iGIE最新文献

{"title":"Use of intraoperative fluoroscopy to reduce post–peroral endoscopic myotomy reflux: a proof-of-concept study","authors":"Erica Loon DO ,&nbsp;Rahul Karna MD ,&nbsp;Amir Sultan Seid MD ,&nbsp;Mohammad Bilal MD ,&nbsp;Nabeel Azeem MD","doi":"10.1016/j.igie.2025.02.003","DOIUrl":"10.1016/j.igie.2025.02.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Post–peroral endoscopic myotomy (POEM) gastroesophageal reflux is a common adverse event. Intraoperative fluoroscopy (IOF) can help identify the gastroesophageal junction (GEJ) during submucosal tunneling and evaluate the extent of myotomy into the stomach during POEM. In this study, we investigated the use of IOF to predict and prevent post-POEM GERD (PPG).</div></div><div><h3>Methods</h3><div>This was a retrospective review of all patients who underwent POEM with IOF at our institution. A blinded gastroenterologist measured the fluoroscopic angle (FA) between the endoscope tip at the GEJ, before submucosal tunneling, and at the distal extent of the submucosal tunnel into the cardia. The FA was compared in patients with and without PPG at 3 and 12 months.</div></div><div><h3>Results</h3><div>Sixty-seven patients were included. The median FA was wider in patients on a proton pump inhibitor at 3 months (10.30 vs –1.35 degrees, <em>P</em> = .28) and 12 months (6.20 vs –1.05 degrees, <em>P</em> = .46) and in patients with presence of heartburn symptoms at 3 months (6.20 vs 2.35 degrees, <em>P</em> = .49) and 12 months (15.10 vs 0.15 degrees, <em>P</em> = .16).</div></div><div><h3>Conclusions</h3><div>Our study suggests that IOF could be used to tailor the myotomy to preserve sling fibers and in turn reduce PPG. Although our findings did not show statistical significance, the trend toward increased PPG in patients with a wider FA warrants a prospective controlled study to further test this hypothesis.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 3","pages":"Pages 213-217"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of esophageal epidermoid metaplasia following eradication of squamous cell carcinoma","authors":"Lesline E. Martes BS ,&nbsp;Dharma Ayer BS ,&nbsp;Hasan B. Aydin MD ,&nbsp;Hwajeong Lee MD ,&nbsp;Kunal Jajoo MD ,&nbsp;Micheal Tadros MD, MPH","doi":"10.1016/j.igie.2025.05.007","DOIUrl":"10.1016/j.igie.2025.05.007","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 3","pages":"Pages 255-256"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of magnifying endoscopy in detecting vessels after gastric endoscopic submucosal dissection","authors":"Xiang Yang MBBS ,&nbsp;Tao Dong MD ,&nbsp;Chao Yu MD ,&nbsp;Yaohui Wang MD ,&nbsp;Jun Xiao MD","doi":"10.1016/j.igie.2025.06.004","DOIUrl":"10.1016/j.igie.2025.06.004","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 3","pages":"Pages 259-260"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnifying endoscopy with novel image enhancement technology for gastrointestinal tumors","authors":"Rui Gong MM ,&nbsp;Bing Yue MD, PhD ,&nbsp;Xiujing Sun MD, PhD ,&nbsp;Shutian Zhang MD, PhD ,&nbsp;Peng Li MD, PhD ,&nbsp;Rui Cheng MD, PhD","doi":"10.1016/j.igie.2025.05.003","DOIUrl":"10.1016/j.igie.2025.05.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>A new magnifying endoscope system applying novel endoscopic image enhancement technology of spectral focused imaging (SFI) and versatile intelligent staining technology (VIST) has been developed. This study aimed to evaluate the technical feasibility and the utility of the detection and diagnosis of gastrointestinal tumors.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed and analyzed the endoscopic images of 6 digestive tract lesions in 4 patients detected with a SonoScape magnifying endoscope (SonoScape Medical Corp, Guangdong, China). The demographics, endoscopic and histopathologic features, and outcomes of the cases were analyzed.</div></div><div><h3>Results</h3><div>By varying the imaging mode of SFI and VIST, we could obtain enhanced endoscopic images clearly revealing esophageal intraepithelial capillary loop, gastric microvascular and microsurface, and colorectal pit pattern. These images significantly improved the efficiency of clinical diagnosis and were consistent with pathologic diagnoses.</div></div><div><h3>Conclusions</h3><div>Our study demonstrated that a novel magnifying endoscope system using SFI/VIST may be useful for diagnosis of gastrointestinal tumors.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 3","pages":"Pages 264-269"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic balloon dissection to remove a percutaneously placed biliary stent with tissue ingrowth: a novel approach","authors":"Abdulrahman Qatomah MBBS","doi":"10.1016/j.igie.2025.03.003","DOIUrl":"10.1016/j.igie.2025.03.003","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 3","pages":"Pages 249-251"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-session endoscopic retrograde cholangiopancreatography and endoscopic ultrasound—guided gallbladder drainage for management of biliary obstruction and gallbladder disease","authors":"Christina S. Gainey MD,&nbsp;Govind Kallumkal MD,&nbsp;Judy A. Trieu MD, MPH,&nbsp;Kelly E. Hathorn MD,&nbsp;Todd H. Baron MD","doi":"10.1016/j.igie.2025.02.001","DOIUrl":"10.1016/j.igie.2025.02.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Conventional management of biliary obstruction is endoscopic retrograde cholangiopancreatography (ERCP) followed by cholecystectomy to prevent recurrent biliary events, particularly when the indication is choledocholithiasis. In nonsurgical candidates, endoscopic ultrasound (EUS)—guided gallbladder drainage (EUS-GBD) is a first-line alternative for gallbladder decompression. Single-session ERCP and EUS-GBD provides definitive management of biliary obstruction and prevention of future biliary adverse events (AEs) without the need for surgical cholecystectomy or repeat intervention. Our study is the first in the United States to evaluate outcomes of patients who underwent ERCP and EUS-GBD for management of both malignant and benign biliary disease.</div></div><div><h3>Methods</h3><div>This is a retrospective review of patients who underwent single-session ERCP and EUS-GBD at the University of North Carolina from January 1, 2014, to November 1, 2023. Patient demographics, comorbidities, procedure details, and follow-up were recorded. Outcomes included technical and clinical success, short and long-term AEs, need for reintervention, and death.</div></div><div><h3>Results</h3><div>During the study period, 37 patients were included. Indications for ERCP and EUS-GBD were choledocholithiasis and cholelithiasis in 24 patients, malignant biliary obstruction and concomitant cholecystitis in 9, and benign biliary stricture and concomitant cholecystitis in 4. The mean (standard deviation) Charlson Comorbidity Index was 7.1 (2.6). Technical success for EUS-GBD was 97.3%, and overall clinical success for combined ERCP and EUS-GBD was 86.5%. Three early (8.1%) and 1 late (2.7%) AEs occurred. Early AEs included stent misdeployment, duodenal perforation, and post-ERCP fever. The late AE involved stent migration. None of the AEs resulted in mortality. Mean follow-up time was 312 (407) days. Four patients (10.8%) required a procedure for reintervention and 1 patient required a follow-up surgery. No patients required a follow-up surgical cholecystectomy.</div></div><div><h3>Conclusions</h3><div>Single-session ERCP and EUS-GBD appears effective for the management of both benign and malignant biliary obstruction and concomitant gallbladder disease with minimal AEs and without the need for surgical cholecystectomy. Larger prospective studies are needed to confirm these early findings.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 2","pages":"Pages 105-109"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency vapor ablation for duodenal mucosal ablation in the treatment of type 2 diabetes: results from the first-in-human pilot study","authors":"Benjamin Charles Norton MD ,&nbsp;Apostolis Papaefthymiou MD ,&nbsp;Andrea Telese MD ,&nbsp;Alex Neiponice MD ,&nbsp;Pablo Becerra Hoebel MD ,&nbsp;Paulina Vignolo MD ,&nbsp;Leonardo A. Rodriguez Grunert MD ,&nbsp;Rehan Haidry MD","doi":"10.1016/j.igie.2025.03.008","DOIUrl":"10.1016/j.igie.2025.03.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Duodenal mucosal ablation (DMA) is an emerging endoscopic treatment modality for type 2 diabetes (T2D). The radiofrequency vapor ablation (RFVA) system (Aqua Medical Inc, Pleasanton, Calif, USA) is a single-use, through-the-scope, circumferential ablation catheter under investigation for DMA. In this pilot study, we assessed the safety, tolerability, procedural feasibility, and initial efficacy of RFVA.</div></div><div><h3>Methods</h3><div>We conducted a first-in-human, prospective, single-center trial enrolling 27 patients with poorly controlled T2D (glycated hemoglobin [HbA1c], 7.5%-10%) despite ≥1 oral antidiabetic drug. DMA was performed with the patient under anesthesia in several dose titrations as follows: safety cohort (180 J once, n = 2), first treatment cohort (180 J twice, n = 11), and second treatment cohort (200 J twice; n = 14). Primary outcomes were safety (number of serious adverse events [SAEs]), tolerability (based on a visual analog scale [VAS] pain score), feasibility (procedure time), and initial efficacy (change in HbA1c at 4, 12, and 24 weeks).</div></div><div><h3>Results</h3><div>Twenty-seven patients with a mean T2D duration of 6 years (standard deviation [SD], 2.6) underwent DMA with 100% technical success. Mean patient age was 54 years (SD, 6.6), 48% were men, and baseline HbA1c was 8.6% (SD, 0.6). Mean procedure time was 49.7 minutes (SD, 14.3) and catheter time 34.5 minutes (SD, 10.9). There were no SAEs, and the maximum mean VAS pain score was 1.4 (SD, 2.1) on day 2. We observed a change in HbA1c at 4 weeks (–0.9%), 12 weeks (–1.2%), and 24 weeks (–0.8%) after the procedure.</div></div><div><h3>Conclusions</h3><div>DMA using the RFVA system is a simple through-the-scope procedure that appears safe, well tolerated, and feasible for the treatment of T2D. (Clinical trial registration number: NCT05887635.)</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 2","pages":"Pages 110-119"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Durable insulin elimination after duodenal re-cellularization via electroporation therapy combined with glucagon-like peptide-1 receptor agonist in patients with type 2 diabetes","authors":"Celine B.E. Busch MD ,&nbsp;Kim van den Hoek MD ,&nbsp;Annieke C.G. van Baar MD, PhD ,&nbsp;Suzanne Meiring MD, PhD ,&nbsp;Thomas A. Bouwmeester MD, PhD ,&nbsp;Frits Holleman MD, PhD ,&nbsp;Max Nieuwdorp MD, PhD ,&nbsp;Jacques J.G.H.M. Bergman MD, PhD","doi":"10.1016/j.igie.2025.03.012","DOIUrl":"10.1016/j.igie.2025.03.012","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Re-cellularization via electroporation therapy (ReCET) is an endoscopic procedure that uses electroporation to induce cellular apoptosis and subsequent re-epithelization in the duodenum. ReCET has demonstrated a positive effect on glycaemia. In this study, a single ReCET procedure was combined with a glucagon-like peptide-1 receptor agonist (GLP-1RA) with the goal of eliminating insulin treatment in patients with type 2 diabetes (T2D). At 12 months 86% of patients remained off insulin. Here we report the longer-term efficacy and safety of ReCET combined with GLP-1RA over 24 months.</div></div><div><h3>Methods</h3><div>This was a first-in-human study in patients with T2D on basal insulin (28-75 years of age; body mass index, 24-40 kg/m²; hemoglobin A_1c [HbA_1c], ≤64 mmol/mol; C-peptide, ≥0.2 nmol/L). All of the patients underwent ReCET, after which insulin was discontinued and semaglutide (GLP-1RA) was initiated. The follow-up was extended to 24 months for initial responders (off insulin and HbA_1c ≤58 mmol/mol at 12 months). Primary end points were number of responders (efficacy) and number of adverse events, serious adverse events, and hypoglycemic events (safety). Secondary end points included glycemic, metabolic, and cardiovascular parameters, and treatment satisfaction scores.</div></div><div><h3>Results</h3><div>Fourteen patients underwent endoscopic ReCET. Eleven initial responders completed the 24-month follow-up, of which 1 withdrew consent after 18 months. All patients remained off insulin with adequate glycemic control. No procedure-related serious adverse events or severe hypoglycemic events were observed during 24 months of follow-up. Homeostatic model assessment of insulin resistance and liver fat percentage improved significantly compared with baseline.</div></div><div><h3>Conclusions</h3><div>These results suggest that duodenal ReCET combined with semaglutide is durable, allowing insulin elimination up to 24 months, and appears safe. Glycemic control was maintained, and metabolic health improved during the 24-month follow-up period.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 2","pages":"Pages 120-128.e1"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lifetime of pushing boundaries: thinking outside the box to endoscopically treat complex gastrointestinal diseases","authors":"Todd H. Baron MD, MASGE ,&nbsp;Phillip S. Ge MD, FASGE","doi":"10.1016/j.igie.2025.03.011","DOIUrl":"10.1016/j.igie.2025.03.011","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 2","pages":"Pages 167-193"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Needle-knife papillotomy for removal of impacted fully covered self-expandable metal stent","authors":"Pang Yong MD,&nbsp;Wang Tao MD,&nbsp;Zhang Hui MB,&nbsp;Luo Zhu-lin MD,&nbsp;Xie Chuan MA,&nbsp;Tian Fu-zhou MD","doi":"10.1016/j.igie.2025.03.002","DOIUrl":"10.1016/j.igie.2025.03.002","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 2","pages":"Pages 151-153"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144322145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}