World Journal of Gastrointestinal Endoscopy最新文献

{"title":"Golden vision: The potential of yellow enhancement in laparoscopic abdominal surgeries and surgical education.","authors":"Harpreet Singh, Frederick Hong Xiang Koh","doi":"10.4253/wjge.v17.i7.107872","DOIUrl":"https://doi.org/10.4253/wjge.v17.i7.107872","url":null,"abstract":"<p><p>Laparoscopic imaging has advanced significantly, with higher resolutions like 4K, and innovative light modes such as narrow band imaging and near-infrared imaging. Recently, yellow enhancement (YE) mode has emerged as a novel tool that enhances the pale-yellow colour of fat into a fluorescent yellow-green, improving contrast without the need for injected dyes. It can be toggled on and off easily during surgery. YE is still under evaluation, but early experience suggests it helps surgeons differentiate anatomical planes and key intra-abdominal structures from surrounding adipose tissue. This is particularly useful in: (1) Dissecting structures surrounded or covered by fat; and (2) operating on patients with obesity, where excess intra-abdominal fat limits visualisation and retraction. By enhancing the visibility of vascular pedicles, ureters, and nerves, YE enables more precise dissections and may reduce the risk of accidental injury. It can also assist less experienced surgeons in identifying important structures, potentially improving efficiency and surgical outcomes. As a training tool, YE may shorten the learning curve, though further study is needed. Overall, YE offers potential benefits in fat-dense surgical fields by improving visualisation, reducing complications, and enhancing patient safety.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 7","pages":"107872"},"PeriodicalIF":1.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660477","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":"Hemostasis: Role of PuraStat^® in the prevention and management of gastrointestinal bleeding.","authors":"Samy A Azer","doi":"10.4253/wjge.v17.i7.106725","DOIUrl":"https://doi.org/10.4253/wjge.v17.i7.106725","url":null,"abstract":"<p><p>The management of gastrointestinal (GI) bleeding patients during endoscopy remains a challenge. Hemorrhage is still one of the significant causes of morbidity and even death. Several therapeutic options have been used over the years depending on the extent, site and cause of bleeding. These include thermal therapy, injection therapy, and mechanical methods of hemostasis (<i>e.g.</i>, endoscopic clips and ligation bands). Patients with refractory bleeding, high-risk ulcer lesions, malignant disease, antiplatelet medications, and chronic kidney disease are at increased risk of upper and lower GI bleeding (LGIB). In this editorial, I commented on the paper by Ballester <i>et al</i>. Their work aimed at evaluating PuraStat^® (TDM-621), a novel hemostatic agent, particularly its efficacy, applications, feasibility, and safety in treating GI bleeding lesions. The authors concluded that PuraStat^® is an effective therapy for GI bleeding and is usually easy to use. Although the authors recommended its consideration as a frontline therapy in the future, they did not explore the clinical and GI uses of PuraStat^®. This editorial focuses on the pharmacology of PuraStat^® and how it differs from Hemospray^® (TC-325) (hemostatic powder). It also explores the current experience of using PuraStat^® in upper and LGIB, its uses and safety, and the need for further research to fully understand its potential.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 7","pages":"106725"},"PeriodicalIF":1.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660478","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 resection: A novel approach for treating oesophageal gastrointestinal stromal tumours.","authors":"Arvind Mukundan, Devansh Gupta, Riya Karmakar, Hsiang-Chen Wang","doi":"10.4253/wjge.v17.i6.107088","DOIUrl":"10.4253/wjge.v17.i6.107088","url":null,"abstract":"<p><p>In this letter, a commentary on the article by Xu <i>et al</i> has been provided. Gastrointestinal stomal tumours (GISTs) are rare tumours that originate commonly in stomach (60%-70%) and small intestine (30%-40%). The course of treatment especially oesophageal GIST is very complex and hard to diagnose because of limited availability of pathological and clinical data. Endoscopic resection (ER) is a minimally invasive approach for removing tumours from the oesophagus and digestive system that does not require open surgery and is especially successful for very small and low-risk GIST. A retrospective examination of 32 patients treated with ER between 2012 and 2023 was conducted to analyse clinical and pathological characteristics, effectiveness of therapy, and long-term prognosis. The findings demonstrate <i>en bloc</i> resection was achieved in 96.9% of cases with an R0 resection rate of 75% with a median size of tumour was approximately 2.12 cm. Post-surgery complication like hydrothorax, post-endoscopic submucosal dissection electrocoagulation syndrome occurred in about 25% of cases which later go resolved by conservative treatment. Recurrence of GIST was approximately 9.4% primarily in high-risk cases. ER should be widely adopted in clinical practise preferably for managing low-risk oesophageal GIST because of its high success rate, low recurrence rates and excellent survival results, ensuring better patient prognosis.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"107088"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477036","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":"Advantages of new generation colonoscopes on adenoma detection: A propensity-score matching study.","authors":"Toshihiro Nishizawa, Osamu Toyoshima, Shuntaro Yoshida, Yoshiyuki Takahashi, Hideki Nakagawa, Hiroya Mizutani, Yosuke Kataoka, Takamitsu Kanazawa, Hirotoshi Ebinuma, Keisuke Hata","doi":"10.4253/wjge.v17.i6.108146","DOIUrl":"10.4253/wjge.v17.i6.108146","url":null,"abstract":"<p><strong>Background: </strong>Recently, Olympus Corporation released new scopes (XZ1200/EZ1500). However, there have been few reports on this topic, although improvement in adenoma detection rate (ADR) by texture and color enhancement imaging (TXI) or computer-aided detection system (CAD) has been reported.</p><p><strong>Aim: </strong>To investigate the effects of the scope on the detection of adenomas and sessile serrated lesions (SSLs).</p><p><strong>Methods: </strong>The subjects were patients who underwent pancolonic chromoendoscopy using the EVIS X1 video system center between May 2023 and October 2024. The patients were divided into the new (CF-XZ1200/CF-EZ1500) and 290 series (CF-HQ290Z/PCF-H290Z) groups. Propensity score matching was performed for age, sex, examination purpose, endoscopist, preparation, TXI use, and CAD use. The effects of the scope were analyzed in terms of the ADR, SSL detection rate (SDR), and mean number of adenomas per colonoscopy (APC).</p><p><strong>Results: </strong>Of the 7014 patients enrolled, 2138 pairs were extracted by propensity score matching (mean age 55.4 years, 45.5% male). The new scopes group had a significantly higher ADR than the 290 series group [51.5% <i>vs</i> 45.5%, odds ratio (OR) = 1.27, 95%CI: 1.13-1.43, <i>P</i> < 0.001]. Similarly, the new scopes group had significantly higher SDR (7.8% <i>vs</i> 5.7%, OR = 1.41, 95%CI: 1.11-1.80, <i>P</i> = 0.005) and APC (0.90 <i>vs</i> 0.76, OR = 1.11, 95%CI: 1.05-1.17, <i>P</i> < 0.001) than the 290 series group.</p><p><strong>Conclusion: </strong>In conclusion, the new scope (CF-XZ1200/CF-EZ1500) enhanced the detection of adenomas and SSLs compared to the old ones (290 series).</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"108146"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477015","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":"Intravenous proton pump inhibitors <i>vs</i> oral potassium competitive acid blockers before endoscopic treatment of bleeding peptic ulcers.","authors":"Na Rae Lim, Woo Chul Chung","doi":"10.4253/wjge.v17.i6.104234","DOIUrl":"10.4253/wjge.v17.i6.104234","url":null,"abstract":"<p><strong>Background: </strong>The use of proton pump inhibitors (PPIs) with the intent of reducing gastric acidity to the desired therapeutic level for treating bleeding peptic ulcer still has several limitations.</p><p><strong>Aim: </strong>To compare intravenous PPIs and oral potassium competitive acid blockers (PCABs) administered prior to endoscopic treatment of bleeding peptic ulcers.</p><p><strong>Methods: </strong>This retrospective study involved 105 consecutive patients with non-variceal upper gastrointestinal bleeding (treated August 2023 to February 2024). Prior to emergency endoscopy, patients received either intravenous PPI (pantoprazole 80 mg bolus) or oral PCAB (tegoprazan 50 mg single-dose). Severity of bleeding was assessed using the Glasgow-Blatchford, Rockall, and AIMS65 scoring systems. Patients with severe comorbidities were excluded. Primary outcomes included need for therapeutic endoscopic intervention and occurrence of re-bleeding. Multivariate logistic regression was performed to adjust for potential confounding factors.</p><p><strong>Results: </strong>Total of the 105 patients, 61 received intravenous PPI injection and 44 received oral PCAB prior to emergency endoscopy. To minimize selection bias, bleeding severity was assessed using the Glasgow-Blatchford, Rockall and AIMS65 scores, with no statistically significant differences observed between the two groups. During emergency endoscopy performed within 48 hours, ulcer bed status was classified according to the Forrest classification. The proportion of lesions graded IIa or higher was significantly lower in the PCAB group (<i>P</i> < 0.001), as was the frequency of therapeutic endoscopy intervention (odds ratio = 0.272, 95% confidence interval: 0.111-0.665, <i>P</i> = 0.004). The frequency of re-bleeding events was statistically significantly higher in the PPI group (odds ratio = 0.141, 95% confidence interval: 0.024-0.844, <i>P</i> = 0.032).</p><p><strong>Conclusion: </strong>Pre-endoscopic PCAB administration is more effective than PPI injection for upper gastrointestinal bleeding and may reduce ulcer bleeding mortality.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"104234"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477039","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":"Sedation in endoscopy: Current practices and future innovations.","authors":"Angelo Bruni, Giovanni Barbara, Alessandro Vitello, Giovanni Marasco, Marcello Maida","doi":"10.4253/wjge.v17.i6.106604","DOIUrl":"10.4253/wjge.v17.i6.106604","url":null,"abstract":"<p><p>Sedation practices in gastrointestinal endoscopy have evolved considerably, driven by patient demand for comfort and the need to minimize cardiopulmonary complications. Recent guidelines emphasize personalized sedation strategies, risk assessment, and vigilant hemodynamic monitoring to ensure that sedation depth aligns with each patient's comorbidities and procedural requirements. Within this landscape, the trial by Luo <i>et al</i> highlights the value of adding etomidate to propofol target-controlled infusion, demonstrating significantly reduced hypotension, faster induction, and fewer respiratory complications in typical American Society of Anesthesiologists I-III candidates. These findings align with broader recommendations from both European and American societies advocating sedation regimens that preserve stable circulation. Etomidate's favorable hemodynamic profile, coupled with propofol's reliability, suggests potential applications in advanced endoscopic interventions such as endoscopic retrograde cholangiopancreatography, interventional endoscopic ultrasound, and endoscopic submucosal dissection, where deeper or more sustained sedation is often required. Remimazolam, a novel short-acting benzodiazepine, has similarly been associated with reduced cardiovascular depression and faster recovery, particularly in high-risk populations, although direct comparisons between etomidate-propofol and remimazolam-based regimens remain limited. Further investigations into these sedation strategies in higher-risk cohorts, as well as complex therapeutic endoscopy, will likely inform more nuanced, patient-specific protocols aimed at maximizing both safety and procedural efficiency.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"106604"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476954","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":"Is endoscopic retrograde cholangiopancreatography safe for centenarians?","authors":"Filippo Antonini, Durante Donnarumma, Tiziana Buono","doi":"10.4253/wjge.v17.i6.106142","DOIUrl":"10.4253/wjge.v17.i6.106142","url":null,"abstract":"<p><p>This letter aims to discuss the article, published in the recent issue of the <i>World Journal of Gastrointestinal Endoscopy</i> 2025. Endoscopic retrograde cholangiopancreatography (ERCP) is widely acknowledged as an effective procedure for managing biliary obstruction. However, its use in very elderly patients, particularly centenarians, presents unique challenges related to both safety and efficacy. In this report, we share our experience with three centenarian patients who underwent ERCP for biliary obstruction in our unit. Remarkably, all patients had favorable outcomes, and no significant adverse events were observed.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"106142"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477040","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":"Advancing hemostasis: A meta-analysis of novel <i>vs</i> conventional endoscopic therapies for non variceal upper gastrointestinal bleeding.","authors":"Shivangini Duggal, Ishana Kalra, Keisha Kalra, Vicky Bhagat","doi":"10.4253/wjge.v17.i6.107142","DOIUrl":"10.4253/wjge.v17.i6.107142","url":null,"abstract":"<p><strong>Background: </strong>Non variceal upper gastrointestinal bleeding (NVUGIB) is a life-threatening condition requiring prompt and effective hemostasis. Various endoscopic interventions, including novel hemostatic powders (HP), over-the-scope clips (OTSC), and traditional approaches, have been employed to manage upper gastrointestinal bleeding (UGIB). Despite advancements, comparative efficacy and safety of these modalities remain uncertain.</p><p><strong>Aim: </strong>To evaluate the efficacy and safety of novel hemostatic interventions compared to conventional endoscopic techniques for managing UGIB.</p><p><strong>Methods: </strong>Cochrane, MEDLINE, PubMed and Scopus libraries were searched for randomized controlled trials (RCTs) published up to October 2024. Only RCTs comparing novel interventions, such as HP or OTSC, with conventional endoscopic treatments computed tomography (CT) were included. The primary outcome was the 30-day rebleeding rate. Secondary outcomes included initial hemostasis, short-term rebleeding rates, need for salvage therapy (surgical/angiographic), 30-day all-cause mortality, and bleeding-related mortality. We performed pairwise and network meta- analyses for all treatments.</p><p><strong>Results: </strong>Seventeen studies were included in this analysis. Regarding the 30-day rebleeding rate, OTSC and HP showed superior efficacy compared with CT [OTSC <i>vs</i> CT: Relative risk (RR): 0.47, 95% confidence interval (CI): 0.33-0.65; HP <i>vs</i> CT: RR: 0.73, 95%CI: 0.45-1.13], while OTSC and HP had comparable efficacy (RR: 0.56, 95%CI: 0.30-1.05). OTSC ranked the highest in the network ranking estimate for this outcome. For the secondary outcomes, OTSC demonstrated superior efficacy for the short-term rebleeding rate (OTSC <i>vs</i> CT: RR: 0.35, 95%CI: 0.14-0.74; HP <i>vs</i> CT: RR: 0.62, 95%CI: 0.28-1.35; OTSC <i>vs</i> HP: RR: 0.59, 95%CI: 0.17-1.67). Regarding the initial hemostasis rate, OTSC was slightly more effective than CT (OTSC <i>vs</i> CT: RR: 1.20, 95%CI: 1.06-1.57) and comparable to HP (OTSC <i>vs</i> HP: RR: 1.08, 95%CI: 0.89-1.40). There were no significant differences among treatments for all-cause mortality, bleeding-related mortality, or the necessity of surgical or angiographic salvage therapy. OTSC consistently ranked highest across most outcomes in the network ranking estimate.</p><p><strong>Conclusion: </strong>This meta-analysis highlights OTSC as the most effective intervention for reducing 30-day and short-term rebleeding rates in NVUGIB, surpassing both CT and HP, supporting OTSC as a preferred first-line treatment for NVUGIB, while HP and CT remain viable alternatives. Further studies are needed to explore long-term outcomes and cost-effectiveness.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"107142"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477014","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 endoscopic ultrasonography in defining the clinical features and histopathological spectrum of gastroenteropancreatic neuroendocrine tumors.","authors":"Syedda Ayesha, Masood Muhammad Karim, Abdul Hadi Shahid, Adeel Ur Rehman, Zeeshan Uddin, Shahab Abid","doi":"10.4253/wjge.v17.i6.104539","DOIUrl":"10.4253/wjge.v17.i6.104539","url":null,"abstract":"<p><strong>Background: </strong>Neuroendocrine tumors (NETs) are rare malignancies arising from the diffuse neuroendocrine system, often in the gastroenteropancreatic (GEP) tract. GEP-NETs, primarily involving the intestines (50%) and pancreas (30%), may occasionally secrete hormones, causing syndromes. Diagnosis relies on markers like chromogranin A, synaptophysin, and Ki-67, along with imaging modalities. Rising NETs incidence is attributed to advancements in diagnostic modalities, particularly endoscopic ultrasonography (EUS). EUS demonstrates high accuracy in detecting small lesions, assessing tumor depth, and identifying locoregional lymph nodes. Despite its proven diagnostic utility, there is limited data on EUS's role in evaluating GEP-NETs in resource-constrained settings like Pakistan.</p><p><strong>Aim: </strong>To evaluate the diagnostic role of EUS in characterizing GEP-NETs based on clinical, histopathological, tumor grading, and site-specific differences.</p><p><strong>Methods: </strong>This single-center retrospective descriptive study was conducted at Aga Khan University Hospital, Karachi, a tertiary care hospital, from January 2021 to December 2023. Fourteen adult patients (≥ 18 years) with suspected NETs who underwent EUS and were diagnosed <i>via</i> histopathology were included. Data on demographics, clinical features, radiological findings, and histopathological characteristics were collected. Descriptive analysis was performed using SPSS version 23, with descriptive statistics expressed as means ± SD for continuous variables and frequencies/percentages for categorical data.</p><p><strong>Results: </strong>A total of 14 adult GEP-NETs patients who underwent EUS were included, with a mean age of 52 ± 14 years and the majority being male (71.4%). Common clinical presentations included weight loss (85.7%) and abdominal pain (78.6%). Computed tomography scans were performed in 92.9% of cases, with pancreatic masses detected in 42.9% of patients. EUS-guided fine needle biopsy (FNB) had a 100% diagnostic yield. The pancreas was the most common tumor site (57.1%). Histopathology revealed 78.6% of cases as well-differentiated NETs with 42.9% being grade II. Metastases were seen in 57.1% of patients, with the liver being the most common site. Surgical interventions were performed in 28.6% of patients, and all patients were alive at the time of study analysis.</p><p><strong>Conclusion: </strong>EUS, with accurate imaging and effective EUS-FNB, is the gold standard for GEP-NET diagnosis, aiding tumor assessment and prognosis. Larger studies are needed to validate its impact on management outcomes.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"104539"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477033","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 resection of colorectal laterally spreading tumors: Clinicopathologic characteristics and risk factors for treatment outcomes.","authors":"Li-Hua Guo, Ke-Feng Hu, Min Miao, Yong Ding, Xin-Jun Zhang, Guo-Liang Ye","doi":"10.4253/wjge.v17.i6.106412","DOIUrl":"10.4253/wjge.v17.i6.106412","url":null,"abstract":"<p><strong>Background: </strong>Colorectal laterally spreading tumors (LSTs) are best treated with endoscopic submucosal dissection or endoscopic mucosal resection.</p><p><strong>Aim: </strong>To analyze the clinicopathological and endoscopic profiles of colorectal LSTs, determine predictive factors for high-grade dysplasia (HGD)/carcinoma (CA), submucosal invasion, and complications.</p><p><strong>Methods: </strong>We retrospectively assessed the endoscopic and histological characteristics of 375 colorectal LSTs at our hospital between January 2016 and December 2023. We performed univariate and multivariate analysis to identify risk factors associated with HGD/CA, submucosal invasion and complications.</p><p><strong>Results: </strong>The numbers of granular (LST-G) and non-granular LST (LST-NG) were 260 and 115, respectively. The rates of low-grade dysplasia and HGD/CA were 60.3% and 39.7%, respectively. Multivariate analysis indicated that a tumor size ≥ 30 mm [odds ratio (OR) = 1.934, <i>P</i> = 0.032], LST granular nodular mixed type (OR = 2.100, <i>P</i> = 0.005), and LST non-granular pseudo depressed type (NG-PD) (OR = 3.016, <i>P</i> = 0.015) were independent risk factors significantly associated with higher odds of HGD/CA. NG-PD (OR = 6.506, <i>P</i> = 0.001), tumor size (20-29 mm) (OR = 2.631, <i>P</i> = 0.036) and tumor size ≥ 30 mm (OR = 3.449, <i>P</i> = 0.016) were associated with increased odds of submucosal invasion. Tumor size ≥ 30 mm (OR = 4.888, <i>P</i> = 0.003) was a particularly important predictor of complications. A nomogram model demonstrated a satisfactory fit, with an area under the receiver operating characteristic curve of 0.716 (95% confidence interval: 0.653-0.780), indicating strong predictive performance.</p><p><strong>Conclusion: </strong>The novel nomogram incorporating tumor size, location, and morphology predicted HGD/CA during endoscopic resection for LSTs. NG-PD lesions larger than 20 mm were more likely to invade the submucosa. Tumor size ≥ 30 mm was an important predictor of complications.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"106412"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477035","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}