Techniques and Innovations in Gastrointestinal Endoscopy最新文献

{"title":"A Novel Cleansing Solution for High-Quality Upper Gastrointestinal Endoscopy: A Multicenter Randomized Controlled Trial","authors":"Noemi Gualandi ,&nbsp;Giulia Gibiino ,&nbsp;Giuliano Francesco Bonura ,&nbsp;Matteo Secco ,&nbsp;Paola Soriani ,&nbsp;Alessandro Cucchetti ,&nbsp;Cecilia Binda ,&nbsp;Valentina Zadro ,&nbsp;Pablo Cortegoso Valdivia ,&nbsp;Paolo Biancheri ,&nbsp;Mauro Manno ,&nbsp;Carlo Fabbri","doi":"10.1016/j.tige.2025.250928","DOIUrl":"10.1016/j.tige.2025.250928","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Esophagogastroduodenoscopy (EGD) is the gold standard examination for upper gastrointestinal (GI) disease diagnosis; however, intraluminal bubbles and mucus may reduce visibility. Mucolytic and tensioactive agents before EGD improve gastric visualization. We compared the efficacy of a novel cleansing preparation vs fasting on upper GI tract visualization during EGD.</div></div><div><h3>METHODS</h3><div>We conducted a multicenter, prospective, randomized controlled trial on consecutive adult outpatients undergoing EGD. Patients were randomized 1:1 to drink 50 mL of simethicone 150 mg, N-acetylcysteine 250 mg, and 10% acetic acid solution (Lumevis, Biofarmatec srl, Palermo, Italy) before the EGD or to fasting. The primary outcome was overall mucosal vision quality score, defined as the sum of 1-10 visual analog scale scores (0 = no visualization; 10 = perfect visualization) for each segment (esophagus, stomach, and duodenum) before washing. Secondary outcomes included adverse event rate, patient satisfaction, and EGD duration.</div></div><div><h3>RESULTS</h3><div>Patients were randomized to cleansing solution (<em>n</em> = 60) or fasting (<em>n</em> = 60). Cleansing preparation administration before EGD was associated with a higher overall mucosal vision quality score compared with fasting only (median visual analog scale score 23 [range, 21-25] vs 19 [range, 16-23], <em>P</em> = 0.001). No adverse events were reported in both groups. Patient satisfaction and EGD duration were similar between the cleansing preparation and fasting only.</div></div><div><h3>CONCLUSION</h3><div>Compared with fasting only, the administration of this novel cleansing solution was associated with improved mucosal visualization of the upper GI tract.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 3","pages":"Article 250928"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Surveillance Patterns and Management of Helicobacter pylori in Newly Diagnosed Gastric Intestinal Metaplasia","authors":"SHIVRAM CHANDRAMOULI ,&nbsp;ANNIE L. WANG ,&nbsp;DAVID A. LEIMAN","doi":"10.1016/j.tige.2024.250904","DOIUrl":"10.1016/j.tige.2024.250904","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250904"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Life Application of Artificial Intelligence for Automatic Characterization of Biliary Strictures: A Transatlantic Experience","authors":"Mariano González-Haba Ruiz ,&nbsp;Pedro Pereira ,&nbsp;Jessica Widmer ,&nbsp;Tiago Ribeiro ,&nbsp;Belén Agudo Castillo ,&nbsp;Filipe Vilas-Boas ,&nbsp;João Ferreira ,&nbsp;Miguel Mascarenhas Saraiva ,&nbsp;Guilherme Macedo","doi":"10.1016/j.tige.2024.250902","DOIUrl":"10.1016/j.tige.2024.250902","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250902"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy and Safety of Endoscopic Ultrasound–Guided Liver Biopsy in Patients with Metabolic Dysfunction–Associated Liver Disease","authors":"JEROME C. EDELSON ,&nbsp;ERIC M. MONTMINY ,&nbsp;CARL L. KAY ,&nbsp;TYLER H. DOTY ,&nbsp;MATTHEW J. SCHWARTZ ,&nbsp;DON C. ROCKEY","doi":"10.1016/j.tige.2025.250918","DOIUrl":"10.1016/j.tige.2025.250918","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 3","pages":"Article 250918"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"White Light Imaging to Narrow Band Imaging via Style Transfer: A Feasibility Test for Enhancing Colonoscopic Diagnostics","authors":"JUN SEO LEE ,&nbsp;DONGHEON LEE ,&nbsp;EUN HYO JIN ,&nbsp;HAE YEON KANG ,&nbsp;JI YEON SEO ,&nbsp;JI MIN CHOI","doi":"10.1016/j.tige.2025.250927","DOIUrl":"10.1016/j.tige.2025.250927","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 3","pages":"Article 250927"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-like Peptide-1 Receptor Agonists Are Not Associated With Increased Incidence of Pneumonia After Endoscopic Procedures","authors":"Natalia Tejada ,&nbsp;Ishak Mansi ,&nbsp;Silvio W. de Melo Jr","doi":"10.1016/j.tige.2025.250925","DOIUrl":"10.1016/j.tige.2025.250925","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Despite their favorable cardiometabolic effects, use of glucagon-like peptide-1 receptor agonists (GLP1-RAs), have raised concerns for increasing the risk of aspiration pneumonia after upper esophagogastroduodenoscopy (EGD)/colonoscopy due to slowing gastrointestinal motility. Such risks are yet to be confirmed. This study aimed to examine the association of GLP1-RA use with risk of aspiration pneumonia or any pneumonia in patients undergoing these procedures.</div></div><div><h3>METHODS</h3><div>This retrospective, propensity score (PS)–matched cohort study, with active control design, used data from the Veterans Health Administration of veterans who underwent EGD/colonoscopy procedures during fiscal years 2016-2021 while using GLP1-RA or dipeptidyl peptidase 4 inhibitors (DPP4i), as active comparators. A PS was created using 60 baseline characteristics encompassing demographics, laboratory investigations, medication use, and comorbidities that may increase risk of aspiration or infection. Our 2 coprimary outcomes were incidence of any pneumonia and incidence of aspiration pneumonia within 30 days of the procedure.</div></div><div><h3>RESULTS</h3><div>Of 59,280 EGD/colonoscopy procedures (22,570 GLP1-RA users and 36,710 DPP4i users), we successfully matched 15,943 pairs of patients. Mean (SD) age of patients was 66 (8) years and mean (SD) weighted Charlson comorbidity index was 4.8 (3.2). In the PS-matched cohort, 48 (0.3%) GLP1-RA users had pneumonia vs 57 (0.4%) DPP4i users (odds ratio, 0.84; 95% CI, 0.57-1.23), and 7 (0.04%) GLP1-RA users had aspiration pneumonia vs 9 (0.06%) DPP4i users (odds ratio, 0.78; 95% CI, 0.29-2.09).</div></div><div><h3>CONCLUSION</h3><div>Risks of aspiration pneumonia or any pneumonia after EGD/colonoscopy procedures were similar in GLP1-RA users and active comparators. Withholding GLP1-RA prior to endoscopic procedures may not be necessary.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 3","pages":"Article 250925"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144107530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Endoscopic Ultrasound–Guided Gastrointestinal Anastomosis for Gastric Outlet Obstruction, Endoscopic Access, and Enteric Decompression","authors":"Michiel Bronswijk ,&nbsp;Giuseppe Vanella ,&nbsp;Roy L.J. van Wanrooij ,&nbsp;Paolo Giorgio Arcidiacono ,&nbsp;Schalk Van der Merwe","doi":"10.1016/j.tige.2025.250915","DOIUrl":"10.1016/j.tige.2025.250915","url":null,"abstract":"<div><div>Endoscopic ultrasound (EUS)-guided gastrointestinal anastomosis techniques using lumen-apposing metal stents are increasingly being used in expert centers throughout the world and have already found their way into day-to-day practice. For patients with gastric outlet obstruction, EUS-guided gastroenterostomy has the potential to become the new reference standard given the most recent prospective data of long-term effectiveness in the setting of oncologic palliation, as well as the promising evidence regarding benign obstruction in poor surgical candidates. For patients with surgically altered anatomy, EUS-directed transgastric or transenteric endoscopic retrograde cholangiopancreatography (ERCP) seems to provide more effective and less invasive alternative to enteroscopy-assisted ERCP and laparoscopy-assisted ERCP. Besides access or management of gastric outlet obstruction, EUS-guided gastrointestinal anastomosis is furthermore increasingly being used for the palliation of afferent loop syndrome, showing high clinical success rates and acceptable safety profile. This also pertains to EUS-directed enterocolostomy, where small series have suggested a potential benefit for patients with malignant intestinal obstruction, although more data are required regarding patient selection and safety. In this review, we discuss the most recent evidence, technical approaches, and future directions for these techniques.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 2","pages":"Article 250915"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143601230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Machine Learning Voice-Based Biomarkers for Characterization of Barrett's Esophagus","authors":"AMRIT K. KAMBOJ ,&nbsp;MANOJ K. YARLAGADDA ,&nbsp;MAYO CLINIC BARRETT'S ESOPHAGUS AND VOICE WORKING GROUP ,&nbsp;KEIKO ISHIKAWA ,&nbsp;DIANA M. ORBELO ,&nbsp;MARY PIETROWICZ ,&nbsp;CADMAN L. LEGGETT","doi":"10.1016/j.tige.2024.250903","DOIUrl":"10.1016/j.tige.2024.250903","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 250903"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143158115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Ultrasound–guided Gastroenterostomy vs Enteral Stenting for Malignant Gastric Outlet Obstruction: A Systematic Review and Meta-Analysis","authors":"Matheus Vanzin Fernandes ,&nbsp;Natália Junkes Milioli ,&nbsp;Vanio Antunes ,&nbsp;Tulio L. Correa ,&nbsp;Otávio Cosendey Martins ,&nbsp;Cynthia Florêncio de Mesquita ,&nbsp;Marcello Maida ,&nbsp;Stefano Baraldo","doi":"10.1016/j.tige.2025.250926","DOIUrl":"10.1016/j.tige.2025.250926","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Treatment options for malignant gastric outlet obstruction (GOO) usually rely on surgical gastroenterostomy or endoscopic stenting (ES). The former is more invasive and has a higher rate of adverse events, and the latter is limited by stent patency and has a higher reintervention rate. Endoscopic ultrasound–guided gastroenterostomy (EUS-GE) is a new option that can provide longer stent patency than ES without the invasiveness of surgery. This study aimed to compare the efficacy and safety of EUS-GE vs ES for the treatment of malignant GOO.</div></div><div><h3>METHODS</h3><div>We performed a systematic review and meta-analysis using the PubMed, Embase, and Cochrane databases. We searched for randomized and nonrandomized matched-control studies comparing EUS-GE with ES in patients with malignant GOO and reporting at least 1 of the outcomes of interest. The primary outcomes assessed were clinical and technical success. The odds ratio was used for binary outcomes and the mean difference for continuous outcomes, with their respective 95% CIs. Heterogeneity was assessed using the Cochran <em>Q</em> test and <em>I</em>² statistics. Trial sequential analysis was performed.</div></div><div><h3>RESULTS</h3><div>This study included 1 randomized controlled trial and 4 matched-control studies, totaling to 507 patients. There was a statistically significant difference between EUS-GE and ES in the clinical success (odds ratio, 2.81; 95% CI, 1.58-4.99; <em>P</em> &lt; 0.001; <em>I</em>² = 0%). Trial sequential analysis crossed the required information size line for the clinical success outcome.</div></div><div><h3>CONCLUSION</h3><div>EUS-GE is a reasonable option in the treatment of malignant GOO, mainly in the context of tertiary-care advanced endoscopy centers, with higher clinical success rate. Standardization and wider dissemination of the EUS-GE technique are required to reduce technical challenges.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 3","pages":"Article 250926"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144243185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Repair for Sleeve Gastrectomy Leaks Is Associated With a High Rate of Leak Resolution","authors":"Khalid Fahoum ,&nbsp;Tamara Kahan ,&nbsp;Olivia Delau ,&nbsp;Matthew Fasullo ,&nbsp;Ki-Yoon Kim ,&nbsp;Lauren Khanna ,&nbsp;Gregory Haber ,&nbsp;Paresh C. Shah ,&nbsp;Tamas Gonda","doi":"10.1016/j.tige.2024.09.004","DOIUrl":"10.1016/j.tige.2024.09.004","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Staple line leaks following sleeve gastrectomy have significant morbidity and mortality. Endoscopic repair approaches are increasingly being used and studied, but follow-up time is limited, and more data are needed. Our primary aim was to describe long-term outcomes following repair; secondary aims were to compare repair approaches and assess factors associated with clinical success.</div></div><div><h3>METHODS</h3><div>We conducted an observational cohort study of patients who underwent endoscopic repair of a sleeve gastrectomy leak from 2017 to 2023 at our tertiary care center. Patients without available follow-up were excluded. Electronic medical records were reviewed to obtain baseline and clinical characteristics; long-term outcomes were ascertained from the electronic medical record and telephonic conversations with patients. Repairs were classified as drainage when transmural stents were placed and as closure when clips, sutures, and/or an intraluminal stent was placed.</div></div><div><h3>RESULTS</h3><div>A total of 30 patients were included. The majority were females (77%) and Whites (74%), with a median age of 41.0 years (IQR, 35.1-51.8 years). The majority of patients (70%) initially underwent drainage, while the rest underwent closure. Median follow-up time was 1.2 years (IQR, 0.6 -1.6 years). Success rates for the initial repair approach without crossover or requiring surgical repair were 71.4% for drainage and 22.2% for closure (<em>P</em> = 0.02). Overall, 24 (80%) patients had leak resolution at the last follow-up, and the median number of endoscopies was 3 (IQR, 2-4).</div></div><div><h3>CONCLUSION</h3><div>Our study demonstrates a high rate of long-term leak resolution following endoscopic repair of sleeve gastrectomy leaks. An initial drainage approach may be associated with higher clinical success, although this was not noted in the multivariable analysis. Prospective randomized multicenter studies are needed to further evaluate and compare repair approaches.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 1","pages":"Article 150897"},"PeriodicalIF":1.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142722413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}