Endoscopy International Open最新文献

{"title":"Verification of the increase in concomitant dysplasia and cancer with the size of sessile serrated lesions","authors":"D. Ohki, Y. Tsuji, Hiroyuki Hisada, Hideki Nakagawa, S. Mizutani, Kaori Oshio, Junichi Sato, Dai Kubota, Rina Cho, Y. Miura, H. Mizutani, Yoshiki Sakaguchi, Yu Takahashi, Seiichi Yakabi, Naomi Kakushima, N. Yamamichi, T. Ushiku, Mitsuhiro Fujishiro","doi":"10.1055/a-2246-0820","DOIUrl":"https://doi.org/10.1055/a-2246-0820","url":null,"abstract":"Background and study aims\u0000This study aimed to evaluate the relationship between sessile serrated lesion (SSL) size and the comorbidity rate of SSL with dysplasia (SSLD) and cancer in SSL (SSL-cancer).\u0000Patients and methods \u0000This retrospective, single-center analysis identified SSL cases that underwent endoscopic resection between January 2015 and December 2022. The prevalence of SSL, SSLD, and SSL-cancer and their annual trends were assessed. The tumor diameter was stratified as 0–5 mm, 6–9 mm, 10–19 mm, and ≥ 20 mm in size. Furthermore, the frequency of SSL-D/SSL-cancer was determined in each group.\u0000Results\u0000The prevalence of SSL was 2.9% (1328/45799). This prevalence was 1.8% (112/6192) in 2015 and 4.2% (230/5500) in 2022, indicating an increasing trend over time. A total of 1825 lesions were assessed: 1751 (96.0%), 55 (3.0%), 14 (0.8%) and 5 (0.3%) lesions were SSL, SSL with low grade dysplasia, SSL with high grade dysplasia and SSL-cancer, respectively. Stratifying the SSLs by size: 0–5 mm, 5–9 mm, 10–19 mm, and ≥ 20 mm, SSLD and SSL-cancer rates were 2.3% (10/429), 2.4% (16/674), 5.3% (31/584), and 11.8% (16/136), respectively. SSLD and SSL-cancer were observed in 2.4% (26/1103) of small SSLs less than 10mm. \u0000Conclusion\u0000In cases of SSL, the rate of SSLD and SSL-cancer increased as the lesion diameter increased. A certain rate of SSLD and SSL-cancer was observed even in small SSLs less than 5mm. \u0000\u0000","PeriodicalId":508938,"journal":{"name":"Endoscopy International Open","volume":"25 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139529305","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":"A safe and effective endoscopic treatment method for simple hepatic cysts（with video)","authors":"Congying Chen, Wenqin Xiao, Gang Xu, Xiaobo Cai, Guoyong Hu, Xiao Han, Rong Wan","doi":"10.1055/a-2239-9493","DOIUrl":"https://doi.org/10.1055/a-2239-9493","url":null,"abstract":"Background Symptomatic simple hepatic cysts require treatment, with several guidelines recommending laparoscopic deroofing. However, cysts located in the posterosuperior segments are considered poor candidates for this procedure. Gastrointestinal endoscopes are more flexible and able to reach less accessible areas than laparoscopes. This study aimed to evaluate the utility of endoscopic transgastric hepatic cyst deroofing (ETGHCD) for treatment of simple hepatic cysts. \u0000Methods 7 patients with simple hepatic cysts were evaluated between June 2021 and October 2023. The success rate, procedure time, post-procedure length of hospital stays, complications, pathologic diagnosis, and efficacy were recorded. \u0000Results 11 cysts in 7 patients (5 men; mean age 65.5 (standard deviation [SD] 8.5) years) were successfully treated without any complications. The mean procedure time was 65.6 (SD 17.2) minutes. Mean post-procedure hospitalization was 4.4 (SD 1.0) days. The pathologic diagnosis of 11 cysts showed simple hepatic cysts. The size of cysts was significantly decreased from 337.0 (SD 528.8) cubic centimeters to 5.2 (SD 6.3) cubic centimeters 1 month after ETGHCD. During the median 12.7-month follow-up in 7 patients, the cysts showed a 99.6% reduction with no recurrence. \u0000Conclusions ETGHCD provided a feasible, safe, effective, and minimal invasive alternative approach for the treatment of simple hepatic cysts.","PeriodicalId":508938,"journal":{"name":"Endoscopy International Open","volume":"57 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139447245","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":"Clinical Usefulness of Tissue Acquisition of Pancreatic Cystic Lesions Using an Endoscopic Ultrasound-Guided Needle for Histological Analysis","authors":"J. Castro, Eloy Taglieri, Otávio Micelli Neto, João Guilherme Guerra, F. Venco, E. Andrade, A. Seraphim, Samuel Galante Romanini, Isabela Trindade Torres, J. Serrano, Suzan Menasce Goldman, R. Kemp, J. D. dos Santos, J. Ardengh","doi":"10.1055/a-2240-0678","DOIUrl":"https://doi.org/10.1055/a-2240-0678","url":null,"abstract":"Background and study aim: There are rare data on the usefulness of endosonography-guided tissue acquisition (EUS-TA) in patients with pancreatic cystic lesions (PCLs). This study aimed to determine the accuracy of EUS-TA with ProCore 20G (PC20) for differentiating between mucinous neoplasia (MN) and non-MNs (n-MN) and identifying malignant PCLs, as well as its adverse events (AEs) in patients with PCLs without a classificatory diagnosis by imaging exams. Patients and methods: In this observational, retrospective, single-center study, all patients with PCL who underwent EUS-TA due to diagnostic doubts in imaging studies were consecutively recruited from June 2017 to December 2021. The outcomes were to determine the diagnostic accuracy of EUS-TA with PC20 for differentiating between MN and n-MN, identifying malignant PCLs, and the AEs. Results: Herein, 145 patients underwent EUS-TA, with 83 women (57.2%) and a mean age of 62.2 years. The mean size was 2.3 cm, with 81 patients (77.9%) having a PCL less than 3.0 cm. The final diagnosis was made by EUS-TA (n = 81), surgery (n = 58), and follow-up (n = 6). The sensitivity, specificity, positive and negative predictive values, and accuracy for differentiating between MNs and n-MNs and identifying malignant PCLs were 92.6%, 98.4%, 98.7%, 91.3%, and 95.2% (kappa=0.9), and 92%, 99.2%, 95.8%, 98.3%, and 97.9% (kappa=0.93), respectively. The AE rate was 2.7%, with no deaths in this cohort. Conclusions: EUS-TA with PC20 has high accuracy and technical success with a low AE rate for PCL diagnosis.","PeriodicalId":508938,"journal":{"name":"Endoscopy International Open","volume":"58 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139447764","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":"Development of a novel endoscopic hemostasis-assisted navigation AI system in the standardization of post-ESD coagulation","authors":"H. Fujinami, Shun Kuraishi, Akira Teramoto, Seitaro Shimada, Saeko Takahashi, Takayuki Ando, I. Yasuda","doi":"10.1055/a-2239-9959","DOIUrl":"https://doi.org/10.1055/a-2239-9959","url":null,"abstract":"Study aim: While gastric endoscopic submucosal dissection (ESD) has become a treatment with fewer complications, delayed bleeding remains a challenge. Post-ESD coagulation (PEC) is performed to prevent delayed bleeding. Therefore, we developed an artificial intelligence (AI) to detect vessels that require PEC in real time.\u0000Materials and methods: Training data were extracted from 153 gastric ESD videos with sufficient images taken with a second-look endoscopy (SLE) and annotated as follows: (1) vessels that showed bleeding during SLE without PEC, (2) vessels that did not bleed during SLE with PEC, and (3) vessels that did not bleed even without PEC. The training model was created using Google Cloud Vertex AI, and a program was created to display the vessels requiring PEC in real time using a bounding box. The evaluation of this AI was verified with 12 unlearned test videos, including 4 cases that required additional coagulation during SLE.\u0000Results and Conclusion: The results of the test video validation indicated that 109 vessels on the ulcer required cauterization. Of these, 80 vessels (73.4%) were correctly determined as not requiring additional treatment. However, 25 vessels (22.9%), which did not require PEC, were overestimated. In the four videos that required additional coagulation in SLE, AI was able to detect all bleeding vessels. The effectiveness and safety of this endoscopic treatment-assisted AI system that identifies visible vessels requiring PEC should be confirmed in future studies.","PeriodicalId":508938,"journal":{"name":"Endoscopy International Open","volume":"40 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139446560","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":"Risk factors of early adverse events associated with endoscopic ultrasound-guided hepaticogastrostomy using self-expandable metal stent","authors":"S. Nakaji, Hirokazu Takahashi, Wataru Yoshioka, T. Shiratori, Shigenobu Yoshimura, Natsuki Kawamitsu, Akiko Tomonari","doi":"10.1055/a-2240-1100","DOIUrl":"https://doi.org/10.1055/a-2240-1100","url":null,"abstract":"Background and Study Aim: This retrospective study aimed to investigate risk factors for early adverse events (AEs) associated with endoscopic ultrasonography-guided hepaticogastrostomy (EUS-HGS) using self-expandable metal stents (SEMS).\u0000Patients and Methods: The clinical success rate, technical success rate, and early AEs were assessed at two hospitals from 2010 to 2022. The analysis focused on risk factors associated with cholangitis, peritonitis, and SEMS migration.\u0000Results: Technical success was achieved in all cases (94/94), and clinical success was 96.8% (91/94). Post-procedural acute cholangitis occurred in 12.8% (12/94) of cases. However, no statistically significant risk factors were identified for cholangitis or biliary tract infection. Peritonitis occurred in only 2.1% (2/94) of cases. Univariate analysis, using a 1.5 cm cut-off for the distance between the liver and gastrointestinal tract, revealed significant risk factors: braided-type SEMS, bile duct diameter (especially >4 mm), 6 mm diameter SEMS, and tract dilation (p=0.001, p=0.020, p=0.023, and p=0.046, respectively). Adjusting the cut-offs to 2 cm highlighted braided-type SEMS and tract dilation as risk factors (p=0.002 and p=0.046, respectively). With 2.5 cm cut-offs, only braided-type SEMS remained significant (p=0.018). Mortality within 14 and 30 days following EUS-HGS was 5.3% (5/94) and 16.0% (15/94), respectively.\u0000Conclusions: EUS-HGS using SEMS demonstrated high technical and clinical success rates. Laser-cut SEMS may be superior in preventing early AEs.","PeriodicalId":508938,"journal":{"name":"Endoscopy International Open","volume":"36 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139447999","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":"Deep Learning and Capsule Endoscopy: Automatic Multi-brand and Multi-device Panendoscopic Detection of Vascular Lesions","authors":"M. Mascarenhas, Miguel Martins, J. Afonso, T. Ribeiro, P. Cardoso, Franscisco Mendes, Patrícia Andrade, Hélder Cardoso, Miguel Mascarenhas-Saraiva, J. Ferreira, G. Macedo","doi":"10.1055/a-2236-7849","DOIUrl":"https://doi.org/10.1055/a-2236-7849","url":null,"abstract":"Introduction: Capsule endoscopy (CE) is commonly used as the initial exam for suspected mid-gastrointestinal bleeding after normal upper and lower endoscopy. Although the assessment of the small bowel is the primary focus of CE, detecting upstream or downstream vascular lesions may also be clinically significant. This study aimed to develop and test a Convolutional Neural Network (CNN)-based model for panendoscopic automatic detection of vascular lesions during CE.\u0000Methods: A multicentric AI model development study was based on 1022 CE exams. Our group used 34655 frames from seven types of CE devices, of which 11091 were considered to have vascular lesions (angiectasia or varices) after triple validation. We divided data into a training and a validation set, and the latter was used to evaluate the model’s performance. At the time of division, all frames from a given patient were assigned to the same dataset. Our primary outcome measures were sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and an area under the precision-recall curve (AUC-PR).\u0000Results: Sensitivity and specificity were 86.4% and 98.3%, respectively. PPV was 95.2%, while the NPV was 95.0%. Overall accuracy was 95.0%. The AUC-PR value was 0.96. The CNN processed 115 frames per second.\u0000Conclusion: This is the first proof-of-concept AI deep learning model developed for pan-endoscopic automatic detection of vascular lesions during CE. The diagnostic performance of this CNN in multi-brand devices addresses an essential issue of technological interoperability, allowing it to be replicated in multiple technological settings.\u0000","PeriodicalId":508938,"journal":{"name":"Endoscopy International Open","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139389878","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":"Per-oral cholangioscopy in patients with primary sclerosing cholangitis: a 12-month follow-up study","authors":"Rachid Mohamed, S. Tejaswi, L. Aabakken, Cyriel Y Ponsioen, C. Bowlus, Douglas G. Adler, Nauzer Forbes, V. Paulsen, R. Voermans, S. Urayama, Joyce A. Peetermans, M. Rousseau, B. Eksteen","doi":"10.1055/a-2236-7557","DOIUrl":"https://doi.org/10.1055/a-2236-7557","url":null,"abstract":"Background & Aims: Patients with primary sclerosing cholangitis (PSC) have a 9%-20% lifetime incidence of cholangiocarcinoma (CCA). Per-oral cholangioscopy (POCS) added to endoscopic retrograde cholangiography (ERC) could potentially improve detection of CCA occurrence. We prospectively assessed POCS identification of 12-month CCA incidence in PSC patients undergoing ERC. \u0000\u0000Methods: Consecutive patients with PSC, an indication for ERC, and no prior liver transplantation were enrolled. During the index procedure, POCS preceded planned therapeutic maneuvers. The primary endpoint was ability of POCS visualization with POCS-guided biopsy to identify CCA during 12-month follow-up. Secondary endpoints included ability of ERC/cytology to identify CCA, repeat ERC, liver transplantation, and serious adverse events (SAEs).\u0000 \u0000Results: Of 42 patients enrolled, 36 with successful cholangioscope advancement were analyzed. Patients had mean age 43.5±15.6 years, and 61% were male. Three patients diagnosed with CCA had POCS visualization impressions of benign/suspicious/suspicious, and respective POCS-guided biopsy findings of suspicious/positive/suspicious for malignancy at the index procedure. The 3 CCA cases had ERC visualization impressions of benign/benign/suspicious, and respective cytology findings of atypical/atypical/suspicious for malignancy. No additional patients were diagnosed with CCA during median 11.5-month follow-up. Twenty-three repeat ERCs (5 including POCS) were performed in 14 patients. Five patients had liver transplantation, one after CCA diagnosis and 4 after benign cytology at the index procedure. Three patients (7.1%) had post-ERC pancreatitis. No SAEs were POCS-related. \u0000\u0000Conclusion: In PSC patients, POCS visualization/biopsy and ERC/cytology each identified 3 cases of CCA. Some patients had a repeat procedure and none experienced POCS-related SAEs. (ClinicalTrials.gov number, NCT03766035).","PeriodicalId":508938,"journal":{"name":"Endoscopy International Open","volume":"104 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139391333","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":"Establishing the optimal number of passes during EUS-guided fine needle biopsy for the diagnosis of pancreatic solid lesions: a prospective multicente","authors":"B. Mangiavillano, A. Facciorusso, Francesco Maria Di Matteo, Carmelo Barbera, A. Larghi, G. Rizzatti, Silvia Carrara, A. Lisotti, Pietro Fusaroli, L. De Luca, M. Di Leo, M. C. Conti Bellocchi, M. Spadaccini, Emanuele Dabizzi, F. Auriemma, S. Stigliano, Daryl Ramai, F. Calabrese, E. Manfrin, D. Paduano, C. Hassan, Alessandro Repici, S. Crinó","doi":"10.1055/a-2236-7654","DOIUrl":"https://doi.org/10.1055/a-2236-7654","url":null,"abstract":"Background and study aims: The optimal number of needle passes during endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is not yet established. We aimed to perform a per-pass analysis of the diagnostic accuracy of EUS-FNB of solid pancreatic lesions using a 22G Franseen needle.\u0000\u0000Patients and methods: Consecutive patients with solid pancreatic lesions referred to 11 Italian centers were prospectively enrolled. Three needle passes were performed; specimens were collected after each pass and processed individually as standard histology following macroscopic on-site evaluation (MOSE) by the endoscopist. The primary endpoint was diagnostic accuracy of each sequential pass. Final diagnosis was established on surgical pathology or based on clinical course of at least six months. Secondary endpoints were specimen adequacy, MOSE reliability, factors impacting diagnostic accuracy, and procedure-related adverse events.\u0000\u0000Results: 504 samples from 168 patients were evaluated. Diagnostic accuracy was 90.5% (85.0%-94.1%) after one pass and 97.6% (94.1%-99.3%) after two passes (p=0.01). Similarly, diagnostic sensitivity and sample adequacy were significantly higher adding the second needle pass (90.2%, 84.6%-94.3% vs 97.5%, 93.8%-99.3%, p=0.009 and 91.1%, 85.7%-94.9% vs 98.2%, 95.8%-99.3%, p=0.009, one pass vs two passes, respectively). Accuracy, sensitivity, and adequacy remained the same after the third pass. The concordance between MOSE and histological evaluation was 89.9%. The number of passes was the only factor associated with accuracy. One case of mild acute pancreatitis (0.6%) was managed conservatively.\u0000\u0000Conclusions: At least two passes should be performed for the diagnosis of solid pancreatic lesions. MOSE is a reliable tool to predict the histological adequacy of specimens.","PeriodicalId":508938,"journal":{"name":"Endoscopy International Open","volume":"60 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139390031","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}