Gastrointestinal endoscopy最新文献

{"title":"Single-Stage EUS-Guided Gastrogastrostomy Secured With Clips With Anchor Prongs to Treat Massive Gastrointestinal Hemorrhage in Roux-en-Y Gastric Bypass.","authors":"David E Jonason, Bjorn Rodriguez, Daryl Ramai, Judith Staub, Christopher Ko","doi":"10.1016/j.gie.2025.02.027","DOIUrl":"https://doi.org/10.1016/j.gie.2025.02.027","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536702","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":"Going straight to the source: treatment of refractory duodenal bleeding in a patient with Roux-en-Y gastric bypass anatomy.","authors":"Samuel Tanner, Allison R Schulman","doi":"10.1016/j.gie.2025.02.028","DOIUrl":"10.1016/j.gie.2025.02.028","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537071","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 of Same-Day Discharge After Gastric Peroral Endoscopic Myotomy in Patients with Refractory Gastroparesis: An International Multi-Center Study.","authors":"Marita Salame, Yervant Ichkhanian, Nwal Hadaki, John M Wo, Sarah A Stainko, Akira Saito, Robert M Siwiec, Thomas V Nowak, Andrew Li, Joo Ha Hwang, Juliana Yang, Joseph Broucek, Tuba Esfandyari, Stephanie Joseph, Michael Ujiki, Ashley E Williams, Jacob R Moremen, Zane Gouda, Alexander Schlachterman, Kristina Hugova, Jan Martinek, Calvin X Geng, Alexander Podboy, Andrew Y Wang, Michael Lajin, Payton Miller, Lennon Gregor, Hashem Albunni, John M Dewitt, Mohammad A Al-Haddad","doi":"10.1016/j.gie.2025.02.020","DOIUrl":"https://doi.org/10.1016/j.gie.2025.02.020","url":null,"abstract":"<p><strong>Background and aims: </strong>The post operative management of gastric peroral endoscopic myotomy (G-POEM) lacks standardization. This study aimed to evaluate adverse events, readmission rates, and feasibility of same-day discharge (SDD) after G-POEM.</p><p><strong>Methods: </strong>A multi-center retrospective review of prospectively collected G-POEM data was conducted. The primary outcome was the 15-day readmission rates in SDD and admitted patients. Secondary outcomes included readmission risk factors, clinical success, and adverse events (AEs).</p><p><strong>Results: </strong>We found a 4.1% 15-day readmission rate in 482 patients (95% CI: 3.2%-5.4%). SDD clinical success rates at 6-12 months were 54.1% against 59.7% for the admitted group. The overall AE rate was 4.1%. SDD patients tended to have shorter procedure times, higher frequency of double myotomies, and endoscopic suturing for closure.</p><p><strong>Conclusions: </strong>G-POEM is safe with low incidence of AEs and 15-day readmission rates. SDD appears safe in uncomplicated cases, suggesting that upper gastrointestinal studies post-G-POEM may be unnecessary.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472326","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":"Natural course of high-grade dysplasia in Barrett's esophagus: a scoping review and case-series.","authors":"Eva P D Verheij, Sanne N van Munster, Man Wai Chan, Arjan Malekzadeh, Cary C Cotton, Bas L A M Weusten, Lorenza Alvarez Herrero, Arjun D Koch, Wouter B Nagengast, Jessie Westerhof, Martin H M G Houben, Nicholas J Shaheen, Jacques J G H M Bergman, Roos E Pouw","doi":"10.1016/j.gie.2025.02.019","DOIUrl":"https://doi.org/10.1016/j.gie.2025.02.019","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic eradication therapy (EET) for Barrett's esophagus (BE) with high-grade dysplasia (HGD) aims to prevent progression to life-limiting cancer. However, HGD patients with a short life expectancy realize limited gains from this approach due to competing mortality. Clinicians are poorly equipped to counsel such patients, since little data describe survival in untreated HGD. We aimed to evaluate existing literature and describe a case-series of patients with untreated HGD.</p><p><strong>Methods: </strong>We systematically reviewed Medline, Embase and Cochrane Library, selecting studies describing the natural history of untreated HGD in BE. The primary outcomes were symptomatic esophageal adenocarcinoma (EAC) and/or EAC-related death. Additionally, cases in whom HGD was left untreated were retrospectively identified in the Netherlands. We assessed the time until progression to clinically evident EAC.</p><p><strong>Results: </strong>A total of 3,229 studies were identified, of which 3 were included. In one study, progression from HGD to clinically evident EAC occurred in 4 subjects after median of 34 months. The remaining two cases progressed to clinically-evident EAC after 70 and 115 months. In our previously unreported case-series, 11 Dutch patients with flat HGD (n=3) or HGD in a visible abnormality (n=8) were included. Four of these 11 patients progressed to clinically-evident EAC after median 52 months (range 17-78 months).</p><p><strong>Conclusion: </strong>The lag-time between the diagnosis of HGD and progression to clinically-evident EAC varied from 1.5 to 10 years. EET for BE with HGD in patients with less than 3 years of life expectancy seems unlikely to be beneficial. These results may guide management decisions for patients with BE. NL7039; CRD42022362088.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472324","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":"Physical recovery after local resection of nonpedunculated rectal adenomas and T1 carcinomas: endoscopic submucosal dissection versus transanal minimally invasive surgery.","authors":"Nik Dekkers, Matthijs D Kruizinga, Hao Dang, Frederik E Stuurman, Vasileios Exadaktylos, Alexandra M J Langers, Jolein van der Kraan, Jonathan Y L Lai, Leendert H Oterdoom, Peter A Neijenhuis, Els L van Persijn van Meerten, Mar Rodríguez-Girondo, Roel Hompes, Pascal G Doornebosch, Marinke Westerterp, Barbara A J Bastiaansen, James C H Hardwick, Jurjen J Boonstra","doi":"10.1016/j.gie.2025.02.017","DOIUrl":"10.1016/j.gie.2025.02.017","url":null,"abstract":"<p><strong>Background and aims: </strong>Rehabilitation of physical activity is an important functional outcome after endoscopic surgery. Our aim was to quantitatively assess recovery after endoscopic submucosal dissection (ESD) and transanal minimally invasive surgery (TAMIS).</p><p><strong>Methods: </strong>In the TRIASSIC study (Netherlands Trial Registry: NL7083), patients with rectal polyps >20 mm were randomized between ESD and TAMIS. This ancillary study used smartwatches to track activity data for a 14-day preoperative baseline period and a 28-day postoperative recovery period. The primary end point for noninferiority was the mean time to recovery (≥90% of baseline step count for 2 consecutive days), assessed by means of Weibull regression with a 7-day noninferiority margin.</p><p><strong>Results: </strong>Forty patients were included: 20 ESD and 20 TAMIS procedures. Median lesion size was 42.5 mm (interquartile range [IQR], 25-50), with 17.5% pT1RCs and 82.5% nonmalignant rectal polyps. Compliance with smartwatch measurements was 98.4% (IQR, 94.2-100). Within the 28-day timespan, 17 patients (85%) in the ESD group recovered and 15 (75%) in the TAMIS group (P = .43). Mean recovery times were 13.9 days for ESD and 21.0 days for TAMIS, indicating noninferiority of ESD (95% confidence interval of difference, -3.41 to 20.25). Recovery as measured by smartwatch significantly correlated with self-reported recovery (Spearman rho, 0.644; P < .001). Moderate to severe pain scores (≥4 out of 10) were reported by 15 patients (42.9%): in 27.8% of the ESD group and 58.9% of the TAMIS-group (P = .06). Increased pain scores were significantly associated with decreased physical activity (P < .01).</p><p><strong>Conclusions: </strong>In terms of mean time to physical recovery, ESD was noninferior to TAMIS. Post-procedural pain was significantly associated with reduced physical activity.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433116","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":"Optical enhancement with magnification versus white-light endoscopy for detecting gastric intestinal metaplasia and neoplasia: a randomized controlled trial.","authors":"Meng Wan, Guang-Chao Li, Ming-Jun Ma, Jing Liu, Zhen Li, Xiu-Li Zuo, Yan-Qing Li","doi":"10.1016/j.gie.2025.02.015","DOIUrl":"10.1016/j.gie.2025.02.015","url":null,"abstract":"<p><strong>Background and aims: </strong>The detection of gastric intestinal metaplasia (GIM), gastric intraepithelial neoplasia (GIN), and early gastric cancer (EGC) using white-light endoscopy (WLE) is unsatisfactory. This study assessed the value of optical enhancement combined with magnification endoscopy (ME-OE) versus WLE for detecting GIM, GIN, and EGC.</p><p><strong>Methods: </strong>Patients at high risk for gastric cancer were randomly assigned to the ME-OE group or WLE group at a 1:1 ratio. Suspicious GIM, GIN, and EGC lesions underwent targeted biopsy sampling in both groups. The diagnostic yield, diagnostic efficacy, and agreement of suspicious lesions were compared between the 2 groups.</p><p><strong>Results: </strong>Two hundred eighty-five patients were finally analyzed. The per-patient diagnostic yields of GIM, GIN, and EGC were 36.6% in the ME-OE group and 23.8% in the WLE group (P = .018). The per-lesion diagnostic yield of GIM, GIN, and EGC in the ME-OE group was higher than that in the WLE group (66.7% vs 48.7%, P = .017). Sensitivity (82.8% vs 54.3%, P = .003), specificity (84.2% vs 81.4%, P = .738), positive predictive value (88.9% vs 70.4%, P = .038), negative predictive value (76.2% vs 68.6%, P = .419), and accuracy (83.3% vs 69.2%, P = .028) for GIM were compared between the 2 groups. The intraobserver agreements of experienced endoscopists were excellent for ME-OE (κ = 0.81 and κ = 0.83) and good for WLE (κ = 0.63 and κ = 0.62). The interobserver agreements of experienced endoscopists were good for both groups (κ = 0.75 and κ = 0.61, respectively).</p><p><strong>Conclusions: </strong>ME-OE showed better performance for detecting GIM than WLE in high-risk populations. (Clinical trial registration number: NCT04411589.).</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433113","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 ultrasound guided coil and glue as a first-line treatment for visceral artery pseudoaneurysm: A long term follow-up study with a proposed algorithmic approach.","authors":"Praveer Rai, Pankaj Kumar, Umair Shamsul Hoda, Nishant Shah, Prabhaker Mishra","doi":"10.1016/j.gie.2025.02.016","DOIUrl":"https://doi.org/10.1016/j.gie.2025.02.016","url":null,"abstract":"<p><strong>Background and aims: </strong>Visceral artery pseudoaneurysm (VAPA) is an uncommon complication associated with pancreatitis. This study aimed to assess the safety and efficacy of endoscopic ultrasound (EUS)-guided coil and glue embolization for pseudoaneurysm (PsA).</p><p><strong>Methods: </strong>Patients with VAPA who underwent EUS-guided embolization as a first-line procedure , were included. The primary outcome was clinical success, defined as the complete obliteration of PsA at 12 weeks.</p><p><strong>Results: </strong>Nineteen patients with 20 pseudoaneurysms were included. The mean age was 38.63±13.87 years, and 89.5% were males. Splenic artery pseudoaneurysm was the most common (75%). The median size of the pseudoaneurysm was 2.5 cm (IQR: 1.5-4.1 cm). There was a 100% technical success rate and 85% clinical success rate. Post procedure one patient developed splenic abscess. No recurrence was seen after a median follow of 37 months.</p><p><strong>Conclusion: </strong>EUS-guided coil and glue embolization is an effective first-line procedure for splenic artery pseudoaneurysms.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433108","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":"Top Tip: Management of esophageal varices not responsive to endoscopic variceal ligation.","authors":"Sherif Andrawes","doi":"10.1016/j.gie.2025.02.013","DOIUrl":"https://doi.org/10.1016/j.gie.2025.02.013","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432333","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 Band Ligation Versus Argon Plasma Coagulation in the Treatment of Gastric Antral Vascular Ectasia: A Systematic Review and Meta-Analysis.","authors":"Archit Garg, Vishali Moond, Khyati Bidani, Aashi Garg, Arkady Broder, Babu P Mohan, Douglas G Adler","doi":"10.1016/j.gie.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.gie.2025.02.014","url":null,"abstract":"<p><strong>Background & aims: </strong>Argon plasma coagulation (APC) is the established endoscopic treatment for gastric antral vascular ectasia (GAVE). Recently, the use of endoscopic band ligation (EBL) has gained recognition as an alternate approach. The objective of our study was to compare the efficacy and safety of APC versus EBL in the treatment of GAVE.</p><p><strong>Methods: </strong>Multiple databases were searched for articles on APC vs EBL for GAVE treatment. Preferred outcomes were subjected to systematic review and meta-analysis.</p><p><strong>Results: </strong>We analyzed 10 studies involving 476 subjects (47.47% males and mean age of 56.25 years). The number of sessions required for the obliteration of lesions was higher with APC. The pooled eradication rate of GAVE with EBL was 88.6% [95% Cl 79.9-81.5; I2=13.5%] and with APC was 57.9% [Cl 43.7-71; I2= 59%]; RR 1.52 [1.16-2.02; I2=72%; P<0.001]. EBL had lower bleeding recurrence, 6.6% [Cl 3.4-12.5; I2=0%] compared to APC 39.7% [Cl 26.9-54.15; I2=55%]; RR 0.21 [0.09-0.44; I2=0%; p< 0.001]. GAVE recurrence with EBL was 7.3% [Cl 3.8-13.6; I2=0%]and with APC was 38.5% [Cl 24.4-54.9; I2=64%]; RR 0.22 [0.109-0.446; I2= 0%; p<0.01]. The transfusion requirements and hospitalizations were lower with EBL compared to APC. adverse events associated with EBL were 16.8% [Cl 6.6-36.7; I2= 83%] compared to APC 9.3% [Cl 5.6-15.1; I2=19%] with RR 2.11 [0.8-5.46; 58%; p =0.1].</p><p><strong>Conclusion: </strong>EBL demonstrated better eradication with fewer treatment sessions, recurrent bleeding, hospitalization and transfusion requirements as compared to APC. It is time that EBL be utilized as the first-line endoscopic treatment for GAVE.</p>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433103","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":"Potential indications for peranal endoscopic myectomy in lower rectal cancer.","authors":"Katsuro Ichimasa, Shin-Ei Kudo, Takemasa Hayashi, Tatsuya Sakurai, Tetsuo Nemoto, Masashi Misawa","doi":"10.1016/j.gie.2025.02.012","DOIUrl":"10.1016/j.gie.2025.02.012","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431946","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}