Digestive Endoscopy最新文献

{"title":"Successful diagnosis of small gastrointestinal stromal tumor using modified mucosal incision-assisted biopsy with a cold snare","authors":"Yoshitaka Ando,&nbsp;Toshiyuki Sakurai,&nbsp;Masayuki Saruta","doi":"10.1111/den.14955","DOIUrl":"10.1111/den.14955","url":null,"abstract":"<p>Gastric subepithelial lesions (G-SELs), including malignant conditions like gastrointestinal stromal tumors (GISTs), require biopsy for diagnosis.<span>¹</span> The European Society of Gastrointestinal Endoscopy guidelines recommend mucosal incision-assisted biopsy (MIAB) as the first choice for small SELs (≤20 mm),<span>²</span> despite its association with complications such as postoperative bleeding and perforation.<span>³</span> In 2020, Zimmer and Eltze<span>⁴</span> presented a modified MIAB using a cold snare to expose G-SELs. Modified MIAB allows for more reliable tissue sampling than boring biopsy by exposing a larger area of the tumor, but it can increase immediate bleeding due to the absence of electrocautery. Despite this, it avoids thermal damage to tissue samples, reduces the risk of delayed complications, and usually avoids hospitalization. However, to our knowledge, only one retrospective study has reported on this method, limited to benign conditions.<span>⁵</span> Here, we report the first case of small GIST successfully diagnosed using modified MIAB (Video S1).</p><p>The G-SEL in the mid-body lesser curvature originated from the muscularis propria layer, measuring 18.1 mm on endoscopic ultrasound (Fig. 1a,b). The covering mucosa was bluntly resected with a thin-wire snare to a size equal to or at least half of the tumor diameter, and submucosal tissue was extracted several times with biopsy forceps (Fig. 1c,d). Once the G-SEL surface became irregular and adequately exposed, three biopsies were performed using biopsy forceps (Fig. 1e). If the tumor is a high-grade GIST, tumor exposure during open laparoscopic and endoscopic cooperative surgery risks peritoneal dissemination, so mucosal defects were clipped (Fig. 1f). All three biopsy procedures yielded c-kit positive tumor tissue, sufficient for a definitive histological diagnosis (Fig. 2). The procedure took 9 min, without complications.</p><p>This report indicates that modified MIAB with cold snare is effective for the histological diagnosis of GISTs and may be performed more quickly than existing methods.</p><p>Authors declare no conflict of interest for this article.</p><p>Approval of the research protocol by an Institutional Reviewer Board: This procedure and case report were approved by the Ethics Committee of Atsugi City Hospital.</p><p>Informed Consent: Informed consent was obtained from the patient after verbally explaining the purpose, method, safety considerations, and risks of the procedure.</p><p>Registry and the Registration No. of the study/trial: N/A.</p><p>Animal Studies: N/A.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 3","pages":"308-310"},"PeriodicalIF":5.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroendocrine neoplasm of the minor papilla diagnosed with endoscopic ultrasonography-guided fine-needle biopsy and curatively resected by endoscopic papillectomy","authors":"Kento Shionoya,&nbsp;Kenjiro Yamamoto,&nbsp;Takao Itoi","doi":"10.1111/den.14953","DOIUrl":"10.1111/den.14953","url":null,"abstract":"<p>Minor papillary neoplasms are rare and surgical resection is the most reported treatment.<span>¹</span> Moreover, reports of endoscopic resection of neoplasm in the minor papilla are scarce.<span>²</span></p><p>A 47-year-old man with an enlarged minor papilla detected on upper gastrointestinal endoscopy was referred to our institution (Fig. 1a). Duodenoscopy revealed a submucosal epithelial lesion in the minor papilla (Fig. 1b), and endoscopic ultrasonography (EUS) showed an 8 mm hypoechoic neoplasm within the submucosal layer without invasion of the muscularis propria or intraductal extension into the pancreatic duct (Fig. 1c,d). Contrast-enhanced EUS showed that the neoplasm was contrast on isoechoic. Based on EUS-guided fine-needle biopsy (EUS-FNB) with a 22G three-prong asymmetry tip needle (Trident; Micro-Tech Endoscopy, Nanjing, China) using the fanning technique, the lesion was diagnosed as a low-grade (G1) neuroendocrine neoplasm (NEN). Computed tomography and magnetic resonance cholangiopancreatography showed no distant metastases or pancreatic divisum (Fig. 1e,f). The patient declined surgery, so endoscopic papillectomy (EP) was performed. The scope was placed in a semi-push position to position the lesion favorably. A snare was placed on the oral side of the lesion, which was then grasped by pushing the snare inward. During grasping, the scope was placed in a pulled position by stretching. The lesion was resected en bloc in endocut mode. Subsequently, pulsatile bleeding was controlled using hemostatic clips. A pancreatic ductal stent was not placed, as the pancreatic divisum was absent (Video S1). The pathological diagnosis was NEN-G1 without invasion of the muscularis propria or lymphovascular invasion, and the neoplasm was completely resected without any complications (Fig. 2). There was no recurrence within 1 year.</p><p>EUS-FNB can be used to diagnose NEN of the minor papilla. EP can be effective for NEN of the minor papilla and should be considered when the neoplasm is &lt;10 mm without intrinsic muscle layer invasion or lymph node metastasis.<span>³</span></p><p>Authors declare no conflict of interest for this article.</p><p>Approval of the research protocol by an Institutional Reviewer Board: N/A.</p><p>Informed Consent: Informed consent was obtained from the patient in this case report.</p><p>Registry and the Registration No. of the study/trial: N/A.</p><p>Animal Studies: N/A.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 4","pages":"430-431"},"PeriodicalIF":5.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14953","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of remimazolam on oxygen reserve compared with propofol during upper gastrointestinal endoscopy: Randomized controlled study","authors":"Kyuho Lee,&nbsp;Da Hyun Jung,&nbsp;Sung Jin Lee,&nbsp;Young Chul Yoo,&nbsp;Sung Kwan Shin","doi":"10.1111/den.14948","DOIUrl":"10.1111/den.14948","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Propofol is commonly used for endoscopic sedation. However, it can induce adverse hemodynamic effects. Remimazolam is known to have a fast onset and short duration comparable to that of propofol, but with fewer effects on hemodynamics. We assessed the Oxygen Reserve Index to verify whether a sedative dose of remimazolam would better preserve oxygenation in the mild hyperoxic range than propofol in sedated patients undergoing diagnostic upper gastrointestinal endoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients scheduled for diagnostic upper gastrointestinal endoscopy were enrolled. Patients were randomly assigned to either the remimazolam or propofol groups and received 0.1 mg/kg remimazolam or 0.5 mg/kg propofol, respectively. Bolus injections of either 0.05 mg/kg remimazolam or 0.25 mg/kg propofol were added if required. The primary outcome was the prevalence of oxygen reserve depletion, defined as the Oxygen Reserve Index decreasing to 0.00, and hypoxia defined as peripheral oxygen saturation falling to &lt;94%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 69 patients, the incidence of oxygen reserve depletion was significantly higher in the propofol group (65.7% vs. 38.2%, <i>P</i> = 0.022). Hypoxia was frequently observed in the propofol group, whereas none was observed in the remimazolam group (11.4% vs. 0%, <i>P</i> = 0.042). Additional sedative injections were frequently required to complete endoscopy in the propofol group. None of the patients in the remimazolam group required airway interventions. Nausea was frequent in the propofol group in the recovery room.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results indicate that remimazolam is a safe and useful sedative for upper gastrointestinal endoscopy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 4","pages":"391-399"},"PeriodicalIF":5.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14948","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WEO Newsletter: Evaluation and Endoscopic Management of Disconnected Pancreatic Duct Syndrome","authors":"","doi":"10.1111/den.14960","DOIUrl":"10.1111/den.14960","url":null,"abstract":"<p>WEO Newsletter Editor: Nalini M Guda MD, MASGE, AGAF, FACG, FJGES</p><p>Surinder Singh Rana MD, D.M, FAMS, AGAF, FASGE, Master ISG, Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh 160012, India</p><p>Dr. Surinder Rana is a Professor of Gastroenterology at the Post Graduate Institute of Medical Education and Research, which is a premier Medical Education Institute in India. Dr. Rana has over 500 publications in peer-reviewed journals. He is a well-known researcher, endoscopist and educator who is involved in several international and national educational conferences and endoscopy workshops.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"36 11","pages":"1292-1294"},"PeriodicalIF":5.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peroral digital cholangioscopy-assisted removal of a migrated biliary plastic stent using a novel small dilating balloon","authors":"Noriyuki Hirakawa,&nbsp;Shuntaro Mukai,&nbsp;Takao Itoi","doi":"10.1111/den.14950","DOIUrl":"10.1111/den.14950","url":null,"abstract":"<p>Biliary plastic stent (PS) migration is occasionally encountered during endoscopic retrograde cholangiopancreatography-related procedures.<span>¹</span> Several removal techniques for migrated stent have been reported.<span>^2-4</span> However, some cases are challenging even with these techniques. Here, we describe a case of successful peroral digital cholangioscopy-assisted removal of a migrated PS using a novel small dilating balloon.</p><p>The patient was a 74-year-old man who had undergone biliary drainage using a straight-type 7F PS for cholangitis because of a common bile duct stone at a previous hospital (Fig. 1a).</p><p>Stone removal was attempted in our hospital, but fluoroscopy showed that the PS had migrated into the bile duct (Fig. 1b). The stone was pushed toward the liver side and papillary balloon dilation was attempted, but this was difficult because of interference from the PS and stone. Therefore, removal of the migrated PS was attempted, first with grasping forceps under fluoroscopic guidance, but was unsuccessful because of the difficulty of grasping the PS. Removal using a basket was predicted to be difficult because of interference from the stone just above the papilla. Therefore, peroral digital cholangioscopy-assisted removal was attempted next. A digital cholangioscope (Spy DS; Boston Scientific, Natick, MA, USA) was inserted into the bile duct and visualized the migrated PS. Then, a 0.025 inch guidewire was passed through the stent's lumen under direct visualization (Fig. 2a). Subsequently, a novel small dilating balloon (3 mm × 6 cm, REN biliary dilation catheter; Kaneka Medix, Osaka, Japan) was inserted into the stent lumen<span>⁵</span> (Fig. 2b,c, Video S1). By inflating the balloon, crimping the balloon and the PS, and pulling back slowly, the migrated PS was successfully removed through-the-scope without interference from the balloon catheter or stone. The novel dilating balloon is longer than conventional versions, allowing for stronger crimping. Finally, the stone was removed and the procedure was completed.</p><p>Author T.I. received lecture fees from Kaneka Medix and Boston Scientific. The other authors declare no conflict of interest for this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 3","pages":"306-307"},"PeriodicalIF":5.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic closure using SureClip Traction Band for delayed perforation after colorectal endoscopic submucosal dissection","authors":"Reo Kobayashi,&nbsp;Naohisa Yoshida,&nbsp;Ken Inoue","doi":"10.1111/den.14938","DOIUrl":"10.1111/den.14938","url":null,"abstract":"<p>Delayed perforation (DP) is reported to occur in 0.1–0.4% of colorectal endoscopic submucosal dissection (ESD).<span>^{1, 2}</span> DP can be fatal due to peritonitis and most cases of colorectal DP result in surgery. Various endoscopic closures after ESD are reported for preventing DP.<span>^{3, 4}</span> However, few reports showed the success of endoscopic closure for DP.<span>⁵</span> In this report, we present a case of DP closed with SureClip Traction Band (SCTB; Micro-Tech Co., Nanjing, China). The patient was a 61-year-old woman. She took prednisolone 10 mg/day for Wegener's granulomatosis. A polypoid lesion of 25 mm was detected in the transverse colon (Fig. 1a). En bloc resection was performed with ESD. The ESD defect was closed using MANTIS Closure Device (Boston Scientific, Marlborough, MA, USA) and SureClip (Micro-Tech Co.), considering the negative impact of prednisolone for would healing (Fig. 1b,c). However, tight complete closure was not achieved due to difficult operability. On the day after ESD, the patient presented abdominal pain and computed tomography (CT) showed free air (Fig. 1d). Because of the localized peritonitis, we decided to close it endoscopically. Although no perforation was found, we performed additional closure with SureClip (Fig. 1e,f). However, 3 days after ESD, free air increased with CT (Fig. 2a). Endoscopic closure was performed again and contrast medium leakage was observed (Fig. 2b). The ulcer base was hard and previous clips remained, making closure difficult. Normal mucosa at the edge of the ulcer on the anal side was captured with SCTB. Then the band was gripped with SureClip and deployed at the oral side of the ulcer for closing the ESD defect. Finally, complete closure could be performed with additional SCTB and SureClip (Fig. 2c–f, Video S1). The patient was discharged 11 days after ESD.</p><p>Author N.Y. had a grant from Fujifilm and received a lecture fee from Fujifilm. The other authors have no conflicts of interest for this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 2","pages":"206-208"},"PeriodicalIF":5.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14938","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of endoscopic submucosal dissection including papilla (with video)","authors":"Naohisa Yahagi,&nbsp;Yusaku Takatori,&nbsp;Motoki Sasaki,&nbsp;Yuri Imura,&nbsp;Shoma Murata,&nbsp;Tsubasa Sato,&nbsp;Daisuke Minezaki,&nbsp;Takaoki Hayakawa,&nbsp;Yuki Nakajima,&nbsp;Haruka Okada,&nbsp;Hinako Sakurai,&nbsp;Anna Tojo,&nbsp;Kentaro Iwata,&nbsp;Kurato Miyazaki,&nbsp;Atsuto Kayashima,&nbsp;Teppei Masunaga,&nbsp;Mari Mizutani,&nbsp;Teppei Akimoto,&nbsp;Takashi Seino,&nbsp;Shintaro Kawasaki,&nbsp;Masayasu Horibe,&nbsp;Seichiro Fukuhara,&nbsp;Noriko Matsuura,&nbsp;Tomohisa Sujino,&nbsp;Atsushi Nakayama,&nbsp;Kaoru Takabayashi,&nbsp;Eisuke Iwasaki,&nbsp;Motohiko Kato","doi":"10.1111/den.14942","DOIUrl":"10.1111/den.14942","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic papillectomy (EP) is a low-invasive treatment for duodenal tumors including papilla. The limit of lesion size and local recurrence have been issues in EP. We developed endoscopic submucosal dissection (ESD) for the duodenal tumors including papilla (ESDIP: ESD including papilla) to overcome the problems. The aim of this study was to evaluate the feasibility of ESDIP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included the patients who underwent ESDIP from August 2010 to January 2024 in this study. We evaluated the retrospective characteristics of patients and lesions, clinical results of ESDIP and of endoscopic retrograde cholangiopancreatography (ERCP) as prevention for delayed adverse events, and pathological findings. We also calculated the cumulative recurrence rate and overall survival rate at 12 months after ESDIP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-four patients were included in this study. The mean lesion size was 39 mm. The third-quarter cases revealed a less than half-circumferential lesion, and the one case with a full-circumferential lesion. Resection was accomplished in 96% (<i>n</i> = 52), and also the en-bloc resection rate was 96%. Of the cases in accomplished resection, 98% of patients were intubated with a pancreaticobiliary drainage tube by ERCP. Intraprocedural perforation occurred in eight cases. Delayed bleeding occurred in 10 cases. Delayed perforation was seen only in one case. The incidence of post-ERCP pancreatitis was 25%. Cumulative local recurrence rate and the overall survival rate were 15% and 96%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ESDIP may be feasible for duodenal tumors including papilla, and is a potential alternative option to avoid pancreaticoduodenectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 4","pages":"402-410"},"PeriodicalIF":5.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete endoscopic debridement combined with partial gastric wall resection successfully treated refractory esophago-gastric anastomotic fistula","authors":"Yajuan Li,&nbsp;Jiyu Zhang,&nbsp;Bingrong Liu","doi":"10.1111/den.14944","DOIUrl":"10.1111/den.14944","url":null,"abstract":"<p>A 59-year-old man presented with an esophagogastric anastomotic fistula following Ivor Lewis esophageal cancer resection. The Interventional Radiology Department treats patients with the new “three-tube” method, which involves the fluoroscopically guided transnasal placement of a sinus drainage tube, a nasogastric decompression tube, and a nasojejunal nutritional tube. However, after 6 months of treatment, his chest pain and fever had not improved, he was unable to eat orally, and pus was still coming out of the sinus drainage tube. Upper gastrointestinal radiography showed a fistula still present (Fig. 1a).</p><p>After he was transferred to our department, we decided to perform further treatment. Endoscopy showed plenty of pus in the upper gastrointestinal tract. After cleaning it up, we saw a large anastomotic fistula. Swollen mucosa covered the fistula and interfered with drainage, which was removed with a snare (Fig. 1b,c). A large amount of dense necrotic tissue in the fistula was removed by a hook knife (Fig. 1d,e). The gastric wall between fistula and gastric lumen was removed with a hook knife and a snare in order to open the fistula for adequate drainage (Fig. 1f). During the operation, coagulation forceps were used to stop the bleeding (Video S1). We placed a tube into the fistula, rinsed daily with 8000 mL of saline, a nasogastric tube for negative pressure drainage, and a nasojejunal tube for feeding. Two days later, endoscopy showed no pus in the fistula, and all tubes were removed. He was started on an oral liquid diet, and discharged.</p><p>Surveillance endoscopy after 1, 4, and 7 months (Fig. 2a–c) showed a good healing process. Then 17 months later, endoscopy and computed tomography showed complete healing of the fistula (Fig. 2d,e), and a weight gain of 9 kg during follow-up.</p><p>Overall, anastomotic fistula is a refractory disease, this case demonstrates that this method is safe and valid and deserves to be promoted.</p><p>Authors declare no conflict of interest for this article.</p><p>This work was supported by grants from Zhongyuan Talent Program (ZYYCYU202012113).</p><p>Approval of the research protocol by an Institutional Reviewer Board: N/A.</p><p>Informed Consent: Informed consent was obtained from the patient for the publication of their information and imaging.</p><p>Registry and the Registration No. of the study/trial: N/A.</p><p>Animal Studies: N/A.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 3","pages":"302-303"},"PeriodicalIF":5.0,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14944","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-assembling peptides for successful hemostasis in advanced gastric cancer","authors":"Shusei Fukunaga,&nbsp;Akinobu Nakata,&nbsp;Yasuhiro Fujiwara","doi":"10.1111/den.14954","DOIUrl":"10.1111/den.14954","url":null,"abstract":"<p>Endoscopic hemostasis of bleeding from advanced gastric cancer is difficult because of the multiple sources and fragile tissues. Palliative radiotherapy, although effective, takes time to be effective.<span>^{1, 2}</span></p><p>The endoscopic application of a self-assembling peptide (SAP; PuraStat; 3-D Matrix, Tokyo, Japan) has been reported as a bridge to radiotherapy.<span>³</span> However, maintaining the visual field through air inflation is difficult because of blood pooling and wall stiffness.</p><p>Gel immersion endoscopy allows visualization under conditions of poor visibility.<span>^{4, 5}</span> However, it is unknown whether SAP coating is possible under gel immersion conditions.</p><p>Here, we demonstrate the application of SAP under gel immersion by a phantom experiment and report successful hemostasis of tumor bleeding by SAP application under gel immersion called the “gel under gel” technique (Video S1).</p><p>We modeled a hemorrhage by injecting simulated blood from a tube in an acrylic aquarium (Fig. 1a,b). We used an irrigation valve (BioShield irrigator; STERIS, Mentor, OH, USA) to simultaneously inject a transparent gel (Viscoclear; Otsuka Pharmaceutical Factory, Tokushima, Japan) and applied the SAP to the hemorrhage site using a dedicated catheter (Fig. 1c). By extruding the SAP with an indigo carmine solution instead of air, the end of the SAP use could be determined without bubbling. The gels did not mix, and the gel-forming SAP remained at the bleeding point after the surrounding gel was removed.</p><p>A 53-year-old man with advanced gastric cancer presented with severe anemia. Esophagogastroduodenoscopy revealed multiple bleeding points (Fig. 2a). The bleeding points were clearly identified by transparent gel injection. Hemostasis was achieved by applying the SAP using a catheter during gel immersion (Fig. 2b). The gel-forming SAP remained attached to the tumor surface, and complete hemostasis was achieved (Fig. 2c).</p><p>Self-assembling peptide application under gel immersion may be useful for achieving hemostasis in bleeding tumors by maintaining a clear visual field.</p><p>Authors declare no conflict of interest for this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 4","pages":"432-433"},"PeriodicalIF":5.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Consensus statements on endoscopic ultrasound-guided tissue acquisition. Guidelines from the Asian Endoscopic Ultrasound group”","authors":"","doi":"10.1111/den.14959","DOIUrl":"10.1111/den.14959","url":null,"abstract":"<p>Chong CC, Pittayanon R, Pausawasdi N, <i>et al</i>. Consensus statements on endoscopic ultrasound-guided tissue acquisition. Guidelines from the Asian Endoscopic Ultrasound Group. <i>Dig Endosc</i> 2024; <b>36</b>: 871–83.</p><p>In the FUNDING INFORMATION section, the project number is wrong. The correct one should be as follows:</p><p>“THIS PROJECT IS supported by the Health and Medical Research Fund (HMRF08190406).”</p><p>The authors apologize for this error and any inconvenience it may have caused.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 6","pages":""},"PeriodicalIF":5.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}