World Journal of Gastrointestinal Endoscopy最新文献

{"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}

{"title":"Pancreato-hepatobiliary neuroendocrine tumors diagnosed through endoscopic ultrasound: Clinical characteristics and factors associated with high-grade lesions.","authors":"Abbas A Tasneem, Nasir H Luck, Muhammed Mubarak","doi":"10.4253/wjge.v17.i6.105904","DOIUrl":"10.4253/wjge.v17.i6.105904","url":null,"abstract":"<p><strong>Background: </strong>Neuroendocrine tumors (NETs) are an important type of neoplastic disease of the digestive tract. There is little data on NETs originating from the pancreato-hepatobiliary region of the digestive tract in Pakistan.</p><p><strong>Aim: </strong>To evaluate different types of pancreato-hepatobiliary NETs (PHB-NET) diagnosed with endoscopic ultrasound (EUS) and to identify factors associated with high-grade NETs.</p><p><strong>Methods: </strong>All patients diagnosed with PHB-NET through EUS-guided biopsy were included in the study. The site of origin, histology, and grade of PHB-NETs were noted and factors associated with high-grade lesions were analyzed. SPSS, version 20.0 was used for statistical analysis.</p><p><strong>Results: </strong>A total of 36 patients with PHB-NET were included. Males and females were equal in numbers, <i>i.e.</i>, 18 (50%) each. The mean age was 48 ± 15.7 years with an age range of 17-70 years. The most common sites of origin of PHB-NET were: Pancreas 20 (55.6%), porta hepatis mass 8 (22.2%), perigastric mass 3 (8.3%) and others 5 (13.9%). The mean size of the PHB-NETs was 34.7 ± 22.5 mm. Among pancreatic NETs, the most commonly affected areas were body 9, tail 5, and head 5. Only 4 (11.1%) PHB-NETs were functioning, all of which were insulinomas originating from the body or tail of the pancreas. Two-thirds of PHB-NETs, 24 (66.6%), were benign (WHO grade I: 19; grade 2: 5) while one-third 12 (33.3%) were neuroendocrine cancers (NEC) (WHO grade III). Histological types were large cell 17 (47.2%), small cell 8 (22.2%), mixed 1 (2.8%), and undetermined 10 (27.8%). Factors associated with NECs were age > 40 years (<i>P</i> = 0.016), extra-pancreatic origin of the lesion (<i>P</i> = 0.014), and small cell histologic type (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The most common site of PHB-NET detected through EUS was the pancreas. Although most were benign, about one-third were high-grade cancers. Insulinoma was the most common functioning tumor. NECs were associated with advanced age, extra-pancreatic origin, and small-cell histology.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"105904"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477043","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":"Practical guide to duodenal stenting for gastric outlet obstruction: Clinical outcomes, selection criteria, placement techniques, and management strategies.","authors":"Sakue Masuda, Chikamasa Ichita, Kazuya Koizumi","doi":"10.4253/wjge.v17.i6.107189","DOIUrl":"10.4253/wjge.v17.i6.107189","url":null,"abstract":"<p><p>Duodenal stenting is a widely used palliative treatment for gastric outlet obstruction (GOO) caused by unresectable malignancies. Compared to surgical gastrojejunostomy, duodenal stenting allows for earlier oral intake, shorter hospitalization, and earlier chemotherapy initiation. However, its long-term efficacy is limited by stent occlusion, which typically occurs 2-4 months post-procedure, due to tumor ingrowth, overgrowth, or food impaction. Covered stents can reduce tumor ingrowth but increase the migration risk, particularly in patients receiving chemotherapy. This review provides a comprehensive comparison of duodenal stenting, surgical gastrojejunostomy, and endoscopic ultrasound-guided gastroenterostomy, by discussing their clinical outcomes, advantages, and limitations. We further explore stent selection based on stricture characteristics, optimal placement techniques, post-procedural management, and for handling complications including occlusion, migration, bleeding, and perforation. Additionally, we address technical challenges and troubleshooting strategies, including management of guidewire-induced perforation, incomplete stent expansion, and bile duct obstruction for overlapping biliary and duodenal stricture cases. Despite its widespread clinical use, no prior review has comprehensively covered both the technical and clinical aspects of duodenal stenting so extensively. By providing a clinically oriented, practical guide, this review serves as a valuable resource for endoscopists and gastroenterologists, facilitating optimized decision-making and improved outcomes for patients with GOO in real-world practice.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"107189"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476953","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":"Current status of endoscopic treatment for esophageal diverticulum based on diverticular peroral endoscopic myotomy.","authors":"Guo-Yao Sun, Yong Sun, Xue-Zhu Wang, Wen Jia, Jiao Liu, Zhuo Yang, Jiang-Ning Gu","doi":"10.4253/wjge.v17.i6.106799","DOIUrl":"10.4253/wjge.v17.i6.106799","url":null,"abstract":"<p><p>Esophageal diverticulum can be broadly classified into three main types: Pharyngoesophageal diverticulum located near the upper esophageal sphincter (including Zenker's diverticulum, Killian-Jamieson diverticulum, and Laimer's diverticulum); Mid-esophageal diverticulum, and epiphrenic diverticulum located just above the lower esophageal sphincter. Most asymptomatic esophageal diverticulum are incidentally detected during routine imaging studies, such as barium swallow, computed tomography scans, or esophagogastroduodenoscopy. For these patients, regular follow-up is typically sufficient. However, a small subset may experience persistent symptoms such as dysphagia and acid reflux. Patients with symptomatic diverticulum should be assessed for the potential need for surgical intervention to prevent serious complications, including aspiration pneumonia and malnutrition. The treatment options for symptomatic esophageal diverticulum encompass both endoscopic and surgical approaches. Due to the technical complexity and significant risks associated with surgical intervention, endoscopic treatment has gained increasing preference, achieving remarkable results with the advancements in endoscopic instruments and techniques. Given the anatomical location and pathophysiological differences among esophageal diverticulum, a personalized endoscopic strategy is essential to achieve optimal results. This review provides an overview of the characteristics of esophageal diverticulum and offers a comprehensive discussion of diverticular peroral endoscopic myotomy and its related variations as the primary endoscopic treatment strategy.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"106799"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477016","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":"Efficacy and safety of single use duodenoscopes in comparison to reusable duodenoscopes for endoscopic retrograde cholangiopancreatography: A single center experience.","authors":"Iyiad Alabdul Razzak, Maram Alenzi, Butros Fakhoury, Xin-Yuan Zhang, Krishnan Sandeep, Syed Kashif Mahmood","doi":"10.4253/wjge.v17.i6.105298","DOIUrl":"10.4253/wjge.v17.i6.105298","url":null,"abstract":"<p><strong>Background: </strong>Single-use duodenoscopes (SDs) were introduced to eliminate exogenous infection risks post-endoscopic retrograde cholangiopancreatography (ERCP).</p><p><strong>Aim: </strong>To evaluate their efficacy and safety against reusable duodenoscopes (RDs).</p><p><strong>Methods: </strong>This was a single-center case control study. All consecutive patients undergoing ERCP using SD between 2020 and 2023 were enrolled. A similar number of patients undergoing ERCP using RD were randomly selected and enrolled. In case of ERCP failure using SD, operators switched to a RD if judged appropriate. The primary outcome was successful ERCP completion rates. The secondary outcomes were rate of difficult biliary cannulation, incidence of crossover from SD to RD, procedure related adverse events, 30-day re-admission rate, and endoscopists' assessment of SD's performance.</p><p><strong>Results: </strong>A total of 133 patients were enrolled (<i>n</i> = 53 for SD, <i>n</i> = 80 for RD). Baseline characteristics and American Society for Gastrointestinal Endoscopy ERCP complexity grades were comparable between both groups. Successful ERCP completion rates were 88.7% for SD and 95% for RD (<i>P</i> = 0.3). In cases of unsuccessful ERCP with SD, crossover to RD occurred in 3 out of 6 instances, with 2 subsequently succeeding with RD. Rates of adverse events and 30-day readmission were comparable: (1) 13.2% <i>vs</i> 11.2% (<i>P</i> = 0.19); and (2) 15.4% <i>vs</i> 8.9% (<i>P</i> = 0.25), respectively. Median overall endoscopists' satisfaction with SD was 8 out of 10.</p><p><strong>Conclusion: </strong>The novel SDs demonstrated no difference in efficacy and safety compared to conventional RDs when used to perform a wide range of ERCPs. Nevertheless, further development and study of SDs' financial and environmental effectiveness is warranted.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"105298"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477034","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 retrograde cholangiopancreatography treatment of cholangitis stone in a patient with total situs inversus: A case report.","authors":"Ke-Rui Gong, Zhuo-Lin Zheng, Guo-Fu Li, Jun-Mao Chen","doi":"10.4253/wjge.v17.i6.106347","DOIUrl":"10.4253/wjge.v17.i6.106347","url":null,"abstract":"<p><strong>Background: </strong>Situs inversus viscerum (SIV) is a rare autosomal recessive genetic disorder characterized a complete mirror-image organ reversal in the thoracic and abdominal cavities. Its low incidence presents considerable challenges in clinical diagnosis and treatment, especially concerning gastrointestinal endoscopic procedures.</p><p><strong>Case summary: </strong>Herein, we report a case of an 80-year-old male with choledocholithiasis and acute obstructive empyematous cholangitis. Imaging revealed total visceral inversion in the patient. Endoscopic retrograde cholangiopancreatography (ERCP) was successfully performed to remove the stones, resulting to substantial relief of clinical symptoms and gradual improvement of the patient's condition, leading to successful recovery and discharge.</p><p><strong>Conclusion: </strong>Therapeutic ERCP is a safe and effective surgical option for patients with SIV. The main focus for successful ERCP in patients with SIV includes positioning adjustments during the surgical process and using the dual-guidewire technique for biliary cannulation.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"106347"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477037","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":"Enhancing laparoscopic inguinal hernia repair with three-dimensional computed tomography reconstruction.","authors":"Yoshinori Kagawa, Katsuya Ota","doi":"10.4253/wjge.v17.i6.107391","DOIUrl":"10.4253/wjge.v17.i6.107391","url":null,"abstract":"<p><p>Zhang <i>et al</i> highlighted the importance of three-dimensional computed tomography reconstruction and myopectineal orifice measurement in laparoscopic inguinal hernia repair. Their findings indicated that preoperative three-dimensional computed tomography provides precise anatomical mapping, allowing surgeons to optimize mesh selection and reduce recurrence rates. Recent studies have corroborated these results, demonstrating that a personalized mesh size based on myopectineal orifice dimensions leads to superior patient outcomes. This article discusses the clinical significance of these advancements in hernia surgery, and emphasises their impact on improving precision, reducing complications, and optimizing surgical planning.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"107391"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477038","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":"Long-term outcomes of post-transplant biliary anastomotic strictures: Endoscopic therapy with plastic and metal stents.","authors":"Larissa Wermelinger Pinheiro, Fernanda Prata Martins, Angelo Paulo Ferrari, Edmar Tafner, Gustavo Andrade De Paulo, Ermelindo Della Libera","doi":"10.4253/wjge.v17.i6.103183","DOIUrl":"10.4253/wjge.v17.i6.103183","url":null,"abstract":"<p><strong>Background: </strong>Biliary anastomotic stricture (BAS) occurs in approximately 14%-20% of patients post-orthotopic liver transplantation (post-OLT). Endoscopic retrograde cholangiopancreatography (ERCP) using multiple plastic stents (MPSs) or fully covered self-expandable metal stents (cSEMSs) represent the standard treatment for BAS post-OLT. Recently, cSEMSs have emerged as the primary option for managing BAS post-OLT.</p><p><strong>Aim: </strong>To compare the resolution and recurrence of BAS rates in these patients.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted in a single tertiary care center (Hospital Israelita Albert Einstein, São Paulo, Brazil). We reported the results of endoscopic therapy in patients with post-OLT BAS between 2012 and 2022. Patients were stratified into two groups according to therapy: (1) MPSs; and (2) cSEMSs. Primary endpoints were to compare stricture resolution and recurrence among the groups. The secondary endpoint was to identify predictive factors for stricture recurrence.</p><p><strong>Results: </strong>A total of 104 patients were included. Overall stricture resolution was 101/104 (97.1%). Stricture resolution was achieved in 83/84 patients (99%) in the cSEMS group and 18/20 patients (90%) in the MPS group (<i>P</i> = 0.094). Failure occurred in 3/104 patients (2.8%). Stricture recurrence occurred in 9/104 patients (8.7%). Kaplan-Meier analysis showed there was no difference in recurrence-free time among the groups (<i>P</i> = 0.201). A multivariate analysis identified the number of ERCP procedures (hazard ratio = 1.4; 95% confidence interval: 1.194-1.619; <i>P</i> < 0.001] and complications (hazard ratio = 2.8; 95% confidence interval: 1.008-7.724; <i>P</i> = 0.048) as predictors of stricture recurrence.</p><p><strong>Conclusion: </strong>cSEMSs and MPSs were effective and comparable regarding BAS post-OLT resolution and recurrence. The number of ERCP procedures and complications were predictors of stricture recurrence.</p>","PeriodicalId":23953,"journal":{"name":"World Journal of Gastrointestinal Endoscopy","volume":"17 6","pages":"103183"},"PeriodicalIF":1.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477041","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}