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

{"title":"Loop-assisted reopenable clip-over-the-line method as a modified closure method for a mucosal defect after gastric endoscopy submucosal dissection.","authors":"Satoshi Ono, Chinari Tanaka, Mitsuhiro Fujishiro","doi":"10.1111/den.15037","DOIUrl":"10.1111/den.15037","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"893-894"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053482","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":"High complete resection rates of underwater endoscopic mucosal resection for intermediate-sized sessile serrated lesions.","authors":"Junki Toyosawa, Masayasu Ohmori, Yasushi Yamasaki, Yuki Aoyama, Shoko Igawa, Keiko Takeuchi, Toshihiro Inokuchi, Hideaki Kinugasa, Masahiro Takahara, Sakiko Hiraoka, Takehiro Tanaka, Motoyuki Otsuka","doi":"10.1111/den.15035","DOIUrl":"10.1111/den.15035","url":null,"abstract":"<p><strong>Objectives: </strong>Sessile serrated lesions (SSLs) pose a risk of carcinoma, necessitating endoscopic resection. Conventional endoscopic mucosal resection (EMR) often fails to achieve complete resection for intermediate-sized SSLs. Although underwater EMR (UEMR) is being increasingly used for colon polyps, its efficacy for SSLs remains unclear. This study evaluated the complete resection rate of UEMR for intermediate-sized SSLs.</p><p><strong>Methods: </strong>This prospective, single-arm, observational study was conducted at two institutions. Patients with endoscopically diagnosed intermediate-sized SSLs (10-20 mm) were enrolled. UEMR was performed, and specimens were histologically assessed. Post-UEMR lesions were closely examined, and biopsies were taken to check for residuals. Follow-up colonoscopy was performed 1 year later to evaluate recurrence. The primary end-point was the complete resection rate, defined as no residual in biopsy specimens. The secondary end-points were the rates of R0 resection, en bloc resection, recurrence, adverse events, and factors regarding procedural difficulty.</p><p><strong>Results: </strong>In total, 103 patients with 133 lesions were consecutively identified. Twenty-seven cases with 30 lesions were excluded by criteria; 103 endoscopically diagnosed SSLs were enrolled. The median postresection lesion size was 12 mm (range 8-23). The R0 and en bloc resection rates were 61% and 91%, respectively. The overall complete resection rate was 97% (95% confidence interval 91.8-99.0%). Follow-up colonoscopy in 87 lesions showed no recurrence. Only one patient (1%) experienced delayed bleeding. Snaring difficulty was significantly associated with piecemeal resection.</p><p><strong>Conclusion: </strong>The complete resection rate of UEMR for intermediate-sized SSLs was acceptable. UEMR may become a standard treatment for intermediate-sized SSLs.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"870-877"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998380","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 and colorectal neoplasia detection performances in patients with positive fecal immunochemical test: Meta-analysis and systematic review.","authors":"Marco Spadaccini, Cesare Hassan, Yuichi Mori, Natalie Halvorsen, Antonio Z Gimeno-García, Hirotaka Nakashima, Antonio Facciorusso, Harsh K Patel, Giulio Antonelli, Kareem Khalaf, Tommy Rizkala, Daryl Ramai, Emanuele Rondonotti, Shunsuke Kamba, Roberta Maselli, Loredana Correale, Michael Bretthauer, Pradeep Bhandari, Prateek Sharma, Douglas K Rex, Alessandro Repici","doi":"10.1111/den.15034","DOIUrl":"10.1111/den.15034","url":null,"abstract":"<p><strong>Objectives: </strong>The combination of fecal immunochemical test (FIT) followed by colonoscopy has established itself as one of the preferred population-based screening strategies. Despite extensive exploration of various techniques and technologies, their impact on adenoma detection rate has shown inconsistency across studies in this specific setting \"FIT+ population.\" We aimed to assess the impact of the computer-aided detection (CADe) system in all randomized trials focused on this subpopulation.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, and Scopus databases until September 2023 for randomized controlled trials reporting diagnostic accuracy of CADe systems for detection of colorectal neoplasia. The primary outcome was pooled adenoma detection rate, and secondary outcomes were adenoma per colonoscopy, advanced adenoma per colonoscopy, serrated lesions, and nonneoplastic per colonoscopy.</p><p><strong>Results: </strong>Ten randomized trials on 5421 patients were included. Adenoma detection rate was higher in the CADe group than in the standard colonoscopy group (0.62 vs. 0.52; relative risk 1.19; 95% confidence interval 1.08-1.31). CADe also resulted in higher detection performances of both adenomas (incidence rate ratio 1.16; 95% confidence interval 1.09-1.24) and serrated lesions (incidence rate ratio, 1.20; 95% confidence interval 1.05-1.38) at per-polyp analysis. No differences were found for advanced adenomas between the groups. On the other hand, more nonneoplastic polyps were removed in the CADe than the standard group (0.45 vs. 0.34; mean difference 0.06; P = 0.026) in a comparable inspection time.</p><p><strong>Conclusions: </strong>The use of CADe during colonoscopy results in an increased detection of adenomas, and serrated lesions, in a FIT+ setting. The impact on advanced adenomas was not significant. Higher rates of unnecessary removal of nonneoplastic polyps were also reported.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"815-823"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047518","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":"Revolutionizing gastroesophageal reflux disease diagnosis and treatment: Promise of EPSIS and EARTh.","authors":"Hironari Shiwaku","doi":"10.1111/den.15027","DOIUrl":"10.1111/den.15027","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"849-850"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712369","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":"Ergonomic endoscopy: Path to your sustainable endoscopy practice.","authors":"Takahiro Utsumi, Yasushi Sano, Hiroshi Seno","doi":"10.1111/den.15032","DOIUrl":"10.1111/den.15032","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"847-848"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803265","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":"Type 2 and type 3 gastric neuroendocrine tumors have high risk of lymph node metastasis: Systematic review and meta-analysis.","authors":"Yohei Ogata, Waku Hatta, Takeshi Kanno, Masahiro Saito, Xiaoyi Jin, Naoki Asano, Tomoyuki Koike, Akira Imatani, Yuhong Yuan, Atsushi Masamune","doi":"10.1111/den.15026","DOIUrl":"10.1111/den.15026","url":null,"abstract":"<p><strong>Objectives: </strong>Lymph node metastasis (LNM) is crucial in determining treatment strategies for gastric neuroendocrine tumors (gNETs). While type 3 is considered more aggressive than types 1 and 2 within the clinical subtype of gNETs, the supporting data were insufficient, due to their rarity. We aimed to study the prevalence and risk factors associated with LNM in gNETs.</p><p><strong>Methods: </strong>We searched electronic databases from 1990 to 2023 to identify case-control and cohort studies regarding gNETs resected either endoscopically or surgically. The primary outcome measured was the pooled prevalence of LNM in gNETs. Secondary outcomes included categorizing the prevalence of LNM by clinical subtypes and identifying pathological risk factors associated with LNM in gNETs.</p><p><strong>Results: </strong>We included 28 studies, involving 1742 patients, among whom 240 had LNM (pooled prevalence rate, 11.8%; 95% confidence interval 7.6-17.9%). The pooled prevalence rates of LNM for type 1, type 2, and type 3 gNETs were 6.0%, 38.5%, and 23.2%, respectively. Type 2 (odds ratio [95% confidence interval] 11.53 [3.46-38.49]) and type 3 (6.88 [3.79-12.49]) gNETs exhibited a higher risk for LNM compared to type 1. Pathological risk factors for LNM included tumor size >10 mm (4.18 [1.91-9.17]), tumor invasion into the muscularis propria or deeper (11.21 [3.50-35.92]), grade 2/grade 3 (5.96 [2.65-13.40]), and lymphovascular invasion (34.50 [6.70-177.51]).</p><p><strong>Conclusion: </strong>We demonstrated that type 2 gNETs, as well as type 3, had a high risk of LNM. Additionally, four pathological risk factors associated with LNM were identified.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"834-843"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143766056","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":"Role of 3D imaging and tissue-clearing method in gastrointestinal neoplasms: Will it offer a glimpse into the future of endoscopic diagnostics?","authors":"Kazunori Takada","doi":"10.1111/den.15033","DOIUrl":"10.1111/den.15033","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"844-846"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804826","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":"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":"851-861"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","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":"Performance of a disposable colonoscope for routine examination: Pilot randomized controlled noninferiority trial (with video).","authors":"Xiao-Ling Wang, Bin-Jia Li, Huo-Wang Ye, Bing-Zhou Wang, Chang-Hui Yu, Shao-Heng Zhang, Dan-Dan Jin, Jian-Lin Yu, Xin-Ying Wang","doi":"10.1111/den.15040","DOIUrl":"10.1111/den.15040","url":null,"abstract":"<p><strong>Objectives: </strong>Reusable colonoscopes pose a risk of iatrogenic infections due to improper disinfection and maintenance, prompting the development of disposable colonoscopes. However, direct comparisons between disposable and reusable colonoscopes remain limited. This pilot study aimed to evaluate the technical performance of disposable colonoscopes compared to reusable ones for routine colon examinations.</p><p><strong>Methods: </strong>This randomized controlled, noninferiority study was conducted at two endoscopy centers. Patients requiring colonoscopy were randomly assigned to either the disposable or reusable colonoscope group. The primary outcome was the successful completion rate of colonoscopy between the groups, with a noninferior margin of -10%. Secondary outcomes included image characteristics, technical maneuverability, colonoscopy performance measures, and adverse events.</p><p><strong>Results: </strong>A total of 116 patients underwent colonoscopy (58 in each group). The successful completion rate of colonoscopy was 100% in both groups (difference: 0% [95% confidence interval -6.21% to 6.21%]), confirming noninferiority. Although the disposable colonoscope group had lower performance scorings in imaging characteristics, technical maneuverability, and longer operating time compared to the reusable colonoscope group, no significant differences were observed in cecal intubation rate, polyp detection rate, polyp characteristics, or adverse event rate. Additionally, experienced endoscopists achieved proficiency with disposable colonoscopes after approximately 10 cases, requiring minimal training.</p><p><strong>Conclusion: </strong>With further technical advancements, disposable colonoscopes may serve as a safe and viable alternative to reusable colonoscopes for routine colon examinations in certain clinical scenarios.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"862-869"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028394","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 diagnosis of immunoglobulin G4-related sclerosing cholangitis.","authors":"Itaru Naitoh, Michihiro Yoshida, Takahiro Nakazawa","doi":"10.1111/den.15039","DOIUrl":"10.1111/den.15039","url":null,"abstract":"<p><p>Immunoglobulin G4 (IgG4)-related sclerosing cholangitis (IgG4-SC) is a distinct form of sclerosing cholangitis frequently associated with autoimmune pancreatitis and is recognized as a biliary manifestation of IgG4-related disease. Endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS) are key diagnostic modalities for IgG4-SC. Cholangiocarcinoma and primary sclerosing cholangitis (PSC) are significant mimickers of IgG4-SC. ERCP is employed to evaluate narrowing of the bile duct, with cholangiograms of IgG4-SC classified into four types. This cholangiographic classification is crucial for differential diagnosis. Characteristic cholangiographic findings of IgG4-SC include diffuse or segmental strictures of the intrahepatic or extrahepatic bile ducts and intrahepatic strictures associated with autoimmune pancreatitis. ERCP is particularly useful for differentiating IgG4-SC from PSC because their cholangiographic features differ. EUS and intraductal ultrasonography (IDUS) are used to assess thickening of the bile duct wall. Characteristic IDUS findings in IgG4-SC include circular and symmetrical wall thickening, smooth outer and inner margins, and homogeneous internal echoes at stricture sites. Additionally, bile duct wall thickening at nonstricture sites is a typical IDUS feature of IgG4-SC. Bile duct biopsy is used to evaluate pathological findings, although its diagnostic yield for IgG4-SC is limited; its primary role is to exclude malignant biliary strictures. Duodenal papilla biopsy serves as a supplementary diagnostic tool for IgG4-SC. EUS and tissue acquisition also aid in diagnosing autoimmune pancreatitis as part of other organ involvement. Thus, endoscopic techniques play critical roles in the diagnosis of IgG4-SC.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"824-833"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055184","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}