Gastroenterologia y hepatologia最新文献

{"title":"Preoperative endoscopic tattooing and its effect on lymph node recovery in pT1 colorectal cancer.","authors":"Inés Gil-Lasa, Luis Bujanda, Cristina Sarasqueta, María Daca-Alvarez, Diana Zaffalon, Karmele Saez de Gordoa, Gemma Ibañez-Sanz, Xavier Sanjuan, Alberto Herreros-de-Tejada, Inmaculada Salces, Lara Aguilera, Marta Ponce, Ángeles Pizarro, David Barquero, Ignasi Puig, Pilar Diez Redondo, Fernando Martínez de Juan, Victor Jair Morales, Marco Alburquerque, Salvador Machlab, Angel Ferrandez, Beatriz Peñas, Alvaro Díaz-González, Lluïsa Sargatal, Rodrigo Jover, Luis Hernandez, Alberto Pérez Pedrosa, Eva Musulen, Goretti Hernandez, Marita Trelles, Akiko Ono, Jorge Lopez Vicente, Isabel Portillo, Miriam Cuatrecasas, María Pellisé","doi":"10.1016/j.gastrohep.2026.502765","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2026.502765","url":null,"abstract":"<p><strong>Objective: </strong>Preoperative endoscopic tattooing in patients with T1 colorectal cancer may increase lymph node retrieval. The aim of our study was to evaluate the use of preoperative tattooing in surgically treated T1 colorectal cancer and to identify its impact on lymph node recovery.</p><p><strong>Patients and methods: </strong>We included all cases of pT1 colorectal cancer treated with oncologic surgery from a retrospective, multicenter Spanish cohort study (EpiT1 Consortium). The use of preoperative tattooing and its influence on lymph node recovery outcomes were analyzed.</p><p><strong>Results: </strong>A total of 1700 patients with pT1 colon cancer undergoing oncologic resection were included. Of these, 63.6% (1082/1700) had received preoperative tattooing. The median number of nodes retrieved was 14 in both groups (p = 0,12). The rate of adequate lymph node recovery (≥ 12 nodes) was similar between tattooed and non-tattooed patients (60.8% vs. 61.9%, p = 0,67), with no differences depending on tumor location. There were also no differences in the rate of positive nodes between tattooed and non-tattooed patients (10.4% vs. 9.5%, p = 0,61) nor by tumor location.</p><p><strong>Conclusion: </strong>The use of endoscopic tattooing does not appear to increase the total lymph node retrieval or the detection of positive lymph nodes during surgery.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502765"},"PeriodicalIF":1.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"INVAGINACIÓN INTESTINAL EN EL ADULTO: MÁS ALLÁ DE LAS CAUSAS HABITUALES.","authors":"Lopez Munoz Marta, Barranco Castro Daniel, Montana Ramirez Ana María, Maldonado Perez Belén","doi":"10.1016/j.gastrohep.2026.502766","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2026.502766","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502766"},"PeriodicalIF":1.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147769770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Biomarkers and Multi-Omics Approaches for Diagnosis and Management of Ulcerative Colitis.","authors":"Arup Dey, Manish Kumar Gautam, Sandip Mondal, Saikat Sen","doi":"10.1016/j.gastrohep.2026.502764","DOIUrl":"https://doi.org/10.1016/j.gastrohep.2026.502764","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis (UC) remains challenging to diagnose, monitor, and treat due to heterogeneous disease presentation and lack of reliable non-invasive markers. Current diagnostic tools, including endoscopy and routine laboratory tests, are limited by invasiveness, cost, and low sensitivity.</p><p><strong>Aim: </strong>This review evaluates emerging biomarkers and multi-omics strategies in UC, highlighting their potential role in disease diagnosis, prognosis, and therapeutic response prediction.</p><p><strong>Methods: </strong>A comprehensive literature analysis was conducted, focusing on fecal, serological, genetic, epigenetic, microbial, and metabolite-based biomarkers, as well as recent advances in transcriptomics, proteomics, and metabolomics. Integration with machine learning approaches was also assessed for their clinical applicability.</p><p><strong>Results: </strong>Fecal calprotectin and lactoferrin remain reliable non-invasive markers for mucosal inflammation, while serological markers such as CRP and ESR show limited specificity. Genetic variants (IL23R, NOD2) and epigenetic regulators, particularly microRNAs, demonstrate potential for disease stratification. Dysbiosis and altered microbial metabolites further correlate with disease severity and treatment response. Multi-omics integration offers a systems-level view of UC, enabling biomarker panels that improve diagnostic precision and predict therapeutic outcomes. Machine learning tools enhance biomarker-based models, but clinical translation is constrained by variability, validation gaps, and regulatory hurdles.</p><p><strong>Conclusion: </strong>Emerging biomarkers, especially when integrated across omics platforms and supported by artificial intelligence, provide promising avenues for precision medicine in UC. However, standardization, external validation, and regulatory qualification remain essential for their successful clinical implementation.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502764"},"PeriodicalIF":1.9,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health and quality of Life in Inflammatory Bowel disease: Cross-sectional Study on its Impact.","authors":"Vanesa Gallardo Arriero, Marta Calvo Moya, Rocío de Lucas Téllez de Meneses, Irene González Partida, Belén Botella Mateu, Virginia Matallana Royo, Pablo Bella Castillo, Macarena González Rodríguez, Maribel Vera Mendoza","doi":"10.1016/j.gastrohep.2026.502763","DOIUrl":"10.1016/j.gastrohep.2026.502763","url":null,"abstract":"<p><strong>Objective: </strong>Inflammatory Bowel Disease (IBD) negatively impacts patients' quality of life. This study aims to evaluate the psychological impact and quality of life in patients with IBD.</p><p><strong>Patients and methods: </strong>A cross-sectional study was conducted involving IBD patients treated at HUPHM. Validated questionnaires were used to assess patients' mental health. Clinical activity was evaluated using the Harvey-Bradshaw Index and the Partial Mayo Score. Clinical data were also collected.</p><p><strong>Results: </strong>A total of 272 patients were included. Seventy-eight percent experienced some degree of psychological impairment, and 68% reported a negative impact on their quality of life. Anxiety showed a median score of 11 (IQR: 10-13) and stress a median of 24 (IQR: 16-31), representing the most frequent psychological disturbances. Quality of life and fatigue results reflected significant impairment, with fatigue being more prevalent in women (52%, p=0.027) and associated with higher stress levels (p=0.0013) and poorer quality of life (p=0.014). Patients with Crohn's disease exhibited worse quality of life compared to those with ulcerative colitis (median score: 46 [IQR: 34-55] vs. 49 [IQR: 41-55], p=0.04). In the occupational domain, patients with work disability showed greater psychological impairment and poorer quality of life (p=0.001). Finally, patients without prior surgery demonstrated better quality of life (p=0.032).</p><p><strong>Conclusions: </strong>The high prevalence of psychological comorbidities in IBD highlights the need for approaches that incorporate psychological assessment and intervention.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502763"},"PeriodicalIF":1.9,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-based real-world adoption of advanced therapies for ulcerative colitis in Brazil: Trends and regional differences from a nationwide public healthcare database.","authors":"Maria Paz Gimenez Villamil, Maria Victoria Bein, Douglas Andreas Valverde, Mariane Christina Savio, Rafaela Araújo Molteni Moretti, Thyago Proença de Moraes, Abel Botelho Quaresma, Paulo Gustavo Kotze","doi":"10.1016/j.gastrohep.2026.502762","DOIUrl":"10.1016/j.gastrohep.2026.502762","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate temporal trends and regional differences in the use of advanced therapies for ulcerative colitis (UC) within Brazil's public healthcare system.</p><p><strong>Patients and methods: </strong>Retrospective population-based study using Brazilian Department of Informatics of the Unified Health System (DATASUS) data (2019-2023). Patients with an ICD-10 code for UC were included. Monthly dispensing rates of infliximab, vedolizumab, and tofacitinib were analyzed.</p><p><strong>Results: </strong>By 2023, 195,807 UC patients were identified. Administrative prevalence increased from 26.37 to 62.47 per 100,000 inhabitants. Nationwide use of advanced therapies rose significantly. Vedolizumab showed the highest Annual Average Percent Change (AAPC) (+8.5%), followed by tofacitinib (+4.8%) and infliximab (+1.02%). The Southeast demonstrated the greatest growth, whereas the Northeast showed a significant decline across all therapies.</p><p><strong>Conclusion: </strong>UC prevalence increased markedly in Brazil, with persistent regional disparities in advanced therapy use.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502762"},"PeriodicalIF":1.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal lymphoid hyperplasia after phosphate enema: Reactive change or incidental finding?","authors":"Daniel Álvarez de Castro, Ángela Benavides Zarama, Ainhoa Sánchez Lorenzo, Benjamín Polo Lorduy","doi":"10.1016/j.gastrohep.2026.502761","DOIUrl":"10.1016/j.gastrohep.2026.502761","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502761"},"PeriodicalIF":1.9,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Idiopathic duodenal bulb intussusception in the adult.","authors":"Marta Torrero Luna, Laura Zamora Sanclemente, Ana Rodríguez Pérez, Iván Fernández Marzo","doi":"10.1016/j.gastrohep.2026.502760","DOIUrl":"10.1016/j.gastrohep.2026.502760","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502760"},"PeriodicalIF":1.9,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Less is more: Simplifying therapy in post-ablative antral hyperplasia.","authors":"Rut Fernandez Bezanilla, Irene Arteagoitia Casero, Mario Salvador Argueta Valdez, Ainara Torralba Gallego, Pilar Pazo Meijide, Iñigo Roa Esparza","doi":"10.1016/j.gastrohep.2026.502758","DOIUrl":"10.1016/j.gastrohep.2026.502758","url":null,"abstract":"","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502758"},"PeriodicalIF":1.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subclinical atherosclerosis in inflammatory bowel disease: Prevalence, vascular distribution and implications for cardiovascular risk stratification.","authors":"Gonzalo Fernández Villar, Fernando Garagoli, Solange Martinez Elhelou, Walter Masson, Maria Josefina Etchevers, Maria Josefina Sobrero, Maria Belen Sanchez, Rodolfo Pizarro","doi":"10.1016/j.gastrohep.2026.502755","DOIUrl":"10.1016/j.gastrohep.2026.502755","url":null,"abstract":"<p><strong>Objective: </strong>Cardiovascular (CV) risk assessment in patients with inflammatory bowel disease (IBD) remains insufficiently explored. This study aimed to assess the role of vascular Doppler ultrasound in refining CV risk stratification in patients with IBD.</p><p><strong>Patients and methods: </strong>We conducted a cross-sectional study including patients with Crohn's disease (CD) and ulcerative colitis (UC) under active follow-up in a tertiary referral center. Consecutive patients referred for cardiology assessment according to predefined clinical criteria between May 2024 and December 2025 underwent carotid and femoral Doppler ultrasound to estimate the prevalence of atherosclerosis. Ultrasound operators were blinded to the CV risk score results and clinical risk stratification at time to image acquisition and interpretation. In the primary prevention cohort, the ability of the PREVENT 10-year risk score for detecting subclinical atherosclerosis was assessed using receiver operating characteristic (ROC) analysis. The optimal cutoff point was determined using the Youden index.</p><p><strong>Results: </strong>A total of 106 patients were included, of whom 100 without established atherosclerotic cardiovascular disease (ASCVD) constituted the main analytical population. The median age was 54.4 years, and 59% were men. Before Doppler assessment, 55% of patients were classified as low risk, 10% as borderline risk, 28% as intermediate risk, and 7% as high risk. Subclinical atherosclerosis was detected in 46%, prompting risk reclassification. Overall upward reclassification occurred in 41% and downward reclassification in 5%, yielding a net reclassification of 36%. The PREVENT 10-year risk score showed good discriminatory performance for the detection of subclinical atherosclerosis (AUC=0.85; 95% CI, 0.77-0.93), with an optimal cutoff value of 2.8%.</p><p><strong>Conclusions: </strong>Vascular Doppler imaging revealed a high prevalence of subclinical atherosclerosis and was associated with substantial CV risk reclassification beyond traditional scores.</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502755"},"PeriodicalIF":1.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer-assisted adenoma detection colonoscopy with an ENDO-AID artificial intelligence system and Endocuff- versus Endocuff-assisted colonoscopy: A randomized controlled trial.","authors":"Antonio Z Gimeno-García, Anjara Hernández, Domingo Hernández Negrin, Eduardo Rodríguez, Gloria Lorenzo, Jorge Mon, Rafael Romero, Alejandro Jiménez, Vanessa Felipe, Zaida Adrián, Raquel de la Barreda, Juan Ortega, Yaiza Cedrés, Manuel Hernández-Guerra, David Nicolás-Pérez","doi":"10.1016/j.gastrohep.2026.502757","DOIUrl":"10.1016/j.gastrohep.2026.502757","url":null,"abstract":"<p><strong>Background: </strong>Compared with conventional colonoscopy, computer-assisted adenoma detection (CADe) colonoscopy and Endocuff-Vision (EV) have been shown to increase the adenoma detection rate (ADR). However, the evidence for whether their combination further increases the ADR compared with that of EV alone is limited. The aim was to compare the combination of CADe and EV, with EV alone.</p><p><strong>Methods: </strong>In all, 696 patients were randomized 1:1 to receive either CADe (ENDO-AID [OIP-1]) plus EV or EV alone at a tertiary care hospital. The primary outcome was the ADR. The secondary outcomes included the advanced ADR and the number of adenomas per colonoscopy (APC). Both intention-to-treat (ITT) and per-protocol (PP) analyses were conducted for the primary outcome.</p><p><strong>Results: </strong>In the ITT analysis, the ADR was 54.6% and 51.1% in the combination and EV groups, respectively (OR 1.15, 95% CI (0.85-1.55)). In the PP analysis, the ADRs were 58.7% and 56.6%, respectively (OR 1.09, 95% CI (0.79-1.52)), for the combination and EV groups. The ADR in the proximal colon was significantly greater in the combination group than in the EV group (39.6% vs. 30%; P=0.015). The APC value was significantly greater in the combination group than in the EV group (mean: 1.7, SD: 2.34 vs. mean: 1.31, SD: 1.92; P=0.029), which was primarily due to increased detection of flat diminutive adenomas.</p><p><strong>Conclusions: </strong>Compared with EV alone, colonoscopy assisted by both ENDO-AID (OIP-1) and EV does not significantly increase the ADR. However, this combination may be beneficial for the detection of proximal and diminutive flat adenomas (NCT05141773).</p>","PeriodicalId":12802,"journal":{"name":"Gastroenterologia y hepatologia","volume":" ","pages":"502757"},"PeriodicalIF":1.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}