Digestive Endoscopy最新文献

{"title":"Beyond Helicobacter pylori Eradication: Endoscopic Surveillance of the Post-Eradication Stomach","authors":"Tatsunori Satoh","doi":"10.1111/den.70101","DOIUrl":"10.1111/den.70101","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967817","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":"Interpreting the Gastric Atrophy–ESCC Association: Avoiding Causal Overreach and Advancing Mechanistic Insights","authors":"Jae Yong Park","doi":"10.1111/den.70103","DOIUrl":"10.1111/den.70103","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967915","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":"Endoscopic Diagnosis of Gastric Subepithelial Lesions < 20 mm: Current Strategies and Emerging Solutions","authors":"Yosuke Minoda,&nbsp;Shuzaburo Nagatomo,&nbsp;Haruei Ogino,&nbsp;Nao Fujimori,&nbsp;Eikichi Ihara","doi":"10.1111/den.70079","DOIUrl":"10.1111/den.70079","url":null,"abstract":"<p>Gastric subepithelial lesions (SELs) &lt; 20 mm are frequently identified during routine endoscopy and account for approximately 90% of all SELs. Although most are benign, a substantial proportion represents gastrointestinal stromal tumors (GISTs), which carry malignant potential even at this small size. Histological confirmation is critical for appropriate risk assessment and treatment planning. However, the diagnostic yield of endoscopic ultrasound-guided tissue acquisition (EUS-TA) is limited for SELs &lt; 20 mm due to technical challenges such as lesion mobility and short needle stroke. Mucosal incision–assisted biopsy (MIAB), which enables direct visualization and targeted sampling, has emerged as a practical alternative. This narrative review summarizes current evidence on endoscopic diagnostic approaches for SELs &lt; 20 mm, including both sampling methods (EUS-TA, MIAB) and nonsampling techniques such as contrast-enhanced EUS, elastography, and artificial intelligence (AI)-assisted image analysis. Each modality has distinct advantages and limitations, and selection should be based on lesion characteristics, endoscopist experience, and resource availability. Nonsampling modalities offer complementary information and are expected to become increasingly relevant. A comprehensive understanding of available diagnostic techniques is essential to support accurate clinical decision-making for SELs &lt; 20 mm.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954098","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":"Comment on: “The One-Minute Triple Stretch Reduces Musculoskeletal Discomfort in Endoscopic Assistants: A Crossover Trial With Motion Analysis”","authors":"Shyam Sundar Sah,&nbsp;Abhishek Kumbhalwar","doi":"10.1111/den.70092","DOIUrl":"10.1111/den.70092","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954105","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":"Partial Injection Underwater Endoscopic Mucosal Resection for a Colorectal Flat Lesion","authors":"Hidenori Kimura,&nbsp;Kazuo Shiotsuki,&nbsp;Takuji Iwashita","doi":"10.1111/den.70095","DOIUrl":"10.1111/den.70095","url":null,"abstract":"<p>Colorectal underwater endoscopic mucosal resection (UEMR) is widely performed because of its higher en bloc and R0 resection rates, as well as lower local recurrence rates compared with conventional EMR [<span>1, 2</span>]. However, identifying the oral side of a lesion can occasionally be challenging in underwater conditions, leading to piecemeal resection. Here, we demonstrate a technique for partial submucosal injection on the oral side during UEMR (PI-UEMR) for a flat colorectal lesion. A 60-year-old man underwent colonoscopy, which revealed a 13-mm flat reddish lesion in the transverse colon (Figure 1a). Endoscopy with narrow-band imaging showed an irregular surface and vessel pattern, suggesting an advanced adenoma (Figure 1b). Underwater conditions made it difficult to continuously visualise the oral side of the lesion without the assistance of a sheath, raising concerns regarding the possibility of piecemeal resection (Figure 1c). Therefore, we decided to perform PI-UEMR. After a partial submucosal injection of 3 mL of saline solution on the oral side of the lesion, the overall visualisation improved (Figure 1d). We captured the lesion while maintaining the snare tip on the oral side. En bloc resection was achieved without any complications (Figure 1e, Video S1). Pathological examination revealed a high-grade adenoma with tumour-free margins (Figure 2). PI-UEMR, which involves local injection only on the oral side of the lesion, can improve the visibility of the oral margin while maintaining the floating effect [<span>3</span>], an original advantage of the underwater resection technique. A previous report demonstrated that PI-UEMR achieved better treatment outcomes than conventional UEMR in the duodenum [<span>4</span>]. The detailed presentation of this case not only suggests the potential applicability of PI-UEMR to colorectal flat lesions for which piecemeal resection is a concern with conventional UEMR [<span>5</span>], but also may contribute to the adoption of this technique as a simple and reproducible procedure.</p><p>H.K.: conception and design of the study. H.K., K.S. and T.I.: drafting and revision of the manuscript and final approval of the manuscript.</p><p>The authors have nothing to report.</p><p>The authors have nothing to report.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954034","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":"High Incidence of Metachronous Lesions After Endoscopic Removal in Patients With Ulcerative Colitis: Results of a Long-Term Follow-Up in Multicenter Registry Study","authors":"Shunichi Yanai,&nbsp;Tadakazu Hisamatsu,&nbsp;Takayuki Matsumoto","doi":"10.1111/den.70087","DOIUrl":"10.1111/den.70087","url":null,"abstract":"","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954040","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":"Traction-Assisted Closure Technique for Peroral Endoscopic Myotomy","authors":"Hiroki Fukuya,&nbsp;Yoshitaka Hata,&nbsp;Eikichi Ihara","doi":"10.1111/den.70084","DOIUrl":"10.1111/den.70084","url":null,"abstract":"<p>Traction-assisted closure technique for peroral endoscopic myotomy.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p><p>Watch a video of this article.</p>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12793824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145954061","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":"Short- and Long-Term Outcomes of Endoscopic Resection for Serrated Lesions in Patients With Ulcerative Colitis: A Retrospective Exploratory Study","authors":"Masafumi Nishio,&nbsp;Kingo Hirasawa,&nbsp;Reiko Kunisaki,&nbsp;Kimio Nozaki,&nbsp;Keita Morohashi,&nbsp;Tomoki Kanemura,&nbsp;Reo Atsusaka,&nbsp;Daisuke Azuma,&nbsp;Atsushi Sawada,&nbsp;Ryosuke Kobayashi,&nbsp;Chiko Sato,&nbsp;Tsuyoshi Ogashiwa,&nbsp;Hideaki Kimura,&nbsp;Sawako Chiba,&nbsp;Shin Maeda","doi":"10.1111/den.70089","DOIUrl":"10.1111/den.70089","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic resection (ER) is well established for serrated lesions in patients with noninflammatory bowel disease; however, limited evidence supports its outcomes in patients with ulcerative colitis (UC). We evaluated the short- and long-term outcomes of ER for serrated polyps in patients with UC and assessed the risk of metachronous UC-associated neoplasia (UCAN).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 127 patients with UC who underwent ER for colorectal neoplasms between 2004 and 2024. Serrated polyps were categorized as sessile serrated lesions (SSLs), traditional serrated adenomas (TSAs), or unclassified serrated adenomas (USAs). Short-term outcomes, including <i>en bloc</i> and R0 resection rates, were compared between UCAN and sporadic neoplasia (SN). Long-term outcomes, including metachronous UCAN, were also analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 127 patients, 25 serrated lesions (13 SSLs, eight TSAs, and four USAs) were identified. The <i>en bloc</i> and R0 resection rates for serrated lesions were 96% and 92%, respectively, comparable to those for UCAN and SN. Over a median follow-up of 68 months, one patient with TSA developed invasive cancer 34 months post-ER, and two patients with USA developed UC-associated dysplasia. No metachronous UCAN was observed in the patients with SSL. The 5-year cumulative UCAN occurrence rate in the serrated lesion group was 18%, comparable to that in the UCAN group (29%) but significantly higher than that in the SN group (2%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Because the outcomes of ER were comparable to those of UCAN and SN, ER appears acceptable for serrated lesions in UC. However, TSA and USA may require stricter post-ER surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919380","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":"CV-SCAN (Crystal Violet Staining for Colitis-Associated Neoplasia): A Novel Endoscopic Staining Method to Detect Paneth Cell Metaplasia and Ulcerative Colitis (UC)-Associated Neoplasia in UC","authors":"Akira Tomioka,&nbsp;Nanoka Chiya,&nbsp;Chie Kurihara,&nbsp;Yoshikiyo Okada,&nbsp;Kazuyuki Narimatsu,&nbsp;Masaaki Higashiyama,&nbsp;Shunsuke Komoto,&nbsp;Ryota Hokari","doi":"10.1111/den.70096","DOIUrl":"10.1111/den.70096","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Paneth cell metaplasia (PCM), a metaplastic change associated with chronic inflammation in ulcerative colitis (UC), may be linked to UC-associated neoplasia (UCAN). However, no endoscopic method currently exists for detecting PCM. This study aimed to develop and validate a novel endoscopic staining technique—CV-SCAN—for identifying PCM and UCAN, and to explore the molecular characteristics of the stained areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective observational study included 131 patients with UC undergoing surveillance colonoscopy. CV-SCAN involved spraying an ultra-diluted solution (0.006%) of crystal violet from the descending colon to the rectum. Biopsies were obtained from stained and non-stained areas and evaluated histologically and molecularly. RNA expression profiles were analyzed via microarray and real-time RT-PCR. The diagnostic performance of CV-SCAN for detecting PCM was assessed, along with its correlation with UCAN history.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CV-SCAN visualized sharply demarcated, purple-stained areas corresponding to PCM or UCAN. PCM was significantly associated with a history of UCAN. Uniform, dark staining was characteristic of PCM, while UCAN showed heterogeneous staining with small round pits. CV-SCAN achieved a sensitivity of 81.3% and a specificity of 84.9% for PCM detection. Molecular analysis revealed upregulation of Paneth cell–specific (DEFA5, DEFA6), small intestinal (CCL25, APOC3), and UCAN-associated (IL17RC) genes, along with downregulation of SATB2 in stained areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CV-SCAN is a novel and effective endoscopic staining method for detecting PCM and UCAN in patients with UC. It enables risk stratification through direct visualization of precancerous changes and may facilitate early detection and targeted surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12775890/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914151","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":"A Multimodal Feature Fusion Model for Predicting Secondary Loss of Response After Infliximab Treatment in Crohn's Disease Patients: A Multicenter Study","authors":"Chang Rong,&nbsp;Yulong Liu,&nbsp;Jing Hu,&nbsp;Ting Cheng,&nbsp;Zhipeng Tai,&nbsp;Shuai Li,&nbsp;Yi Shen,&nbsp;Bo Zhang,&nbsp;Yankun Gao,&nbsp;Xiaoming Zheng,&nbsp;Kaicai Liu,&nbsp;Mingzhai Sun,&nbsp;Xingwang Wu","doi":"10.1111/den.70097","DOIUrl":"10.1111/den.70097","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The early prediction of secondary loss of response (SLOR) after infliximab (IFX) treatment in Crohn's disease (CD) patients can help optimize treatment strategies. This study developed and validated a multimodal deep learning model that uses baseline endoscopic ulcer lesions to predict SLOR. Additionally, a deep learning–based ulcer detection model was established to automatically identify ulcer lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 385 CD patients from three centers were retrospectively analyzed. An ulcer detection model was developed to identify endoscopic ulcer lesions from 12,092 endoscopic images. Following lesion localization, 2189 ulcer images were selected and used to train feature fusion models, while clinical data were incorporated to construct a multimodal model for SLOR prediction. These models were validated in two external test cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The ulcer detection model achieved precision values of 0.853 in the validation cohort. The multimodal model outperformed the clinical model in predicting SLOR with areas under the ROC curve (AUCs) of 0.892, 0.847, and 0.824 in the internal validation cohort, external test cohort 1, and external test cohort 2, respectively. Gradient-weighted class activation mapping (Grad-CAMs) revealed highly pronounced activation of the ulcerated area in SLOR patients in the model, providing crucial support for model prediction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The ulcer detection model effectively identifies ulcer lesions, increasing diagnostic efficiency. The multimodal model, which integrates baseline endoscopic images and clinical data, offers a potential tool for early SLOR prediction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":159,"journal":{"name":"Digestive Endoscopy","volume":"38 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919354","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}