World Journal of Gastroenterology最新文献

{"title":"Clinicopathological features and treatment of gastrointestinal schwannomas.","authors":"Peng-Cheng Zhang, Shu-Hui Wang, Jun Li, Jing-Jie Wang, Hong-Tan Chen, Ai-Qing Li","doi":"10.3748/wjg.v31.i5.101280","DOIUrl":"10.3748/wjg.v31.i5.101280","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal schwannomas (GIS) are rare neurogenic tumors arising from Schwann cells in the gastrointestinal tract. Studies on GIS are limited to small case reports or focus on specific tumor sites, underscoring the diagnostic and therapeutic challenges they pose.</p><p><strong>Aim: </strong>To comprehensively examine the clinical features, pathological characteristics, treatment outcomes, associated comorbidities, and prognosis of GIS.</p><p><strong>Methods: </strong>The study population included patients diagnosed with GIS at the First Affiliated Hospital, Zhejiang University School of Medicine, between June 2007 and April 2024. Data were retrospectively collected and analyzed from medical records, including demographic characteristics, endoscopic and imaging findings, treatment modalities, pathological evaluations, and follow-up information.</p><p><strong>Results: </strong>In total, 229 patients with GIS were included, with a mean age of 56.00 years and a male-to-female ratio of 1:1.83. The mean tumor size was 2.75 cm, and most (76.9%) were located in the stomach. Additionally, 6.6% of the patients had other malignant tumors. Preoperative imaging and endoscopy frequently misdiagnosed GIS as gastrointestinal stromal tumors. However, accurate preoperative diagnosis was achieved using endoscopic ultrasound-guided fine-needle aspiration combined with immunohistochemical analysis, in which S100 and SOX-10 markers were mostly positive. Smaller tumors were typically managed with endoscopic resection, while larger lesions were treated with surgical resection. Follow-up results showed that most patients experienced favorable outcomes.</p><p><strong>Conclusion: </strong>Preoperative diagnosis of GIS <i>via</i> clinical characteristics, endoscopy, and imaging examinations remains challenging but crucial. Endoscopic therapy provides a minimally invasive and effective option for patients.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"101280"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological diagnosis of microvascular invasion in hepatocellular carcinoma: Is it reliable?","authors":"Liu-Jun Li, Chao-Qun Wu, Fei-Le Ye, Zhou Xuan, Xiao-Li Zhang, Jian-Ping Li, Jia Zhou, Zhong-Zhen Su","doi":"10.3748/wjg.v31.i5.98928","DOIUrl":"10.3748/wjg.v31.i5.98928","url":null,"abstract":"<p><strong>Background: </strong>Microvascular invasion (MVI) is a critical prognostic factor for postoperative hepatocellular carcinoma recurrence, but the reliability of its current pathological diagnosis remains uncertain.</p><p><strong>Aim: </strong>To evaluate the accuracy of current 7-point sampling methods and propose an optimal pathological protocol using whole-mount slide imaging (WSI) for better MVI detection.</p><p><strong>Methods: </strong>We utilized 40 New Zealand white rabbits to establish VX2 liver tumor models. The entire tumor-containing liver lobe was subsequently obtained, following which five different sampling protocols (A-E) were employed to evaluate the detection rate, accuracy, quantity, and distribution of MVI, with the aim of identifying the optimal sampling method.</p><p><strong>Results: </strong>VX2 liver tumor models were successfully established in 37 rabbits, with an incidence of MVI of 81.1% (30/37). The detection rates [27% (10/37), 43% (16/37), 62% (23/37), 68% (25/37), and 93% (14/15)] and quantity (15, 36, 107, 125, and 395) of MVI increased significantly from protocols A to E. The distribution of MVI showed fewer MVIs farther away from the tumor, but the percentage of MVI detected quantity gradually increased from 6.7% to 48.3% in the distant nonneoplastic liver tissue from protocols A to E. Protocol C was identified as the optimal sampling method by comparing them in sequence. The sampling protocol of three consecutive interval WSIs at the tumor center (WSI₃) was further screened to determine the optimal number of WSIs. Protocol A (7-point sampling method) exhibited only 46% accuracy and a high false-negative rate of 67%. Notably, the WSI₃ protocol improved the accuracy to 78% and decreased the false-negative rate to 27%.</p><p><strong>Conclusion: </strong>The current 7-point sampling method has a high false-negative rate in MVI detection. In contrast, the WSI₃ protocol provides a practical and effective approach to improve MVI diagnostic accuracy, which is crucial for hepatocellular carcinoma diagnosis and treatment planning.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"98928"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New perspectives and prospects for the next generation of combination therapy in inflammatory bowel disease.","authors":"Wen-Ting Xie, Hui Yang, Lan Bai, Feng-Fei Wu","doi":"10.3748/wjg.v31.i5.99462","DOIUrl":"10.3748/wjg.v31.i5.99462","url":null,"abstract":"<p><p>This article comments on the letter by Lowell <i>et al</i>, which addresses the next generation of combination therapy for inflammatory bowel disease (IBD). As the understanding of the pathogenesis of IBD continues to improve, treatment strategies are evolving rapidly. The letter examines the current status and future directions of combination therapy for IBD, focusing on approaches that combine biologics with immunomodulators and the emerging dual-biologic therapy (DBT). The traditional combination of biologics and immunomodulators has demonstrated preliminary efficacy by enhancing the effects of biologics through immunomodulation. However, concerns regarding long-term safety warrant careful evaluation. Recent trials, including DUET-Crohn's disease and DUET-ulcerative colitis, have shown promising potential for the broader adoption of DBT. Nevertheless, comprehensive data on efficacy and safety, as well as the effective integration of supportive treatments, remain essential to establish new paradigms for the next generation of IBD care.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"99462"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the role of nonalcoholic fatty liver disease in pulmonary carcinoma development?","authors":"Qin Pan, Qing-Yang Xu, Lang-Hua Zhang, Ya-Fang He","doi":"10.3748/wjg.v31.i5.97500","DOIUrl":"10.3748/wjg.v31.i5.97500","url":null,"abstract":"<p><p>This article summarizes the epidemiological characteristics and clinical manifestations of nonalcoholic fatty liver disease (NAFLD). The incidence of NAFLD has been increased dramatically and become the leading cause of chronic liver disease worldwide. In addition to its adverse outcomes of liver fibrosis, cirrhosis, and hepatocellular carcinoma, and related complications, NAFLD has recently been found to be associated with the high-risk extrahepatic carcinomas, such as various types of lung cancer (<i>i.e</i>., lung adenocarcinoma, squamous cell carcinoma, and small cell lung cancer). The presence of hepatic steatosis also predisposes lung cancer to liver metastasis, but has better response to immune checkpoint inhibitors. Whether other factors (<i>i.e</i>., gender, smoking, <i>etc</i>.) are associated with NAFLD and lung cancer remains controversial. We also comment on the reciprocal relationships between NAFLD and components of metabolic syndrome. Most metabolic syndrome components are suggested to facilitate lung cancer development <i>via</i> activating insulin/insulin-like growth factor axis. In addition, suppressed anti-tumor immunity and accelerated tumor progression could be attributed to the cell-specific metabolic reprogramming in condition of high-fat diet and related obesity. These findings may reveal the role of NAFLD in pulmonary carcinoma and help develop new treatment strategies for this disease.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"97500"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capsule endoscopy: Do we still need it after 24 years of clinical use?","authors":"Ahmed Tawheed, Alaa Ismail, Mohab S Amer, Osama Elnahas, Tawhid Mowafy","doi":"10.3748/wjg.v31.i5.102692","DOIUrl":"10.3748/wjg.v31.i5.102692","url":null,"abstract":"<p><p>In this letter, we comment on a recent article published in the <i>World Journal of Gastroenterology</i> by Xiao <i>et al</i>, where the authors aimed to use a deep learning model to automatically detect gastrointestinal lesions during capsule endoscopy (CE). CE was first presented in 2000 and was approved by the Food and Drug Administration in 2001. The indications of CE overlap with those of regular diagnostic endoscopy. However, in clinical practice, CE is usually used to detect lesions in areas inaccessible to standard endoscopies or in cases of bleeding that might be missed during conventional endoscopy. Since the emergence of CE, many physiological and technical challenges have been faced and addressed. In this letter, we summarize the current challenges and briefly mention the proposed methods to overcome these challenges to answer a central question: Do we still need CE?</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"102692"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hollow cerium nanoparticles synthesized by one-step method for multienzyme activity to reduce colitis in mice.","authors":"Lin Mi, Kai Zhang, Jian-Xia Ma, Jian-Feng Yao, Yi-Li Tong, Zhi-Jun Bao","doi":"10.3748/wjg.v31.i5.98732","DOIUrl":"10.3748/wjg.v31.i5.98732","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a common chronic intestinal inflammatory disease. High oxidative stress is a treatment target for IBD. Cerium oxide (CeO₂) nanomaterials as nanozymes with antioxidant activity are potential drugs for the treatment of colitis.</p><p><strong>Aim: </strong>To synthesize hollow cerium (H-CeO₂) nanoparticles by one-step method and to validate the therapeutic efficacy of H-CeO₂ in IBD.</p><p><strong>Methods: </strong>H-CeO₂ was synthesized by one-step method and examined its characterization and nanoenzymatic activity. Subsequently, we constructed dextran sulfate sodium (DSS)-induced colitis in mice to observe the effects of H-CeO₂ on colonic inflammation. The effects of H-CeO₂ on colon inflammation and reactive oxygen species (ROS) levels in IBD mice were detected by hematoxylin and eosin staining and dichlorofluorescein diacetate staining, respectively. Finally, the biological safety of H-CeO₂ on mice was evaluated by hematoxylin and eosin staining, blood routine, and blood biochemistry.</p><p><strong>Results: </strong>H-CeO₂ nanoparticles prepared by the one-step method were uniform, monodisperse and hollow. H-CeO₂ had a good ability to scavenge ROS, ∙OH and ∙OOH. H-CeO₂ reduced DSS-induced decreases in body weight and colon length, colonic epithelial damage, inflammatory infiltration, and ROS accumulation. H-CeO₂ administration reduced the disease activity index of DSS-induced animals from about 8 to 5. H-CeO₂ had no significant effect on body weight, total platelet count, hemoglobin, white blood cell, and red blood cell counts in healthy mice. No significant damage to major organs was observed in healthy mice following H-CeO₂ administration.</p><p><strong>Conclusion: </strong>The one-step synthesis of H-CeO₂ nanomaterials had good antioxidant activity, biosafety, and inhibited development of DSS-induced IBD in mice by scavenging ROS.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"98732"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Modulen <i>vs</i> budesonide on clinical response and mucosal healing in Crohn's patients.","authors":"Baruch Ovadia, Eva Niv, Sara Stern Katie, Elisabeth Mahajna, Oren Gal, Yael Kopelman","doi":"10.3748/wjg.v31.i5.100238","DOIUrl":"10.3748/wjg.v31.i5.100238","url":null,"abstract":"<p><strong>Background: </strong>Mucosal healing has become an important goal of Crohn's disease (CD) treatments. Modulen, enriched with transforming growth factor-beta 2, and budesonide are commonly accepted treatments for mild-moderate CD. However, their effects on the small bowel (SB) mucosa remain underexplored.</p><p><strong>Aim: </strong>To prospectively assess clinical and mucosal responses to Modulen <i>vs</i> budesonide in adults with CD, using SB capsule endoscopy.</p><p><strong>Methods: </strong>Thirty patients were divided into two groups: Modulen + home-based diet (21 patients) and budesonide (9 patients) for an eight-week intervention followed by four weeks of follow-up. Clinical, laboratory, and endoscopic responses were evaluated. The mucosal changes were assessed through SB capsule endoscopy.</p><p><strong>Results: </strong>Results indicated significant clinical improvement in the Modulen group with reduced CD activity index (<i>P</i> = 0.041) and improved inflammatory bowel disease questionnaire score (<i>P</i> = 0.016). Moreover, Modulen was associated with a significant SB mucosal improvement, evidenced by a decrease in Lewis score (<i>P</i> = 0.027). No significant changes were observed in calprotectin or other laboratory parameters. Conversely, budesonide exhibited more modest clinical effects, but it improved calprotectin, hemoglobin, and C-reactive protein levels (<i>P</i> = 0.051, <i>P</i> = 0.014, and <i>P</i> = 0.038, respectively). The capsule endoscopy did not reveal a significant mucosal response in the budesonide group.</p><p><strong>Conclusion: </strong>Both interventions have a role in CD treatment. Yet, their effects differ and may complement each other: Modulen yields clinical and mucosal improvements, while budesonide primarily leads mainly to laboratory improvements.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"100238"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Important role of lymphovascular and perineural invasion in prognosis of colorectal cancer patients with N1c disease.","authors":"Zhi-Gang Sun, Shao-Xuan Chen, Bai-Long Sun, Da-Kui Zhang, Hong-Liang Sun, Huang Chen, Yu-Wan Hu, Tong-Yin Zhang, Zi-Han Han, Wen-Xiao Wu, Zhi-Yong Hou, Li Yao, Jian-Zheng Jie","doi":"10.3748/wjg.v31.i5.102210","DOIUrl":"10.3748/wjg.v31.i5.102210","url":null,"abstract":"<p><strong>Background: </strong>Lymphovascular invasion (LVI) and perineural invasion (PNI) are associated with decreased survival in colorectal cancer (CRC), but its significance in N1c stage remains to be clearly defined.</p><p><strong>Aim: </strong>To evaluate LVI and PNI as potential prognostic indicators in N1c CRC.</p><p><strong>Methods: </strong>We retrospectively identified 107 consecutive patients who had CRC with N1c disease radically resected at our hospital. Tumors were reviewed for LVI and PNI by one pathologist blinded to the patients' outcomes. Disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) were determined using the Kaplan-Meier method, with LVI and PNI prognosis differences determined by multivariate analysis using the Cox multiple hazards model. Results were compared using log-rank test. The receiver operating characteristic (ROC) curve was used to evaluate the prognostic predictive ability.</p><p><strong>Results: </strong>The median follow-up time was 63.17 (45.33-81.37) months for DFS, with 33.64% (36/107) of patients experiencing recurrence; 21.5% of tumors were found to be LVI positive and 44.9% PNI positive. The 5-year DFS rate was greater for patients with LVI-negative tumors compared with LVI-positive tumors (74.0% <i>vs</i> 35.6%), and PNI was similar (82.5% <i>vs</i> 45.1%). On multivariate analysis, LVI [hazard ratio (HR) = 3.368, 95% confidence interval (CI): 1.628-6.966, <i>P =</i> 0.001] and PNI (HR = 3.055, 95%CI: 1.478-6.313, <i>P =</i> 0.002) were independent prognostic factors for DFS. All patients could be divided into three groups of patients with different prognosis according to LVI and PNI. The 5-year ROC curve for LVI, PNI and their combination prediction of DFS was 0.646, 0.709 and 0.759, respectively. Similar results were seen for OS and CSS.</p><p><strong>Conclusion: </strong>LVI and PNI could serve as independent prognostic factors of outcomes in N1c CRC patients. Patients with LVI or PNI should be given more attention during treatment.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"102210"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking the secrets of the human gut microbiota: Comprehensive review on its role in different diseases.","authors":"Jibon Kumar Paul, Mahir Azmal, Anm Shah Newaz Been Haque, Meghla Meem, Omar Faruk Talukder, Ajit Ghosh","doi":"10.3748/wjg.v31.i5.99913","DOIUrl":"10.3748/wjg.v31.i5.99913","url":null,"abstract":"<p><p>The human gut microbiota, a complex and diverse community of microorganisms, plays a crucial role in maintaining overall health by influencing various physiological processes, including digestion, immune function, and disease susceptibility. The balance between beneficial and harmful bacteria is essential for health, with dysbiosis - disruption of this balance - linked to numerous conditions such as metabolic disorders, autoimmune diseases, and cancers. This review highlights key genera such as <i>Enterococcus</i>, <i>Ruminococcus</i>, <i>Bacteroides</i>, <i>Bifidobacterium</i>, <i>Escherichia coli</i>, <i>Akkermansia muciniphila</i>, <i>Firmicutes</i> (including <i>Clostridium</i> and <i>Lactobacillus</i>), and <i>Roseburia</i> due to their well-established roles in immune regulation and metabolic processes, but other bacteria, including <i>Clostridioides difficile</i>, <i>Salmonella</i>, <i>Helicobacter pylori</i>, and <i>Fusobacterium nucleatum</i>, are also implicated in dysbiosis and various diseases. Pathogenic bacteria, including <i>Escherichia coli</i> and <i>Bacteroides fragilis</i>, contribute to inflammation and cancer progression by disrupting immune responses and damaging tissues. The potential for microbiota-based therapies, such as probiotics, prebiotics, fecal microbiota transplantation, and dietary interventions, to improve health outcomes is examined. Future research directions in the integration of multi-omics, the impact of diet and lifestyle on microbiota composition, and advancing microbiota engineering techniques are also discussed. Understanding the gut microbiota's role in health and disease is essential for formulating personalized, efficacious treatments and preventive strategies, thereby enhancing health outcomes and progressing microbiome research.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"99913"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances and challenges in peroral endoscopic myotomy: Safety, precision, and post-procedure management.","authors":"Grigorios Christodoulidis, Kyriaki Tsagkidou, Konstantinos Eleftherios Koumarelas, Marina Nektaria Kouliou","doi":"10.3748/wjg.v31.i5.97574","DOIUrl":"10.3748/wjg.v31.i5.97574","url":null,"abstract":"<p><p>Peroral endoscopic myotomy (POEM) has revolutionized the treatment of upper gastrointestinal tract motility disorders, particularly achalasia. This editorial explores the efficacy, safety, and challenges of POEM, emphasizing its role as a primary treatment with excellent long-term outcomes and minimal adverse events. The evolution of POEM underscores the need for precision in myotomy techniques and the importance of interdisciplinary collaboration, especially regarding anesthetic considerations. Despite significant advances, challenges remain in standardizing safety protocols and managing complications. As POEM applications expand, precision endoscopy continues to enhance therapeutic outcomes, promising a transformative impact on gastrointestinal motility disorder management.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":"31 5","pages":"97574"},"PeriodicalIF":4.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11718603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}