Gastrointestinal endoscopy最新文献_第8页

A novel robotic arm-assisted endoscopic submucosal dissection platform with augmented traction for gastric neoplasms: a first-in-human prospective pilot study (with videos). 一种新型机械臂辅助内镜粘膜下剥离平台，增强胃肿瘤牵引：首次人体前瞻性先导研究（含视频）。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-15 DOI: 10.1016/j.gie.2025.09.012

Han Jo Jeon, Bora Keum, Bomee Lee, Sanghyun Kim, Hyuk Soon Choi, Jae Min Lee, Eun Sun Kim, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun

{"title":"A novel robotic arm-assisted endoscopic submucosal dissection platform with augmented traction for gastric neoplasms: a first-in-human prospective pilot study (with videos).","authors":"Han Jo Jeon, Bora Keum, Bomee Lee, Sanghyun Kim, Hyuk Soon Choi, Jae Min Lee, Eun Sun Kim, Yoon Tae Jeen, Hong Sik Lee, Hoon Jai Chun","doi":"10.1016/j.gie.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.gie.2025.09.012","url":null,"abstract":"Background and aims: Robotic arm-assisted endoscopic submucosal dissection (R-ESD) facilitates visualization of the submucosal dissection plane and aids complete tumor resection. However, the practicality of a robotic arm for gastric neoplasms remains unclear. This study aimed to evaluate the clinical performance of minimally invasive gastric R-ESD.Methods: A total of 15 consecutive patients who underwent R-ESD between June 2024 and September 2024 at the Korea University Medical Center were prospectively enrolled and analyzed. The primary outcome was en bloc resection.Results: All patients underwent both en bloc and R0 resections (100%). The majority of tumors (73.3%) were located in the lower third of the stomach (34.7 ± 5.8 mm) and were diagnosed as adenocarcinoma (53.3%) or low-grade adenoma (47.7%). The mean total procedure time (TPT) was 28.8 min and the median robot-assisted dissection time (RDT) was 14.3 min, achieving a dissection speed of 48.2 mm2/min. Specimen injury was occurred in four cases (26.7%). The robotic arm conducted a median of 3.9 grasps per procedure, with an RDT/TPT ratio of 53.8%. A comparison between lower and middle/upper lesions revealed an increased pattern of RDT, grasps and RDT/TPT ratio. The total NASA-TLX score was strongly correlated with the number of grasps, RDT/TPT ratio and TPT.Conclusions: R-ESD proved feasible and safe in gastric ESD through high en bloc resection rates and dissection speed. R-ESD holds promise for improving procedural safety and performance through augmented traction.","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080191","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}

引用次数: 0

SEDATION AND ANESTHESIA IN GI ENDOSCOPY IN 2025: HOW, WHO, AND WHY. 2025年胃肠内镜中的镇静和麻醉：如何，谁，为什么。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-15 DOI: 10.1016/j.gie.2025.09.014

Alberto Tringali

引用次数: 0

Outcomes of Submucosal Tunneling Endoscopic Resection for Subepithelial Tumors in the Upper Gastrointestinal Tract: Experience from the United States. 粘膜下隧道内镜切除上消化道上皮下肿瘤的疗效：来自美国的经验。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-15 DOI: 10.1016/j.gie.2025.09.011

Sonmoon Mohapatra, Hiroyuki Aihara, Dennis Yang, Amrita Sethi, Fnu Deepali, Abel Joseph, Suchapa Arayakarnkul, Saowanee Ngamruengphong, Amit Bhatt, Neil Sharma, David L Diehl, Louis M Wong Kee Song, Norio Fukami

{"title":"Outcomes of Submucosal Tunneling Endoscopic Resection for Subepithelial Tumors in the Upper Gastrointestinal Tract: Experience from the United States.","authors":"Sonmoon Mohapatra, Hiroyuki Aihara, Dennis Yang, Amrita Sethi, Fnu Deepali, Abel Joseph, Suchapa Arayakarnkul, Saowanee Ngamruengphong, Amit Bhatt, Neil Sharma, David L Diehl, Louis M Wong Kee Song, Norio Fukami","doi":"10.1016/j.gie.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.gie.2025.09.011","url":null,"abstract":"Background: Data on outcomes of submucosal tunneling endoscopic resection (STER) for upper gastrointestinal (UGI) subepithelial lesions (SELs) in Western countries is limited. This study assesses the outcomes of STER for UGI SELs in US centers.Methods: This retrospective analysis included UGI SELs referred for STER at eight US centers. Study included lesions originating or inseparable from the muscularis propria (MP) layer, SELs with symptoms, potential malignancy on endoscopic ultrasound (EUS), or inconclusive EUS-fine needle aspiration (EUS-FNA) but suspected gastrointestinal stromal tumor (GIST).Results: A total of 47 patients with 51 SELs (median size 25 mm) were included; 42 (82.3%) had prior sampling. Median procedure time was 89.8 minutes. Submucosal fibrosis (SF) was present in 19.6% lesions, all with prior sampling history. En bloc resection and retrieval were achieved in 94.1% lesions. Transmural resection (TMR) was needed in 21.6% of the lesions and was significantly associated with extraluminal extension (OR 8.4), GIST histology (OR 6.0), and SF (OR 5.8). TMR was linked to a higher rate of R1 resection (OR: 4.1) and longer procedural time (>90 minutes, OR 8.6), without an increased risk of adverse events (AEs). AEs occurred in 7/47 (14.8%) patients and were managed conservatively. No lesion recurred within a median follow-up of 17 months.Conclusions: STER is a safe and effective approach for selected UGI SELs. Extraluminal extension, GIST histology, and SF predict the need for TMR. R1 resection was more common with TMR with increased procedural time. Minimizing pre-resection sampling may reduce fibrosis and optimize outcomes.","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080208","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}

引用次数: 0

Long-term outcomes after endoscopic resection for cervical esophageal squamous cell carcinoma. 宫颈食管鳞状细胞癌内镜切除术后的远期疗效。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-13 DOI: 10.1016/j.gie.2025.09.015

Yoshiaki Ando, Minoru Kato, Yasuhiro Tani, Tomoya Ueda, Gentaro Tanabe, Yuta Fujimoto, Noriaki Ito, Nobutoshi Tsukuda, Kazuki Matsuyama, Muneshin Morita, Shunsuke Yoshii, Satoki Shichijo, Takashi Kanesaka, Sachiko Yamamoto, Koji Higashino, Noriya Uedo, Tomoki Michida, Ryu Ishihara

{"title":"Long-term outcomes after endoscopic resection for cervical esophageal squamous cell carcinoma.","authors":"Yoshiaki Ando, Minoru Kato, Yasuhiro Tani, Tomoya Ueda, Gentaro Tanabe, Yuta Fujimoto, Noriaki Ito, Nobutoshi Tsukuda, Kazuki Matsuyama, Muneshin Morita, Shunsuke Yoshii, Satoki Shichijo, Takashi Kanesaka, Sachiko Yamamoto, Koji Higashino, Noriya Uedo, Tomoki Michida, Ryu Ishihara","doi":"10.1016/j.gie.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.gie.2025.09.015","url":null,"abstract":"Background and aims: Data on long-term outcomes of endoscopic resection (ER) for cervical esophageal squamous cell carcinoma (ESCC) are limited. We investigated long-term outcomes of ER for superficial cervical ESCC by stratifying lesions based on invasion depth and lymphovascular involvement (LVI).Methods: A total of 131 patients who underwent ER for T1 cervical ESCC were divided into three groups based on final pathological diagnosis: pT1a-EP/LPM without LVI (group A, 103 patients), pT1a-MM without LVI (group B, 10 patients), and pT1a-MM with LVI or pT1b-SM1/SM2 (group C, 18 patients). Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were compared among the groups.Results: The median observation period was 64 months. In the groups A and B, none of the patients received additional therapy after ER and none had metastatic recurrence. In the group C, 14 of 18 patients received additional chemoradiotherapy (CRT) after ER, while the remaining four patients did not. Of the 14 patients who received additional CRT, one (7%) had local and lymph node recurrence, resulting in cervical ESCC-related death. One of the four patients (25%) who did not receive additional CRT had lymph node recurrence, but was salvaged by lymphadenectomy and CRT. The 5-year OS in the group A, B, and C was 90%, 100%, and 75% (P=0.06), the 5-year DSS was 100%, 100%, and 92% (P=0.046), and the 5-year RFS was 90%, 100%, and 69% (P=0.02), respectively.Conclusions: The long-term outcomes following ER for cervical ESCC in this study were comparable to those previously reported for thoracic ESCC in the literature.","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145069446","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}

引用次数: 0

Cold Snare Polypectomy versus Hot Snare Polypectomy for Small Pedunculated Polyps: A Cost-Effectiveness Analysis. 冷陷阱息肉切除术与热陷阱息肉切除术治疗小带蒂息肉：成本-效果分析。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-11 DOI: 10.1016/j.gie.2025.09.005

Sneh Sonaiya, Raj Patel, Dushyant Singh Dahiya, Shahryar Khan, Charmy Parikh, Mark Stasiewicz, Pranav D Patel, Kyaw Min Tun, Bradley Confer, Harshit S Khara, Sumant Inamdar, Vignan Manne, Babu P Mohan, Douglas G Adler

{"title":"Cold Snare Polypectomy versus Hot Snare Polypectomy for Small Pedunculated Polyps: A Cost-Effectiveness Analysis.","authors":"Sneh Sonaiya, Raj Patel, Dushyant Singh Dahiya, Shahryar Khan, Charmy Parikh, Mark Stasiewicz, Pranav D Patel, Kyaw Min Tun, Bradley Confer, Harshit S Khara, Sumant Inamdar, Vignan Manne, Babu P Mohan, Douglas G Adler","doi":"10.1016/j.gie.2025.09.005","DOIUrl":"https://doi.org/10.1016/j.gie.2025.09.005","url":null,"abstract":"Background and aims: For small colorectal polyps, Cold Snare Polypectomy (CSP) carries a higher risk of immediate post-polypectomy bleeding (IPPB) compared to Hot Snare Polypectomy (HSP), but is associated with a significantly lower risk of delayed post-polypectomy bleeding (DPPB). Given these trade-offs, we evaluated the cost-effectiveness of CSP versus HSP for small (4-10 mm) pedunculated colorectal polyps.Methods: Cost-effectiveness analysis was conducted over a 2-week time horizon using a decision tree model, based on the Multicenter Randomized Taiwan Cold Polypectomy Study and published literature. Incremental Cost-Effectiveness Ratio (ICER) was calculated for a base case patient undergoing CSP vs HSP, with analysis performed using TreeAge Pro Healthcare 2024.Results: IPPB was defined as perioperative bleeding requiring clipping, while DPPB referred to bleeding within 2 weeks requiring transfusion or endoscopic intervention. DPPB was evaluated at the patient level (386 participants: 192 CSP, 194 HSP), and IPPB at the polyp level (647 polyps: 306 CSP, 341 HSP). In the base case (61.8-year-old with a ≤10 mm pedunculated polyp), CSP vs HSP yielded an ICER of $35,684/QALY. Sensitivity analyses showed CSP remained cost-effective when IPPB risk following CSP was <21.64% or DPPB risk with HSP exceeded 0.76%.Conclusion: CSP is cost-effective compared to HSP for small pedunculated polyps at a willingness-to-pay threshold of $100,000/QALY. Despite a higher IPPB risk, CSP's lower DPPB risk underlies its favorable economic profile. Our findings support CSP as the preferred technique for small pedunculated polyps, while emphasizing that patient- and polyp-specific clinical factors should be considered alongside cost-effectiveness in practice.","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058514","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}

引用次数: 0

Grafting to prevent esophageal strictures after endoscopic submucosal dissection (with video). 内镜下粘膜下剥离后的食管狭窄的移植（附视频）。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-11 DOI: 10.1016/j.gie.2025.09.009

Paipai Qi, Xue Peng, Xubiao Nie, Wei He, Xinwei Diao, Shiming Yang, Chaoqiang Fan

引用次数: 0

Submucosal tunneling to extract a bullet from the mediastinum. 粘膜下隧道从纵隔取出子弹。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-11 DOI: 10.1016/j.gie.2025.09.010

Juan Carlos Carames, Minerva Carames, Michel Kahaleh

引用次数: 0

Best of EUS-guided transluminal interventions in 2025. 2025年最佳超声引导下的超声介入治疗。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-10 DOI: 10.1016/j.gie.2025.09.004

Thiruvengadam Muniraj

引用次数: 0

Best of endoscopic submucosal dissection, 2025. ESD最佳，2025。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-09 DOI: 10.1016/j.gie.2025.09.002

Mohamed O Othman

引用次数: 0

LONG-TERM FOLLOW-UP OF PATIENTS UNDERGOING CHOLANGIOPANCREATOSCOPY-GUIDED LASER DISSECTION AND ABLATION FOR REFRACTORY PANCREATIC AND BILIARY STRICTURES. 胆管镜引导下激光切除及消融治疗难治性胰腺及胆道狭窄患者的长期随访。

IF 7.5 1区医学

Gastrointestinal endoscopy Pub Date : 2025-09-09 DOI: 10.1016/j.gie.2025.08.059

Thomas Enke, Nicole Rueb, Fernanda Pessorrusso, Samuel Han, Raj J Shah

{"title":"LONG-TERM FOLLOW-UP OF PATIENTS UNDERGOING CHOLANGIOPANCREATOSCOPY-GUIDED LASER DISSECTION AND ABLATION FOR REFRACTORY PANCREATIC AND BILIARY STRICTURES.","authors":"Thomas Enke, Nicole Rueb, Fernanda Pessorrusso, Samuel Han, Raj J Shah","doi":"10.1016/j.gie.2025.08.059","DOIUrl":"https://doi.org/10.1016/j.gie.2025.08.059","url":null,"abstract":"Background and aims: A subgroup of patients with benign biliary (BD) and pancreatic duct (PD) strictures fail to resolve with endoscopic retrograde cholangiopancreatography (ERCP)-guided stenting. Novel endoscopic approaches are needed. Our study aims to evaluate the efficacy and safety of cholangiopancreatoscopy-guided laser dissection or ablation (CPL) for the treatment of refractory pancreaticobiliary strictures.Methods: Single-center retrospective review of all CPL cases performed for refractory BD or PD strictures. Primary outcome was stricture resolution.Secondary outcomes: technical success, adverse events, and stent-free survival assessed using Kaplan-Meier analysis.Results: Thirty patients underwent CPL from 5/2016 - 8/2023 and had a median 3 (interquartile range [IQR] 1-5) prior ERCPs to treat the stricture(s) of interest. Fifty-three CPL's were performed (median 1 per patient; IQR 1-2) for 49 strictures: 41 PD (83.7%; 17 body,15 head, 6 neck, and 3 tail) and 8 BD (16.3%; 5 common hepatic duct, 2 common bile duct, and 1 hilum). Complete and partial resolution occurred in 30 (61.2%) and 17 (34.7%) of strictures, respectively. Technical success was 100%. Stent-free trial was attempted in 25 (83.3%) patients after a median of 6 months (IQR 3-8) and median of 4 (IQR 2-4) ERCPs including index CPL and ERCP with stent removal. In 22 patients with follow-up data, reintervention with stenting occurred in 45.5% (n=10) with a median survival time of 32 months (95% confidence interval: 12-42). No severe adverse events occurred.Conclusions: CPL has high technical success and an acceptable safety profile for the treatment of benign refractory BD and PD strictures.","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":7.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040006","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}

引用次数: 0