Gastrointestinal endoscopy最新文献

{"title":"Efficacy and safety of novel VAC-Stent in management of upper gastrointestinal post-surgical leaks: results from a large multicenter study in tertiary referral centers.","authors":"F P Zito, A D'Alessandro, G Dell'Anna, A Martino, S Saviano, F V Mandarino, F Bernardi, A De Leone, M Di Serafino, S Giovine, S Danese, R Rosati, G De Roberto, M Maregatti, V Colace, S Mangiafico, G Donatelli, H Bertani, F Pirozzi, D Esposito, C Giardiello, G Galasso, R Manta, G Lombardi","doi":"10.1016/j.gie.2026.09.021","DOIUrl":"https://doi.org/10.1016/j.gie.2026.09.021","url":null,"abstract":"<p><strong>Background and aim: </strong>Self-expandable metal stents (SEMS) and endoscopic vacuum therapy (EVT) represent the mainstay of endoscopic treatment for leaks of the upper gastrointestinal (UGI) tract. The VAC-Stent GIᵀᴹ (MicroTech, Düsseldorf, Germany) is a novel device that combines the principles of both SEMS and EVT. In this study, we evaluate the efficacy and safety of VAC-Stent in the management of post-surgical UGI wall defects.</p><p><strong>Methods: </strong>A retrospective multicenter study was performed in seven Italian endoscopic centers between June 2023 and January 2025. A total of 81 patients with evidence of UGIpost-surgical leak were enrolled (71.6% male; age range 32 - 83 yrs; mean age 63.5 ± 11.8 yrs). VAC-Stent removal or substitution was scheduled within 7 days from the deployment; continuous suction with negative pressure of - 125 mmHg was applied; leak closure was radiologically and/or endoscopically confirmed.</p><p><strong>Results: </strong>A total of 156 VAC-Stents GIᵀᴹ was implanted in 81 patients (range 1-7; mean stent per patient 2.0 ± 1.0), with a mean treatment duration of 12.7 ± 6.3 days (range 7 - 41 days). Six out 81 patients were excluded because of premature death unrelated to stent failure. Deployment was successful in 100% of cases (150/150). Mean diameter of the wall defect was 19.6 ± 18.2 mm and complete healing was achieved in 85.3% of patients (64/75). Enteral nutrition was provided in 53.3% of the cases. One case of late bleeding occurred after stent deployment and was managed conservatively; no cases of recurrence were recorded during follow-up.</p><p><strong>Conclusions: </strong>VAC-stent GIᵀᴹ represents a safe and effective approach in treating anastomotic leaks following upper GI surgery.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001624","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":"Competing mortality, not age or sex, may explain the loss of benefit from colonoscopy in adults aged 80 to 85 years.","authors":"Christos Zavos","doi":"10.1016/j.gie.2026.07.043","DOIUrl":"https://doi.org/10.1016/j.gie.2026.07.043","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976535","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 decompression of congenital diaphragmatic incarceration.","authors":"Satomi Otaki, Naoki Oshima, Shunji Ishihara","doi":"10.1016/j.gie.2026.09.016","DOIUrl":"10.1016/j.gie.2026.09.016","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976454","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":"Jahnvi Dhar, Jayanta Samanta","doi":"10.1016/j.gie.2026.07.033","DOIUrl":"https://doi.org/10.1016/j.gie.2026.07.033","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164571","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":"An endoscopic solution for a medically refractory Crohn's manifestation.","authors":"Dr Samantha Ehrlich, Dr Jakob Saidman, Dr Arun Swaminath","doi":"10.1016/j.gie.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.gie.2026.09.010","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919162","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 prospective clinical trial of endoscopic ultrasound-guided shear wave measurement of liver and spleen for hepatic fibrosis.","authors":"Divyanshoo R Kohli, Paxton Smith, Michael P Simanonok, Kara C Phelps, Nishant Puri, Wichit Srikureja","doi":"10.1016/j.gie.2026.09.004","DOIUrl":"10.1016/j.gie.2026.09.004","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic ultrasound-guided shear wave measurement (EUS-SWM) is a novel method for assessing hepatic fibrosis. We assessed its diagnostic accuracy, reproducibility, and the impact of transducer pressure. In addition, EUS-SWM of the spleen was performed to assess the correlation with liver fibrosis.</p><p><strong>Methods: </strong>Between January and October 2025, this single-center, prospective clinical trial enrolled patients undergoing EUS-guided liver biopsy for concomitant EUS-SWM of the liver and spleen. Measurements of both hepatic lobes were obtained using standard and excessive transducer pressure. For each site, 10 elasticity measurements (E values) were acquired, with reliability defined as a velocity signal-to-noise ratio (VsN) >60%. Histologic fibrosis served as the reference standard. Statistical analyses included paired t tests, Pearson correlation, and area under the receiver operating characteristic curve evaluation for fibrosis staging.</p><p><strong>Results: </strong>EUS-SWM in 109 participants (mean age, 58 ± 15.9 years; 63 women) demonstrated that E values from both hepatic lobes correlated strongly with histologic fibrosis (left lobe: r = 0.837-0.872; right lobe: r = 0.748-0.766). Right lobe measurements showed higher VsN than the left lobe (93.6 ± 8.9 vs 84.1 ± 8.8; P < .001). Excessive transducer pressure reduced left lobe E values (P = .02) but did not affect right lobe measurements or VsN in either lobe. Splenic stiffness was consistently higher than hepatic stiffness (30.1 ± 7.8 kPa; P < .01) and demonstrated excellent diagnostic performance for cirrhosis (area under the curve, 0.962). For F2-F3 fibrosis, hepatic SWM achieved moderate accuracy, outperforming splenic SWM. EUS-SWM exceeded the diagnostic accuracy of the aspartate aminotransferase to platelet ratio index and fibrosis-4 index for liver fibrosis for the detection of cirrhosis. Operator experience did not significantly influence measurement reliability under standard pressure.</p><p><strong>Conclusions: </strong>EUS-SWM has excellent accuracy for cirrhosis and correlates with histologic fibrosis. Although left lobe measurements are less reliable, overall diagnostic performance is comparable across lobes, and excessive transducer pressure has minimal impact. Splenic SWM adds value for detecting cirrhosis but not intermediate fibrosis.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919251","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":"Subtle surface changes revealing malignant transformation in an ampullary adenomyoma.","authors":"Shinsuke Akiyama, Gensho Tanke, Masaya Wada, Shigeo Hara, Tetsuro Inokuma","doi":"10.1016/j.gie.2026.09.012","DOIUrl":"10.1016/j.gie.2026.09.012","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919351","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":"Assisted securement of a gastrojejunostomy tube using the through-the-scope helix tack suture system.","authors":"Ana R Scherf, Abdulhameed M Al-Sabban","doi":"10.1016/j.gie.2026.09.011","DOIUrl":"10.1016/j.gie.2026.09.011","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919178","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":"Prospective evaluation of tension-reducing closure with intentional muscle-layer grasping for large colorectal post-ESD defects using an anchor-pronged clip (MANTIS study).","authors":"Hiroshi Ashizawa, Kenichiro Imai, Kinichi Hotta, Sayo Ito, Kazunori Takada, Noboru Kawata, Masao Yoshida, Hiroyuki Matsubayashi, Kohei Shigeta, Shunsuke Ueda, Takuya Doi, Eiichiro Yokoyama, Keijiro Numa, Tetsuhiko Hirai, Mari Oba, Hiroyuki Ono","doi":"10.1016/j.gie.2026.08.053","DOIUrl":"https://doi.org/10.1016/j.gie.2026.08.053","url":null,"abstract":"<p><strong>Background and aims: </strong>Complete mucosal defect closure after colorectal endoscopic submucosal dissection (ESD) may reduce delayed adverse events. However, the durable closure of large defects remains technically challenging. We prospectively evaluated the feasibility, efficacy, and durability of a novel anchor-pronged clip (MANTIS Clip; Boston Scientific Co., Massachusetts, United States) for defect closure after colorectal ESD.</p><p><strong>Methods: </strong>This single-center prospective study evaluated defect closure using the MANTIS Clip after colorectal ESD for lesions measuring 30-50 mm. The clip was used to approximate the defect by grasping the mucosal and muscular layers to achieve deeper plication and tension reduction. The primary endpoint was the complete closure rate. The secondary endpoints included closure times, number of clips used, sustained closure, and adverse events.</p><p><strong>Results: </strong>Complete closure was achieved in 95.2% (20/21) of cases during a median closure time of 17 min using a median of eight clips. Closure was successful in all defects with a specimen size ≤59 mm in size and in 75% of those ≥60 mm in size. Sustained complete closure was observed in 76.2% (16/21) of cases at 3-5 days and partial or complete dislodgement at ≥2 weeks after ESD in 95.2%. Delayed bleeding, delayed perforation, and post-ESD coagulation syndrome occurred in 0%, 0%, and 14.3% of cases, respectively.</p><p><strong>Conclusions: </strong>The MANTIS Clip achieved a high complete closure rate with acceptable short-term durability for mucosal defects after colorectal ESD of lesions measuring 30-50 mm.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919282","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-guided placement of a vascular plug for the management of a chronic gastrocutaneous fistula (with video).","authors":"Dhruval Amin, Neil B Marya","doi":"10.1016/j.gie.2026.09.008","DOIUrl":"10.1016/j.gie.2026.09.008","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":8.0,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919167","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}