Digestive Diseases最新文献

{"title":"Research Article Useful bowel preparation with ultralow-volume (500 ml) polyethylene glycol for colonoscopy: a retrospective study.","authors":"Yusuke Mizuno, Takaya Shimura, Takayuki Nukui, Konomu Uno, Ruriko Nishigaki, Yuki Kojima, Takuya Kannno, Makiko Sasaki, Shigeki Fukusada, Naomi Sugimura, Mamoru Tanaka, Keiji Ozeki, Eiji Kubota, Hiromi Kataoka","doi":"10.1159/000543858","DOIUrl":"https://doi.org/10.1159/000543858","url":null,"abstract":"<p><strong>Introduction: </strong>Adequate bowel preparation is indispensable for high-quality colonoscopy. We have developed an ultralow-volume (500 ml) polyethylene glycol (PEG) combined with other laxatives (sennoside, sodium picosulfate, and lactulose) and applied this regimen clinically to all patients with colonoscopy for three decades. This study aimed to assess the effectiveness of this ultralow-volume bowel preparation regimen.</p><p><strong>Methods: </strong>This single-center, retrospective study analyzed data from consecutive outpatients who underwent colonoscopy between January 2022 and December 2022. All the patients took sennoside (24 mg) two nights before, sodium picosulfate (75 mg) one night before, and 500 ml of PEG with lactulose (58.5 g) on the day of examination. Cleaning efficacy was evaluated using the Boston Bowel Preparation Scale (BBPS). Adequate bowel preparation was defined as a total BBPS score ≥ 6, with all colon segments scoring ≥ 2.</p><p><strong>Results: </strong>Out of 862 patients with colonoscopy, 773 were eligible for this study, and the median age was 66 years. The adequate bowel preparation rate was 91.8% (710/773). Notably, the BBPS full score \"9\" was observed in 50.5% (390/773). The median cecal intubation time and examination time were 8 and 20 min, respectively. Only three patients vomited as a side effect. In the multivariate analysis, age ≥ 70 years, diabetes mellitus, and diverticula were significantly independent risk factors for inadequate bowel preparation.</p><p><strong>Conclusions: </strong>Our established ultralow-volume (500 ml) PEG is safe and useful as a bowel preparation method.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-18"},"PeriodicalIF":2.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscular Injury is a Risk Factor for Post-Entire Circumferential Esophageal Endoscopic Submucosal Dissection Stricture.","authors":"Daisuke Azuma, Kingo Hirasawa, Reo Atsusaka, Yuichiro Ozeki, Atsushi Sawada, Masafumi Nshio, Ryosuke Kobayashi, Chiko Sato, Shin Maeda","doi":"10.1159/000543846","DOIUrl":"https://doi.org/10.1159/000543846","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic submucosal dissection (ESD) has become a widely adopted treatment for early esophageal cancer. However, extensive mucosal defects resulting from ESD pose a significant risk of post-procedural strictures. Despite efforts to prevent strictures through various means, including steroid administration, they remain a challenge, significantly impacting patients' quality of life and healthcare costs. Thus, identifying risk factors for refractory strictures following entire circumferential esophageal ESD (EC-E-ESD) is imperative.</p><p><strong>Methods: </strong>Between July 2013 and September 2023, 49 patients who underwent EC-E-ESD were retrospectively analyzed. Patients were classified based on the presence of refractory or non-refractory strictures. A refractory stricture was defined as requiring six or more endoscopic balloon dilation (EBD) procedures before stricture improvement. Clinicopathological features and outcomes were examined using multivariate logistic regression analysis.</p><p><strong>Results: </strong>Refractory strictures were observed in 51% of patients. A comparison showed that the refractory group had a significantly higher percentage of muscular injury (52% vs. 8%, p=0.002) and mucosal defect length ≥50 mm (68% vs. 37%, p=0.047) than the non-refractory group. Multivariate analysis showed that muscular injury (odds ratio 16.2; 95% confidence interval: 2.04-129.1) was an independent risk factor for refractory strictures after EC-E-ESD.</p><p><strong>Conclusions: </strong>Muscular injury during EC-E-ESD is a risk factor for refractory strictures. Strategies to prevent injury, such as meticulous dissection techniques, and effective steroid administration, may mitigate this risk. However, current prophylactic measures are inadequate, highlighting the need for further research into preventive strategies.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-24"},"PeriodicalIF":2.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Outcomes in Hepatocellular Carcinoma through Integration of Machine Learning: Development of a Tumor-Associated Macrophage Signature.","authors":"Zicheng Zhou, Sijia Ge, Chiyu Gu, Jing Chen, Cuihua Lu, Yanhua Liu, Sutian Jiang","doi":"10.1159/000543642","DOIUrl":"https://doi.org/10.1159/000543642","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatocellular carcinoma (HCC) is one of the most common malignant tumors globally. Macrophages, as essential components of the immune system, play crucial roles in immune regulation, inflammation modulation, and antitumor activity. However, it remains unclear whether tumor-associated macrophages can serve as prognostic markers for HCC.</p><p><strong>Methods: </strong>First, we identified tumor-associated macrophages based on single-cell data from GSE140228. Then, using a machine learning approach with a combination of 101 module genes, we constructed an optimal prognostic model. Subsequently, we compared our constructed model with other published prognostic models for HCC. Finally, we utilized the generated model score to predict the response to chemotherapy and immune therapy.</p><p><strong>Results: </strong>First, we identified clusters of tumor-associated macrophages using single-cell data. Subsequently, we calculated the tumor-associated macrophage score based on module genes from the previous step. Compared to traditional clinical indicators, tumor-associated macrophage signature (TAMS) exhibits significant advantages. The TAMS C-index not only predicts overall survival, but also recurrence-free survival in HCC patients. Additionally, there was a higher prevalence of TP53 mutations in HCC patients with high TAMS. Furthermore, patients with low TAMS showed greater sensitivity to immunotherapy compared to those with high TAMS. Notably, the number and intensity of interactions between TAM and other T lymphocytes were significantly higher than those involving other cell populations. Interestingly, the high TAMS group exhibited significantly elevated levels of immune checkpoint markers and M2 macrophage markers.</p><p><strong>Conclusion: </strong>TAMS can serve as a novel and potent tool, offering improved treatment options and prognostic assessment for patients with HCC.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-19"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Markers of Prognosis for Acute Esophageal Necrosis: A Systematic Review.","authors":"Judah Kupferman, Maliyat Matin, Matthew Wend, Jesus Javier Rubio Castillon, Richard Mitchell, Joshua Aron, Rebecca Ye","doi":"10.1159/000543815","DOIUrl":"https://doi.org/10.1159/000543815","url":null,"abstract":"<p><strong>Introduction: </strong>Acute esophageal necrosis (AEN) is a rare and lethal condition that may progress to sepsis and perforations. Most related literature comes from case reports; however, a few small reviews have been published. We conducted a large systematic review of AEN using PubMed, MEDLINE, and Embase to organize data into one consolidated manuscript, find potential prognosticators of illness, and determine possible treatment guidelines for AEN.</p><p><strong>Methods: </strong>Advanced searches were performed of all English case reports from 1990 to 2021 using medical subject heading (MeSH) terms. Data on patient age, sex, comorbidities, initial presentation, management, progression of illness, and hospital survival were collected.</p><p><strong>Results: </strong>Our study included 226 articles, encompassing 319 cases. 32.3% of patients had diabetes, 26.6% had hypertension, and 19.7% had alcohol use disorder. 66.5% presented with an upper gastrointestinal bleed and 21.9% developed sepsis or esophageal perforation. 60.9% of patients were reported to have survived their illness, but 16.6% of cases did not have their discharge status documented. Interestingly, patients presenting with pain or ketoacidosis demonstrated improved survival.</p><p><strong>Conclusion: </strong>AEN becomes more prevalent as patients age and develop cardiovascular disease, which increases the risk of developing a hypoperfusive state and mucosal injury to the distal esophagus. Early fluid resuscitation, acid-reducing agents, and bowel rest may serve as potential lifesaving interventions, and antibiotics should be considered if there is concern for infection. Patients require close follow up in anticipation of impending stricture.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-18"},"PeriodicalIF":2.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and endoscopic features of colorectal non-polypoid lesions: a single-center retrospective study from a large cohort of FIT-positive screening patients in Northern Italy.","authors":"Alessandro Pezzoli, Francesco Buttitta, Caterina Palmonari, Marzia Simoni, Chiara Pierantoni, Alberto Merighi, Luigi Ricciardiello","doi":"10.1159/000543307","DOIUrl":"https://doi.org/10.1159/000543307","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal non-polypoid lesions (NPLs) are flat, hard-to-detect and mainly right-sided lesions. We aimed to assess the prevalence and endoscopic features of NPLs lesions in a large cohort of screening patients in Northern Italy.</p><p><strong>Methods: </strong>FIT-positive subjects between 50 and 69 years old who had undergone at least a screening colonoscopy from March 2005 to December 2017 at the Endoscopy Unit of Ferrara were included. We selected only non-diminutive (>5 mm) and neoplastic polyps (i.e.: adenomas, serrated adenomas and carcinomas). Patients' demographics and polyps' endoscopic-histopathological data were collected. Categorical variables were compared using the Pearson's χ2 test and Fisher's Exact Test, while odd Ratios and confidence intervals were estimated with univariate analysis.</p><p><strong>Results: </strong>6,676 FIT-positive subjects underwent 7,616 colonoscopies during the study period. Total lesions were 3,231, of which 133 were NPLs and among these 123 were neoplastic. Prevalence of NPLs among total lesions was 4.1% while prevalence of neoplastic NPLs among total neoplastic lesions was 4.6%. Prevalence of NPLs and neoplastic NPLs among total colonoscopies was 1.7% and 1.6%, respectively. Neoplastic NPLs were more frequent between 60 and 64 years old (p=0.03) and associated with other colonic polyps in subjects older than 60 years (p=0.016). Cancerized NPLs were more likely in younger patients (50-59 years old, p=0.04).</p><p><strong>Conclusions: </strong>Prevalence of NPLs is low among screening population, but NPLs are frequently associated with other colonic polyps in patients older than 60 years and carry a higher risk of cancer in patients younger than 60 years old.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-23"},"PeriodicalIF":2.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of genetic mutations of gastric cancer diagnosed before or after H. pylori eradication and between differentiated and undifferentiated types using next-generation sequencing.","authors":"Masaaki Kodama, Manami Oda, Kazuhiro Mizukami, Ryo Ogawa, Yuka Hirashita, Masahide Fukuda, Kazuhisa Okamoto, Kensuke Fukuda, Takafumi Fuchino, Sotaro Ozaka, Tadayoshi Okimoto, Hisanori Abe, Kazumi Inaba, Masanori Tokoro, Keiko Arita, Hidefumi Nishikiori, Takashi Abe, Takayuki Nagai, Satoshi Yamashita, Kazunari Murakami","doi":"10.1159/000543645","DOIUrl":"https://doi.org/10.1159/000543645","url":null,"abstract":"<p><strong>Introduction: </strong>Genetic abnormalities specific to post-H. pylori eradication gastric cancer (GC), especially those associated with undifferentiated post-eradication GC, are unknown. We conducted next-generation sequencing of GC diagnosed either before or after eradication to investigate the carcinogenesis of post-eradication GC.</p><p><strong>Methods: </strong>Five cases of post-eradication differentiated GC [HP(-)-D group], five cases of H. pylori-positive differentiated GC [HP(+)-D group], four cases of post-eradication undifferentiated GC [HP(-)-U group)], and six cases of H. pylori-positive undifferentiated GC [HP(+)-U group)] underwent analysis. DNA was extracted from tumor samples, and non-tumor samples of all subjects. Next-generation target sequencing was conducted using the Ion AmpliSeq Library Kit 2.0 with the Ion AmpliSeq Cancer Hotspot Panel v2. Next-generation targeted sequencing results of the cancer part were subtracted from the results of the non-cancer part.</p><p><strong>Results: </strong>The HP (-)-D group displayed significantly fewer SNPs in hotspot than the other groups (P < 0.01). Definitive DNA mutations were identified by sequencing of cancerous and non-cancerous tissues. 5 of 20 patients had specific somatic mutations, with different TP53 mutations in the HP(+)-D and HP(-)-U groups, CTNNB1 mutations in the HP(+)-U group, and ATM mutations in the HP(+)-U group, but no mutations in the HP(-)-D group.</p><p><strong>Conclusion: </strong>Several definite genetic mutations involved in GC were observed. Mutations were less frequent in post-eradication differentiated GC. However, because of small number of cases analyzed to identify carcinogenic differences, further analysis with a large number of cases and with strictly grading GC samples is needed.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-22"},"PeriodicalIF":2.0,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Symptom Reporting in Patients with Primary Biliary Cholangitis: Higher Burden of Symptom Detection Using an Interactive App.","authors":"Jimmy Daza, Nathally Espinosa-Montagut, Achim Kautz, Diane Langenbacher, Michael Hetjens, Fabian Siegel, Matthias P Ebert, Andreas Teufel","doi":"10.1159/000543229","DOIUrl":"10.1159/000543229","url":null,"abstract":"<p><strong>Introduction: </strong>Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease causing bile duct destruction and inflammation, impacting patient's quality of life (QoL) due to variable symptoms. Digital symptom-tracker apps may improve patient care through enhanced monitoring. This study reassessed symptom burden in PBC patients using a tailored symptom-tracker app, focusing on its usability, effectiveness, and impact on management and QoL.</p><p><strong>Methods: </strong>Based on Kautz5 gUG \"Symptomtracker,\" our app in REDCap allowed users to log PBC symptoms over 4 weeks, alongside medication use. Ethics approval and data security complied with German regulations. User feedback was incorporated for better usability. Symptom data were standardized, and R software was used for descriptive statistics and Chi-square tests.</p><p><strong>Results: </strong>From March 2023 to October 2024, 210 patients (190 female, 20 male) were enrolled, median age 51 years. Among 90 patients who completed the questionnaire, fatigue was most prevalent (87.8%), followed by joint pain (80%), concentration difficulties (74.4%), abdominal discomfort (70%), and sicca symptoms. Other common symptoms were leg cramps (50%) and swollen feet (40%); jaundice was rare (7.8%). Older patients, especially those aged 50-60, reported a higher symptom burden, but Chi-square tests showed no significant differences across age or gender.</p><p><strong>Conclusion: </strong>This study highlights a significant symptom burden in PBC, particularly fatigue and joint pain. While older patients reported more symptoms, no significant differences were observed by age or gender. The symptom-tracker app enhanced monitoring and patient engagement, showing the potential of digital tools in PBC management. Further research is needed to evaluate long-term impacts.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the Achievement of Textbook Outcomes in Liver Surgery (TOLS) and Overall Survival in Perihilar Cholangiocarcinoma Patients Following Major Hepatectomy: A Multicenter Study.","authors":"Shi-Yun Zhong, Shu-Yang Gao, Yan Jiang, Yu-Le Luo, Yi Gong, Ting Yu, Xing-Chao Liu, Hai-Ning Fan, Shu-Jie Pang, Jie Bai, Hai-Su Dai, Zhi-Yu Chen, Yan-Qi Zhang, Zhi-Peng Liu, Hua-Qiang Wang","doi":"10.1159/000543439","DOIUrl":"https://doi.org/10.1159/000543439","url":null,"abstract":"<p><p>Introduction Major hepatectomy is the mainstay of curative-intent resection for perihilar cholangiocarcinoma (pCCA) patients. Textbook Outcomes in Liver Surgery (TOLS) are a new composite parameter for evaluating the short-term outcomes of surgery; however, their association with overall survival (OS) is unknown. Therefore, this study aimed to investigate the association between TOLS and OS in pCCA patients following major hepatectomy. Methods Consecutive pCCA patients who underwent major hepatectomy between 2014 and 2020 at 5 hospitals were included in this analysis. TOLS were defined as no intraoperative grade ≥ 2 incidents, no postoperative grade B/C bile leakage, no postoperative grade B/C liver failure, no postoperative major morbidity, no readmission within 90 days due to surgery-related major morbidity, no mortality within 90 days after hospital discharge, and R0 resection. The Kaplan‒Meier method was used to compare OS rates between patients who achieved TOLS and those who did not. Cox regression analysis was used to identify independent risk factors for poor OS. Results In total, 399 patients were included in this study, 214 (53.6%) of whom achieved TOLS. After excluding patients who died within 90 days, the 5-year OS rate of patients who achieved TOLS were significantly greater than that of patients who did not achieve TOLS (5-year OS rate: 26.2% vs. 17.3%, P=0.001). TOLS were independently associated with OS for pCCA patients following major hepatectomy. Conclusions TOLS were achieved in approximately half of the pCCA patients following major hepatectomy, and the patients who achieved TOLS had better survival.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-21"},"PeriodicalIF":2.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Overlap between Type 1 Diabetes and Celiac Disease in Children and the Role of Tissue Transglutaminase-IgA Positivity in Endoscopy Decision.","authors":"Elif Eviz, Sinan Sari, Nuray Uslu Kizilkan, Esra Doger, Gul Yesiltepe Mutlu, Ödül Eğritaş, Cigdem Arikan, Aysun Bideci, Buket Dalgic, Sukru Hatun","doi":"10.1159/000543168","DOIUrl":"10.1159/000543168","url":null,"abstract":"<p><strong>Introduction: </strong>Celiac disease (CD)-related antibody positivity in children with type 1 diabetes (T1D) may fluctuate and become negative spontaneously. There are uncertainties about the optimal tissue transglutaminase IgA (tTG-IgA) titre and timing of endoscopy in the diagnosis of CD, and this study aimed to contribute to the debate on the tTG-IgA threshold titre for endoscopy decisions in children with T1D.</p><p><strong>Methods: </strong>The data of 991 children with T1D who had undergone serologic evaluation for CD were analysed retrospectively. The tTG-IgA positivity rate and the upper limit of normal (ULN) tTG-IgA positivity were assessed. Participants were grouped according to the frequency, course, and test results of tTG-IgA tests. Those with and without histopathologic diagnosis of CD by endoscopic biopsy were compared in terms of tTG-IgA screening time and tTG-IgA predictive values.</p><p><strong>Results: </strong>In 10.2% (n:101) of all cases, tTG-IgA antibody was positive and endoscopic biopsy was performed in 68.3% (n:69) of these cases. Of all cases, 4.3% (n:43) were diagnosed with CD by endoscopic biopsy. A tTG-IgA titre of 7×ULN and above was found to be the best predictive value for the diagnosis of CD with 79.1% sensitivity, 80.8% specificity 87.2% positive predictive value, and 70% negative predictive value.</p><p><strong>Conclusions: </strong>Approximately 10% of antibody positive cases showed fluctuating and low-titre positivity, and no CD was detected by endoscopic biopsy in the group with fluctuating antibody course. The results of our study suggest that endoscopy in children with tTG-IgA levels 7×ULN or above may prevent both false-positive results and missed cases.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Colon Adenoma Detection Rate Using Transparent Cap-Assisted and Conventional Colonoscopy: Result from an International Trial in Asia.","authors":"Sakkarin Chirapongsathorn, Sho Suzuki, Panlert Prasanwon, Satimai Aniwan, Han-Mo Chiu, Kannikar Laohavichitra, Takeshi Yamamura, Chen-Ya Kuo, Naohisa Yoshida, Tiing Leong Ang, Takahito Takezawa, Rungsun Rerknimitr, Hideki Ishikawa, Takuji Gotoda","doi":"10.1159/000543296","DOIUrl":"10.1159/000543296","url":null,"abstract":"<p><strong>Introduction: </strong>Controversy remains regarding transparent cap-assisted technique improves adenoma detection rate (ADR) in colonoscopy. We aimed to investigate the effect of transparent cap-assisted colonoscopy (CAC) on ADR and other colonoscopy performance.</p><p><strong>Methods: </strong>We performed subanalysis of an international, multicenter, open-label database containing colonoscopy data from 11 centers in 4 Asian countries/regions on patients who underwent colonoscopy. The patient characteristics, procedure-related characteristics, and pathological findings of all detected lesions were prospectively recorded. The patients were divided into 2 groups as receiving colonoscopy with or without transparent cap attachment. The ADR and procedure time were compared between the 2 groups. Other procedural factors related to ADR were also investigated.</p><p><strong>Results: </strong>Between November 2020 and January 2022, 3,029 who underwent colonoscopy (transparent CAC, n = 1,796; standard colonoscopy, n = 1,233) were enrolled in this study. The transparent CAC group ADR was significantly higher than the conventional colonoscopy (55.1% vs. 50.0%, p < 0.01). Transparent CAC detected a higher proportion of patients with adenoma (odd ratio [OR]: 1.59, 95% CI: 1.13-2.24, p < 0.01) and any polypoid lesion (OR: 1.49, 95% CI: 1.04-2.16, p = 0.03). Transparent CAC also reduced cecal intubation time (mean difference: -0.35 min) and total colonoscopy time (mean difference -3.4 min). In the other procedural factors, using linked-color imaging (OR: 1.75, 95% CI: 1.49-2.06, p < 0.01), patient body rotation (OR: 1.54, 95% CI: 1.12-2.13, p < 0.01), longer withdrawal time (OR: 1.12, 95% CI: 1.09-1.15, p < 0.01) were also significantly associated to adenoma detection.</p><p><strong>Conclusion: </strong>In real-world practice, transparent CAC is a safe and inexpensive technology that could improve adenoma and polyp detection.</p>","PeriodicalId":11294,"journal":{"name":"Digestive Diseases","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142930926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}