postoperative complications, and postoperative additional operation (P>0.05).

Both CS-EMR and ESD methods are safe and effective for carcinoids with a diameter of less than 1 cm located in the rectum without lymph node metastasis. New-style(CS-EMR) method is relatively simple to operate, and has advantages of short operation time and postoperative hospital stay. Compared with ESD method, there was no increase in the rate of positive postoperative margin and postoperative additional surgery.

To explore the clinical management strategy of patients with recurrent gastric low-grade intraepithelial neoplasia after radiofrequency ablation.

53 patients with recurrent gastric low-grade intraepithelial neoplasia who completed radiofrequency ablation in our center from October 2014 to September 2022 were retrospectively selected and divided into follow-up group and treatment group according to whether they received additional treatment. The relevant indicators of the two groups were compared and analyzed.

There were no significant differences in gender, age, course of disease, site of lesion and duration of follow-up between the two groups (P> 0.05), but the elimination rate of lesion in the treatment group was significantly better than that in the follow-up group (91.3% vs 43.3%, P< 0.001). However, there was no significant difference between the three surgical methods in the treatment group (P= 0.640).

Additional endoscopic ablation or resection is recommended for patients with recurrent gastric low-grade intraepithelial neoplasia after radiofrequency ablation.

To study clinical application value of Vonoprazan combined with amoxicillin for 7 day regimen of Helicobacter pylori eradication.

The clinical data of 100 cases of Hp infection admitted to the Gastroenterology Department of the Fifth Affiliated (Zhuhai) Hospital of Zunyi Medical University were divided into study group (Vonoprazan+ amoxicillin) and control group (Standard quadruple therapy). There were 50 patients in each group. Statistical analysis of Helicobacter pylori eradication, remission of clinical symptoms, occurrence of adverse reactions and cost-effectiveness of the two groups.

The radical cure rate was 94% in the study group and 88% in the control group, the difference was not statistically significant (P>0.05); The remission rate of clinical symptoms in the study group was 84%, Significantly higher than the 62% of the control group, The difference was statistically significant (P<0.05); The incidence of adverse reactions in the observation group was 12%, Significantly lower than the 54% of the control, The difference was statistically significant (P<0.05); The total cost of the study group was 143.02 yuan, and the total cost of the control group was 384.41 yuan, The cost of the study group was significantly lower than that of the control group.

The 7-day regimen containing Vonoprazan and amoxicillin can achieve the eradication rate of standard quadruple, the high remission rate of clinical symptoms, low adverse reactions, low cost, which is more worthy of promotion.

To explore the endoscopic ambulatory ward model and evaluate the safety and feasibility of endoscopic ambulatory procedures.

A total of 850 cases of patients were admitted in our endoscopic ambulatory ward from October 2016 to October 2017.The clinical data of patients, such as operation success rate, adverse event rate, patient transfer rate, hospitalization expenses were recorded and analyzed.

Of the 850 cases, 812 endoscopic ambulatory procedures were performed, and the success rate was 99.88%(811/812). Five cases experienced adverse events (2 immediate bleeding, 2 delayed bleeding, and 1 immediate perforation), but were managed endoscopically without asverse events in the follow-up.None was transferred to surgery.Due to potential risk of adverse events, 5 patients were transferred to general digestive ward and the transfer rate was 0.59%(5/850). The top 5 of endoscopic ambulatory procedures were colorectal polypectomy (525 cases), gastric polypectomy (112 cases), endoscopic dilation or resection for digestive tract stenosis (86 cases), endoscopic radiofrequency ablation for gastroesophageal superficial neoplasms(14 cases), EUS/FNA (12 cases) and endoscopic resection for esophageal leiomyoma or papilloma (12 cases).

Endoscopic ambulatory procedures are safety and feasible, such as colorectal or gastric polypectomy, endoscopic dilation or resection for digestive tract stenosis, endoscopic radiofrequency ablation and EUS/FNA.Our endoscopic ambulatory ward model and procedures may provide reference for other centers.