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Recent Advances in Gastrointestinal Endoscopy
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Recent Advances in Gastrointestinal Endoscopy

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: closed (20 May 2024) | Viewed by 4618

Special Issue Editor

Dr. Shinya Kodashima

E-Mail Website
Guest Editor
Department of Medicine, Teikyo University School of Medicine, Tokyo, Japan
Interests: gastrointestinal endoscopy; digestive endoscopy; colorectal neoplasms; digestive diseases; gastroenterology

Special Issue Information

Dear Colleagues,

Recently, there have been remarkable advances in endoscopic diagnosis and treatment of gastrointestinal neoplasms in accordance with improvements in endoscopic technology. In particular, the application of artificial intelligence (AI) to endoscopic diagnosis and the development of image-enhanced endoscopy (IEE) have markedly progressed, and these have a stronger influence on the clinical diagnosis of gastrointestinal neoplasms. These endoscopic technologies provide opportunities for minimally invasive endoscopic treatment, including endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR). While the technical difficulty of endoscopic treatment was high, many kinds of efforts have improved the security of endoscopic treatment.

Authors can submit original articles, reviews, or short communications. We encourage submissions of papers on topics surrounding the endoscopic diagnosis and treatment of gastrointestinal neoplasms.

Dr. Shinya Kodashima
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • esophageal cancer
  • gastric cancer
  • colorectal cancer
  • endoscopic mucosal resection
  • endoscopic submucosal dissection
  • diagnostic endoscopy

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

13 pages, 2113 KiB  
Article
Esophageal Self-Expandable Metal Stents Can Fracture in the Distal Third When Used for Post-Bariatric Surgery Complications: A Single Center Experience and Review of the Literature with Video
by Yazan Abboud, Mohamad Othman El Helou, Joseph Meza, Jamil S. Samaan, Liliana Bancila, Navkiran Randhawa, Kenneth H. Park, Shahab Mehdizadeh, Srinivas Gaddam and Simon K. Lo
J. Clin. Med. 2024, 13(12), 3419; https://doi.org/10.3390/jcm13123419 - 11 Jun 2024
Viewed by 1244
Abstract
Background: Esophageal self-expandable metal stents (SEMS) are an important endoscopic tool. These stents have now been adapted successfully to manage post-bariatric surgery complications such as anastomotic leaks and strictures. In centers of expertise, this has become the primary standard-of-care treatment given its minimally [...] Read more.
Background: Esophageal self-expandable metal stents (SEMS) are an important endoscopic tool. These stents have now been adapted successfully to manage post-bariatric surgery complications such as anastomotic leaks and strictures. In centers of expertise, this has become the primary standard-of-care treatment given its minimally invasive nature, and that it results in early oral feeding, decreased hospitalization, and overall favorable outcomes. Self-expandable metal stents (SEMS) fractures are a rare complication of unknown etiology. We aimed to investigate possible causes of SEMS fractures and highlight a unique endoscopic approach utilized to manage a fractured and impaled SEMS. Methods: This is a retrospective study of consecutive patients who underwent esophageal SEMS placement between 2015–2021 at a tertiary referral center to identify fractured SEMS. Patient demographics, stent characteristics, and possible etiologies of fractured SEMS were identified. A comprehensive literature review was also conducted to evaluate all prior cases of fractured SEMS and to hypothesize fracture theories. Results: There were seven fractured esophageal SEMS, of which six were used to manage post-bariatric surgery complications. Five SEMS were deployed with their distal ends in the gastric antrum and proximal ends in the distal esophagus. All stents fractured within 9 weeks of deployment. Most stents (5/7) were at least 10 cm in length with fractures commonly occurring in the distal third of the stents (6/7). The wires of a fractured SEMS were embedded within the esophagogastric junction in one case, prompting the use of an overtube that was synchronously advanced while steadily extracting the stent. Discussion: We suggest the following four etiologies of SEMS fractures: anatomical, physiological, mechanical, and chemical. Stent curvature at the stomach incisura can lead to strain- and stress-related fatigue due to mechanical bending with exacerbation from respiratory movements. Physiologic factors (gastric body contractions) can result in repetitive squeezing of the stent, adding to metal fatigue. Intrinsic properties (long length and low axial force) may be contributing factors. Lastly, the stomach acidic environment may cause nitinol-induced chemical weakness. Despite the aforementioned theories, SEMS fracture etiology remains unclear. Until more data become available, it may be advisable to remove these stents within 6 weeks. Full article
(This article belongs to the Special Issue Recent Advances in Gastrointestinal Endoscopy)
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11 pages, 11495 KiB  
Article
Case Series of Endoscopic Papillary Balloon Dilation for Children with Common Bile Duct Stones and a Review of the Literature
by Katsunori Kouchi, Ayako Takenouchi, Aki Matsuoka, Kiyoaki Yabe, Hiroko Yoshizawa, Chikako Nakata, Jun Fujishiro and Harutoshi Sugiyama
J. Clin. Med. 2024, 13(8), 2251; https://doi.org/10.3390/jcm13082251 - 12 Apr 2024
Cited by 2 | Viewed by 1314
Abstract
Background: Endoscopic sphincterotomy (EST) has been employed for the endoscopic treatment of common bile duct stones (CBDSs) and has been reported to have a high success rate for stone removal. However, EST is associated with a risk of bleeding, perforation, and sphincter [...] Read more.
Background: Endoscopic sphincterotomy (EST) has been employed for the endoscopic treatment of common bile duct stones (CBDSs) and has been reported to have a high success rate for stone removal. However, EST is associated with a risk of bleeding, perforation, and sphincter of Oddi function disruption. To avoid these risks, endoscopic papillary balloon dilation (EPBD) is an option for CBDS. Sphincter of Oddi function preservation decreases long-term biliary infection and gallstone recurrence. EPBD may have advantages in children who require a long follow up. However, there have been few reports on pediatric cases, particularly in infants. Methods: From September 2017 to December 2023, we performed EPBD for four pediatric CBDSs. The patients were aged from 5 months to 8 years, including two infants aged 5 and 6 months. Furthermore, we reviewed the stone removal rate and complications of 545 ESTs performed at high-volume centers and 13 EPBD-reported cases in children with CBDSs. Results: CBDSs of all patients who underwent EPBD in our institution were successfully removed. No bleeding or perforation was noted; pancreatitis was observed in three patients. In an analysis of 545 ESTs in children, the stone removal rate was high, ranging from 83% to 100% (mean 96%). The incidence of pancreatitis was 0–9.6% (mean 4.4%), and the grade of pancreatitis was almost mild. The bleeding frequency was 1.3–5.4% (mean 2.7%). With regards to the grade of bleeding, seven cases were mild (64%) and four were moderate (36%). Compared with adults who underwent EST, the frequencies of pancreatitis and bleeding were almost equal in children; however, in children, once bleeding occurs, it has a higher risk of leading to blood transfusion. Stone removal via EPBD in children has a 100% success rate. Pancreatitis was responsible for all complications were related; its frequency was 46% (6/13 patients, including five mild cases and one moderate case), which is higher than that of EST and adult cases who underwent EPBD. In most children with pancreatitis, pancreatic enzyme levels returned to normal within 2–3 days following EPBD, and no severe cases caused by EPBD were reported. Conclusions: CBDS removal via EPBD in children has a high success rate with very low risk of bleeding and perforation. Although pancreatitis frequently occurs, most cases are mild. Sphincter of Oddi function preservation via EPBD is expected to prevent long-term stone recurrence and biliary tract infection, and EPBD is considered to be an effective method for CBDS removal in children. Full article
(This article belongs to the Special Issue Recent Advances in Gastrointestinal Endoscopy)
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10 pages, 4955 KiB  
Article
Development of an Artificial Intelligence Diagnostic System Using Linked Color Imaging for Barrett’s Esophagus
by Tsutomu Takeda, Daisuke Asaoka, Hiroya Ueyama, Daiki Abe, Maiko Suzuki, Yoshihiro Inami, Yasuko Uemura, Momoko Yamamoto, Tomoyo Iwano, Ryota Uchida, Hisanori Utsunomiya, Shotaro Oki, Nobuyuki Suzuki, Atsushi Ikeda, Yoichi Akazawa, Kohei Matsumoto, Kumiko Ueda, Mariko Hojo, Shuko Nojiri, Tomohiro Tada and Akihito Nagaharaadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(7), 1990; https://doi.org/10.3390/jcm13071990 - 29 Mar 2024
Cited by 1 | Viewed by 1719
Abstract
Background: Barrett’s esophagus and esophageal adenocarcinoma cases are increasing as gastroesophageal reflux disease increases. Using artificial intelligence (AI) and linked color imaging (LCI), our aim was to establish a method of diagnosis for short-segment Barrett’s esophagus (SSBE). Methods: We retrospectively selected 624 consecutive [...] Read more.
Background: Barrett’s esophagus and esophageal adenocarcinoma cases are increasing as gastroesophageal reflux disease increases. Using artificial intelligence (AI) and linked color imaging (LCI), our aim was to establish a method of diagnosis for short-segment Barrett’s esophagus (SSBE). Methods: We retrospectively selected 624 consecutive patients in total at our hospital, treated between May 2017 and March 2020, who experienced an esophagogastroduodenoscopy with white light imaging (WLI) and LCI. Images were randomly chosen as data for learning from WLI: 542 (SSBE+/− 348/194) of 696 (SSBE+/− 444/252); and LCI: 643 (SSBE+/− 446/197) of 805 (SSBE+/− 543/262). Using a Vision Transformer (Vit-B/16-384) to diagnose SSBE, we established two AI systems for WLI and LCI. Finally, 126 WLI (SSBE+/− 77/49) and 137 LCI (SSBE+/− 81/56) images were used for verification purposes. The accuracy of six endoscopists in making diagnoses was compared to that of AI. Results: Study participants were 68.2 ± 12.3 years, M/F 330/294, SSBE+/− 409/215. The accuracy/sensitivity/specificity (%) of AI were 84.1/89.6/75.5 for WLI and 90.5/90.1/91.1/for LCI, and those of experts and trainees were 88.6/88.7/88.4, 85.7/87.0/83.7 for WLI and 93.4/92.6/94.6, 84.7/88.1/79.8 for LCI, respectively. Conclusions: Using AI to diagnose SSBE was similar in accuracy to using a specialist. Our finding may aid the diagnosis of SSBE in the clinic. Full article
(This article belongs to the Special Issue Recent Advances in Gastrointestinal Endoscopy)
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