Clinical Endoscopy

Long-term outcome of grade 1 rectal neuroendocrine tumor ≤1 cm after incomplete endoscopic resection: Jong Sun Park, Hye Lynn Jeon, Bumhee Park, Jong Hoon Park, Gil Ho Lee, Sun Gyo Lim, Sung Jae Shin, Kee Myung Lee, Choong-Kyun Noh; Clin Endosc 2025;58(6):871-880. Published online July 22, 2025; DOI: https://doi.org/10.5946/ce.2025.043

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Background
/Aims: Surveillance strategies for small grade 1 rectal neuroendocrine tumors (G1 rNETs) after incomplete endoscopic resection (ER) remain controversial. We evaluated the long-term outcomes of patients with G1 rNET ≤1 cm after ER who did and did not undergo complete resection.
Methods
We retrospectively evaluated 441 patients with G1 rNETs measuring ≤1 cm after ER between 2011 and 2022. Patients were divided into complete and incomplete resection groups according to histopathological evaluation. Logistic regression analysis identified the risk factors for incomplete resection after ER.
Results
The mean follow-up intervals were 38.6 and 45.7 months in all patients and the incomplete resection group, respectively. No recurrences were observed during the follow-up period. The mean lesion size was 5.5 mm and the complete resection rate was 80.5% (n=355). In the logistic regression analysis, lesion size 5.1 to 10 mm (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.245–4.203; p=0.008), multiple lesions (OR, 8.3; 95% CI, 1.247–54.774; p=0.029), and retroflexion view during the procedure (OR, 4.0; 95% CI, 1.668–9.615; p=0.002) were independent risk factors for incomplete resection.
Conclusions
The prognosis of G1 rNET ≤1 cm after ER was very good, regardless of the histopathological results.

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Prognostic Factors in Neuroendocrine Neoplasms of the Rectum
Frederike Butz, Charlotte Friederike Müller-Debus, Flora Georgina Ecseri, Gianna Sophia Mani, Elif Akgündüz, Agata Dukaczewska, Peter Richard Steinhagen, Uli Fehrenbach, Catarina A. Kunze, Henning Jann, Johann Pratschke, Eva Maria Dobrindt, Martina T. Mog
Cancers.2025; 17(17): 2841. CrossRef

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Could a bleeding-sensor device be established as a new paradigm for detecting upper gastrointestinal bleeding before performing endoscopy?: Sun Gyo Lim; Clin Endosc 2024;57(2):191-192. Published online March 14, 2024; DOI: https://doi.org/10.5946/ce.2024.008

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Endoscopic stenting for malignant gastric outlet obstruction: focusing on comparison of endoscopic stenting and surgical gastrojejunostomy: Sun Gyo Lim, Chan Gyoo Kim; Clin Endosc 2024;57(5):571-580. Published online February 23, 2024; DOI: https://doi.org/10.5946/ce.2023.160

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Malignant gastric outlet obstruction (GOO) is a condition characterized by blockage or narrowing where the stomach empties its contents into the small intestine due to primary malignant tumors or metastatic diseases. This condition leads to various symptoms such as nausea, vomiting, abdominal pain, and weight loss. To manage malignant GOO, different treatment options have been employed, including surgical gastrojejunostomy (SGJ), gastroduodenal stenting (GDS) using self-expandable metallic stent (SEMS), and endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ). This review focuses on comparing the clinical outcomes of endoscopic stenting (GDS and EUS-GJ) with SGJ for malignant GOO. Studies have shown that GDS with SEMS provides comparable clinical outcomes and safety for the palliation of obstructive symptoms. The choice between covered and uncovered SEMS remains controversial, as different studies have reported varying results. EUS-GJ, performed via endoscopic ultrasound guidance, has shown promising efficacy and safety in managing malignant GOO, but further studies are needed to establish it as the primary treatment option. Comparative analyses suggest that GDS has higher recurrence and reintervention rates compared to EUS-GJ and SGJ, with similar overall procedural complications. However, bleeding rates were lower with GDS than with SGJ. Randomized controlled trials are required to determine the optimal treatment approach for malignant GOO.

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Palliative management for malignant biliary obstruction and gastric outlet obstruction from pancreatic cancer
Pengfei Wu, Kai Chen, Jin He
Annals of Gastroenterological Surgery.2025; 9(2): 218. CrossRef
Aortoenteric Fistula Formation From Chronic Erosion of an Axios Gastroduodenal Stent in a Patient With a History of Radiation
Caleb M Glover, Adam Bowen, Claire Russell, Ali Rida, Alexandra Davies, Edward Cay, John Walling
Cureus.2025;[Epub] CrossRef
Advances in Surgical Management of Malignant Gastric Outlet Obstruction
Sang-Ho Jeong, Miyeong Park, Kyung Won Seo, Jae-Seok Min
Cancers.2025; 17(15): 2567. CrossRef
Maximum stomach area on preoperative CT predicts delayed gastric emptying in palliative gastrojejunostomy
Jaewook Shin, Joshua T. Cohen, Shriya Perati, Timothy D. Murtha, Rachel E. Beard, Thomas J. Miner
Surgical Oncology Insight.2025; 2(3): 100172. CrossRef

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Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection?: Yunho Jung, Gwang Ho Baik, Weon Jin Ko, Bong Min Ko, Seong Hwan Kim, Jin Seok Jang, Jae-Young Jang, Wan-Sik Lee, Young Kwan Cho, Sun Gyo Lim, Hee Seok Moon, In Kyung Yoo, Joo Young Cho; Clin Endosc 2021;54(4):555-562. Published online January 13, 2021; DOI: https://doi.org/10.5946/ce.2020.229

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Background
/Aims: A new medical fiber-guided diode laser system (FDLS) is expected to offer high-precision cutting with simultaneous hemostasis. Thus, this study aimed to evaluate the feasibility of using the 1,940-nm FDLS to perform endoscopic submucosal dissection (ESD) in the gastrointestinal tract of an animal model.
Methods
In this prospective animal pilot study, gastric and colorectal ESD using the FDLS was performed in ex vivo and in vivo porcine models. The completeness of en bloc resection, the procedure time, intraprocedural bleeding, histological injuries to the muscularis propria (MP) layer, and perforation were assessed.
Results
The en bloc resection and perforation rates in the ex vivo study were 100% (10/10) and 10% (1/10), respectively; those in the in vivo study were 100% (4/4) and 0% for gastric ESD and 100% (4/4) and 25% (1/4) for rectal ESD, respectively. Deep MP layer injuries tended to occur more frequently in the rectal than in the gastric ESD cases, and no intraprocedural bleeding occurred in either group.
Conclusions
The 1,940-nm FDLS was capable of yielding high en bloc resection rates without intraprocedural bleeding during gastric and colorectal ESD in animal models.

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Sequential injection-electrocoagulation vs. traditional electrocoagulation haemostasis during endoscopic submucosal dissection: a randomized controlled trial
Zi-yi Ma, Zhen Yang, Jia Liu, Xue Peng, Xu-biao Nie, Pai-pai Qi, Quan-bing Jiang, Wei-Hao Kok, En Liu, Chao-qiang Fan
Surgical Endoscopy.2025; 39(7): 4633. CrossRef
Thermal Ablation (Laser vs. Argon Plasma Coagulation) for the Treatment of Excessive Dynamic Airway Collapse: An in vivo Study in Bama Miniature Pigs
Faming Liu, Jiyang Li, Ting Wang, Bing Xue, Yishan Lv, Jie Zhang, Felix J.F. Herth
Respiration.2025; : 1. CrossRef
Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review
Andrea Etrusco, Giovanni Buzzaccarini, Antonio Simone Laganà, Vito Chiantera, Salvatore Giovanni Vitale, Stefano Angioni, Maurizio Nicola D’Alterio, Luigi Nappi, Felice Sorrentino, Amerigo Vitagliano, Tommaso Difonzo, Gaetano Riemma, Liliana Mereu, Alessa
Diagnostics.2024; 14(3): 327. CrossRef
Recent advances in endoscopic management of gastric neoplasms
Hira Imad Cheema, Benjamin Tharian, Sumant Inamdar, Mauricio Garcia-Saenz-de-Sicilia, Cem Cengiz
World Journal of Gastrointestinal Endoscopy.2023; 15(5): 319. CrossRef
Safety and efficacy of dual emission endoscopic laser treatment in patients with upper or lower gastrointestinal vascular lesions causing chronic anemia: results from the first multicenter cohort study
Gian Eugenio Tontini, Lorenzo Dioscoridi, Alessandro Rimondi, Paolo Cantù, Flaminia Cavallaro, Aurora Giannetti, Luca Elli, Luca Pastorelli, Francesco Pugliese, Massimiliano Mutignani, Maurizio Vecchi
Endoscopy International Open.2022; 10(04): E386. CrossRef

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Insertion of Self Expandable Metal Stent for Malignant Stomal Obstruction in a Patient with Advanced Colon Cancer: Jeong Ook Wi, Sung Jae Shin, Jun Hwan Yoo, Jeong Woo Choi, Byung-Hyun Yoo, Sun Gyo Lim, Kee Myung Lee, Jin Hong Kim; Clin Endosc 2012;45(4):448-450. Published online November 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.4.448

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Self expandable metal stent can be used both as palliative treatment for malignant colorectal obstruction and as a bridge to surgery in patients with potentially resectable colorectal cancer. Here, we report a case of successful relief of malignant stomal obstruction using a metal stent. A 56-year-old man underwent loop ileostomy and was given palliative chemotherapy for ascending colon cancer with peritoneal carcinomatosis. Eight months after the surgery, he complained of abdominal pain and decreased fecal output. Computed tomography and endoscopy revealed malignant stomal obstruction. Due to his poor clinical condition, we inserted the stent at the stomal orifice, instead of additional surgery, and his obstructive symptoms were successfully relieved. Stent insertion is thought to be a good alternative treatment for malignant stomal obstruction, instead of surgery.

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Endoscopic transstomal stent insertion: a novel approach for a stenosed stoma in a challenging patient
Feras Aljarad, Ashutosh Gumber, Anne Marie McLeary, Kawan Shalli
Annals of Coloproctology.2023; 39(4): 357. CrossRef
Use of metallic stents in the management of stenotic bowel stomas
Mohammad Arabi, Hasan Aljaziri, Mohammed Rashid Akhtar, Tim Fotheringham
International Journal of Gastrointestinal Intervention.2022; 11(4): 201. CrossRef
Metal Stent Insertion for Malignant Obstruction of a Colostomy
Antonios Wehbeh, Mahmoud Rahal, Hala Fatima
Cureus.2020;[Epub] CrossRef

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