World Journal of Gastrointestinal Endoscopy最新文献

{"title":"Rectal neuroendocrine tumours and the role of emerging endoscopic techniques.","authors":"Eoin Keating,&nbsp;Gayle Bennett,&nbsp;Michelle A Murray,&nbsp;Sinead Ryan,&nbsp;John Aird,&nbsp;Donal B O'Connor,&nbsp;Dermot O'Toole,&nbsp;Conor Lahiff","doi":"10.4253/wjge.v15.i5.368","DOIUrl":"https://doi.org/10.4253/wjge.v15.i5.368","url":null,"abstract":"<p><p>Rectal neuroendocrine tumours represent a rare colorectal tumour with a 10 fold increased prevalence due to incidental detection in the era of colorectal screening. Patient outcomes with early diagnosis are excellent. However endoscopic recognition of this lesion is variable and misdiagnosis can result in suboptimal endoscopic resection with subsequent uncertainty in relation to optimal long-term management. Endoscopic techniques have shown particular utility in managing this under-recognized neuroendocrine tumour.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 5","pages":"368-375"},"PeriodicalIF":2.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/33/WJGE-15-368.PMC10236980.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9934466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic role of fractional exhaled nitric oxide in pediatric eosinophilic esophagitis, relationship with gastric and duodenal eosinophils.","authors":"Panamdeep Kaur,&nbsp;Rachel Chevalier,&nbsp;Craig Friesen,&nbsp;Jamie Ryan,&nbsp;Ashley Sherman,&nbsp;Stephanie Page","doi":"10.4253/wjge.v15.i5.407","DOIUrl":"https://doi.org/10.4253/wjge.v15.i5.407","url":null,"abstract":"<p><strong>Background: </strong>Eosinophilic esophagitis (EoE) is an eosinophilic-predominant inflammation of the esophagus diagnosed by upper endoscopy and biopsies. A non-invasive and cost-effective alternative for management of EoE is being researched. Previous studies assessing utility of fractional exhaled nitric oxide (FeNO) in EoE were low powered. None investigated the contribution of eosinophilic inflammation of the stomach and duodenum to FeNO.</p><p><strong>Aim: </strong>To assess the utility of FeNO as a non-invasive biomarker of esophageal eosinophilic inflammation for monitoring disease activity.</p><p><strong>Methods: </strong>Patients aged 6-21 years undergoing scheduled upper endoscopy with biopsy for suspected EoE were recruited in our observational study. Patients on steroids and with persistent asthma requiring daily controller medication were excluded. FeNO measurements were obtained in duplicate using a chemiluminescence nitric oxide analyzer (NIOX MINO, Aerocrine, Inc.; Stockholm, Sweden) prior to endoscopy. Based on the esophageal peak eosinophil count (PEC)/high power field on biopsy, patients were classified as EoE (PEC ≥ 15) or control (PEC ≤ 14). Mean FeNO levels were correlated with presence or absence of EoE, eosinophil counts on esophageal biopsy, and abnormal downstream eosinophilia in the stomach (PEC ≥ 10) and duodenum (PEC ≥ 20). Wilcoxon rank-sum test, Spearman correlation, and logistic regression were used for analysis. <i>P</i> value < 0.05 was considered significant.</p><p><strong>Results: </strong>We recruited a total of 134 patients, of which 45 were diagnosed with EoE by histopathology. The median interquartile range FeNO level was 17 parts <i>per</i> billion (11-37, range: 7-81) in the EoE group and 12 parts <i>per</i> billion (8-19, range: 5-71) in the control group. After adjusting for atopic diseases, EoE patients had significantly higher FeNO levels as compared to patients without EoE (<i>Z</i> = 3.33, <i>P</i> < 0.001). A weak yet statistically significant positive association was found between the number of esophageal eosinophils and FeNO levels (<i>r</i> = 0.30, <i>P</i> < 0.005). On subgroup analysis within the EoE cohort, higher FeNO levels were noted in patients with abnormal gastric (<i>n</i> = 23, 18 <i>vs</i> 15) and duodenal eosinophilia (<i>n</i> = 28, 21 <i>vs</i> 14); however, the difference was not statistically significant.</p><p><strong>Conclusion: </strong>After ruling out atopy as possible confounder, we found significantly higher FeNO levels in the EoE cohort than in the control group.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 5","pages":"407-419"},"PeriodicalIF":2.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/bd/WJGE-15-407.PMC10236975.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9950946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unlocking quality in endoscopic mucosal resection.","authors":"Eoin Keating,&nbsp;Jan Leyden,&nbsp;Donal B O'Connor,&nbsp;Conor Lahiff","doi":"10.4253/wjge.v15.i5.338","DOIUrl":"https://doi.org/10.4253/wjge.v15.i5.338","url":null,"abstract":"<p><p>A review of the development of the key performance metrics of endoscopic mucosal resection (EMR), learning from the experience of the establishment of widespread colonoscopy quality measurements. Potential future performance markers for both colonoscopy and EMR are also evaluated to ensure continued high quality performance is maintained with a focus service framework and predictors of patient outcome.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 5","pages":"338-353"},"PeriodicalIF":2.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/eb/30/WJGE-15-338.PMC10236981.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9632143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving polyp detection at colonoscopy: Non-technological techniques.","authors":"Ragul Rajivan,&nbsp;Sreedhari Thayalasekaran","doi":"10.4253/wjge.v15.i5.354","DOIUrl":"https://doi.org/10.4253/wjge.v15.i5.354","url":null,"abstract":"<p><p>Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer. Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions interrupts the progression to carcinoma. The adenoma detection rate is a key performance indicator. Increasing adenoma detection rates are associated with reducing rates of interval colorectal cancer. Endoscopists with high baseline adenoma detection rate have a meticulous technique during colonoscopy withdrawal that improves their adenoma detection. This minireview article summarizes the evidence on the following simple operator techniques and their effects on the adenoma detection rate; minimum withdrawal times, dynamic patient position change and proximal colon retroflexion.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 5","pages":"354-367"},"PeriodicalIF":2.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6f/4b/WJGE-15-354.PMC10236979.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9950948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of music on colonoscopy performance: A propensity score-matched analysis.","authors":"Eun Jeong Choi,&nbsp;Sam Ryong Jee,&nbsp;Sang Heon Lee,&nbsp;Jun Sik Yoon,&nbsp;Seung Jung Yu,&nbsp;Jong Hyun Lee,&nbsp;Han Byul Lee,&nbsp;Sang Wook Yi,&nbsp;Myeong Pyo Kim,&nbsp;Byung Cheol Chung,&nbsp;Hong Sub Lee","doi":"10.4253/wjge.v15.i5.397","DOIUrl":"https://doi.org/10.4253/wjge.v15.i5.397","url":null,"abstract":"<p><strong>Background: </strong>Music has been used to reduce stress and improve task performance during medical therapy.</p><p><strong>Aim: </strong>To assess the effects of music on colonoscopy performance outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent colonoscopy performed by four endoscopists with popular music. Colonoscopy performance outcomes, such as insertion time, adenoma detection rate (ADR), and polyp detection rate (PDR), were compared between the music and non-music groups. To reduce selection bias, propensity score matching was used.</p><p><strong>Results: </strong>After one-to-one propensity score matching, 169 colonoscopies were selected from each group. No significant differences in insertion time (4.97 <i>vs</i> 5.17 min, <i>P</i> = 0.795) and ADR (39.1% <i>vs</i> 46.2%, <i>P</i> = 0.226) were found between the two groups. Subgroup analysis showed that the insertion time (3.6 <i>vs</i> 3.8 min, <i>P</i> = 0.852) and ADR (51.1% <i>vs</i> 44.7%, <i>P</i> = 0.488) did not significantly differ between the two groups in experts. However, in trainees, PDR (46.9% <i>vs</i> 66.7%, <i>P</i> = 0.016) and ADR (25.9% <i>vs</i> 47.6%, <i>P</i> = 0.006) were significantly lower in the music than in the non-music group.</p><p><strong>Conclusion: </strong>The current study found that listening to music during colonoscopy did not affect procedure performance. Moreover, it suggested that music may distract trainees from appropriately detecting adenomas and polyps.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 5","pages":"397-406"},"PeriodicalIF":2.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/a1/WJGE-15-397.PMC10236976.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9934467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of modified ShengYangYiwei decoction on painless gastroscopy and gastrointestinal and immune function in gastric cancer patients.","authors":"Sui-Cai Mi,&nbsp;Ling-Yan Wu,&nbsp;Zheng-Jin Xu,&nbsp;Li-Yan Zheng,&nbsp;Jian-Wen Luo","doi":"10.4253/wjge.v15.i5.376","DOIUrl":"https://doi.org/10.4253/wjge.v15.i5.376","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Painless gastroenteroscopy is a widely developed diagnostic and treatment technology in clinical practice. It is of great significance in the clinical diagnosis, treatment, follow-up review and other aspects of gastric cancer patients. The application of anesthesia techniques during manipulation can be effective in reducing patient fear and discomfort. In clinical work, the adverse drug reactions of anesthesia regimens and the risk of serious adverse drug reactions are increased with the increase in propofol application dose application dose; the application of opioid drugs often causes gastrointestinal reactions, such as nausea, vomiting and delayed gastrointestinal function recovery, after examination. These adverse effects can seriously affect the quality of life of patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To observe the effect of modified ShengYangYiwei decoction on gastrointestinal function, related complications and immune function in patients with gastric cancer during and after painless gastroscopy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 106 patients with gastric cancer, who were selected from January 2022 to September 2022 in Xiamen Traditional Chinese Medicine Hospital for painless gastroscopy, were randomly divided into a treatment group (&lt;i&gt;n&lt;/i&gt; = 56) and a control group (&lt;i&gt;n&lt;/i&gt; = 50). Before the examination, all patients fasted for 8 h, provided their health education, and confirmed if there were contraindications to anesthesia and gastroscopy. During the examination, the patients were placed in the left decubitus position, the patients were given oxygen through a nasal catheter (6 L/min), the welling needle was opened for the venous channel, and a multifunction detector was connected for monitoring electrocardiogram, oxygen saturation, blood pressure, &lt;i&gt;etc.&lt;/i&gt; Naporphl and propofol propofol protocols were used for routine anesthesia. Before anesthesia administration, the patients underwent several deep breathing exercises, received intravenous nalbuphine [0.nalbuphine (0.025 mg/kg)], followed by intravenous propofol [1.propofol (1.5 mg/kg)] until the palpebral reflex disappeared, and after no response, gastroscopy was performed. If palpebral reflex disappeared, and after no response, gastroscopy was performed. If any patient developed movement, frowning, or hemodynamic changes during the operation (heart rate changes during the operation (heart rate increased to &gt; 20 beats/min, systolic blood pressure increased to &gt; 20% of the base value), additional propofol [0.propofol (0.5 mg/kg)] was added until the patient was sedated again. The patients in the treatment group began to take the preventive intervention of Modified ShengYangYiwei decoction one week before the examination, while the patients in the control group received routine gastrointestinal endoscopy. The patients in the two groups were examined by conventional painless gastroscopy, and the characteristics of the painless gastroscopies o","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 5","pages":"376-385"},"PeriodicalIF":2.0,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6d/60/WJGE-15-376.PMC10236977.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9632142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic ultrasound-guided vascular interventions: An expanding paradigm.","authors":"Jahnvi Dhar, Jayanta Samanta","doi":"10.4253/wjge.v15.i4.216","DOIUrl":"10.4253/wjge.v15.i4.216","url":null,"abstract":"<p><p>Endoscopic ultrasound (EUS) has expanded its arena from a mere diagnostic modality to an essential therapeutic tool in managing gastrointestinal (GI) diseases. The proximity of the GI tract to the vascular structures in the mediastinum and the abdomen has facilitated the growth of EUS in the field of vascular interventions. EUS provides important clinical and anatomical information related to the vessels' size, appearance and location. Its excellent spatial resolution, use of colour doppler with or without contrast enhancement and ability to provide images \"real-time\" helps in precision while intervening vascular structures. Additionally, structures such as venous collaterals or varices can be dealt with optimally using EUS. EUS-guided vascular therapy with coil and glue combination has revolutionized the management of portal hypertension. It also helps to avoid radiation exposure in addition to being minimally invasive. These advantages have led EUS to become an upcoming modality to complement traditional interventional radiology in the field of vascular interventions. EUS-guided portal vein (PV) access and therapy is a new kid on the block. EUS-guided portal pressure gradient measurement, injecting chemotherapy in PV and intrahepatic portosystemic shunt has expanded the horizons of endo-hepatology. Lastly, EUS has also forayed into cardiac interventions allowing pericardial fluid aspiration and tumour biopsy with experimental data on access to valvular apparatus. Herein, we provide a comprehensive review of the expanding paradigm of EUS-guided vascular interventions in GI bleeding, portal vein access and its related therapeutic interventions, cardiac access, and therapy. A synopsis of all the technical details involving each procedure and the available data has been tabulated, and the future trends in this area have been highlighted.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 4","pages":"216-239"},"PeriodicalIF":1.4,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/e9/WJGE-15-216.PMC10150286.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9779292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships of hospitalization outcomes and timing to endoscopy in non-variceal upper gastrointestinal bleeding: A nationwide analysis.","authors":"Simcha Weissman,&nbsp;Muhammad Aziz,&nbsp;Ayrton I Bangolo,&nbsp;Dean Ehrlich,&nbsp;Arnold Forlemu,&nbsp;Anthony Willie,&nbsp;Manesh K Gangwani,&nbsp;Danish Waqar,&nbsp;Hannah Terefe,&nbsp;Amritpal Singh,&nbsp;Diego Mc Gonzalez,&nbsp;Jayadev Sajja,&nbsp;Fatma L Emiroglu,&nbsp;Nicholas Dinko,&nbsp;Ahmed Mohamed,&nbsp;Mark A Fallorina,&nbsp;David Kosoy,&nbsp;Ankita Shenoy,&nbsp;Anvit Nanavati,&nbsp;Joseph D Feuerstein,&nbsp;James H Tabibian","doi":"10.4253/wjge.v15.i4.285","DOIUrl":"https://doi.org/10.4253/wjge.v15.i4.285","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing of esophagogastroduodenoscopy (EGD) and the impact of clinico-demographic factors on hospitalization outcomes in non-variceal upper gastrointestinal bleeding (NVUGIB) remains an area of active research.</p><p><strong>Aim: </strong>To identify independent predictors of outcomes in patients with NVUGIB, with a particular focus on EGD timing, anticoagulation (AC) status, and demographic features.</p><p><strong>Methods: </strong>A retrospective analysis of adult patients with NVUGIB from 2009 to 2014 was performed using validated ICD-9 codes from the National Inpatient Sample database. Patients were stratified by EGD timing relative to hospital admission (≤ 24 h, 24-48 h, 48-72 h, and > 72 h) and then by AC status (yes/no). The primary outcome was all-cause inpatient mortality. Secondary outcomes included healthcare usage.</p><p><strong>Results: </strong>Of the 1082516 patients admitted for NVUGIB, 553186 (51.1%) underwent EGD. The mean time to EGD was 52.8 h. Early (< 24 h from admission) EGD was associated with significantly decreased mortality, less frequent intensive care unit admission, shorter length of hospital stays, lower hospital costs, and an increased likelihood of discharge to home (all with <i>P</i> < 0.001). AC status was not associated with mortality among patients who underwent early EGD (aOR 0.88, <i>P</i> = 0.193). Male sex (OR 1.30) and Hispanic (OR 1.10) or Asian (aOR 1.38) race were also independent predictors of adverse hospitalization outcomes in NVUGIB.</p><p><strong>Conclusion: </strong>Based on this large, nationwide study, early EGD in NVUGIB is associated with lower mortality and decreased healthcare usage, irrespective of AC status. These findings may help guide clinical management and would benefit from prospective validation.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 4","pages":"285-296"},"PeriodicalIF":2.0,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0d/59/WJGE-15-285.PMC10150287.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9779293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of colon self-expandable metal stents for malignant <i>vs</i> benign indications at a tertiary care center and review of literature.","authors":"Saqib Walayat,&nbsp;Andrew J Johannes,&nbsp;Mark Benson,&nbsp;Eric Nelsen,&nbsp;Ahmed Akhter,&nbsp;Gregory Kennedy,&nbsp;Anurag Soni,&nbsp;Mark Reichelderfer,&nbsp;Patrick Pfau,&nbsp;Deepak Gopal","doi":"10.4253/wjge.v15.i4.309","DOIUrl":"https://doi.org/10.4253/wjge.v15.i4.309","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic placement of a self-expandable metal stent (SEMS) is a minimally invasive treatment for use in malignant and benign colonic obstruction. However, their widespread use is still limited with a nationwide analysis showing only 5.4% of patients with colon obstruction undergoing stent placement. This underutilization could be due to perceived increase risk of complications with stent placement.</p><p><strong>Aim: </strong>To review long- and short-term clinical success of SEMS use for colonic obstruction at our center.</p><p><strong>Methods: </strong>We retrospectively reviewed all the patients who underwent colonic SEMS placement over a eighteen year period (August 2004 through August 2022) at our academic center. Demographics including age, gender, indication (malignant and benign), technical success, clinical success, complications (perforation, stent migration), mortality, and outcomes were recorded.</p><p><strong>Results: </strong>Sixty three patients underwent colon SEMS over an 18-year period. Fifty-five cases were for malignant indications, 8 were for benign conditions. The benign strictures included diverticular disease stricturing (<i>n</i> = 4), fistula closure (<i>n</i> = 2), extrinsic fibroid compression (<i>n</i> = 1), and ischemic stricture (<i>n</i> = 1). Forty-three of the malignant cases were due to intrinsic obstruction from primary or recurrent colon cancer; 12 were from extrinsic compression. Fifty-four strictures occurred on the left side, 3 occurred on the right and the rest in transverse colon. The total malignant case (<i>n</i> = 55) procedural success rate was 95% <i>vs</i> 100% for benign cases (<i>P</i> = 1.0, NS). Overall complication rate was significantly higher for benign group: Four complications were observed in the malignant group (stent migration, restenosis) <i>vs</i> 2 of 8 (25%) for benign obstruction (1-perforation, 1-stent migration) (<i>P</i> = 0.02). When stratifying complications of perforation and stent migration there was no significant difference between the two groups (<i>P</i> = 0.14, NS).</p><p><strong>Conclusion: </strong>Colon SEMS remains a worthwhile option for colonic obstruction related to malignancy and has a high procedural and clinical success rate. Benign indications for SEMS placement appear to have similar success to malignant. While there appears to be a higher overall complication rate in benign cases, our study is limited by sample size. When evaluating for perforation alone there does not appear to be any significant difference between the two groups. SEMS placement may be a practical option for indications other that malignant obstruction. Interventional endoscopists should be aware and discuss the risk for complications in setting of benign conditions. Indications in these cases should be discussed in a multi-disciplinary fashion with colorectal surgery.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 4","pages":"309-318"},"PeriodicalIF":2.0,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/42/WJGE-15-309.PMC10150280.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9410335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic luminal stenting: Current applications and future perspectives.","authors":"Miltiadis Moutzoukis,&nbsp;Konstantinos Argyriou,&nbsp;Andreas Kapsoritakis,&nbsp;Dimitrios Christodoulou","doi":"10.4253/wjge.v15.i4.195","DOIUrl":"https://doi.org/10.4253/wjge.v15.i4.195","url":null,"abstract":"<p><p>Endoscopic luminal stenting (ELS) represents a minimally invasive option for the management of malignant obstruction along the gastrointestinal tract. Previous studies have shown that ELS can provide rapid relief of symptoms related to esophageal, gastric, small intestinal, colorectal, biliary, and pancreatic neoplastic strictures without compromising cancer patients' overall safety. As a result, in both palliative and neoadjuvant settings, ELS has largely surpassed radiotherapy and surgery as a first-line treatment modality. Following the abovementioned success, the indications for ELS have gradually expanded. To date, ELS is widely used in clinical practice by well-trained endoscopists in managing a wide variety of diseases and complications, such as relieving non-neoplastic obstructions, sealing iatrogenic and non-iatrogenic perforations, closing fistulae and treating post-sphincterotomy bleeding. The abovementioned development would not have been achieved without corresponding advances and innovations in stent technology. However, the technological landscape changes rapidly, making clinicians' adaptation to new technologies a real challenge. In our mini-review article, by systematically reviewing the relevant literature, we discuss current developments in ELS with regard to stent design, accessories, techniques, and applications, expanding the research basis that was set by previous studies and highlighting areas that need to be further investigated.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"15 4","pages":"195-215"},"PeriodicalIF":2.0,"publicationDate":"2023-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4a/d0/WJGE-15-195.PMC10150289.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9779291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}