DEN open最新文献

{"title":"Double-balloon endoscopy for duodenal diverticulitis with calculus after intestinal reconstruction: A case report","authors":"Kai Toyoshima,&nbsp;Yunosuke Takishin,&nbsp;Kiko Toda,&nbsp;Katsuma Nakajima,&nbsp;Yutaro Otuka,&nbsp;Daisuke Yokoyama,&nbsp;Tetsuhito Muranaka,&nbsp;Yasuyuki Kunieda","doi":"10.1002/deo2.70044","DOIUrl":"10.1002/deo2.70044","url":null,"abstract":"<p>Small-bowel diverticulosis is relatively common, but there is no set treatment strategy for duodenal diverticulitis with stone impaction. A woman aged in her 70s presented with a chief complaint of abdominal pain, and she had been reconstructed by the Roux-en-Y method after total gastrectomy. We performed an enhanced computed tomography which revealed edematous wall thickening of the duodenum. We diagnosed her with duodenal diverticulitis and treated them with antibiotics but her disease was not cured, we therefore attempted endoscopic stone removal as a nonoperative treatment. After stone removal with a nonoperative procedure, when we contrasted the duodenal papillary diverticulum, it was found to form a fistula on the other side, and the successful treatment made her discharged on the 17th day. The duodenal diverticulitis with calculus is extremely rare, and there is no report to treat it using double-balloon endoscopy, therefore we report this case with a literature review.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11647045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840598","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 rectal ulcer caused by hydrogel spacer insertion: A case report and review of the literature","authors":"Sen Yagi,&nbsp;Moyu Kawano,&nbsp;Keitaro Kawasaki,&nbsp;Takatoshi Murakami,&nbsp;Jiro Miyaike,&nbsp;Shinya Furukawa","doi":"10.1002/deo2.70036","DOIUrl":"https://doi.org/10.1002/deo2.70036","url":null,"abstract":"<p>A 75-year-old man presented with hematochezia. He had been diagnosed with prostate cancer (stage 1) 1 month previously and had undergone gold marker injection and hydrogel spacer insertion 3 weeks previously to prepare for radiotherapy. Hydrogel spacer insertion is a safe procedure that can prevent the side effects of radiotherapy for prostate cancer. A computed tomography evaluation identified a low-density area that extended from the prostate to the rectal wall. Magnetic resonance imaging of the abdomen revealed the hydrogel spacer between the anterior rectal wall and prostate. A colonoscopy revealed an approximately 2 cm ulcer in the rectum. The patient was diagnosed with a rectal ulcer with bleeding caused by hydrogel spacer insertion. Conservative follow-up was performed, and his condition improved over time. Radiotherapy for prostate cancer was initiated 4 months after hydrogel spacer insertion. The patient has not experienced any abdominal symptoms such as bloody stools since that time. Because the incidence of prostate cancer is increasing, the number of such cases is likely to increase in the future.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762540","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":"Lymph node metastasis risk factors in T2 colorectal cancer","authors":"Yuriko Morita,&nbsp;Shin-ei Kudo,&nbsp;Yuki Takashina,&nbsp;Katsuro Ichimasa,&nbsp;Yuta Kouyama,&nbsp;Shigenori Semba,&nbsp;Kenichi Mochizuki,&nbsp;Osamu Shiina,&nbsp;Shun Kato,&nbsp;Takanori Kuroki,&nbsp;Shoji Shimada,&nbsp;Kenta Nakahara,&nbsp;Yusuke Takehara,&nbsp;Shunpei Mukai,&nbsp;Noriyuki Ogata,&nbsp;Takemasa Hayashi,&nbsp;Kunihiko Wakamura,&nbsp;Hideyuki Miyachi,&nbsp;Naruhiko Sawada,&nbsp;Tetsuo Nemoto,&nbsp;Toshiyuki Baba,&nbsp;Masashi Misawa","doi":"10.1002/deo2.70040","DOIUrl":"https://doi.org/10.1002/deo2.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study evaluates risk factors for lymph node metastasis (LNM) in T2 colorectal cancer to refine patient selection for endoscopic resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed records from consecutive patients who had undergone curative surgical resection of T2 colorectal cancer at our institution in Japan between April 2001 and December 2021. Data on conventional clinicopathologic variables were retrieved from the pathology reports at the time of surgery. The clinicopathological features included patient age, sex, tumor diameter, morphology, tumor location, lymphatic invasion, vascular invasion, tumor differentiation, carcinoembryonic antigen and carbohydrate antigen 19-9 levels, number of lymph node dissections, presence of adenoma component, and LNM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the patients (338 men, 320 women), 170 (25.8%) exhibited LNM. Multivariate logistic regression identified three independent risk factors for LNM: lymphatic invasion (odds ratio [OR], 32.6; 95% confidence interval [CI], 17.3–61.4; <i>p</i> &lt; 0.0001), female sex (OR, 1.70; 95% CI, 1.10–2.62; <i>p</i> = 0.02), and elevated carcinoembryonic antigen levels (OR, 2.56; 95% CI, 1.10–5.96; <i>p</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lymphatic invasion, female sex, and high carcinoembryonic antigen levels significantly increase the risk of LNM in T2 colorectal cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749284","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 features of the duodenal pyloric gland adenoma: A case series of 14 patients","authors":"Takeshi Uozumi,&nbsp;Satoru Nonaka,&nbsp;Yasuhiko Mizuguchi,&nbsp;Haruhisa Suzuki,&nbsp;Seiichiro Abe,&nbsp;Shigetaka Yoshinaga,&nbsp;Shigeki Sekine,&nbsp;Yutaka Saito","doi":"10.1002/deo2.70038","DOIUrl":"https://doi.org/10.1002/deo2.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pyloric gland adenoma (PGA) is a distinct subtype of duodenal adenoma. PGA has been increasingly recognized as a histologically and molecularly distinct entity; however, its endoscopic features have not been precisely described. This study aims to investigate the endoscopic characteristics of duodenal PGA, including the association of their putative precursors, Brunner's gland hyperplasia (BGH), and gastric epithelial heterotopia/metaplasia (GEM/H).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a single-center, retrospective case series. Fourteen consecutive patients with duodenal PGA were retrieved from the pathological database. PGA was diagnosed according to the World Health Organization classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median tumor size was 22.5 mm (range: 12–40 mm), and 79% of cases were located in the first part of the duodenum. Six PGAs demonstrated high-grade dysplasia. PGA could be classified into two subtypes based on their appearance: villous lobulated type and smoothly protruding type. BGH and GEM/H were identified in the background mucosa in 28% and 7% of the cases, respectively. BGH was more abundant in the background mucosa of the PGA group than in the control group <i>(p</i> &lt; 0.05). Six PGAs (43%) exhibited high-grade dysplasia, and no significant difference was observed in the endoscopic findings between low- and high-grade dysplasia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The 14 patients with PGA demonstrated characteristic endoscopic findings. BGH and GEM/H might be precursors of PGA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674170","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 “The outcomes of endoscopic ultrasound-guided tissue acquisition for small focal liver lesions measuring ≤2 cm”","authors":"","doi":"10.1002/deo2.70039","DOIUrl":"https://doi.org/10.1002/deo2.70039","url":null,"abstract":"<p>Takano Y, Tamai N, Yamawaki M <i>et al.</i> The outcomes of endoscopic ultrasound-guided tissue acquisition for small focal liver lesions measuring ≤2 cm. <i>DEN Open</i> 2025; <b>5</b>: e70031.</p><p>1. In the abstract section, the next “The sensitivity, specificity, and accuracy rates were 96.8%, 100%, and 96.8%, respectively, in the ≤2 cm group and 97.4%, 100%, and 97.4%, respectively, in the &gt;2 cm group, with no significant differences between the groups. There was no difference in adverse events between the groups (0% in the ≤2 cm group and 2.3% in the &gt;2 cm group).” was incorrect.</p><p>This should have read: “The sensitivity, specificity, and accuracy rates were <span>96.5%</span>, 100%, and 96.8%, respectively, in the ≤2 cm group and <span>97.2%</span>, 100%, and 97.4%, respectively, in the &gt;2 cm group, with no significant differences between the groups. There was no difference in adverse events between the groups (0% in the ≤2 cm group and <span>2.5%</span> in the &gt;2 cm group). ” (Please correct the underlined numbers.)</p><p>2. In the result outcomes of the EUS-TA section, the next “The sensitivity, specificity, and accuracy rates of EUS-TA were 96.8%, 100%, and 96.8%, respectively, in the ≤2 cm group and 97.4%, 100%, and 97.4%, respectively, in the &gt;2cm group, with no significant differences between the two size groups. Moreover, there was no difference in adverse events between the two groups. There were two cases (2.3%) of mild abdominal pain in the &gt;2 cm group, but the pain resolved spontaneously.” was incorrect</p><p>This should have read: “The sensitivity, specificity, and accuracy rates of EUS-TA were <span>96.5%</span>, 100%, and 96.8%, respectively, in the ≤2 cm group and <span>97.2%</span>, 100%, and 97.4%, respectively, in the &gt;2 cm group, with no significant differences between the two size groups. Moreover, there was no difference in adverse events between the two groups. There were two cases (<span>2.5%</span>) of mild abdominal pain in the &gt;2 cm group, but the pain resolved spontaneously.” (Please correct the underlined numbers.)</p><p>3. The numbers in Table 3 are incorrect.\u0000\u0000 </p><p>The correct table is listed below: Please correct the underlined numbers.\u0000\u0000 </p><p>We apologize for this error.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674169","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":"PuraStat as secondary therapy for hemostasis in Mallory−Weiss syndrome with oral antithrombotic medication","authors":"Makoto Higashino,&nbsp;Hidehiro Murakami,&nbsp;Tetsu Hirata,&nbsp;Hiroaki Miyaoka","doi":"10.1002/deo2.70033","DOIUrl":"https://doi.org/10.1002/deo2.70033","url":null,"abstract":"<p>Mallory−Weiss syndrome (MWS) is a common cause of gastroesophageal bleeding. Vomiting increases intra-abdominal and intra-esophageal pressures, causing hyperextension of the esophagogastric junction and laceration. Most affected patients respond well to conservative treatment; however, those with active bleeding require endoscopic intervention. Upon contacting blood, PuraStat gels and coats the bleeding point to achieve hemostasis. PuraStat is reportedly effective for non-variceal bleeding and bleeding associated with endoscopic procedures. However, there have been no reports on the use of PuraStat in MWS. Here we report a case in which PuraStat was useful for achieving hemostasis in a patient with MWS and difficult-to-achieve hemostasis. The patient was a 67-year-old man who had undergone coronary artery bypass grafting 1 month earlier and was taking an antithrombotic drug. He visited our hospital with bloody vomiting and melena in the evening and was diagnosed with upper gastrointestinal bleeding for which he underwent endoscopy. MWS with active bleeding was observed in the lower esophagus extending to the esophagogastric junction. We treated the patient with clipping; however, the oozing did not stop because of the large laceration. We applied PuraStat to the bleeding site and confirmed that the oozing had resolved; therefore, the procedure was terminated. The endoscope was reinserted the next day and confirmed the hemostasis. The patient was discharged without further deterioration. In patients with MWS with active bleeding, endoscopic hemostasis is commonly achieved using clips or endoscopic band ligation. However, PuraStat can achieve complete hemostasis when these techniques fail.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674168","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":"Impact of time from diagnosis to endoscopic submucosal dissection on curability in superficial esophageal squamous cell carcinoma","authors":"Daiki Sato,&nbsp;Maasa Sasabe,&nbsp;Tomohiro Mitsui,&nbsp;Yasuaki Furue,&nbsp;Takako Yoshii,&nbsp;Hiroki Hara,&nbsp;DaiJi Oka,&nbsp;Takashi Fukuda,&nbsp;Yusuke Yoda","doi":"10.1002/deo2.70035","DOIUrl":"10.1002/deo2.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the time delay effect from initial diagnosis to endoscopic submucosal dissection on superficial esophageal squamous cell carcinoma curability, considering the preoperative invasion depth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included superficial esophageal squamous cell carcinoma diagnosed as T1a-epithelial/lamina propria mucosa cancer (cEP/LPM; cancer invading up to the lamina propria mucosa) or cT1a-muscularis mucosa (MM)/T1b-submucosal cancer (cMM/SM1; cancer invading up to 200 µm into the submucosa) and treated using endoscopic submucosal dissection from January 2017 to December 2021. We compared curability in lesions treated within three months (early treatment group) versus those treated ≥7 months post-diagnosis (delayed treatment group). Curative resection criteria included lesions confined within the muscularis mucosae, with negative vertical margins, and with absence of lymphovascular invasion. Non-curative resection included all other cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 231 and 75 lesions in the early and delayed treatment groups, respectively, no significant difference was observed in non-curative resections for all lesions and cEP/LPM lesions (early: 194, delayed: 70). Conversely, the proportions were significantly higher in the delayed treatment group than in the early treatment group for cMM/SM1 lesions (early: 37, delayed: 5; <i>p</i> = 0.018).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests that delayed endoscopic submucosal dissection does not significantly affect cEP/LPM lesions curability but is associated with reduced cMM/SM1 lesions curability. Prompt treatment is important for cMM/SM1, whereas delayed treatment may be acceptable for cEP/LPM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633024","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 competency of the novel through-the-scope suture device for gastric mucosal defects: In vivo study in a porcine model (with video)","authors":"Mamoru Ito,&nbsp;Akira Dobashi,&nbsp;Takanori Tominaga,&nbsp;Toshiki Futakuchi,&nbsp;Naoto Tamai,&nbsp;Machi Suka,&nbsp;Kazuki Sumiyama","doi":"10.1002/deo2.70037","DOIUrl":"10.1002/deo2.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic closures of mucosal defects following endoscopic resection can be challenging and time-consuming. The novel through-the-scope suture device has demonstrated acceptable closure times, but its learning curve is still unknown. This study aims to evaluate the number of cases required to achieve competency in this device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two endoscopists participated; a novice with less than 400 experiences in upper gastrointestinal endoscopy and an expert with over 500 experiences in endoscopic submucosal dissection. Neither endoscopist had previous exposure to the device. In four porcine models, 24 gastric mucosal defects, each 2–4 cm in diameter, were created by endoscopic mucosal resection with ligation. Each endoscopist performed endoscopic closure for 12 mucosal defects with a single through-the-scope suture device per lesion. The primary endpoint was the number of cases needed to reach competency, defined as achieving a procedure time below the average closure time reported in the literature. Secondary endpoints included procedure time, complete closure success rates, and incidence of adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean defect size was 2.9 (±0.2) cm. Competency was achieved after six cases in the expert and seven cases in the novice. The median closure time was 9.0 (interquartile range [IQR]: 6.0–11.0) min for the expert and 8.0 (IQR: 6.2–9.7) min for the novice (<i>p</i> = 0.862). Complete closure success rates were 75.0% (<i>n</i> = 9) for the expert and 83.3% (<i>n</i> = 10) for the novice. No adverse events were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A small number of cases were required for both expert and novice endoscopists to reach competency in the novel through-the-scope suture device.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633025","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":"Combination of artificial intelligence endoscopic diagnosis and Kimura-Takemoto classification determined by endoscopic experts may effectively evaluate the stratification of gastric atrophy in post-eradication status","authors":"Kumiko Kirita,&nbsp;Seiji Futagami,&nbsp;Ken Nakamura,&nbsp;Shuhei Agawa,&nbsp;Nobue Ueki,&nbsp;Kazutoshi Higuchi,&nbsp;Mayu Habiro,&nbsp;Rie Kawawa,&nbsp;Yusuke Kato,&nbsp;Tomohiro Tada,&nbsp;Katsuhiko Iwakiri","doi":"10.1002/deo2.70029","DOIUrl":"10.1002/deo2.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Since it is difficult for expert endoscopists to diagnose early gastric cancer in post-eradication status, it may be critical to evaluate the stratification of high-risk groups using the advance of gastric atrophy or intestinal metaplasia. We tried to determine whether the combination of endoscopic artificial intelligence (AI) diagnosis for the evaluation of gastric atrophy could be a useful tool in both pre- and post-eradication status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>270 <i>Helicobacter pylori</i>-positive outpatients (Study I) were enrolled and Study II was planned to compare patients (<i>n</i> = 72) with pre-eradication therapy with post-eradication therapy. Assessment of endoscopic appearance was evaluated by the Kyoto classification and Kimura-Takemoto classification. The trained neural network generated a continuous number between 0 and 1 for gastric atrophy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were significant associations between the severity of gastric atrophy determined by AI endoscopic diagnosis and not having a regular arrangement of collecting venules in angle, visibility of vascular pattern, and mucus using Kyoto classification in <i>H. pylori</i>-positive gastritis. There were significant differences (<i>p</i> = 0.037 and <i>p</i> = 0.014) in the severity of gastric atrophy between the high-risk group and low-risk group based on the combination of Kimura-Takemoto classification and endoscopic AI diagnosis in pre- and post-eradication status. The area under the curve values of the severity of gastric atrophy (0.674) determined by the combination of Kimura-Takemoto classification and gastric atrophy determined by AI diagnosis was higher than that determined by Kimura-Takemoto classification alone in post-eradication status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A combination of gastric atrophy determined by AI endoscopic diagnosis and Kimura-Takemoto classification may be a useful tool for the prediction of high-risk groups in post-eradication status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634988","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":"Treatment outcomes of non-curative endoscopic submucosal dissection for superficial gastric neoplasia: A retrospective study at a tertiary care center in the United States","authors":"Sayaka Nagao,&nbsp;Makoto Nishimura,&nbsp;Mako Koseki,&nbsp;Jacques Beauvais,&nbsp;Monika Laszkowska,&nbsp;Laura Tang,&nbsp;Vivian E. Strong,&nbsp;Mark A. Schattner","doi":"10.1002/deo2.70034","DOIUrl":"10.1002/deo2.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer; additional treatment may be recommended for patients in whom resection is not curative per the American Society for Gastrointestinal Endoscopy guidelines. The aim of this study was to assess treatment outcomes of ESD for gastric neoplasia, with a focus on cases of non-curative resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective study of all individuals undergoing ESD for the treatment of gastric adenocarcinoma or dysplasia in a high-volume tertiary care center in the United States. Data on patient demographic characteristics, clinical history, lesion characteristics, and procedural and clinical outcomes were collected from the electronic medical record.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 82 cases undergoing ESD for the management of gastric neoplasia, 32 cases resulted in non-curative resection. 20 of these non-curative cases did not get additional treatment, among which recurrence occurred in two cases with positive horizontal margins only. These patients did not show lymph node metastasis and underwent further endoscopic or surgical resection. There was no recurrence in 11 cases with undifferentiated carcinomas of ≤2 cm in size.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although this study was limited by its retrospective design, small sample size, and follow-up duration, our findings suggest that a risk-adapted strategy could be employed for certain patients undergoing non-curative ESD per American Society for Gastrointestinal Endoscopy guidelines, with close follow-up instead of routine surgery in select cases with favorable features. Further studies are needed to refine the criteria for additional treatment after non-curative ESD in Western populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633227","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}