Techniques and Innovations in Gastrointestinal Endoscopy最新文献

{"title":"Accuracy and Safety of Endoscopic Ultrasound–Guided Liver Biopsy in Patients with Metabolic Dysfunction–Associated Liver Disease","authors":"JEROME C. EDELSON , ERIC M. MONTMINY , CARL L. KAY , TYLER H. DOTY , MATTHEW J. SCHWARTZ , 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 , DONGHEON LEE , EUN HYO JIN , HAE YEON KANG , JI YEON SEO , 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":"Over-the-Scope Clip versus Standard Endoscopic Therapy as First-Line Intervention for Nonvariceal Upper Gastrointestinal Bleeding: A Cost-Effectiveness Analysis","authors":"Sneh Sonaiya ,&nbsp;Sahib Singh ,&nbsp;Tooba Laeeq ,&nbsp;Vaishnavi Modi ,&nbsp;Magnus Chun ,&nbsp;Pranav Patel ,&nbsp;Vignan Manne ,&nbsp;Babu P. Mohan","doi":"10.1016/j.tige.2025.250935","DOIUrl":"10.1016/j.tige.2025.250935","url":null,"abstract":"<div><h3>BACKGROUND AND AIMS</h3><div>Recent studies have indicated the superiority of the Over-The-Scope Clip (OTSC) as a first-line treatment compared with standard endoscopic therapy (ST) for nonvariceal upper gastrointestinal bleeding (NVUGIB). Given the high cost of OTSCs, we assessed the cost-effectiveness of OTSCs vs ST for NVUGIB.</div></div><div><h3>METHODS</h3><div>We conducted an incremental cost-effectiveness analysis comparing OTSCs with ST as the first-line hemostatic intervention for NVUGIB over a 30-day period using a decision tree model based on pooled randomized controlled trial data. All costs were derived from Centers for Medicare &amp; Medicaid Services reimbursement data and published literature. Analysis was performed using TreeAge Pro Healthcare 2024.</div></div><div><h3>RESULTS</h3><div>Pooled data of 443 patients (216 OTSCs; 227 ST) were analyzed. For the base case of a 69.8-year-old patient with Forrest Ia, Ib, IIa, or IIb NVUGIB, OTSCs resulted in an incremental cost-effectiveness ratio (ICER) of −$45,454 per quality-adjusted life year (QALY), indicating cost savings. For NVUGIB with stigmata of active bleeding (Forrest Ia or Ib), OTSCs yielded an ICER of −$85,046 per QALY. For acute NVUGIB with high risk of rebleeding (complete Rockall score ≥ 7), OTSCs yielded an ICER of −$112,960 per QALY. OTSCs remained cost-effective compared with ST when the per-OTSC cost was ≤$927 or when ≤2.3 OTSCs were utilized.</div></div><div><h3>CONCLUSION</h3><div>At a willingness-to-pay of $100,000 per QALY, OTSCs are cost-saving compared with ST for Forrest Ia, Ib, IIa, or IIb NVUGIB, as well as NVUGIB with stigmata of active bleeding or high rebleeding risk. Reducing OTSC costs (≤$927) and optimizing usage (≤2 clips) further improve the economic viability of OTSCs. Our findings support OTSCs as a first-line hemostatic intervention for high-risk NVUGIB to improve clinical and economic outcomes.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 4","pages":"Article 250935"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679885","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":"Training in Colorectal Endoscopic Submucosal Dissection: US Perspectives","authors":"Fredy Nehme ,&nbsp;Phillip S. Ge","doi":"10.1016/j.tige.2025.250934","DOIUrl":"10.1016/j.tige.2025.250934","url":null,"abstract":"<div><div>Endoscopic submucosal dissection (ESD) was established in Japan in the early 2000s for the removal of early neoplastic gastrointestinal lesions with high en bloc and curative resection rates. Although ESD has gained widespread use in Asia, its adoption in the West has been gradual. The procedural complexity, steep learning curve, and limited training resources have been major obstacles. Nonetheless, ESD has been gaining popularity in the United States. The growing body of evidence on the efficacy and safety of ESD, technological advancements in endoscopy, and the establishment of effective training systems are contributing to increased adoption of ESD in the West. More endoscopists are showing interest and have started to adopt this technique, with excellent clinical outcomes. Although there is currently no standardized approach for ESD training in the United States, several pathways and training opportunities have emerged to facilitate broader adoption. These programs aim to bridge the proficiency gap by enhancing the trainee’s cognitive and technical skills. This article aimed to review the current state of colorectal ESD training in the West.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 4","pages":"Article 250934"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144686086","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":"Cost-effectiveness of Endoscopic Sleeve Gastroplasty for Obesity: Sufficient Evidence Supporting a Higher Utilization?","authors":"JIANRONG ZHANG","doi":"10.1016/j.tige.2025.250933","DOIUrl":"10.1016/j.tige.2025.250933","url":null,"abstract":"","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 4","pages":"Article 250933"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144885440","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":"Proper Management and Prevention of Bleeding and Perforation in Endoscopic Submucosal Dissection","authors":"Jay Bapaye ,&nbsp;Saurabh Chandan ,&nbsp;Sagar Pathak ,&nbsp;Peter V. Draganov ,&nbsp;Dennis Yang","doi":"10.1016/j.tige.2025.250930","DOIUrl":"10.1016/j.tige.2025.250930","url":null,"abstract":"<div><div>Endoscopic submucosal dissection (ESD) has become widely accepted as a minimally invasive technique for the management of superficial neoplasia throughout the gastrointestinal tract. Despite its therapeutic benefits, ESD is technically demanding, with a steep learning curve and can be associated with serious adverse events (AEs). The most common and clinically significant AEs include intraprocedural or delayed bleeding and perforation. With prompt recognition and intervention, most of these AEs can be safely and adequately managed endoscopically. This review focuses on best practices for the prevention, early identification, and management of ESD-related bleeding and perforation. We aimed to provide insight into the tools, techniques, and general approach on how to mitigate and manage AEs that may arise with the goal of optimizing patient safety and the ongoing adoption of this therapeutic modality.</div></div>","PeriodicalId":36169,"journal":{"name":"Techniques and Innovations in Gastrointestinal Endoscopy","volume":"27 4","pages":"Article 250930"},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865232","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}