Gastrointestinal endoscopy最新文献

{"title":"Noninvasive positive airway pressure for hypoxemia prevention during sedated gastrointestinal endoscopy in adults with obesity: a systematic review and meta-analysis.","authors":"Jariel Abreu Pérez, Valeria Esther Acosta Casana, Carlos Josue Alfaro Lazo, Valentina Alonzo, Carla Daniela Calizaya Baldellon, Alejandro Chen Liang, Macarena Chalbaud, Edgar Lozano, Suleen Daniela Barrera Mosquera, Alejandra Anez Gonzalez, Alexander Vega, Rashmi Advani, Ernesto Calderón Martínez","doi":"10.1016/j.gie.2026.08.037","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.037","url":null,"abstract":"<p><strong>Background and aims: </strong>Adults with obesity undergoing gastrointestinal endoscopy under sedation are at increased risk of hypoxemia. We evaluated nasal continuous positive airway pressure (nCPAP) and noninvasive positive pressure ventilation (NIPPV) versus conventional oxygen therapy in this population.</p><p><strong>Methods: </strong>We searched six databases from inception through May 2026 for randomized controlled trials evaluating nCPAP or NIPPV in adults with obesity undergoing gastrointestinal endoscopy. The review followed PRISMA guidelines and was registered in PROSPERO (CRD420261391143). The primary outcome was oxygen desaturation, defined as SpO₂ <90% or ≤90% according to study definitions. Rescue airway maneuvers were secondary. Random-effects meta-analysis, trial sequential analysis, and GRADE were performed.</p><p><strong>Results: </strong>Four RCTs comprising 457 participants were included. Positive airway pressure strategies reduced oxygen desaturation (RR 0.27; 95% CI 0.14-0.53; p<0.01; I²=0%), with moderate-certainty evidence. Rescue airway maneuvers were also reduced (RR 0.45; 95% CI 0.23-0.89; p=0.03; I²=46.5%); however, certainty was very low, and the prediction interval included no effect. Trial sequential analysis crossed the monitoring boundaries for benefit for both outcomes. Oxygen-delivery protocols differed across trials, and effective FiO₂ was not directly measured.</p><p><strong>Conclusions: </strong>NCPAP or NIPPV may reduce oxygen desaturation during sedated gastrointestinal endoscopy in adults with obesity. The effect on rescue airway maneuvers remains uncertain. Larger trials using standardized oxygen-delivery and airway-rescue protocols are warranted.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873892","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":"Diagnostic Accuracy of the Endoscopic Grading of Gastric Intestinal Metaplasia for Detecting Extensive Disease: a Systematic Review and Meta-analysis.","authors":"Mai Ngoc Luu, Nhi Ai Trinh, Truc Le Thanh Tran, Thinh Phuong Dang, Toru Hiyama, Duc Trong Quach","doi":"10.1016/j.gie.2026.08.036","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.036","url":null,"abstract":"<p><strong>Background and aims: </strong>The Endoscopic Grading of Gastric Intestinal Metaplasia (EGGIM) has been proposed as a real-time endoscopic tool for staging gastric intestinal metaplasia (GIM) to identify high-risk subjects for surveillance. This meta-analysis evaluated the accuracy of EGGIM for identifying extensive GIM, defined as Operative Link on Gastric Intestinal Metaplasia (OLGIM) stage III-IV.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, Cochrane Library, and ClinicalTrials.gov were searched through February 2026. Studies assessing EGGIM in adults undergoing upper gastrointestinal endoscopy, using histological OLGIM staging as the reference standard, were included. Pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratio (DOR) were calculated using a hierarchical bivariate random-effects model, with the primary analysis restricted to studies using narrow-band imaging (NBI) or blue light imaging (BLI). Subgroup analyses were conducted by imaging modality and geographic region (Eastern vs. Western).</p><p><strong>Results: </strong>Of nine studies identified, seven studies comprising 1,143 patients using NBI or BLI were included in the primary pooled analysis. All applied an EGGIM cutoff of ≥5. The pooled sensitivity and specificity were 0.90 (95% confidence interval [CI] 0.84-0.95) and 0.92 (95% CI 0.89-0.94), respectively. The pooled DOR was 105.93 (95% CI 53.81-208.54), and the area under the summary receiver operating characteristic curve (AUC) was 0.96 (95% CI 0.94-0.97). In descriptive subgroup analyses, diagnostic performance appeared broadly similar across Eastern and Western subgroups and across NBI and BLI platforms, despite higher disease prevalence in Eastern studies (55% vs. 18%, p <0.001). No formal between-subgroup comparison was performed due to the limited number of studies.</p><p><strong>Conclusions: </strong>EGGIM at a cutoff of ≥5 appears to demonstrate high diagnostic accuracy for identifying extensive GIM when applied using NBI- or BLI-compatible modalities. These findings appear to support the validity of EGGIM as a real-time endoscopic tool for risk stratification of patients with gastric precancerous conditions. Further studies are warranted to confirm these findings and strengthen the evidence base.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873914","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":"American Society for Gastrointestinal Endoscopy guideline on the role of endoscopy in acute lower gastrointestinal bleeding.","authors":"Nauzer Forbes, Nayantara Coelho-Prabhu, Hana Osman, Howard Guo, Sunil Samnani, Indraneel Datta, Edward Wolfgang Lee, Anirudh Mirakhur, Wasif M Abidi, Natalie Cosgrove, Madhav Desai, Sara Ghoneim, Calvin Lee, Jorge D Machicado, Jared Magee, Neil B Marya, Saowanee Ngamruengphong, Michael D Rice, Wenly Ruan, Monica Saumoy, Sunil G Sheth, Nikhil R Thiruvengadam, Bashar J Qumseya, Nirav C Thosani","doi":"10.1016/j.gie.2026.06.046","DOIUrl":"https://doi.org/10.1016/j.gie.2026.06.046","url":null,"abstract":"<p><p>This clinical practice guideline from the American Society for Gastrointestinal Endoscopy provides evidence-based recommendations regarding the role of endoscopy in the diagnosis and management of acute lower GI bleeding (LGIB). This document was developed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. In the broad context of acute LGIB, this guideline addresses the use of colonoscopy versus CT +/- angiography as the first modality, urgent versus nonurgent colonoscopy, and prepped versus unprepped colonoscopy. For diverticular bleeding in particular, this guideline assesses endoscopic band ligation versus clipping and direct clipping of the bleeding site or vessel versus indirect clip closure of the diverticulum. All of these clinical questions were answered using the GRADE framework. The guideline also discusses the roles of upper endoscopy and surgery in the setting of acute LGIB and outlines the absolute and relative contraindications of colonoscopy. Finally, the guideline provides an overview of available endoscopic modalities to treat LGIB, with special attention to the evidence supporting the use of specific modalities according to lesion type. A summary of recommendations is provided in Table 1.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850451","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":"Best of Endoscopic Ultrasound 2026.","authors":"Muniraj Thiruvengadam","doi":"10.1016/j.gie.2026.08.028","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.028","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817413","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":"Associations between body surface gastric mapping parameters and response to gastric peroral endoscopic myotomy for gastroparesis.","authors":"Homira Ayubi, Chris Varghese, Mabel Tanne, Gabriel Schamberg, Shraddha Gulati, Sri Ganeshamurthy Thrumurthy, Mehul Patel, Amyn Haji, Greg O'Grady, Bu'Hussain Hayee","doi":"10.1016/j.gie.2026.08.030","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.030","url":null,"abstract":"<p><strong>Background and aims: </strong>Gastric per oral endoscopic myotomy (GPOEM) is a promising therapy for refractory gastroparesis, but patient selection remains challenging. We evaluated body surface gastric mapping (BSGM) phenotypes to predict treatment response.</p><p><strong>Methods: </strong>Patients were recruited at King's College Hospital (Nov 2022-July 2025). BSGM comprised 30 min fasting, standardized nutrient drink with oatmeal bar (482 kcal), and 4 h postprandial recording. Success was defined as ≥1 point reduction in Gastroparesis Cardinal Symptom Index or complete symptom resolution at follow-up.</p><p><strong>Results: </strong>Among 30 patients that completed follow-up (median 7.1 months, IQR 4.3-10.1; 77% female; median age 38.5, IQR 30-52), 53% responded to GPOEM, including all patients with dysrhythmic or continuous phenotypes. Higher gastric frequencies predicted non-response (adjusted odds ratio 0.01, 95% confidence interval 0.00-0.39, p=0.03).</p><p><strong>Conclusions: </strong>Clinical response to GPOEM varied by BSGM phenotype, offering a novel tool to aid patient selection.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817510","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":"2026 Best of Systematic Review & Meta-Analyses in Gastrointestinal Endoscopy.","authors":"Babu P Mohan","doi":"10.1016/j.gie.2026.08.029","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.029","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812614","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":"Efficacy of Primary Endoscopic Bariatric and Metabolic Therapies Combined with Anti-Obesity Medications: A Systematic Review and Meta-Analysis.","authors":"Harishankar Gopakumar, Christopher C Thompson, Pichamol Jirapinyo","doi":"10.1016/j.gie.2026.08.025","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.025","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic bariatric and metabolic therapies (EBMTs) and anti-obesity medications (AOMs) are effective minimally invasive treatments for obesity. This study aims to compare the safety and efficacy of EBMT combined with AOMs to that of EBMT alone.</p><p><strong>Methods: </strong>Electronic databases, including PubMed, Medline (Ovid), EMBASE, and the Cochrane Library, were reviewed from inception to August 10, 2025. The primary outcome was percent total weight loss (%TWL) at 12 months. Secondary outcomes included %TWL at 6 months and the rate of serious adverse events. Subgroup analyses by EBMT type and timing of AOM initiation were also performed.</p><p><strong>Results: </strong>Eleven studies comprising 2,609 patients were included, of whom 2,026 (78%) received EBMT alone, and 583 (22%) received EBMT plus an AOM. Combination therapy was associated with significantly greater weight loss compared to EBMT alone (pooled mean difference in %TWL at 12 months of 3.0%; 95% CI, 1.1-4.9; p=0.002). At 12 months, the pooled %TWL was 18.6% (95% CI, 14.0 - 23.2) in the EBMT plus AOM group and 15.6% (95% CI, 11.6 - 19.6) in the EBMT-alone group. This benefit was observed across both intragastric balloon and endoscopic gastric remodeling subgroups. Combination therapy was also associated with greater improvement in diabetes and MASLD. Initiation of AOM after EBMT was associated with greater weight loss than EBMT alone, while initiation prior to EBMT was not.</p><p><strong>Conclusion: </strong>EBMT combined with AOM therapy is associated with significantly greater weight loss compared with EBMT alone, with post-EBMT initiation of AOM therapy appearing to be the optimal timing strategy.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812652","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 Liver Biopsy and Portal Pressure Measurement Compared With a Transjugular Approach: A Systematic Review and Random Effect Meta-analysis.","authors":"Bolaji Ayinde, Olamide Asifat, Rahim Khan, Milton Rangel da Silva Neto, Aryanna Sousa, Abirami Rajendiran, Yash Shah, Dushyant Singh Dahiya, Manesh Kumar Gangwani, Vishnu Charan Suresh Kumar, Sumant Inamdar","doi":"10.1016/j.gie.2026.08.024","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.024","url":null,"abstract":"<p><strong>Background and aims: </strong>The transjugular (TJ) approach has traditionally been used to assess the severity of sinusoidal portal hypertension and obtain a liver biopsy (LB). According to evidence, approximately 25-35% of TJ-LBs satisfy the adequacy quality criteria set by the American Association for the Study of Liver Diseases (AASLD). Endoscopic ultrasound (EUS) is a novel technology that allows for simultaneous portal pressure, liver biopsy, and variceal screening assessment. This study aims to compare outcomes of EUS versus the TJ approach.</p><p><strong>Methodology: </strong>A comprehensive search of PubMed, Cochrane, and Embase, with eight studies included in the final analysis. The primary outcome was correlation between hepatic venous pressure gradient (HVPG) and portal pressure gradient (PPG), with secondary outcomes of LB adequacy and technical success. A systematic review and meta-analysis were performed to generate a pooled synthesis of outcomes.</p><p><strong>Results: </strong>A total of eight studies with 663 patients were included. EUS-PPG exhibited a strong pooled correlation with HVPG (r = 0.81), demonstrating a close correlation between pressure measurements. Technical success rates were similar for EUS and TJ approaches (97.4% vs 97.3%). Biopsy-related outcomes such as portal triad count (MD = 6.28), total specimen length (MD = 30.01 mm), and longest core length (MD = 5.60 mm) demonstrated a numerical difference that did not achieve statistical significance.</p><p><strong>Conclusion: </strong>The measurement of EUS-PPG exhibited excellent physiologic correlation with HVPG and similar technical success. Outcomes related to the biopsy had numerical differences that were not statistically significant and should be considered hypothesis-generating, given considerable heterogeneity.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812631","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":"Best of Third Space Endoscopy, 2026","authors":"Mohamed O. Othman M.D., Martha Ann, Harold M. Selzman M.D","doi":"10.1016/j.gie.2026.08.027","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.027","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"271 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148853091","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":"BEST ARTICLES ON GASTROINTESTINAL BLEEDING IN 2026","authors":"Alberto Tringali MD","doi":"10.1016/j.gie.2026.08.026","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.026","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"27 1","pages":""},"PeriodicalIF":7.7,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148853092","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}