Therapeutic Advances in Gastrointestinal Endoscopy最新文献

{"title":"Needle-knife stricturotomy in Crohn's-related anorectal strictures: a prospective study of long-term outcomes, safety profile, and risk factors for recurrence.","authors":"Qi He, Jin Qin, Zouji Wang, Danhua Yao, Yuhua Huang, Tao Tian, Yuexin Wang, Zeyu Ding, Mengyi Zhang, Yousheng Li, Zhenlong Wang","doi":"10.1177/26317745261471450","DOIUrl":"10.1177/26317745261471450","url":null,"abstract":"<p><strong>Background: </strong>Anorectal stricture is a challenging complication of Crohn's disease (CD). Endoscopic needle-knife stricturotomy (NKSt) has emerged as a minimally invasive treatment option, but its long-term outcomes and factors influencing recurrence remain underexplored.</p><p><strong>Objectives: </strong>This study aimed to prospectively evaluate the long-term efficacy, safety, and risk factors for recurrence after NKSt for primary high-grade anorectal strictures in CD.</p><p><strong>Design: </strong>Single-center prospective cohort study.</p><p><strong>Methods: </strong>Between October 2020 and September 2023, 54 consecutive CD patients with primary high-grade anorectal strictures undergoing NKSt were enrolled. The primary endpoint was stricture recurrence requiring re-intervention. Risk factors were analyzed using univariable and multivariable Cox proportional hazards regression. Recurrence-free survival was estimated with the Kaplan-Meier method. A restricted cubic spline model within the Cox framework was employed to explore the nonlinear relationship between stricture length and recurrence.</p><p><strong>Results: </strong>The median follow-up was 24 months (interquartile range (IQR): 6-43). Immediate technical success was achieved in all patients (100%), and 38 patients (70.4%) reported symptomatic improvement at 3 months. Recurrence occurred in 20 patients (37.0%). Multivariable analysis identified stricture length (hazard ratio (HR) 1.184 per cm increase, 95% confidence interval (CI): 1.015-1.380; <i>p</i> = 0.032), the presence of an ostomy (HR 3.901, 95% CI: 1.406-10.823; <i>p</i> = 0.009), and concurrent biologic therapy (HR 0.177, 95% CI: 0.057-0.546; <i>p</i> = 0.003) as independent predictors of recurrence. In univariable analysis, NKSt combined with bleomycin injection was associated with a lower recurrence risk compared to NKSt alone (<i>p</i> = 0.027).</p><p><strong>Conclusion: </strong>NKSt is an effective and safe treatment for primary high-grade anorectal strictures in CD, although recurrence is common. Stricture length, ostomy status, and the use of biologic agents are independent predictors of recurrence, while concomitant bleomycin injection may reduce recurrence risk. These findings can inform individualized treatment strategies and highlight the need for validation in larger, multicenter trials.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745261471450"},"PeriodicalIF":1.2,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654716","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":"Optimizing bowel preparation regimens for colon capsule endoscopy: an umbrella review (overview of systematic reviews).","authors":"Pablo Cortegoso Valdivia, Noemi Gualandi, Giuliano Francesco Bonura, Mauro Manno, Marco Pennazio, Ervin Toth, Jean-François Rey, Reena Sidhu, Anastasios Koulaouzidis","doi":"10.1177/26317745261463059","DOIUrl":"10.1177/26317745261463059","url":null,"abstract":"<p><strong>Background: </strong>Colon capsule endoscopy (CCE) is a minimally invasive alternative to colonoscopy, but its diagnostic performance depends entirely on adequate mucosal cleansing (adequate cleansing rate, ACR) and complete colonic transit (completion rate, CR). These requirements impose stringent preparation demands. Existing systematic reviews (SRs) show substantial heterogeneity in recommendations.</p><p><strong>Objectives: </strong>To identify optimal CCE preparation strategies.</p><p><strong>Design: </strong>Umbrella review (overview of SRs).</p><p><strong>Methods: </strong>A comprehensive literature search was conducted through November 2025 for SRs and meta-analyses (MAs) assessing CCE bowel preparation regimens. Methodological quality was assessed using AMSTAR2, and primary study overlap was quantified using the Corrected Covered Area (CCA). Outcomes included ACR and CR, stratified by preparation components.</p><p><strong>Results: </strong>Fourteen SRs (11 MAs) encompassing 102 primary studies (moderate overlap, CCA 8.59%) were included. Pooled ACR (72.5%-76.8%) and CR (79.8%-83.0%) remained below colonoscopy benchmarks. In inflammatory bowel disease, ACR varied widely (49%-98.5%) with no superior regimen. In the general population, low-volume polyethylene glycol (PEG <4 L) yielded higher ACR (77.5%) than high-volume PEG (72.9%). Sodium phosphate (NaP) boosters outperformed PEG specifically for CR, with NaP + Gastrografin achieving the highest CR (93.1%). Castor oil improved excretion (OR 0.17 of incomplete CCE transit, 95% CI 0.09-0.32), and routine prokinetics improved CR compared with no use (OR 1.86, 95% CI 1.13-3.05). Low-fiber diets provided better cleansing than clear liquids (ACR 78.5% vs 70.0%).</p><p><strong>Conclusion: </strong>Current CCE bowel preparation regimens demonstrate variable performance relative to targets, with no single intervention demonstrating unequivocal superiority over others in pairwise comparisons. Evidence supports optimizing performance via low-volume PEG, NaP or Gastrografin-based boosters, routine prokinetics, and a low-fiber diet. A universal regimen is unlikely to suit all patients, highlighting the need for personalized protocols. Standardized cleansing scores and AI-assisted assessment are critical to improving reproducibility and cost-effectiveness.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745261463059"},"PeriodicalIF":1.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392145","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 biliary stenting combined with nasobiliary drainage in hilar malignant biliary obstruction.","authors":"Yonghua Shen, Zongliang Wu, Xinyi Zhao, Taishun Li, Lei Xu, Nannan Zhang, Xiaojiao Zheng, Xiaoliang Zhou, Yanqing Zheng, Lei Wang","doi":"10.1177/26317745261457315","DOIUrl":"10.1177/26317745261457315","url":null,"abstract":"<p><strong>Background: </strong>There is no consensus on the optimal endoscopic drainage strategy for hilar malignant biliary obstruction (HMBO).</p><p><strong>Objectives: </strong>To compare transpapillary plastic stent (PS) plus endoscopic nasobiliary drainage (ENBD) with PSs alone for HMBO, and to evaluate risk factors for cholangitis in the combined strategy group.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>A total of 175 consecutive patients with HMBO (Bismuth type II-IV) who underwent either PS plus ENBD or PSs alone were enrolled. Propensity score matching (1:1) was performed to reduce selection bias. The primary endpoint was successful drainage. Univariate analysis was used to identify risk factors for cholangitis in the PS plus ENBD group.</p><p><strong>Results: </strong>After matching, 74 patients remained in each group, with balanced baseline characteristics. Successful drainage rates were 77.0% in the PS plus ENBD group and 68.9% in the PSs alone group (<i>p</i> = 0.267). The PSs alone group had significantly higher rates of cholangitis (23.0% vs 10.8%, <i>p</i> = 0.048) and overall adverse events (29.7% vs 12.2%, <i>p</i> = 0.009). No significant differences were observed in biliary patency, reintervention, or survival time between groups. In the PS plus ENBD group, initial drainage was associated with cholangitis (100.0% vs 59.3%, <i>p</i> = 0.011), and median drainage volume was lower in patients who developed cholangitis (85 mL vs 250 mL, <i>p</i> = 0.021). In 19 patients, the nasobiliary catheter was snipped to convert external to internal drainage.</p><p><strong>Conclusion: </strong>Endoscopic biliary stenting combined with ENBD followed by catheter snipping is a safe and effective approach for HMBO. The addition of ENBD was associated with reduced rates of cholangitis and overall adverse events. In this combined strategy, lack of initial drainage and low drainage volume were associated with cholangitis.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745261457315"},"PeriodicalIF":1.2,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370183","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":"Post-ERCP pancreatitis after self-expanding metal stent placement in patients with pancreatic versus non-pancreatic malignant biliary obstruction.","authors":"Jad AbiMansour, Bret T Petersen, Eric J Vargas Valls, Ryan Law, Samuel Han, Vinay Chandrasekhara","doi":"10.1177/26317745261458987","DOIUrl":"10.1177/26317745261458987","url":null,"abstract":"<p><strong>Background: </strong>Self-expanding metal stents (SEMS) are recommended for the endoscopic palliation of distal malignant biliary obstruction (DMBO). Placement of SEMS during endoscopic retrograde cholangiopancreatography (ERCP) has been associated with an increased risk of post-ERCP pancreatitis (PEP).</p><p><strong>Objectives: </strong>The aim of this study is to evaluate rates of PEP in patients who underwent SEMS placement for pancreatic versus non-pancreatic malignancy.</p><p><strong>Design: </strong>Retrospective Cohort Study.</p><p><strong>Methods: </strong>Patients who underwent SEMS placement for DMBO between June 2017 and May 2021 were identified retrospectively from a procedural billing database. PEP incidence was compared between pancreatic and non-pancreatic DMBO groups and multivariate logistic regression was performed to identify risk factors for PEP.</p><p><strong>Results: </strong>A total of 488 individuals were identified, with 395 (80.9%) cases of DMBO due to pancreatic and 93 (19.1%) due to non-pancreatic malignancy. Stent types included 124 (25.4%) fully covered (FCSEMS) and 364 (74.6%) uncovered metal stents (UCSEMS). The overall rate of PEP in the cohort was 6.3% with no significant difference between pancreatic and non-pancreatic etiologies (6.1% vs 7.5%, <i>p</i> = 0.606). When adjusted for age <50 years old, female sex, and pancreatic stent placement, a non-pancreatic malignancy was not associated with an increased risk of PEP (OR 0.83, 95% CI 0.36-2.15).</p><p><strong>Conclusion: </strong>No statistically significant difference in PEP rates was seen after biliary sphincterotomy and SEMS placement for palliation of DMBO in patients with pancreatic versus non-pancreatic malignancies.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745261458987"},"PeriodicalIF":1.2,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13305409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346654","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":"Probing the gut barrier: epithelial permeability as a dynamic marker in eosinophilic gastroenteritis via pCLE.","authors":"Paola Spessotto, Alberto Piacentini, Riccardo Rebuzzi, Diego Rossi, Adrian Zdjelar, Chiara Cigana, Silvia Crestani, Mariagrazia Michieli, Edoardo Vincenzo Savarino, Antonio Di Sabatino, Stefania Maiero, Renato Cannizzaro, Stefano Realdon","doi":"10.1177/26317745261436496","DOIUrl":"10.1177/26317745261436496","url":null,"abstract":"<p><p>Eosinophilic gastroenteritis (EGE) is a rare, chronic inflammatory condition characterized by symptoms and eosinophilic infiltration of the gastrointestinal tract in the absence of secondary causes of gastrointestinal eosinophilia. The advent of probe-based confocal laser endomicroscopy (pCLE) has introduced the possibility of real-time, in vivo microscopic imaging, enabling dynamic assessment of mucosal architecture and barrier function. We report the case of a 32-year-old woman with an atypical manifestation of mucosal EGE, initially presenting with pseudothrombotic microangiopathy secondary to vitamin B12 deficiency. The diagnostic work-up included standard endoscopy, histopathological examination of biopsy samples, and pCLE imaging. pCLE was performed both at baseline and during follow-up to evaluate disease distribution and monitor therapeutic response. Imaging was conducted using the GastroFlex UHD Confocal Miniprobe connected to the Cellvizio system, with images captured within 10 min of intravenous fluorescein administration, digitally stored, and later reviewed by blinded pCLE experts. Initial assessment revealed marked eosinophilic infiltration in the stomach, terminal ileum, and cecum, with corresponding interstitial leakage and inflammatory cell infiltration observed on pCLE. Increased epithelial permeability was also detected in additional intestinal segments lacking histological involvement. After 5 weeks of corticosteroid therapy, the patient achieved clinical and histological remission, accompanied by normalization or significant improvement in pCLE findings. Interestingly, pCLE continued to reveal subtle barrier dysfunction in regions showing histological recovery, highlighting persistent subclinical mucosal alterations. This case underscores the value of pCLE in identifying early intestinal barrier dysfunction and in monitoring therapeutic response in EGE. The concordance between pCLE imaging, histological findings, and clinical outcomes supports its use as a complementary diagnostic and monitoring tool in EGE management.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745261436496"},"PeriodicalIF":1.2,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147976196","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":"Toward high-quality bowel preparation in Italy: insights from a nationwide cross-sectional survey of endoscopists.","authors":"Cesare Hassan, Roberto Di Mitri, Lorenzo Fuccio, Marcello Maida, Gianpiero Manes, Mauro Manno, Franco Radaelli, Cristiano Spada, Roberto Vassallo, Alessandro Repici","doi":"10.1177/26317745261441726","DOIUrl":"10.1177/26317745261441726","url":null,"abstract":"<p><strong>Background: </strong>Understanding endoscopists' perspectives and routine practice offers opportunities to improve bowel cleansing for colonoscopy.</p><p><strong>Objective: </strong>To elucidate Italian endoscopists' perceptions of bowel preparation quality, focusing on defining high-quality cleansing (HQC) and its perceived benefits in clinical practice and for diagnostic outcomes.</p><p><strong>Design: </strong>Nationwide, cross-sectional, web-based survey.</p><p><strong>Methods: </strong>A nationwide, web-based cross-sectional survey was undertaken in Italy between August and September 2024 among gastroenterologists with special interest in endoscopy. Participants were recruited via telephone screening; of 498 gastroenterologists contacted, 150 respondents completed an online questionnaire; analyses were descriptive.</p><p><strong>Results: </strong>The survey results revealed that all respondents (100%) routinely evaluate and document cleansing in the endoscopy report and almost all (99%) used validated scales. The majority (72%) of endoscopists aimed for HQC, which they defined as a segment score of ⩾8-9 on the Boston Bowel Preparation Scale or 'excellent' on the Aronchick scale. Almost all (93%) considered HQC important in every colonoscopy regardless of indication. All respondents considered that HQC allows higher identification rates for adenomas and sessile serrated lesions, reduces procedure time, and improves overall clinical efficiency; 99% considered that HQC allows for more appropriate surveillance intervals. On a scale of 1-10 to rate confidence with the diagnostic reliability of the exam (1 = not at all confident, 10 = very confident), the respondents' levels of confidence improved with high-quality bowel preparation; mean scores were 2.1 with inadequate preparation, 6.6 with good cleansing and 9.2 with high-quality bowel cleansing.</p><p><strong>Conclusion: </strong>The survey revealed that the vast majority of Italian endoscopists consider HQC essential across all clinical indications. The results support the transition from 'good' to 'high-quality' cleansing as the new standard in clinical colonoscopy practice.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745261441726"},"PeriodicalIF":1.2,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13167322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147943138","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":"Patient experiences of colon capsule endoscopy: a qualitative study.","authors":"Laura Jefferson, Holly Essex, Karl Atkin, Veronica Dale, Karen Bloor, Monica Haritakis, James Turvill","doi":"10.1177/26317745261433689","DOIUrl":"10.1177/26317745261433689","url":null,"abstract":"<p><strong>Background: </strong>Colon capsule endoscopy (CCE) was introduced by NHS England at scale during the COVID-19 pandemic to support colorectal diagnostics recovery. However, little was known about the patient experience of CCE.</p><p><strong>Objective: </strong>To explore the experiences of CCE during the NHS England pilot, to better understand what a patient-centered service for the future should look like.</p><p><strong>Design: </strong>A qualitative study to explore the patient and clinician experiences of CCE.</p><p><strong>Methods: </strong>Focus group discussions (<i>n</i> = 25 participants) and semi-structured interviews (<i>n</i> = 7), selected purposively on the basis of maximum variation, generated qualitative material exploring patient understanding, preferences and experiences. To place their experiences in context, we conducted asynchronous focus group discussions with clinicians (<i>n</i> = 16). Analysis was thematic.</p><p><strong>Results: </strong>Most patients valued CCE's convenience and would repeat it, although for some their experiences would deter them from having the procedure again. Anxieties included fear when swallowing the capsule; concerns about it becoming stuck and/or whether the recording was working; what to do when the capsule was inside them; and worries about the novelty of the treatment. Women expressed greater discomfort, pain and anxieties during bowel preparation and the procedure than men. Participants highlighted the need for a more balanced description of the procedure than indicated in information leaflets and videos. They particularly felt the possibility of further investigations could be better explained. Healthcare professionals may underestimate patient concerns.</p><p><strong>Conclusion: </strong>CCE has the potential to expand colorectal diagnostic capacity but requires patients to be well informed and supported throughout the process. Gender differences in experiences of CCE are notable and could be partially addressed by providing more specific information, consistent with women's experiences.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745261433689"},"PeriodicalIF":1.2,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575768","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":"Clinical efficacy and safety of short-length peroral endoscopic myotomy (POEM) compared with long-length myotomy for the treatment of achalasia.","authors":"Valentina Dávila-Ruales, Hernando J Vergara, Oscar M Muñoz, Alexander Castañeda, Rómulo D Vargas, Jesús A Rodríguez","doi":"10.1177/26317745261433142","DOIUrl":"10.1177/26317745261433142","url":null,"abstract":"<p><strong>Background: </strong>Previous evidence suggests that a short myotomy does not reduce the efficacy of peroral endoscopic myotomy (POEM) or increase intraoperative complications. However, the available studies are still limited and there has been no research in Latin America.</p><p><strong>Objectives: </strong>This study aims to evaluate whether POEM with a short myotomy differs significantly from a long myotomy in terms of efficacy and safety in patients with achalasia.</p><p><strong>Design/methods: </strong>A retrospective cohort study including patients who underwent POEM for achalasia between 2017 and 2024. Efficacy was assessed according to the Eckardt scale at 6 months and at 1 year of follow-up. Safety was assessed for perioperative adverse events according to the iPOEM classification.</p><p><strong>Results: </strong>A total of 57 patients were included, 44% underwent short myotomy (median esophageal length of 5 cm; interquartile range (IQR) 4-5), and 56% long myotomy (median 11 cm IQR 10-13). 35% had previously undergone surgery for achalasia. The long myotomy group had more frequently minor complications such as emphysema (15.6% vs 0%; <i>p</i> = 0.039), capnoperitoneum (65.6% vs 16.0%, <i>p</i> < 0.001) and required more abdominal punctures (56.2% vs 12.0%, <i>p</i> < 0.001). There was no difference in the incidence of other complications. The probability of symptomatic response, defined as an Eckardt score ⩽ 3 at 12 months, was similar between groups (84.3% vs 88%, <i>p</i> = 0.69). The median operative time for the short myotomy was shorter (median 80 min; IQR 70-95 vs 127.5 min; IQR 102-155 min; <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Short myotomy is not inferior to long myotomy in terms of clinical success and long-term reflux disease in the management of patients with achalasia. Furthermore, it offers advantages such as shorter procedure times and potentially lower rates of minor complications, making it the preferred option in most cases.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745261433142"},"PeriodicalIF":1.2,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13009758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515662","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":"Benign gastric outlet obstruction: evolving strategies from surgery to endoscopic ultrasound-guided gastrojejunostomy.","authors":"Giacomo Emanuele Maria Rizzo, Giuseppe Infantino, Gabriele Rancatore, Dario Quintini, Dario Ligresti, Nicoletta Belluardo, Giuseppe Rizzo, Elio D'amore, Marco Giacchetto, Ilaria Tarantino","doi":"10.1177/26317745251398950","DOIUrl":"10.1177/26317745251398950","url":null,"abstract":"<p><p>Benign gastric outlet obstruction (bGOO) presents a significant therapeutic challenge, with etiologies ranging from peptic strictures to complex postsurgical or inflammatory conditions. While surgery has historically offered durable outcomes, its morbidity in frail populations underscores the need for effective, less invasive alternatives. This review critically examines the current literature up to April 2025 on surgical, endoscopic, and endoscopic ultrasound-guided interventions for bGOO, evaluating technical success, clinical outcomes, recurrence rates, and adverse events. Endoscopic balloon dilation shows excellent efficacy in simple peptic strictures but has limited efficacy in anatomically complex cases. Fully covered self-expandable metal stents can provide temporary relief but are associated with significant migration risk. Among emerging techniques, endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) stands out by combining the anatomical efficacy of surgery with the minimal invasiveness of endoscopy. Recent studies report technical and clinical success rates exceeding 95%, with lower recurrence and complication rates compared to traditional approaches. Comparative data increasingly support EUS-GJ as the preferred option in refractory or high-risk patients. Tailoring treatment strategies based on etiology, anatomical complexity, and patient condition is essential. EUS-GJ is redefining the therapeutic landscape of bGOO, offering a minimally invasive and durable alternative to surgery in carefully selected cases.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745251398950"},"PeriodicalIF":1.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147366821","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":"Gastrointestinal endoscopy and visceral surgery: current status and potentials for interdisciplinary patient care.","authors":"Quang Trung Tran, Dai Que Vu, Irka Wiedenhaupt, Ali Aghdassi, Tobias Kleemann","doi":"10.1177/26317745251409064","DOIUrl":"10.1177/26317745251409064","url":null,"abstract":"<p><p>Gastrointestinal (GI) endoscopy and visceral surgery have been tightly merging to change GI disease diagnosis and the course of treatment. In addition to facilitating minimally invasive therapeutic procedures and improving postoperative outcomes, this synergistic strategy increases diagnostic precision. Recent technical advancements, such as high-definition endoscopic imaging, robotic-assisted surgery, and artificial intelligence integration, have refined patient care. The historical development, current therapeutic application, interdisciplinary collaborations, and potential future directions of integrating endoscopy and visceral surgery are covered in this review. It also discusses the difficulties in putting advanced approaches into clinical practice, including the need for specialized training and ethical issues. It is important to fully realize how endoscopic and surgical cooperation could translate into GI healthcare.</p>","PeriodicalId":40947,"journal":{"name":"Therapeutic Advances in Gastrointestinal Endoscopy","volume":"19 ","pages":"26317745251409064"},"PeriodicalIF":1.2,"publicationDate":"2026-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285508","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}