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

{"title":"A Method to Release a Denture Clasp Embedded in the Cervical Esophagus Using Balloon Dilation.","authors":"Rei Miyake, Yohei Nishikawa, Haruhiro Inoue","doi":"10.1111/den.15070","DOIUrl":"https://doi.org/10.1111/den.15070","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303776","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":"Transcolonic Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Pancreatic Head Cancer With Difficult Access From the Upper Gastrointestinal Tract.","authors":"Indria Melianti, Kazuo Hara, Nozomi Okuno","doi":"10.1111/den.15064","DOIUrl":"https://doi.org/10.1111/den.15064","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303778","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":"Computer-aided detection for esophageal achalasia (with video).","authors":"Hironari Shiwaku, Masashi Misawa, Haruhiro Inoue, Kai Jiang, Masahiro Oda, Pietro Familiari, Guido Costamagna, Yuto Shimamura, Yuichiro Ikebuchi, Yugo Iwaya, Masaki Ominami, Bu'Hussain Hayee, Khek-Yu Ho, Jimmy B Y So, Hein Myat Thu Htet, Pradeep Bhandari, Kevin Grimes, Helmut Messmann, Bianca Maria Quarta Colosso, Roberta Maselli, Cesare Hassan, Alessandro Repici, Stavros N Stavropoulos, Norio Fukami, Robert Bechara, Michel Kahaleh, Amrita Sethi, Torsten Beyna, Horst Neuhaus, Philip W Y Chiu, Esperanza Grace Santi, Prateek Sharma, Nikolas Eleftheriadis, Hitomi Minami, Gregory Haber, Peter V Draganov, Stefan Seewald, Akio Shiwaku, Yoshiyuki Shiwaku, Kensaku Mori, Shin-Ei Kudo, Suguru Hasegawa","doi":"10.1111/den.15028","DOIUrl":"https://doi.org/10.1111/den.15028","url":null,"abstract":"<p><strong>Objectives: </strong>Achalasia is an esophageal motility disorder that impairs quality of life and is often missed (20-50%) on endoscopy. A newly developed computer-aided detection (CAD) software has shown high accuracy for achalasia diagnosis in preclinical settings. However, its benefit in a clinical setting remains unclear.</p><p><strong>Methods: </strong>Between February and August 2023, 83 endoscopists from 27 centers assessed 50 randomized endoscopic videos (25 achalasia, 25 nonachalasia) without and with CAD. Endoscopists assessed videos without CAD, then with CAD after 2 months. The primary end-point was improvement in sensitivity for nonexperienced endoscopists (no endoscopic experience of achalasia). Sensitivity, specificity, and accuracy with and without CAD were compared using the McNemar test.</p><p><strong>Results: </strong>Sensitivity for diagnosing achalasia increased significantly with CAD, rising from 74.2% (95% confidence interval [CI] 72.2-76.0%) to 91.2% (95% CI 89.9-92.4%) for all readers, showing a difference of 17.1% (95% CI 15.1-19.0%). Specifically, sensitivity improved from 66.9% (95% CI 63.6-70.0%) to 91.9% (95% CI 89.9-93.6%) among nonexperienced endoscopists, resulting in a difference of 25.0% (95% CI 21.7-28.4%), and from 79.5% (95% CI 77.1-81.8%) to 90.8% (95% CI 89.0-92.3%) among experienced endoscopists (endoscopic experience of at least one achalasia case), with a difference of 11.3% (95% CI 8.9-13.6%). Accuracy and specificity improved significantly with CAD assistance, regardless of reader's experience.</p><p><strong>Conclusion: </strong>CAD improves achalasia detection by 17%, confirming preclinical results. The benefit was higher for nonexperienced endoscopists. CAD assistance may lead to prompt and effective treatment, minimizing the risk of false-negative diagnosis in clinical practice.</p><p><strong>Trial registration: </strong>This study was registered in the University Hospital Medical Information Network Clinical Trial Registry (https://www.umin.ac.jp/ctr/) number: UMIN000053047.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287426","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":"Identification of the source of biliary bleeding using a novel ultrathin-type peroral cholangioscope.","authors":"Kento Shionoya, Ryosuke Tonozuka, Takao Itoi","doi":"10.1111/den.15061","DOIUrl":"https://doi.org/10.1111/den.15061","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268016","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":"Size matters: Establishing a cut-off for rectal neuroendocrine neoplasm to predict recurrence and standardize surveillance guidelines.","authors":"Seijong Kim, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim, Jung Kyong Shin, Yoonah Park, Jung Wook Huh, Hee Cheol Kim, Seong Hyeon Yun, Woo Yong Lee, Yong Beom Cho","doi":"10.1111/den.15056","DOIUrl":"https://doi.org/10.1111/den.15056","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify risk factors for recurrence of rectal neuroendocrine neoplasms, establish a cut-off size for recurrence prediction, and standardize surveillance guidelines.</p><p><strong>Methods: </strong>This retrospective study analyzed patients diagnosed with rectal neuroendocrine neoplasm at Samsung Medical Center from January 2007 to July 2021. Tumors were classified according to World Health Organization and European Neuroendocrine Tumor Society guidelines. The primary outcome was to determine the ideal cut-off size for predicting recurrence.</p><p><strong>Results: </strong>A total of 1011 patients (median follow-up: 58 months) were included: 967 with grade (G) I neuroendocrine tumor (NET), 35 with GII NET, and 9 with neuroendocrine carcinoma. Disease-free and overall survival were significantly better in GI NET than in GII and neuroendocrine carcinoma. For NET G1 patients undergoing endoscopic resection, a 0.7 cm cut-off (area under the curve = 0.94) showed 100% sensitivity, 79% specificity, and no recurrence. In contrast, for lymphovascular invasion (LVI)-positive, lymph node-negative NET G1 patients undergoing transanal endoscopic microsurgery/transanal excision or radical resection, an optimal cut-off of 1.5 cm (area under the curve = 0.92) was identified. NET G2 had a 22.9% lymph node metastasis rate, with recurrence risk increasing with size.</p><p><strong>Conclusions: </strong>For NET G1 tumors ≤0.7 cm without LVI following endoscopic resection, routine surveillance may not be necessary due to the minimal risk of recurrence. Similarly, for LVI-positive, lymph node-negative NET G1 tumors that underwent surgical resection, surveillance may not be required if the tumor is ≤1.5 cm. Additionally, NET G2 tumors require regular follow-up regardless of size to ensure favorable oncologic outcomes. These findings contribute to a risk-based approach for surveillance, optimizing follow-up strategies.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268017","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":"Spastic Esophageal Disorders-How Much Muscle Should We Cut?","authors":"Siew-Fung Hau, Hon Chi Yip","doi":"10.1111/den.15068","DOIUrl":"https://doi.org/10.1111/den.15068","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268018","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":"Fully-covered metal stent for perihilar biliary strictures after liver transplantation: Highly effective but not a panacea.","authors":"Tatsuya Sato, Naminatsu Takahara, Mitsuhiro Fujishiro","doi":"10.1111/den.15054","DOIUrl":"https://doi.org/10.1111/den.15054","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259456","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":"What is the ideal shape of a self-expandable metal stent with no migration or obstruction?","authors":"Masaki Kuwatani","doi":"10.1111/den.15058","DOIUrl":"https://doi.org/10.1111/den.15058","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259457","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":"How often does a mixed type intraductal papillary mucinous neoplasm on imaging indicate pathological involvement of the main pancreatic duct?","authors":"Kosuke Takahashi, Ichiro Yasuda, Toshiki Entani, Iori Motoo, Nobuhiko Hayashi, Takayuki Ando, Haruka Fujinami, Kazuto Tajiri, Johji Imura, Kenichi Hirabayashi, Eisuke Ozawa, Hisamitsu Miyaaki, Kazuhiko Nakao","doi":"10.1111/den.15051","DOIUrl":"https://doi.org/10.1111/den.15051","url":null,"abstract":"<p><strong>Objectives: </strong>A pancreatic cyst >5 mm in diameter that communicates with the dilated main pancreatic duct (MPD) ≥5 mm on imaging is defined as mixed type intraductal papillary mucinous neoplasm (MX-IPMN). However, the frequency of tumor involvement of the MPD in MX-IPMN remains unknown. This study investigated how often MX-IPMNs involve the MPD and whether MPD involvement can be diagnosed by peroral pancreatoscopy (POPS).</p><p><strong>Methods: </strong>This retrospective cohort study included patients who underwent POPS for MX-IPMN followed by surgical resection between July 2018 and December 2021. The pathological features of MX-IPMN, including tumor extension to the MPD, were analyzed. Additionally, the diagnostic performance of various imaging modalities in detecting tumor extension to the MPD was evaluated.</p><p><strong>Results: </strong>Among a total of 15 patients, 10 (67%) had pathologically confirmed tumor extension to the MPD. In most cases with pathologically confirmed MPD involvement, the main tumor was diagnosed as high-grade dysplasia (60%) or invasive carcinoma (10%). Conversely, low-grade dysplasia was the main lesion in most cases without MPD involvement (low-grade dysplasia 80%; high-grade dysplasia 20%, invasive carcinoma 0%). The diagnostic accuracy, sensitivity, and specificity of POPS with or without biopsy was 93.3%, 90.0%, and 100%, respectively. POPS demonstrated higher accuracy and sensitivity than computed tomography, magnetic resonance cholangiopancreatography, and endoscopic ultrasonography (accuracy: 93.3%, 40%, 60%, and 80%; sensitivity: 93.3%, 10%, 40%, and 70%, respectively).</p><p><strong>Conclusions: </strong>Overall, 67% of MX-IPMNs had pathologically proven MPD involvement. Tumor extension to the MPD is highly suspicious of malignancy, and POPS may be useful for evaluating MPD involvement.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227837","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":"Outcomes of endoscopic papillectomy should be evaluated not only based on short-term results but also long-term prognosis.","authors":"Hiroki Kawashima","doi":"10.1111/den.15044","DOIUrl":"https://doi.org/10.1111/den.15044","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227838","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}