Digestive Endoscopy最新文献

{"title":"Virtual-reality endoscopic navigation system in mediastinal natural orifice transluminal endoscopic surgery (with video)","authors":"Masaya Uesato,&nbsp;Senri Umetsu,&nbsp;Akira Nakano,&nbsp;Mayuko Kinoshita,&nbsp;Toshiya Nakaguchi,&nbsp;Hisahiro Matsubara","doi":"10.1111/den.15001","DOIUrl":"10.1111/den.15001","url":null,"abstract":"<p>The approaches to mediastinal surgery are open thoracic, thoracoscopic, and mediastinoscopy. However, using natural orifice transluminal endoscopic surgery (NOTES) would be minimally invasive if the mediastinum is reached via the esophagus. One disadvantage of NOTES was no information outside the wall. We focused on the electromagnetic tracking solution. The sensor position in the space created by the magnetic field generator can be determined. We performed a computed tomography (CT) of a pig before constructing the target mediastinal organs in 3D. The pig was placed in the magnetic field space, and the endoscope with the sensor was subsequently inserted orally and synchronized with the 3D image. By simultaneously viewing the actual and the virtual endoscopic image in 3D, the mediastinum can be visualized through the esophagus. We determined six points in advance in the 3D images, and the esophageal lumen closest to the esophagus from the points was marked with a clip under the endoscope. The CT scans showed that the mean error between the clip position and the closest point from the target point to the esophagus was 4.7 mm across three trials. We named this system the virtual-reality endoscopic navigation system (VENaS). VENaS can help determine the shortest distance to the point away from the esophagus and the 3D relation with the surrounding organs during esophageal endoscopy, and also displays gravity direction and an overhead view, thereby making it easy to approach areas with tumors or malformations in the mediastinum and increasing the realism of mediastinal NOTES.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 5","pages":"541-547"},"PeriodicalIF":5.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494970","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":"Ergonomic endoscopy – Fundamentals of ergonomics and interventions for endoscopy-related musculoskeletal disorders","authors":"Ippei Matsuzaki,&nbsp;Takeshi Ebara,&nbsp;Yasuki Hori,&nbsp;Shoko Ono,&nbsp;Yousuke Nakai,&nbsp;Kazuki Hayashi,&nbsp;Mafu Tsunemi,&nbsp;Mitsuhiro Fujishiro","doi":"10.1111/den.14999","DOIUrl":"10.1111/den.14999","url":null,"abstract":"<p>Recently, musculoskeletal disorders (MSDs) among endoscopists have attracted considerable attention. MSDs are caused by prolonged static postures, forceful manual exertions, and repetitive twisting maneuvers. Basic knowledge of ergonomics is useful for improving the posture, movements, and work environment of endoscopists, as well as developing equipment to prevent MSDs. This review discusses problematic endoscopic tasks from an ergonomic perspective, issues with MSD definitions, the prevalence of MSDs, local site interpretations, risk factors including working time and environment, and ergonomic evaluations. The evidence highlights the importance of multifaceted strategies for risk avoidance using the Hierarchy of Controls. Additionally, this review summarizes global trends and introduces the Ergonomic Endoscopy 7 Tips for MSD prevention, emphasizing a systems approach through collaboration with various stakeholders. Thus, it may serve as a guide for gastroenterologists and staff engaged in endoscopic procedures for prolonged periods.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 6","pages":"588-600"},"PeriodicalIF":5.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14999","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450282","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":"Long-term outcomes of a modified nonflared fully covered self-expandable metal stent for refractory anastomotic biliary strictures after liver transplantation (with video)","authors":"Jae Woo Park,&nbsp;Jong Ho Moon,&nbsp;Yun Nah Lee,&nbsp;Il Sang Shin,&nbsp;Jun Chul Chung,&nbsp;Jaehong Jeong,&nbsp;Tae Hoon Lee,&nbsp;Jae Kook Yang,&nbsp;Young Deok Cho,&nbsp;Sang-Heum Park","doi":"10.1111/den.14990","DOIUrl":"10.1111/den.14990","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Although fully covered self-expandable metal stents (FCSEMS) are used for the management of anastomotic biliary stricture (ABS) after liver transplantation (LT), there is concern about long-term adverse events such as recurrence of stricture. We evaluated the long-term efficacy of a modified nonflared FCSEMS (M-FCSEMS) compared to plastic stents (PS) for refractory ABS after LT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consecutive patients who underwent placement of an M-FCSEMS (M-FCSEMS group) or multiple PS (PS group) for refractory ABS after LT were enrolled. The primary outcome was the stricture recurrence rate, and the secondary outcomes were technical success, clinical success, and the rate of de novo stricture.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In both groups, technical success was achieved in all patients. The median stent duration was 3.1 months in the M-FCSEMS group and 7.6 months in the PS group (<i>P</i> &lt; 0.001). Clinical success rates were 96.7% (29/30) for the M-FCSEMS group and 94.4% (17/18) for the PS group (<i>P</i> = 0.709). Stent migration occurred in 10.0% (3/30) of the patients before removal of the stent in the M-FCSEMS group, while 27.8% (5/18) of patients in the PS group showed stent migration (<i>P</i> = 0.110). Stricture recurrence occurred in 17.2% (5/29) in the M-FCSEMS group, compared to 47.1% (8/17) in the PS group (<i>P</i> = 0.036). There were no de novo strictures observed in either cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Modified nonflared FCSEMS is effective for relieving refractory ABS after LT, with a low recurrence rate and the absence of de novo stricture after long-term follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 6","pages":"651-658"},"PeriodicalIF":5.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442799","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":"Underwater endoscopic mucosal resection of an ileal adenoma using double-balloon endoscopy","authors":"Tatsuki Hamaya,&nbsp;Yosuke Toya,&nbsp;Takayuki Matsumoto","doi":"10.1111/den.15003","DOIUrl":"10.1111/den.15003","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 4","pages":"428"},"PeriodicalIF":5.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416107","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":"Three-dimensional optically cleared tissue imaging for analyzing endoscopic images of gastrointestinal neoplasms (with video)","authors":"Koki Nakamura,&nbsp;Koki Morishita,&nbsp;Nobuhiko Onda,&nbsp;Ikuko Sakai,&nbsp;Shinya Matsumoto,&nbsp;Eri Tamura,&nbsp;Yuta Kouyama,&nbsp;Yushi Ogawa,&nbsp;Masashi Misawa,&nbsp;Takemasa Hayashi,&nbsp;Hideyuki Miyachi,&nbsp;Shin-ei Kudo,&nbsp;Tetsuo Nemoto","doi":"10.1111/den.15000","DOIUrl":"10.1111/den.15000","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To develop a procedure that matches magnifying endoscopic images with narrow-band imaging to 3D tissue structures using a tissue-clearing technique and to qualitatively and quantitatively analyze specified structures in gastrointestinal neoplasms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Endoscopically resected formalin-fixed paraffin-embedded gastrointestinal tissues (three esophagus, four stomach, seven colon) were made transparent by ethyl cinnamate. They were then subjected to fluorescent staining of nuclei and blood vessels followed by 3D imaging using a confocal laser scanning microscope. A one-to-one correspondence between magnifying endoscopic and 3D reconstructed images was established using vessels and crypts with characteristic shapes as guides, and the depth and caliber of specified vessels were measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All tissues were optically cleared, which allowed 3D visualization of vascular structures and nuclei in all layers. In the esophagus, intraepithelial papillary capillary loops and subepithelial capillary networks were identified. In the upper part of the stomach, polygonal subepithelial capillary loops surrounding the pits were observed, while in the lower part, surface epithelium with ridge-like structures and coiled vessels were observed. A honeycomb pit structure and surrounding vascular structures were identified in the colon. Quantitative analysis showed the various contrasts of a single continuous vessel in the endoscopic image were due to different depths at which the vessel tortuously ran.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We established a procedure to allow one-to-one correspondence between magnifying endoscopic and 3D reconstructed images and to measure the depth and caliber of endoscopically visualized vessels of interest. This method is expected to improve endoscopic diagnosis and further the development of endoscopic imaging technologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 6","pages":"659-669"},"PeriodicalIF":5.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.15000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124023","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":"Usefulness of novel line traction-assisted polypectomy for a large gastric polyp prolapsing into the duodenum","authors":"Muneshin Morita,&nbsp;Kotaro Waki,&nbsp;Yasuhito Tanaka","doi":"10.1111/den.14993","DOIUrl":"10.1111/den.14993","url":null,"abstract":"<p>Recently, innovative techniques such as the line-assisted complete closure<span>^{1, 2}</span> and the reopenable clip-over-the-line method,<span>³</span> which involve the passage of a threaded clip through the endoscope channel, have been reported. Based on those techniques, we developed the line traction-assisted polypectomy procedure. We present a case in which this method was applied to a large gastric polyp prolapsing into the duodenum.</p><p>A 70-year-old man was referred to our hospital after a routine esophagogastroduodenoscopy (EGD) revealed a gastric polyp. Our hospital EGD showed the 40 mm pedunculated gastric polyp prolapsing into the duodenum (Fig. 1). We opted for endoscopic resection of the gastric lesion to prevent bleeding and potential obstruction (Video S1).</p><p>Initially, a 3-0 nylon line was tied at the clip, which was inserted through the channel. Subsequently, the clip with the nylon line was attached to the stalk apex of the lesion (Fig. 2a). By gently pulling on the nylon line, we successfully retracted the lesion into the stomach (Fig. 2b). Next, a 15 mm plastic tube handmade from an MTW catheter (990120111; ABIS, Hyogo, Japan) was inserted through the channel along the line, aiming to prevent the lesion from coming too close to the endoscope and to facilitate easier snaring. Following this, we inserted the Endoloop (HX-400U-30; Olympus Medical, Tokyo, Japan) and the rotatable polypectomy snare (M00561831; Boston Scientific, Marlborough, MA, USA) along the line and performed endoscopic resection (Fig. 2c–f). The patient was then discharged after 6 days without any postoperative adverse events. The pathological diagnosis was a hyperplastic polyp.</p><p>We believe that this technique is particularly effective for managing lesions that prolapse into areas such as the duodenum, diverticula, and ileocecal valve. It not only facilitates the extraction of these lesions, but also maintains adequate tension to prevent their prolapsing again.</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 to publish the patient's information and imaging data.</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 6","pages":"712-713"},"PeriodicalIF":5.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14993","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070031","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 sleeve gastroplasty – Current status and future perspectives","authors":"Stephen Ka-Kei Ng,&nbsp;Anthony Yuen-Bun Teoh","doi":"10.1111/den.14994","DOIUrl":"10.1111/den.14994","url":null,"abstract":"<p>Obesity is a worldwide epidemic and present significant health-care burdens for individuals and health-care systems. Bariatric endoscopy is an evolving field known for benefits including being minimally invasive, reversible, and organ preserving, providing a promising alternative to traditional bariatric surgery. Various endoscopic procedures targeting on the stomach and small bowel have been developed. Amongst all, endoscopic sleeve gastroplasty (ESG) is shown to be more effective, durable, and safe. It utilizes endoscopic suturing device to perform full-thickness plication of gastric wall, thereby restricting stomach volume and altering gastric mobility to induce satiety. Its application was recently addressed by the National Institute for Health Care Excellence (NICE), the American Society for Gastrointestinal Endoscopy (ASGE), the European Society for Gastrointestinal Endoscopy (ESGE), the International Federation for the Surgery of Obesity and Metabolic Diseases (IFSO) and the World Gastroenterology Organization (WGO). This review aims to provide a comprehensive summary of ESG and discusses potential future developments.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 6","pages":"601-610"},"PeriodicalIF":5.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14994","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070029","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":"Response to: Site of puncture in endoscopic ultrasound-guided fine needle biopsy: Does it change diagnostic outcome?","authors":"Sung Woo Ko,&nbsp;Tae Jun Song","doi":"10.1111/den.14997","DOIUrl":"10.1111/den.14997","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 2","pages":"201"},"PeriodicalIF":5.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034898","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":"Spectrum of gastric neoplasms in Helicobacter pylori-naïve patients","authors":"Kotaro Shibagaki,&nbsp;Ryoji Kushima,&nbsp;Shigeki Sekine,&nbsp;Tsuyoshi Mishiro,&nbsp;Satoshi Kotani,&nbsp;Yoichi Miyaoka,&nbsp;Norihisa Ishimura,&nbsp;Asuka Araki,&nbsp;Hideyuki Ohnuma,&nbsp;Daisuke Niino,&nbsp;Shunji Ishihara","doi":"10.1111/den.14980","DOIUrl":"10.1111/den.14980","url":null,"abstract":"<p>Chronic <i>Helicobacter pylori</i> (<i>Hp</i>) infection is the largest etiological factor for gastric cancer, but in recent years the reports of <i>Hp</i>-naïve gastric neoplasms (HpNGNs) have increased as the <i>Hp</i>-infected population in Japan has been declining. The histopathologic spectrum of HpNGNs differs significantly from that of conventional <i>Hp</i>-infected gastric neoplasms. Molecularly, the former harbor considerably fewer genetic and epigenetic abnormalities, reflecting the absence of chronic inflammatory conditions in the gastric mucosa. The majority of HpNGNs fall within several specific histological entities; each arise from particular background mucosa. Most originate from the fundic gland mucosa and have a gastric immunophenotype, as seen in foveolar-type gastric adenoma (FGA), oxyntic gland adenoma (OGA)/gastric adenocarcinoma of fundic gland type (GA-FG), signet-ring cell carcinoma (SRCC), and sporadic fundic gland polyp with dysplasia (FGPD). In contrast, tumors arising from the pyloric or cardiac gland mucosa have a diverse immunophenotype, as seen in intestinal-type gastric dysplasia (IGD) and gastric cardiac carcinoma. FGA, FGPD, SRCC, and IGD are mostly found as small intramucosal lesions. OGA/GA-FG frequently progresses to invasive carcinoma, but only a few have lymph node metastases. Thus, these tumors are regarded as precancerous lesions by Western pathologists, while in Japan they tend to be diagnosed as carcinomas, even in cases of low-grade dysplasia. Gastric cardiac carcinomas, on the other hand, are often found as advanced carcinomas and harbor a high malignant biological potential. A new diagnostic framework for gastric neoplasms is required in the present era of <i>Hp</i>-naïve individuals in Japan.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 6","pages":"611-628"},"PeriodicalIF":5.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/den.14980","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025523","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":"Utility of endoscopic pressure study integrated system for gastroesophageal reflux disease after endoscopic antireflux therapy","authors":"Kazuki Yamamoto,&nbsp;Haruhiro Inoue,&nbsp;Ippei Tanaka,&nbsp;Kei Ushikubo,&nbsp;Miyuki Iwasaki,&nbsp;Yohei Nishikawa,&nbsp;Hidenori Tanaka,&nbsp;Mayo Tanabe,&nbsp;Satoshi Abiko,&nbsp;Boldbaatar Gantuya,&nbsp;Manabu Onimaru,&nbsp;Yuto Shimamura","doi":"10.1111/den.14989","DOIUrl":"10.1111/den.14989","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The endoscopic pressure study integrated system (EPSIS) measures intragastric pressure (IGP) during esophagogastroduodenoscopy. Previous research demonstrated that EPSIS correlates with the 24-h impedance-pH (MII-pH) test and shows lower maximum IGP (IGP-Max) and a flatter waveform gradient in gastroesophageal reflux disease (GERD) patients, attributed to lower esophageal sphincter dysfunction. Although endoscopic antireflux therapy (EARTh) is effective for GERD, the MII-pH monitoring, the gold standard for assessing treatment outcomes, requires hospitalization and can be a burden. EPSIS offers a noninvasive alternative for evaluating post-EARTh outcomes. This study aimed to assess EPSIS as an additional diagnostic tool in this context.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of GERD patients who underwent EARTh and were subsequently assessed using EPSIS within 6 months, from May 2018 to April 2024. Changes in IGP parameters, including IGP-Max and waveform gradient, were analyzed pre- and post-EARTh. Additionally, the study examined Hill's Classification following EARTh.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 39 patients assessed with EPSIS before and after EARTh, the average age was 55 years (standard deviation [SD] 16.7), with 64.1% male. Postoperative IGP-Max increased from 15.2 mmHg to 18.0 mmHg (<i>P</i> = 0.004), and the pressure gradient improved from 0.16 mmHg/s to 0.28 mmHg/s (<i>P</i> &lt; 0.001). Hill's Classification improved significantly from a mean of 2.2 (SD 0.7) to 1.1 (SD 0.3) (<i>P</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicates that EPSIS is a reliable diagnostic tool for evaluating the effects of EARTh and holds potential as a supplementary tool for assessing GERD treatment outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"37 6","pages":"670-679"},"PeriodicalIF":5.0,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017410","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}