World Journal of Gastrointestinal Endoscopy最新文献

{"title":"Extended 72-hour patency capsule protocol improves functional patency rates in high-risk patients undergoing capsule endoscopy.","authors":"Fintan John O'Hara, Conor Costigan, Deirdre McNamara","doi":"10.4253/wjge.v16.i12.661","DOIUrl":"10.4253/wjge.v16.i12.661","url":null,"abstract":"<p><strong>Background: </strong>Capsule endoscopy (CE) is a pivotal diagnostic tool for gastrointestinal (GI) disorders, yet capsule retention poses a significant risk, especially in patients with known risk factors. The patency capsule (PC) helps assess the functional patency of the GI tract to mitigate this risk. However, the standard 28-hour protocol for confirming patency often results in high false-positive rates, unnecessarily excluding many patients from undergoing diagnostic CE.</p><p><strong>Aim: </strong>To investigate the use of a 72-hour extended patency protocol to improve functional patency rates in patients at risk of capsule retention.</p><p><strong>Methods: </strong>We performed a prospective, open-label study evaluating an extended 72-hour protocol for confirming functional patency with the PC. Conducted over six months, 135 patients with risk factors for capsule retention were enrolled. The primary endpoint was the capsule retention rate in patients with confirmed functional patency. Secondary endpoints included the rates of confirmed patency <i>via</i> self-reporting or radiology, small bowel transit times, and adverse events.</p><p><strong>Results: </strong>Functional patency was confirmed in 48.9% (<i>n</i> = 66) of patients within 28 hours, with an additional 17.4% (<i>n</i> = 12) confirmed within 72 hours, increasing the overall patency rate to 57.8%. There was no significant difference in small bowel transit time between patients confirmed for patency at 28 hours <i>vs</i> those confirmed at 72 hours. Importantly, no capsule retention was observed in patients who were confirmed for patency under the extended protocol. Notably, 50% (<i>n</i> = 39) of patients who proceeded to CE had clinically significant findings.</p><p><strong>Conclusion: </strong>Extending the patency assessment protocol to 72 hours significantly improves the rate of confirmed functional patency without increasing the risk of capsule retention. This protocol is safe, effective, and cost-neutral, allowing more patients to benefit from CE. Further studies are recommended to refine the protocol and enhance its clinical utility.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 12","pages":"661-667"},"PeriodicalIF":1.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11669961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903726","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":"Postprandial gastrin-17 level is a useful dynamic marker for atrophic gastritis.","authors":"Huck-Joo Tan, Eunice Zhi-Yi Tan","doi":"10.4253/wjge.v16.i11.623","DOIUrl":"10.4253/wjge.v16.i11.623","url":null,"abstract":"<p><p>Atrophic gastritis and intestinal metaplasia may progress to gastric malignancy. Non-invasive serum biomarkers have been extensively studied and proven to be useful as a screening tool to stratify risk and identify patients for endoscopy to detect early gastric cancer. These non-invasive biomarkers have been endorsed and recommended by many international consensus guidelines. In this letter, we reviewed the literature and evidence supporting the use of serum biomarkers as a dynamic test to monitor the status of atrophic gastritis.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 11","pages":"623-626"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733168","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":"Systemic air embolism associated with endoscopic retrograde cholangiopancreatography: A case report.","authors":"Jing-Hao Li, Zhi-Kun Luo, Yu Zhang, Ting-Ting Lu, Yue Deng, Rui-Ting Shu, Hang Yu","doi":"10.4253/wjge.v16.i11.617","DOIUrl":"10.4253/wjge.v16.i11.617","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is a key procedure for diagnosing and treating biliary and pancreatic disorders. Although effective, it carries risks, including rare but severe complications such as air embolism.</p><p><strong>Case summary: </strong>We report a case of a 58-year-old man who developed extensive air embolism during ERCP. He previously underwent a Whipple procedure and experienced a sudden drop in vital signs and loss of consciousness. Immediate intervention with hyperbaric oxygen therapy and supportive care led to gradual recovery. Imaging confirmed widespread air embolism, which resolved with continued treatment.</p><p><strong>Conclusion: </strong>Air embolism is a rare, critical complication of ERCP, especially in patients with prior surgery such as pancreaticoduodenectomy. Early detection and prompt treatment, including hyperbaric oxygen therapy, are crucial for favorable outcomes.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 11","pages":"617-622"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733172","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":"Motorized spiral enteroscopy: A cautious step forward in technological innovation.","authors":"Shu-Ping Xiao, Hai Lin, Hong-Bin Chen","doi":"10.4253/wjge.v16.i11.581","DOIUrl":"10.4253/wjge.v16.i11.581","url":null,"abstract":"<p><p>With the continuous advancement in medical technology, endoscopy has gained significant attention as a crucial diagnostic tool. The introduction of motorized spiral enteroscopy (MSE) represents a significant advancement in the diagnosis and treatment of small bowel diseases. While there are safety concerns and a high reliance on the operator's skills, MSE should not be disregarded entirely. Instead, it should be considered as a supplementary endoscopic technique, particularly in situations where conventional endoscopy proves ineffective. Through continuous research and technical optimization, MSE has the potential to become an important addition to the endoscopy toolbox in the future. We call on colleagues in the industry to work together to promote the improvement of MSE technology through continuous research and practice, with the aim to bring out its unique value in endoscopy while ensuring patient safety.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 11","pages":"581-586"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733166","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":"Role of macroscopic on-site evaluation of endoscopic ultrasound-guided fine-needle aspiration/biopsy: Results of a multicentric prospective study.","authors":"Hussein H Okasha, Hiwa A Hussein, Khaled M Ragab, Omar Abdallah, Fedoua Rouibaa, Borahma Mohamed, Fahd Ghalim, Mahmoud Farouk, Mohamed Lasheen, Mohamed A Elbasiony, Ahmed E Alzamzamy, Ahmed El Deeb, Hassan Atalla, Mahmoud El-Ansary, Sahar Mohamed, Moaz Elshair, Wafaa Khannoussi, Mohamed Z Abu-Amer, Amine Elmekkaoui, Mohammed S Naguib, Adil Ait Errami, Ahmed El-Meligui, Ahmed H El-Habashi, Mahmoud G Ameen, Dalia Abdelfatah, Mona Kaddah, Hanane Delsa","doi":"10.4253/wjge.v16.i11.595","DOIUrl":"10.4253/wjge.v16.i11.595","url":null,"abstract":"<p><strong>Background: </strong>The concept of macroscopic on-site evaluation (MOSE) was introduced in 2015 when the endoscopist observed better diagnostic yield when the macroscopically visible core on MOSE was superior to 4 mm. Recent studies suggest that MOSE by the endoscopist may be an excellent alternative to rapid on-site evaluation, and some classifications have been published. Few studies have assessed the adequacy of histologic cores in MOSE during endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB).</p><p><strong>Aim: </strong>To evaluate the performance of MOSE during EUS-FNA/FNB.</p><p><strong>Methods: </strong>This multicentric prospective study was conducted in 16 centers in 3 countries (Egypt, Iraq, and Morocco) and included 1108 patients with pancreatic, biliary, or gastrointestinal pathology who were referred for EUS examination. We prospectively analyzed the MOSE in 1008 patients with available histopathological reports according to 2 classifications to determine the adequacy of the histological core samples. Data management and analysis were performed using a Statistical Package for Social Sciences (SPSS) version 27.</p><p><strong>Results: </strong>A total of 1074 solid lesions were biopsied in 1008 patients with available cytopathological reports. Mean age was 59 years, and 509 patients (50.5%) were male. The mean lesion size was 38 mm. The most frequently utilized needles were FNB-Franseen (74.5%) and 22 G (93.4%), with a median of 2 passes. According to 2 classifications, 618 non-bloody cores (61.3%) and 964 good samples (95.6%) were adequate for histological evaluation. The overall diagnostic yield of cytopathology was 95.5%. The cytological examination confirmed the diagnosis of malignancy in 861 patients (85.4%), while 45 samples (4.5%) were inconclusive. Post-procedural adverse events occurred in 33 patients (3.3%). Statistical analysis showed a difference between needle types (<i>P</i> = 0.035) with a high sensitivity of FNB (97%). The analysis of the relationship between the MOSE-score and the final diagnosis showed a significant difference between the different scores of the MOSE (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>MOSE is a simple method that allows endoscopists to increase needle passes to improve sample quality. There is significantly higher FNB sensitivity and cytopathology diagnostic yield with good MOSE cores.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 11","pages":"595-606"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733170","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":"Limited validity of Mayo endoscopic subscore in ulcerative colitis with concomitant primary sclerosing cholangitis.","authors":"Pavel Wohl, Alzbeta Krausova, Petr Wohl, Ondrej Fabian, Lukas Bajer, Jan Brezina, Pavel Drastich, Mojmir Hlavaty, Petra Novotna, Michal Kahle, Julius Spicak, Martin Gregor","doi":"10.4253/wjge.v16.i11.607","DOIUrl":"10.4253/wjge.v16.i11.607","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis (UC) with concomitant primary sclerosing cholangitis (PSC) represents a distinct disease entity (PSC-UC). Mayo endoscopic subscore (MES) is a standard tool for assessing disease activity in UC but its relevance in PSC-UC remains unclear.</p><p><strong>Aim: </strong>To assess the accuracy of MES in UC and PSC-UC patients, we performed histological scoring using Nancy histological index (NHI).</p><p><strong>Methods: </strong>MES was assessed in 30 PSC-UC and 29 UC adult patients during endoscopy. NHI and inflammation were evaluated in biopsies from the cecum, rectum, and terminal ileum. In addition, perinuclear anti-neutrophil cytoplasmic antibodies, fecal calprotectin, body mass index, and other relevant clinical characteristics were collected.</p><p><strong>Results: </strong>The median MES and NHI were similar for UC patients (MES grade 2 and NHI grade 2 in the rectum) but were different for PSC-UC patients (MES grade 0 and NHI grade 2 in the cecum). There was a correlation between MES and NHI for UC patients (Spearman's <i>r</i> = 0.40, <i>P</i> = 0.029) but not for PSC-UC patients. Histopathological examination revealed persistent microscopic inflammation in 88% of PSC-UC patients with MES grade 0 (46% of all PSC-UC patients). Moreover, MES overestimated the severity of active inflammation in an additional 11% of PSC-UC patients.</p><p><strong>Conclusion: </strong>MES insufficiently identifies microscopic inflammation in PSC-UC. This indicates that histological evaluation should become a routine procedure of the diagnostic and grading system in both PSC-UC and PSC.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 11","pages":"607-616"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733229","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":"Treatment of choice for malignant gastric outlet obstruction: More than clearing the road.","authors":"Li Jiang, Xiao-Ping Chen","doi":"10.4253/wjge.v16.i11.587","DOIUrl":"10.4253/wjge.v16.i11.587","url":null,"abstract":"<p><p>In this editorial, we comment on the in-press article in the <i>World Journal of Gastrointestinal Endoscopy</i> concerning the treatment of malignant gastric outlet obstruction (mGOO). The original theory of treatment involves bypassing the obstruction or reenabling the patency of the passage. Conventional surgical gastroenterostomy provides long-term relief of symptoms in selected patients, with substantial morbidity and a considerable rate of delayed gastric emptying. Endoscopic stenting was introduced as an alternative minimally invasive procedure with less procedural morbidity and rapid clinical improvement; however, it presented a high rate of long-term recurrence. Therefore, challenges remain in the treatment of mGOO patients to improve clinical outcomes. Endoscopic ultrasound-guided gastroenterostomy has recently emerged as a promising method because of the combined effects of surgery and endoscopy, whereas stomach-partitioning gastrojejunostomy has been reported as a modified surgical procedure to reduce the rate of delayed gastric emptying. In decision-making regarding the treatment of choice, it should be taken into account that mGOO might be accompanied by a variety of pathological conditions, including cancer cachexia, anorexia, malabsorption, and <i>etc.</i>, all of which can also lead to the characteristic symptoms and poor nutritional status of mGOO. The treatment plan should consider comprehensive aspects of patients to achieve practical improvements in prognosis and the quality of life.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 11","pages":"587-594"},"PeriodicalIF":1.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733174","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":"Safety and efficacy of peroral endoscopic myotomy for treating achalasia in pediatric and geriatric patients: A meta-analysis.","authors":"Xin-Xin Pu, Shu Huang, Chun-Yu Zhong, Xia Wang, Su-Fen Fu, Ying-Qin Lv, Kang Zou, Mu-Han Lü, Yan Peng, Xiao-Wei Tang","doi":"10.4253/wjge.v16.i10.566","DOIUrl":"https://doi.org/10.4253/wjge.v16.i10.566","url":null,"abstract":"<p><strong>Background: </strong>As a less invasive technique, peroral endoscopic myotomy (POEM) has recently been widely accepted for treating achalasia with an excellent safety profile, durability, and efficacy in adults. In pediatric and geriatric patients, the treatment is more difficult.</p><p><strong>Aim: </strong>To discuss the clinical outcomes of POEM in pediatric and geriatric patients with achalasia.</p><p><strong>Methods: </strong>We conducted a comprehensive search of PubMed, Embase and Cochrane Library databases from inception to July 2024. The primary outcomes were technical and clinical success. Secondary outcomes of interest included adverse events and gastroesophageal reflux disease (GERD). The pooled event rates were calculated by comprehensive meta-analysis software.</p><p><strong>Results: </strong>A total of 32 studies with 547 pediatric patients and 810 geriatric patients were included in this study. The pooled event rates of technical success, clinical success, GERD and adverse events of POEM for treating achalasia in pediatric patients were 97.1% [95% confidence interval (CI): 95.0%-98.3%; <i>I</i>² = 0%; <i>P</i> < 0.000], 93.2% (95%CI: 90.5%-95.2%; <i>I</i>² = 0%; <i>P</i> < 0.000), 22.3% (95%CI: 18.4%-26.7%; <i>I</i>² = 43.874%; <i>P</i> < 0.000) and 20.4% (95%CI: 16.6%-24.8%; <i>I</i>² = 67.217%; <i>P</i> < 0.000), respectively. Furthermore, in geriatric patients, the pooled event rates were 97.7% (95%CI: 95.8%-98.7%; <i>I</i>² = 15.200%; <i>P</i> < 0.000), 93.2% (95%CI: 90.3%-95.2%; <i>I</i>² = 0%; <i>P</i> < 0.000), 23.9% (95%CI: 19.4%-29.1%; <i>I</i>² = 75.697%; <i>P</i> < 0.000) and 10.8% (95%CI: 8.3%-14.0%; <i>I</i>² = 62.938%; <i>P</i> < 0.000], respectively.</p><p><strong>Conclusion: </strong>Our findings demonstrated that POEM was an effective and safe technique for pediatric and geriatric patients with achalasia.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 10","pages":"566-580"},"PeriodicalIF":1.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547933","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":"Gastric fundoplication with endoscopic technique: A novel approach for gastroesophageal reflux disease treatment.","authors":"Eyad Gadour, Anna Carolina Hoff","doi":"10.4253/wjge.v16.i10.557","DOIUrl":"https://doi.org/10.4253/wjge.v16.i10.557","url":null,"abstract":"<p><strong>Background: </strong>Gastric fundoplication with endoscopic technique (GFET) is an innovative approach to managing gastroesophageal reflux disease (GERD). This minimally invasive procedure utilizes the GEN-2 Apollo endosuture device and Olympus H2T180 gastroscope to perform partial fundoplication by strategically placing Prolene 2-0 sutures at the 11, 7, 5, 1, and 3 o'clock positions around the gastroesophageal junction.</p><p><strong>Aim: </strong>To evaluate whether GFET enhances the lower esophageal sphincter function by creating comprehensive plication to improve the barrier against reflux.</p><p><strong>Methods: </strong>This single-center prospective study included patients undergoing GFET. Before beginning GFET, pH metrics and subsequent manometric measurements were obtained. An analysis of variance was performed to determine statistically significant differences between quality of life (QOL) and DeMeester scores at the time of the procedure and 6 and 12 months postoperatively. Pearson's <i>χ</i> ² test was performed to identify statistically significant differences between categorical variables at the time of the procedure and 6 and 12 months postoperatively.</p><p><strong>Results: </strong>Eighteen participants were enrolled (11 males and 7 females; mean age, 35 years). More than 70% had an initial Hill grade of IIb. One adverse event was recorded after the procedure. One patient underwent valve reinforcement at 12 months. The mean QOL score was markedly higher at the time of the procedure (39.9 ± 4.0) compared to those at 6 and 12 months postoperatively (<i>P</i> < 0.001). Scores at 12 months were slightly higher than those at 6 months. The highest mean QOL score was observed at the time of the procedure, followed by those at 6 and 12 months postoperatively (<i>P</i> < 0.001). A similar trend was noted for the mean DeMeester scores (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>GFET is a minimally invasive alternative to traditional surgical interventions and endoscopic techniques for managing GERD. Further research is warranted to validate its long-term efficacy and effectiveness over existing treatments.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 10","pages":"557-565"},"PeriodicalIF":1.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547932","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 \"calabash\" ligation and resection for small gastric mesenchymal tumors.","authors":"Xi-Min Lin, Yue-Ming Peng, Hao-Tian Zeng, Jia-Xing Yang, Zheng-Lei Xu","doi":"10.4253/wjge.v16.i10.545","DOIUrl":"https://doi.org/10.4253/wjge.v16.i10.545","url":null,"abstract":"<p><strong>Background: </strong>Gastric mesenchymal tumors (GMT) are identified as soft tissue neoplasms that arise from mesenchymal stem cells within the gastrointestinal tract. GMT primarily encompass gastric stromal tumors (GST), gastric leiomyomas, and gastric schwannomas. Although most GMT are benign, there are still potential malignant changes, especially GST. Thus, early surgical intervention is the primary treatment for GMT. We have designed a simple endoscopic \"calabash\" ligation and resection (ECLR) procedure to treat GMT. Its efficacy and safety need to be compared with those of traditional endoscopic techniques, such as endoscopic submucosal excavation (ESE).</p><p><strong>Aim: </strong>To assess the safety and effectiveness of ECLR in managing small GMT (sGMT) with a maximum diameter ≤ 20 mm by comparing to ESE.</p><p><strong>Methods: </strong>This retrospective analysis involved patients who were hospitalized in our institution between November 2021 and March 2023, underwent endoscopic resection, and received a pathological diagnosis of GMT. Cases with a tumor diameter ≤ 20 mm were chosen and categorized into two cohorts: Study and control groups. The study group was composed of patients treated with ECLR, whereas the control group was composed of those treated with ESE. Data on general clinical characteristics (gender, age, tumor diameter, tumor growth direction, tumor pathological type, and risk grade), surgery-related information (complete tumor resection rate, operation duration, hospitalization duration, hospitalization cost, and surgical complications), and postoperative follow-up were collected for both groups. The aforementioned data were subsequently analyzed and compared.</p><p><strong>Results: </strong>Five hundred and eighty-nine individuals were included, with 297 cases in the control group and 292 in the study group. After propensity score matching, the final analysis incorporated 260 subjects in each cohort. The findings indicated that the study group exhibited shorter operation duration and lowered medical expenses relative to the control group. Furthermore, the study group reported less postoperative abdominal pain and had a lower incidence of intraoperative perforation and postoperative electrocoagulation syndrome than the control group. There were no substantial variations observed in other parameters among the two cohorts.</p><p><strong>Conclusion: </strong>ECLR is a viable and effective approach for managing sGMT.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"16 10","pages":"545-556"},"PeriodicalIF":1.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547931","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}