Gastrointestinal endoscopy最新文献

{"title":"EUS-guided shear wave elastography for fibrosis screening in patients with obesity and metabolic dysfunction–associated steatotic liver disease: a pilot study (with video)","authors":"Thomas J. Wang MD ,&nbsp;Pichamol Jirapinyo MD, MPH ,&nbsp;Raj Shah MD ,&nbsp;Kimberly Schuster BA ,&nbsp;David J. Papke MD, PhD ,&nbsp;Christopher C. Thompson MD, MSc ,&nbsp;Laura Doyon MD ,&nbsp;David B. Lautz MD ,&nbsp;Marvin Ryou MD","doi":"10.1016/j.gie.2024.10.054","DOIUrl":"10.1016/j.gie.2024.10.054","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Liver fibrosis staging is challenging in patients with obesity and metabolic dysfunction–associated steatotic liver disease (MASLD). Liver biopsies are invasive, whereas noninvasive tests such as vibration-controlled transient elastography (VCTE) can be inaccurate in patients with obesity. We hypothesized that EUS-guided shear wave elastography (EUS-SWE) is more accurate for liver fibrosis staging in patients with MASLD and obesity; the aim of this pilot study was to test this hypothesis and establish optimal fibrosis stage cutoffs for EUS-SWE.</div></div><div><h3>Methods</h3><div>This was a multicenter, cross-sectional study from prospectively collected data. Consecutive patients who underwent EUS-SWE with subsequent liver biopsy were included. EUS-SWE was compared with Fibrosis-4 Index (FIB-4) and VCTE. Area under the receiver-operating characteristic (AUROC) curve analysis was performed, and 90% sensitivity and specific cutoffs were calculated to determine optimal cutoffs.</div></div><div><h3>Results</h3><div>Sixty-two patients were included. Mean body mass index was 40.74 kg/m². EUS-SWE was superior to FIB-4 in discriminating significant fibrosis (F2; AUROC, .87 vs .61; <em>P</em> &lt; .0048) and advanced fibrosis (F3; AUROC, .93 vs .63; <em>P</em> &lt; .0001), but not cirrhosis (F4; AUROC, .95 vs .81; <em>P</em> = .099). EUS-SWE was superior to VCTE in predicting advanced fibrosis and cirrhosis (<em>P</em> = .0067 and <em>P</em> = .0022, respectively). The 90% sensitivity cutoffs for EUS-SWE were 7.50, 8.48, and 11.30 for F2, F3, and F4, and the 90% specificity cutoffs were 9.82, 10.20, and 14.60.</div></div><div><h3>Conclusions</h3><div>In this pilot study, EUS-SWE was superior to FIB-4 and VCTE for liver fibrosis staging in patients with MASLD and obesity. (Clinical trial registration number: NCT05728697.)</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 456-462.e1"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557650","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":"Under pressure: changing our way of caring","authors":"Eric M. Pauli MD","doi":"10.1016/j.gie.2024.10.017","DOIUrl":"10.1016/j.gie.2024.10.017","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 375-376"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074508","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":"Preprocedural arterial embolization as a novel proactive approach for safe endoscopic submucosal dissection","authors":"Sandip Pal MD, DM,&nbsp;Srikant Mohta MD, DM,&nbsp;Shuvro Roy Choudhury MD","doi":"10.1016/j.gie.2024.09.011","DOIUrl":"10.1016/j.gie.2024.09.011","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 466-467"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142283748","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":"Through-the-scope proximal flange fixation: “Edging” toward single-session procedures for all?","authors":"Michiel Bronswijk MD,&nbsp;Giuseppe Vanella MD, PhD,&nbsp;Roy L.J. van Wanrooij MD, PhD,&nbsp;Schalk Van der Merwe MD, PhD","doi":"10.1016/j.gie.2024.08.038","DOIUrl":"10.1016/j.gie.2024.08.038","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 486-487"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074503","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 position statement on periendoscopic management of patients on glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors","authors":"Reem Z. Sharaiha MD, MSc ,&nbsp;Alpana P. Shukla MD ,&nbsp;Sudipta Sen MD, FASA ,&nbsp;Walter C. Chan MD, MPH ,&nbsp;David T. Broome MD ,&nbsp;Diana Anca MD ,&nbsp;Wasif Abidi MD, PhD ,&nbsp;Neil Marya MD ,&nbsp;Muniraj Thiruvengadam MD, PhD, FRCP ,&nbsp;Nirav Thosani MD, MHA ,&nbsp;Allison R. Schulman MD, MPH","doi":"10.1016/j.gie.2024.10.057","DOIUrl":"10.1016/j.gie.2024.10.057","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 285-294"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074369","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 for the evaluation of esophageal injury after catheter ablation for atrial fibrillation","authors":"Karl Akiki MD ,&nbsp;William B. Minteer MD ,&nbsp;Vinay Chandrasekhara MD ,&nbsp;Tala Mahmoud MD ,&nbsp;Ryan J. Law MD ,&nbsp;Elizabeth Rajan MD ,&nbsp;Alan M. Sugrue MB, BCh, BAO ,&nbsp;Ammar M. Killu MBBS ,&nbsp;Ferga C. Gleeson MB, BCh ,&nbsp;Barham K. Abu Dayyeh MD, MPH ,&nbsp;Michael J. Levy MD ,&nbsp;Mark Topazian MD ,&nbsp;Andrew C. Storm MD","doi":"10.1016/j.gie.2024.08.036","DOIUrl":"10.1016/j.gie.2024.08.036","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Atrial fibrillation (AF) ablation is an increasingly used rhythm control strategy that can damage adjacent structures in the mediastinum including the esophagus. Atrioesophageal fistulas and esophagopericardial fistulas are life-threatening adverse events that are believed to progress from early esophageal mucosal injury (EI). EUS has been proposed as a superior method to EGD to survey EI and damage to deeper structures. We evaluated the safety of EUS in categorizing postablation EI and quantified EUS-detected lesions and their correlation with injury severity and clinical course.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 234 consecutive patients between 2006 and 2020 who underwent AF ablation followed by EUS for the purpose of EI screening. The Kansas City classification was used to classify EI (type 1, type 2a/b, or type 3a/b).</div></div><div><h3>Results</h3><div>EUS identified pleural effusions in 31.6% of patients, mediastinal adventitia changes in 22.2%, mediastinal lymphadenopathy in 14.1%, pulmonary vein changes in 10.6%, and esophageal wall changes in 7.7%. EGD revealed 175 patients (75%) without and 59 (25%) with EI. Patients with type 2a/b EI and no EI were compared with multivariate logistic regression, and the presence of esophageal wall abnormality on EUS (odds ratio [OR], 72.85; 95% confidence interval [CI], 13.9-380.7), female sex (OR, 3.97; 95% CI 1.3-12.3), and number of energy deliveries (OR, 1.01; 95% CI, 1.003-1.03) were associated with EI type 2a or 2b. Preablation use of proton pump inhibitors was not associated with a decreased risk of EI.</div></div><div><h3>Conclusions</h3><div>EUS safely assesses mediastinal damage after ablation for AF and may excel over EGD in evaluating mucosal lesions of uncertain significance, with a reduced risk of gas embolization in the setting of a full-thickness injury (enterovascular fistula). We propose an EUS-first guided approach to post-AF ablation examination, followed by EGD if it is safe to do so.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 385-390"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106343","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":"Effects of glucagon-like peptide-1 receptor agonists on endoscopy outcomes: systematic review and meta-analysis","authors":"Sahib Singh MD ,&nbsp;Syed Hamaad Rahman DO ,&nbsp;Nihal Khan MD ,&nbsp;Anjali Rajagopal MD ,&nbsp;Nouman Shafique MD ,&nbsp;Poonam Tawde MD ,&nbsp;Vaishali Bhardwaj MD ,&nbsp;Vishnu Charan Suresh Kumar MD ,&nbsp;Ganesh Aswath MD ,&nbsp;Sumant Inamdar MD ,&nbsp;Sudhir Dutta MD ,&nbsp;Abu Hurairah MD ,&nbsp;Babu P. Mohan MD","doi":"10.1016/j.gie.2024.10.011","DOIUrl":"10.1016/j.gie.2024.10.011","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are known to cause delayed gastric emptying; however, the effect on clinical outcomes during upper endoscopy and colonoscopy remains unclear. We conducted a meta-analysis to reconcile the data.</div></div><div><h3>Methods</h3><div>Online databases were searched for studies evaluating GLP-1RAs versus a control group (no GLP-1RAs) in patients undergoing endoscopy. The outcomes of interest were rate of retained gastric contents (RGCs), aborted procedures, aspiration events, and subjective bowel preparation quality. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using a random-effects model.</div></div><div><h3>Results</h3><div>Twenty-three studies with 77,152 patients (4449 in the GLP-1RA arm and 72,703 in the control arm) were included. Mean patient age ranged from 47.6 to 72 years, and 58.4% were women. As compared with the control group, the GLP-1RA group had higher odds of RGCs (OR, 15.39; 95% CI, 4.65-50.99; <em>P</em> &lt; .01) and aborted procedures (OR, 13.86; 95% CI, 4.42-43.43; <em>P</em> &lt; .01). No significant differences were observed between the 2 groups in terms of aspiration events (OR, 21.06; 95% CI, .13-3379.01; <em>P</em> = .24) and subjective bowel preparation quality (OR, .94; 95% CI, .67-1.31; <em>P</em> = .83).</div></div><div><h3>Conclusions</h3><div>Although statistical significance was reached in terms of visible RGCs and early termination of endoscopies in patients on GLP-1RAs, these events were overall rare. GLP-1RAs do not appear to pose significant risk, as the odds of developing aspiration were comparable in the 2 groups.</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 343-349.e5"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142462624","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":"Acetic acid–enhanced magnifying endoscopy with narrow-band imaging: A simple, efficient, and nontoxic alternative chromoendoscopy for pit pattern analysis in colorectal neoplasm?","authors":"Kai Deng MD","doi":"10.1016/j.gie.2024.10.060","DOIUrl":"10.1016/j.gie.2024.10.060","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 425-426"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074351","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 randomized controlled trial of water exchange plus cap versus water exchange colonoscopy in unsedated veterans","authors":"Felix W. Leung MD ,&nbsp;Ramsey Cheung MD ,&nbsp;Shai Friedland MD ,&nbsp;Naom Jacob MD, PhD ,&nbsp;Joseph W. Leung MD ,&nbsp;Jennifer Y. Pan MD, MS ,&nbsp;Susan Y. Quan MD ,&nbsp;James Sul MD ,&nbsp;Andrew W. Yen MD, MAS ,&nbsp;Nora Jamgotchian MS ,&nbsp;Yu Chen PhD ,&nbsp;Vivek Dixit PhD ,&nbsp;Aliya Shaikh MBBS ,&nbsp;David Elashoff PhD ,&nbsp;Angshuman Saha PhD ,&nbsp;Holly Wilhalme MS","doi":"10.1016/j.gie.2024.07.010","DOIUrl":"10.1016/j.gie.2024.07.010","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Water exchange (WE) and cap-assisted colonoscopy separately have been shown to reduce pain during insertion in unsedated patients. We hypothesized that compared with WE, WE cap-assisted colonoscopy (WECAC) could significantly lower real-time maximum insertion pain (RTMIP).</div></div><div><h3>Methods</h3><div>Veterans without escort were recruited, randomized, blinded, and examined at 3 U.S. Veterans Affairs sites. The primary outcome was RTMIP, defined as the highest segmental pain (0 = no pain, 10 = most severe pain) during insertion.</div></div><div><h3>Results</h3><div>Randomization (WECAC, 143; WE, 137) produced an even distribution of a racially diverse group of men and women of low socioeconomic status. The intention-to-treat analysis reported results of WECAC and WE for cecal intubation (93% and 94.2%, respectively), mean RTMIP (2.9 [standard deviation {SD}, 2.5] and 2.6 [SD, 2.4]), proportion of patients with no pain (28.7% and 27.7%), mean insertion time (18.6 minutes [SD, 15.6] and 18.8 minutes [SD, 15.9]), and overall adenoma detection rate (48.3% and 55.1%); all <em>P</em> values were &gt;.05. When RTMIP was binarized as \"no pain\" (0) versus \"some pain\" (1-10) or \"low pain\" (0-7) versus \"high pain\" (8-10), different significant predictors of RTMIP were identified.</div></div><div><h3>Conclusions</h3><div>Unsedated colonoscopy was appropriate for unescorted veterans. WE alone was sufficient. Adding a cap did not reduce RTMIP. Patient-specific factors and application of WE with insertion suction of infused water contributed to high and low RTMIP, respectively. For unescorted patients, selecting those with low anxiety, avoiding low body mass index, history of depression or self-reported poor health, and complying with the steps of WE can minimize RTMIP to ensure success of unsedated colonoscopy. (Clinical trial registration number: NCT03160859.)</div></div>","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 402-413.e2"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758142","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 clinical practice guideline development policy and checklist","authors":"The ASGE Standards of Practice Committee,&nbsp;Nirav C. Thosani MD, MHA ,&nbsp;(ASGE Standards of Practice Committee Chair),&nbsp;Madhav Desai MD, MPH ,&nbsp;Wasif M. Abidi MD, PhD ,&nbsp;Natalie Cosgrove MD ,&nbsp;Nauzer Forbes MD, MSc, FASGE ,&nbsp;Sara Ghoneim MD ,&nbsp;Calvin Lee MD ,&nbsp;Jorge D. Machicado MD, MPH ,&nbsp;Jared Magee DO, MPH ,&nbsp;Neil B. Marya MD ,&nbsp;Saowanee Ngamruengphong MD, FASGE ,&nbsp;Michael D. Rice MD ,&nbsp;Wenly Ruan MD ,&nbsp;Monica Saumoy MD, MS ,&nbsp;Sunil G. Sheth MD, FASGE ,&nbsp;Nikhil R. Thiruvengadam MD ,&nbsp;Bashar J. Qumseya MD, MPH, FASGE ,&nbsp;(previous ASGE Standards of Practice Committee Chair)","doi":"10.1016/j.gie.2024.06.037","DOIUrl":"10.1016/j.gie.2024.06.037","url":null,"abstract":"","PeriodicalId":12542,"journal":{"name":"Gastrointestinal endoscopy","volume":"101 2","pages":"Pages 261-266"},"PeriodicalIF":6.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544922","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}