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

{"title":"Long-Term Clinical Success of Endoscopic Ultrasound-Guided Gastroenterostomy in Benign Gastric Outlet Obstruction.","authors":"Antonio Martinez-Ortega, F Javier García-Alonso, Natalia Marcos Carrasco, Amaia Arrubla Gamboa, Lucía Guilabert, Carlos Abril García, Félix Téllez-Avila, José Carlos Subtil Íñigo, Belén Martínez-Moreno, Marina Cobreros Del Caz, Juan J Vila, Vicente Sanchiz Soler, José R Aparicio Tormo, Alejandro Repiso Ortega, José Miguel Esteban, Antonio Velasco-Guardado, Ferrán Gónzalez-Huix, Carlos de la Serna Higuera, Manuel Perez-Miranda","doi":"10.1111/den.15087","DOIUrl":"https://doi.org/10.1111/den.15087","url":null,"abstract":"<p><strong>Background and aims: </strong>Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is an established treatment for malignant gastric outlet obstruction (GOO). Data on EUS-GE for benign GOO (bGOO) are limited. This study aimed to evaluate long-term clinical outcomes of EUS-GE in bGOO.</p><p><strong>Methods: </strong>Retrospective study on consecutive patients who underwent EUS-GE for bGOO using lumen apposing metal stents (LAMS) at 9 Spanish centers. The primary outcome was the ability to regain and maintain oral feeding. Secondary outcomes included technical success, immediate clinical success, LAMS dysfunction, and adverse event rates.</p><p><strong>Results: </strong>Sixty-two patients (75.8% male) with a median age of 65 years (56.9-74) were included. Most cases of bGOO were related to chronic (35.5%) or acute (24.2%) pancreatitis. Technical success was achieved in 61 (98.4%), and immediate clinical success in 57 (91.9%) patients. Among patients reaching immediate clinical success, the median LAMS indwell time was 505 (201-848) days. LAMS dysfunction developed in 7 (12.3%) patients after a median of 1200 (IQR: 94-1568) days. Oral feeding at 24 months was maintained in 85.3% patients overall and in 93.6% patients among those with immediate clinical success. Seven adverse events, including a fatal aspiration pneumonia and a fatal delayed bleeding, occurred in 6 (9.7%) patients.</p><p><strong>Conclusions: </strong>EUS-GE has a high immediate clinical success rate in patients with bGOO and a low risk of stent dysfunction.</p><p><strong>Trial registration: </strong>Promotor center identification number: PI-24-448-H.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651386","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":"Awareness Survey on Green Endoscopy for Endoscopists in Japan.","authors":"Shunsuke Yamamoto, Hiroyasu Iishi, Mathieu Pioche","doi":"10.1111/den.70000","DOIUrl":"https://doi.org/10.1111/den.70000","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651385","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":"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":"Whole slide images-based prediction of lymph node metastasis in T1 colorectal cancer using unsupervised artificial intelligence.","authors":"Yuki Takashina, S. Kudo, Y. Kouyama, K. Ichimasa, H. Miyachi, Y. Mori, T. Kudo, Y. Maeda, Y. Ogawa, Takemasa Hayashi, K. Wakamura, Enami Yuta, N. Sawada, T. Baba, T. Nemoto, F. Ishida, M. Misawa","doi":"10.2139/ssrn.4185475","DOIUrl":"https://doi.org/10.2139/ssrn.4185475","url":null,"abstract":"BACKGROUND AND AIMS\u0000Lymph node metastasis (LNM) prediction for T1 colorectal cancer (CRC) is critical for determining the need for surgery after endoscopic resection because LNM occurs in 10%. We aimed to develop a novel artificial intelligence (AI) system using whole slide images (WSIs) to predict LNM.\u0000\u0000\u0000METHODS\u0000We conducted a retrospective single center study. To train and test the AI model, we included LNM status-confirmed T1 and T2 CRC between April 2001 and October 2021. These lesions were divided into two cohorts: training (T1 and T2) and testing (T1). WSIs were cropped into small patches and clustered by unsupervised K-means. The percentage of patches belonging to each cluster was calculated from each WSI. Each cluster's percentage, sex, and tumor location were extracted and learned using the random forest algorithm. We calculated the areas under the receiver operator characteristics curves (AUCs) to identify the LNM and the rate of over-surgery of the AI model and the guidelines.\u0000\u0000\u0000RESULTS\u0000The training cohort contained 217 T1 and 268 T2 CRCs, while 100 T1 cases (LNM-positivity 15%) were the test cohort. The AUC of the AI system for the test cohort was 0.74 (95% confidence interval [CI], 0.58-0.86), and 0.52 (95% CI, 0.50-0.55) using the guidelines criteria (p=0.0028). This AI model could reduce the 21% of over-surgery compared to the guidelines.\u0000\u0000\u0000CONCLUSION\u0000We developed a pathologist-independent predictive model for LNM in T1 CRC using WSI for determination of the need for surgery after endoscopic resection.","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90837064","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":"Esophagitis Dissecans Superficialis in a 49- year-old woman.","authors":"Noam Harpaz,&nbsp;Suparna A Sarkar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"28 2","pages":"238-9"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34667013","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":"Esophageal stromal tumor.","authors":"Joseph Sung","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"24 1","pages":"66"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39967855","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}