Endoscopy International Open最新文献

{"title":"Comprehensive Review of How Endoscope Channel Biofilm Differs from Hydrated and Dry Surface Biofilm and Its Implications.","authors":"Michelle J Alfa","doi":"10.1055/a-2965-6797","DOIUrl":"10.1055/a-2965-6797","url":null,"abstract":"<p><p><b>Background and Study Aims</b> Flexible endoscope-related infection outbreaks with respect to the biofilm in endoscope channels continue to be reported. This article reviews how endoscope fixed-biofilm accumulation (EFBA) develops in flexible endoscope channels over repeated clinical use. The aim of this review is to highlight how EFBA differs from dry surface biofilm (DSB) and hydrated biofilm (HB). <b>Patients/Materials and Methods</b> The process of (EFBA) formation in patient-used endoscope channels is compared to that of DSB and HB. The inadequate (or lack) of cleaning in narrow endoscope channels and the impact of high level disinfection (HLD) fixing of the EBFA within the endoscope channels result in a very different matrix compared to DSB or HB. The impact of fixed EFBA on microorganism survival within the matrix provides a more stringent and realistic challenge compared to DSB or HB. The choice of an appropriate multispecies biofilm model is also crucial to ensuring that it closely mirrors the clinical aspects related to EFBA. <b>Results</b> This comprehensive review confirms that EFBA is a driver of persistent endoscope channel contamination and exogenous transfer of pathogens to patients that can lead to infection. The literature review demonstrates that mono-microbic HB is the most common biofilm model used over the past 20 years, whereas models that integrate rounds of fixation such as the endoscope cyclic buildup biofilm (ECBB) and endoscope buildup biofilm (EBBF) better reflect the clinical aspects of EFBA in patient-used endoscope channels. <b>Conclusions</b> The published data support the need for the use of an appropriate fixed-biofilm model when validating cleaning and disinfection processes for flexible endoscope channels, thereby ensuring an optimal margin of safety during clinical use.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29656797"},"PeriodicalIF":2.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135389","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":"Inter- and Intra-Observer Reliability for Colon Capsule CLEansing Assessment and Report.","authors":"Eimear Gibbons, Syafiq Ismail, Dana AlSharqi, Lisa Keating, Claire Smyth, Richard Farrell, Barry Hall, Orlaith Kelly","doi":"10.1055/a-2961-4842","DOIUrl":"10.1055/a-2961-4842","url":null,"abstract":"<p><p>A validated scoring system for reporting of colonic cleanliness at colon capsule endoscopy (CCE) is not routinely used to date and great inter-observer variability exists. To ensure appropriate and standardised bowel cleansing reporting, a validated scoring system is of great importance. This would improve the quality of colon capsule reporting and facilitate optimisation of bowel preparation protocols by supporting research reliability. A novel system named Colon Capsule CLEansing Assessment and Report (CC-Clear) has shown superior inter- and intra-observer agreement to the Leighton-Rex scale, an earlier scoring system from 2011. This was a retrospective, single-centre study assessing the intra- and inter-observer reliability of CC-Clear. <b>Materials and Methods</b> Studies were identified retrospectively from the capsule database of a tertiary referral centre. In all, 30 consecutive complete CCE were included. Three expert capsule readers reviewed and reported each examination twice. <b>Results and Conclusion</b> The inter-observer agreement was reported as Kendall's <i>W</i> and was 0.8, <i>p</i> < 0.01. An intra-rater reliability analysis was performed between the first and second readings of the three readers. The weighted Cohen's Kappa showed that there was moderate agreement between the readings of Reader A with κ = 0.52 and <i>p</i> < 0.001. For Reader B, the weighted Cohen's Kappa showed moderate agreement between first and second readings, κ = 0.5 and <i>p</i> < 0.001. For Reader C, the weighted Cohen's Kappa revealed almost perfect agreement between reading with κ = 0.8 and <i>p</i> < 0.001. CC-Clear is a simple tool for the CCE reader to utilise and has been shown again here to have excellent inter- and intra-observer reliability.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29614842"},"PeriodicalIF":2.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135357","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":"Correction: Practices and Perspectives on Prophylactic Pancreatic Stent Removal Practice: The PIRATE Survey.","authors":"Marius Zimmerli, Lisette Krassenburg, Enrique de-Madaria, Egle Dieninyte, Paula Ribeiro Sousa, Sophie Schlosser-Hupf, Andreas Wannhoff, Abdullah Murat Buyruk, Lucía Guilabert, Lumir Kunovsky, Mohamed Alboraie, Anna Feiden, Lukas Welsch, Stefanie Reichermeier, Stefan Kahl, Clara Benedetta Conti, Benjamin Misselwitz, Elisabetta Goni, Henriette Heinrich","doi":"10.1055/a-2956-4815","DOIUrl":"https://doi.org/10.1055/a-2956-4815","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1055/a-2879-7331.].</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29564815"},"PeriodicalIF":2.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135384","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":"Impact of Sphincterotomy on Suprapapillary Inside Stent Patency in Unresectable Malignant Hilar Biliary Obstruction: A Multicenter Cohort Study.","authors":"So Nakaji, Kyoyoshi Saito, Emiri Kita, Wataru Yoshioka, Motoyasu Kan, Yusuke Ishida, Rintaro Mikata, Kenichi Tanaka, Toshiyasu Shiratori, Sohei Yoshimura, Hiroshi Ohyama, Toshio Tsuyuguchi, Shigenobu Yoshimura, Yoshiki Nakaya, Naoaki Tsuchiya, Hirokazu Takahashi","doi":"10.1055/a-2962-1556","DOIUrl":"10.1055/a-2962-1556","url":null,"abstract":"<p><p><b>Background and Study Aims</b> The role of endoscopic sphincterotomy (EST) during suprapapillary inside stent placement for unresectable malignant hilar biliary obstruction (MHBO) remains uncertain. We evaluated its association with stent patency and adverse events. <b>Patients and Methods</b> This multicenter retrospective cohort included 376 consecutive patients treated at 8 institutions (2014-2024). The primary outcome was time to recurrent biliary obstruction (TRBO). Multivariable Cox regression, 1:1 propensity score matching (PSM), and competing-risk analysis were performed. Patients with prior EST were excluded from index-procedure safety analyses. <b>Results</b> Clinical success was achieved in 315 patients; 244 (77.5%) were in the EST group. TRBO did not differ between the EST and non-EST groups overall (median 170 vs 157 days; <i>p</i> = 0.85), after PSM (196 vs 207 days; <i>p</i> = 0.49), or in adjusted Cox analysis (hazard ratio 1.21, 95% CI 0.77-1.90). Competing-risk analysis likewise showed no difference (Gray's <i>p</i> = 0.45). Among 360 patients without prior EST, PEP occurred in 7.8% versus 11.0% ( <i>p</i> = 0.388), PEB in 1.5% versus 0% ( <i>p</i> = 0.576), and perforation in 0.4% versus 0% ( <i>p</i> = 1.000) in the index EST and non-EST groups, respectively. The single perforation was type III and was classified as mild in severity. <b>Conclusions</b> EST was not associated with longer initial stent patency. These retrospective findings do not support routine EST solely to prolong patency; its potential role in facilitating subsequent transpapillary reinterventions requires prospective evaluation.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29621556"},"PeriodicalIF":2.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135448","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":"Trends and Variations in Colonoscopy Sedation: Insights based on the Dutch Gastrointestinal Endoscopy Audit.","authors":"Querijn N E van Bokhorst, Paula F B Vernooij, Karlijn J Nass, Jos W Borkent, Jurriën G P Reijnders, Peter J van der Schaar, Marc A M T Verhagen, Paul Fockens, Manon van der Vlugt, Evelien Dekker","doi":"10.1055/a-2942-3921","DOIUrl":"10.1055/a-2942-3921","url":null,"abstract":"<p><p><b>Background</b> Sedative medication is routinely used during colonoscopy. Sedation practices may vary in terms of the type and dose of administered medication, possibly impacting clinical outcomes, associated risks, and financial and environmental burdens. We aimed to assess trends and variations in colonoscopy sedation in the Netherlands. <b>Methods</b> Data prospectively recorded in the Dutch Gastrointestinal Endoscopy Audit registry between January 2020 and January 2025 were analyzed. Annual trends in the application of different types of sedation were assessed. Variations across endoscopy units were evaluated by comparing midazolam dosing regimens and the proportional application of propofol-based sedation. Regression analyses assessing the association between sedation and cecal intubation and polyp detection were performed. <b>Results</b> Data from 285,241 colonoscopies were included. Application of propofol-based sedation increased from 5.8% (2020) to 10.0% (2024). The largest increases were observed for IBD-related (11.6-23.2%) and therapeutic indications (28.2-51.7%). For midazolam-based sedation, the mean dose administered varied considerably across units (2.1-5.6mg), as did the proportional application of propofol-based sedation (median 5.0% [IQR 2.3-15.7]; range 0-38%). Compared to midazolam-based sedation using doses equal to or lower than 2.5 mg, propofol-based sedation was not associated with improved cecal intubation (-0.7%; 95% confidence interval [CI] -1.0 to -0.3%), although it was associated with polyp detection (+5.5%; 95% CI +2.8 to +8.3%). <b>Conclusion</b> Colonoscopy sedation practices vary across Dutch endoscopy units in terms of midazolam dosing regimens and the proportional application of propofol-based sedation. In general, propofol-based colonoscopy sedation is increasing. This study's findings may inform guidelines for more standardized, evidence-based, and resource-conscious sedation practices.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29423921"},"PeriodicalIF":2.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135545","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":"Author Reply to Wurm Johansson et al.","authors":"Andrea Nevárez, Reinier Noorda, Valery Naranjo, Vicente Pons-Beltran","doi":"10.1055/a-2961-0747","DOIUrl":"10.1055/a-2961-0747","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29610747"},"PeriodicalIF":2.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135408","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":"Seated Versus Standing Endoscopic Retrograde Cholangiopancreatography: Association with Operator Fatigue and Pain.","authors":"Kazuya Sumi, Jun Ushio, Minoru Daira, Hisaki Kato, Yuki Kawasaki, Tomoaki Kakazu, Yukiko Okada, Ryo Hashizume, Satoshi Ishijima, Takayoshi Ito, Noboru Yokoyama, Haruhiro Inoue","doi":"10.1055/a-2957-0590","DOIUrl":"10.1055/a-2957-0590","url":null,"abstract":"","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29570590"},"PeriodicalIF":2.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135477","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":"Improving Endoscopic Scoring Accuracy in Pediatric Inflammatory Bowel Disease: Impact of a Focused Training Intervention.","authors":"Matteo Bramuzzo, Sara Renzo, Flavio Labriola, Fabiola Giudici, Serena Arrigo, Sara Lega, Erasmo Miele, Lorenzo Norsa, Salvatore Oliva, Francesca Bravin, Sara Curto, Marco Deganello Saccomani, Martina Di Benedetto, Elvira Difrancisca, Marta Maino, Cecilia Mantegazza, Giacomo Mulinacci, Elena Sofia Pieri, Antonio Pizzol, Claudio Romano, Paola De Angelis","doi":"10.1055/a-2955-0298","DOIUrl":"10.1055/a-2955-0298","url":null,"abstract":"<p><p><b>Background</b> High variability has been reported in assessing endoscopic scoring systems for pediatric inflammatory bowel disease (IBD). This study assessed whether a structured training could improve interobserver agreement when scoring IBD endoscopy findings. <b>Methods</b> Ten ileocolonoscopic videos were scored using the Mayo Endoscopic Score (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) for ulcerative colitis, and the Simple Endoscopic Score for Crohn's Disease (SES-CD). Ten expert endoscopists and ten trainees evaluated the videos before and after a focused training session. Agreement was measured using intraclass correlation coefficient (ICC) and Fleiss kappa (κ), and perceived benefit was surveyed. <b>Results</b> For MES, κ slightly improved among experts, but ICC declined; trainees showed stable κ and improved ICC. The UCEIS agreement was stable in experts and slightly improved in trainees. The SES-CD scores showed improved agreement for both groups, with trainee accuracy improving from 74% to 86% (Δ = 12%, <i>p</i> = 0.051). Both groups reported subjective improvement, although not statistically significant. <b>Conclusions</b> Interobserver agreement ranged from moderate to good. Structured training produced only modest improvements, especially in SES-CD scoring, with limited overall effect on scoring consistency.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29550298"},"PeriodicalIF":2.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135387","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":"Clinical Outcomes of Endoscopic Resection for Large (>3 cm) Ampullary Tumors.","authors":"Tian-Yu Zhang, Zhang-Han Chen, Dong-Li He, Jia Song, Lin-Da Li, Han-Xiao Zhang, Yun-Shi Zhong, Yan Wang","doi":"10.1055/a-2961-1504","DOIUrl":"10.1055/a-2961-1504","url":null,"abstract":"<p><p><b>Background and Study Aims</b> Current guidelines recommend en bloc endoscopic resection (ER) for ampullary tumors up to 3 cm and surgery for those exceeding 4 cm, based on low-quality evidence. Robust clinical data and operative experience with ER for tumors >3 cm are relatively limited. This study aimed to investigate the safety and efficacy of ER for large ampullary tumors exceeding 3 cm. <b>Patients and Methods</b> This retrospective study included 28 patients with large ampullary tumors (>3 cm) treated with ER at two tertiary academic endoscopy centers from September 2017 to July 2025. Clinical, endoscopic, and pathological records and follow-up data were collected and analyzed. <b>Results</b> All 28 patients successfully underwent ER with a complete ER rate of 100% and an R0 resection rate of 67.9%. The overall postoperative delayed bleeding rate was 14.3% (4/28; 95% CI: 5.7-31.5%). In subgroup data, bleeding occurred in 2 of 24 patients (8.3%; 95% CI: 1.5-25.8%) with stent placement, in 2 of 4 patients (50.0%; 95% CI: 8.9-91.1%) without stent placement; bleeding occurred in 3 of 27 patients (11.1%; 95% CI: 3.9-28.1%) with wound closure, and in the single patient without wound closure (100%; 95% CI: 5.1-100.0%). All bleeding events were managed endoscopically. No other adverse events occurred. After a mean follow-up of 27.4 months (range 10.0-97.0 months), two patients (7.1%) developed recurrence and underwent surgical resection ( <i>n</i> = 1) or repeat ER ( <i>n</i> = 1). <b>Conclusions</b> ER appears safe and effective for ampullary tumors exceeding 3 cm. The potential roles of wound closure and stent placement in reducing adverse events require validation in larger comparative trials.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29611504"},"PeriodicalIF":2.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135353","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":"Colorectal Endoscopic Submucosal Dissection and Acute Kidney Injury: A Rare but Clinically Relevant Adverse Event, a Cohort Study of 1537 Patients.","authors":"Eugenio Baglione, Veronique Van der Voort, Zhour El Ouafi, Jérémie Albouys, Romain Legros, Sara Battistella, Hugo Lepetit, Clément Juglard, Remi Collin, Pauline Champy, Bertrand Landreau, Youssef Mlaiki, Nora Boutarbouch, Clement Danthu, Constance Grunewald, Sophie Geyl, Paul Carrier, Mathieu Pioche, Fatouma Toure, Jérémie Jacques","doi":"10.1055/a-2914-8234","DOIUrl":"10.1055/a-2914-8234","url":null,"abstract":"<p><p><b>Background and Aims</b> Colorectal endoscopic submucosal dissection (ESD) is established for large superficial neoplasia, but systemic adverse events remain underexplored. We aimed to assess the frequency, predictors, and outcomes of clinically evident acute kidney injury (AKI) after colorectal ESD. <b>Methods</b> All consecutive colorectal ESDs performed at Limoges University Hospital (2017-2024) within the prospective French ESD Colorectal Cohort (FECCO) were retrospectively analyzed to identify AKI events and related factors. <b>Results</b> Among 1537 patients, the frequency of clinically evident AKI was 1.3% ( <i>n</i> = 20). Compared with non-AKI patients, AKI-patients were older (74 vs. 70 years, <i>p</i> = 0.029) and more often receiving angiotensin-converting enzyme (ACE) inhibitors (40% vs. 13.6%, <i>p</i> = 0.003). AKI-patients had larger lesions (100 vs. 55 mm, <i>p</i> < 0.001), longer procedures (181 vs. 55 min, <i>p</i> < 0.001), and higher rates of perforation (35% vs. 10.4%, <i>p</i> = 0.003) and delayed bleeding (36% vs. 5.4%, <i>p</i> = 0.003). ACE-inhibitors (OR 3.96, 95% CI 1.40-9.36) and lesion diameter (OR 1.03, 95% CI 1.02-1.04) were independent predictors of AKI. By the end of follow-up, all patients recovered their baseline renal function. <b>Conclusions</b> AKI after colorectal ESD is rare but clinically relevant. Patients receiving ACE inhibitors and with larger lesions are at higher risk. Careful periprocedural management, including adequate hydration, close monitoring during prolonged or complex procedures, and consideration of ACE inhibitor therapy, may be relevant in this setting.</p>","PeriodicalId":11671,"journal":{"name":"Endoscopy International Open","volume":"14 ","pages":"a29148234"},"PeriodicalIF":2.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149135364","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}