Digestion最新文献_第2页

IF 3.6 3区医学

Digestion Pub Date : 2025-09-19 DOI: 10.1159/000548054

Marta Raposo

引用次数: 0

Clinical application of confocal laser endomicroscopy in the diagnosis of gastrointestinal diseases. 激光共聚焦内镜在胃肠道疾病诊断中的临床应用。

IF 3.6 3区医学

Digestion Pub Date : 2025-09-18 DOI: 10.1159/000548414

Wenli Ruan, Jianfeng Yang, Yingdong Hou, Aiyv Yv, Qi Ding, Yifeng Zhou

{"title":"Clinical application of confocal laser endomicroscopy in the diagnosis of gastrointestinal diseases.","authors":"Wenli Ruan, Jianfeng Yang, Yingdong Hou, Aiyv Yv, Qi Ding, Yifeng Zhou","doi":"10.1159/000548414","DOIUrl":"https://doi.org/10.1159/000548414","url":null,"abstract":"Background Confocal laser endomicroscopy (CLE) is a real-time microscopic imaging technique based on laser scanning technology. It enables subcellular histological visualization in vivo with a resolution of up to 1μm and demonstrates over 90% sensitivity for detecting early gastrointestinal cancers and precancerous lesions. In recent years, the integration of CLE with fluorescence staining and artificial intelligence (AI) has further improved its image interpretation capabilities in identifying gastrointestinal inflammation and early cancer. Summary This review provides an overview of CLE's clinical applications in gastric and intestinal diseases. It also discusses the synergistic role of AI in enhancing CLE and highlights the clinical relevance of CLE in the detection of digestive tract disorders. Key Messages 1.CLE is a high-resolution real-time imaging technology that can identify early gastrointestinal cancers and precancerous lesions with high sensitivity, providing important basis for diagnosis and treatment. 2. The integration of CLE with fluorescent staining and AI significantly improves its real-time in vivo interpretation of inflammation and early cancerous lesions in the gastrointestinal tract. 3. CLE is valuable in the auxiliary diagnosis and dynamic monitoring of gastrointestinal diseases, and the integration of AI further expands its clinical application potential.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-24"},"PeriodicalIF":3.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145085376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Erratum. 勘误表。

IF 3.6 3区医学

Digestion Pub Date : 2025-09-16 DOI: 10.1159/000548007

Marta Raposo

引用次数: 0

Underwater Clip Closure versus Conventional Clip Closure following Endoscopic Submucosal Dissection in Colorectal Lesions: A First Comparative Study. 内镜下粘膜下夹层对结直肠病变的水下夹子闭合与常规夹子闭合：首次比较研究。

IF 3.6 3区医学

Digestion Pub Date : 2025-09-15 DOI: 10.1159/000548463

Hirotaka Oura, Daisuke Murakami, Harutoshi Sugiyama, Takayoshi Nishino, Makoto Arai

{"title":"Underwater Clip Closure versus Conventional Clip Closure following Endoscopic Submucosal Dissection in Colorectal Lesions: A First Comparative Study.","authors":"Hirotaka Oura, Daisuke Murakami, Harutoshi Sugiyama, Takayoshi Nishino, Makoto Arai","doi":"10.1159/000548463","DOIUrl":"https://doi.org/10.1159/000548463","url":null,"abstract":"Introduction This single-center retrospective study compared underwater clip closure (UCC) with conventional clip closure (CCC) under routine gas insufflation for post-endoscopic submucosal dissection (ESD) ulcers of colorectal lesions measuring ≤5 cm. Methods Between May 2021 and June 2023, 89 patients were enrolled. Since March 2022, all cases underwent UCC. Patients were divided into the UCC group (n = 52) and the CCC group (n = 37). Primary outcomes were complete closure rate and incidence of post-ESD coagulation syndrome (PECS), delayed bleeding, and perforation. Secondary outcomes included closure time and number of clips used. Results Complete closure was achieved in all cases, with no PECS, delayed bleeding, or perforation in either group. Median closure time was significantly shorter in the UCC group (10 min [IQR, 7-14]) than in the CCC group (11 min [IQR, 8.5-19]; p = 0.044). The number of clips used was similar (median 10 in both groups; p = 0.290). Multiple regression analysis identified both resection area (p < 0.001) and closure method (p = 0.002) as independent factors affecting closure time. Conclusion UCC may decrease the time required for post-ESD closure of colorectal lesions measuring ≤5 cm, while using a comparable number of clips to CCC, with no serious complications.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-16"},"PeriodicalIF":3.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Etiology and pathophysiology of Barrett's esophagus/neoplasia. Barrett食管/肿瘤的病因学和病理生理学。

IF 3.6 3区医学

Digestion Pub Date : 2025-09-15 DOI: 10.1159/000548413

Naoki Asano, Tomoyuki Koike, Masahiro Saito, Yutaka Hatayama, Yohei Ogata, Xiaoyi Jin, Takeshi Kanno, Waku Hatta, Kaname Uno, Akira Imatani, Atsushi Masamune

引用次数: 0

Efficacy and Safety of Cold Snare Polypectomy in Intensive Downstaging Polypectomy for Colorectal Polyps in Patients with Familial Adenomatous Polyposis. 冷陷阱息肉切除术在家族性腺瘤性息肉病患者结肠直肠息肉强化降期切除术中的疗效和安全性。

IF 3.6 3区医学

Digestion Pub Date : 2025-09-15 DOI: 10.1159/000548434

Kazuki Ishibashi, Yuji Urabe, Takahiro Uda, Yukiko Sako, Tomoyuki Gurita, Satoshi Masuda, Yoshiki Hatsushika, Takeo Nakamura, Hirona Konishi, Akiyoshi Tsuboi, Hidenori Tanaka, Ken Yamashita, Yoshihiro Kishida, Yuichi Hiyama, Hidehiko Takigawa, Toshio Kuwai, Shiro Oka

{"title":"Efficacy and Safety of Cold Snare Polypectomy in Intensive Downstaging Polypectomy for Colorectal Polyps in Patients with Familial Adenomatous Polyposis.","authors":"Kazuki Ishibashi, Yuji Urabe, Takahiro Uda, Yukiko Sako, Tomoyuki Gurita, Satoshi Masuda, Yoshiki Hatsushika, Takeo Nakamura, Hirona Konishi, Akiyoshi Tsuboi, Hidenori Tanaka, Ken Yamashita, Yoshihiro Kishida, Yuichi Hiyama, Hidehiko Takigawa, Toshio Kuwai, Shiro Oka","doi":"10.1159/000548434","DOIUrl":"https://doi.org/10.1159/000548434","url":null,"abstract":"Introduction: Intensive downstaging polypectomy (IDP) has emerged as an alternative strategy for managing colorectal polyps in patients with familial adenomatous polyposis (FAP), aiming to endoscopically control the disease in those who delay or refuse colectomy. This study evaluated the safety and efficacy of cold snare polypectomy (CSP) compared to hot snare polypectomy (HSP) and hot biopsy (HB) in patients with FAP undergoing IDP.Methods: This retrospective study included patients diagnosed with FAP who underwent IDP between September 2012 and March 2024 at Hiroshima University Hospital. The patients were divided into two groups: CSP (October 2022 onward) and HOT (HSP and HB; 2012-2022). Outcomes assessed included adverse events, resection time per polyp, total procedure time, number of polyps removed per procedure, and R0 resection rate.Results: A total of 185 treatment sessions were performed in 32 patients. The CSP group had a significantly shorter resection time per lesion and a higher number of polyps removed per procedure compared to the HOT group. The incidence of adverse events was significantly lower in the CSP group. Immediate bleeding occurred in 10 cases in the HOT group, while no such events were observed in the CSP group. Additionally, delayed bleeding and perforation were each observed in two cases in the HOT group, whereas neither event occurred in the CSP group.Conclusion: CSP is a safe and efficacious method for polyp removal in patients with FAP undergoing IDP, offering shorter resection time and fewer adverse events compared to HSP and HB.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-18"},"PeriodicalIF":3.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anti-reflux mucosal intervention for gastroesophageal reflux disease: a new horizon of endoscopic anti-reflux therapy. 胃食管反流病的抗反流黏膜干预：内镜下抗反流治疗的新视野。

IF 3.6 3区医学

Digestion Pub Date : 2025-09-15 DOI: 10.1159/000547947

Haruhiro Inoue, Mayo Tanabe, Kazuki Yamamoto, Yohei Nishikawa, Kei Ushikubo, Ippei Tanaka, Kaori Owada, Manabu Onimaru, Takayoshi Ito, Noboru Yokoyama, Stefan Seewald

{"title":"Anti-reflux mucosal intervention for gastroesophageal reflux disease: a new horizon of endoscopic anti-reflux therapy.","authors":"Haruhiro Inoue, Mayo Tanabe, Kazuki Yamamoto, Yohei Nishikawa, Kei Ushikubo, Ippei Tanaka, Kaori Owada, Manabu Onimaru, Takayoshi Ito, Noboru Yokoyama, Stefan Seewald","doi":"10.1159/000547947","DOIUrl":"https://doi.org/10.1159/000547947","url":null,"abstract":"Anti-reflux mucosal (ARM) interventions have expanded the therapeutic spectrum for gastroesophageal reflux disease beyond pharmacologic therapy and surgery. This narrative review traces the evolution from anti-reflux mucosectomy (ARMS) and anti-reflux mucosal ablation (ARMA) to the more recently developed anti-reflux mucoplasty (ARMP) and ARMP with valve (ARMPV). Collectively, the available cohort studies and systematic reviews indicate a clinical response rate of 70-82%, with proton-pump inhibitor discontinuation achieved in up to 55% of cases. The most common adverse events are transient dysphagia (~11%) and post-procedural bleeding (~5%), both of which are manageable endoscopically. Direct defect closure in ARMP shortens the interval to symptom relief and virtually eliminates delayed bleeding, while technical refinements such as the angle booster and counter-mucosal incision have improved access and tension management. When selecting among ARM intervention techniques, we propose ARMP as the first-line option in naïve anatomy, reserving ARMA for redo or post-surgical settings where submucosal fibrosis limits application. Ongoing trials are assessing durability beyond five years, the role of full-thickness suturing that incorporates sling- and clasp-muscle fibers, and applications in bariatric or para-esophageal hernia populations. Future research priorities include standardizing ulcer dimensions to optimize shrinkage, refining patient-reported outcome measures, and clarifying cost-effectiveness relative to fundoplication and magnetic sphincter augmentation. In summary, ARM interventions offers a spectrum of flexible, minimally invasive solutions that can be tailored to individual anatomic and physiological profiles, potentially bridging the treatment gap between long-term acid suppression and surgery.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-22"},"PeriodicalIF":3.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epidemiology of Barrett's Neoplasia in Japan. 巴雷特病流行病学；日本的肿瘤。

IF 3.6 3区医学

Digestion Pub Date : 2025-09-12 DOI: 10.1159/000548362

Katsunori Iijima

{"title":"Epidemiology of Barrett's Neoplasia in Japan.","authors":"Katsunori Iijima","doi":"10.1159/000548362","DOIUrl":"10.1159/000548362","url":null,"abstract":"Background: With a 50-year delay compared to Europe and the USA, esophageal adenocarcinoma (EAC) began to increase in Japan around 2010, and it is expected to continue rising over the next few decades. This 50-year discrepancy is primarily attributable to variations in the timing of the decline in Helicobacter pylori infection rates across the two regions, with the extent of obesity in Japan also exerting an influence on the projected increase in EAC. Currently, the incidence of EAC in Japan is approximately one-tenth to one-twentieth that observed in Europe and the USA. However, ongoing monitoring is essential to assess the potential for escalation of this cancer. Accurate estimation of the incidence of EAC in Barrett's esophagus (BE), a precancerous condition of EAC, is imperative for the establishment of appropriate endoscopic surveillance for early cancer detection.Summary: The incidence of EAC in BE is largely determined by its length. In the Japanese population, BE with a length greater than 3 centimeters exhibits a high incidence of EAC and necessitates surveillance, while BE with a length less than 1 centimeter exhibits an exceptionally low incidence of EAC and is considered to require no surveillance. The challenge lies in determining the optimal approach for addressing BE with a length of 1-3 cm, which is observed in 5-15 percent of endoscopic examinees, necessitating careful consideration due to its significance.Key message: Since the EAC risk of BE varies greatly depending on its length, the need for surveillance and inspection intervals for BE in Japan should be defined by its length.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-10"},"PeriodicalIF":3.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145052397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Magnifying Endoscopic Classification for Early Barrett's Neoplasia. 早期Barrett&apos的放大内镜分型瘤形成。

IF 3.6 3区医学

Digestion Pub Date : 2025-09-08 DOI: 10.1159/000548227

Yohei Ikenoyama, Aiji Hattori, Yasuko Fujiwara, Misaki Nakamura, Yasuhiko Hamada, Noriyuki Horiki, Hayato Nakagawa

{"title":"Magnifying Endoscopic Classification for Early Barrett's Neoplasia.","authors":"Yohei Ikenoyama, Aiji Hattori, Yasuko Fujiwara, Misaki Nakamura, Yasuhiko Hamada, Noriyuki Horiki, Hayato Nakagawa","doi":"10.1159/000548227","DOIUrl":"10.1159/000548227","url":null,"abstract":"Background: Barrett's esophagus (BE) is becoming increasingly prevalent in both Western countries and Japan. Early diagnosis of Barrett's neoplasia remains challenging. Traditionally, the Seattle protocol, a four-quadrant random biopsy method, has been recommended in Western guidelines. However, this approach has several limitations, including sampling errors, poor adherence, and a high procedural burden. Therefore, magnifying endoscopy has gained attention as a valuable tool for detecting and characterizing neoplastic lesions in patients with BE.Summary: This review outlines historical and current developments in magnifying endoscopic classification systems for BE, with a focus on narrow-band imaging (NBI) and acetic acid chromoendoscopy in both Western countries and Japan. Although various NBI-based classifications have been proposed, their complexity and poor reproducibility have limited their widespread clinical adoption. Recently, simplified and standardized classification systems, including the Barrett's International NBI Group classification in the West and the Japan Esophageal Society-Barrett's esophagus classification in Japan, have been introduced. These systems adopt a binary framework, categorizing mucosal and vascular patterns as \"regular\" (non-neoplastic) or \"irregular\" (neoplastic). They are easy to apply and have demonstrated high diagnostic accuracy and substantial interobserver agreement. Further simplification and practical refinement are required for broader clinical implementation.Key messages: Compared with other gastrointestinal cancers, the magnifying endoscopic diagnosis of Barrett's neoplasia remains technically demanding. However, based on a growing body of evidence, endoscopists should be encouraged to actively challenge this area. Continued efforts to simplify and validate the classification systems are essential for their widespread clinical use in BE surveillance.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-11"},"PeriodicalIF":3.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Family History as a Dominant Risk Factor for Uninvestigated Dyspepsia and Chronic Constipation: A Rome IV-Based Study among Japanese University Students. 家族史是未调查的消化不良和慢性便秘的主要危险因素：一项基于罗马iv的日本大学生研究

IF 3.6 3区医学

Digestion Pub Date : 2025-09-08 DOI: 10.1159/000548363

Nhu Thi Hanh Vu, Duc Trong Quach, Mai Ngoc Luu, Shunsuke Miyauchi, Naoki Ishiuchi, Doan Thi Nha Nguyen, Atsuo Yoshino, Yoshie Miyake, Yuri Okamoto, Shiro Oka, Toru Hiyama

{"title":"Family History as a Dominant Risk Factor for Uninvestigated Dyspepsia and Chronic Constipation: A Rome IV-Based Study among Japanese University Students.","authors":"Nhu Thi Hanh Vu, Duc Trong Quach, Mai Ngoc Luu, Shunsuke Miyauchi, Naoki Ishiuchi, Doan Thi Nha Nguyen, Atsuo Yoshino, Yoshie Miyake, Yuri Okamoto, Shiro Oka, Toru Hiyama","doi":"10.1159/000548363","DOIUrl":"https://doi.org/10.1159/000548363","url":null,"abstract":"Background Uninvestigated dyspepsia (UD) and chronic constipation (CC) are common disorders of gut-brain interaction (DGBI). However, limited research has assessed their risk factors in young adults, particularly the influence of family history. This study investigated the associated factors for UD and CC, focusing on family history among Japanese university students. Methods A cross-sectional study was conducted at Hiroshima University. UD and CC were diagnosed using the Rome IV criteria. Multivariate logistic regression was performed to identify associated factors of UD and CC. Results Among 10,500 individuals participating in the annual health checkup, 7,496 responded to the web-based questionnaire, and 5,386 completed it. The mean age of the participants was 21.1 ± 4.1 years, with a male-to-female ratio of 1:1.17. The prevalence of UD and CC was 7.3% and 13.7%, respectively. Family history was associated with both UD (odds ratio [OR]: 4.29; 95% confidence interval [CI]: 3.17-5.79) and CC (OR: 2.77; 95% CI: 2.31-3.31). Depression and physical inactivity were shared associated factors. Alcohol consumption (OR = 2.36; 95% CI: 1.15-4.83) and smoking (OR = 1.59; 95% CI: 1.02-2.49) were identified as associated factors for UD, while female sex (OR = 2.00; 95% CI: 1.69-2.36) and short sleep duration (OR = 1.28; 95% CI: 1.09-1.50) were associated with CC. Conclusions Family history was found to be a predominant factor associated with both UD and CC, with a relatively stronger association for UD. Our finding highlights the need to consider familial factors in future prevention and intervention strategies for UD and CC in young adults.","PeriodicalId":11315,"journal":{"name":"Digestion","volume":" ","pages":"1-15"},"PeriodicalIF":3.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0