Endoscopy最新文献

{"title":"Should endoscopic ultrasound-guided portal pressure gradient assessment replace the transjugular method?","authors":"David L Diehl","doi":"10.1055/a-2958-9839","DOIUrl":"https://doi.org/10.1055/a-2958-9839","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149243844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic performance of endoscopic ultrasound-guided portal pressure gradient: preliminary results from the EVADIPP study.","authors":"Francesco Santopaolo, Lucia Giuli, Brigida Eleonora Annicchiarico, Clelia Cavallo, Antonella Carcagnì, Andrea Contegiacomo, Antonio Gasbarrini, Roberto Iezzi, Maria Pallozzi, Francesca Romana Ponziani, Gianenrico Rizzatti, Rosa Talerico, Giulia Tripodi, Giulia Venturini, Alberto Larghi","doi":"10.1055/a-2948-9632","DOIUrl":"10.1055/a-2948-9632","url":null,"abstract":"<p><strong>Background: </strong>Clinically significant portal hypertension (CSPH) is the main driver of hepatic decompensation, and its early identification allows timely initiation of preventive therapies. The hepatic venous pressure gradient (HVPG) is the current gold standard for assessing portal hypertension, but it may underestimate portal hypertension in conditions with a presinusoidal component. Endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) measurement enables direct measurement of portal pressure and may overcome these limitations. We evaluated the prognostic performance of the EUS-PPG compared with HVPG for predicting hepatic decompensation in patients with suspected CSPH.</p><p><strong>Methods: </strong>This preliminary exploratory analysis of the ongoing prospective EVADIPP study included 90 patients who underwent paired HVPG and EUS-PPG measurements and were followed for decompensation.</p><p><strong>Results: </strong>The mean (SD) EUS-PPG and HVPG values were 13.8 (5.8) mmHg and 8.9 (4.8) mmHg, respectively, with poor overall agreement (intraclass correlation coefficient [ICC] 0.08, 95%CI -0.08 to 0.24). Agreement remained poor in portosinusoidal vascular disorder, slight in metabolic dysfunction-associated steatotic liver disease, and substantial in alcohol- and viral-related liver disease. During follow-up, 28 patients (31%) developed decompensation; none of these patients had an EUS-PPG <10 mmHg, while 60.7% of them had an HVPG <10 mmHg. On multivariable analysis, the EUS-PPG (hazard ratio 1.19, 95%CI 1.10-1.30; P < 0.001) and albumin were independently associated with decompensation. The EUS-PPG demonstrated better discrimination than the HVPG (C-index 0.78 vs. 0.56), and time-dependent receiver operating characteristic (ROC) analysis identified an optimal threshold of 12 mmHg.</p><p><strong>Conclusions: </strong>The EUS-PPG is independently associated with hepatic decompensation and showed better prognostic discrimination than the HVPG in this exploratory cohort.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adding finesse to colonoscopy quality assessment: the potential role of proximal serrated polyp detection rate.","authors":"Joep E G IJspeert","doi":"10.1055/a-2965-5063","DOIUrl":"https://doi.org/10.1055/a-2965-5063","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic management of an ileal Dieulafoy's lesion: a rare cause of severe lower gastrointestinal hemorrhage.","authors":"Stefania-Raluca Jurcan, Paul Doumbe-Mandengue, Romain Coriat, Flavius-Stefan Marin","doi":"10.1055/a-2971-4045","DOIUrl":"https://doi.org/10.1055/a-2971-4045","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconstructive Endoscopic Suturing for Defect Closure After Large ≥90% Circumferential Colorectal Endoscopic Submucosal Dissection.","authors":"Fatih Aslan, Ozgur Aktas, Serhat Ozer, Alper Hatipoglu","doi":"10.1055/a-2985-8822","DOIUrl":"https://doi.org/10.1055/a-2985-8822","url":null,"abstract":"<p><strong>Background and aim: </strong>Large (≥10cm) near-circumferential and circumferential colorectal endoscopic submucosal dissection (ESD) carries substantial stricture risk, with no established prophylactic strategy. We describe a reconstructive suturing technique for immediate defect closure and report its feasibility and clinical outcomes.</p><p><strong>Methodology: </strong>Consecutive patients undergoing reconstructive endoscopic suturing after ESD of colorectal lesions ≥10 cm with ≥90% circumferential involvement were analyzed. Closure was performed in patients who consented to suturing. Primary outcomes were technical feasibility in defects elected for closure, adverse events, and symptomatic stricture requiring dilatation. Secondary outcomes included post-polypectomy syndrome, delayed bleeding, perforation, length of hospital stay, resection outcomes, and dissection speed.</p><p><strong>Results: </strong>Nineteen patients underwent suturing (median specimen length 153 mm; 36.8% fully circumferential). Technical feasibility was 100% in those elected to be closed, with a median of 11 anchors and a median suturing time of 23 minutes (IQR: 14-27). En-bloc and R0 resection were 100%. No delayed bleeding, perforation, suturing-related adverse events, or symptomatic strictures occurred during a median follow-up of 30 months (planned follow-up completed in all patients). Median hospital stay was 3 days. In a contemporary (≥2019) reference comparison, symptomatic stricture occurred in 0/19 sutured versus 8/15 (53.3%) non-sutured patients, whose lesions were larger.</p><p><strong>Conclusion: </strong>Reconstructive endoscopic suturing was feasible and safe in defects selected for closure within an exceptionally high-risk cohort and showed a promising signal against post-ESD stricture, warranting prospective multicenter validation.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothermia: mitigating a hidden procedural risk of saline-immersion/irrigation endoscopic submucosal dissection.","authors":"Georgios Kalopitas, Elisabet Maristany Bosch, Michael Spiro, Hironori Yamamoto, Alberto Murino, Edward John Despott","doi":"10.1055/a-2960-1308","DOIUrl":"https://doi.org/10.1055/a-2960-1308","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic closure of plastic biliary stent-induced duodenal perforation opposite the major papilla using anchor pronged clips.","authors":"Daiki Hiraga, Takashi Abe, Takayuki Baba, Riku Yodo, Masanori Tokoro, Takayuki Nagai, Kazuhiro Mizukami","doi":"10.1055/a-2970-8269","DOIUrl":"https://doi.org/10.1055/a-2970-8269","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prophylactic clip closure after right-colon endoscopic mucosal resection in a matched cohort of 470 patients exhibits subsite heterogeneity.","authors":"Mayan Eitan, Sunil Gupta, Jun Young Kim, Yong Sul Kim, Charlene Deane, Albert Jeroen De Groof, Stephen Williams, Eric Y Lee, Brian Lam, Nicholas G Burgess, Michael J Bourke","doi":"10.1055/a-2944-4098","DOIUrl":"10.1055/a-2944-4098","url":null,"abstract":"<p><strong>Background: </strong>Clinically significant post-endoscopic mucosal resection (EMR) bleeding (CSPEB) is the most common adverse event after EMR of large nonpedunculated colorectal polyps (LNPCPs). Randomized trials of prophylactic through-the-scope (TTS) clip closure have produced conflicting results, and it remains unclear whether the effect is uniform across right-colon subsites and whether complete apposition is required. We examined real-world outcomes of a universal right-colon clipping policy, with attention given to subsite heterogeneity and closure completeness.</p><p><strong>Methods: </strong>Consecutive patients who underwent EMR of right-sided LNPCPs ≥20 mm (January 2020-October 2025) with prophylactic TTS clip closure were identified from the prospectively maintained ACE (Australian Colonic Endoscopic resection) registry, and matched 1:1 by propensity score to a no-clip comparator from the same registry (pre-2020). The primary end point was CSPEB within 14 days; subsite heterogeneity and closure completeness were exploratory analyses.</p><p><strong>Results: </strong>Propensity score matching yielded 235 matched pairs (n = 470), who were well balanced on all covariates. CSPEB occurred in 8/235 clipped (3.4%) versus 26/235 unclipped patients (11.1%; relative risk 0.31, 95%CI 0.14-0.66; number needed to treat 13; <i>P</i> = 0.002). Exploratory subsite analyses suggested benefit concentrated at the hepatic flexure (0% vs. 17.2%; <i>P</i> = 0.02) and ascending colon (2.0% vs. 10.1%; <i>P</i> = 0.03), with a nonsignificant difference at the cecum (8.2% vs. 13.7%; <i>P</i> = 0.43). Within the clipped cohort, CSPEB rates were similar with complete (5/143; 3.5%) and partial (3/92; 3.3%) closure (<i>P</i> > 0.99).</p><p><strong>Conclusion: </strong>In this single-center analysis, TTS clip closure was associated with lower CSPEB after right-colon EMR, especially at the hepatic flexure and ascending colon; partial apposition appeared as effective as complete closure. These hypothesis-generating observations warrant prospective evaluation.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond surface assessment: the emerging role of deep-margin optical diagnosis in early rectal cancer.","authors":"Leon M G Moons","doi":"10.1055/a-2953-9044","DOIUrl":"https://doi.org/10.1055/a-2953-9044","url":null,"abstract":"","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serrated polyp detection rates beyond adenoma detection rate for postcolonoscopy colorectal cancer: findings from the SCREESCO trial.","authors":"Masau Sekiguchi, Marcus Westerberg, Anna Andreasson, Soran R Bozorg, Anna M Forsberg","doi":"10.1055/a-2955-8529","DOIUrl":"https://doi.org/10.1055/a-2955-8529","url":null,"abstract":"<p><strong>Background: </strong>The association between serrated polyp detection rates, including proximal serrated polyp detection rate (PSPDR), and postcolonoscopy colorectal cancer (PCCRC) remains unestablished. We investigated PCCRC incidence and characteristics, and explored associations of PSPDR and adenoma detection rate (ADR) with PCCRC in colonoscopy- and fecal immunochemical test (FIT)-based screening within the Screening of Swedish Colons (SCREESCO) trial.</p><p><strong>Methods: </strong>Data from participants who underwent colonoscopy in the colonoscopy and FIT arms were analyzed. PCCRC, defined as colorectal cancer (CRC) diagnosed >6 months after a colonoscopy that did not detect CRC, was identified through linkage with cancer registries. Associations between PSPDR and PCCRC incidence were assessed using Cox models.</p><p><strong>Results: </strong>Of 9982 and 5875 individuals in the colonoscopy and FIT arms, PCCRC was identified in 20 and 17 individuals, with 3-year PCCRC rates of 5.9% (3/51) and 3.5% (4/115), respectively. Compared with screening-detected CRC, PCCRC more often involved right-sided location and advanced stage. The 5-year cumulative incidence of PCCRC was 0.16% (95%CI 0.10%-0.27%) and 0.06% (95%CI 0.02%-0.15%) when colonoscopies were performed by endoscopists with low vs. high PSPDR (<10% vs. ≥10%), respectively. Among endoscopists with high ADR, 5-year PCCRC incidence was 0.13% (95%CI 0.04%-0.32%) vs. 0.06% (95%CI 0.02%-0.16%) for those with low vs. high PSPDR, respectively. Within this group, PCCRC incidence over 8 years decreased as PSPDR increased (hazard ratio per percentage-point increase, 0.90; 95%CI 0.82-1.00; P = 0.04).</p><p><strong>Conclusions: </strong>Despite the limited number of PCCRC events, this study suggests that PSPDR provides complementary information beyond ADR for identifying colonoscopies with higher PCCRC incidence.</p>","PeriodicalId":11516,"journal":{"name":"Endoscopy","volume":" ","pages":""},"PeriodicalIF":11.8,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}