Umar Akram, Eeman Ahmad, Shahzaib Ahmed, Zain Ali Nadeem, Muhammad Ahmed Raza, Eeshal Fatima, Syed Adeel Hassan, Ahtshamullah Chaudhry, Hareesha Rishab Bharadwaj, Muhammad Arslan Tariq, Faryal Altaf, Zaheer Qureshi
{"title":"Efficacy and safety of polyethylene glycol in combination with linaclotide versus polyethylene glycol alone for colonoscopy: a grade-assessed systematic review and meta-analysis.","authors":"Umar Akram, Eeman Ahmad, Shahzaib Ahmed, Zain Ali Nadeem, Muhammad Ahmed Raza, Eeshal Fatima, Syed Adeel Hassan, Ahtshamullah Chaudhry, Hareesha Rishab Bharadwaj, Muhammad Arslan Tariq, Faryal Altaf, Zaheer Qureshi","doi":"10.5946/ce.2025.073","DOIUrl":"10.5946/ce.2025.073","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of colonoscopy largely depends on the quality of bowel preparation. Polyethylene glycol (PEG) is commonly used but has certain limitations. This review evaluates whether combining PEG with linaclotide improves preparation efficacy and safety compared with PEG alone.</p><p><strong>Methods: </strong>A search was conducted in Medline, Embase, and ClinicalTrials.gov up to October 2024. Only randomized controlled trials comparing PEG combined with linaclotide versus PEG alone and reporting adenoma detection rates (ADR) or polyp detection rates (PDR) were included. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were reported.</p><p><strong>Results: </strong>A total of eight studies, including 3,071 participants, were included. Pooled analysis indicated that PEG combined with linaclotide was significantly associated with a higher ADR (RR, 1.15; 95% CI, 1.03-1.28), higher Boston bowel preparation scale score (MD, 0.31; 95% CI, 0.02-0.61), and greater willingness to repeat colonoscopy (RR, 1.16; 95% CI, 1.08-1.24). Although PDR (RR, 1.05; 95% CI, 0.89-1.24) was numerically higher in the intervention group, the difference was not statistically significant. Additionally, the intervention significantly reduced the incidence of nausea, vomiting, bloating, and abdominal pain.</p><p><strong>Conclusions: </strong>PEG combined with linaclotide is a safe alternative to PEG alone, improving ADR, bowel preparation quality, and patient comfort.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"670-683"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945144","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}
Clinical EndoscopyPub Date : 2025-09-01Epub Date: 2025-08-27DOI: 10.5946/ce.2024.256
Arsalan Nadeem, Ali Husnain, Aleena Ahmed, Haider Ashfaq, Hamza Ashraf, Zain Ali Nadeem, Khawaja Abdul Rehman, Shahroze Ahmad, Muhammad Rafay Shahzad Cheema
{"title":"Percutaneous cholecystolithotomy and lithotripsy for managing acute calculous cholecystitis in non-surgical candidates: a systematic review and meta-analysis.","authors":"Arsalan Nadeem, Ali Husnain, Aleena Ahmed, Haider Ashfaq, Hamza Ashraf, Zain Ali Nadeem, Khawaja Abdul Rehman, Shahroze Ahmad, Muhammad Rafay Shahzad Cheema","doi":"10.5946/ce.2024.256","DOIUrl":"10.5946/ce.2024.256","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to review and update the evidence regarding the efficacy and safety of percutaneous cholecystolithotomy/lithotripsy (PCCL) for managing acute calculous cholecystitis (ACC) in non-surgical candidates.</p><p><strong>Methods: </strong>A systematic search of PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase was conducted. We included studies focusing on the use of PCCL in patients deemed ineligible for surgery owing to ACC and reporting outcomes such as technical success, stone clearance, recurrence, and length of hospital stay. This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>Meta-analysis of 13 studies showed a technical success rate of 97%, with stone and cholecystitis recurrence in 10% and 1% of cases, respectively. The pooled average length of hospital stay was 2.79 days. Complications included retained stones (3%), duct perforations (6%), catheter displacement (5%), bleeding (4%), and bile leakage (5%). A sensitivity analysis confirmed the robustness of these results.</p><p><strong>Conclusions: </strong>PCCL demonstrated high efficacy with minimal recurrence and low complication rates in managing ACC in non-surgical candidates. Further randomized controlled trials are necessary to compare its efficacy and safety with standard care approaches, such as cholecystectomy or percutaneous cholecystostomy.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"684-695"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945193","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}
Clinical EndoscopyPub Date : 2025-09-01Epub Date: 2025-05-23DOI: 10.5946/ce.2024.354
Wilfredo Pagani, Tavia Buysse, Kulwinder S Dua
{"title":"Digital platforms, virtual reality, and augmented reality in gastrointestinal endoscopy training.","authors":"Wilfredo Pagani, Tavia Buysse, Kulwinder S Dua","doi":"10.5946/ce.2024.354","DOIUrl":"10.5946/ce.2024.354","url":null,"abstract":"<p><p>Remote training in procedural tasks has experienced robust growth in recent years, spurred by the coronavirus disease 2019 pandemic to meet the need for basic and continued skills development, including in gastrointestinal endoscopy. Remote endoscopy training offers learners the opportunity for skill acquisition, real-time feedback, and access to experts from around the world, and gives mentors the ability to educate trainees without the need to travel themselves. Remote training can be cost-effective but requires reliable technology and continuous assessment to ensure training quality. Ethical and legal issues related to patient safety may also exist. Training using virtual or augmented reality, on the other hand, does not involve patients and, hence, has no patient safety, legal, or ethical issues. Multiple endoscopic scenarios, from basic to advanced, can be practiced multiple times with immediate feedback on performance. These innovations are expected to not only increase individual endoscopy skills but also expand access to specialized care in remote areas, either in the same country or in underserved regions of the world. This review describes various techniques in remote endoscopy training with associated advantages and drawbacks and analyzes research outcomes on the effectiveness of remote endoscopy training.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"653-661"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126937","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":"Efficacy and safety of endoscopic submucosal dissection versus endoscopic papillectomy for managing laterally spreading duodenal papillary tumors.","authors":"Yuki Kano, Ken Ohata, Toshifumi Iida, Susumu Banjoya, Tomoya Kimura, Koichi Furuta, Shinya Nagae, Yohei Ito, Hiroshi Yamazaki, Nao Takeuchi, Shunya Takayanagi, Yoshiaki Kimoto, Yuji Koyama, Seitaro Tsujino, Takashi Sakuno, Kohei Ono, Yohei Minato, Yuji Fujita, Eiji Sakai, Hideyuki Chiba","doi":"10.5946/ce.2025.066","DOIUrl":"10.5946/ce.2025.066","url":null,"abstract":"<p><strong>Background/aim: </strong>Endoscopic submucosal dissection (ESD) can be performed to treat laterally spreading duodenal papillary tumors (LSPTs). However, no studies have been conducted on the outcomes of ESDs for LSPTs.</p><p><strong>Methods: </strong>We retrospectively compared 47 patients who underwent endoscopic papillectomies (EPs) for papillary tumors (PTs) between June 2007 and July 2023 (EP group) and eight patients who underwent ESDs for LSPTs between February 2022 and July 2023 (ESD group). In the subgroup analysis, five patients who underwent EPs for LSPTs were compared with eight patients who underwent ESDs for LSPTs.</p><p><strong>Results: </strong>Procedure times and tumor diameters were significantly greater in the ESD group than in the EP group. The positive or unclear vertical margin (VM1/X) rate was significantly higher in the ESD group. Additional therapies were administered for patients with VM1/X in the ESD group, and no local recurrence was observed. No delayed adverse events occurred in the ESD group; however, delayed bleeding and perforation occurred in the EP group. In the subgroup analysis, the en bloc resection rate was significantly higher in the ESD group than in the EP group. The VM1/X rate did not differ significantly between groups.</p><p><strong>Conclusions: </strong>We suggest that ESD is both feasible and safe for LSPTs.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"712-721"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945123","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}
Clinical EndoscopyPub Date : 2025-09-01Epub Date: 2025-09-02DOI: 10.5946/ce.2025.213
Seong-Jung Kim
{"title":"Terminal ileum in screening colonoscopy: routine practice or risk-stratified approach?","authors":"Seong-Jung Kim","doi":"10.5946/ce.2025.213","DOIUrl":"10.5946/ce.2025.213","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"696-697"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945187","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":"A retrospective study on the comparative use of fine-needle biopsy and aspiration for the diagnosis and classification of malignant lymphoma in Japan.","authors":"Fumitaka Niiya, Akihiro Nakamura, Yasuo Ueda, Takafumi Ogawa, Naoki Tamai, Masataka Yamawaki, Jun Noda, Tetsushi Azami, Yuichi Takano, Masatsugu Nagahama","doi":"10.5946/ce.2024.320","DOIUrl":"10.5946/ce.2024.320","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for diagnosing malignant lymphoma (ML). However, the optimal needle type for maximizing the diagnostic yield and tissue quality remains unclear. We compared the diagnostic performance and histological tissue quality between fine-needle biopsy (FNB) and fine-needle aspiration (FNA) needles in EUS-TA for ML.</p><p><strong>Methods: </strong>This retrospective study included patients who underwent EUS-TA for suspected ML. The diagnostic accuracy, histological sample quality assessed by scoring, and adverse events were compared between the FNB and FNA groups. A subgroup analysis was performed for 22-gauge needles.</p><p><strong>Results: </strong>FNB demonstrated higher diagnostic accuracy (75%) than FNA (50%) for cytology, with 100% sensitivity for histological diagnosis compared with 78.9% for FNA. The FNB group had significantly higher diagnostic rates for the World Health Organization subclassification of ML (71.4% vs. 31.6%, p=0.037). Additionally, FNB obtained superior histological quality, with 71.4% of samples scoring 5 compared with 41.2% in the FNA group. Adverse events were minimal in both groups.</p><p><strong>Conclusions: </strong>EUS-FNB showed better diagnostic performance and histological tissue quality than EUS-FNA for ML, particularly in obtaining adequate samples for histological evaluation and subclassification. Therefore, EUS-FNB can be safely performed. Future research with larger sample sizes and genetic testing is warranted.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"757-765"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172700","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}
Clinical EndoscopyPub Date : 2025-09-01Epub Date: 2025-09-02DOI: 10.5946/ce.2025.220
Yiheng Yao, Guolei Shi, Liang Liu
{"title":"Comment on 'The comparative study of Stretta radiofrequency and anti-reflux mucosectomy in the management of intractable gastroesophageal reflux disease: a single-center retrospective study from Korea'.","authors":"Yiheng Yao, Guolei Shi, Liang Liu","doi":"10.5946/ce.2025.220","DOIUrl":"10.5946/ce.2025.220","url":null,"abstract":"","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":" ","pages":"782-783"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945103","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}
Clinical EndoscopyPub Date : 2025-09-01Epub Date: 2025-07-07DOI: 10.5946/ce.2024.317
Christopher Robert Smith, Michael Adesida, Gibran Timothy Yusuf, Hesham Soliman, Mintimer Negametzyanov, Efthymios Ypsilantis
{"title":"Colonic stenting for colorectal cancer: stoma avoidance with acceptable radiation exposure.","authors":"Christopher Robert Smith, Michael Adesida, Gibran Timothy Yusuf, Hesham Soliman, Mintimer Negametzyanov, Efthymios Ypsilantis","doi":"10.5946/ce.2024.317","DOIUrl":"10.5946/ce.2024.317","url":null,"abstract":"<p><strong>Background: </strong>Self-expanding metal stents (SEMS) are used to manage colonic obstruction for palliative decompression or as a bridge to curative surgery and are typically placed under fluoroscopic guidance. This study aimed to quantify the radiation exposure associated with colonic stenting for obstructing colorectal cancer (CRC) and compare it with established diagnostic reference levels (DRLs) for similar fluoroscopy-guided procedures. Secondary outcomes included procedural success rates, stent patency, stoma rates, and complications.</p><p><strong>Methods: </strong>This retrospective observational study was conducted at a single district general hospital and included all the patients who underwent colonic stenting for CRC between March 2016 and February 2021. Radiation exposure was measured using the kerma-area product (KAP) in µGy*m² and fluoroscopy time in minutes, obtained from existing electronic patient records.</p><p><strong>Results: </strong>Fifty-two stenting procedures were performed in 47 patients. Median KAP was 1,373.7 (interquartile range [IQR], 584.4-3,185.2) µGy*m², and fluoroscopy time was 8.9 (IQR, 4.4-12.6) minutes. Technical and clinical success was achieved in 86.5% of the cases. In palliative cases, 88.9% of patients maintained stent patency until death. The complications included perforation (5.8%) and stent migration (3.9%). Laparoscopic surgery was performed in 70% of curative cases.</p><p><strong>Conclusions: </strong>Radiation exposure during colonic stenting is within acceptable ranges and comparable to that of other fluoroscopy-guided procedures. These findings support the listing of colonic stenting in future National DRLs in the United Kingdom.</p>","PeriodicalId":10351,"journal":{"name":"Clinical Endoscopy","volume":"58 5","pages":"738-743"},"PeriodicalIF":2.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12489556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191373","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}