Endoscopic Ultrasound最新文献

{"title":"Endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy <i>versus</i> transbronchial needle aspiration for diagnosing sarcoidosis: A randomized controlled trial.","authors":"Mingming Deng, Fei Tang, Yifei Chen, Shuai Zhao, Run Tong, Zhen Yang, Changhao Zhong, Feng Wang, Quncheng Zhang, Ziwen Zheng, Nan Zhang, Guowu Zhou, Gang Hou","doi":"10.1097/eus.0000000000000147","DOIUrl":"10.1097/eus.0000000000000147","url":null,"abstract":"<p><strong>Background and objectives: </strong>Endobronchial ultrasound (EBUS)-guided transbronchial mediastinal cryobiopsy (TBMC) has potential superiority compared with EBUS-guided transbronchial needle aspiration (TBNA) in the diagnosis of patients with intrathoracic sarcoidosis. However, high-quality clinical evidence is lacking. The aim of this study was to compare the efficacy and safety of EBUS-TBMC and EBUS-TBNA in diagnosing patients with intrathoracic sarcoidosis.</p><p><strong>Methods: </strong>A multicenter randomized controlled trial was conducted in patients with suspected stage I/II sarcoidosis. Following identification of the mediastinal lesion via EBUS, TBNA and TBMC were sequentially performed in a randomized order. The granuloma detection rate was the primary outcome. The final diagnosis was based on pathology results and clinical follow-up at 6 months after randomization.</p><p><strong>Results: </strong>A total of 128 patients with suspected stage I/II sarcoidosis were recruited for this study. Among them, 116 patients were diagnosed with sarcoidosis at 6 months after randomization. The granuloma detection rate was 89.8% (95% confidence interval [CI], 83.3-94.5) for EBUS-TBMC and 78.1% (95% CI, 70.0-84.9) for EBUS-TBNA, and the difference was significant (<i>P</i> < 0.001). The histological quality of the EBUS-TBMC samples was superior to that of the EBUS-TBNA samples (<i>P</i> < 0.001). Only one case of pneumothorax was detected by chest radiography, which resolved spontaneously without the need for drainage or other interventions.</p><p><strong>Conclusions: </strong>Compared with EBUS-TBNA, EBUS-TBMC had superior granuloma detection rate and histological quality of samples with acceptable safety in patients suspected with stage I/II sarcoidosis.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"266-273"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided ablation for pancreatic cystic lesions: An updated review.","authors":"Mengruo Jiang, Lisi Peng, Yuwei Sun, Shiyu Li, Zhaoshen Li, Liqi Sun, Haojie Huang, Jin Zhendong","doi":"10.1097/eus.0000000000000144","DOIUrl":"10.1097/eus.0000000000000144","url":null,"abstract":"<p><p>Pancreatic cystic lesions (PCLs) are a globally prevalent condition, with incidence increasing with age. The proper treatment modality for PCLs remains a controversial topic. EUS-guided ablation represents an innovative and promising minimally invasive treatment for selected PCL patients, including EUS-guided pancreatic cyst chemoablation (EUS-PCC, such as ethanol, lauromacrogol, chemotherapeutic agents, and combination therapies) and EUS-guided radiofrequency ablation (EUS-RFA). Each treatment modality varies in treatment indications, efficacy, and safety. Herein, with ongoing advancements in clinical research, we present a comprehensive, updated review of procedural techniques, patient selection, clinical outcomes, and adverse events for EUS-PCC and EUS-RFA.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"239-248"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided fine-needle aspiration for the diagnosis of hepatic metastatic neuroendocrine tumor (with videos).","authors":"Sashuang Wang, Yating Wang, Dongqiang Zhao","doi":"10.1097/eus.0000000000000146","DOIUrl":"10.1097/eus.0000000000000146","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"288-290"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel designed balloon specialized for EUS-guided gastroenterostomy: A pilot study.","authors":"Shimin Wang, Pingping Zhang, Hangyu Chen, Ping Li, Bo Li, Xiangyu Kong, Yu Zhang, Ting Yang, Jing Sun, Zhendong Jin, Kaixuan Wang","doi":"10.1097/eus.0000000000000129","DOIUrl":"10.1097/eus.0000000000000129","url":null,"abstract":"<p><strong>Background and objectives: </strong>We recently developed a balloon-assisted device for EUS-guided gastroenterostomy (EUS-GE) to enhance the safety and convenience of the procedure. This pilot study was conducted to evaluate the safety and feasibility of this device.</p><p><strong>Methods: </strong>A retrospective analysis of data of patients who underwent EUS-GE using this balloon-assisted device at our institution from March 2024 to July 2024 was conducted. The primary end point was the procedure time, and the secondary end points were the volume of water injection, technical success rate, clinical success rate, and adverse events (AEs).</p><p><strong>Results: </strong>A total of 20 patients (male: 55%; female: 45%) were enrolled, with a mean age of 67.7 ± 9.9 years. The mean procedure time was 29.3 ± 9.4 minutes, and the mean intraoperative water infusion in the jejunum was 92.5 (80-117.5) mL. The technical success rate was 100% (20/20). The clinical success rate was 95% (19/20). One patient (5%) experienced mild abdominal pain after the procedure. No other AEs, such as bleeding, perforation, stent occlusion, or migration, were observed during follow-up. The median follow-up duration was 132 (74-170) days.</p><p><strong>Conclusion: </strong>The balloon-assisted device facilitates the application of EUS-GE, with short procedure time, less intraoperative water injection, high technical success rate, and low incidence of AEs.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"282-287"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146045823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare pancreatic tumor unamenable to accurate diagnosis by EUS-guided tissue acquisition.","authors":"Naho Kondo, Akihiko Kida, Jun Asai, Tatsuya Yamashita, Takeshi Urabe, Taro Yamashita","doi":"10.1097/eus.0000000000000135","DOIUrl":"10.1097/eus.0000000000000135","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 5","pages":"291-293"},"PeriodicalIF":5.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese expert consensus on the clinical practice of EUS-guided biliary drainage (2024, Shanghai).","authors":"Kaixuan Wang, Jiayi Ma, Jun Li, Zhaoshen Li, Siyu Sun, Zhendong Jin","doi":"10.1097/eus.0000000000000133","DOIUrl":"10.1097/eus.0000000000000133","url":null,"abstract":"<p><p>In recent years, EUS-guided biliary drainage has been widely implemented in China, and standardization of this procedure has become an urgent matter. As EUS-guided biliary drainage technology and accessories continue to advance, the understanding of its clinical benefits and complications is also evolving. This expert consensus summarizes the current evidence and presents 12 clinical questions and 40 recommendations in the form of questions and answers regarding indications and contradictions, techniques, accessory selection, complications, perioperative management, and learning and training. The goal of this consensus is to assist in decision-making and standardize the treatment process.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 4","pages":"161-176"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided bridging stent placement using a new slim-delivery system for malignant hilar biliary obstruction: Two case reports (with video).","authors":"Fumiya Kataoka, Mitsuru Okuno, Tsuyoshi Mukai, Hiroshi Araki, Eiichi Tomita, Hisataka Moriwaki, Masahito Shimizu","doi":"10.1097/eus.0000000000000137","DOIUrl":"10.1097/eus.0000000000000137","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 4","pages":"228-229"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-blind randomized noninferiority study of the effect of pharyngeal lidocaine anesthesia on EUS.","authors":"Yuki Fujii, Kazuyuki Matsumoto, Kei Harada, Nao Hattori, Ryosuke Sato, Taisuke Obata, Akihiro Matsumi, Kazuya Miyamoto, Daisuke Uchida, Shigeru Horiguchi, Koichiro Tsutsumi, Toshiharu Mitsuhashi, Motoyuki Otsuka","doi":"10.1097/eus.0000000000000138","DOIUrl":"10.1097/eus.0000000000000138","url":null,"abstract":"<p><strong>Background and objectives: </strong>EUS is typically performed under sedation, often with concomitant analgesics to reduce pain. Traditionally used pharyngeal anesthesia, commonly with lidocaine, may cause pharyngeal discomfort and allergic reactions. This study investigated whether lidocaine-based pharyngeal anesthesia is necessary for EUS under sedation with analgesics.</p><p><strong>Methods: </strong>A double-blind, randomized, noninferiority study was conducted on EUS cases that met the selection criteria. Patients were randomly assigned to receive either 5 sprays of 8% lidocaine (lidocaine group: LG) or saline spray (placebo group: PG) as endoscopy pretreatment. The primary outcome was EUS tolerability, analyzed separately for endoscopists and patients, with a noninferiority margin set at 15%. Secondary outcomes included endoscopist and patient satisfaction, midazolam/pethidine doses, number of gag events, number of esophageal insertion attempts, use of sedative/analgesic antagonists, interruptions due to body movements, throat symptoms after endoscopy, and sedation-related adverse events.</p><p><strong>Results: </strong>Favorable tolerance was 85% in LG and 88% for PG among endoscopists (percent difference: 3.0 [95% confidence interval, -6.6 to 12.6]) and 90% in LG and 91% in PG among patients (percent difference, 0.94 [95% confidence interval, -7.5 to 9.4]). Both groups exceeded the noninferiority margin (<i>P</i> = 0.0002 for endoscopists and patients). Patient satisfaction was significantly higher in PG (<i>P</i> = 0.0080), but no intergroup differences were found in other secondary outcomes.</p><p><strong>Conclusions: </strong>PG was noninferior to LG for pharyngeal anesthesia during EUS with sedation and analgesics. These results suggest that pharyngeal anesthesia with lidocaine can be omitted when performing EUS under sedation with concomitant analgesics. Omitting pharyngeal anesthesia with lidocaine may prevent discomfort and complications caused by pharyngeal anesthesia, shorten examination times, and reduce medical costs.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 4","pages":"205-211"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS appearance of a rare mesenchymal tumor: Plexiform fibromyxoma.","authors":"Dominique Béchade, Lola-Jade Palmieri, Benjamin Bonhomme, Fanny Castanet, Grégoire Desolneux","doi":"10.1097/eus.0000000000000120","DOIUrl":"10.1097/eus.0000000000000120","url":null,"abstract":"","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 4","pages":"230-231"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EUS-guided hepaticogastrostomy <i>versus</i> single balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography for malignant biliary obstruction in patients with surgically altered anatomy.","authors":"Taro Shibuki, Norio Fukami, Tsuyoshi Igarashi, Shota Yamaguchi, Kanae Inoue, Tomonao Taira, Tomoyuki Satake, Kazuo Watanabe, Mitsuhito Sasaki, Hiroshi Imaoka, Shuichi Mitsunaga, Naoto Gotohda, Masafumi Ikeda","doi":"10.1097/eus.0000000000000130","DOIUrl":"10.1097/eus.0000000000000130","url":null,"abstract":"<p><strong>Background and objective: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for managing malignant biliary obstruction (MBO), but it is challenging in patients with surgically altered anatomy (SAA). EUS-guided hepaticogastrostomy (EUS-HGS) and enteroscopy-assisted ERCP are alternative techniques, but their comparative efficacy and safety in this population are not well-researched. Herein, we evaluated the outcomes of EUS-HGS <i>versus</i> single-balloon-assisted enteroscopy ERCP (SBE-ERCP) in MBO patients with SAA.</p><p><strong>Patients and methods: </strong>This retrospective study included 70 patients with MBO who underwent EUS-HGS (<i>n</i> = 29) or SBE-ERCP (<i>n</i> = 41) at a single center between April 2015 and June 2024. Data on the patient characteristics, procedure details, time to recurrent biliary obstruction (TRBO), and adverse events (AEs) were analyzed.</p><p><strong>Results: </strong>The EUS-HGS group showed a higher technical success rate (100% <i>vs.</i> 68%, <i>P</i> = 0.002), shorter procedure time (23 <i>vs.</i> 50 min, <i>P</i> < 0.001), and longer TRBO (251 <i>vs.</i> 103 d, <i>P</i> = 0.020) as compared with the SBE-ERCP group. Subgroup analysis revealed that pancreatobiliary cancer and SBE-ERCP were significantly associated with a shorter TRBO. When stratified by stent type, the median TRBO in the SBE-ERCP with PS group was 49 days, serving as the reference. In comparison, the median TRBO was 140 days in the SBE-ERCP with the self-expandable metallic stent group (hazard ratio [HR], 0.46; <i>P</i> = 0.181), 127 days in the EUS-HGS with PS group (HR, 0.38; <i>P</i> = 0.055), and 701 days in the EUS-HGS with the self-expandable metallic stent group (HR, 0.13; <i>P</i> = 0.014). The overall incidence of AEs was comparable between the 2 groups (20.6% <i>vs.</i> 17.1%), and there were no severe AEs. Regarding reintervention, there was no significant difference in technical success rate and procedure time between EUS-HGS and SBE-ERCP.</p><p><strong>Conclusion: </strong>EUS-HGS was associated with a superior technical success rate, shorter procedure time, and longer stent patency, without an increased risk of AEs, as compared with SBE-ERCP. Thus, EUS-HGS should be appropriate for managing MBO patients with SAA.</p>","PeriodicalId":11577,"journal":{"name":"Endoscopic Ultrasound","volume":"14 4","pages":"196-204"},"PeriodicalIF":5.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12829724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146050899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}