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IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/S0016-5107(25)00017-3

引用次数: 0

Refining adaptive traction insights for enhanced endoscopic submucosal dissection outcomes 完善自适应牵引技术，提高内镜黏膜下剥离术的效果

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/j.gie.2024.10.043

Yinfang Wu MM, Weixing Xu MM

引用次数: 0

Success rate of fiducial marker placement for treatment of esophageal or rectal cancers: a prospective multicenter study (FIDECHO study) (with video) 前瞻性多中心研究（FIDECHO 研究）：食管癌或直肠癌治疗弧形标记置入术的成功率。

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/j.gie.2024.08.014

Marine Camus MD, PhD , David Karsenti MD , Jonathan Levy MD , Maira Moreno PhD , Emmanuel Coron MD, PhD , Anouk Esch MD , Nicolas Williet MD , Marc Wangermez MD , Stéphane Koch MD , Jean Christophe Valats MD , Mathieu Pioche MD, PhD , Aymeric Becq MD , Geoffroy Vanbiervliet MD, PhD , Etienne Audureau MD, PhD , Florence Huguet MD, PhD , Ulriikka Chaput MD

Background and Aims

EUS-guided placement of fiducial markers in patients with esophageal or rectal cancer who have been referred for radiation therapy lacks data regarding its feasibility and safety. The aim of this study was to assess the success rate of EUS-guided fiducial marker placement in these indications.

Methods

This prospective multicenter study enrolled patients with rectal or esophageal tumors who were treated between March 2017 and June 2021. The primary endpoint was the success of fiducial marker placement under EUS guidance utilizing the preloaded 22-gauge EchoTip Ultra Fiducial Needle (Cook Medical, Limerick, Ireland), defined by the ability to release fiducials at least at the proximal and distal ends of the tumor. Secondary endpoints were the adverse events, length of procedure, and fiducial markers remaining throughout radiation therapy.

Results

A total of 33 patients were included in this study, with a mean age of 64.2 ± 11.3 years; 66.7% were male. Twenty patients had rectal adenocarcinoma, and 13 had esophageal malignancies. The success rate of fiducial marker placement was 93.9%. Markers could only be released at the proximal end of the tumor in 2 cases. The average procedure time (±SD) was 12.5 ± 4.8 minutes. The number of fiducial markers placed for each patient was 3.8 ± .5. No adverse events were reported. At the end of radiotherapy, markers were still visible on imaging in all patients.

Conclusions

This prospective multicenter study highlights the safety and high success of the placement of fiducial markers under EUS guidance for rectal and esophageal tumors, with no adverse events and with a short procedure time. Fiducial markers remained in place over time during radiation therapy. (Clinical trial registration number: NCT03057288.)

背景和研究目的：在内镜超声（EUS）引导下，食管癌或直肠癌患者在接受放射治疗时进行靶点标记置入术的可行性和安全性尚缺乏相关数据。本研究旨在评估 EUS 引导下靶标置入术在这些适应症中的成功率：这项前瞻性多中心研究招募了2017年3月至2021年6月期间接受治疗的直肠或食道肿瘤患者。主要终点是在 EUS 引导下使用预装 22 号 EchoTip Ultra Fiducial 针®（Cook Medical，爱尔兰利默里克）放置靶标的成功率，其定义是至少在肿瘤近端和远端释放靶标的能力。次要终点是不良事件、手术时间和整个放疗过程中剩余的靶标：本研究共纳入 33 名患者，平均年龄（64.2 岁±11.3）岁，男性占 66.7%。20名患者患有直肠腺癌，13名患者患有食道恶性肿瘤。放置靶标的成功率为 93.9%。有两例患者只能在肿瘤近端释放标记物。平均手术时间（±SD）为12.5分钟（±4.8）。每位患者放置的靶标数量为 3.8 个（±0.5）。无不良事件报告。放疗结束时，所有患者的标记在成像中仍清晰可见：这项前瞻性多中心研究强调了在 EUS 下放置靶标治疗直肠和食道肿瘤的安全性和高成功率，且无不良反应，手术时间短。在放射治疗期间，靶标将长期保持原位：NCT03057288.

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引用次数: 0

Long-term outcomes of pneumatic balloon dilation versus peroral endoscopic myotomy in type I and II achalasia patients: a propensity score–matched analysis 气动球囊扩张术与口周内窥镜肌切开术对 I 型和 II 型崩漏患者的长期疗效对比：倾向评分匹配分析

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/j.gie.2024.10.046

Tanawat Geeratragool MD , Porakit Boonumnuay MD , Monthira Maneerattanaporn MD, MSc , Saris Sunsaneevithayakul MD , Aukapatra Jaruchaiyong MD , Nawin Penrasamee MD , Preravit Laothanasin MD , Pritsana Chuenprapai BNS , Chainarong Phalanusitthepha MD , Somchai Leelakusolvong MD

Background and Aims

Peroral endoscopic myotomy (POEM) shows higher efficacy than pneumatic balloon dilation (PBD) for type I and II achalasia over 2 years. However, long-term durability beyond 5 years remains under-investigated. This study assessed the long-term efficacy of PBD versus POEM.

Methods

This retrospective comparative study examined treatment-naïve achalasia patients who underwent either PBD or POEM. Cohort balance was achieved through propensity score (PS) matching based on age, sex, Eckardt score, and Charlson Comorbidity Index. The primary outcome was the time to a second intervention. Secondary outcomes were treatment failure, Eckardt score, number of intervention sessions, weight gain, and adverse events.

Results

Of the 127 patients, 67 underwent PBD and 60 underwent POEM, with an average follow-up of 7 years (interquartile range, 5-10). After PS matching, 100 patients with 1:1 matching were included in the analysis. Baseline characteristics, including clinical, endoscopic, and manometric attributes, were comparable between groups. The POEM group had a significantly longer time to a second intervention than the PBD group (hazard ratio, .139; 95% confidence interval, .048-.405) and underwent less endoscopic sessions (P < .001 by linear marginal model analysis) within the first 2 years. Beyond 2 years, subsequent interventions were comparable between groups. There were no differences in the Eckardt score or weight gain. Hospital stays were shorter in the PBD group (2 vs 4 days, P < .001). POEM patients had more adverse events, including perforation.

Conclusions

POEM demonstrated greater long-term durability than PBD, but PBD was associated with shorter hospital stays and fewer adverse events.

背景和目的：对于 I 型和 II 型贲门失弛缓症，口周食管肌切开术（POEM）在 2 年内的疗效高于气囊扩张术（PBD）。然而，5 年以上的长期疗效仍有待研究。本研究旨在评估 PBD 与 POEM 的长期疗效：这项回顾性比较研究考察了接受 PBD 或 POEM 治疗的未经治疗的贲门失弛缓症患者。根据年龄、性别、Eckardt评分和Charlson合并症指数进行倾向评分（PS）匹配，实现队列平衡。主要结果是干预的秒速时间。次要结果包括治疗失败、埃卡尔特评分、干预次数、体重增加和不良事件：127 名患者中，67 人接受了 PBD，60 人接受了 POEM，平均随访时间为 7 年（IQR 5-10 年）。经过PS匹配后，100名1:1匹配的患者纳入分析。两组患者的基线特征（包括临床、内窥镜和压力测量属性）相当。POEM 组的第二次干预时间明显长于 PBD 组（危险比为 0.139，95% CI 为 0.048-0.405），并且在头两年内接受了更多的内镜治疗（通过线性边际模型分析，P< 0.001）。2年后，各组间的后续干预效果相当。埃卡评分和体重增加没有差异。PBD 组的住院时间更短（2 天对 4 天；P < 0.001）。POEM患者发生的不良事件较多，包括穿孔：结论：POEM 的长期耐久性优于 PBD，但 PBD 的住院时间更短，不良反应更少。

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IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/j.gie.2024.11.026

Pedro Cortés MD, Maoyin Pang MD, PhD

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Addressing the obesity epidemic through safe and effective endoscopic bariatric therapies

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/j.gie.2024.11.010

Sven Adamsen MD

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Editors

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/S0016-5107(25)00013-6

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IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/S0016-5107(25)00015-X

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IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/S0016-5107(25)00016-1

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Pancreatic gout 胰腺痛风

IF 6.7 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Gastrointestinal endoscopy

Pub Date : 2025-03-01 DOI: 10.1016/j.gie.2024.10.031

Ewan Glassey MBChB, Cameron Schauer MBChB, Russell Walmsley MBChB, Riley Riddell MBChB, Sean Liddle MBChB

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