Scandinavian Journal of Gastroenterology最新文献

{"title":"Colorectal ESD in a nordic community hospital: learning curves and clinical outcomes.","authors":"Jens Aksel Nilsen, Frederik Emil Juul, Anders Egeland, Petter Tandberg, Espen Norvard, Terje Lund-Iversen, Johannes Kurt Schultz, Mette Kalager, Svein Oskar Frigstad","doi":"10.1080/00365521.2025.2553279","DOIUrl":"https://doi.org/10.1080/00365521.2025.2553279","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic submucosal dissection (ESD) enables <i>en-bloc</i> resection of large (>2cm) colorectal lesions. Despite its proven benefits, ESD remains underutilized in many countries. We evaluated the quality and safety of colorectal ESD resections during the implementation of this technique in a Norwegian endoscopy centre.</p><p><strong>Methods: </strong>This single centre cohort study included all ESD-procedures performed from March 2021 until March 2025 in a Norwegian community hospital. All data were registered prospectively for quality and safety purposes. Main outcomes were <i>en-bloc and complete (</i>R0) <i>resection rates</i> as well as <i>curative rate</i> and <i>complications</i>. Additional outcomes were dissection time and speed. Outcomes were compared in three equal periods.</p><p><strong>Results: </strong>In total, 131 procedures were performed, 105 (83%) were outpatient procedures and 123 (94%) were completed. <i>En-bloc</i> resection was achieved in 117 (95%), R0 resections in 98 (80%) and curative resections in 84 (68%). Complications occurred in 19 (15%) patients, intraprocedural in five (4%) and post-procedural in 14 (11%). All intraprocedural perforations (<i>n</i> = 3) were managed endoscopically. One patient (0,7%) had emergency surgery due to a suspicion of perforation (Clavien-Dindo score IIIb). Elective completion surgery was required in 15 patients (11%). Median dissection time was 135 min (interquartile range [IQR]: 100-195) in the first period and 80 min (IQR: 56-110) in the third period. Dissection speed (in mm²/min) increased from 13 (IQR: 10-20) in the first period, to 26 (IQR: 19-38) in the third period.</p><p><strong>Conclusion: </strong>Colorectal ESD can be safely and effectively implemented in the Nordic setting.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-10"},"PeriodicalIF":1.7,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144967138","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":"Is budesonide on demand an option for microscopic colitis treatment? A qualitative study on patient's perspective.","authors":"Katarina Pihl Lesnovska, Andreas Münch","doi":"10.1080/00365521.2025.2547222","DOIUrl":"https://doi.org/10.1080/00365521.2025.2547222","url":null,"abstract":"<p><strong>Background: </strong>Budesonide is the standard treatment for microscopic colitis (MC), effectively alleviating diarrhoea. However, diarrhoea recurrence upon discontinuation raises ideas about the feasibility of on-demand treatment. While self-management is emphasized in care of chronic diseases, less is known about patients' perspectives on initiating budesonide on-demand.</p><p><strong>Method: </strong>A qualitative study was conducted using semi-structured interviews with 15 patients diagnosed with MC and previous experience with budesonide treatment. Data were analysed using qualitative content analysis to explore patients' perceptions of on-demand treatment.</p><p><strong>Results: </strong>Three main categories emerged: (1) <b>Self-management and confidence in handling flares</b>: Patients expressed a strong desire for self-management, valuing the ability to initiate treatment independently during flares. However, some were hesitant due to uncertainty about proper dosing and treatment duration. (2) <b>Perceptions of budesonide and attitudes towards medication</b>: While budesonide was perceived as highly effective, concerns about long-term use, side effects, and potential loss of efficacy influenced adherence. Some adjusted doses based on diarrhoea, while others preferred guidance from their physician before initiating treatment. (3) <b>The role of healthcare in treatment decisions</b>: Patients emphasized the importance of accessible healthcare, clear treatment guidelines, and structured follow-up. Many felt that healthcare providers focused primarily on prescribing medication rather than providing a holistic approach. A model integrating person-centred care with professional guidance was seen as ideal for optimizing treatment outcomes.</p><p><strong>Conclusion: </strong>On-demand budesonide treatment could provide patients with greater flexibility but requires individualized support. A structured approach that balances self-management with follow-up and person-centred guidance may enhance adherence and improve quality of life in patients with MC.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856121","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":"One-year follow-up of short-term dietary intervention for MASLD: sustained improvements in steatosis, weight and dietary intake.","authors":"Magnus Holmer, Hannes Hagström, Veronika Tillander, Mohamad Alkadri, Sven Petersson, Torkel B Brismar, Per Stål, Catarina Lindqvist","doi":"10.1080/00365521.2025.2544305","DOIUrl":"https://doi.org/10.1080/00365521.2025.2544305","url":null,"abstract":"<p><strong>Background: </strong>Dietary interventions promoting weight loss are central to managing Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). While short-term benefits of various diets on liver health are well-documented, their long-term effects remain unclear. This study reports one-year follow-up results from a randomized controlled trial of a 12-week diet intervention.</p><p><strong>Method: </strong>The RCT involved 74 individuals with MASLD, with 64 completing the intervention. One year later, 47 were contacted for follow-up, and 28 attended. Due to restrictions during the Covid-19 pandemic, 17 were could not be included in the one-year follow-up. Liver health was assessed using magnetic resonance spectroscopy and vibration-controlled transient elastography at baseline, 12 weeks, and one-year post-intervention. Dietary habits were evaluated <i>via</i> a food frequency questionnaire and three-day food diary.</p><p><strong>Results: </strong>One-year post-trial, sustained improvements were observed in key parameters. Compared to baseline, body mass index (30.2 kg/m² [95%CI = 28.4-31.7] vs. 31.5 kg/m² [95%CI = 30.4-32.3], <i>p</i> < 0.001), steatosis (6.8% [95%CI = 3.2-10.5] vs. 10.9% [95%CI = 8.2-16.1], <i>p</i> < 0.001), and liver stiffness (5.5 kPa [95%CI = 4.2-6.0] vs. 6.7 [95%CI = 5.2-9.2], <i>p</i> = 0.001), were significantly reduced. Self-reported dietary habits indicated lower total energy intake, sustained changes in carbohydrate intake, and healthier dietary fat composition one year after baseline. However, the overall dietary quality index showed no long-term improvement.</p><p><strong>Conclusion: </strong>Short-term dietary interventions yielded significant, sustained improvements in liver health and dietary behaviours after one year. These findings underscore the potential of structured diet programs in MASLD management.</p><p><strong>Clinical trial number: </strong>Clinicaltrials.gov (NCT03118310).</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-9"},"PeriodicalIF":1.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837576","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":"Administrative coding for alpha-1 antitrypsin deficiency including the pi*ZZ phenotype is accurate in Sweden.","authors":"Joost Boeckmans, Sofia Ullman, Jonas F Ludvigsson, Axel Wester, Staffan Wahlin, Hannes Hagström","doi":"10.1080/00365521.2025.2544310","DOIUrl":"https://doi.org/10.1080/00365521.2025.2544310","url":null,"abstract":"<p><strong>Background: </strong>We aimed to validate the International Classification of Diseases (ICD)-10 codes for alpha-1 antitrypsin deficiency (AATD) (E880A = asymptomatic AATD; E880B = symptomatic AATD) in a large hospital reporting to the Swedish National Patient Register and to ascertain their relation to the protease inhibitor (Pi)*ZZ-phenotype.</p><p><strong>Methods: </strong>We randomly selected 150 adults and 50 children who visited Karolinska University Hospital (Stockholm, Sweden) between 2014 and 2024 with coding for E880A or E880B (1:1). Positive predictive values (PPVs) of AATD ICD-10 codes were calculated for correctly assigned codes and the Pi*ZZ-phenotype using medical charts as gold standard. Information on smoking status, lung disease, liver disease, and living area, were also retrieved.</p><p><strong>Results: </strong>The PPV of AATD ICD-10 codes (E880A + E880B) in adults was 99% (95%CI = 95-100%; <i>n</i> = 148/150). The PPV for the Pi*ZZ-phenotype was only 59% (95%CI = 50-67; <i>n</i> = 83/141) but increased to 79% (95%CI = 67-88%; <i>n</i> = 50/63) when only considering outpatients with E880B coding. Of adult participants, 13% had liver disease, 51% had lung disease, and 50% were ever-smokers. In children, the PPV of E880A + E880B was 100% (95%CI = 91-100%; <i>n</i> = 50/50) for any AATD diagnosis and was 88% for the Pi*ZZ-phenotype (95%CI = 75-95%; <i>n</i> = 43/49). Liver or lung disease occurred in 6% of children. Results were consistent across several sensitivity analyses.</p><p><strong>Conclusion: </strong>In a tertiary care setting, the validity of ICD-10 codes for AATD is excellent. The PPV of these codes for delineating the Pi*ZZ-phenotype is high in children but requires an algorithm in adults with coding for E880B in outpatients.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-8"},"PeriodicalIF":1.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817393","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":"Correction.","authors":"","doi":"10.1080/00365521.2025.2530908","DOIUrl":"10.1080/00365521.2025.2530908","url":null,"abstract":"","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"I-II"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601387","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":"Should chest computed tomography be routine in patients referred to abdominal computed tomography for major emergency abdominal pathology: an exploratory clinical study.","authors":"Jannick Brander Hansen, Lasse Lykkebo Hald, Nicolas Storm, Michael Brun Andersen, Christoph Felix Müller, Morten Vester-Andersen","doi":"10.1080/00365521.2025.2525906","DOIUrl":"10.1080/00365521.2025.2525906","url":null,"abstract":"<p><strong>Purpose: </strong>The introduction of optimised care bundles in emergency major abdominal surgery has reduced mortality. Core elements are fast diagnostic work-up with abdominal computed tomography (CT) and surgery without delay. Given the diagnostic challenges in patients with abdominal pain, we aimed to investigate if the addition of a full contrast-enhanced chest CT provides additional clinically significant diagnostic information in patients referred to an emergency abdominal CT.</p><p><strong>Methods: </strong>This retrospective cohort study included patients with suspected major abdominal pathology referred to an emergency abdominal CT with complementary chest CT (extended CT) from 1 April 2020 to 9 September 2020. This population was compared to a historic cohort with a regular emergency abdominal CT. The primary outcome was chest CT findings leading to treatment or intervention during index admission.</p><p><strong>Results: </strong>A total of 187 patients were scanned in the study period and compared to 170 historic controls. The two groups were comparable. The extended CT group had more clinically significant chest findings 28 (15.0%) compared to the standard group 9 (5.3%) (<i>p</i> = 0.002), of which pneumonia was found 18 versus 3 times, respectively. The extended CT group had more suspicious findings 22 versus 7 (<i>p</i> = 0.008) but did not result in significantly more out-patient referrals (8 versus 4, <i>p</i> = 0.38).</p><p><strong>Conclusion: </strong>In patients with suspected major abdominal pathology, an extended CT protocol which includes a full chest CT provides additional diagnostic information without reducing mortality.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"780-787"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592132","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":"Underwater versus standard endoscopic submucosal dissection for superficial colorectal neoplasms: a propensity score matched analysis.","authors":"Gianluca Andrisani, Giulio Antonelli, Takehide Fukuchi, Leonardo Frazzoni, Jun Hamanaka, Cesare Hassan, Giovanni Parente, Francesco Maria Di Matteo, Kingo Hirasawa","doi":"10.1080/00365521.2025.2531040","DOIUrl":"10.1080/00365521.2025.2531040","url":null,"abstract":"<p><strong>Background and study aims: </strong>Underwater ESD (UESD) has recently emerged as a less complex technical alternative to standard endoscopic submucosal dissection (SESD), but only small retrospective data are currently available. Our aim was to evaluate the effectiveness and safety of UESD, as compared to the current standard of care.</p><p><strong>Patients and methods: </strong>We performed a 1-to-4 nearest-neighbor retrospective propensity-score-matched-analysis between all UESD cases and all SESD cases performed and collected prospectively in a Western and an Eastern interventional endoscopy referral center, respectively. The primary outcomes were the rate of resections with histologically negative lateral and deep margins and the en-bloc resection rate. The secondary outcomes were procedure speed (mm²/min) and procedure time. The secondary outcomes were procedure speed (mm²/min) and procedure time.</p><p><strong>Results: </strong>Overall, 100 patients for UESD and 400 patients for SESD were included, matched for all baseline parameters. According to the Kudo and Paris classifications, in both groups most of lesions were laterally spreading tumours, granular type (LST-G) (60.7% vs. 55%). The mean size of lesions in the SESD group was 40.9 ± 14.7 mm. In the UESD group, the mean size of lesions was 57.4 ± 27.9 mm. UESD yielded higher rate of en-bloc resection (100% vs. 86.5%, <i>p</i> < 0.001) and lower rate of perforation (1% vs. 9.5%, <i>p</i> = 0.009). No significant difference between the two techniques was observed in terms of vertical R0 resection rate, speed and time of dissection, and delayed bleeding rate.</p><p><strong>Conclusion: </strong>Our findings suggest that UESD allows to achieve resection speed and procedure times comparable to those of expert Japanese endoscopists, with a significant reduction in the risk of perforation.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"755-761"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144612362","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":"Rethinking iron therapy in IBD: integrating the microbiota perspective.","authors":"Wojciech Marlicz, Karolina Skonieczna-Żydecka, Igor Łoniewski, Anastasios Koulaouzidis","doi":"10.1080/00365521.2025.2525909","DOIUrl":"10.1080/00365521.2025.2525909","url":null,"abstract":"<p><p>Iron deficiency and anemia are common in patients with inflammatory bowel disease (IBD), requiring effective and well-tolerated iron replacement strategies. While oral iron is widely used, growing evidence suggests it can disrupt the gut microbiota by reducing beneficial commensal bacteria and promoting pro-inflammatory shifts in the intestinal environment. These changes may exacerbate mucosal inflammation and contribute to gastrointestinal side effects, often resulting in poor adherence. Intravenous iron, by bypassing the gastrointestinal tract, appears to have a less disruptive effect on the microbiota and may more reliably restore iron stores, particularly in patients with active disease or intolerance to oral formulations. Current expert recommendations support intravenous iron as the first-line option in such cases, though oral iron remains a practical choice for selected patients with mild anemia and inactive disease. Emerging research also raises concerns about the safety of oral iron in vulnerable populations, as it may promote dysbiosis and expansion of potentially pathogenic bacteria. In response, adjunctive strategies are being explored to support the microbiota and improve the tolerability and efficacy of oral iron. Incorporating microbiota-related considerations into treatment decisions may enhance outcomes and reduce side effects. Future clinical guidelines should reflect the evolving understanding of the gut microbiome's role in iron metabolism and inflammation, promoting more personalized, microbiota-conscious approaches to iron therapy in IBD.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"817-819"},"PeriodicalIF":1.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508050","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":"Initial experience with robotic-assisted resection for suspected or confirmed gallbladder cancer - comparison with open technique in a single centre retrospective observational cohort study.","authors":"Hannes Wållgren, Stefan Gilg, Christoph Ansorge, Ernesto Sparrelid, Christian Sturesson","doi":"10.1080/00365521.2025.2525902","DOIUrl":"https://doi.org/10.1080/00365521.2025.2525902","url":null,"abstract":"<p><strong>Background and aim: </strong>Robotic-assisted surgery has become increasingly common and is now the gold standard for many procedures. In hepato-pancreato-biliary surgery, it has shown promise but remains insufficiently studied. This study reports our initial experience with robotic-assisted radical cholecystectomy for suspected or confirmed gallbladder cancer. The primary objective was to compare hospital length-of-stay - used as a proxy for functional recovery - between robotic-assisted and open surgery. The secondary objective was to assess surgical quality by comparing the number of retrieved lymph nodes.</p><p><strong>Methods: </strong>All patients with suspected or confirmed gallbladder cancer accepted for radical cholecystectomy at Karolinska University Hospital between January 2019 and December 2022 were reviewed. Ninety-five patients were identified; 22 were excluded. Of the remaining 73, 23 underwent robotic-assisted surgery and 50 underwent open surgery.</p><p><strong>Results: </strong>Robotic-assisted surgery was associated with shorter hospital stays: a median of four days compared to seven days for open surgery (<i>p</i> < 0.001). The number of retrieved lymph nodes was low in both groups but lower in the robotic group (median 1 vs. 3, <i>p</i> = 0.013). No difference regarding severe complications, readmissions or positive margin resections was found.</p><p><strong>Conclusion: </strong>In this single-centre retrospective observational study, robotic-assisted radical cholecystectomy was associated with faster recovery compared to open surgery. To confirm these findings, a multi-centre randomized clinical trial has been initiated (ClinicalTrials.gov NCT06246448).</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"1-6"},"PeriodicalIF":1.6,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576190","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":"Pathological reevaluation of gastric neoplasms with differentiation into the fundic gland.","authors":"Tetsuya Suwa, Tadakazu Shimoda, Masao Yoshida, Daisuke Aizawa, Noboru Kawata, Takashi Sugino, Hiroyuki Ono","doi":"10.1080/00365521.2025.2515428","DOIUrl":"10.1080/00365521.2025.2515428","url":null,"abstract":"<p><strong>Objectives: </strong>In the original classification, oxyntic gland neoplasms (OGNs) are classified as carcinoma based on the submucosal (SM) involvement and differentiation into MUC5AC- and MUC6-positive cells. Some cases without structural or nuclear atypia or desmoplastic reaction (DR) in the SM layer, which is essential for typical carcinoma, are also categorized as carcinoma of OGNs. To address potential overdiagnoses, we conducted a histopathological review of OGNs to propose a clinically relevant reevaluation.</p><p><strong>Methods: </strong>Forty-one OGNs diagnosed pathologically in our institution between 2010 and 2022 were included. We defined carcinoma based on the structural or nuclear atypia of the tumor cells and evaluated DR in cases of SM involvement. Furthermore, our novel classification was compared to the original one.</p><p><strong>Results: </strong>Among 41 OGNs, 10 were classified as carcinoma and 31 as adenoma. Carcinoma had a significantly larger endoscopic and pathological tumor size (<i>p</i> = 0.03, <i>p</i> < 0.01) and more MUC5AC/MUC6 co-expression than adenoma (<i>p</i> < 0.01). All cases of SM involvement with DR were recognized in nine carcinoma (90%), and all 20 cases without DR were adenoma (65%). According to the original classification, 47% (14/30) of OGNs were categorized as noncurative endoscopic resection according to the Japanese guidelines, which recommended additional gastrectomy; however, no cases of lymph node metastasis and recurrence were observed.</p><p><strong>Conclusion: </strong>Our definition of carcinoma could categorize all cases of SM involvement with DR and lymphatic invasion as carcinoma. This novel classification for OGNs may be possible to overcome the issue of overdiagnosis caused by the original classification.</p>","PeriodicalId":21461,"journal":{"name":"Scandinavian Journal of Gastroenterology","volume":" ","pages":"664-674"},"PeriodicalIF":1.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235035","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}