iGIE最新文献

{"title":"Recommendations for endoscopy and sedation in the lactating patient","authors":"Lauren D. Feld MD ,&nbsp;Katherine M. Cooper MD ,&nbsp;Shara I. Feld MD, PhD ,&nbsp;Sarah Gray MD ,&nbsp;Amy S. Oxentenko MD","doi":"10.1016/j.igie.2025.01.008","DOIUrl":"10.1016/j.igie.2025.01.008","url":null,"abstract":"<div><div>Lactation is common amongst patients of childbearing age, providing a valuable nutrition source for their infants. There are several concerns to balance with lactating patients in the procedural setting, including interrupted lactation, milk supply, and child safety. However, clinicians have variable comfort with and training in counseling regarding periprocedural lactation. Anecdotally, the authors have noted many endoscopy centers do not use a standardized or guideline-based approach with lactating patients. In this article, we will (1) briefly review the safety and impact of periendoscopy medications on breastmilk and breastmilk supply, and (2) describe our approach for the lactating patient undergoing endoscopy.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 75-77.e2"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698011","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 ultrasound–guided fine-needle biopsy as a novel approach for risk stratification of pancreatic cystic lesions","authors":"Ghazal Hashemipour Moussavi BS ,&nbsp;Maria F. Gomez MPH ,&nbsp;Jennifer Permuth PhD ,&nbsp;Aamir Dam MD ,&nbsp;Anjuli K. Luthra MD ,&nbsp;Luis Pena MD ,&nbsp;Mark Friedman MD ,&nbsp;Saraswathi Cappelle MD ,&nbsp;Barbara Centeno MD ,&nbsp;Shaffer R.S. Mok MD","doi":"10.1016/j.igie.2025.01.009","DOIUrl":"10.1016/j.igie.2025.01.009","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Unlike fine-needle biopsy (FNB), fine-needle aspiration (FNA) is limited by its inability to preserve histopathology. We compared the diagnostic yield of endoscopic ultrasound (EUS)–guided FNA and EUS-FNB for pancreatic cystic lesions (PCLs), hypothesizing that EUS-FNB would frequently provide a tissue diagnosis.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort study was conducted from 2022 to 2023 on patients with PCLs who underwent either EUS-FNA or EUS-FNB. We compared cyst characteristics and pathology reports to assess diagnostic yield. The relative risk (RR) was calculated to compare FNB’s probability of identifying intraductal papillary mucinous neoplasm (IPMN) grade compared with FNA.</div></div><div><h3>Results</h3><div>A total of 130 PCLs were identified (FNA: n = 34; FNB: n = 96). Patients had a mean age of 68 ± 12 years, and 49% were women. Sex, age, cyst size, location, and presence of pancreatic ductal dilation did not differ significantly between FNA and FNB groups. FNB showed a significantly higher diagnostic yield compared with FNA (81% vs 62%; <em>P</em> = .02), with better performance in identifying an IPMN grade compared with FNA (RR = 1.92; <em>P</em> = .013).</div></div><div><h3>Conclusions</h3><div>Our results reflect one of the first studies, to our knowledge, to consider the diagnostic role of FNB in evaluating PCLs. These preliminary results suggest that FNB may have a potential for high diagnostic performance in PCLs and warrant further exploration using a larger cohort and randomized controlled trials.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 42-47"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697908","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 ultrasound–guided gastroenterostomy for managing gastroparesis refractory to gastric peroral endoscopic pylorotomy: a promising new therapeutic option","authors":"Jean-Michel Gonzalez MD, PhD,&nbsp;Juliette Phelip MD,&nbsp;Mohamed Gasmi MD,&nbsp;Véronique Vitton MD, PhD,&nbsp;Marc Barthet MD, PhD","doi":"10.1016/j.igie.2025.01.011","DOIUrl":"10.1016/j.igie.2025.01.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric peroral endoscopic myotomy (G-POEM) reaches an efficacy rate around 65% for gastroparesis. Endoscopic ultrasound (EUS)–guided gastroenteroanastomosis (EUS-GEA) has demonstrated efficacy in gastric outlet obstruction. We evaluated it for refractory gastroparesis.</div></div><div><h3>Methods</h3><div>We undertook a single-center retrospective study enrolling patients with gastroparesis treated with G-POEM with failure or symptoms recurrence managed with EUS-GEA. The drain-assisted EUS-GEA technique with 20-mm lumen-apposing stent was applied. End points were clinical efficacy at 6 months, adverse events, and recurrence rate.</div></div><div><h3>Results</h3><div>Twelve patients were included, median age 46 years (interquartile range [IQR], 16-78 y). Patients had an abnormal gastric emptying or bezoar, and 50% never improved from baseline. Median follow-up was 11.5 months (IQR, 6-26 mo). Clinical efficacy rate was 75% at 6 months. The median preoperative Gastroparesis Cardinal Symptoms Index was 4.1 (IQR, 1.6-5) versus 1.6 (IQR, 0-2.6; <em>P</em> &lt; .05). No severe periprocedural adverse events occurred.</div></div><div><h3>Conclusions</h3><div>EUS-GEA demonstrated promising results in improving patients with gastroparesis refractory to G-POEM. Prospective evaluation is required to confirm these results.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 16-20"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697900","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":"Pilot randomized trial of efficacy and safety of yogic technique versus polyethylene glycol solution for bowel preparation in colonoscopy","authors":"Manas Kumar Panigrahi MD, DM, FRCP (Edin) ,&nbsp;Mitali Madhumita Rath MD ,&nbsp;Mohd Imran Chouhan MD, DM ,&nbsp;Rajesh Manik PhD ,&nbsp;Ajaya Ghosh R U MSc ,&nbsp;Madhav Sameer Makashir MD, DM ,&nbsp;Hemanta Kumar Nayak MD, DM ,&nbsp;Biswa Mohan Padhy MD, DM ,&nbsp;Subash Chandra Samal MD, DM","doi":"10.1016/j.igie.2024.08.005","DOIUrl":"10.1016/j.igie.2024.08.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The traditional yogic technique of shankha prakshalana (SP) has been known to cleanse the bowel, but its efficacy as a bowel preparation agent in colonoscopy has not been studied widely. We compared the efficacy and safety of SP with split-dose polyethylene glycol (PG) in bowel preparation for colonoscopy.</div></div><div><h3>Methods</h3><div>Patients undergoing elective colonoscopy were randomized into 2 groups: PG group (n = 47) and SP group (n = 47). Patients in the PG group were given 2 liters of PG 3350 in a split-dose regimen. Patients in the SP group were administered 400 mL of lukewarm saline water followed by a set of 5 asanas (physical exercises) of SP, with each asana performed 8 times under the supervision of a certified yoga trainer (R.M.). This constituted 1 cycle, which was repeated 6 times (total intake of 2400 mL lukewarm saline water). The Boston Bowel Preparation Scale (BBPS) was used to assess the main outcome of the efficacy of bowel preparation.</div></div><div><h3>Results</h3><div>A total of 94 patients were enrolled, with 47 in each study group. The mean BBPS for the whole colon in the SP group (8.15 ± 1.02) was higher than that in the PG group (7.55 ± 1.08; <em>P</em> = .007). Moreover, the segmental BBPS for the right side of the colon was significantly higher in the SP group (2.64 ± 0.48) than in the PG group (2.36 ± 0.60; <em>P</em> = .010). Adverse effects, such as nausea (31.9% vs 4.3%; <em>P</em> = .001), bloating (27.7% vs none; <em>P</em> &lt; .0001), and disturbed sleep (63.8% vs 12.8%; <em>P</em> &lt; .0001), were significantly more frequent in the PG group than in the SP group.</div></div><div><h3>Conclusions</h3><div>The traditional yogic technique of shankha prakshalana is an effective method for bowel preparation in colonoscopy, with overall better efficacy and safety, compared with the standard split-dose PG regimen. (Clinical trial registration number: CTRI/2020/07/026899.)</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 31-37.e1"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697903","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":"Reduced migration of esophageal fully covered self-expandable metal stents affixed with clips with anchor prongs","authors":"Jason DuBroff MD, MPH,&nbsp;Daniel Holten MD,&nbsp;Gregory Toy MD,&nbsp;David Jonason MD,&nbsp;Daryl Ramai MD, MPH,&nbsp;John Morris MSc, MD,&nbsp;John Fang MD,&nbsp;Christopher Ko MD","doi":"10.1016/j.igie.2025.01.005","DOIUrl":"10.1016/j.igie.2025.01.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Fully covered self-expandable metal stents (FCSEMSs) are a common therapeutic treatment for benign and malignant esophageal disorders. Stent migration is a common adverse event of FSCEMSs. We describe clips with anchor prongs (CAPs) as a novel technique to reduce FCSEMS migration.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 27 patients with FCSEMSs affixed with CAPs and 28 patients without FCSEMS affixation for stent migration as the primary endpoint and used previously published data to determine the relative risk reduction (RRR).</div></div><div><h3>Results</h3><div>Migration was observed in 14.8% of cases (RRR, 43%). CAP affixation was associated with a decreased odds of migration (odds ratio, .19; <em>P</em> = .02). The only adverse event reported in those with (n = 4) or without (n = 14) CAP fixation was postprocedural pain.</div></div><div><h3>Conclusions</h3><div>CAPs may reduce stent migration, providing a novel option for the endoscopist seeking a means of securely attaching esophageal FCSEMSs.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 38-41"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697907","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":"Endosonography-guided suture device for gastrointestinal lumen-to-lumen apposition in a porcine model","authors":"Jad AbiMansour MD,&nbsp;Shunsuke Kamba MD,&nbsp;Barham K. Abu Dayyeh MD,&nbsp;Ryan J. Law DO,&nbsp;Vinay Chandrasekhara MD,&nbsp;Elizabeth Rajan MD,&nbsp;Andrew C. Storm MD","doi":"10.1016/j.igie.2024.08.009","DOIUrl":"10.1016/j.igie.2024.08.009","url":null,"abstract":"<div><h3>Background and Aims</h3><div>The ability to effectively tether 2 separate lumens would simplify performance of transluminal therapeutic endoscopic ultrasound (EUS). This article describes a novel device permitting simple and effective luminal apposition under EUS guidance.</div></div><div><h3>Methods</h3><div>A porcine preclinical study using 1 domestic pig was performed to show proof-of-concept of a novel suturing device that can be deployed with EUS to appose the gallbladder wall to the stomach. The goal is to facilitate a simple and straightforward approach to cholecystogastrostomy using a lumen-apposing metal stent.</div></div><div><h3>Results</h3><div>EUS was performed to identify the porcine gallbladder. The device was used to puncture across the gastric wall and into the gallbladder. Once needle access was obtained, 4 flexible braided suture tags were extruded over a 3-0 polypropylene suture into the gallbladder lumen. Upon applying suture tension, the tags bunch to form a secure loop within the gallbladder lumen. With tension on this suture, the gallbladder may be brought up to the gastric wall and the transmural 3-0 suture then cinched at the gastric mucosa to effect durable luminal apposition. After this, cholecystogastrostomy with an electrocautery-enhanced lumen-apposing metal stent was performed using a standard freehand technique.</div></div><div><h3>Conclusions</h3><div>A novel EUS-guided suturing device permits apposition of the porcine gallbladder and stomach, facilitating EUS-guided transmural gallbladder drainage. This approach may affect the safety and technical success rates of novel translumenal therapeutic EUS procedures.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697897","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 the effectiveness of Chat-GPT 4.0, an artificial intelligence conversational tool, for addressing common patient queries in gastrointestinal endoscopy","authors":"Giulio Calabrese MD ,&nbsp;Roberta Maselli MD, PhD ,&nbsp;Marcello Maida MD ,&nbsp;Federico Barbaro MD, PhD ,&nbsp;Rui Morais MD ,&nbsp;Olga Maria Nardone MD, PhD ,&nbsp;Emanuele Sinagra MD, PhD ,&nbsp;Roberto Di Mitri MD ,&nbsp;Sandro Sferrazza MD","doi":"10.1016/j.igie.2025.01.012","DOIUrl":"10.1016/j.igie.2025.01.012","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Chat Generative Pre-Trained Transformer (Chat-GPT) has proven effective in addressing patient inquiries related to gastrointestinal (GI) disease. We aimed to assess the effectiveness and reliability of Chat-GPT in answering common patients’ queries on GI endoscopy.</div></div><div><h3>Methods</h3><div>Eighteen selected patients’ queries regarding GI endoscopy were rated on a Likert-type scale by 10 health professionals and 2 non-health professionals on the following features: reliability (1-6), accuracy (1-3), and comprehensibility (1-3).</div></div><div><h3>Results</h3><div>The mean reliability, accuracy, and comprehensibility values were 5.2 ± 1.7, 2.7 ± 0.4, and 2.9 ± 0.2, respectively. Overall, most answers were rated as having a solid level of reliability (94.4%) and accuracy (100%) and fair levels of comprehensibility (61.1%). The physicians considered the tool to be adequate for addressing questions related to clinical practice, except for inquiries regarding bowel prep solutions, medications, and pacemaker management.</div></div><div><h3>Conclusions</h3><div>Chat-GPT 4.0 demonstrated effectiveness in providing patients with informative content about GI endoscopy, even though health professional support remains essential for a comprehensive approach.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 21-25"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143697901","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":"Freedom to innovate: the story of natural orifice translumenal endoscopic surgery and the endoscopic suturing device","authors":"Sergey V. Kantsevoy MD, PhD, FJGES ,&nbsp;Phillip S. Ge MD, FASGE","doi":"10.1016/j.igie.2025.01.014","DOIUrl":"10.1016/j.igie.2025.01.014","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"4 1","pages":"Pages 78-103"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698012","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":"On behalf of our editors, authors, and readers: A tribute to our reviewers","authors":"","doi":"10.1016/j.igie.2024.11.001","DOIUrl":"10.1016/j.igie.2024.11.001","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Page 567"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139966","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":"Impact of a machine learning–based prediction model on annual surveillance endoscopy costs for detecting gastric cancer","authors":"Junya Arai MD, PhD ,&nbsp;Atsushi Miyawaki MD, PhD ,&nbsp;Yoku Hayakawa MD, PhD ,&nbsp;Tomonori Aoki MD, PhD ,&nbsp;Ryota Niikura MD, PhD ,&nbsp;Hiroaki Fujiwara MD, PhD ,&nbsp;Tetsuo Ushiku MD, PhD ,&nbsp;Masato Kasuga MD, PhD ,&nbsp;Mitsuhiro Fujishiro MD, PhD","doi":"10.1016/j.igie.2024.09.003","DOIUrl":"10.1016/j.igie.2024.09.003","url":null,"abstract":"<div><h3>Background and Aims</h3><div>In this study, we assessed our machine learning (ML)-based model's impact on reducing annual surveillance endoscopy costs for detecting gastric cancer (GC).</div></div><div><h3>Methods</h3><div>We analyzed 1099 patients with chronic gastritis undergoing annual EGD and randomly divided them into training and test sets (4:1). Using gradient-boosting decision trees and incorporating patient characteristics, we developed the ML model. In the test sets, we compared the EGD number needed to screen (NNS) for 1 GC, cost, and GC detection rate across different risk stratification strategies.</div></div><div><h3>Results</h3><div>The ML-selected high-risk cohort demonstrated low NNS values, low total cost, low cost per 1 GC, and high GC detection rates compared with alternative risk stratification approaches, including operative link for gastric atrophy assessment and operative link for gastric intestinal metaplasia assessment.</div></div><div><h3>Conclusions</h3><div>Our ML model holds promise in reducing endoscopy surveillance costs while maintaining a robust GC detection rate.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"3 4","pages":"Pages 463-467"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143140070","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}