Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society最新文献

{"title":"A Novel Method for Effective Closure of Mucosal Defects After Endoscopic Full-Thickness Resection Using a Dual-Channel Endoscope.","authors":"Geng Qin, Guanyu Chen, Shiyu Du","doi":"10.1111/den.15080","DOIUrl":"https://doi.org/10.1111/den.15080","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585769","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 of Metastasis and Local Residual Cancer After Non-Curative Endoscopic Submucosal Dissection for Esophageal Cancer.","authors":"Ryu Ishihara, Hirofumi Kawakubo, Yoshinobu Yamamoto, Jun Nakamura, Takako Yoshii, Hiroshi Sato, Akira Nakano, Takashi Ogata, Yusuke Okuda, Kazuhiro Furukawa, Osamu Dohi, Koji Miyahara, Yoichi Hamai, Tomonori Yano, Hiroya Takeuchi","doi":"10.1111/den.15082","DOIUrl":"https://doi.org/10.1111/den.15082","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic submucosal dissection (ESD) is widely used to treat early-stage esophageal squamous cell carcinoma (SCC). However, the risk of recurrence in non-curative cases remains uncertain. This study aimed to elucidate the risk of local and metastatic recurrence of esophageal SCC treated with ESD.</p><p><strong>Methods: </strong>We retrospectively analyzed data for 222 patients who underwent ESD followed by esophagectomy and fulfilled the following criteria: (1) no metastatic lesions diagnosed before ESD and (2) pathologically diagnosed SCC with SM invasion regardless of VM status or pathologically diagnosed SCC with lymphovascular invasion. The primary outcome was the proportion of metastasis and local residual cancer determined using the pathological findings of additional esophagectomy specimens and follow-up data.</p><p><strong>Results: </strong>For submucosal cancer with positive lymphovascular invasion, the metastasis rate was 29.5% (23/78) compared with 8.8% (5/57) in submucosal cancers with negative lymphovascular invasion. The metastasis rate for vertical margin (VM) 1 or VMX was 30.8% (16/52) compared with 20.7% (28/135) in submucosal cancer. Local residual cancer was observed in 10 (19.2%) individuals with VM1/X, with 80% of these involving the submucosal layer (n = 4) and muscularis propria or deeper (n = 4). Among cases with VM0, local residual cancer was observed in six (3.5%) individuals, of which 66.7% were mucosal cancers.</p><p><strong>Conclusions: </strong>In conclusion, the proportions of metastasis and local residual cancer in non-curative cases were clarified. While additional treatment is necessary to reduce these risks, if a patient is managed with observation alone, strict surveillance that accounts for these risks is required.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577114","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":"Evolving Role of Artificial Intelligence in Endoscopic Management of Inflammatory Bowel Disease: Diagnosis, Surveillance, and Assessment.","authors":"Virginia Gregorio, Yasuharu Maeda, Shin-Ei Kudo, Yurie Kawabata, Takanori Kuroki, Giovanni Santacroce, Miguel Puga-Tejada, Kento Takenaka, Kaoru Takabayashi, Jun Ohara, Chiyo Maeda, Katsuro Ichimasa, Masashi Misawa, Noriyuki Ogata, Haruhiko Ogata, Kazuo Ohtsuka, Marietta Iacucci","doi":"10.1111/den.15081","DOIUrl":"https://doi.org/10.1111/den.15081","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, presents substantial diagnostic and management challenges because of its variable clinical course and the limitations of conventional endoscopy. Although endoscopic procedures are crucial for diagnosis and surveillance, their inherent subjectivity and inter-observer variability complicate disease assessment. Recent advances in artificial intelligence (AI) offer promising solutions to these challenges by enabling automated, precise, and objective image analysis. AI technologies have demonstrated success in diagnosing IBD, distinguishing it from other gastrointestinal disorders, and facilitating early identification of neoplasia in IBD patients, improving clinical decision-making and potentially reducing the need for invasive procedures. Furthermore, AI applications for evaluating endoscopic images have enhanced the accuracy of disease severity assessments such as the Mayo Endoscopic Score and Ulcerative Colitis Endoscopic Index of Severity by overcoming issues related to observer variability. Integration of AI with advanced endoscopic technologies, including image-enhanced and magnified endoscopy, further improves lesion characterization and offers insights into mucosal healing, which is crucial for optimizing treatment. While AI's potential in IBD management is substantial, challenges remain in its clinical implementation, necessitating further validation through real-world data and regulatory approval. This review explores the evolving role of AI in transforming IBD diagnosis, surveillance, and assessment, with a focus on enhancing patient care through improved precision and efficiency.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562049","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":"Disposable Colonoscopes: Unpacking the Infection-Free Endoscopy With the REAL Price Tag-What About Performance?","authors":"Yoshihiro Kishida, Shiro Oka","doi":"10.1111/den.15083","DOIUrl":"https://doi.org/10.1111/den.15083","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562147","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":"Effect of Computer-Aided Detection During Colonoscopy on Adenoma Detection Rate in a Community Hospital Setting: Randomized Controlled Trial.","authors":"Yohei Yabuuchi, Kazuya Hosotani, Yoshiki Morihisa, Yukie Fujio, Daisuke Oshikawa, Manami Oshita, Momoko Iketani, Kazuyuki Tsukamoto, Asuka Sone, Toshiya Nanjo, Ryoko Tatsuno, Kosuke Tanaka, Soichiro Nagao, Shinsuke Akiyama, Gensho Tanke, Masaya Wada, Shuko Morita, Satoko Inoue, Hobyung Chung, Yoshitaka Nishikawa, Tetsuro Inokuma","doi":"10.1111/den.15086","DOIUrl":"https://doi.org/10.1111/den.15086","url":null,"abstract":"<p><strong>Objectives: </strong>Computer-aided detection (CADe) is promising for improving adenoma detection rates (ADRs) but mostly in academic centers. Therefore, we evaluated the effect of CADe on ADR and related outcomes in a Japanese community hospital setting.</p><p><strong>Methods: </strong>In this single-center, randomized controlled trial conducted between September 2022 and August 2023, patients were eligible for inclusion if they were 40 years of age or older and had undergone colonoscopy for screening, post-polypectomy surveillance, a positive fecal immunochemical test, or symptoms. Patients were randomized at a 1:1 ratio to undergo colonoscopy with or without CADe. The primary outcome was ADR. Secondary outcomes included the number of adenomas per colonoscopy (APC) and the withdrawal time.</p><p><strong>Results: </strong>A total of 1041 patients were recruited. After exclusion, 497 and 501 patients in the control and CADe groups, respectively, were included in the analysis. ADR was 54.5% in the control group and 50.7% in the CADe group, with no significant difference between the groups (adjusted risk ratio, 0.93; 95% confidence interval [CI], 0.83-1.05). The mean number of APC was lower in the CADe group than in the control group (1.34 vs. 1.14) (adjusted rate ratio, 0.86; 95% CI, 0.77-0.96). The mean withdrawal time was longer in the CADe group than in the control group (691 vs. 751 s, p = 0.034).</p><p><strong>Conclusions: </strong>CADe did not significantly improve ADR in a Japanese community hospital setting, possibly due to the high baseline ADR in the control group. Further research is needed to understand in which settings CADe is useful.</p><p><strong>Trial registration: </strong>University Hospital Medical Information Network Clinical Trials Registry: UMIN000049054.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562048","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":"Underwater Endoscopic Mucosal Resection With a Multiloop Traction Device for a Colorectal Tumor at the Flexure.","authors":"Kazuki Matsuyama, Minoru Kato, Tomoki Michida","doi":"10.1111/den.15079","DOIUrl":"https://doi.org/10.1111/den.15079","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562050","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":"Comparison of Remimazolam and Propofol for Sedation in Endoscopic Retrograde Cholangiopancreatography: A Systematic Review and Meta-Analysis With Trial Sequential Analysis.","authors":"In Jung Kim, Geun Joo Choi, Hyoung-Chul Oh, Hyun Kang","doi":"10.1111/den.15078","DOIUrl":"https://doi.org/10.1111/den.15078","url":null,"abstract":"<p><strong>Objectives: </strong>Sedation for endoscopic retrograde cholangiopancreatography (ERCP) is challenging owing to patient comorbidities and procedural complexity. Remimazolam, a novel benzodiazepine, has potential safety benefits. We aimed to systematically compare the efficacy and safety of remimazolam and propofol for ERCP sedation through a meta-analysis and trial sequential analysis (TSA).</p><p><strong>Methods: </strong>We searched Ovid-MEDLINE, Ovid-Embase, Cochrane Central, and Google Scholar for randomized controlled trials (RCTs) that compared efficacy and safety of remimazolam and propofol in ERCP sedation. Sensitivity analysis and TSA were also performed.</p><p><strong>Results: </strong>Five RCTs (965 participants) were included. In these trials, remimazolam significantly reduced hypoxia (risk ratio [RR], 0.522; 95% confidence interval [CI] 0.348-0.783; Grading of Recommendations, Assessment, Development, and Evaluation [GRADE], high), hypotension (RR, 0.507; 95% CI 0.396-0.649; GRADE, high), and bradycardia (RR, 0.475; 95% CI 0.308-0.732; GRADE, high). However, it increased tachycardia (RR, 3.363; 95% CI, 1.466-7.714; GRADE, moderate) and body movement (RR, 2.744; 95% CI, 1.216-6.193; GRADE, moderate). Delirium and agitation (RR, 0.586; 95% CI, 0.157-2.179; GRADE, moderate) and completion rate (RR, 1.009; 95% CI, 0.97-1.042; GRADE, moderate) were comparable. Recovery quality was higher in remimazolam group (mean difference, 1.541; 95% CI, 0.057-3.024; GRADE, low). Other outcomes, including induction and recovery times, were similar.</p><p><strong>Conclusion: </strong>Remimazolam demonstrated superior safety profile than propofol for ERCP sedation, significantly reducing hypoxia, hypotension, and bradycardia with high certainty evidence and TSA confirmation. Despite the higher incidence of tachycardia and body movement associated with remimazolam, the completion rate and risk of delirium or agitation were similar for both sedatives.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546403","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":"Contribution of Endoscopy in the Diagnosis and Treatment of Patients With Primary Sclerosing Cholangitis.","authors":"Mamoru Takenaka, Masatoshi Kudo","doi":"10.1111/den.15074","DOIUrl":"https://doi.org/10.1111/den.15074","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546404","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":"Non-Helicobacter pylori Helicobacter Infection in the Development of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma and Characteristic Endoscopic Findings.","authors":"Mitsushige Sugimoto, Masaki Murata","doi":"10.1111/den.15085","DOIUrl":"https://doi.org/10.1111/den.15085","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546405","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":"Artificial Intelligence in Gastrointestinal Endoscopy: The Japan Gastroenterological Endoscopy Society Position Statements.","authors":"Yuichi Mori, Ryu Ishihara, Haruhiko Ogata, Hiromu Kutsumi, Yutaka Saito, Kazuki Sumiyama, Masau Sekiguchi, Hisao Tajiri, Mitsuhiro Fujishiro, Koji Matsuda, Tomonori Yano, Rika Aoki, Misaki Ishiyama, Atsushi Imagawa, Masami Omae, Yasushi Oda, Motohiko Kato, Taku Sakamoto, Maasa Sasabe, Akiko Shiotani, Shiho Suzuki, Naoto Tamai, Takuto Hikichi, Toshiaki Hirasawa, Mai Makiguchi, Masashi Misawa, Yohei Yabuuchi, Daisuke Yamaguchi, Masayoshi Yamada, Yoshinori Igarashi, Shinji Tanaka","doi":"10.1111/den.15075","DOIUrl":"https://doi.org/10.1111/den.15075","url":null,"abstract":"<p><p>Research and development of artificial intelligence (AI) in the field of gastrointestinal endoscopy is progressing rapidly. In Japan alone, there are more than 10 AI-assisted endoscopic medical devices that have received regulatory approval, and numerous randomized controlled trials have been published both domestically and internationally. However, the adoption of AI in clinical practice has not been smooth due to factors such as insufficient evaluation of the balance between clinical benefits and harms, unclear cost-effectiveness, the lack of reliable guidelines, and the absence of established reimbursement systems for medical fees. Considering this situation, the Japan Gastroenterological Endoscopy Society (JGES) presents its perspective on the status of AI in endoscopic practice in the form of the following position statements. This comprises nine statements developed by the JGES AI Committee in collaboration with a diverse panel of members. These statements comprehensively address issues related to the quality of endoscopic examinations, cost-effectiveness, clinical disadvantages, preparatory knowledge, medical safety, and legal responsibilities. They have been developed to be practical and useful in actual endoscopy settings.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531386","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}