Annals of Gastroenterology最新文献

{"title":"Impact of p53 mutations on the synergistic effects of metformin and radiation on colorectal cancer cells.","authors":"Kyoko Sakamoto, Koji Okabayashi, Yujin Kato, Kaoru Hattori, Satoru Morita, Kohei Shigeta, Yuko Kitagawa","doi":"10.20524/aog.2026.1078","DOIUrl":"10.20524/aog.2026.1078","url":null,"abstract":"<p><strong>Background: </strong>Metformin has been reported to be effective as an adjunctive therapy in cancer treatment. In this study, the synergistic effects of metformin and radiotherapy were investigated in colorectal cancer cell lines and colorectal cancer organoids, as were the underlying mechanisms.</p><p><strong>Methods: </strong>This was an experimental study conducted <i>in vitro</i>. Cell proliferation was investigated <i>in vitro</i> after treatment of colorectal cancer cell lines with metformin and radiation. Western blotting was used to analyse treatment-induced changes in p53 expression. The combination index for metformin and irradiation was calculated. Organoids were generated via genomic analysis of colorectal cancer cells from surgical specimens from patients with colorectal cancer. Responses of colorectal cancer organoids with and without p53 mutations to metformin and radiation were compared. Organoids cultured from human colorectal cancer and cell lines were used.</p><p><strong>Results: </strong>In experiments using the colorectal cancer cell lines HCT116 and Lovo, which are p53 wild type cells, the combination treatment of metformin and irradiation appeared to have a synergistic effect. In HCT116 and Lovo cells, metformin treatment increased TP53 expression. No synergistic effect of metformin treatment and irradiation was demonstrated in WiDr and SW620 cells, which contain p53 mutations. Measurements of cell proliferation rates in colorectal cancer organoids also confirmed a similar trend in p53 wild-type organoids and those with p53 mutations.</p><p><strong>Conclusion: </strong>Mutations in the p53 gene in colorectal cancer cells may influence the synergistic effect of metformin and radiotherapy.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"487-494"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417807","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":"The effect of pembrolizumab on the healing of colonic anastomosis: a pre-clinical study in Wistar rats.","authors":"Elissavet Symeonidou, Georgios Petrakis, Ioannis Taitoglou, Maria Papaioannou, Vasileios Geropoulos, Theodora Papamitsou, Sofia Karachrysafi, Vasileios Fouskas, Grigorios Rallis, Ioannis Savvas, Konstantinos Mpallas, Georgios Zacharioudakis","doi":"10.20524/aog.2026.1073","DOIUrl":"10.20524/aog.2026.1073","url":null,"abstract":"<p><strong>Background: </strong>Pembrolizumab is a monoclonal antibody that targets the programmed cell death-1 (PD-1) protein. Blocking this pathway alters T-cell activity, and has been approved for the treatment of several malignancies, including microsatellite instability-high (MSI-H) and mismatch repair-deficient (dMMR) colorectal cancers. The aim of this study was to evaluate the effect of pembrolizumab on colonic anastomotic healing in a rat model.</p><p><strong>Methods: </strong>Sixty male Wistar rats were randomly divided into 2 groups of 30: a control group, and an experimental group receiving pembrolizumab. Each group was further divided into 3 subgroups of 10 rats, sacrificed on postoperative day (POD) 3, 7 or 14. All animals underwent laparotomy, a 1-centimeter segmental colectomy, and an end-to-end colonic anastomosis. Postmortem evaluation included measuring anastomotic bursting pressure, tissue hydroxyproline levels, and histopathological assessment.</p><p><strong>Results: </strong>Statistically significant differences in bursting pressure (P=0.019) and rupture site (P=0.033) were observed between the groups on POD 7. Tissue hydroxyproline levels were significantly lower in the pembrolizumab-treated subgroups on POD 7 (P=0.003), and POD 14 (P=0.001). Histopathological analysis demonstrated significant differences on POD 3, in neovascularization (P=0.026), fibroblast ingrowth (P=0.005), and collagen deposition (P=0.030), suggesting impaired inflammatory-phase healing.</p><p><strong>Conclusions: </strong>This experimental study suggests that a high single dose of pembrolizumab may negatively affect colonic anastomotic healing in rats. Further studies are necessary to determine the safety of intestinal anastomosis in both emergency and elective clinical settings.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"430-437"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417820","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":"A national consensus guideline on the performance and interpretation of hydrogen- and methane-based breath tests for carbohydrate malabsorption, small intestinal bacterial overgrowth, and intestinal methanogen overgrowth.","authors":"Tsachi Tsadok Perets, Tamar Thurm, Meirav Ben-Yehoyada, Liat Deutsch, Yishai Ron, Ronnie Baruch, Eva Niv, Tiberiu Hershcovici, Orit Picard, Tal Engel, Tsili Zangen, Sigal Frishman, Ram Dickman","doi":"10.20524/aog.2026.1082","DOIUrl":"10.20524/aog.2026.1082","url":null,"abstract":"<p><p>Abdominal bloating, distension, excessive gas, abdominal pain, diarrhea and constipation are common symptoms that may arise from carbohydrate malabsorption, carbohydrate intolerance, small intestinal bacterial overgrowth (SIBO), intestinal methanogen overgrowth (IMO), or disorders of gut-brain interaction. Hydrogen- and methane-based breath tests are safe, noninvasive, inexpensive and widely used, but differences in indications, patient preparation, test performance and interpretation can lead to inconsistent diagnoses and management. At the recommendation of the Israeli Gastroenterology Association, a multidisciplinary panel of adult and pediatric gastroenterologists, neurogastroenterologists, dietitians, clinical nutrition specialists and heads of gastrointestinal laboratories reviewed the literature and reached consensus during 8 meetings. This guideline provides practical standards for breath testing in adults and children. The panel recommends simultaneous measurement of hydrogen and methane, structured symptom recording during testing, standardized pretest preparation, and cautious interpretation in settings that alter anatomy or orocecal transit time. Lactulose is recommended as the preferred substrate for SIBO/IMO testing, with glucose as an acceptable alternative. Carbohydrate malabsorption should be distinguished from intolerance by the presence or absence of typical symptoms during the test. The guideline also defines suspected hypersensitivity and highlights methane production as a cause of false-negative hydrogen-based carbohydrate tests. These recommendations are intended to harmonize breath test practice and reporting, and to support rational, test-directed treatment in adult and pediatric patients.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"383-389"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417694","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":"Nonconventional dysplasia in ulcerative colitis: a clinicopathological study of 694 patients.","authors":"Thanna Elsayed Helal, Nehal Ahmed Radwan, Mariam Ibrahim Halim, Fatma Magdy Elgendy","doi":"10.20524/aog.2026.1077","DOIUrl":"10.20524/aog.2026.1077","url":null,"abstract":"<p><strong>Background: </strong>Ulcerative colitis (UC) carries an increased risk of colorectal carcinoma (CRC) through the inflammation-dysplasia-carcinoma sequence. Recently, several nonconventional dysplastic subtypes have been recognized, often lacking classical features and posing diagnostic challenges.</p><p><strong>Method: </strong>This retrospective study evaluated dysplasia frequency and patterns in UC patients using archival colonoscopic biopsy specimens from the Pathology Laboratory at Ain Shams University Hospitals between 2020 and 2024.</p><p><strong>Results: </strong>A total of 694 patients with histologically confirmed UC were included. For each patient, 1 representative colonoscopic biopsy was evaluated: the most recent biopsy from the most distal colonic site when multiple biopsies were available. This specimen was reviewed histologically, regardless of whether dysplasia had previously or concurrently been diagnosed at another site. Based on this standardized approach, 203 of the 694 patients (29.3%) were found to have dysplasia, including 88 patients (43.3%) with conventional dysplasia and 115 patients (56.7%) with nonconventional dysplasia. The most common nonconventional subtype was dysplasia with increased Paneth cell differentiation (48.7%), followed by hypermucinous dysplasia (19.1%), crypt cell dysplasia (18.3%), goblet cell-deficient dysplasia (11.3%), and serrated dysplasia variants (2.6%). Over 87% of nonconventional dysplastic lesions presented endoscopically with flat/invisible appearance; however, serrated dysplasia subtypes represented an exception, as all serrated lesions in our cohort were polypoid. Patients with nonconventional dysplasia were significantly younger (median 29.5 vs. 35 years for conventional dysplasia, P=0.015).</p><p><strong>Conclusions: </strong>Nonconventional dysplasia is frequent in UC, and often presents endoscopically with flat/invisible appearance. Pathologists should recognize and report these subtypes to improve surveillance accuracy.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"480-486"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417815","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":"Authors' reply.","authors":"Malek Shatila, Yinghong Wang","doi":"10.20524/aog.2026.1075","DOIUrl":"10.20524/aog.2026.1075","url":null,"abstract":"","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 4","pages":"495-496"},"PeriodicalIF":2.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148417611","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":"Temporal trends in colorectal cancer mortality in Greece, 2014-2022: a Joinpoint regression analysis.","authors":"Vasilios Papastergiou, John Souglakos, George Karamanolis, Gregorios Paspatis, Gregory Chlouverakis","doi":"10.20524/aog.2026.1039","DOIUrl":"10.20524/aog.2026.1039","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer (CRC) is the second most deadly cancer worldwide; however, data on CRC mortality in Greece remain scarce. This study aimed to evaluate temporal trends in CRC mortality in Greece between 2014 and 2022, focusing on sex- and age-groups.</p><p><strong>Methods: </strong>CRC mortality and demographics were gathered from the Hellenic Statistical Authority (ELSTAT). Age-adjusted mortality rates (AAMRs) were calculated, using age-specific mortality rates standardized to the WHO standard population. For age subgroups, crude mortality rates were analyzed. Temporal trends were established using Joinpoint regression with estimation of annual percent change (APC).</p><p><strong>Results: </strong>During the study period, there were 24,973 CRC-related deaths (14,201 men, 56.8%). The overall AAMRs were 10.7 [95% confidence interval (CI) 10.3-11.1] per 100,000 population in 2014 and 10.2 (95%CI 9.7-10.6) in 2022, exhibiting no significant change (APC -0.62, 95%CI -1.34 to 0.13; P=0.11). Men had consistently higher AAMRs than women throughout the study. The AAMRs for women significantly declined between 2014 and 2022 (APC -1.02, 95%CI -1.98 to -0.03; P=0.03). Contrarily, the decline was not significant in men (APC -0.35, 95%CI -1.34 to 0.67; P=0.48). All age subgroups for both sexes exhibited declining trends, except for men 45-59 years who showed a non-significant uptrend throughout the study, and men <45 years who showed a significant increase between 2017 and 2022.</p><p><strong>Conclusions: </strong>In Greece, CRC mortality significantly declined between 2014 and 2022 in women, although not in men. Increasing trends observed in younger men warrant further consideration, aiming to optimize prevention and outcomes of CRC.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 3","pages":"336-343"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13365625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444121","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":"Vonoprazan-amoxicillin dual therapy improves 14-day eradication and reduces adverse events in patients with <i>Helicobacter pylori</i> infection: an updated landmark systematic review and meta-analysis of 11 randomized trials with subgroup analysis.","authors":"Urvashi Bharia, Anika Goel, Fnu Raja, Gowrishankar Palaniswamy, Krishna Sangeetha Gadde, Erine Joseph, Ishita Gupta, Sharath Udaya Kumar, Isha Piyushkumar Shah, Anika Chowdhury, Homi Patel, Kaival Malav Shah, Venkata Dileep Kumar Veldi, Ashesh Das","doi":"10.20524/aog.2026.1033","DOIUrl":"10.20524/aog.2026.1033","url":null,"abstract":"<p><strong>Background: </strong>Vonoprazan, a potassium-competitive acid blocker (P-CAB), may enhance <i>Helicobacter pylori</i> (<i>H. pylori</i>) eradication in combination with amoxicillin. With increasing drug resistance, dual therapy is a potential alternative to standard triple and quadruple regimens. This systematic review and meta-analysis evaluated the efficacy and safety of vonoprazan dual therapy (VDT) as first-line treatment for <i>H. pylori</i> infection.</p><p><strong>Methods: </strong>A comprehensive systematic search on PubMed, Embase, Scopus and Cochrane Library identified 11 randomized controlled trials (RCTs) involving 2877 patients (1439 VDT; 1438 control), comparing VDT with standard triple therapy, quadruple therapy or individualized treatment regimens for <i>H. pylori</i> eradication, up to March 2025. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel method for dichotomous outcomes. Random or fixed-effects models were applied based on heterogeneity, assessed using the Higgins <i>I</i>2 statistic. A P-value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>VDT significantly improved eradication rates compared to standard therapy (RR 1.06, 95%CI 1.00-1.12; P<0.001), driven primarily by 14-day regimens (RR 1.08, 95%CI 1.01-1.15; P=0.0001); no benefit was seen for 7-day regimens (RR 0.97, 95%CI 0.91-1.04; P=0.30), with low heterogeneity (8.6%). There was no significant difference in drug compliance (RR 1.02, 95%CI 0.99-1.05; P=0.03), with moderate heterogeneity (50.3%). VDT demonstrated significantly fewer adverse events (RR 0.66, 95%CI 0.52-0.84; P<0.001).</p><p><strong>Conclusions: </strong>VDT is as effective as standard therapies overall, but shows clear superiority in 14-day regimens, with no advantage in 7-day durations. The observed heterogeneity was probably due to differences in treatment duration and regional variability in resistance.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 3","pages":"294-302"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980145","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":"Evaluating outcomes of alternative pathologic terminology in high-grade dysplastic colorectal lesions.","authors":"Shaman Dalal, Aakash Desai, Nahel Tunio, Jacqueline Khalil, Devereaux Sellers, Marc Landsman","doi":"10.20524/aog.2026.1059","DOIUrl":"10.20524/aog.2026.1059","url":null,"abstract":"<p><strong>Background: </strong>Pathologists occasionally classify colorectal adenomas with dysplastic mucosal invasion as intramucosal carcinoma (IMC), or carcinoma <i>in situ</i> (CIS), instead of high-grade dysplasia (HGD), potentially leading to earlier surveillance colonoscopies and inappropriate surgical referrals. We aimed to analyze differences in the management of patients with these diagnoses, and examined the factors that may lead to inappropriate early interval (IEI) follow-up recommendations for surveillance.</p><p><strong>Methods: </strong>We reviewed 870 colonoscopy and pathology reports from 2015-2022, excluding cases of colorectal cancer, inflammatory bowel disease, and lesions not amenable to endoscopic resection. Surveillance appropriateness was defined in accordance with the 2020 US Multi Society Task Force (USMSTF) guidelines. ANOVA and Fisher's exact tests were used to compare patient groups, while binary logistic regression identified predictors of IEI.</p><p><strong>Results: </strong>Among 233 patients analyzed, 86% had HGD, 12% IMC and 2% CIS. IMC (odds ratio [OR] 4.09, 95% confidence interval [CI] 1.52-11.5; P=0.01) and CIS (OR 3.70, 95%CI 0.57-29.7; P=0.17) had significantly higher IEI rates relative to HGD. Predictors of IEI included Black race (OR 2.39, 95%CI 1.17 - 5.03; P=0.02), <i>en bloc</i> resection (OR 10.9, 95%CI 3.53-49.0; P<0.001), and IMC (OR 4.09, 95%CI 1.52-11.50; P=0.01). No differences in surveillance outcomes were observed.</p><p><strong>Conclusions: </strong>Endoscopic resection is curative for dysplasia confined to the mucosa in completely resected colonic adenomas. Labeling these lesions as \"carcinoma\" increases IEI recommendations without improving outcomes. Our findings support the 2020 USMSTF guidelines to standardize all dysplastic colorectal lesion terminology as HGD to ensure appropriate follow-up intervals.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 3","pages":"352-359"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980081","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":"Investigating the relationship between vitamin D levels and immune-mediated colitis.","authors":"Varun Vemulapalli, Nina Quirk, Sharada Wali, Cristina Natha, Anirudha Chatterjee, Rohan Ahuja, Tanvi Gupta, Jarrett Rong, Saivaroon Gajagowni, Arjun Peddireddy, Faraz Jafri, Yinghong Wang, Anusha Shirwaikar Thomas","doi":"10.20524/aog.2026.1053","DOIUrl":"10.20524/aog.2026.1053","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to evaluate the potential association between serum vitamin D levels and the incidence and severity of immune-mediated colitis (IMC), and to explore the potential role of vitamin D supplementation as a preventative or therapeutic intervention.</p><p><strong>Methods: </strong>This was a single-center study in which we retrospectively reviewed patients who received immune checkpoint inhibitor (ICI) treatment, had serum vitamin D levels measured within 6 months before or after starting treatment, and subsequently developed IMC.</p><p><strong>Results: </strong>A total of 179 patients were included in the study. Patients were stratified by serum vitamin D levels: 121 (67.6%) had levels ≤40 ng/mL, and 58 (32.4%) had levels >40 ng/mL. Individuals with vitamin D levels ≤40 ng/mL had more severe diarrhea (65.0%) and severe colitis (48.0%), both defined as common terminology criteria for adverse events grade ≥2, compared to those with vitamin D levels >40 ng/mL (45.6% and 28.6%, respectively; P=0.022 and P=0.034). Univariate analysis revealed that patients receiving vitamin D during ICI therapy had ~1.9 times higher odds of requiring steroid treatment (odds ratio [OR] 1.899, 95% confidence interval [CI] 1.0338-3.474; P=0.038). Patients with grade ≥2 diarrhea had 11 times higher odds of requiring steroids (OR 11.11, 95%CI 5.35-22.73; P<0.001). Patients with colitis grade ≥2 had 3 times higher odds of steroid use (OR 3.08, 95%CI 1.54-6.13; P=0.001).</p><p><strong>Conclusions: </strong>This study suggests that there is a relationship between serum vitamin D levels and IMC. Vitamin D deficiency in those with IMC was associated with more severe disease, and those with more severe disease were more likely to require steroid therapy.</p>","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 3","pages":"344-351"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980084","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":"Methodological concerns in evaluating water exchange combined with distal attachments for adenoma detection.","authors":"Selim Coşkun, Shota Hoshika, Masahiro Banno","doi":"10.20524/aog.2026.1063","DOIUrl":"10.20524/aog.2026.1063","url":null,"abstract":"","PeriodicalId":7978,"journal":{"name":"Annals of Gastroenterology","volume":"39 3","pages":"378-382"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980101","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}