The ASGE Standards of Practice Committee, Madhav Desai MD, MPH , Wenly Ruan MD , Nirav C. Thosani MD , Manuel Amaris MD , J. Stephen Scott MD , Ahmed Saeed MD , Barham Abu Dayyeh MD, MPH, FASGE , Marcia Irene Canto MD, MHS, MASGE , Wasif Abidi MD, PhD , Omeed Alipour MD , Stuart K. Amateau MD, PhD, FASGE , Natalie Cosgrove MD , Sherif E. Elhanafi MD , Nauzer Forbes MD, MSc, FASGE , Divyanshoo R. Kohli MD , Richard S. Kwon MD, FASGE , Larissa L. Fujii-Lau MD , Jorge D. Machicado MD, MPH , Neil B. Marya MD , Bashar J. Qumseya MD, MPH, FASGE
{"title":"American Society for Gastrointestinal Endoscopy guideline on the diagnosis and management of GERD: summary and recommendations","authors":"The ASGE Standards of Practice Committee, Madhav Desai MD, MPH , Wenly Ruan MD , Nirav C. Thosani MD , Manuel Amaris MD , J. Stephen Scott MD , Ahmed Saeed MD , Barham Abu Dayyeh MD, MPH, FASGE , Marcia Irene Canto MD, MHS, MASGE , Wasif Abidi MD, PhD , Omeed Alipour MD , Stuart K. Amateau MD, PhD, FASGE , Natalie Cosgrove MD , Sherif E. Elhanafi MD , Nauzer Forbes MD, MSc, FASGE , Divyanshoo R. Kohli MD , Richard S. Kwon MD, FASGE , Larissa L. Fujii-Lau MD , Jorge D. Machicado MD, MPH , Neil B. Marya MD , Bashar J. Qumseya MD, MPH, FASGE","doi":"10.1016/j.gie.2024.10.008","DOIUrl":"10.1016/j.gie.2024.10.008","url":null,"abstract":"<div><div>This clinical practice guideline from the American Society for Gastrointestinal Endoscopy (ASGE) provides an evidence-based approach for strategies to diagnose and manage GERD. This document was developed using the Grading of Recommendations Assessment, Development, and Evaluation framework and serves as an update to the 2014 ASGE guideline on the role of endoscopy in the management of GERD. This updated guideline addresses the indications for endoscopy in patients with GERD as well as in the emerging population of patients who develop GERD after sleeve gastrectomy or peroral endoscopic myotomy. It also discusses how to endoscopically evaluate gastroesophageal junctional integrity in a comprehensive and uniform manner. Importantly, this guideline also discusses management strategies for GERD including the role of lifestyle interventions, proton pump inhibitors (PPIs), and endoscopic antireflux therapy (including transoral incisionless fundoplication [TIF], radiofrequency energy, and combined hiatal hernia repair and TIF [cTIF]) in the management of GERD. The ASGE suggests upper endoscopy for the evaluation of GERD in patients with alarm symptoms, with multiple risk factors for Barrett’s esophagus, and with a history of sleeve gastrectomy. The ASGE recommends careful endoscopic evaluation, reporting, and photo-documentation of objective GERD findings with attention to gastroesophageal junction landmarks and integrity in patients who undergo upper endoscopy to improve care. In patients with GERD symptoms, the ASGE recommends lifestyle modifications. In patients with symptomatic and confirmed GERD with predominant heartburn symptoms, the ASGE recommends medical management including PPIs at the lowest dose for the shortest duration possible while initiating discussion about long-term management options. In patients with confirmed GERD with small hiatal hernias (≤2 cm) and Hill grade I or II who meet specific criteria, the ASGE suggests evaluation for TIF as an alternative to chronic medical management. In patients with persistent GERD with large hiatal hernias (> 2cm) and Hill grade III or IV, the ASGE suggests either cTIF or surgical therapy based on multidisciplinary review. This document summarizes the methods, analyses, and decision processes used to reach the final recommendations and represents the official ASGE recommendations on the above topics.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 267-284"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846371","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}
Wei-Zhen Tang MD, Zhe-Ming Kang MD, Tai-Hang Liu PhD
{"title":"Comparative efficacy of short versus standard esophageal myotomy in sigmoid-type achalasia treatment","authors":"Wei-Zhen Tang MD, Zhe-Ming Kang MD, Tai-Hang Liu PhD","doi":"10.1016/j.gie.2024.09.034","DOIUrl":"10.1016/j.gie.2024.09.034","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Page 481"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074425","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}
Katarzyna M. Pawlak MD, PhD, Mateusz Jagielski MD, PhD, Kareem Khalaf H.BsC, MD, Jacek Piątkowski MD, PhD, Jacek Szeliga MD, PhD, Marek Jackowski MD, PhD
Giacomo Emanuele Maria Rizzo MD , Mario Traina MD , Dario Ligresti MD , Lucio Carrozza MD , Gabriele Rancatore MD , Rosa Liotta MD , Alessandro Bertani PhD , Ilaria Tarantino MD
{"title":"EUS-guided transesophageal fine-needle biopsy sampling of lung masses: diagnostic performance and safety","authors":"Giacomo Emanuele Maria Rizzo MD , Mario Traina MD , Dario Ligresti MD , Lucio Carrozza MD , Gabriele Rancatore MD , Rosa Liotta MD , Alessandro Bertani PhD , Ilaria Tarantino MD","doi":"10.1016/j.gie.2024.09.042","DOIUrl":"10.1016/j.gie.2024.09.042","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Pulmonary masses are a diagnostic challenge in the field of EUS tissue acquisition, especially through transesophageal EUS-guided fine-needle biopsy sampling (EUS-FNB). Our study evaluated the feasibility, diagnostic performance, and safety of EUS-FNB of pulmonary lesions.</div></div><div><h3>Methods</h3><div>Fifty-three patients were enrolled in a prospective registry. All EUS procedures were performed by experienced endosonographers. Outcomes were specimen adequacy, diagnostic accuracy, diagnostic sensibility, diagnostic specificity, and safety.</div></div><div><h3>Results</h3><div>The mean patient age was 70 ± 10.4 years, and 71.7% were men. The mean lesion size was 52.4 ± 23.3 mm, and patients mostly had a single lesion (86.8%). Most patients had an advanced stage at diagnosis (stage IV, 41.82%), and the most common lung cancer was non–small cell lung carcinoma (69.4%). The diagnostic adequacy rate was 92.86%, and diagnostic accuracy was 87.5%. Adverse events were reported in 3 procedures.</div></div><div><h3>Conclusions</h3><div>Transesophageal EUS-FNB is a feasible and safe diagnostic method of tissue sampling for lung masses reachable by EUS.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 436-440.e3"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377751","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":"EUS-guided coiling plus glue injection compared with endoscopic glue injection alone in endoscopic treatment for gastric varices: a systematic review and meta-analysis","authors":"Cynthia Florencio de Mesquita , Vanio L.J. Antunes , Natalia Junkes Milioli MD , Matheus Vanzin Fernandes MD , Tulio L. Correa MD , Otavio Cosendey Martins , Radhika Chavan MD, DNB, FISG, FASGE , Stefano Baraldo MD","doi":"10.1016/j.gie.2024.10.005","DOIUrl":"10.1016/j.gie.2024.10.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>EUS-guided coil plus glue injection has emerged as a safe and effective modality for gastric varices (GVs). Very few studies have compared EUS embolization with the direct endoscopic glue injection (EGI) technique for its safety and effectiveness. In this systematic review and meta-analysis, we compared the outcomes of EUS-guided coil plus glue injection versus EGI.</div></div><div><h3>Methods</h3><div>MEDLINE, EMBASE, and Cochrane databases were searched for studies that compared EUS and EGI for GVs, and 1454 articles were screened following the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Endpoints were pulmonary embolism, recurrent bleeding rate, reintervention rate, technical success, abdominal pain, and mortality rate. A restricted maximum likelihood random-effects model with odds ratios (ORs) and 95% confidence intervals (CIs) was used for binary endpoints. Heterogeneity was evaluated through Cochrane’s Q statistic and Higgins and Thompson’s <em>I</em><sup>2</sup> statistic. Significance was defined as <em>P</em> < .05.</div></div><div><h3>Results</h3><div>We included 6 studies with 445 patients treated for GVs. Mean patient age was 49 years, and 43% were women. EUS was associated with a reduction in recurrent bleeding rate (OR, .22; 95% CI, .11-.45; <em>P</em> < .001; <em>I</em><sup>2</sup> = 0) and reintervention rate (OR, .29; 95% CI, .09-.89; <em>P</em> = .03; <em>I</em><sup>2</sup> = 49%) compared with EGI. There were no differences between groups in pulmonary embolism (OR, .34; 95% CI, .10-1.18; <em>P</em> = .09; <em>I</em><sup>2</sup> = 0%), mortality rate (OR, .78; 95% CI, .28-2.13; <em>P</em> = .63; <em>I</em><sup>2</sup> = 0%), technical success (OR, 3.50; 95% CI, .60-20.49; <em>P</em> = .16; <em>I</em><sup>2</sup> = 0%), fever (OR, 1.49; 95% CI, .42-5.21 days; <em>P</em> = .5; <em>I</em><sup>2</sup> = 0%), and abdominal pain (OR, .96; 95% CI, .31-2.95; <em>P</em> = .94; <em>I</em><sup>2</sup> = 32%).</div></div><div><h3>Conclusions</h3><div>In patients with GVs, EUS-guided coil plus glue injection is associated with lower recurrent bleeding and reintervention rates than EGI with no difference in pulmonary embolization rate, abdominal pain, technical success, and mortality rate.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 331-340.e8"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399937","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}
Rena Yadlapati MD, MS, Dayna Early MD, Prasad G. Iyer MD, MS, Douglas R. Morgan MD, MPH, Neil Sengupta MD, Prateek Sharma MD, Nicholas J. Shaheen MD, MPH
{"title":"Quality indicators for upper GI endoscopy","authors":"Rena Yadlapati MD, MS, Dayna Early MD, Prasad G. Iyer MD, MS, Douglas R. Morgan MD, MPH, Neil Sengupta MD, Prateek Sharma MD, Nicholas J. Shaheen MD, MPH","doi":"10.1016/j.gie.2024.08.023","DOIUrl":"10.1016/j.gie.2024.08.023","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 236-260"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638677","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}