{
  "abstract": "Background General anesthesia (GA) with tracheal intubation is increasingly used for endoscopic submucosal dissection(ESD) to ensure procedural stability. A prior study developed an endoscopist-assisted endotracheal intubation (EAEI) technique. To verify the advantages and generalizability of EAEI, we compared EAEI with video laryngoscope(VL)-guided intubation.Methods In this prospective, single-blinded, randomized controlled trial conducted at Affiliated First Hospital of Ningbo University, patients undergoing upper gastrointestinal ESD under GA were randomized 1:1 to EAEI or VL-guided intubation. The primary outcome was preoperational time. Secondary outcome included intubation time, time to visualize the vocal cords (TVVC), time to advance the tracheal tube (TATT), first-attempt success, immediate and late complications.Results A total of 128 patients were included, with 64 patients in each group ( IDDF2026-ABS-0300 Figure 1). Preoperational time was significantly shorter with EAEI than with VL (median [IQR], 285 [114] s vs 513 [164] s, P < 0.001) (IDDF2026-ABS-0300 Figure 2). Intubation time was similar (20.0 [15.0–30.0] s vs 24.0 [18.3–29.0] s; P = 0.078), as were TVVC (7.0 [5.0–12.0] s vs 8.0 [6.0–12.0] s; P = 0.550). In group EAEI, TATT was significantly shorter (9.0 [7.3–12.8] s vs 13.0 [10.3–18.0] s; P = 0.001). First-attempt success was numerically higher with EAEI (96.9% vs 90.9%, P = 0.273) (IDDF2026-ABS-0300 Table 1). Immediate complications were lower with EAEI (7.8% vs 43.8%, P < 0.001), driven mainly by fewer soft tissue injuries (1.6% vs 29.7%, P < 0.001). Late complications were also reduced (4.7% vs 59.4%, P < 0.001), including sore throat (3.1% vs 51.6%, P < 0.001).Conclusions In upper gastrointestinal ESD under GA, EAEI may improve endoscopy unit efficiency and reduce airway-related complications without compromising intubation performance.Abstract IDDF2026-ABS-0300 Table 1Outcome parameters for patients allocated to tracheal intubation using a video laryngoscope or endoscopyParameterVideo laryngoscope(n=64)Endoscopy-assisted(n=64)P valueTracheal intubation successFirst attempt, n (%)58 (90.6%)62 (96.9%)0.273Second attempt, n (%)6 (9.4%)2 (3.1%)0.273Tracheal intubation timeIntubation time, Median (Q1, Q3), s24.0 (18.3, 29.0)20.0 (15.0, 30.0)0.078TVVC, Median (Q1, Q3), s8.0 (6.0, 12.0)7.0 (5.0, 12.0)0.550TATT, Median (Q1, Q3), s13.0 (10.3, 18.0)9.0 (7.3, 12.8)0.001Abstract IDDF2026-ABS-0300 Figure 1Abstract IDDF2026-ABS-0300 Figure 2",
  "authors": [
    {
      "affiliations": [
        "Health Science Center, Ningbo University, Ningbo, Zhejiang Province, China"
      ],
      "name": "Xinzhi Jiang"
    },
    {
      "affiliations": [
        "Department of Gastroenterology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China"
      ],
      "name": "Lei Xu"
    }
  ],
  "title": "IDDF2026-ABS-0300 Endoscopy-assisted versus video laryngoscope-guided endotracheal intubation for preoperative preparation of ESD: a prospective randomized controlled trial",
  "uid": "65a849f5-c3a0-5566-a287-ae7f121e4740"
}