DEN open最新文献

{"title":"Comparison effectiveness of topical analgesics with and without Entonox for esophagogastroduodenoscopy: A randomized controlled trial","authors":"Papiroon Noitasaeng,&nbsp;Uayporn Kaosombatwattana,&nbsp;Rojsirin Chaiwong,&nbsp;Phongthara Vichitvejpaisal","doi":"10.1002/deo2.70107","DOIUrl":"https://doi.org/10.1002/deo2.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Esophagogastroduodenoscopy (EGD) is vital for diagnosing and treating upper gastrointestinal symptoms, but patient discomfort and anxiety can affect procedural outcomes. This study aimed to compare the effectiveness of topical analgesics with and without Entonox during EGD in terms of procedural success, patient tolerance, and satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective, randomized, double-blinded, controlled trial. Patients were assigned to receive either 10% xylocaine spray in the control group (Group C) or 10% xylocaine spray combined with Entonox (Group E). Procedural success and patient comfort were evaluated using the Bath Gastroscopy Toleration Score and patient comfort scores, with scores of 0 or 1 indicating success. Satisfaction was measured using the numeric rating scale, where scores of 7 or higher indicated high satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 211 patients underwent EGD successfully (Group C = 106, Group E = 105). Patients in Group E demonstrated a significantly higher proportion of success rate (76.2% vs. 35.9%, <i>p</i> &lt; 0.001), better toleration score (82.9% vs. 75.5%, <i>p</i> = 0.004), and better patient comfort score (86.7% vs. 39.6%, <i>p</i> &lt; 0.001) compared to Group C. Endoscopists and patients in Group E expressed higher satisfaction levels (9 vs. 8, <i>p</i> &lt; 0.01 and 9 vs. 8, <i>p</i> &lt; 0.01). The side effects of Entonox were minimal. Notably, Group E had a lower proportion of high blood pressure and tachycardia during the procedure (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Combining Entonox with topical analgesics significantly improves tolerance, satisfaction, and procedural success during EGD, offering a safe and effective option for managing patient discomfort and anxiety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70107","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085385","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":"Adequacy evaluation of 22-gauge needle endoscopic ultrasound-guided tissue acquisition samples and glass slides preparation for successful comprehensive genomic profiling testing: A single institute experience","authors":"Tami Nagatani,&nbsp;Yoji Wani,&nbsp;Masahiro Takatani,&nbsp;Soichiro Fushimi,&nbsp;Hirofumi Inoue,&nbsp;Shinichiro Hori,&nbsp;Kyohei Kai,&nbsp;Hideki Yamamoto,&nbsp;Tetsuya Okazaki,&nbsp;Maki Tanioka,&nbsp;Hiroyuki Okada,&nbsp;Akira Hirasawa","doi":"10.1002/deo2.70104","DOIUrl":"https://doi.org/10.1002/deo2.70104","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the successful sequencing rate of Foundation One CDx (F1CDx) using small tissue samples obtained with a 22-gauge needle (22G) through endoscopic ultrasound-guided fine needle acquisition (EUS-TA) and to propose guidelines for tissue quantity evaluation criteria and proper slide preparation in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between June 2019 and April 2024, 119 samples of 22G EUS-TA collected for F1CDx testing at Himeji Red Cross Hospital were retrospectively reviewed. Tissue adequacy was only assessed based on tumor cell percentage (≥20%). The procedure stopped when white tissue fragments reached 20 mm during macroscopic on-site evaluation. The specimens were prepared using both ‘tissue preserving sectioning’ to retain tissue within formalin-fixed paraffin-embedded blocks and the ‘thin sectioning matched needle gauge and tissue length’ method with calculation to ensure minimal unstained slides for the 1 mm³ sample volume criterion. Tissue area from HE slides and sample volume were measured, and F1CDx reports were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 119 samples, 108 (90.8%) were suitable for F1CDx. Excluding the cases not submitted for testing, in the 45 cases where F1CDx was done using 22G EUS-TA samples, eight (17.8%) had a sum of tissue area tissue of 25 mm² or greater in the HE-stained sample. However, all cases met the F1CDx 1 mm³ volume criterion by submitting &gt; 30 unstained slides per sample. As a result, 43 of 45 cases (95.6%) were successfully analyzable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The 22G EUS-TA needle is an effective tool for providing the sufficient tissue volume required for F1CDx.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143930349","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":"Endoscopic resection of polypoid solitary rectal ulcer: A novel first-line therapeutic strategy using snare-assisted mucosal and fibrosis resection","authors":"Mojgan Forootan,&nbsp;Alessandro Repici,&nbsp;Mohsen Rajabnia,&nbsp;Mohammad Ali Karimi,&nbsp;Ali Jahanian,&nbsp;Pardis Ketabi Moghadam,&nbsp;Mahsa Mohammadi,&nbsp;Erfan Ghadirzadeh,&nbsp;Abdorraoof Soudi,&nbsp;Elham Paraandavaji,&nbsp;Sasan Shafiei,&nbsp;Mohammad Reza Zali,&nbsp;Mohammad Tashakoripour","doi":"10.1002/deo2.70108","DOIUrl":"https://doi.org/10.1002/deo2.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To propose a novel first-line endoscopic therapy for treating polypoid lesions in solitary rectal ulcer syndrome (P-SRUS), the rarest and most challenging subtype of SRUS, which encompasses various endoscopic findings including mucosal erythema, superficial or deep ulcers, and polypoid lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective, single-arm study was conducted on 56 patients with histologically confirmed SRUS and broad-based polypoid lesions in the rectum and anal canal. These patients were referred to the Department of Motility Disorders of the Lower Gastrointestinal Tract. The lesions were removed using snare-assisted mucosal and fibrosis resection. Patients were monitored for clinical and endoscopic responses at 1, 3, 6, and 12 months post-treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study observed improvement in clinical symptoms, a complete endoscopic response, and the absence of late complications following endoscopic resection. Endoscopic evaluations revealed no recurrence of lesions in the follow-up period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Endoscopic resection using the snare-assisted mucosal and fibrosis resection method appears to be an effective and safe treatment option for polypoid SRUS. (Clinical Trial Registration Number: IRCT20211101052935N2).</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926100","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":"Advancements and limitations of image-enhanced endoscopy in colorectal lesion diagnosis and treatment selection: A narrative review","authors":"Taku Sakamoto,&nbsp;Shintaro Akiyama,&nbsp;Toshiaki Narasaka,&nbsp;Kiichiro Tuchiya","doi":"10.1002/deo2.70141","DOIUrl":"https://doi.org/10.1002/deo2.70141","url":null,"abstract":"<p>Colorectal cancer (CRC) is a leading cause of cancer-related mortality, highlighting the need for early detection and accurate lesion characterization. Traditional white-light imaging has limitations in detecting lesions, particularly those with flat morphology or minimal color contrast with the surrounding mucosa. It also struggles to distinguish neoplastic from non-neoplastic lesions. These limitations led to the development of image-enhanced endoscopy (IEE). Image-enhanced endoscopy modalities such as narrow-band imaging, blue laser imaging, linked color imaging, and texture and color enhancement imaging enhance mucosal surface and vascular pattern visualization, thereby improving lesion detection and characterization.</p><p>In contrast, red dichromatic imaging is primarily designed to enhance the visibility of deep blood vessels, making it particularly useful during therapeutic endoscopies, such as identifying bleeding sources and monitoring post-treatment hemostasis. Although IEE enhances lesion detection and characterization, it remains limited in assessing submucosal invasion depth, which is a key factor in treatment decisions. Endoscopic submucosal dissection requires accurate prediction of invasion depth; however, IEE mainly reflects superficial features. Endoscopic ultrasound and artificial intelligence-assisted diagnostics have emerged as complementary techniques for improving depth assessment and lesion classification. Additionally, IEE plays a critical role in detecting ulcerative colitis-associated neoplasia (UCAN), which often presents with a flat morphology and indistinct borders. High-definition chromoendoscopy and IEE modalities enhance detection; however, inflammation-related changes limit diagnostic accuracy. Artificial intelligence and molecular biomarkers may improve UCAN diagnosis. This review examines the role of IEE in lesion detection and treatment selection, its limitations, and complementary techniques such as endoscopic ultrasound and artificial intelligence. We also explored pit pattern diagnosis using crystal violet staining and discussed emerging strategies to refine colorectal cancer screening and management.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70141","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926099","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":"Diagnosis and treatment of gastric abscess by endoscopic ultrasound: A mini-review of the preliminary application","authors":"Jia Xie,&nbsp;Mo-Jin Wang,&nbsp;Rui Wang","doi":"10.1002/deo2.70129","DOIUrl":"https://doi.org/10.1002/deo2.70129","url":null,"abstract":"<p>Gastric abscess is a rare condition caused by gastric barrier damage. It is easily misdiagnosed in clinical practice as a cancer recurrence or submucosal tumor, especially after surgery or endoscopic submucosal dissection. With a relatively high mortality rate, the cause and clinical characteristics of gastric abscesses are obscure. To date, diagnostic evaluations have mostly included indirect gastroscopy and abdominal computed tomography. A definite diagnosis of gastric abscess is challenging, and unnecessary surgery is sometimes performed. Relatively few applications of endoscopic ultrasound (EUS) have been described. EUS-guided fine needle aspiration for diagnosis and drainage is not commonly used. Therefore, more experiences related to the cause and clinical characteristics of gastric abscesses should be reported. Further recognition of EUS ultrasonographic images and related minimally invasive EUS therapies are urgently needed. Herein, through a literature review of previous cases, we summarized the causes, clinical features, and diagnostic methods for gastric abscess. Moreover, we aimed to gain more experience diagnosing gastric abscesses by EUS for future differentiation and treatment strategies by endoscopy.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143919889","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":"Antireflux myoplasty: Endoscopic myoplasty with bilateral sling fiber plication for refractory gastroesophageal reflux disease","authors":"Hironari Shiwaku,&nbsp;Akio Shiwaku,&nbsp;Hisatoshi Irie,&nbsp;Takayuki Akasaki,&nbsp;Seiya Sato,&nbsp;Nobuhiko Koreeda,&nbsp;Katsudai Shirakabe,&nbsp;Kosuke Yamauchi,&nbsp;Haruhiro Inoue,&nbsp;Suguru Hasegawa","doi":"10.1002/deo2.70134","DOIUrl":"https://doi.org/10.1002/deo2.70134","url":null,"abstract":"<p>Endoscopic antireflux therapy is a novel endoscopic treatment for refractory gastroesophageal reflux disease. We developed antireflux myoplasty (AR-MP), a modified version of antireflux mucoplasty (ARM-P), in which exposed bilateral sling fibers are sutured directly via endoscopic hand-suturing. AR-MP was performed on a 60-year-old man, resulting in symptomatic improvement and allowing discontinuation of acid-suppressive medication 3 months after the procedure. One month postoperatively, endoscopy showed an improvement in the Hill classification from grade 3 to grade 1. Before AR-MP, endoscopic pressure study integrated system findings showed a maximum intragastric pressure value of 13.7 mmHg, indicating a flat pattern. After AR-MP, maximum intragastric pressure exceeded 20 mmHg, and the pattern shifted to uphill. AR-MP is an innovative endoscopic technique that reconstructs the native antireflux mechanism by suturing the sling fibers and reforming the gastroesophageal flap valve. This innovative endoscopic procedure, like ARM-P, provides immediate symptom relief and represents a breakthrough in the endoscopic treatment of gastroesophageal reflux disease.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914077","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":"Optimal timing of precut sphincterotomy to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis in difficult biliary cannulation: A retrospective study","authors":"Tomohiro Tanikawa,&nbsp;Keisuke Miyake,&nbsp;Mayuko Kawada,&nbsp;Katsunori Ishii,&nbsp;Takashi Fushimi,&nbsp;Noriyo Urata,&nbsp;Nozomu Wada,&nbsp;Ken Nishino,&nbsp;Mitsuhiko Suehiro,&nbsp;Miwa Kawanaka,&nbsp;Hidenori Shiraha,&nbsp;Ken Haruma,&nbsp;Hirofumi Kawamoto","doi":"10.1002/deo2.70138","DOIUrl":"https://doi.org/10.1002/deo2.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Precut sphincterotomy is often performed when bile duct cannulation is difficult; however, the former has a higher risk of complications than conventional methods. Early precut reduces the risk of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP). This study aimed to determine the appropriate timing for precut sphincterotomy to minimize the incidence of PEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study analyzed 320 patients who underwent precut sphincterotomy during their first endoscopic retrograde cholangiopancreatography at a single center. The optimal precut timing was identified using receiver operating characteristic analysis. Patients were divided into an optimized precut group (≤12 min, <i>n</i> = 198) and a delayed group (&gt;12 min, <i>n</i> = 122). The incidence and risk factors of PEP were evaluated using multivariate analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Receiver operating characteristic analysis identified 12.5 min as the optimal cutoff for transitioning to precut sphincterotomy (area under the curve, 0.613; sensitivity, 61.5%; specificity, 63.9%). The incidence of PEP was significantly lower in the optimized precut group than in the delayed precut group (5.1% vs. 13.1%, <i>p</i> = 0.02). Multivariate analysis identified delayed precut timing (odds ratio [OR], 3.134; <i>p</i> = 0.04) and the absence of endoscopic pancreatic stenting (OR, 0.284; <i>p</i> = 0.01) as independent risk factors for PEP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Precut sphincterotomy within 12.5 min of a cannulation attempt reduces the risk of PEP while maintaining procedural safety. Additionally, endoscopic pancreatic stenting can reduce PEP, even in precut scenarios.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914500","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":"Updated evidence on epidemiology, diagnosis, and treatment for colonic diverticular bleeding","authors":"Chikamasa Ichita,&nbsp;Takaaki Kishino,&nbsp;Tomonori Aoki,&nbsp;Tomohiko Machida,&nbsp;Takashi Murakami,&nbsp;Yoshinori Sato,&nbsp;Naoyoshi Nagata","doi":"10.1002/deo2.70122","DOIUrl":"https://doi.org/10.1002/deo2.70122","url":null,"abstract":"<p>Since 2020, multiple large-scale studies (CODE BLUE-J) in Japan have accelerated the accumulation of evidence on colonic diverticular bleeding (CDB). This review summarizes the latest findings regarding CDB epidemiology and endoscopic hemostasis. Recent data show that CDB has become the most common cause of lower gastrointestinal bleeding in Japan, driven by an aging population and the increased use of antithrombotic medications. Although 70%–90% of patients achieve spontaneous hemostasis, rebleeding occurs in up to 35% of cases within 1 year. Despite an overall mortality rate of &lt; 1%, patients with CDB can present with hypovolemic shock and may require urgent intervention. There are no effective pharmacological treatments for controlling CDB. Therefore, endoscopic therapy plays a crucial role in its management. Based on available evidence, both clipping and endoscopic band ligation are considered effective initial treatments. Recent studies indicate that direct clipping reduces early rebleeding compared with indirect clipping, while endoscopic band ligation achieves lower rebleeding rates (13%–15%) than clipping. The choice between direct clipping and endoscopic band ligation depends on the diverticulum location and the presence of active bleeding. Newer techniques, such as over-the-scope clip and self-assembling peptide application, have shown potential, but require further study. The detection of the bleeding source remains challenging because accurate identification is essential for successful hemostasis. Additional research is needed to refine the endoscopic diagnostic and therapeutic techniques, prevent rebleeding, and improve patient outcomes.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70122","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143909230","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":"Prognostic factors and long-term outcomes with endoscopic submucosal dissection for colorectal tumors in patients aged 75 years or older","authors":"Takaya Miura,&nbsp;Satohiro Matsumoto,&nbsp;Azumi Sato,&nbsp;Shu Kojima,&nbsp;Goya Sasaki,&nbsp;Mina Morino,&nbsp;Keita Matsumoto,&nbsp;Hitomi Kashima,&nbsp;Yudai Koito,&nbsp;Takehiro Ishii,&nbsp;Shuhei Yoshikawa,&nbsp;Haruka Otake,&nbsp;Takeshi Uehara,&nbsp;Masanari Sekine,&nbsp;Takeharu Asano,&nbsp;Hiroyuki Miyatani,&nbsp;Hirosato Mashima","doi":"10.1002/deo2.70137","DOIUrl":"https://doi.org/10.1002/deo2.70137","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Studies regarding the long-term outcomes of endoscopic submucosal dissection (ESD) performed in older patients with colorectal tumors are limited. Therefore, in this study, we aimed to analyze the long-term outcomes of older patients with colorectal tumors who underwent ESD and identify prognostic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The data of patients aged ≥ 75 years who underwent ESD for colorectal tumors (adenoma and Tis/T1 colorectal cancer) at a single center were retrospectively analyzed. Prognostic factors for overall survival were analyzed using the Kaplan–Meier method and the Cox proportional hazard model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 156 patients included, 51 patients died during the follow-up period, among whom two deaths were due to colorectal cancer. The univariate analysis revealed that an age ≥83 years, Charlson Comorbidity Index ≥2, prognostic nutritional index &lt;46, and neutrophil-to-lymphocyte ratio (NLR) ≥3 were associated with poor overall survival. The multivariate analysis identified Charlson Comorbidity Index ≥2 (hazard ratio: 2.26; 95% confidence interval (CI): 1.24–4.13; <i>p </i>= 0.0008) and NLR ≥3 (hazard ratio, 1.98; 95% CI: 1.02–3.81; <i>p </i>= 0.042) as independent prognostic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CCI and NLR may be useful parameters for decision-making in older patients undergoing colorectal ESD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914429","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 case of duodenal pyloric gland adenoma with high-grade dysplasia arising from ectopic gastric mucosa","authors":"Kenichiro Nakachi,&nbsp;Hironobu Nagumo,&nbsp;Tetsuro Okura,&nbsp;Wataru Ohno,&nbsp;Takashi Ashikawa,&nbsp;Tomoyuki Funato,&nbsp;Toshiyasu Shiratori,&nbsp;So Nakaji,&nbsp;Shion Ando","doi":"10.1002/deo2.70135","DOIUrl":"https://doi.org/10.1002/deo2.70135","url":null,"abstract":"<p>Superficial non-ampullary duodenal epithelial tumor is a rare disease, but its frequency has reportedly been increasing in recent years. We report a case of duodenal pyloric gland adenoma with high-grade dysplasia arising from ectopic gastric mucosa. Esophagogastroduodenoscopy detected a 5-mm raised lesion on the anterior surface of the duodenal bulb. The lesion was diagnosed as gastric foveolar metaplasia with biopsy. A second esophagogastroduodenoscopy was performed 13 years later. The nodule showed a two-stage elevation and a biopsy revealed EGM. The lesion was followed up with EGD almost every year, with enlargement observed each time. Endoscopic submucosal dissection was performed. Histopathological examination revealed pyloric gland adenoma with high-grade dysplasia. Ectopic gastric mucosa was observed in the tumor pathologically and transformation of the EGM into a tumor was followed endoscopically over time.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"6 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914430","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}