Clinical Endoscopy最新文献

{"title":"Self-expandable metal vs. plastic stents for preoperative biliary drainage in patients receiving neoadjuvant chemotherapy.","authors":"Takashi Tamura, Reiko Ashida, Yuki Kawaji, Masahiro Itonaga, Yasunobu Yamashita, Masayuki Kitano","doi":"10.5946/ce.2025.045","DOIUrl":"https://doi.org/10.5946/ce.2025.045","url":null,"abstract":"<p><p>Neoadjuvant chemotherapy (NAC) improves the rate of curative resection and overall prognosis in patients with resectable or borderline resectable pancreatic cancer. The treatment period from the initiation of NAC to surgery typically ranges from 2 to 6 months. In cases of malignant biliary obstruction caused by pancreatic cancer, maintaining preoperative biliary drainage (PBD) until surgery is essential to continue NAC. Minimizing adverse events related to endoscopic biliary drainage and avoiding perioperative adverse events are crucial. Plastic stents (PSs) are commonly used for PBD; however, the extended duration of PBD required for NAC increases the risk of recurrent biliary obstruction (RBO), potentially leading to discontinuation of NAC. Therefore, preventing RBO during PBD in patients with pancreatic cancer receiving NAC is important. The placement of self-expandable metal stents (SEMSs) for PBD significantly reduces the rate of RBO compared with PS placement. Although SEMS placement may increase the risk of pancreatitis or cholecystitis, its effect on postoperative outcomes is comparable to that of PS placement. Given their lower rate of RBO, SEMSs are considered more suitable than PSs for PBD in patients with pancreatic cancer receiving NAC.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741340","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":"Best practice of gastrointestinal endoscopy during Mpox upsurge: an Indonesian Society for Digestive Endoscopy recommendation.","authors":"Rabbinu Rangga Pribadi, Ahmad Fariz Malvi Zamzam Zein, Raisa Wibowo, Achmad Fauzi, Abdul Aziz Rani, Marcellus Simadibrata, Dadang Makmun, Murdani Abdullah, Ari Fahrial Syam, Muhammad Miftahussurur, Agasjtya Wisjnu Wardhana, Amanda Pitarini Utari, Andi Muhammad Luthfi Parewangi, Arles Arles, Arnelis Arnelis, Bradley Jimmy Waleleng, Bogi Pratomo Wibowo, Fauzi Yusuf, Hasan Maulahela, Hery Djagat Purnomo, I Dewa Nyoman Wibawa, Ignatia Sinta Murti, Indra Marki, Kaka Renaldi, Masrul Lubis, Muhammad Begawan Bestari, Muhammad Firhat Idrus, Pieter Saragih, Putut Bayupurnama, Ruswhandi Ruswhandi, Saskia Aziza Nursyirwan, Suyata Suyata, Titong Sugihartono, Triyanta Yuli Pramana, Virly Nanda Muzellina, Yustar Mulyadi","doi":"10.5946/ce.2024.294","DOIUrl":"https://doi.org/10.5946/ce.2024.294","url":null,"abstract":"<p><p>The emergence of Mpox as a significant zoonotic viral threat presents new challenges in gastrointestinal endoscopy. This article outlines the risk of Mpox transmission during gastrointestinal endoscopy, particularly through respiratory droplets and contact with the mucosal surfaces. Gastrointestinal endoscopy may also facilitate transmission by fomites, as the Mpox virus can persist on medical instruments and surfaces for long periods. Nosocomial Mpox transmission is a significant concern in both endemic and non-endemic regions. This highlights the necessity for enhanced infection control measures in gastrointestinal endoscopy, including pre-endoscopic assessment, proper use of personal protective equipment, and rigorous post-procedural disinfection. Additionally, vaccination of healthcare workers frequently exposed to high-risk situations is emphasized. Ongoing surveillance and monitoring of healthcare workers are key components in minimizing the transmission risk. Although no direct cases of Mpox transmission via gastrointestinal endoscopy have been reported, these recommendations mitigate the potential risks associated with such procedures and necessitate strict adherence to infection control protocols. By adhering to these protocols and adapting to current practices, gastrointestinal endoscopy can be safely performed during the Mpox upsurge, ensuring the protection of both patients and healthcare workers.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741338","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":"Magnetically guided gastric capsule endoscopy: a review and new developments.","authors":"Jean-Francois Rey","doi":"10.5946/ce.2025.062","DOIUrl":"https://doi.org/10.5946/ce.2025.062","url":null,"abstract":"<p><p>Since 2001, capsule endoscopy has been the primary test used to diagnose small-intestinal diseases. However, video capsule endoscopy of the stomach was considered impractical because visualizing the entire stomach was deemed impossible and would require a steerable capsule. Magnetically controlled gastric capsule endoscopy has been increasingly used for the diagnosis of gastric diseases, with significant developments in China. This noninvasive, hygienic, and comfortable method has gained popularity as an alternative to traditional electronic gastroscopy owing to its disposable nature and recent hardware upgrades (resolution, brightness, and field of view). Important steps forward with artificial intelligence and robots allow for the automated detection and characterization of gastric lesions. As it was restricted in China, questions have been raised about its cost-effectiveness worldwide, particularly in countries where early gastric cancer is not a priority. In this paper, I review the initial trials with this innovative capsule and the important technical updates in the last 5 years: robots for capsule guidance and artificial intelligence for the detection and characterization of gastric lesions.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741339","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":"Long-term outcome of grade 1 rectal neuroendocrine tumor ≤1 cm after incomplete endoscopic resection.","authors":"Jong Sun Park, Hye Lynn Jeon, Bumhee Park, Jong Hoon Park, Gil Ho Lee, Sun Gyo Lim, Sung Jae Shin, Kee Myung Lee, Choong-Kyun Noh","doi":"10.5946/ce.2025.043","DOIUrl":"https://doi.org/10.5946/ce.2025.043","url":null,"abstract":"<p><strong>Background/aims: </strong>Surveillance strategies for small grade 1 rectal neuroendocrine tumors (G1 rNETs) after incomplete endoscopic resection (ER) remain controversial. We evaluated the long-term outcomes of patients with G1 rNET ≤1 cm after ER who did and did not undergo complete resection.</p><p><strong>Methods: </strong>We retrospectively evaluated 441 patients with G1 rNETs measuring ≤1 cm after ER between 2011 and 2022. Patients were divided into complete and incomplete resection groups according to histopathological evaluation. Logistic regression analysis identified the risk factors for incomplete resection after ER.</p><p><strong>Results: </strong>The mean follow-up intervals were 38.6 and 45.7 months in all patients and the incomplete resection group, respectively. No recurrences were observed during the follow-up period. The mean lesion size was 5.5 mm and the complete resection rate was 80.5% (n=355). In the logistic regression analysis, lesion size 5.1 to 10 mm (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.245-4.203; p=0.008), multiple lesions (OR, 8.3; 95% CI, 1.247-54.774; p=0.029), and retroflexion view during the procedure (OR, 4.0; 95% CI, 1.668-9.615; p=0.002) were independent risk factors for incomplete resection.</p><p><strong>Conclusions: </strong>The prognosis of G1 rNET ≤1 cm after ER was very good, regardless of the histopathological results.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682148","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 assessment of terminal ileum in screening colonoscopy: is it worth the effort?","authors":"Krzysztof Dąbkowski, Maciej Tryba, Ernest Biesiada, Kamila Konczanin, Małgorzata Michalak, Magdalena Szczygłowska, Krzysztof Safranow, Teresa Starzyńska","doi":"10.5946/ce.2025.018","DOIUrl":"https://doi.org/10.5946/ce.2025.018","url":null,"abstract":"<p><strong>Background/aims: </strong>Screening colonoscopies often do not include terminal ileum assessment. In this study, we examined how often endoscopists assessed the terminal ileum during screening colonoscopy, how it influenced the procedure time and patient comfort, and whether it revealed pathological findings.</p><p><strong>Methods: </strong>We retrospectively analyzed the screening colonoscopy examinations performed in our department between 2017 and 2021. We retrieved the procedure duration (minutes), patient age and sex, pain scale, and screening colonoscopy results.</p><p><strong>Results: </strong>A total of 2,449 screening colonoscopy examinations were performed between 2017 and 2021. The patients were classified into one of two groups: the cecum reached or the terminal ileum intubated. These two groups did not significantly differ in sex or reported pain score, while the patients were significantly younger (55.2±6.5 vs. 56.2±6 years, p=0.015) and the colonoscopy duration was longer (22.8±9.8 vs. 18±10.5 min, p<0.001) in the terminal ileum group. Pathological conditions (nonspecific inflammatory lesions) in the small intestine were reported in 5/297 patients.</p><p><strong>Conclusions: </strong>Small intestine intubation was associated with a significantly longer colonoscopy duration and revealed pathological conditions of no apparent clinical significance.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658601","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":"Metastatic leiomyosarcoma manifesting as a gastric erosion: an uncommon clinical presentation.","authors":"Angelo Bruni, Luisa Di Sciascio, Maria Giulia Pirini, Antonietta D'Errico, Giovanni Barbara, Lorenzo Fuccio","doi":"10.5946/ce.2025.093","DOIUrl":"https://doi.org/10.5946/ce.2025.093","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658602","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":"Recent advancement in endoscopic diagnosis for risk stratification of gastric cancer.","authors":"Takuma Hiramatsu, Naomi Kakushima, Hikaru Kuribara, Ryohei Miyata, Hideki Nakagawa, Hiroyuki Hisada, Dai Kubota, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Chihiro Takeuchi, Seiichi Yakabi, Yosuke Tsuji, Nobutake Yamamichi, Mitsuhiro Fujishiro","doi":"10.5946/ce.2024.355","DOIUrl":"https://doi.org/10.5946/ce.2024.355","url":null,"abstract":"<p><p>Approximately 90% of cases of gastric cancer (GC) are caused by Helicobacter pylori infection, and screening esophagogastroduodenoscopy is effective for secondary prevention of GC. Endoscopic findings of the stomach due to H. pylori infection vary widely, and the risk of GC varies according to each finding. GC risk is evaluated by combining endoscopic and histopathological findings. In the operative link on gastritis assessment and operative link on gastric intestinal metaplasia assessment staging, GC risk is determined by histopathological evaluation. In the endoscopic grading of gastric intestinal metaplasia, Kyoto classification, and modified Kyoto classification, the risk is considered based on endoscopic findings. However, evaluating endoscopic findings is challenging because the evaluation varies depending on the skill of the endoscopist. Similarly, histopathological findings can be assessed differently by different pathologists. Histopathological evaluation by biopsy carries a risk of bleeding; thus, simpler and less-invasive risk stratification methods are desirable. Artificial intelligence for risk stratification, which has the potential for improved accuracy and consistency, has been developed for endoscopic and histopathological evaluations. Appropriate GC risk stratification would benefit the economy and patients, and further evaluation of surveillance intervals tailored to individual risks is warranted.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599611","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":"Impact of opioid addition on procedural conditions during colonoscopy: a randomized trial comparing propofol-based sedation protocols.","authors":"David Novotny, Jan Palenik, Tomas Tyll, Nadija Brodyuk, Stepan Suchanek, Michal Sotak","doi":"10.5946/ce.2024.347","DOIUrl":"https://doi.org/10.5946/ce.2024.347","url":null,"abstract":"<p><strong>Background/aims: </strong>Propofol is the most effective sedative for colonoscopy; however, opioids do have several adverse effects that need to be discussed. The objective of this study was to compare the ease of colonoscopy during propofol-based sedation with and without fentanyl, while closely monitoring ventilatory data and the safety of the procedure.</p><p><strong>Methods: </strong>This prospective single-center trial randomized 50 patients who underwent minor colonoscopies. The propofol group received sedation exclusively via propofol, whereas the propofol+fentanyl group was premedicated with 1 µg/kg fentanyl. Patients were monitored using a bioimpedance ventilatory monitor, and both the patients and endoscopists were questioned regarding their level of satisfaction.</p><p><strong>Results: </strong>The endoscopists reported a higher level of ease with the colonoscopy procedure (mean on a 5-point scale, 1.2 vs. 1.72; p=0.028) and the overall patient satisfaction score was higher (1.15 vs. 1.28, p=0.026) in the propofol+fentanyl group. No significant differences were observed in the ventilatory parameters between the groups. No major adverse events were reported in any of the groups.</p><p><strong>Conclusions: </strong>The inclusion of fentanyl leads to enhanced levels of satisfaction for both the endoscopist and the patient, without any impact on ventilation and safety. The use of bioimpedance monitoring of ventilation during colonoscopy is a suitable approach that may enhance the safety of procedural sedation.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559400","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":"Pre-endoscopy erythromycin versus metoclopramide for upper gastrointestinal bleeding: a systematic review and network meta-analysis.","authors":"Ravi Teja Pasam, Kanwal Bains, Srilekha Chava, Babu P Mohan","doi":"10.5946/ce.2024.351","DOIUrl":"https://doi.org/10.5946/ce.2024.351","url":null,"abstract":"<p><strong>Background/aims: </strong>Given the limited head-to-head trials comparing the outcomes of pre-endoscopy erythromycin and metoclopramide for upper gastrointestinal bleeding (UGIB), a network meta-analysis (NMA) and component NMA were conducted.</p><p><strong>Methods: </strong>A comprehensive review of the Medline, Embase, and Cochrane databases was conducted for randomized controlled trials comparing pre-endoscopy erythromycin or metoclopramide for UGIB with or without gastric lavage (GL) to placebo and/or GL. The primary outcome was the adequate visualization of the mucosa. The secondary outcomes were endoscopy visualization score, endoscopy duration, diagnosis established at initial endoscopy, second-look endoscopy, blood transfusions, mortality, and duration of hospitalization.</p><p><strong>Results: </strong>A total of 16 studies (1,447 patients) were included. No significant differences were observed between erythromycin and metoclopramide in all the outcomes, but erythromycin had significantly better outcomes than the control group in terms of endoscopic visualization score (standardized mean difference, 0.58; 95% confidence interval [CI], 0.26-0.91), adequate mucosal visualization (risk ratio, 1.55; 95% CI, 1.18-2.04), second-look endoscopy, transfusion requirements, and duration of hospitalization. Component network meta-analysis revealed that erythromycin, but not metoclopramide or GL, provided significantly better endoscopic visualization than the placebo.</p><p><strong>Conclusions: </strong>Erythromycin should be considered before UGIB endoscopy. The current data do not support the use of metoclopramide or GL.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559401","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":"Spirals and balloons: a new chapter in deep enteroscopy?","authors":"Seung Min Hong, Dong Hoon Baek","doi":"10.5946/ce.2025.133","DOIUrl":"https://doi.org/10.5946/ce.2025.133","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559402","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}