Gastrointestinal endoscopy最新文献

{"title":"More efficient endoscopic submucosal dissection with deep endotracheal intubation for superficial cervical esophageal carcinoma: a dual-center, prospective, randomized controlled study","authors":"Yanqin Xu MD ,&nbsp;Yinxin Wu MD ,&nbsp;Wanyin Deng MD ,&nbsp;Xianbin Guo MD ,&nbsp;Pingting Gao MD ,&nbsp;Shijie Yang MD ,&nbsp;Yahua Chen MD ,&nbsp;Pinghong Zhou MD ,&nbsp;Wei Liang MD","doi":"10.1016/j.gie.2024.09.018","DOIUrl":"10.1016/j.gie.2024.09.018","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Deep endotracheal intubation (DET) has been proposed to improve cervical esophageal endoscopic submucosal dissection (ESD) because of the limited space and visibility. We aimed to evaluate the efficacy and safety of DET.</div></div><div><h3>Methods</h3><div>In the current dual-center trial, patients were randomized into DET or conventional endotracheal intubation (CET) groups. Complete resection rate, operation time, and adverse events were measured and compared.</div></div><div><h3>Results</h3><div>Fifty-nine patients (60 lesions) were assigned to the groups, showing comparable baseline characteristics. The complete resection rates were similarly high in both groups. However, DET significantly reduced ESD operation time (52.2 minutes vs 71.1 minutes, <em>P</em> &lt; .001) and postoperative pain scores (3.1 vs 4.7, <em>P</em> &lt; .01). Severe stenosis occurred more frequently in the CET patients (20% vs 0%, <em>P</em> = .035). No significant differences were observed in other adverse events.</div></div><div><h3>Conclusions</h3><div>DET can overcome technical challenges to improve therapeutic efficiency and safety. (Clinical trial registration number: NCT06420258.)</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 655-658"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142283744","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":"Safety and efficacy of underwater EMR for 10- to 20-mm colorectal serrated lesions (SEA CLEAR study)","authors":"Kosuke Tanaka MD ,&nbsp;Yohei Yabuuchi MD ,&nbsp;Kenichiro Imai MD, FJGES ,&nbsp;Kazuya Hosotani MD ,&nbsp;Shuko Morita MD ,&nbsp;Kazunori Takada MD ,&nbsp;Yoshihiro Kishida MD, PhD, FJGES ,&nbsp;Sayo Ito MD ,&nbsp;Kinichi Hotta MD, FJGES ,&nbsp;Keita Mori PhD ,&nbsp;Tetsuro Inokuma MD, PhD ,&nbsp;Hiroyuki Ono MD, PhD","doi":"10.1016/j.gie.2024.08.040","DOIUrl":"10.1016/j.gie.2024.08.040","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Colorectal serrated lesions (SLs) are precursors of colorectal carcinoma via the serrated neoplasia pathway. However, the success rate of endoscopic resection of large SLs is low. Therefore, this study aimed to determine the safety and efficacy of underwater EMR (UEMR) for SLs sized 10 to 20 mm.</div></div><div><h3>Methods</h3><div>This 2-center, prospective, observational study included patients with at least 1 SL sized 10 to 20 mm. We resected the SLs by UEMR and performed tattooing at the resection site. Surveillance colonoscopy was performed 12 months postoperatively to evaluate local recurrence. The primary outcome was the complete resection rate of UEMR, which was defined as en bloc resection with no serrated tissue in the 4 marginal biopsy samples and histologically negative margins.</div></div><div><h3>Results</h3><div>UEMR was performed for 65 SLs in 58 patients, with a median lesion size of 14 mm. The en bloc, R0 resection, and complete resection rates were 87.7% (57 of 65), 61.5% (40 of 65), and 60.0% (39 of 65), respectively. Adverse events included 1 (1.5%) immediate bleeding and 1 (1.5%) delayed perforation. Surveillance colonoscopy was performed in 50 patients with 57 scars, and the rates of identification for tattoos and scars were 94.7% (54 of 57) and 100% (57 of 57), respectively. The recurrence rate was 5.3% (3 of 57), and all 3 recurrent lesions were completely resected endoscopically.</div></div><div><h3>Conclusions</h3><div>This 2-center prospective study demonstrated that UEMR for SLs sized 10 to 20 mm was comparable to previous conventional EMR outcomes.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 632-638"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142283750","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":"Rectal mass: Cancer or endometriosis?","authors":"Jiedong Ma MS,&nbsp;Wenjuan Yang MD, PhD,&nbsp;Yuting Zhao MS,&nbsp;Jing Li MD, PhD","doi":"10.1016/j.gie.2024.10.034","DOIUrl":"10.1016/j.gie.2024.10.034","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 688-689"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142498520","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":"Malek Shatila MD,&nbsp;Yinghong Wang MD, PhD","doi":"10.1016/j.gie.2024.11.008","DOIUrl":"10.1016/j.gie.2024.11.008","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 696-698"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143519299","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":"Advancing the management of achalasia with peroral endoscopic myotomy (POEM) versus pneumatic balloon dilation: Is POEM the superior choice?","authors":"Yuto Shimamura MD, PhD","doi":"10.1016/j.gie.2024.11.044","DOIUrl":"10.1016/j.gie.2024.11.044","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 568-569"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520746","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":"Misleading metrics in classification tasks: a closer look at negative predictive value in the context of post-ERCP pancreatitis prediction","authors":"Erfan Arabpour MD,&nbsp;Amir Sadeghi MD","doi":"10.1016/j.gie.2024.10.044","DOIUrl":"10.1016/j.gie.2024.10.044","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 692-693"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520766","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 endoscopic vacuum therapy for stricture prevention after wide-field endoscopic submucosal dissection of superficial esophageal cancer","authors":"Tobias Blasberg MD ,&nbsp;Moritz Meiborg MD ,&nbsp;Johannes Richl MD ,&nbsp;Marie Weber MD ,&nbsp;Lukas Hiebel MD ,&nbsp;Ardian Mekolli MD ,&nbsp;Ali Seif Amir Hosseini MD ,&nbsp;Ahmad Amanzada MD ,&nbsp;Volker Ellenrieder MD ,&nbsp;Jürgen Hochberger MD ,&nbsp;Edris Wedi MD, PhD","doi":"10.1016/j.gie.2024.08.011","DOIUrl":"10.1016/j.gie.2024.08.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Esophageal stricture is a severe adverse event after wide-field endoscopic submucosal dissection (ESD) of superficial esophageal carcinoma. This study evaluated the efficacy and safety of combining endoscopic vacuum therapy (EVT) and a budesonide orodispersible tablet (BOT) in preventing post-ESD strictures.</div></div><div><h3>Methods</h3><div>This prospective case series included patients with superficial esophageal squamous cell carcinoma and adenocarcinoma who had wide-field ESD (≥75% circumference, resection length ≥50 mm). After ESD, EVT was applied immediately followed by 8 weeks of BOTs. The main outcome measurement was the incidence of post-ESD stricture.</div></div><div><h3>Results</h3><div>Eleven patients underwent ESD. Of these, 81.8% had 75% to 99% circumference resected and 18.2% had a circumferential resection. EVT remained in situ for a mean of 3.5 days. No esophageal strictures were observed by the final follow-up, and no major adverse events occurred related to EVT or the BOT.</div></div><div><h3>Conclusions</h3><div>The prophylactic combination of EVT and BOT is a novel and promising strategy for reducing post-ESD strictures.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 650-654"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142283749","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":"Symptomatic jejunal Dieulafoy lesion masquerading as a polyp","authors":"Thomas Enke MD,&nbsp;Patrick Henn MD,&nbsp;Augustin R. Attwell MD","doi":"10.1016/j.gie.2024.10.023","DOIUrl":"10.1016/j.gie.2024.10.023","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 680-682"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142462633","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 devices and techniques for the management of gastric varices (with videos)","authors":"ASGE Technology Committee,&nbsp;Guru Trikudanathan MD, FASGE ,&nbsp;Erik F. Rahimi MD, FASGE ,&nbsp;Amit Bhatt MD ,&nbsp;Juan Carlos Bucobo MD, FASGE ,&nbsp;Vinay Chandrasekhara MD, FASGE ,&nbsp;Andrew P. Copland MD ,&nbsp;Samuel Han MD, MS ,&nbsp;Allon Kahn MD ,&nbsp;Kumar Krishnan MD, FASGE ,&nbsp;Nikhil A. Kumta MD, MS ,&nbsp;David R. Lichtenstein MD, FASGE ,&nbsp;Jorge V. Obando MD ,&nbsp;Rahul Pannala MD, MPH, FASGE ,&nbsp;Mansour A. Parsi MD, MPH, MBA, FASGE ,&nbsp;Monica Saumoy MD, MS ,&nbsp;Arvind J. Trindade MD, FASGE ,&nbsp;Julie Yang MD, FASGE ,&nbsp;Ryan J. Law DO ,&nbsp;ASGE Technology Committee Chair","doi":"10.1016/j.gie.2024.06.038","DOIUrl":"10.1016/j.gie.2024.06.038","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Gastric variceal bleeding occurs less commonly than bleeding from esophageal varices (EVs), although it is associated with higher morbidity and mortality. Bleeding from gastroesophageal varices type 1 (GOV1) is treated like EVs. In contrast, other forms of gastric variceal bleeding, including gastroesophageal varices type 2 (GOV2) and isolated gastric varices types 1 (IGV1) and 2 (IGV2), are treated with varying endoscopic approaches. Nonendoscopic methods include transjugular intrahepatic portosystemic shunt (TIPS) or balloon-occluded retrograde transvenous obliteration (BRTO). This technology report focuses on endoscopic management of gastric varices (GVs).</div></div><div><h3>Methods</h3><div>The MEDLINE database was searched through August 2022 for relevant articles by using key words such as gastric varices, glue, cyanoacrylate, thrombin, sclerosing agents, band ligation, topical hemostatic spray, coils, EUS, TIPS, and BRTO. The article was drafted, reviewed, and edited by the American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee and approved by the Governing Board of the ASGE.</div></div><div><h3>Results</h3><div>Endoscopic injection with cyanoacrylate (CYA) glue has been the primary endoscopic method to treat GVs. EUS-guided angiotherapy with CYA glue and coil embolization has emerged as an alternative method enabling improved detection of GVs with a high technical success for targeting and obliterating GVs. Combining CYA glue with coil therapy allows the coil to act as a scaffold for the glue, reducing the risk of glue embolization and improving outcomes. Alternative injectates or topical treatments have been described but remain poorly studied.</div></div><div><h3>Conclusions</h3><div>The mainstay paradigm for the endoscopic management of gastric variceal bleeding is the injection of CYA glue. The published success of EUS-guided angiotherapy using CYA glue with or without embolization coils has increased our treatment armamentarium.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 496-510"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544923","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":"Reproducibility of EUS-guided shear wave elastography for assessment of hepatic fibrosis: a prospective pilot cohort study","authors":"David L. Diehl MD ,&nbsp;Vikas Sangwan MD ,&nbsp;Sandeep Khurana MD ,&nbsp;Harshit S. Khara MD ,&nbsp;Jianying Zhang MD, MPH, MSc ,&nbsp;Bradley D. Confer DO","doi":"10.1016/j.gie.2024.10.064","DOIUrl":"10.1016/j.gie.2024.10.064","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Noninvasive assessment of liver fibrosis is important in the management of liver disease. EUS-guided shear wave elastography (EUS-SWE) is a newer technology that can measure liver stiffness, thereby estimating hepatic fibrosis. There are limited data comparing EUS-SWE to vibration-controlled transient elastography (VCTE) using liver biopsy as the reference standard, and the reproducibility of EUS-SWE measurements is not known.</div></div><div><h3>Methods</h3><div>In total, 52 patients referred for EUS-guided liver biopsy (EUS-LB) were prospectively enrolled. Patients first underwent VCTE, then 2 consecutive EUS-SWE measurements done first in the left and then another 2 in the right. Bilobar EUS-LB was then done. Receiver operating characteristic curves were developed to compare EUS-SWE to VCTE and correlate to histology. Analysis was performed to determine EUS-SWE variability in paired measurements for each lobe and between right and left liver lobes.</div></div><div><h3>Results</h3><div>The most common indication for EUS-LB was non-alcoholic steatohepatitis fibrosis staging in 46% of patients. Right lobe SWE had a strong correlation with fibrosis stage ρ = 0.571 (<em>P</em> &lt; .0001) whereas left lobe EUS-SWE had a moderate correlation ρ = 0.368 (<em>P</em> &lt; .0079). Both EUS-SWE and VCTE were similar for discrimination of all stages of fibrosis based on empiric receiver operating characteristic curves. However, the variance between paired consecutive EUS-SWE measurements was 3.5 times higher in the left lobe compared to the right lobe (<em>P</em> &lt; .0001).</div></div><div><h3>Conclusion</h3><div>EUS-SWE provides an assessment of hepatic fibrosis comparable to VCTE. EUS-SWE in the left lobe has 3.5 times higher variance between consecutive measurements compared to the right.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 3","pages":"Pages 659-662"},"PeriodicalIF":6.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142618378","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}