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

{"title":"The One-Minute Triple Stretch Reduces Musculoskeletal Discomfort in Endoscopic Assistants: A Crossover Trial With Motion Analysis.","authors":"Mafu Tsunemi, Ippei Matsuzaki, Yasuki Hori, Kazuki Hayashi, Hazuki Tamada, Shota Yamada, Kazuki Matsuzaki, Kazuki Sakai, Michihiro Kamijima, Takeshi Ebara","doi":"10.1111/den.70040","DOIUrl":"https://doi.org/10.1111/den.70040","url":null,"abstract":"<p><strong>Objectives: </strong>Musculoskeletal disorders (MSDs) among endoscopic assistants are a major occupational concern. While ergonomic interventions such as education and microbreaks have reduced MSDs in surgical settings, few studies have focused specifically on endoscopic assistants. This study evaluated the effectiveness of a brief stretching protocol, the one-minute triple stretch (OMTS), in reducing MSD symptoms and improving posture.</p><p><strong>Methods: </strong>This crossover study of 10 endoscopic assistants from two hospitals used a repeated measures quasi-experimental design. Participants were alternately assigned to a control group (standard procedures) or intervention group (OMTS every 20 min). Musculoskeletal discomfort was assessed using the Numerical Rating Scale. Work performance was evaluated via two standardized scales, and posture was analyzed using a motion tracking system. Data were collected at baseline, mid-, and postprocedure.</p><p><strong>Results: </strong>The OMTS significantly reduced left shoulder discomfort at 120 min (p = 0.02, Hedges' g = -0.79), exceeding the minimal clinically important difference (MCID = 1.5). Moderate, nonsignificant effects were observed in the neck and lower back. Neck flexion posture improved significantly in the OMTS group (p = 0.03, g = -0.54), exceeding the MCID (2.9°).</p><p><strong>Conclusion: </strong>The OMTS appears to be a feasible ergonomic intervention that can reduce MSD symptoms in endoscopic assistants. Further multicenter studies are needed to confirm its effectiveness.</p><p><strong>Trial registration: </strong>The study was registered in the UMIN Clinical Trials Registry (Registration Number: UMIN000048799) on August 31, 2022.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281993","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":"Low-Power Pure-Cut Hot Snare Polypectomy for Intensive Downstaging in Familial Adenomatous Polyposis: Promise, Practicality, and Evidence Still Needed.","authors":"Kazunori Takada","doi":"10.1111/den.70046","DOIUrl":"https://doi.org/10.1111/den.70046","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245591","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":"Significance of Peroral Pancreatoscopy in the Diagnosis of Intraductal Papillary Mucinous Neoplasm.","authors":"Toshifumi Kin","doi":"10.1111/den.70044","DOIUrl":"https://doi.org/10.1111/den.70044","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226443","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 Features of Invasive Gastric Cancer Developed After Helicobacter pylori Eradication During Regular Endoscopic Surveillance.","authors":"Akiko Sasaki, Junko Fujisaki, Masaaki Kobayashi, Ken Namikawa, Yusuke Kumazawa, Shu Hoteya, Kotaro Shibagaki, Kenshi Yao, Mitsushige Sugimoto, Takashi Kawai, Seiichiro Abe, Hiroya Ueyama, Masaaki Kodama, Kazunari Murakami, Hajime Isomoto, Masanori Ito, Kyoichi Adachi, Ken Ohata, Takanori Yamada, Moriya Iwaizumi, Mototsugu Kato, Shin'ichi Miyamoto, Kazuyoshi Yagi, Takashi Yao, Daisuke Yoshimura, Naoki Miyazaki, Toshikazu Ushijima, Naomi Uemura","doi":"10.1111/den.70043","DOIUrl":"https://doi.org/10.1111/den.70043","url":null,"abstract":"<p><strong>Objectives: </strong>Gastric cancer (GC) may be diagnosed after Helicobacter pylori eradication, sometimes with submucosal invasion; however, its clinical features on regular endoscopic surveillance remain unclear. This study evaluated invasive GC's characteristics after H. pylori eradication during regular endoscopic surveillance by comparing them with intramucosal cancers.</p><p><strong>Methods: </strong>This retrospective multicenter study across 14 institutions between 2001 and 2022 evaluated patients with GC with submucosal or deeper invasion after surgical or endoscopic resection (invasive GC), compared to patients with intramucosal GC from high-volume facilities. GC depth was analyzed using logistic regression (patient and mucosal factors as covariates), with significant factors explored in a subanalysis.</p><p><strong>Results: </strong>In total, 116 of 413 patients with invasive GC and 189 of 545 with intramucosal GC were eligible for analysis. Invasive GC exhibited the following characteristics: (1) GC was a more common reason for H. pylori eradication (adjusted odds ratio [OR] 2.67; 95% confidence interval [CI] 1.25-5.69); (2) the upper third of the stomach was the more common site (OR 2.63; 95% CI 1.41-5.30); and (3) map-like redness (MLR) could not be confirmed (OR 4.12; 95% CI 2.53-6.69). Subgroup analysis suggested that GC with less MLR occurred more often in younger females (p < 0.004), showed antral intestinal metaplasia (p < 0.001), and was common in undifferentiated or mixed-type GC (p < 0.001).</p><p><strong>Conclusions: </strong>Characteristic findings of invasive GC during regular endoscopic surveillance after H. pylori eradication were associated with less MLR, along with H. pylori eradication due to GC and the upper gastric lesion locations.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187812","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 Multicenter Observational Study for the Establishment of Novel Severity Criteria Including Endoscopic Evaluation for Intestinal Behçet's Disease.","authors":"Toshiro Fukui, Makoto Naganuma, Yohei Kirino, Reiko Kunisaki, Yohei Mikami, Nobuhiro Ueno, Junji Umeno, Shigeki Bamba, Makoto Ooi, Shuhei Hosomi, Takayuki Matsumoto, Katsuyoshi Matsuoka, Chikako Watanabe, Masakazu Nagahori, Motoi Uchino, Kenji Watanabe, Fumihito Hirai, Minoru Matsuura, Yoshiya Tanaka, Mitsuhiro Takeno, Tadakazu Hisamatsu","doi":"10.1111/den.70041","DOIUrl":"https://doi.org/10.1111/den.70041","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to establish a novel severity classification for intestinal Behçet's disease (BD) (SCIBD) and validate its criteria across multiple institutions.</p><p><strong>Methods: </strong>Five parameters, including abdominal pain, tenderness, intestinal bleeding, serum C-reactive protein (CRP) level, and endoscopic findings, were identified to assess the severity of intestinal BD. Disease severity was categorized into remission and mild, moderate, or severe disease based on the criteria of each factor. This study also evaluated the correlation among the SCIBD scale, serum biomarkers, former disease activity for intestinal BD (DAIBD), and treatment decisions.</p><p><strong>Results: </strong>A total of 146 patients with intestinal BD and simple ulcers were retrospectively enrolled from 14 institutions between April and November 2022. As SCIBD severity increased, CRP and DAIBD levels significantly increased, whereas serum albumin levels decreased in the whole population. Similar correlations have been observed even in patients with intestinal BD. Antitumor necrosis factor-alpha treatment was also significantly more common in severe cases (49.4%) than in moderate cases (20.8%; p = 0.001). However, the proportion of patients requiring corticosteroids was comparable between the moderate and severe disease groups (39.6% vs. 33.3%). In addition, no significant differences were observed in the frequency of corticosteroid treatment, anti-TNF-α treatment, or surgery among the four groups: quiescent, mild, moderate, and severe cases of DAIBD. SCIBD was changed after treatment with corticosteroids and TNF-α according to improving clinical, biological, and endoscopic findings.</p><p><strong>Conclusions: </strong>The severity assessment of intestinal BD using our novel criteria correlated with appropriate treatment decisions, prognosis prediction, and treatment responses.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180601","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-Assisted Whole Slide Image Analysis for Lymph Node Status Prediction in Early Colorectal and Gastric Cancer.","authors":"Katsuro Ichimasa, Shin-Ei Kudo, Yuta Kouyama, Yuki Takashina, Hyunsoo Chung, Yasuharu Maeda, Wai Phyo Lwin, Yosuke Toya, Waku Hatta, Jimmy Bok Yan So, Khay Guan Yeoh, Tetsuo Nemoto, Masashi Misawa","doi":"10.1111/den.70042","DOIUrl":"https://doi.org/10.1111/den.70042","url":null,"abstract":"<p><p>With the widespread use of advanced endoscopic techniques such as endoscopic submucosal dissection, an increasing number of early colorectal cancer (T1 CRC) and early gastric cancer (EGC) cases are now treated with endoscopic resection as the first-line approach. However, the risk of lymph node metastasis (LNM)-approximately 10% in T1 CRC and 5%-10% in EGC-necessitates additional surgical resection in high-risk cases. Current guideline-based risk stratification depends on pathological evaluation of the resected specimens to determine whether further surgery is needed. Yet both T1 CRC and EGC face shared challenges in LNM risk prediction, particularly in terms of accuracy and reproducibility. This review focuses on the latter. The diagnosis of key pathological risk factors, which serve as predictors of LNM, is subject to considerable interobserver variability among pathologists. One potential solution is the application of artificial intelligence (AI)-assisted whole slide image (WSI) analysis, which has been gaining attention in recent studies. AI-assisted models for LNM prediction in T1 CRC and EGC have shown encouraging results, suggesting that WSI-based AI could offer a pathologist-independent strategy to improve diagnostic consistency. However, the field remains in an early stage, with key limitations including small sample sizes and limited external validation. Additional high-quality evidence will be needed to support clinical implementation. Addressing challenges such as stain standardization and image artifacts will also be critical for achieving regulatory approval and broader clinical adoption.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180634","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-Directed Transgastric ERCP in Patients With Roux-En-Y Gastric Bypass: A Multicenter Prospective Cohort Study (EDGE-Pilot).","authors":"A G Overdevest, S Haal, J E van Hooft, A Inderson, S D Kuiken, W O A Rohof, J M Vrolijk, M C B Wielenga, T Wijnands, R L J van Wanrooij, R P Voermans","doi":"10.1111/den.70037","DOIUrl":"https://doi.org/10.1111/den.70037","url":null,"abstract":"<p><strong>Objectives: </strong>Endoscopic retrograde cholangiopancreatography (ERCP) is frequently indicated in patients who underwent Roux-en-Y gastric bypass (RYGB) surgery. Endoscopic ultrasound-directed ERCP (EDGE) is a technique that is used to create a gastro-gastrostomy by placing a lumen-apposing metal stent (LAMS) between the gastric pouch and the excluded stomach, facilitating subsequent ERCP. However, prospective studies on EDGE are lacking. The aim of this study is to provide prospective evidence for the efficacy and safety of EDGE, including fistula closure.</p><p><strong>Methods: </strong>This multicenter prospective cohort study included patients scheduled for elective ERCP after RYGB surgery. EDGE was performed as a two-step procedure. The primary endpoint was overall technical success. Secondary endpoints were the technical success of LAMS placement and ERCP individually, persistent fistula, and adverse events (AEs).</p><p><strong>Results: </strong>Between January 2021 and August 2024, 26 patients were included in four Dutch hospitals. Overall technical success was achieved in 25/26 patients (96.2%). Median LAMS indwelling time was 14 days [IQR 11-28 days]. Two EDGE-related AEs occurred (7.7%): one perforation of the duodenal wall following scope insertion and one bleeding after LAMS placement. Two ERCP-related AEs occurred (7.7%): one CBD perforation and one post-ERCP pancreatitis. Two patients were lost to follow-up. None of the remaining patients had a persistent fistula (0/24). No mortality occurred.</p><p><strong>Conclusions: </strong>This prospective study shows that two-step EDGE is relatively safe and associated with high technical success, without any cases of a persistent fistula. However, AEs occurred in 4 patients (15.4%), of which two were EDGE-related (7.7%).</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126579","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":"Transvalvular Precision: Digital Cholangioscopy-Guided SEMS Deployment for Malignant Ileocecal Obstruction.","authors":"Shanbin Wu, Yan Zhang, Guoliang Zhao","doi":"10.1111/den.70039","DOIUrl":"https://doi.org/10.1111/den.70039","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082569","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":"The Role of Artificial Intelligence, Including Endoscopic Diagnosis, in the Prediction of Presence, Bleeding, and Mortality of Esophageal Varices.","authors":"Yoshihiro Furuichi, Ryohei Nishiguchi, Yuko Furuichi, Shirei Kobayashi, Tomoyuki Fujiwara, Koichiro Sato","doi":"10.1111/den.70032","DOIUrl":"https://doi.org/10.1111/den.70032","url":null,"abstract":"<p><p>Esophagogastric varices (EGVs) are a disease that occurs as a complication of the progression of liver cirrhosis, and since bleeding can be fatal, regular endoscopy is necessary. With the development of artificial intelligence (AI) in recent years, it is beginning to be applied to predicting the presence of EGVs, predicting bleeding, and making a diagnosis and prognosis. Based on previous reports, application methods of AI can be classified into the following four categories: (1) noninvasive prediction using clinical data obtained from clinical records such as laboratory data, past history, and present illness, (2) invasive detection and prediction using endoscopy and computed tomography (CT), (3) invasive prediction using multimodal AI (clinical data and endoscopy), (4) invasive virtual measurement on the image of endoscopy and CT. These methods currently allow for the use of AI in the following ways: (1) prediction of EGVs existence, variceal grade, bleeding risk, and survival rate, (2) detection and diagnosis of esophageal varices (EVs), (3) prediction of bleeding within 1 year, (4) prediction of variceal diameter and portal pressure gradient. This review explores current studies on AI applications in assessing EGVs, highlighting their benefits, limitations, and future directions.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088493","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":"Does Depth of Breathing Matter in Gastroesophageal Reflux? Esophagogastric Junction Barrier Function Should Also Be Considered.","authors":"Shiko Kuribayashi, Toshio Uraoka","doi":"10.1111/den.70038","DOIUrl":"https://doi.org/10.1111/den.70038","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":4.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076642","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}