Gastrointestinal endoscopy最新文献

{"title":"American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in the management of chronic pancreatitis: methodology and review of evidence.","authors":"Sunil G Sheth, Jorge D Machicado, Ankit Chhoda, Jean M Chalhoub, Christopher Forsmark, Nicholas Zyromski, Behnam Sadeghirad, Rebecca L Morgan, Nirav C Thosani, Nikhil R Thiruvengadam, Wenly Ruan, Swati Pawa, Saowanee Ngamruengphong, Neil B Marya, Divyanshoo R Kohli, Larissa L Fujii-Lau, Nauzer Forbes, Sherif E Elhanafi, Madhav Desai, Natalie Cosgrove, Nayantara Coelho-Prabhu, Stuart K Amateau, Omeed Alipour, Wasif Abidi, Bashar J Qumseya","doi":"10.1016/j.gie.2024.05.017","DOIUrl":"https://doi.org/10.1016/j.gie.2024.05.017","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145520","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":"Summary: Guidewires in GI endoscopy.","authors":"Samuel Han, Mohit Girotra, Venkata S Akshintala, Dennis Chen, Yen-I Chen, Koushik K Das, Allon Kahn, Girish Mishra, V Raman Muthusamy, Jorge V Obando, Frances U Onyimba, Swati Pawa, Tarun Rustagi, Sonali Sakaria, Guru Trikudanathan, Ryan J Law","doi":"10.1016/j.gie.2023.12.031","DOIUrl":"https://doi.org/10.1016/j.gie.2023.12.031","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145521","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":"Comparison of flexible endoscopic needle knife septotomy and peroral endoscopic myotomy for treatment of Zenker's diverticulum.","authors":"Yara Sarkis, Sarah Stainko, Anthony Perkins, Mohammad A Al-Haddad, John M DeWitt","doi":"10.1016/j.gie.2024.08.035","DOIUrl":"https://doi.org/10.1016/j.gie.2024.08.035","url":null,"abstract":"<p><strong>Background and aims: </strong>Treatment of Zenker's diverticulum (ZD) has evolved from flexible endoscopic septotomy (FES) to peroral endoscopic myotomy (Z-POEM). In this study, we compare efficacy and safety of FES with a needle knife septotomy (FENKS) and Z-POEM for symptomatic ZD.</p><p><strong>Methods: </strong>Consecutive patients at a single institution who underwent endoscopic ZD treatment by FENKS or Z-POEM were identified. Demographics, clinical characteristics, procedure technique, technical and clinical success, and adverse events (AEs) within 30 days were reviewed and compared between the two groups. AEs were classified by the AGREE classification. Baseline and post-procedure Dakkak and Bennett's (DB) scores were reported at 6, 12 and 24 months. Clinical success (DB score ≤1) was assessed by per-protocol (PP) and intention-to-treat analyses (ITT).</p><p><strong>Results: </strong>60 patients (55% M, mean 72±12 yrs.) underwent FENKS (n=21) or Z-POEM (n=39) between 2016 and 2023. Baseline clinical characteristics were similar and overall technical success was 98.3%. Clinical success by PP and ITT analyses at 6, 12 and 24 months after intervention were similar between both groups. The FENKS group had a higher prevalence (29% vs. 5%, p=0.018) and severity (p=0.032) of AEs and were more likely to be hospitalized after treatment (71% vs. 33%, p=0.007). During a median follow up of 18 months, reintervention was required for 5 (10%) in the FENKS (n=2, 9%) and Z-POEM (n=3, 7.6%) groups (p=1.0) a mean 7.6 ± 4.4 months after initial therapy.</p><p><strong>Conclusion: </strong>Treatment of ZD with Z-POEM appears to be safer than FENKS with similar short- and mid-term clinical success.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106342","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 Ultrasound for the Evaluation of Esophageal Injury After Catheter Ablation for Atrial Fibrillation.","authors":"Karl Akiki, William B Minteer, Vinay Chandrasekhara, Tala Mahmoud, Ryan J Law, Elizabeth Rajan, Alan M Sugrue, Ammar M Killu, Ferga C Gleeson, Barham K Abu Dayyeh, Michael J Levy, Mark Topazian, Andrew C Storm","doi":"10.1016/j.gie.2024.08.036","DOIUrl":"https://doi.org/10.1016/j.gie.2024.08.036","url":null,"abstract":"<p><strong>Background & aim: </strong>Atrial fibrillation (AF) ablation is an increasingly utilized rhythm control strategy that can damage adjacent structures in the mediastinum including the esophagus. Atrioesophageal fistulas and esophagopericardial fistulas are life-threatening complications that are thought to progress from early esophageal mucosal injury (EI). Endoscopic ultrasound (EUS) has been proposed as a superior method than EGD to survey EI and damage to deeper structures. We aim to evaluate the safety of EUS in categorizing post-ablation EI and quantify EUS-detected lesions and their correlation with injury severity and clinical course.</p><p><strong>Methods: </strong>234 consecutive patients between 2006-2020 who underwent AF ablation followed by EUS for the purpose of EI screening were retrospectively reviewed. Kansas City Classification (KCC) was used to classify EI (Type 1, Type 2a/b, Type 3a/b).</p><p><strong>Results: </strong>EUS identified pleural effusions (31.6%) of patients, mediastinal adventitia changes (22.2%), mediastinal lymphadenopathy (14.1%), pulmonary vein changes (10.6%), and esophageal wall changes (7.7%). EGD revealed 175 (75%) patients without and 59 (25%) with EI. Patients with Type 2a/b EI and no EI were compared with multivariate logistic regression, and the presence of esophageal wall abnormality on EUS with OR 72.85 (95% CI 13.9-380.7), female sex with OR 3.97 (95% CI 1.3-12.3), and number of energy deliveries with OR 1.01 (95% CI 1.003-1.03), were associated with the presence EI type 2a or 2b. Pre-ablation PPI use was not associated with decreased risk of EI.</p><p><strong>Conclusions: </strong>EUS safely assesses mediastinal damage after ablation for atrial fibrillation and may excel over EGD in evaluating mucosal lesions of uncertain significance, with reduced risk of gas embolization in the setting of a full thickness injury (entero-vascular fistula). We propose an EUS-first guided approach to post-AF ablation examination, followed by EGD if it is safe to do so.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106343","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 Vacuum Therapy for Treatment of Boerhaave's syndrome: a multicenter analysis.","authors":"Andreas Wannhoff, Konstantinos Kouladouros, Ronald Koschny, Benjamin Walter, Zita Zoll, Karsten Büringer, Susanne Blank, Ulrike Schempf, Karel Caca, Dörte Wichmann","doi":"10.1016/j.gie.2024.08.037","DOIUrl":"https://doi.org/10.1016/j.gie.2024.08.037","url":null,"abstract":"<p><strong>Background and aims: </strong>Boerhaave's syndrome, an effort rupture of the esophagus, is a rare but serious condition. Endoscopic vacuum therapy (EVT) is a new therapeutic approach for gastrointestinal perforation.</p><p><strong>Methods: </strong>This retrospective study was conducted at five tertiary hospitals in southern Germany. All patients treated for Boerhaave's syndrome since 2010 were identified and included. Treatment success and outcomes were assessed and compared between the different modes of primary treatment.</p><p><strong>Results: </strong>Fifty-seven patients with Boerhaave's syndrome were identified (median age 68 years; n = 16 female). The primary treatment was EVT in 25 cases, surgery in 14, and endoscopic stenting in 15. Primary EVT was successful in 20 of the 25 patients (80.0%). Two patients were switched to surgical treatment and one was switched to esophageal stenting and two died. The mortality rate was lower (P = 0.160) in patients treated primarily with EVT (n = 2, 8.0%) than in comparison to patients of the non-EVT group (n = 8, 25.0%). Treatment success was significantly higher (P = 0.007) for primary EVT (80.0%) than for non-EVT (43.8%). Primary EVT was associated with treatment success in multivariate analysis.</p><p><strong>Conclusions: </strong>EVT showed a high success rate for treatment of Boerhaave's syndrome and was associated with treatment success.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106344","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":"Use of Artificial Intelligence Improves Colonoscopy Performance in Adenoma Detection: A Systematic Review and Meta-Analysis.","authors":"Jonathan Makar, Jonathan Abdelmalak, Danny Con, Bilal Hafeez, Mayur Garg","doi":"10.1016/j.gie.2024.08.033","DOIUrl":"https://doi.org/10.1016/j.gie.2024.08.033","url":null,"abstract":"<p><strong>Background and aims: </strong>Artificial intelligence (AI) is increasingly used to improve adenoma detection during colonoscopy. This meta-analysis aimed to provide an updated evaluation of computer-aided detection (CADe) systems and their impact on key colonoscopy quality indicators.</p><p><strong>Methods: </strong>We searched the Embase, PubMed and MEDLINE databases from inception until February 15, 2024, for randomised control trials (RCTs) comparing the performance CADe systems with routine unassisted colonoscopy in the detection of colorectal adenomas.</p><p><strong>Results: </strong>28 RCTs were selected for inclusion involving 23861 participants. Random-effects meta-analysis demonstrated a 20% increase in ADR (RR 1.20, 95% CI 1.14-1.27, p<0.01) and 55% decrease in AMR (RR 0.45, 95% CI 0.37-0.54, p<0.01) with AI-assisted colonoscopy. Subgroup analyses involving only expert endoscopists demonstrated a similar effect size (RR 1.19, 95% CI 1.11-1.27, p<0.001), with similar findings seen in analysis of differing CADe systems and healthcare settings. CADe use also significantly increased adenomas per colonoscopy (weighted mean difference 0.21, 95% CI 0.14-0.29, p<0.01), primarily due to increased diminutive lesion detection, with no significant difference seen in detection of advanced adenoma. Sessile serrated lesion detection (RR 1.10, 95% CI 0.93-1.30, p=0.27) and miss rates (RR 0.44, 95% CI 0.16-1.19, p=0.11) were similar. There was an average 0.15 minute prolongation of withdrawal time with AI-assisted colonoscopy (weighted mean difference 0.15, 95% CI 0.04-0.25, p = 0.01) and a 39% increase in the rate of non-neoplastic resection (RR 1.39, 95% CI 1.23-1.57, p<0.001).</p><p><strong>Conclusions: </strong>AI-assisted colonoscopy significantly improved adenoma, but not sessile serrated lesion, detection irrespective of endoscopist experience, system type or healthcare setting.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106345","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":"Response","authors":"","doi":"10.1016/j.gie.2024.04.017","DOIUrl":"10.1016/j.gie.2024.04.017","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049613","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":"Focus On...","authors":"","doi":"10.1016/S0016-5107(24)03369-8","DOIUrl":"10.1016/S0016-5107(24)03369-8","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049415","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":"Information for readers","authors":"","doi":"10.1016/S0016-5107(24)03373-X","DOIUrl":"10.1016/S0016-5107(24)03373-X","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049418","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":"Editors","authors":"","doi":"10.1016/S0016-5107(24)03367-4","DOIUrl":"10.1016/S0016-5107(24)03367-4","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":null,"pages":null},"PeriodicalIF":6.7,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0016510724033674/pdfft?md5=e4476f252cf77d8c37c27743bb09869b&pid=1-s2.0-S0016510724033674-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049414","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}