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Gel-immersion Endoscopic Submucosal Dissection for Superficial Colorectal Neoplasms: A Retrospective Study Comparing Conventional Endoscopic Submucosal Dissection 凝胶浸泡内镜粘膜下夹层治疗浅表结直肠肿瘤:比较传统内镜粘膜下夹层的回顾性研究
IF 1.5
DEN open Pub Date : 2025-10-10 DOI: 10.1002/deo2.70221
Kenji Yamauchi, Tomoki Inaba, Takeshi Morimoto, Hugh Shunsuke Colvin, Akira Nakanishi, Shigenao Ishikawa, Masaki Wato
{"title":"Gel-immersion Endoscopic Submucosal Dissection for Superficial Colorectal Neoplasms: A Retrospective Study Comparing Conventional Endoscopic Submucosal Dissection","authors":"Kenji Yamauchi,&nbsp;Tomoki Inaba,&nbsp;Takeshi Morimoto,&nbsp;Hugh Shunsuke Colvin,&nbsp;Akira Nakanishi,&nbsp;Shigenao Ishikawa,&nbsp;Masaki Wato","doi":"10.1002/deo2.70221","DOIUrl":"https://doi.org/10.1002/deo2.70221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Gel-immersion endoscopy offers benefits such as buoyancy, traction, and a clear visual field without gas insufflation. While some case reports have described colorectal gel-immersion endoscopic submucosal dissection (Gi-ESD), there have been no consecutive case series. This study aimed to clarify the usefulness of Gi-ESD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective cohort study included consecutive patients with colorectal neoplasms who underwent ESD. Gi-ESD was defined as mucosal incision and submucosal dissection performed under clear gel. The primary outcomes were en bloc and histologic R0 resection rates, whereas the secondary outcomes were procedure time, dissection speed, and adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 260 ESD cases, 29 and 231 were in the Gi-ESD and conventional ESD groups, respectively. Gel was used for submerged or poorly accessible lesions. The Gi-ESD group had a significantly larger tumor diameter (25 mm vs. 18 mm, <i>p</i> = 0.001), a higher rate of lesions in the cecum or ascending colon (55.2% vs. 31.2%, <i>p</i> = 0.01), and more lesions with ESD difficulty factors (24.1% vs. 9.5%, <i>p</i> &lt; 0.05). There were no significant differences in the en bloc resection (100% vs. 99.1%), histologic R0 resection (96.6% vs. 88.7%), or adverse events. In the propensity score-matched cohort, the histologic R0 resection rate was significantly higher in the Gi-ESD group (100% vs. 82.6%, <i>p</i> = 0.045). Procedure time was significantly longer in the Gi-ESD group (45 vs. 29.5 min, <i>p</i> = 0.006), with no significant difference in dissection speed (14.9 vs. 19.2 mm<sup>2</sup>/min, <i>p</i> = 0.19).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Gi-ESD may be an alternative approach for treating submerged gravity-side or poorly approached colorectal lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272603","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}
引用次数: 0
Is Single-Session Peroral Endoscopic Myotomy With Fundoplication Safe and Effective in Achalasia? A Systematic Review and Meta-Analysis 单次经口内窥镜肌切开术治疗贲门失弛缓症安全有效吗?系统回顾和荟萃分析。
IF 1.5
DEN open Pub Date : 2025-10-08 DOI: 10.1002/deo2.70220
Yusuf Kagzi, Abuzar Asif, Srinivas Reddy Puli
{"title":"Is Single-Session Peroral Endoscopic Myotomy With Fundoplication Safe and Effective in Achalasia? A Systematic Review and Meta-Analysis","authors":"Yusuf Kagzi,&nbsp;Abuzar Asif,&nbsp;Srinivas Reddy Puli","doi":"10.1002/deo2.70220","DOIUrl":"10.1002/deo2.70220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peroral endoscopic myotomy (POEM) is a minimally invasive treatment for achalasia but is often associated with gastroesophageal reflux disease (GERD). Adding fundoplication (POEM+F) may reduce reflux while maintaining the benefits of myotomy. This systematic review and meta-analysis evaluate the efficacy and safety of POEM+F in achalasia patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of electronic databases and conference proceedings was conducted through November 2024 to identify studies on POEM+F. Pooled proportions were calculated using both fixed effects models. Heterogeneity was assessed via Cochran's Q test. Primary outcomes included technical success, Eckardt score improvement, and post-procedure esophagitis. Secondary outcomes included procedure time, adverse events, wrap integrity, and hospital stay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine studies with 202 patients were included. The pooled technical success rate was 94.80% (95% confidence interval [CI]: 91.37–97.40). Mean total procedure time was 110.51 min, with 52.04 min for fundoplication. Eckardt scores improved from 8.30 (95% CI: 6.83–9.76) pre-operatively to 1.08 (95% CI: 0.33–2.50) post-operatively. Post-procedure, 11.52% (95% CI: 6.10–18.38) had abnormal acid exposure and 20.65% (95% CI: 14.47–27.61) developed esophagitis. An intact wrap was seen in 75.69% (95% CI: 58.55–89.40) on follow-up endoscopy. Mean hospital stay was 2.27 days (95% CI: 1.09–3.45).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>POEM with fundoplication is a safe and effective treatment for achalasia, offering high technical success, symptom relief, and a low incidence of GERD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260325","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}
引用次数: 0
Dilation Device Use and Concomitant Antegrade Stenting are Associated With Procedure-related Early Adverse Events After Endoscopic Ultrasound-guided Hepaticogastrostomy: A Retrospective Multicenter Study 超声内镜引导下肝胃造口术后使用扩张装置和同时行顺行支架植入与手术相关的早期不良事件相关:一项回顾性多中心研究。
IF 1.5
DEN open Pub Date : 2025-10-07 DOI: 10.1002/deo2.70211
Shinichi Hashimoto, Hiroki Taguchi, Norimasa Araki, Yu Yamazato, Hiroki Iwata, Yuji Tabira, Ryusuke Shibata, Yusuke Kamikihara, Koshiro Toyodome, Issei Kojima, Takafumi Hamada, Kengo Tsuneyoshi, Yoshitaka Nakamura, Hiroki Yano, Makoto Hinokuchi, Shiho Arima, Shiroh Tanoue, Fumisato Sasaki, Shuji Kanmura, Akio Ido
{"title":"Dilation Device Use and Concomitant Antegrade Stenting are Associated With Procedure-related Early Adverse Events After Endoscopic Ultrasound-guided Hepaticogastrostomy: A Retrospective Multicenter Study","authors":"Shinichi Hashimoto,&nbsp;Hiroki Taguchi,&nbsp;Norimasa Araki,&nbsp;Yu Yamazato,&nbsp;Hiroki Iwata,&nbsp;Yuji Tabira,&nbsp;Ryusuke Shibata,&nbsp;Yusuke Kamikihara,&nbsp;Koshiro Toyodome,&nbsp;Issei Kojima,&nbsp;Takafumi Hamada,&nbsp;Kengo Tsuneyoshi,&nbsp;Yoshitaka Nakamura,&nbsp;Hiroki Yano,&nbsp;Makoto Hinokuchi,&nbsp;Shiho Arima,&nbsp;Shiroh Tanoue,&nbsp;Fumisato Sasaki,&nbsp;Shuji Kanmura,&nbsp;Akio Ido","doi":"10.1002/deo2.70211","DOIUrl":"10.1002/deo2.70211","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is useful in cases of endoscopic retrograde cholangiopancreatography failure. However, the procedure has a high incidence of procedure-related early adverse events (PRAEs). This study retrospectively evaluated risk factors for such events post-EUS-HGS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multicenter study included 222 patients (120 males and 102 females; median age = 73 years) who underwent initial EUS-HGS. The clinical success rate and PRAE incidence, and risk factors were analyzed. PRAEs were defined as AEs occurring within 2 weeks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median procedure time was 41 min. Metal or plastic stents were used for EUS-HGS in 107 and 115 patients, respectively. Fistula dilation and concomitant antegrade stenting (AGS) were performed in 166 and 45 patients, respectively. The clinical success rate and PRAE incidence were 85.1% and 22.1%, respectively. Identified PRAEs included acute peritonitis (9.5%), fever (6.8%), abdominal pain (2.3%), and acute pancreatitis (1.4%). Multivariate analysis identified dilation device use (<i>p</i> = 0.01) and AGS (<i>p</i> = 0.03) as PRAE risk factors. AGS in patients who underwent fistula dilation (<i>p</i> = 0.02) and procedure time ≥41 min in those who underwent EUS-HGS with AGS (<i>p</i> = 0.01) were PRAE risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Fistula dilation and AGS are associated with an increased risk of PRAEs post-EUS-HGS. Careful postoperative follow-up for such events is required in patients undergoing fistula dilation for EUS-HGS with AGS and prolonged procedure time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254194","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}
引用次数: 0
Delayed Bleeding After Endoscopic Ultrasound-guided Hepaticogastrostomy due to Pseudoaneurysm Rupture in a Patient Who Underwent Plastic Stent Placement: A Case Report 超声内镜引导下肝胃造口术后假性动脉瘤破裂延迟出血1例。
IF 1.5
DEN open Pub Date : 2025-10-07 DOI: 10.1002/deo2.70218
Kohei Takano, Takuya Ishikawa, Kentaro Yamao, Yasuyuki Mizutani, Tadashi Iida, Kota Uetsuki, Yoshihisa Takada, Hiroki Kawashima
{"title":"Delayed Bleeding After Endoscopic Ultrasound-guided Hepaticogastrostomy due to Pseudoaneurysm Rupture in a Patient Who Underwent Plastic Stent Placement: A Case Report","authors":"Kohei Takano,&nbsp;Takuya Ishikawa,&nbsp;Kentaro Yamao,&nbsp;Yasuyuki Mizutani,&nbsp;Tadashi Iida,&nbsp;Kota Uetsuki,&nbsp;Yoshihisa Takada,&nbsp;Hiroki Kawashima","doi":"10.1002/deo2.70218","DOIUrl":"10.1002/deo2.70218","url":null,"abstract":"<p>Endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS) is a useful alternative treatment for endoscopic retrograde cholangiopancreatography (ERCP) failure. However, serious complications sometimes occur. Bleeding is an early complication that occurs during puncture; however, there have been some reports of late-onset rupture of a pseudoaneurysm. These reports describe cases of patients who underwent metal stent placement. Herein, we report the first case of pseudoaneurysm formation after plastic stent placement via EUS-HGS. The patient was a 75-year-old man with obstructive jaundice due to pancreatic head cancer. ERCP was unsuccessful, and EUS-HGS was performed with plastic stent placement from B3. The patient subsequently experienced repeated HGS stent failure within a short period, and the plastic stent was replaced each time. No metal stents were placed during treatment. 106 days after EUS-HGS, the patient presented with hematochezia and shock, and contrast-enhanced computed tomography suggested the rupture of a pseudoaneurysm in the left hepatic artery branch. Emergency angiography revealed that the pseudoaneurysm originated from the A2+3 branch of the left hepatic artery, and embolization was performed. Subsequently, there has been no recurrence of bleeding, and the patient was eligible for chemotherapy to treat pancreatic cancer.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260311","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}
引用次数: 0
Severe Gastroduodenitis Associated With Ulcerative Colitis After Total Colectomy Successfully Treated With Endoscopic Hemostasis and Oral Tacrolimus 经内镜止血及口服他克莫司成功治疗全结肠切除术后严重胃十二指肠炎合并溃疡性结肠炎。
IF 1.5
DEN open Pub Date : 2025-10-06 DOI: 10.1002/deo2.70217
Koji Fujimoto, Shuhei Hosomi, Yumie Kobayashi, Rieko Nakata, Yu Nishida, Fumio Tanaka, Yasuhiro Fujiwara
{"title":"Severe Gastroduodenitis Associated With Ulcerative Colitis After Total Colectomy Successfully Treated With Endoscopic Hemostasis and Oral Tacrolimus","authors":"Koji Fujimoto,&nbsp;Shuhei Hosomi,&nbsp;Yumie Kobayashi,&nbsp;Rieko Nakata,&nbsp;Yu Nishida,&nbsp;Fumio Tanaka,&nbsp;Yasuhiro Fujiwara","doi":"10.1002/deo2.70217","DOIUrl":"10.1002/deo2.70217","url":null,"abstract":"<p>Herein, we report a rare case of gastroduodenitis associated with ulcerative colitis (UC). A 42-year-old man was diagnosed with UC 1 year prior to admission to our hospital. The patient underwent a 3-stage total colectomy and ileal pouch-anal anastomosis for severe UC. Two months after the second surgery, the patient was admitted to our hospital with nausea, appetite loss, abdominal pain, and frequent bloody diarrhea. Blood analysis showed an increase in white blood cell count and C-reactive protein levels. Esophagogastroduodenoscopy (EGD) revealed diffuse UC-like inflammation from the stomach to the duodenum and ulcers in the descending and horizontal regions of the duodenum. Pouchoscopy revealed ulcers and friable mucosa within the pouch. The patient was diagnosed with gastroduodenitis associated with UC (GDUC) and diversion pouchitis based on endoscopic and pathological findings. Inflammation in the GDUC was resistant to oral crushed mesalazine and prednisolone (60 mg/day) infusion, resulting in arterial bleeding from the duodenal ulcer and bloody stool in the stoma. Endoscopic hemostasis was performed for the duodenal ulcer. Oral tacrolimus was initiated because the inflammation was steroid-resistant. Approximately 2 weeks after the initiation of tacrolimus, abdominal symptoms, including bloody diarrhea, disappeared, and EGD showed improvement in the GDUC.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246139","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}
引用次数: 0
Clinicopathological Characteristics With the Status of Mismatch Repair Deficient Invasive Colorectal Cancer With Spontaneous Regression 失配修复缺陷侵袭性结直肠癌自发性消退的临床病理特征。
IF 1.5
DEN open Pub Date : 2025-10-06 DOI: 10.1002/deo2.70216
Fumiya Okano, Naohisa Yoshida, Yukiko Morinaga, Naoto Iwai, Reo Kobayashi, Ken Inoue, Osamu Dohi, Takashi Ando, Yoshito Itoh
{"title":"Clinicopathological Characteristics With the Status of Mismatch Repair Deficient Invasive Colorectal Cancer With Spontaneous Regression","authors":"Fumiya Okano,&nbsp;Naohisa Yoshida,&nbsp;Yukiko Morinaga,&nbsp;Naoto Iwai,&nbsp;Reo Kobayashi,&nbsp;Ken Inoue,&nbsp;Osamu Dohi,&nbsp;Takashi Ando,&nbsp;Yoshito Itoh","doi":"10.1002/deo2.70216","DOIUrl":"10.1002/deo2.70216","url":null,"abstract":"<p>Spontaneous regression of endoscopically invasive colorectal cancer (CRC) after biopsy has been rarely reported. We report three cases of endoscopically invasive CRC with spontaneous regression after biopsy and a review of the literature regarding spontaneous regression of CRC with somatic mismatch repair deficiency (MMR-d). Case 1 involved a 54-year-old man who underwent a colonoscopy (CS) after positive fecal immunohistochemical test. A 15-mm elevated lesion with a depression was detected in the transverse colon, and biopsy results indicated adenocarcinoma. When surgical resection was performed 8 weeks later, the lesion was no longer present. Case 2 involved a 75-year-old man with a 10-mm elevated lesion with a depression in the ascending colon during screening CS. Biopsy results indicated adenocarcinoma. CS was performed 9 weeks later to tattoo the lesion before surgery; however, it was no longer present at that time. Case 3 involved an 84-year-old man who underwent surveillance CS after polyp resection and a 12-mm elevated lesion with a depression was observed in the rectum. Biopsy results indicated adenocarcinoma; therefore, endoscopic resection was scheduled. CS performed 8 weeks later showed the disappearance of the lesion. Mismatch repair deficiency was detected in two of these three patients. The literature search identified 12 cases with the evaluation of MMR, including our three cases, which showed spontaneously regressing colorectal cancer. All 12 lesions had depression; 11 were located on the proximal colon, and 11 cases showed MMR-d.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246116","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}
引用次数: 0
Comparison of the Usefulness of Covered and Uncovered Laser-cut Metal Stents 覆盖与未覆盖激光切割金属支架的有效性比较。
IF 1.5
DEN open Pub Date : 2025-10-01 DOI: 10.1002/deo2.70208
Toshio Fujisawa, Masao Toki, Kei Saito, Yuta Hasegawa, Eisuke Iwasaki, Michihiro Saito, Katsuya Kitamura, Ryosuke Tonozuka, Takao Itoi, Ken Ito, Keiko Kaneko, Naminatsu Takahara, Tadakazu Hisamatsu, Hiroyuki Isayama
{"title":"Comparison of the Usefulness of Covered and Uncovered Laser-cut Metal Stents","authors":"Toshio Fujisawa,&nbsp;Masao Toki,&nbsp;Kei Saito,&nbsp;Yuta Hasegawa,&nbsp;Eisuke Iwasaki,&nbsp;Michihiro Saito,&nbsp;Katsuya Kitamura,&nbsp;Ryosuke Tonozuka,&nbsp;Takao Itoi,&nbsp;Ken Ito,&nbsp;Keiko Kaneko,&nbsp;Naminatsu Takahara,&nbsp;Tadakazu Hisamatsu,&nbsp;Hiroyuki Isayama","doi":"10.1002/deo2.70208","DOIUrl":"10.1002/deo2.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the clinical characteristics of laser-cut self-expandable metal stents (SEMS) and to compare the outcomes between covered and uncovered laser-cut SEMS for malignant distal biliary obstruction (MDBO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter retrospective analysis was conducted across eight Japanese university hospitals, including 124 patients (81 with covered and 43 with uncovered SEMS). Treatment outcomes, recurrent biliary obstruction (RBO), survival, and treatment-related adverse events (tAEs) were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The rates of technical success (100% vs. 100%) and clinical success (94% vs. 98%) were comparable between the two groups. However, the incidence of RBO was significantly higher in the uncovered SEMS group compared to the covered SEMS group (37% vs. 20%, <i>p</i> = 0.034), particularly due to stent occlusion (37% vs. 14%, <i>p</i> = 0.005). Nevertheless, there were no significant differences in time to RBO (567 days vs. 459 days) or overall patient survival (277 days vs. 227 days) between the groups. The overall rate of tAEs was similar (15% vs. 12%), though pancreatitis was observed exclusively in the covered SEMS group, with a trend toward lower incidence in the uncovered group (10% vs. 0%, <i>p</i> = 0.050). Stent removal was performed only in patients with covered SEMS, and all 13 removal attempts were successful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Laser-cut SEMS demonstrated similar efficacy to braided stents in the management of MDBO. The covered laser-cut SEMS was associated with a lower RBO rate than the uncovered SEMS. Additionally, Laser-cut SEMS can be removed if it is fully covered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12487949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214993","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}
引用次数: 0
Evaluating the Additional Value of Endoscopic Ultrasonography for Depth Assessment of Esophagogastric Junction Adenocarcinoma 超声内镜对食管胃交界腺癌深度评估的附加价值评价。
IF 1.5
DEN open Pub Date : 2025-09-30 DOI: 10.1002/deo2.70215
Keita Suzuki, Yohei Ikenoyama, Ken Namikawa, Yoshitaka Tokai, Shoichi Yoshimizu, Yusuke Horiuchi, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Manabu Takamatsu, Takahisa Matsuda, Junko Fujisaki
{"title":"Evaluating the Additional Value of Endoscopic Ultrasonography for Depth Assessment of Esophagogastric Junction Adenocarcinoma","authors":"Keita Suzuki,&nbsp;Yohei Ikenoyama,&nbsp;Ken Namikawa,&nbsp;Yoshitaka Tokai,&nbsp;Shoichi Yoshimizu,&nbsp;Yusuke Horiuchi,&nbsp;Akiyoshi Ishiyama,&nbsp;Toshiyuki Yoshio,&nbsp;Toshiaki Hirasawa,&nbsp;Manabu Takamatsu,&nbsp;Takahisa Matsuda,&nbsp;Junko Fujisaki","doi":"10.1002/deo2.70215","DOIUrl":"10.1002/deo2.70215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic ultrasonography (EUS) is sometimes used to assess the depth of invasion in esophagogastric junction adenocarcinoma (EGJA); however, its diagnostic performance in EGJA remains unclear. This study aimed to evaluate the additional value of EUS to conventional endoscopy (CE) in assessing invasion depth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-institution retrospective study, we compared the diagnostic performance of CE alone with that of CE + EUS for preoperative depth assessment of early-stage EGJA. In addition, we examined the clinicopathologic features associated with incorrect depth assessment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 93 cases of early-stage EGJA. Comparing the diagnostic performance for diagnosing submucosal cancer (CE vs. CE + EUS), CE + EUS had a significantly lower specificity than CE alone (78.4% vs. 62.2%). However, no significant differences were observed in sensitivity (73.2% vs. 71.4%) and accuracy (75.3% vs. 67.7%) between the two modalities. The addition of EUS was associated with significantly higher misdiagnosis rates in the following types of lesions: lesions located on the esophageal side (42.6% vs. 25.5%), elevated lesions (29.2% vs. 15.4%), complex lesions (32.7% vs. 16.3%), and lesions with hiatal hernia (31.1% vs. 19.7%). No clinicopathological factors were significantly associated with overdiagnosis or underdiagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The addition of EUS to CE reduced the ability to accurately identify mucosal cancers in early-stage EGJA, suggesting a risk of overdiagnosis and unnecessary therapeutic escalation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12481211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208650","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}
引用次数: 0
Major Basic Protein Deposition Without Eosinophilic Infiltration in Hypercontractile Esophagus: A Case Report 食道过度收缩无嗜酸性粒细胞浸润的主要碱性蛋白沉积1例。
IF 1.5
DEN open Pub Date : 2025-09-29 DOI: 10.1002/deo2.70206
Tetsuya Tatsuta, Keinosuke Hizuka, Shigeharu Ueki, Masatoshi Kaizuka, Shinji Oota, Keisuke Hasui, Hidezumi Kikuchi, Hiroto Hiraga, Daisuke Chinda, Hirotake Sakuraba
{"title":"Major Basic Protein Deposition Without Eosinophilic Infiltration in Hypercontractile Esophagus: A Case Report","authors":"Tetsuya Tatsuta,&nbsp;Keinosuke Hizuka,&nbsp;Shigeharu Ueki,&nbsp;Masatoshi Kaizuka,&nbsp;Shinji Oota,&nbsp;Keisuke Hasui,&nbsp;Hidezumi Kikuchi,&nbsp;Hiroto Hiraga,&nbsp;Daisuke Chinda,&nbsp;Hirotake Sakuraba","doi":"10.1002/deo2.70206","DOIUrl":"10.1002/deo2.70206","url":null,"abstract":"<p>Hypercontractile esophagus is a motility disorder characterized by excessive contractions in the esophageal body. Certain cases of hypercontractile esophagus exhibit eosinophilic infiltration in the muscle layer; however, its clinical significance is unclear. Here, we report a case of hypercontractile esophagus with possible eosinophilic inflammation despite the absence of eosinophilic infiltration on hematoxylin and eosin staining. A 75-year-old man presented with dysphagia, primarily triggered by the ingestion of meat. Esophagogastroduodenoscopy showed abnormal peristalsis of the esophageal body, while the lower esophageal sphincter function remained normal. High-resolution manometry confirmed hypercontractile esophagus, according to the Chicago Classification version 4.0. As symptoms persisted despite medical treatment, the patient underwent peroral endoscopic myotomy. Biopsies obtained from the inner circular muscle layer revealed no notable eosinophilic infiltration on hematoxylin and eosin staining. However, immunofluorescence staining for major basic protein (MBP), a cytotoxic eosinophil granule protein that persists in tissues, showed patchy depositions. Corresponding counterstaining revealed collapsed nuclei surrounded by eosinophilic material, suggesting MBP release via eosinophil cytolysis. This case demonstrated that immunostaining for eosinophil granule proteins may uncover eosinophilic activity in the esophageal muscle layer, even in the absence of eosinophils. While the precise pathogenic role of eosinophilic inflammation in hypercontractile esophagus remains unclear, MBP deposition could reflect a localized immune-mediated process contributing to motility disturbance. Further investigation is needed to determine the prevalence, mechanisms, and clinical implications of these findings in esophageal motor disorders.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12478599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202528","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}
引用次数: 0
Patient Characteristics and Outcomes of Endoscopically Placed Dedicated Transgastric Jejunal Tubes Compared to Percutaneous Endoscopic Gastrostomy With Jejunal Extension Tubes 内镜下放置经胃专用空肠管与经皮内镜下空肠延伸管胃造口术的患者特点和结果比较
IF 1.5
DEN open Pub Date : 2025-09-26 DOI: 10.1002/deo2.70213
Laura D. Kek, David H. Bruining, Navtej S. Buttar, Hadi Abou Zeid, Andrew C. Storm, William S. Harmsen, Louis M. Wong Kee Song, Nayantara Coelho-Prabhu
{"title":"Patient Characteristics and Outcomes of Endoscopically Placed Dedicated Transgastric Jejunal Tubes Compared to Percutaneous Endoscopic Gastrostomy With Jejunal Extension Tubes","authors":"Laura D. Kek,&nbsp;David H. Bruining,&nbsp;Navtej S. Buttar,&nbsp;Hadi Abou Zeid,&nbsp;Andrew C. Storm,&nbsp;William S. Harmsen,&nbsp;Louis M. Wong Kee Song,&nbsp;Nayantara Coelho-Prabhu","doi":"10.1002/deo2.70213","DOIUrl":"https://doi.org/10.1002/deo2.70213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Patients requiring long-term enteral nutrition or continuous infusion of carbidopa/levodopa can benefit from jejunostomy tube placement. Recently, directly placed percutaneous transgastric jejunal tubes (TGJs) have been used instead of gastrostomy tubes with jejunal extensions (PEG-Js) for enteral access. We aim to compare patient characteristics and outcomes after placement of TGJs placed via the introducer technique compared to PEG-Js.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a retrospective study of 141 patients (TGJ = 58, PEG-J = 83) assessed at Mayo Clinic between 2010 and 2024. Patients were identified using a prospectively maintained procedure data registry. Demographic data, patient characteristics, procedural indications, complications, and first-replacement date were gathered. Statistical analysis included the Wilcoxon rank sum test, chi-square test, Fisher's exact test, and Kaplan-Meier estimates. Patients receiving carbidopa/levodopa were excluded from complications analysis due to the carbidopa/levodopa tube's proprietary structure. A <i>p</i>-value of &lt;0.05 was set as a threshold for significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our results demonstrated no difference in cumulative incidence of complications within 1 year for TGJs and PEG-Js, <i>p</i>-value 0.48. Regarding time to first replacement, treating death as a competing risk factor, there was no statistically significant difference in cumulative incidence of replacement within 1 year for TGJs and PEG-Js, <i>p</i>-value 0.389.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our study demonstrates that both direct TGJs and PEG-Js are safe options for long-term jejunal feeding. More studies are needed to compare endoscopic to radiologically placed percutaneous transgastric jejunal feeding tubes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146730","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}
引用次数: 0
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