DEN open最新文献

{"title":"Evaluating a Modified American Society of Anesthesiologists Physical Status-Based Sedation Management System for Pancreatobiliary Endoscopy: A Prospective Feasibility Study","authors":"Taro Hanaoka,&nbsp;Kosuke Okuwaki,&nbsp;Masafumi Watanabe,&nbsp;Hiromi Matsuda,&nbsp;Kai Adachi,&nbsp;Akihiro Tamaki,&nbsp;Daisuke Ogawa,&nbsp;Mayuko Sakai,&nbsp;Chika Kusano","doi":"10.1002/deo2.70445","DOIUrl":"10.1002/deo2.70445","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To prospectively evaluate the feasibility of implementing a modified American Society of Anesthesiologists Physical Status (ASA-PS)-based sedation management system for endoscopist-managed sedation in pancreatobiliary endoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, single-arm prospective feasibility study involved 2000 patients (2024–2025). Sedation risk was stratified using a modified ASA-PS classification system combined with predefined high-risk clinical factors (severe obesity, obstructive sleep apnea requiring continuous positive airway pressure, chronic obstructive pulmonary disease requiring home oxygen therapy, reduced functional capacity, and difficult sedation history). Patients meeting high-risk criteria underwent pre-procedural anesthesiologist assessment to determine sedation providers. The primary outcome was sedation-related adverse event (SRAE) incidence during endoscopist-managed sedation. The secondary outcomes were the sedation success rate and SRAE-associated risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2000 patients, 231 (11.6%) were classified as having high risk for sedation. Post-assessment, anesthesiologists and endoscopists managed sedation for 86 (4.3%) and 1914 (95.7%) patients, respectively. In the endoscopist-managed group, SRAEs occurred in 63 patients (3.3%), corresponding to a success rate of 96.7%. No patient required tracheal intubation or conversion to general anesthesia. In multivariable analysis, endoscopic ultrasonography-guided sampling was independently associated with reduced SRAEs (odds ratio 0.407, 95% confidence interval 0.184–0.899; <i>p</i> = 0.026); no independent predictors of increased SRAEs were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The modified ASA-PS-based sedation management system may be a feasible approach in settings with limited anesthesiology resources, warranting further validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>UMIN000053211</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187054","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":"Therapeutic Balloon-Assisted Enteroscopy: Recent Advances in the Management of Small Bowel Diseases","authors":"Manabu Nagayama,&nbsp;Tsubasa Kinoshita,&nbsp;Hiroyuki Kawaguchi,&nbsp;Toshihiro Fujinuma,&nbsp;Sawako Fujikura,&nbsp;Hiroki Hayashi,&nbsp;Tomoko Tamaru,&nbsp;Hirotsugu Sakamoto,&nbsp;Tomonori Yano","doi":"10.1002/deo2.70449","DOIUrl":"10.1002/deo2.70449","url":null,"abstract":"<p>Balloon-assisted enteroscopy (BAE) has substantially advanced small bowel disease management. This review summarizes recent therapeutic BAE advances, focusing on three major indications: small bowel vascular lesions, hereditary polyposis syndromes, and Crohn's disease (CD). For suspected small bowel bleeding from vascular lesions, morphological classification guides lesion-specific hemostasis—primarily using argon plasma coagulation and clipping—while gel immersion endoscopy helps secure the visual field. In hereditary polyposis syndromes (e.g., Peutz–Jeghers syndrome and familial adenomatous polyposis), endoscopic ischemic and cold snare polypectomy prevent intussusception and reduce cancer risk, decreasing surgical needs. Additionally, endoscopic balloon dilation is an established bowel-preserving treatment for fibrotic CD strictures, reducing surgical resection and short bowel syndrome risk. Driven by evolving imaging and devices, BAE remains central to small bowel management, improving patient outcomes and quality of life.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139999","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":"Gel Immersion Endoscopic Mucosal Resection With Submucosal Injection for Superficial Esophageal Squamous Neoplasms (With Video)","authors":"Takahiro Uda,&nbsp;Yuji Urabe,&nbsp;Tomoyuki Gurita,&nbsp;Yoshiki Hatsushika,&nbsp;Satoshi Masuda,&nbsp;Yukiko Sako,&nbsp;Takeo Nakamura,&nbsp;Yuki Kamigaichi,&nbsp;Takeshi Takasago,&nbsp;Hidenori Tanaka,&nbsp;Akiyoshi Tsuboi,&nbsp;Ken Yamashita,&nbsp;Yuichi Hiyama,&nbsp;Yoshihiro Kishida,&nbsp;Hidehiko Takigawa,&nbsp;Akira Ishikawa,&nbsp;Toshio Kuwai,&nbsp;Shinji Mii,&nbsp;Shiro Oka","doi":"10.1002/deo2.70444","DOIUrl":"10.1002/deo2.70444","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Gel immersion can provide a stable immersion environment during endoscopic mucosal resection (EMR). However, its application in superficial esophageal squamous lesions remains limited. In this study, we evaluated a gel immersion EMR (GI-EMR) technique in which submucosal injection was intentionally performed before snaring for selected small superficial esophageal squamous lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center, retrospective case series included consecutive patients who underwent GI-EMR with submucosal injection for superficial esophageal squamous lesions ≤15 mm in size between January and March 2026. The primary outcome was the histological en bloc resection rate, while secondary outcomes included technical success, endoscopic en bloc resection rate, procedure time, adverse events, and histopathological findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>GI-EMR with submucosal injection was attempted for 13 lesions, achieving a technical success rate of 92% (12/13). One procedure was discontinued because adequate lifting could not be achieved due to post-chemoradiotherapy scarring. The endoscopic and histological en bloc resection rates were both 85% (11/13) on an intention-to-treat basis. The median procedure time was 4.25 min (range, 2.0–11.0 min). No intraoperative or delayed perforation, post-procedure bleeding, or gel-related adverse events occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>GI-EMR with submucosal injection was technically feasible for selected superficial esophageal squamous lesions ≤15 mm, with no serious procedure-related adverse events observed in this small case series.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>N/A</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139996","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":"Transient Whitish Change in the Gastric Mucosa Induced by Water-Jet Flushing","authors":"Hidetaka Hamamoto,&nbsp;Hiroaki Saito,&nbsp;Tomoki Matsuda","doi":"10.1002/deo2.70448","DOIUrl":"10.1002/deo2.70448","url":null,"abstract":"<p>Localized transient whitening of the gastric mucosa after water-jet flushing through the auxiliary water channel is rarely described. We report a 49-year-old man who underwent endoscopic submucosal dissection for a 5-mm gastric-type neoplasm on the greater curvature of the lower gastric body. During washing of adjacent non-lesional mucosa, strong auxiliary water-channel flushing for approximately 2–5 s was followed by a focal whitish linear change confined to the flushed area, which became evident approximately 10 s after flushing was stopped and persisted for approximately 30 s before resolving spontaneously, without symptoms or adverse events. Similar changes were observed on the following day and 84 days after resection, but not under the recorded conditions of weaker auxiliary water-channel flushing or manual instrument-channel spraying. When a localized whitish change is observed after strong auxiliary water-channel flushing, brief observation for spontaneous resolution may help distinguish this transient finding from a fixed mucosal lesion.</p><p><b>Trial Registration</b>: N/A</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129376","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":"Flushing-Assisted Saline Immersion Endoscopic Submucosal Dissection in the Rectum: A Video-Based Feasibility Series","authors":"Thomas Matthews,&nbsp;Jonathan Landy,&nbsp;Hiromitsu Ban,&nbsp;Takashi Toyonaga,&nbsp;Noriko Suzuki","doi":"10.1002/deo2.70447","DOIUrl":"10.1002/deo2.70447","url":null,"abstract":"<p>Flushing endoscopic submucosal dissection (ESD) is a refinement of saline immersion ESD in which energy-synchronized saline flushing from the knife tip is hypothesized to disperse micro-bubbles and facilitate more controlled coagulation at the tissue interface. We retrospectively evaluated the technical feasibility of this approach in 10 rectal procedures performed at a tertiary referral center. Complete procedural videos were reviewed to describe treated visible submucosal vessel burden, minor bleeding, episodes of transient loss of visualization, and hemostatic forceps use. En bloc and histologically margin-negative (R0) resection was achieved in all 10 cases, while curative endoscopic resection was achieved in nine cases (90%). No intraprocedural perforation, delayed bleeding, post-ESD coagulation syndrome, or unplanned repeat intervention occurred. Median lesion size was 55 mm (interquartile range, 40–69.5), median procedure duration was 102.5 min (100–167.5), and median treated visible vessel count was 21 (11.5–40.75), corresponding to 1.04 vessels/cm² (0.64–1.74). Minor bleeding and transient loss of visualization occurred during procedures but were controlled endoscopically. Hemostatic forceps were required therapeutically for active bleeding from one vessel across the series, and no procedure required abandonment or conversion to surgery. These findings support the technical feasibility of rectal flushing-assisted saline immersion ESD. The video-derived hemostatic measures are descriptive and may provide candidate endpoints for future prospective comparative studies; they do not establish comparative efficacy, hemostatic benefit, or safety.</p><p><b>Trial Registration</b>: N/A.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120624","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 Ultrasound-Guided Gallbladder Drainage as a Bridge to Surgery for Acute Cholecystitis: A Comparative Study","authors":"Keiki Nagai,&nbsp;Yuji Fujita,&nbsp;Hiroki Uechi,&nbsp;Yuji Koyama,&nbsp;Shintaro Tsujikawa,&nbsp;Eisuke Suzuki,&nbsp;Seitaro Tsujino,&nbsp;Ken Ishii,&nbsp;Atsuki Nagao,&nbsp;Masato Yoneda","doi":"10.1002/deo2.70436","DOIUrl":"10.1002/deo2.70436","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Gallbladder drainage is used for patients with acute cholecystitis (AC) who are unsuitable for emergency cholecystectomy. Percutaneous transhepatic gallbladder drainage (PTGBD), endoscopic ultrasound-guided gallbladder drainage (EUS-GBD), and endoscopic transpapillary GBD (ETGBD) are used as bridge-to-surgery (BTS) approaches, but comparative data are limited. We compared clinical and perioperative outcomes among these strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective, single-center study included 84 patients with AC who underwent GBD between January 2016 and January 2026 (PTGBD, <i>n</i> = 26; EUS-GBD, <i>n</i> = 39; ETGBD, <i>n</i> = 19). The primary endpoint was technical success. Secondary endpoints included clinical success, adverse events, recurrent cholecystitis, hospital stay, and surgical outcomes after BTS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Technical success rates were 100% in the PTGBD and EUS-GBD groups and 73.7% in the ETGBD group (<i>p</i> &lt; 0.001). Clinical success rates were 92.3%, 100%, and 85.7%, respectively. Recurrent cholecystitis occurred in 7.7% of PTGBD cases and 14.3% of ETGBD cases, but not in EUS-GBD cases. Median hospital stay was the shortest in the EUS-GBD group (7 vs. 13.5 days for PTGBD and 9 days for ETGBD; <i>p</i> &lt; 0.001). Among patients who proceeded to surgery, laparoscopic cholecystectomy was performed in 100%, 87.5%, and 75.0% of the EUS-GBD, PTGBD, and ETGBD groups, respectively (<i>p</i> = 0.041).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>All three approaches were feasible BTS strategies for AC. EUS-GBD achieved high technical and clinical success with acceptable safety. After successful BTS, surgical outcomes were broadly comparable among groups. Drainage strategy should be individualized based on patient conditions, anatomical feasibility, and circumstances.</p>\u0000 \u0000 <p><b>Trial Registration</b>: N/A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083488","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":"Clinical Outcomes of Double Half-Pigtail Versus Straight Plastic Stents for Endoscopic Biliary Drainage of Malignant Distal Biliary Obstruction","authors":"Wataru Yoshioka,&nbsp;Mutsumi Tasaki,&nbsp;Hinata Tasaki,&nbsp;Hikaru Fujimoto,&nbsp;Shuzo Yunotani,&nbsp;Chika Inadomi,&nbsp;Shotaro Noge,&nbsp;Yoshihito Kubotsu,&nbsp;Futa Koga","doi":"10.1002/deo2.70446","DOIUrl":"10.1002/deo2.70446","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The clinical performance of double half-pigtail plastic stents (DHPs) for malignant distal biliary obstruction (MDBO) remains unclear. We compared DHPs with straight plastic stents (STs) regarding the timing, incidence, and causes of recurrent biliary obstruction (RBO).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective cohort study evaluated endoscopic retrograde cholangiopancreatography-guided transpapillary single plastic stent placements for MDBO performed between October 2022 and March 2026. For the primary analysis, only initial stenting episodes were included. The primary endpoint was the time to RBO (TRBO), which was analyzed using Kaplan–Meier and log-rank methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 131 stent-placement episodes in 86 patients were eligible. The primary analysis included 72 patients undergoing initial stenting, comprising 20 patients in the DHP group and 52 patients in the ST group. The DHP and ST groups had a similar median TRBO (116 vs. 119 days; log-rank <i>p</i> = 0.726), incidence of RBO (40.0% vs. 46.2%; <i>p</i> = 0.638), and incidence of stent occlusion (40.0% vs. 32.7%; <i>p</i> = 0.560). No migration occurred with DHPs, whereas seven migration events occurred with STs (0% vs. 13.5%; <i>p</i> = 0.084). Both groups had similar adverse event rates (0% vs. 11.5%; <i>p</i> = 0.113).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DHPs did not prolong the TRBO or reduce its incidence compared with STs. However, migration-related RBO occurred only with STs. The potential advantage of DHPs may be a lower incidence of stent migration rather than longer overall stent patency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>N/A</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083426","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":"Synchronous and Metachronous Multiple Gastric Epithelial Neoplasms Detected During Index Evaluation and Post-Endoscopic Submucosal Dissection Surveillance: A Descriptive Comparison","authors":"Tomokazu Yoshio,&nbsp;Shuhei Fukunaga,&nbsp;Tomoyuki Nakane,&nbsp;Shinpei Minami,&nbsp;Tomonori Cho,&nbsp;Kozo Tsuruta,&nbsp;Hiroshi Tanaka,&nbsp;Ryousuke Gotou,&nbsp;Yusei Watanabe,&nbsp;Michita Mukasa,&nbsp;Miwa Sakai,&nbsp;Takumi Kawaguchi,&nbsp;Hidetoshi Takedatsu","doi":"10.1002/deo2.70437","DOIUrl":"10.1002/deo2.70437","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We compared synchronous and metachronous gastric tumors detected during index evaluation and surveillance after endoscopic submucosal dissection (ESD), focusing on Kimura-Takemoto O-3 atrophy. <i>Helicobacter pylori</i> eradication history and the neutrophil-to-lymphocyte ratio (NLR) were exploratory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed consecutive patients who underwent ESD. Patients whose first additional lesion was detected simultaneously or within 1 year after index ESD were classified as having synchronous gastric tumors (SGT); those with no synchronous lesion whose first additional lesion was detected later were classified as having metachronous gastric tumors (MGT). Logistic regression estimated associations with SGT rather than MGT presentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1064 screened patients, 256 had multiple lesions (SGT, <i>n</i> = 169; MGT, <i>n</i> = 87). SGT patients were older (median, 76 vs. 72 years; <i>p</i> = 0.005), and O-3 atrophy was more frequent (34.3% vs. 20.5%; <i>p</i> = 0.045). In exploratory multivariable analysis, age (adjusted odds ratio [aOR], 1.67 per 10 years; 95% confidence interval [CI], 1.12–2.51) and O-3 atrophy (aOR, 2.17; 95% CI, 1.01–4.65) were associated with SGT presentation. Eradication timing was unavailable, and NLR was not independently associated with SGT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>O-3 atrophy was more frequent when the first additional lesion was detected synchronously. SGT and MGT may represent timing-defined phenotypes within a continuous atrophic field rather than biologically distinct entities. Extensive atrophy supports meticulous whole-stomach inspection at index evaluation and sustained surveillance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042661","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":"Submucosal Invasion and Ulceration in Early Gastric Cancer Affect Mucosal Impedance","authors":"Kaede Miyashiro,&nbsp;Yohei Sawada,&nbsp;Hidezumi Kikuchi,&nbsp;Shintaro Goto,&nbsp;Tadashi Yoshizawa,&nbsp;Saki Nakano,&nbsp;Taka Asari,&nbsp;Tatsuta Tetsuya,&nbsp;Daisuke Chinda,&nbsp;Hirotake Sakuraba","doi":"10.1002/deo2.70434","DOIUrl":"10.1002/deo2.70434","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate early changes in gastric cancers that are difficult to evaluate using endoscopic imaging through the assessment of mucosal impedance (MI) in endoscopic submucosal dissection (ESD) specimens.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-center prospective cohort study, we included patients who underwent ESD for early gastric cancer (EGC). MI was measured at both the main tumor site and the surrounding non-neoplastic mucosa in resected specimens. Histopathological evaluation and immunohistochemical staining for claudin-3, -4, and -18 were performed. Furthermore, multivariate analysis was used to investigate factors influencing MI-L.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The MI measured under high-frequency current (MI-H) of the non-neoplastic mucosa was significantly higher than that of the tumor (<i>p</i> = 0.0025). Additionally, the MI measured under low-frequency current (MI-L) was significantly lower in pT1b cases than in pT1a cases (6.9 Ω vs. 9.7 Ω, <i>p</i> = 0.021). Similarly, the MI-L was significantly lower in the pUL1 cases than in the pUL0 cases (7.5 Ω vs. 9.7 Ω, <i>p</i> = 0.030). Multivariable linear regression analysis demonstrated that, among the explanatory variables—including tumor invasion, ulcer status, macroscopic type, and the H-scores for each claudin- only the H-score of claudin-18 was identified as an independent associated factor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In resected specimens, MI-L was independently associated with claudin-18 expression and correlated with submucosal invasion, ulcer status, and macroscopic type. MI has the potential to detect non-surface changes involving tight junction proteins in EGC that cannot be observed via endoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <p><b>Trial Registration</b>: N/A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042665","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":"Correction to “Respiratory Support with Nasal High Flow Reduces Opioid Requirements During Endoscopic Retrograde Cholangiopancreatography”","authors":"","doi":"10.1002/deo2.70442","DOIUrl":"10.1002/deo2.70442","url":null,"abstract":"<p>T. Mori, T. Ayuse, S. Sato, et al., “Respiratory Support With Nasal High Flow Reduces Opioid Requirements During Endoscopic Retrograde Cholangiopancreatography,” <i>DEN Open</i> 7, no. 1 (2027): e70421, https://doi.org/10.1002/deo2.70421.</p><p>There was an error in the author list for the above article. The author name “Taiga Ichinomia” was incorrect and should have read “Taiga Ichinomiya.” The online article has been corrected.</p><p>We apologize for this error.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"7 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042682","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}