iGIE最新文献

{"title":"Neural ablation as a mechanism of action for antral myotomy in the treatment of obesity","authors":"Pichamol Jirapinyo MD, MPH, Christopher C. Thompson MD, MSc, Sohail Shaikh MD, Nitin Kumar MD","doi":"10.1016/j.igie.2024.07.006","DOIUrl":"10.1016/j.igie.2024.07.006","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Page 366"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of phosphorus-32 microparticle intratumoral implantation added to chemotherapy in patients with metastatic pancreatic adenocarcinoma","authors":"Amanda Huoy Wen Lim MBBS, FRACP, MMedStats ,&nbsp;Nimit Singhal MBBS, FRACP ,&nbsp;Dylan Bartholomeusz MBBS, FRACP, PhD ,&nbsp;Joshua Zobel BMedSc, GradDipBiostats ,&nbsp;Jeevinesh Naidu MB ChB, MRCP ,&nbsp;William Hsieh BPharmSc ,&nbsp;Benjamin Crouch BSc(Hons), MPhil ,&nbsp;Harpreet Wasan MBBS, MRCP ,&nbsp;Daniel Croagh MBBS, PhD, FRACS ,&nbsp;Adnan Nagrial MBBS, FRACP, PhD ,&nbsp;Morteza Aghmesheh MBBS, FRACP, PhD ,&nbsp;Edmund Tse MBBS, FRACP, PhD ,&nbsp;Christopher K. Rayner MBBS, FRACP, PhD ,&nbsp;Nam Quoc Nguyen MBBS, FRACP, PhD","doi":"10.1016/j.igie.2024.06.005","DOIUrl":"10.1016/j.igie.2024.06.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Metastatic pancreatic ductal adenocarcinoma (mPDAC) has a 5-year survival rate of 3%. In nonmetastatic, locally advanced pancreatic cancer, the addition to chemotherapy of EUS-guided intratumoral phosphorus-32 (³²P) microparticle implantation has achieved good local disease control. The aim of this study was to report the clinical outcomes of this treatment in patients with mPDAC.</div></div><div><h3>Methods</h3><div>Patients with mPDAC treated with chemotherapy and intratumoral ³²P-microparticles from 5 centers in Australia and the United Kingdom were analyzed retrospectively.</div></div><div><h3>Results</h3><div>Fourteen patients were treated (7 female subjects; median age, 64.5 years; Eastern Cooperative Oncology Group performance status scores 0/1/2, 21.4%/57.1%/21.4%). The median baseline primary tumor longest diameter was 40.5 mm. Patients had a median of 3 metastases (interquartile range, 2.25 to 5) and received either 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (n = 4) or gemcitabine/nab-paclitaxel (n = 10). ³²P microparticles were implanted at a median 3.1 months from chemotherapy commencement. Local disease control rate at 3 months’ postimplantation was 100%. Primary tumor longest diameter decreased by 25% (interquartile range, –31.4% to –16.7%; <em>P</em> = .008), and serum cancer antigen 19-9 levels declined from 134 U/mL to 66 U/mL (<em>P</em> = .018). Local progression-free survival was 12.2 months (95% CI, 9.0-15.4 months) from chemotherapy commencement and 8.3 months (95% CI, 2.6-16.0 months) from ³²P microparticle implantation. Therapy was associated with improved quality of life, including global health status at 12 weeks’ postimplantation (<em>P</em> = .037). Median overall survival was 13.8 months (95% CI, 10.5-17.1 months) from chemotherapy commencement and 11 months (95% CI, 5.6-17.4 months) from ³²P microparticle implantation. No grade 4/5 acute toxicities were observed.</div></div><div><h3>Conclusions</h3><div>This first multicenter analysis of combined chemotherapy and EUS-guided ³²P microparticle implantation in mPDAC shows the potential clinical benefits of local tumor control in a cohort for whom outcomes are historically poor.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 373-381"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of hard candy on saliva production and gastric fluid volume: implications for safe endoscopy","authors":"Saleh Alghsoon MD ,&nbsp;Madeline Alizadeh PhD ,&nbsp;William H Scott, MA ,&nbsp;Guofeng Xie MD ,&nbsp;Jean-Pierre Raufman MD ,&nbsp;Erik C. von Rosenvinge MD","doi":"10.1016/j.igie.2024.07.008","DOIUrl":"10.1016/j.igie.2024.07.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Patients presenting for endoscopic procedures consuming or having recently consumed hard candy may have their procedures delayed or canceled because of concern for aspiration. Our aim is to determine the time needed after ingestion of hard candy for the safe performance of sedated endoscopy.</div></div><div><h3>Methods</h3><div>A 2-phase institutional review board–approved study was performed. In phase 1, healthy adults collected their oral secretions before and after ingestion of hard candy to measure the impact of hard candy on saliva production. In phase 2, patients undergoing clinical upper endoscopy were randomized to receive hard candy (HC group) or not receive hard candy (no-HC group) approximately 30 minutes before endoscopy. Blinded endoscopists aspirated gastric fluid immediately after gastric intubation and measured its volume and weight. Participants were assessed for adverse events.</div></div><div><h3>Results</h3><div>Ten healthy volunteers (6 women; median age, 28 years) were enrolled in phase 1. Saliva production peaked at the collection 10 minutes after initiating hard candy. The mean time from candy completion for saliva production to return to within 10% of unstimulated levels was 32 minutes (standard deviation, 12). In phase 2, 63 participants were randomized and had gastric fluid volumes and weights measured. The mean gastric fluid volume was 23.3 mL in the HC group and 17.6 mL in the no-HC group (<em>P</em> = .21). No adverse events were attributable to study participation.</div></div><div><h3>Conclusions</h3><div>Our results suggest that endoscopic procedures can be safely performed after ingestion of hard candy and should not be delayed by more than 30 minutes.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 418-423.e1"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142420536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling a rare adverse event: sponge migration during endoscopic vacuum therapy for colorectal anastomotic leak","authors":"","doi":"10.1016/j.igie.2024.02.005","DOIUrl":"10.1016/j.igie.2024.02.005","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 367-370"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139878549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peroral cholecystoscopy–guided interventions through a lumen-apposing metal stent after EUS-guided gallbladder drainage: proof-of-concept study in a swine model","authors":"Naminatsu Takahara MD, PhD ,&nbsp;Yousuke Nakai MD, PhD ,&nbsp;Tatsuya Sato MD, PhD ,&nbsp;Ryunosuke Hakuta MD, PhD ,&nbsp;Hiroki Oyama MD, PhD ,&nbsp;Kensaku Noguchi MD, PhD ,&nbsp;Tatsunori Suzuki MD, PhD ,&nbsp;Kazunaga Ishigaki MD, PhD ,&nbsp;Tomotaka Saito MD, PhD ,&nbsp;Tsuyoshi Hamada MD, MPH, PhD ,&nbsp;Mitsuhiro Fujishiro MD, PhD","doi":"10.1016/j.igie.2024.07.001","DOIUrl":"10.1016/j.igie.2024.07.001","url":null,"abstract":"<div><h3>Background and Aims</h3><div>EUS-guided gallbladder drainage (EUS-GBD) using a lumen-apposing metal stent (LAMS), originally developed as drainage for cholecystitis, enables endoscopic access into the gallbladder lumen. However, few studies have investigated the feasibility of peroral cholecystoscopy (POCCS)-guided interventions through a LAMS.</div></div><div><h3>Methods</h3><div>EUS-GBD using a LAMS followed by POCCS-guided interventions were performed in 4 swine. Technical success, safety, and feasibility of POCCS visualization and POCCS-guided biopsy sampling and mucosal resection through the LAMS immediately and 3 weeks after EUS-GBD were investigated. Additionally, all specimens including necropsy were pathologically evaluated.</div></div><div><h3>Results</h3><div>POCCS and target biopsy sampling were successful through the LAMS in all swine immediately after EUS-GBD, without any adverse events. POCCS-guided biopsy sampling and mucosal resection 3 weeks after EUS-GBD were technically feasible and pathologically assessable in all swine. The necropsy specimens displayed hyperplastic and inflammatory changes in the gallbladder and nearby organs after 3 weeks of EUS-GBD.</div></div><div><h3>Conclusions</h3><div>POCCS-guided interventions including mucosal resection were technically feasible through a LAMS after EUS-GBD.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 3","pages":"Pages 352-357"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic treatment of nonoperable large postsurgical esophageal fistulas: retrospective analysis of a single tertiary center cohort","authors":"Sebastian Petruzzella MSc ,&nbsp;Elodie Romailler MD ,&nbsp;Thomas Greuter PD, MD ,&nbsp;Sarra Oumrani MD ,&nbsp;Domenico Galasso MD ,&nbsp;Maxime Robert MD ,&nbsp;Styliani Mantziari PD, MD ,&nbsp;Markus Schäfer Pr, MD ,&nbsp;Sébastien Godat PD, MD","doi":"10.1016/j.igie.2024.03.001","DOIUrl":"10.1016/j.igie.2024.03.001","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Anastomotic fistulas are a frequent and dreaded adverse event of esophagectomy. Endoscopic therapy using different techniques is now a well-established first-line treatment option. The aim of our study was to evaluate the efficacy of such endoscopic treatments in patients not fit for surgical reintervention and particularly in cases of major tissue defects of &gt;10 mm.</p></div><div><h3>Methods</h3><p>Fifty-seven patients with postoperative large esophageal fistulas who were not considered for surgical reintervention were retrospectively analyzed after undergoing treatment with different endoscopic techniques in a single tertiary center. The primary endpoint was to evaluate the technical and clinical efficacy of endoscopic treatments of those fistulas. The secondary endpoint was to evaluate the endoscopic treatment–related adverse events.</p></div><div><h3>Results</h3><p>In 94.7% of patients (n = 54), the intervention was effectively carried out from a technical point of view. In 77.2% of patients (n = 44), treatment led to successful complete closure of the fistula. If we consider the 54 patients in whom technical success was reached, in 75.9% of them (n = 41), clinical success with complete closure of the fistula was achieved. Minor adverse events related to the procedure occurred in 26.32% of patients (n = 15) and major adverse events in 8.8% (n = 5). The mortality rate related to the procedure was 3.5% (n = 2).</p></div><div><h3>Conclusions</h3><p>Endoscopic treatment is a technically achievable, highly effective way of treating postoperative large esophageal fistulas in patients who were not considered fit for surgical treatment, including major defects of &gt;10 mm. It allows patients with a high risk of rapid deterioration to safely recover from their condition, avoiding severe and fatal adverse events without having to resort to debilitating surgical treatment.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 210-215"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000323/pdfft?md5=0f63d84c92f64e8254998570e11639c3&pid=1-s2.0-S2949708624000323-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140399189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrograde balloon pull-through technique for benign esophageal strictures: a single-center pilot experience","authors":"Shae Patel DO ,&nbsp;Andrew Wright MD ,&nbsp;Paul Leonor MD ,&nbsp;Wasseem Skef MD","doi":"10.1016/j.igie.2024.03.002","DOIUrl":"10.1016/j.igie.2024.03.002","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Antegrade savary dilation and static balloon dilation are the mainstays of management of simple and complex benign esophageal strictures (BESs). A modified technique, termed retrograde balloon dilation, has potential advantages for the management of BESs. Efficacy and safety data on this technique are limited. We report a single-center experience of retrograde balloon dilation for BESs.</p></div><div><h3>Methods</h3><p>We conducted a retrospective study evaluating retrograde balloon and antegrade savary dilation for BESs in 53 unique patients who met inclusion criteria, including 23 undergoing a retrograde balloon pull-through technique and 30 undergoing antegrade savary dilation. The primary endpoint was technical success, defined as achieving a luminal diameter of ≥16 mm. Secondary endpoints were repeat dilation rates within 1 year after achieving therapeutic endpoint dilation and adverse events.</p></div><div><h3>Results</h3><p>Technical success was achieved in 22 of 23 patients (95.7%) with the retrograde balloon pull-through technique and in all 30 patients (100%) with antegrade savary dilation (<em>P</em> = .434). A nonsignificant trend of lower repeat dilation rates was present for the retrograde balloon pull-through group, with 4 of 22 in the retrograde balloon pull-through group versus 12 of 30 in the antegrade savary dilation group (<em>P</em> = .076). Only 1 minor adverse event occurred in the retrograde balloon pull-through group.</p></div><div><h3>Conclusions</h3><p>Our experience suggests that retrograde balloon pull-through dilation is effective and safe for simple and complex benign esophageal stenosis.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 216-221"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000335/pdfft?md5=c4083a9bc45686b3c4a5dcfe96b649ba&pid=1-s2.0-S2949708624000335-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140407644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring human–artificial intelligence interactions in a negative pragmatic trial of computer-aided polyp detection","authors":"Kate Watkins BS ,&nbsp;Uri Ladabaum MD, MS ,&nbsp;Esther Olsen MHA ,&nbsp;Jonathan Hoogerbrug MBBS ,&nbsp;Ajitha Mannalithara PhD ,&nbsp;Yingjie Weng MHS ,&nbsp;Blake Shaw MS ,&nbsp;Roger Bohn PhD ,&nbsp;Sara Singer MBA, PhD","doi":"10.1016/j.igie.2024.04.016","DOIUrl":"10.1016/j.igie.2024.04.016","url":null,"abstract":"<div><h3>Background and Aims</h3><p>The progress of artificial intelligence (AI) in endoscopy is at a crossroads. The positive results of randomized controlled trials of computer-aided detection (CADe) have not been replicated in multiple pragmatic CADe trials, including ours. This gap between efficacy and effectiveness remains to be understood. We surveyed and interviewed our trial’s colonoscopists to gain insight into human-AI interactions.</p></div><div><h3>Methods</h3><p>We used a sequential, mixed-methodology design. After the trial, we administered Survey 1, focusing on attitudes and beliefs before and after trying CADe. The trial’s null results were disclosed, and we then administered Survey 2 and conducted open-ended interviews, focusing on reactions to the null results. Responses were analyzed overall and by baseline adenoma detection rate (ADR) tertile. We identified key themes using thematic analysis and qualitative software.</p></div><div><h3>Results</h3><p>Nearly all colonoscopists responded (22 and 21 of 24 [92% and 88%] for Surveys 1 and 2, respectively). Most (96%) regarded endoscopic ability as critical to their professional identity. Large majorities conveyed trust in and enthusiasm for AI before and after trying CADe (82%-87%) and desired to have CADe available (72%). Nearly two-thirds (62%) were surprised by the null results. There were few differences by ADR. No unifying explanation for the null results emerged from surveys or individual interviews. Colonoscopists expressed a range of expectations for AI in endoscopy.</p></div><div><h3>Conclusions</h3><p>Lack of enthusiasm or mistrust of AI/CADe do not explain our pragmatic CADe trial’s null results. AI may need to target dimensions beyond optical recognition to realize its promise in endoscopy.</p></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 274-285.e10"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000499/pdfft?md5=f0f11d67d92c9d30275a2d7055aa931c&pid=1-s2.0-S2949708624000499-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel point-of-care capsule to detect upper GI bleeding: initial real-world cases","authors":"Daniel Szvarca MD ,&nbsp;Trent Walradt MD ,&nbsp;Amit Grover MD ,&nbsp;Linda Lee MD","doi":"10.1016/j.igie.2024.02.004","DOIUrl":"10.1016/j.igie.2024.02.004","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 174-177"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000165/pdfft?md5=bb98406ae27e3b9371a39f154fcc1de6&pid=1-s2.0-S2949708624000165-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139880583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrathoracic cholecystitis managed with endoscopic gallbladder drainage","authors":"Andrea Huang MBBS, MPH ,&nbsp;Thomas Williams MBBS ,&nbsp;Nivene Saad MBBS ,&nbsp;Adam Frankel MBBS ,&nbsp;Zaki Hamarneh MD ,&nbsp;Shwan Karim MBBS, MSc ,&nbsp;Adrian Maher MD, MMed","doi":"10.1016/j.igie.2024.04.010","DOIUrl":"10.1016/j.igie.2024.04.010","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 2","pages":"Pages 191-192"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949708624000438/pdfft?md5=5e6dbe6aec4749a3b586ee033d6f5ecb&pid=1-s2.0-S2949708624000438-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}