Gastrointestinal endoscopy最新文献

{"title":"Clinical Applications of Device-Assisted Enteroscopy: A Comprehensive Review.","authors":"Kambiz S Kadkhodayan, Shayan Irani","doi":"10.1016/j.gie.2025.01.022","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.022","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051628","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":"The effect of the timing of endoscopic detorsion on clinical outcomes in patients with sigmoid volvulus.","authors":"Refael Aminov, Anton Bermont, Vered Richter, Haim Shirin, Daniel L Cohen","doi":"10.1016/j.gie.2025.01.023","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.023","url":null,"abstract":"<p><strong>Background and aims: </strong>Guidelines recommend endoscopic detorsion in cases of sigmoid volvulus without ischemia or perforation, but the timing in which this should be performed is unclear.</p><p><strong>Methods: </strong>Admissions for sigmoid volvulus in which endoscopic detorsion was performed between 1/2010-4/2024 were retrospectively reviewed. The timing was calculated as the time between when the confirmatory radiologic exam and endoscopic detorsion were performed. The timing was compared to various patient outcomes.</p><p><strong>Results: </strong>118 episodes of sigmoid volvulus from 73 unique adult patients were included (mean age 69.0; 76.3% male). The median time until endoscopic detorsion was 225.5 minutes (IQR 144.5-478.3) with 81 (68.6%) performed in <6 hours. The timing of detorsion was not associated with the presence of ischemia (p=0.289) or a combination of serious outcomes (p=0.777). Those who underwent delayed endoscopic detorsion (>6 hours) were more likely to be younger (62.4 vs 67.4, p=0.034) and have had a rectal tube placed (59.5% vs 21.0%, p<0.001). Delayed cases were associated with a longer length of admission (5.0 vs 3.0 days, p=0.011); however, other outcomes such as the success of endoscopic detorsion, presence of ischemia, readmission rate, and mortality rate showed no difference between the groups. In a multivariate regression analysis, serious outcomes were associated with \"on call\" status (p=0.045), but not the timing of detorsion (p=0.404).</p><p><strong>Conclusions: </strong>There does not appear to be a clear correlation between a longer delay until endoscopic detorsion and worse patient outcomes, with only the length of hospitalization affected. This suggests that endoscopic detorsion need not always be performed urgently.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051934","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":"Long-term outcomes after endoscopic eradication therapy for dysplastic and T1a adenocarcinoma related Barrett's esophagus: higher rate of late dysplastic recurrence with radio-frequency ablation monotherapy.","authors":"Tony He, Vijaya Sundararajan, Nicholas J Clark, Edward H Tsoi, Alexander J Thompson, Bronte A Holt, Paul V Desmond, Andrew Cf Taylor","doi":"10.1016/j.gie.2025.01.026","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.026","url":null,"abstract":"<p><strong>Background & aims: </strong>There is conflicting literature describing the durability of complete remission of intestinal metaplasia (CRIM) after endoscopic eradication therapy (EET) for Barrett's esophagus (BE). We aim to assess the timeline, predictors and long-term outcomes of recurrence.</p><p><strong>Methods: </strong>Data on 365 patients who underwent EET for dysplastic BE were collected prospectively between 2008 and 2022 at a Barrett's referral unit. Kaplan-Meier method and Epanechnikov-kernel density estimate were used to determine the cumulative incidence of recurrence following CRIM and the rate of recurrence over time. A logistic regression analysis was fitted to identify factors associated with recurrence.</p><p><strong>Results: </strong>216 patients achieved CRIM and were then followed for a median (IQR) 5.8 years (2.9, 7.2). Intestinal metaplasia (IM) recurred in 57 patients (26.4%) and dysplasia in 18 patients (8.3%). The time to recurrence peaked at 1.8 years. The cumulative recurrence risk within 2 years was 23.1% with an additional 29.2% risk over the next 10 years. Increased risks of any BE recurrence (Odds ratio (OR) 3.0; p=0.009), dysplastic (Relative risk ratio (RRR) 5.53; p=0.001) and late (≥2 years) recurrences (RRR 3.24; p=0.01) were associated with radio-frequency ablation (RFA) monotherapy, whereas combination endoscopic mucosal resection (EMR) and RFA was associated with a decreased risk of dysplastic recurrence (RRR 0.27; p=0.02).</p><p><strong>Conclusion: </strong>The risk of recurrence is highest within the first 2 years post-CRIM, but remains significant long term. The risk of IM, dysplasia and late recurrence is higher when RFA was the sole modality used to achieve CRIM, raising the possibility that RFA provides a less durable response. These findings may impact treatment and surveillance decisions.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051570","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":"A Comparison of Endoscopic and Surgical Gastrojejunostomy in Patients with Malignant Gastric Outlet Obstruction: A National Cohort Analysis (2016-2020).","authors":"Bhanu Siva Mohan Pinnam, Pius Ehiremen Ojemolon, Abdul Mohammed, Dushyant Singh Dahiya, Saurabh Chandan, Harishankar Gopakumar, Hassam Ali, Manesh Kumar Gangwani, Rohit Agrawal, Benjamin Mba, Hemant Mutneja, Seema Gandhi, Muhammad K Hasan, Sumant Inamdar","doi":"10.1016/j.gie.2025.01.025","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.025","url":null,"abstract":"<p><strong>Background and aims: </strong>Malignant gastric outlet obstruction (MGOO) is an unfortunate complication of advanced upper gastrointestinal malignancies. Historically, surgical gastrojejunostomy has been the procedure of choice to achieve enteral bypass. Recently, endoscopic techniques have gained popularity in the management of MGOO. We aimed to compare peri-procedural outcomes between surgical and endoscopic gastrojejunostomy in patients with MGOO.</p><p><strong>Methods: </strong>The National Inpatient Sample (NIS) was queried for 2016 through 2020. The International Classification of Diseases, Tenth Revision (ICD-10) codes were used to identify adult admissions with a principal diagnosis of gastric, pancreatic, or duodenal cancer undergoing endoscopic gastrojejunostomy (EGJ) or surgical gastrojejunostomy (SGJ). The two cohorts were compared for peri-procedural adverse events.</p><p><strong>Results: </strong>Twenty thousand nine hundred thirty (20,930) hospitalizations undergoing gastrojejunostomy (16,585 SGJ and 4,345 EGJ) for MGOO were identified. The SGJ cohort had a higher proportion of patients with pancreatic cancer (36.16% vs 19.56%) and a lower proportion of patients with gastric cancer (55.16% vs 71.99%). A higher percentage of endoscopic GJs were performed in the Northeast (20.33% vs 27.66%, P<0.001), while a smaller percentage of endoscopic GJs were performed in the South (30.56% vs. 39.52%, P <0.001). Between the two groups, the difference in mortality rates was not significantly different [0.62, 95% CI 0.35-1.10, P =0.106), but the EGJ group had lower odds of respiratory failure [4.7% vs. 7.4%, aOR (adjusted odds ratio) 0.68, 95% CI (confidence interval) 0.48 - 0.96, P =0.032], blood transfusion [9.25% vs. 13.74%, aOR 0.63, 95% CI 0.48 - 0.82, P =0.001], and peritonitis [2.19% vs 4.5%, aOR 0.55, 95% CI 0.33-0.91, P =0.022]. The EGJ group had lesser hospitalization charges [mean $164,794 vs. $183,519, adjusted difference on regression $16,495, 95% CI $29,204 - $3,786, P =0.011], and shorter hospital stays [mean 9.88 vs. 12.56 days, adjusted difference 2.24 days, 95% CI 1.53 - 2.96 days, P <0.001]. The use of EGJ increased over five years [16.86% in 2016 to 24.14% in 2020, P-value for trend=0.002], while the use of SGJ decreased [83.13% in 2016 to 75.85% in 2020, Trend P=0.002].</p><p><strong>Conclusions: </strong>Compared to surgical GJ, endoscopic GJ is associated with lower rates of peri-procedural adverse events, hospitalization charges, and length of stay. For these reasons, endoscopic GJ should be strongly considered in managing malignant gastric outlet obstruction.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051621","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":"Predicting the need for step-up after EUS-guided drainage of peripancreatic fluid collections, including Quadrant Necrosis Infection score validation: a prospective cohort study.","authors":"Giuseppe Vanella, Roberto Leone, Francesco Frigo, Gemma Rossi, Piera Zaccari, Diego Palumbo, Giorgia Guazzarotti, Francesca Aleotti, Nicolò Pecorelli, Paoletta Preatoni, Luca Aldrighetti, Massimo Falconi, Gabriele Capurso, Francesco De Cobelli, Paolo Giorgio Arcidiacono","doi":"10.1016/j.gie.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.019","url":null,"abstract":"<p><strong>Background and aims: </strong>Factors predicting the need for step-up procedures after EUS-guided drainage (EUS-FCD) of peripancreatic fluid collections (PFCs) were explored in retrospective studies restricted to Walled-Off Necrosis (WON) and Lumen Apposing Metal Stents (LAMS).</p><p><strong>Methods: </strong>All consecutive candidates for EUS-FCD between 2020-2024 were included in a Prospective Registry of Therapeutic EUS (PROTECT, NCT04813055), with prospective monthly follow-up evaluating clinical success, adverse events and recurrences. Prospectively assessed baseline clinical and morphological factors, including the Quadrant-Necrosis-Infection (QNI) classification, were included in a stepwise logistic regression model to predict the need for step-up. The agreement between EUS and Radiology in assessing the extent of necrosis was compared with Cohen's kappa.</p><p><strong>Results: </strong>Seventy patients (29 post-surgical collections, 21 pseudocysts, and 20 WONs) were treated with double-pigtail plastic stents (DPPS) in 59% of cases and LAMS in 41%. Clinical success was 92.9%, with a need for step-up (mostly endoscopic necrosectomy) in 35.7% of cases. Necrosis ≥60% (OR=7.7, 95%CI 1.4-43) and being in the high-risk QNI group (OR=4.6, 95%CI 1.4-15) were the only independent predictors of any step-up. The same factors predicted the endoscopist's decision to allocate PFCs to LAMS vs. DPPS. The high-risk QNI group was associated with a significantly longer hospital stay (12 days vs. 4 days, p=0.004). EUS tended to upscale the necrotic content compared to preprocedural Radiology (κ=0.31) CONCLUSIONS: The extent of necrosis and the QNI classification strongly correlated with the need for step-up and allocation to LAMS vs. DPPS drainage, proposing a central role in treatment personalization.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023010","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":"ERCP for choledocholithiasis in a patient with Situs Inversus presenting with abdominal pain.","authors":"Bernard Dankyi, Michael Harris, Justin Lawandales, Mehak Sachdeva","doi":"10.1016/j.gie.2025.01.011","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.011","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023009","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 submucosal excavation for ileal lipoma (with video).","authors":"Aihong Yin, Yiying Qi, Zhi Wei","doi":"10.1016/j.gie.2025.01.014","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.014","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143003725","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":"Top linear incision:a modified endoscopic submucosal excavation for the management of cardiac subepithelial leiomyoma.","authors":"Suhuan Liao, Bo Li, Silin Huang, Huizhao Deng, Qiuping Qiu","doi":"10.1016/j.gie.2025.01.006","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.006","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143003797","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 dissection of an esophageal stent.","authors":"Jinfeng Zhou","doi":"10.1016/j.gie.2025.01.010","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.010","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143003714","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":"Budesonide MMX for prevention of colonic stricture after subcircumferential endoscopic submucosal dissection.","authors":"Keisuke Kawasaki, Yoshiaki Taniguchi, Akihiro Shigemori, Takehiro Torisu","doi":"10.1016/j.gie.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.gie.2025.01.013","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143003656","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}