{
  "abstract": "Background Endoscopic Direct-Vision Appendicitis Therapy (EDAT) has emerged as a pivotal minimally invasive intervention for acute uncomplicated and chronic appendicitis. Despite its increasing clinical adoption, a standardized endoscopic classification system to categorize luminal findings and guide subsequent therapeutic strategies is currently lacking. This study introduces the FIS classification system to provide a structured framework for the precision management of appendicitis during EDAT.Methods The FIS classification system evaluates three key pathological dimensions within the appendiceal lumen: Type F (Fecalith/Residue): Scored as 1 (fecal stones present), X (only fecal residue), or 0 (absence of both).Type I (Inflammatory Exudate): Scored as 1 (significant inflammatory exudate present) or 0 (only congestion and edema).Type S (Stenotic Type): Scored as 2 (luminal stenosis >50% due to fibrin), 1 (septum formation with stenosis <50%), or 0 (no stenosis). Tailored therapeutic interventions, including simple irrigation, basket stone removal, and stent drainage, were assigned based on the specific FIS profiles of 116 enrolled patients.Results Among the 116 patients treated via EDAT, specific FIS-guided interventions were implemented as follows: F0I0S0 (n=4): Successfully managed with simple irrigation. F1 Profiles: Patients with F1I0S0 (n=9) and F1I1S0 (n=28) primarily underwent simple irrigation combined with endoscopic basket stone removal. Inflammatory & Stenotic Profiles: Stent placement was frequently combined with irrigation for F0I1S0 (n=35), F0I1S1 (n=15), and FXI1S1 (n=6) patients. High-Grade Stenosis: F1I0S2 (n=2) patients required both irrigation and stent placement. Residual Findings: FXI0S1 (n=2) and F1I0S1 (n=7) patients were primarily managed with simple irrigation, while F1I1S1 (n=7) cases required simultaneous irrigation and stenting.Conclusions EDAT is an effective diagnostic and therapeutic modality for appendicitis. The FIS classification system offers a standardized and accurate grading method that enables endoscopists to implement personalized treatment strategies, potentially improving clinical outcomes and procedural precision.",
  "authors": [
    {
      "affiliations": [
        "The First Affiliated Hospital of Xi’an Medical University, China"
      ],
      "name": "Anna Li"
    },
    {
      "affiliations": [
        "The First Affiliated Hospital of Xi’an Medical University, China"
      ],
      "name": "Mingxin Zhang"
    }
  ],
  "title": "IDDF2026-ABS-0198 FIS classification system: a novel endoscopic guidance for the precision management of appendicitis via endoscopic direct-vision appendicitis therapy (EDAT)",
  "uid": "9cff87bd-6feb-528e-985e-2e8d7c6e6f43"
}