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Device-assisted enteroscopy: Are we ready to dismiss the spiral?

World Journal of Gastroenterology 2024年第26期30卷 3185-3192页

作者： Alessandro Mussetto Elettra Merola Cesare Casadei Daniele Salvi Fabiola Fornaroli Silvia Cocca Margherita Trebbi Armando Gabbrielli Cristiano Spada Andrea Michielan Department of Gastroenterology S Maria della Croci HospRavenna 48121Italy Department of Gastroenterology unit G.B.Grassi Hospital(ASL Roma 3)Roma 00122Italy Section of digestive endoscopy and Gastroenterology Fondazione PoliambulanzaBrescia 25124Italy Gastroenterology and endoscopy unit Department of Medicine and SurgeryUniversity of ParmaParma 43125Italy Gastroenterology and endoscopy unit Azienda Ospedaliero Universitaria Policlinico di ModenaModena 41121Italy Center for Medical Sciences(CISMed) University of TrentoTrento 38122Italy Gastroenterology and digestive endoscopy unit Santa Chiara HospitalAzienda Provinciale per i Servizi SanitariTrento 38122Italy digestive endoscopy unit Fondazione Policlinico Universitario A.Gemelli IRCSSRoma 00168Italy

Motorized spiral enteroscopy(MSE)is the latest advance in device-assisted *** events related to MSE were discussed in a recent large systematic review and meta-analysis and were directly compared with those of balloon enteroscopy in a case-matched study and a randomized controlled *** the real-life application of MSE,an unexpected safety issue emerged regarding esophageal injury and the technique has been withdrawn from the global market,despite encouraging results in terms of diagnostic and therapeutic *** conducted an Italian multicenter real-life prospective study,which was prematurely terminated after the withdrawal of MSE from the *** primary goals were the evaluation of MSE performance(both diagnostic and therapeutic)and its safety in routine endoscopic practice,particularly in the early phase of introduction in the endoscopic unit.A subanalysis,which involved patients who underwent MSE after unsuccessful balloon enteroscopy,demonstrated,for the first time,the promising performance of MSE as a rescue *** its remarkable performance in clinical practice and its potential role as a backup technique following a previously failed enteroscopy,it may be more appropriate to refine and enhance MSE in the future rather than completely abandoning it.

关键词： Motorized spiral enteroscopy Rescue enteroscopy Diagnostic yield Adverse events AGREE classification

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Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients?

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1334-1343页

作者： Zi-Wei Li Xiao-Juan Luo Fei Liu Xu-Rui Liu Xin-Peng Shu Yue Tong Quan Lv Xiao-Yu Liu Wei Zhang Dong Peng Department of Gastrointestinal surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China Department of endoscopy Center The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400012China

BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with *** The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,*** mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for *** quality of the included studies was evaluated using the Newcastle-Ottawa Scale *** used Stata(V.16.0)software for data *** This study consists of six studies involving 878 elderly *** analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.

关键词： Enhanced recovery after surgery Gastric cancer Elderly Mortality

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Machine learning in predicting postoperative complications in Crohn’s disease

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World Journal of Gastrointestinal surgery 2024年第8期16卷 2745-2747页

作者： Li-Fan Zhang Liu-Xiang Chen Wen-Juan Yang Bing Hu Department of Gastroenterology and Hepatology West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina digestive endoscopy Medical Engineering Research Laboratory West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

Crohn's disease(CD)is a chronic inflammatory bowel disease of unknown origin that can cause significant disability and morbidity with its *** to the unique nature of CD,surgery is often necessary for many patients during their lifetime,and the incidence of postoperative complications is high,which can affect the prognosis of ***,it is essential to identify and manage post-operative *** learning(ML)has become increasingly im-portant in the medical field,and ML-based models can be used to predict post-operative complications of intestinal resection for ***,a valuable article titled“Predicting short-term major postoperative complications in intestinal resection for Crohn's disease:A machine learning-based study”was published by Wang et *** appreciate the authors'creative work,and we are willing to share our views and discuss them with the authors.

关键词： Crohn’s disease Intestinal resection Postoperative complications Machine learning Explainability

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Chinese national clinical practice guidelines on prevention, diagnosis and treatment of early colorectal cancer

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中华医学杂志(英文版) 2024年第17期137卷 2017-2039页

作者： Li Jingnan Yao Hongwei Lu Yun Zhang Shutian Zhang Zhongtao Society of digestive endoscopy of the Chinese Medical Association Colorectal surgery Group of the Chinese Medical Association Chinese Association of Gastroenterologist & Hepatologist National Clinical Research Center for digestive Diseases Chinese Medical Journal Clinical Practie Guideline Collaborative Department of Gastroenterology Peking Union Medical College Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China Department of General surgery Beijing Friendship Hospital Capital Medical University National Clinical Research Center for Digestive Diseases Beijing China Department of General surgery The Affiliated Hospital of Qingdao University Qingdao Shandong China Department of Gastroenterology Beijing Friendship Hospital Capital Medical University National Clinical Research Center for Digestive Disease Beijing China

Background: The incidence and mortality of colorectal cancer (CRC) in China are increasing in recent years. The clarified pathogenesis and detectable precancerous lesions of CRC make it possible to prevent, screen, and diagnose CRC at an early stage. With the development of endoscopic and surgical techniques, the choice of treatment for early CRC is also worth further discussion, and accordingly, a standard follow-up program after treatment needs to be ***: This clinical practice guideline (CPG) was developed following the recommended process of the World Health Organization, adopting Grading of Recommendations Assessment, Development and Evaluation (GRADE) in assessing evidence quality, and using the Evidence to Decision framework to formulate clinical recommendations, thereby minimizing bias and increasing transparency of the CPG development process. We used the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement and Appraisal of Guidelines for Research and Evaluation II (AGREE II) as reporting and conduct guides to ensure the guideline’s completeness and ***: This CPG comprises 46 recommendations concerning prevention, screening, diagnosis, treatment, and surveillance of CRC. In these recommendations, we have indicated protective and risk factors for CRC and made recommendations for chemoprevention. We proposed a suitable screening program for CRC based on the Chinese context. We also provided normative statements for the diagnosis, treatment, and surveillance of CRC based on existing clinical evidence and ***: The 46 recommendations in this CPG are formed with consideration for stakeholders’ values and preferences, feasibility, and acceptability. Recommendations are generalizable to resource-limited settings with similar CRC epidemiology pattern as China.

关键词： Colorectal cancer Early detection of cancer Prevention Screening Diagnosis Treatment Follow-up Guideline

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Early postoperative complications after transverse colostomy closure,a retrospective study

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World Journal of Gastrointestinal surgery 2024年第3期16卷 807-815页

作者： Fei Liu Xiao-Juan Luo Zi-Wei Li Xiao-Yu Liu Xu-Rui Liu Quan Lv Xin-Peng Shu Wei Zhang Dong Peng Department of Gastrointestinal surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400016China endoscopy Center The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400012China

BACKGROUND Ostomy is a common surgery usually performed to protect patients from clinical symptoms caused by distal anastomotic leakage after colorectal cancer(CRC)surgery and perforation or to relieve intestinal *** To analyze the complications after transverse colostomy *** Patients who underwent transverse colostomy closure from Jan 2015 to Jan 2022 were retrospectively enrolled in a single clinical *** differences between the complication group and the no complication group were *** regression analyses were conducted to find independent factors for overall complications or incision *** A total of 102 patients who underwent transverse colostomy closure were enrolled in the current ***(68.6%)patients underwent transverse colostomy because of CRC related *** complications occurred in 30(29.4%)patients and the most frequent complication occurring after transverse colostomy closure was incision infection(46.7%).The complication group had longer hospital stays(Psurgery in our center was incision *** operation time,interval from transverse colostomy to reversal,and method of anastomosis might have no impact on the postoperative *** should pay more attention to aseptic techniques.

关键词： Transverse colostomy closure surgery Complications A single clinical centre Risk factors

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Challenges and advancing strategies of endoscopic submucosal dissection for early gastric cancer:The puzzle of eCura C1

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World Journal of Gastrointestinal endoscopy 2024年第8期16卷 439-444页

作者： Giulio Calabrese Guido Manfredi Marcello F Maida Francesco V Mandarino Endrit Shahini Francesco Pugliese Paolo Cecinato Liboria Laterza Emanuele Sinagra Sandro Sferrazza Department of Gastroenterology and endoscopy ARNAS Civico–Di Cristina–BenfratelliPalermo 90127SiciliaItaly Department of Gastroenterology and digestive endoscopy Ospedale MaggioreCrema 26013Italy Department of Medicine and surgery University of Enna"Kore"Enna 94100SiciliaItaly Department of Gastroenterology and digestive endoscopy IRCCS Ospedale San RaffaeleMilan 20132LombardyItaly Department of Gastroenterology National Institute of Gastroenterology-IRCCS“Saverio de Bellis”Castellana GrotteBari 70013Italy Department of digestive and Interventional endoscopy Niguarda HospitalASST NiguardaMilan 20162LombardyItaly Department of Medical and Surgical Sciences IRCCS Azienda Ospedaliero-Universitaria di BolognaPoliclinico Sant’OrsolaBologna 40138Emilia-RomagnaItaly Department of Gastroenterology and endoscopy Fondazione Instituto San Raffaele GiglioCefalù90015PalermoItaly

In this editorial,we explore the challenges of managing noncurative resections in early gastric cancer after endoscopic submucosal dissection(ESD),starting from the consideration recently made by Zhu et ***,we evaluate the management of eCura C1 lesions,where decisions regarding further interventions are pivotal yet *** among endoscopists,surgeons,and pathologists is underscored to refine risk assessment and personalize therapeutic *** advancements in ESD techniques and interdisciplinary collaboration offer opportunities for outcome optimization in managing eCura C1 ***,despite needing further clinical validation,molecular biomarkers have emerged as promising tools for enhancing *** manuscript highlights the ongoing research attempts to define treatment paradigms effectively and evaluates the potential of emerging options,ultimately aiming to improve patient care and outcomes in this complex clinical scenario.

关键词： Early gastric cancer Endoscopic submucosal dissection eCura Non-curative resection Multidisciplinary approach

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Corrigendum to ‘A novel STK11 gene mutation (c.388dupG,***130Glyfs∗33) in a Peutz-Jeghers family and evidence of higher gastric cancer susceptibility associated with alterations in STK11 region aa 107–170’ [Gene Dis (9) (2022) 288–291]

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Genes & Diseases 2024年第2期11卷 1082-1083页

作者： Giovanna Forte Filomena Cariola Katia De Marco Andrea Manghisi Filomena Anna Guglielmi Raffaele Armentano Giuseppe Lippolis Pietro Giorgio Cristiano Simone Vittoria Disciglio Medical Genetics National Institute of Gastroenterology “S. de Bellis” Research Hospital Castellana Grotte Bari 70013 Italy Histopathology unit National Institute of Gastroenterology “S. de Bellis” Research Hospital Castellana Grotte Bari 70013 Italy Department of General surgery National Institute of Gastroenterology “S. de Bellis” Research Hospital Castellana Grotte Bari 70013 Italy Gastroenterology and digestive endoscopy unit National Institute of Gastroenterology “S. de Bellis” Research Hospital Castellana Grotte Bari 70013 Italy Department of Biomedical Sciences and Human Oncology (DIMO) Medical Genetics University of Bari Aldo Moro Piazza Umberto I Bari 70124 Italy

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Pediatric stricturing Crohn's disease

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World Journal of Gastroenterology 2024年第12期30卷 1651-1654页

作者： Alessandro Boscarelli Matteo Bramuzzo Department of Pediatric surgery and Urology Institute for Maternal and Child Health-IRCCS“Burlo Garofolo”Trieste 34137Italy Department of Gastrointestinal endoscopy and Nutrition Institute for Maternal and Child Health-IRCCS"Burlo Garofolo"Trieste 34137Italy

Crohn’s disease(CD)is a chronic inflammatory disease of the digestive *** incidence of pediatric CD is increasing and is currently 2.5-11.4 per 100000 ***,approximately 25%of children with CD develop stricturing CD(SCD)that requires *** stricturing diseases refractory to pharmacological management frequently require non-pharmacological ***-pharmacological therapeutic strategies include endoscopic balloon dilatation,stricturoplasty,and surgical resection of the strictured ***,strictures tend to recur postoperatively regardless of treatment *** lifetime risk of surgery in patients with childhood SCD remains at 50%-90%.Thus,new and emerging strategies,advanced diagnostic tools,and minimally invasive approaches are under investigation to improve the outcomes and overall quality of life of pediatric patients with SCD.

关键词： Stricturing Crohn’s disease Pediatrics Insights Future perspectives

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Asymptomatic low-grade appendiceal mucinous neoplasm:A case report

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World Journal of Clinical Cases 2024年第2期12卷 361-366页

作者： Min-Quan Yao Yu-Peng Jiang Yuan-Yu Wang Yi-Ping Mou Jin-Xing Fan Department of Gastrointestinal surgery Tongxiang First People’s HospitalJiaxing 314500Zhejiang ProvinceChina Department of General surgery Zhejiang Provincial People’s HospitalHangzhou 310014Zhejiang ProvinceChina endoscopy Center Tongxiang First People’s HospitalJiaxing 314500Zhejiang ProvinceChina

BACKGROUND Low-grade appendiceal neoplasms(LAMN)are characterized by low incidence and atypical clinical presentations,often leading to misdiagnosis as acute or chronic appendicitis before *** primary diagnostic tool for LAMN is abdominal computed tomography(CT)*** resection remains the cornerstone of LAMN management,necessitating en bloc tumor excision to minimize the risk of iatrogenic ***,known for its minimal invasiveness,reduced postoperative discomfort,and expedited recovery,is a safe and reliable approach for LAMN *** the possibility of pseudomyxoma peritonei development,appendectomy and partial appendectomy generally result in negative tumor margins and favorable outcomes,which can be attributed to the disease’s slow growth and lower *** SUMMARY A 71-year-old male patient was admitted to our hospital with a pelvic spaceoccupying lesion detected 1 mo *** examination showed a soft abdomen without tenderness or rebound and no palpable *** shifting dullness was noted,and digital rectal examination revealed no palpable *** revealed a raised,smooth-surfaced mass measuring 3.0 cm in the *** contrast-enhanced CT showed a markedly thickened and dilated appendix with visible cystic *** surgery was performed and revealed a significantly dilated appendix,leading to laparoscopic resection of the appendix and part of the ***-surgical pathologic analysis confirmed *** patient received symptomatic and supportive post-operative care and was discharged on postoperative day 4 without complications such as abdominal bleeding,intestinal obstruction,or incision *** tumor recurrence was observed during a 7-mo follow-up *** LAMN is a rare disease that lacks specific clinical *** CT plays a crucial role in diagnosing LAMN,and laparoscopic surgery is a safe and effective diagnostic and therapeutic approach.

关键词： Low-grade appendiceal mucinous neoplasm Pseudomyxoma peritonei Computed tomography Laparoscopy appendectomy Case report

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Colonoscopy in the diagnosis and management of appendiceal disease

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World Journal of Gastrointestinal endoscopy 2024年第4期16卷 187-192页

作者： Yuan Gao Bing Hu Department of Gastroenterology and Hepatology/Medical Engineering Integration Laboratory of digestive endoscopy West China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina

In this editorial,we comment on the article published in the recent issue of the World Journal of Gastrointestinal *** focused on the understanding of appendiceal disease,and the various options for diagnosis and treatment via *** factors affecting the diagnosis and management of appendiceal diseases are also *** existence of any organ has its natural rationality,and the appendix is such a magical organ.A growing number of experts and scholars have gradually come to a consensus that the appendix is not a useless evolutionary *** are many lymphocytes and lymph nodes in the appendix wall,which has a strong immune function,and this function is particularly important for children and *** intestinal probiotics in the appendix are very helpful for maintaining the balance of the intestinal *** the continuous progress of endoscopic technology,endoscopic treatment involving preservation of the appendix has shown great advantages over *** the diagnosis of appendiceal inflammation and neoplasms,colonoscopy,endoscopic retrograde appendicography and choledochoscopy help assess conditions of the *** retrograde appendicitis therapy,abscess drainage under colonoscopy,fenestration of abscess under colonoscopy,and endoscopic or natural orifice transluminal endoscopic surgery resection of appendiceal neoplasms are safe and effective endoscopic treatments for appendiceal *** breakthroughs in the application of endoscopy in the appendix are expected to occur in the near future.

关键词： Appendicitis Appendiceal neoplasms Colonoscopy Endoscopic ultrasonography

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