Clinical Endoscopy

Systematic Review and Meta-analysis

To what extent can bowel preparation quality be considered “adequate”?: a systematic review and meta-analysis: Chen-Ya Kuo, David Karsenti, Salvador Machlab, Fu-Jen Lee, Yu-Tsung Chen, Te-Ling Ma, Chi-Yang Chang, Yu-Tse Chiu; Clin Endosc 2026;59(4):569-580. Published online July 30, 2026; DOI: https://doi.org/10.5946/ce.2026.022

Graphical Abstract Abstract PDF Supplementary Material: Background
/Aims: While low-quality bowel preparation is known to reduce the adenoma detection rate (ADR), the distinction between intermediate- and high-quality preparations remains unclear.
Methods
Electronic searches were conducted in PubMed and Embase through July 2024. Randomized controlled trials reporting ADR and the Boston bowel preparation scale (BBPS) were included, and outcomes were pooled according to bowel preparation quality using a random-effects model. The primary outcome was ADR in intermediate-quality (BBPS ≥6, and ≥2 in each segment) versus high-quality (BBPS≥8) bowel preparation. Secondary outcomes included advanced ADR.
Results
Fourteen trials were included (5,246 in the high-quality group and 1,728 in the other group). There was no significant difference in ADR (risk difference [RD], –0.02; p=0.13; I2=21%). Subgroup analyses showed no significant difference with computer-aided detection (CADe; RD, –0.03; p=0.70; I2=81%) or linked color imaging (RD, 0.04; p=0.31; I2=0%). The heterogeneity observed with CADe may reflect differences in colonoscopist experience or CADe systems. The results were similar for advanced ADR. Funnel plot and Egger’s test indicated minimal publication bias.
Conclusions
Intermediate-quality preparation allows adequate adenoma detection. When each BBPS subscore is ≥2, surveillance recommendations can generally be followed.

506 View
23 Download

Original Article

Effect of external evaluation and training on the incomplete resection rate in cold snare polypectomies for colonic lesions <10 mm: a prospective Spanish study (POLIPEVA): Marina de Benito Sanz, Jorge Feito, Luis Hernández, Javier Tejedor-Tejada, Pilar Diez-Redondo, María Henar Núñez Rodríguez, Raúl Honrubia-López, Cristina Fernández, Victoria Busto, Sofia Parejo, Marta Aicart-Ramos, Marina Solano, Silvia Patricia Ortega, Natalia Marcos, Francisco Javier García-Alonso, on behalf of the POLIPEVA study group; Clin Endosc 2026;59(4):653-662. Published online July 30, 2026; DOI: https://doi.org/10.5946/ce.2025.474

Graphical Abstract Abstract PDF Supplementary Material: Background
/Aims: Cold snare polypectomy (CSP) technique for polyps <10 mm varies widely among endoscopists. This study aimed to evaluate an online educational intervention for incomplete resections.
Methods
This multicenter trial was performed between 2021 and 2024. After a baseline assessment of incomplete resection rates for CSP of lesions <10 mm was completed, participants undertook a 1-hour online course led by an expert senior endoscopist. A second assessment was performed following course completion. Resections were evaluated using two marginal biopsies obtained after CSP, assessed by a single pathologist blinded to polyp histology. Follow-up was conducted by telephone 4 weeks after colonoscopy.
Results
A total of 29 endoscopists participated in the baseline assessment, yielding a baseline 4.8% incomplete resection rate, with a median individual rate of 4.3% (interquartile range [IQR], 2.9%–5.7%; range, 0%–15.6%). Thirteen endoscopists completed the course and participated in the second study phase, which included 1,271 polyps in phase 1 and 826 in phase 2. No significant improvement in incomplete resection rate was observed (4.8% in phase 1 vs. 4.0% in phase 2; difference, 0.8%; 95% confidence interval [CI], –1.1% to 2.6%; p=0.4). Among 3,087 polypectomies, intraprocedural bleeding occurred in 288 (9.3%) cases; most were self-limited, with only 45 (1.5%) requiring clipping. Delayed bleeding was observed in five (0.5%) patients, four of whom had mild bleeding and one severe. No perforations were observed.
Conclusions
The utility of online endoscopic technique courses appears limited. CSP demonstrates an excellent safety profile (ClinicalTrials.gov number: NCT04636619).

467 View
37 Download
1 Web of Science

Systematic Review and Meta-analysis

Oral sulfate-based versus low-volume polyethylene glycol-ascorbate regimens for colonoscopy preparation in the geriatric population: a systematic review and meta-analysis of randomized controlled trials: Ali Emre Bardak, Gizem Teker, Yusuf Yalcin, Stefan Mitev, Ayse Ipek Bardak, Zulal Istemihan, Nazli Begum Ozturk, Sandeep Krishnan; Clin Endosc 2026;59(4):557-568. Published online July 29, 2026; DOI: https://doi.org/10.5946/ce.2025.430

Graphical Abstract Abstract PDF Supplementary Material: Background
/Aims: Adequate bowel preparation is essential for high-quality colonoscopy; however, older adults often struggle with large-volume regimens. Low-volume oral sulfate (OS)-based and polyethylene glycol-ascorbate (PEG-Asc) may improve tolerability without compromising efficacy. This study compared the efficacy, tolerability, and safety of these regimens in older adults.
Methods
We searched the PubMed, Embase, and Cochrane databases from inception until May 2025 for randomized controlled trials comparing OS with low-volume PEG-Asc in adults aged ≥65 years. Outcomes were pooled using random-effects models as risk ratios (RRs) or mean differences (MDs).
Results
Six trials (n=682; OS, 340; PEG-Asc, 342) were included. The overall cleansing success rates were comparable (RR, 1.00; 95% confidence interval [CI], 0.96–1.03). Total Boston bowel preparation scale and segmental scores did not significantly differ between the groups (MD, 0.08; 95% CI, −0.10 to 0.27). OS improved lesion detection in terms of polyp detection (RR, 1.21; 95% CI, 1.01–1.45) and adenoma detection rates (RR, 1.28; 95% CI, 1.10–1.49). Patient-reported satisfaction modestly favored OS compared with PEG-Asc (MD, 0.69; 95% CI, 0.10–1.29), whereas willingness to reuse was similar between the two groups (RR, 1.09; 95% CI, 0.97–1.23). Adverse events and procedural metrics did not significantly differ between the groups.
Conclusions
In adults aged ≥65 years, OS and low-volume PEG-Asc achieved similar cleansing quality and safety. OS may confer higher polyp and adenoma detection rates than PEG-Asc and may be a reasonable option for maximizing lesion detection.

314 View
14 Download

Reviews

Best choice for colorectal cancer screening at the population level: fecal immunochemical test, stool DNA test, or colonoscopy: Hyoung Il Choi, Jae Myung Cha; Received February 12, 2026 Accepted March 17, 2026 Published online June 15, 2026; DOI: https://doi.org/10.5946/ce.2026.061 [Epub ahead of print]

Abstract PDF: Fecal immunochemical testing (FIT) remains the cornerstone of organized, population-based colorectal cancer (CRC) screening owing to its noninvasive nature, affordability, and proven mortality reduction. FIT facilitates early detection; however, its population impact depends on sustained participation, adequate colonoscopy capacity for positive results, and data-driven optimization of thresholds and intervals. Stool DNA-based tests offer higher sensitivity for CRC and advanced adenomas than FIT, with lower specificity and higher costs. Multitarget stool DNA tests may serve as complementary options within hybrid risk-stratified strategies; however, further evidence is needed regarding their long-term effectiveness, programmatic feasibility, and economic sustainability before widespread adoption at the population level. In contrast, methylation-based stool DNA tests utilize stable epigenetic alterations and simpler laboratory workflows, offering advantages in logistics, scalability, and cost-effectiveness, and thus represent promising candidates for organized screening. Colonoscopy remains the most comprehensive screening modality, enabling the detection and removal of precancerous lesions, thereby preventing the development of CRC. However, its use as an organized screening tool at the population level is limited by its invasiveness, cost, logistical complexity, and suboptimal participation, which compels most organized programs to position colonoscopy primarily as a confirmatory test following noninvasive screening rather than as a universal first-line modality.

1,012 View
79 Download

Korean clinical practice guidelines for bowel preparation before colonoscopy: Jae Hyun Kim, Seung-Joo Nam, Beom Jae Lee, Eun Ran Kim, Eun Sun Kim, Eun Soo Kim, Chang Kyun Lee, Yehyun Park, Geom Seog Seo, Jong-Jae Park, Hyun-Soo Kim, The Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2026;59(4):529-556. Published online April 22, 2026; DOI: https://doi.org/10.5946/ce.2026.053

Abstract PDF Supplementary Material: Appropriate bowel cleansing is essential for successful and safe colonoscopy. Inadequate bowel cleansing can lead to poor visualization of the delicate mucosa, leading to missed precancerous lesions, increased risk of procedure-related complications, and increased medical costs due to re-examination. Several types of bowel cleansing agents that improve ease of administration have been developed in recent years, and the clinical outcomes have been published. Bowel cleansing efficiency can differ between races due to differences in socio-environmental factors, including dietary patterns. This paper is the first Korean clinical guideline for bowel preparation for colonoscopy, formulated by the Korean Society of Gastrointestinal Endoscopy. These guidelines were developed using adaptation methods and the findings of studies on Korean patients; recently published studies were considered to the extent possible. These guidelines will be revised as and when new data regarding bowel preparation are accumulated.

5,157 View
272 Download

Systematic Review and Meta-analysises

Impact of glucagon-like peptide-1 receptor agonists on colonoscopy outcomes: a systematic review and meta-analysis: Ahmad Abdulraheem, Bara Abujaber, Lindsay Ayers, Usman Afzal, Dania Qarkash, Nadera Altork, Qusai Al-Zureikat, Kiandokht Bashiri, Ghaith Almhanni, Peppas Spyros, Won Kyoo Cho; Clin Endosc 2026;59(2):211-222. Published online February 13, 2026; DOI: https://doi.org/10.5946/ce.2025.137

Graphical Abstract Abstract PDF Supplementary Material: Background
/Aims: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are widely prescribed for diabetes and obesity. Recent studies suggest they may negatively affect bowel preparation quality before colonoscopy (CLN), leading to inadequate bowel preparation (IBP) and repeat procedures. We conducted a systematic review and meta-analysis to assess this association.
Methods
PubMed, Embase and Cochrane databases, along with abstracts from Digestive Disease Week 2024 and the American College of Gastroenterology Meeting 2024, were searched. Outcomes included IBP, repeat CLNs, and the mean difference in Boston Bowel Preparation Scale (BBPS) scores between GLP-1 RA users and non-users. Adjusted odds ratios (OR), for age, sex, body mass index, and diabetes, were pooled.
Results
Twelve studies including 123,858 patients (57,699 GLP-1 RA users) were analyzed. GLP-1 RA use was associated with higher IBP risk (OR, 1.55; 95% CI, 1.11–2.16); adjusted analyses confirmed this (OR, 2.35; 95% CI, 2.02–2.74). BBPS scores were lower among GLP-1 RA users (mean difference, –0.68; 95% CI, –0.77 to –0.58). No association with repeat CLNs was observed (OR, 1.5; 95% CI, 0.88–2.56).
Conclusions
GLP-1 RA use is linked to inadequate bowel preparation but not repeat CLNs. Further prospective studies are warranted to further evaluate this finding.

3,278 View
148 Download

Enhanced adenoma detection with Endocuff Vision: a GRADE assessed systematic review and meta-analysis: Ahmed Ali Khan, Fariha Hasan, Mohammed Dheyaa Marsool Marsool, Muhammad Uzair, Kanz Ul Eman Maryam, Muhammad Usman Babar, Mutahhar Talha, Haider Imran, Rayyan Mohammad Makki Bakhsh, Kalsoom Zulfiqar, Fatima Wahid, Amal Shahzad Khan, Daniel Ashraf Guirguis, Christina Tofani, Anthony Infantolino; Clin Endosc 2026;59(3):371-385. Published online February 2, 2026; DOI: https://doi.org/10.5946/ce.2025.163

Graphical Abstract Abstract PDF Supplementary Material: Background
/Aims: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths and the third most common cancer worldwide. Detecting adenomas during colonoscopy reduces the CRC risk, with higher adenoma detection rates (ADRs) correlating with lower CRC incidence and mortality. Endocuff Vision (EV) enhances mucosal visualization and may improve ADRs.
Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, PubMed, Embase, and Cochrane databases were searched through April 2025 for studies comparing EV-assisted and standard colonoscopy. The primary outcomes of interest were the ADRs, polyp detection rates (PDRs), and adverse events (AEs). Outcomes were pooled using a random-effects meta-analysis model and are presented as risk ratios (RRs) and mean differences. Heterogeneity in the pooled outcomes was assessed using the Higgins I².
Results
Thirty-four studies (43,702 participants) were included. EV significantly improved ADRs (RR, 1.15; 95% confidence interval [CI],1.07–1.25) and PDRs (RR, 1.16; 95% CI, 1.10–1.23). EV also improved lesion detection in the left colon (RR, 1.23; 95% CI, 1.11–1.35) and right colon (RR, 1.19; 95% CI, 1.09–1.29). No significant improvement was observed in advanced ADRs or cecal intubation. EV use was associated with more AEs.
Conclusions
EV-assisted colonoscopy improved ADRs and PDRs in both colonic regions and enhanced CRC screening despite increased AEs.

3,371 View
175 Download

Original Article

Comparison of colon adenoma detection rate using cap-assisted and artificial intelligence-assisted colonoscopy at a tertiary hospital in the Philippines: a propensity score-matched analysis: Justin Ryan Lay Tan, Keith Brian Tan Enriquez, Kenneth Vergel Tecson Aballe, Mary Anne Gonzales Go, Michael Louie Ong Lim, Jonard Tan Co; Clin Endosc 2026;59(1):106-114. Published online December 31, 2025; DOI: https://doi.org/10.5946/ce.2024.337

Graphical Abstract Abstract PDF

Background
/Aims: The integration of artificial intelligence (AI)-powered image analysis and mucosal exposure devices, such as distal attachment caps, has been demonstrated to significantly improve the adenoma detection rate (ADR) during colonoscopy. This study aimed to compare AI-assisted colonoscopy (AIC) with cap-assisted colonoscopy (CAC).
Methods
This retrospective propensity score-matched cohort study was performed at a tertiary care hospital between January 2022 and May 2022. Data were extracted from the electronic health record system and colonoscopy video recordings. Adult patients aged 40 years who underwent screening or surveillance colonoscopies were included. The primary outcome was the ADR, whereas the secondary outcome was the polyp detection rate (PDR).
Results
A 1:1 propensity score-matched analysis was performed, resulting in 49 well-matched patient pairs. One patient from each pair was assigned to the CAC group, whereas the other was assigned to the AIC group. No significant difference in ADR was observed between the CAC and AIC groups (47% vs. 51%, p=0.69). Similarly, PDR did not significantly differ between the two groups (80% vs. 71%, p=0.35).
Conclusions
Both CAC and AIC have the potential to increase ADR and PDR. However, neither modality offers a significant advantage.

Citations

Citations to this article as recorded by

Is cap still useful for colon adenoma detection rate improvement in the artificial intelligence era?
Tae-Woo Kim, Soo-Young Na
Clinical Endoscopy.2026; 59(1): 73. CrossRef

2,522 View
76 Download
1 Web of Science
1 Crossref

Reviews

The potential for social implementation of colorectal cancer screening by colonoscopy: Fumiaki Ishibashi, Masau Sekiguchi, Sho Suzuki; Received August 5, 2025 Accepted October 14, 2025 Published online December 23, 2025; DOI: https://doi.org/10.5946/ce.2025.259 [Epub ahead of print]

Abstract PDF: The incidence of colorectal cancer (CRC) is increasing worldwide, which poses substantial social and economic challenges. To reduce CRC-related mortality, the implementation of screening programs is essential. The current standard approach involves initial screening using the fecal immunochemical test (FIT), followed by colonoscopy. However, the FIT has inherent limitations, including the potential to miss early stage CRC and insufficient detection rates from a single test. Therefore, the FIT is repeated annually or biennially, and the incidence of interval cancer remains a concern. In contrast, colonoscopy allows a highly accurate diagnosis of CRC in a single examination. Of the five randomized controlled trials evaluating the impact of colonoscopy on CRC mortality, two have reported results to date. The mortality reduction effect of colonoscopy-based screening was somewhat lower than expected in these studies, primarily because of low participation rates. Nonetheless, the fact that countries such as the United States and Germany, which have already implemented colonoscopy-based screening, have experienced substantial reductions in CRC mortality, which supports the expectations of the effectiveness of implementing such programs at the societal level. Among the challenges in their implementation, ensuring adequate participation rates is essential, and the establishment of an organized screening system is warranted.

1,931 View
241 Download

Updated bowel preparation regimens for colonoscopy: benefits and drawbacks: Seung Min Hong, Dong Hoon Baek; Clin Endosc 2026;59(3):345-355. Published online December 18, 2025; DOI: https://doi.org/10.5946/ce.2025.201

Abstract PDF

Optimal bowel preparation is critical for high-quality colonoscopy and the effective prevention of colorectal cancer. Although traditional high-volume polyethylene glycol (PEG) electrolyte lavage solutions are effective and safe, they are frequently limited by poor patient tolerability. To improve adherence, several low- and ultralow-volume PEG-based regimens, particularly 2 L and 1 L PEG plus ascorbate, have demonstrated noninferior efficacy and better patient compliance. Hyperosmotic alternatives, including oral sulfate solution and sodium picosulfate with magnesium citrate, provide comparable bowel-cleansing efficacy and are often favored for their improved palatability and tolerability. The recent introduction of oral sulfate tablets offers the convenience of a tablet form while maintaining efficacy similar to that of PEG-based regimens and significantly enhancing tolerability. However, a few cases of gastric mucosal irritation have been reported. Adjunctive simethicone also improves mucosal visibility by reducing intraluminal bubbles. With the growing diversity of bowel preparation options, regimen selection should be tailored to individual patient characteristics, including age, comorbidities, prior experiences, and personal preferences. A personalized evidence-based approach, guided by patient-specific factors and supported by emerging clinical data, can improve adherence, ensure adequate bowel cleansing, and enhance the diagnostic yield and procedural efficiency of colonoscopy.

Citations

Citations to this article as recorded by

Bowel preparation compliance in adult patients undergoing colonoscopy: An integrated analysis of influencing factors and advances in intervention research
Xia Wang, Xiu-Qin Zhu, Qiao-Zhen Guo
World Chinese Journal of Digestology.2026; 34(3): 251. CrossRef
Response
Tae-Geun Gweon
Gastrointestinal Endoscopy.2026; 104(2): 349. CrossRef
Advancing bowel preparation: DWJ1609 represents a patient-centered evolution in colonoscopy preparation
Iyad A Issa, Taly Issa
World Journal of Gastroenterology.2026;[Epub] CrossRef

7,909 View
417 Download
2 Web of Science
3 Crossref

Computer-aided quality control in colonoscopy: clinical applications and limitations: Elizabeth Lee Yoong Chen, James Weiquan Li; Received August 30, 2025 Accepted October 23, 2025 Published online December 17, 2025; DOI: https://doi.org/10.5946/ce.2025.309 [Epub ahead of print]

Abstract PDF

Computer-aided quality control (CAQ) systems are redefining colonoscopy by enabling the objective evaluation of procedural metrics and providing real-time feedback. This review explores the clinical utility, implementation barriers, and future prospects of CAQ, with an emphasis on its role in standardizing quality assessment and enhancing patient outcomes. A systematic search of PubMed (inception to January 2025) identified 66 relevant publications, including eight systematic reviews or meta-analyses, seven randomized controlled trials, and five cohort studies, in addition to validation and observational reports. CAQ systems improve traditional quality indicators such as withdrawal time, bowel preparation scores, and cecal intubation rates (CIRs). Emerging metrics—including effective withdrawal time, fold examination quality, and withdrawal speed—offer novel, quantifiable insights. Artificial intelligence-assisted colonoscopy consistently increases adenoma detection rates (from 38.5% to 47.9%) and extends withdrawal time (from 5.68 to 7.03 minutes). Automated systems achieve high accuracy in bowel preparation scoring (93.3%), cecal intubation recognition (95.5%), and surveillance interval assignment (92.0%), thereby addressing persistent gaps in documentation and follow-up care. CAQ systems hold transformative promise for improving colonoscopy quality. Addressing implementation challenges—including false positives, clinician adoption, cost, and regulatory issues—is essential. Future research should emphasize comparative effectiveness, standardized metrics, and large-scale clinical integration to help reduce the burden of colorectal cancer.

Citations

Citations to this article as recorded by

Artificial Intelligence in Colonoscopy Surveillance for Lynch Syndrome: Emerging Evidence, Lessons Learned From Average‐Risk Populations, and Future Directions
Robert Hüneburg, Querijn N. E. van Bokhorst, Evelien Dekker, Jacob Nattermann
International Journal of Cancer.2026;[Epub] CrossRef

2,051 View
290 Download
1 Web of Science
1 Crossref

Iatrogenic colon perforation: endoscopic management or surgery: Seung Bum Lee; Clin Endosc 2026;59(1):33-39. Published online October 28, 2025; DOI: https://doi.org/10.5946/ce.2025.182

Abstract PDF

Iatrogenic colonic perforation is a rare but serious complication of colonoscopy, particularly during therapeutic procedures. Prompt recognition and individualized management are essential to prevent adverse outcomes. This review summarizes current treatment strategies based on major international guidelines. Endoscopic closure is recommended for selected cases involving minor defects, early detection, and adequate bowel preparation. Techniques such as clipping, endoloop application, and suturing have demonstrated favorable success rates. Surgical intervention is crucial for larger, delayed, or complicated perforations, particularly those associated with significant contamination or clinical deterioration. Recognizing risk factors such as age, diverticulosis, and inadequate bowel preparation can help prevent this complication.

Citations

Citations to this article as recorded by

Endoloop-clip closure versus hemoclips for large sigmoid colon perforations: a randomized controlled ex vivo study
Geun Hyuk Choi, Jae Kook Yang, Young Sin Cho, Il-Kwun Chung, Yunho Jung
Scandinavian Journal of Gastroenterology.2026; : 1. CrossRef
Response
Tae-Geun Gweon
Gastrointestinal Endoscopy.2026; 104(2): 349. CrossRef

4,954 View
248 Download
2 Web of Science
2 Crossref

Original Article

Assessment of colorectal polyp detection along the short-axis direction of the intestinal lumen during colonoscopic observation: a retrospective study in Japan: Daichi Mori, Atsushi Katagiri, Yoshinao Onishi, Yuta Yamazaki, Kensuke Higuchi, Norihiro Suzuki, Kazuo Kikuchi, Shinya Nakatani, Takahisa Fujiwara, Kazuya Inoki, Kenichi Konda, Masayuki Tojo, Fuyuhiko Yamamura, Hitoshi Yoshida; Clin Endosc 2026;59(1):96-105. Published online October 23, 2025; DOI: https://doi.org/10.5946/ce.2025.112

Graphical Abstract Abstract PDF Supplementary Material

Background
/Aims: Colorectal polyp detection during colonoscopy is influenced by the lesion location, size, morphology, and histology. However, no studies have systematically assessed the difficulty of detection along the short axis of the intestinal lumen. This study aimed to evaluate the colorectal polyp detection rates on this axis during colonoscopy.
Methods
This retrospective study analyzed 1,169 polyps in 513 patients who underwent colonoscopy at Showa University Hospital between November 2022 and February 2023. The short-axis lumen was divided into: upper right, lower right, lower left, and upper left. Each polyp detected was assigned to a quadrant. Detection rates were compared across quadrants and analyzed for associations with clinicopathological factors including lesion size, location, macroscopic type, and examiner experience.
Results
The lesion detection rates varied significantly by quadrant. The upper left quadrant had the lowest detection rate (17.5%) compared with the expected 25.0% per quadrant. Subgroup analyses consistently confirmed the lower detection rates in this quadrant across most lesion types and patient groups, except for lesions in the cecum and rectum.
Conclusions
The lower detection rate in the upper left quadrant suggests that this orientation poses a challenge and may increase the number of missed lesions. Enhanced examination of this area may improve detection; however, further prospective studies are required.

Citations

Citations to this article as recorded by

Directional Bias in Polyp Detection during Colonoscopy: A Prospective Observational Study
Atsushi Katagiri, Sayaka Mizuno, Daichi Mori, Yoshinao Onishi, Yuta Yamazaki, Kensuke Higuchi, Norihiro Suzuki, Kazuo Kikuchi, Shinya Nakatani, Takahisa Fujiwara, Kazuya Inoki, Kenichi Konda, Masayuki Tojo, Kunihiko Wakamura, Hitoshi Yoshida
Digestion.2026; : 1. CrossRef

3,183 View
165 Download
1 Web of Science
1 Crossref

Systematic Review and Meta-Analysis

Efficacy and safety of polyethylene glycol in combination with linaclotide versus polyethylene glycol alone for colonoscopy: a grade-assessed systematic review and meta-analysis: Umar Akram, Eeman Ahmad, Shahzaib Ahmed, Zain Ali Nadeem, Muhammad Ahmed Raza, Eeshal Fatima, Syed Adeel Hassan, Ahtshamullah Chaudhry, Hareesha Rishab Bharadwaj, Muhammad Arslan Tariq, Faryal Altaf, Zaheer Qureshi; Clin Endosc 2025;58(5):670-683. Published online September 1, 2025; DOI: https://doi.org/10.5946/ce.2025.073

Graphical Abstract Abstract PDF Supplementary Material

Background
/Aims: The effectiveness of colonoscopy largely depends on the quality of bowel preparation. Polyethylene glycol (PEG) is commonly used but has certain limitations. This review evaluates whether combining PEG with linaclotide improves preparation efficacy and safety compared with PEG alone.
Methods
A search was conducted in Medline, Embase, and ClinicalTrials.gov up to October 2024. Only randomized controlled trials comparing PEG combined with linaclotide versus PEG alone and reporting adenoma detection rates (ADR) or polyp detection rates (PDR) were included. Mean differences (MDs) and risk ratios (RRs) with 95% confidence intervals (CIs) were reported.
Results
A total of eight studies, including 3,071 participants, were included. Pooled analysis indicated that PEG combined with linaclotide was significantly associated with a higher ADR (RR, 1.15; 95% CI, 1.03–1.28), higher Boston bowel preparation scale score (MD, 0.31; 95% CI, 0.02–0.61), and greater willingness to repeat colonoscopy (RR, 1.16; 95% CI, 1.08–1.24). Although PDR (RR, 1.05; 95% CI, 0.89–1.24) was numerically higher in the intervention group, the difference was not statistically significant. Additionally, the intervention significantly reduced the incidence of nausea, vomiting, bloating, and abdominal pain.
Conclusions
PEG combined with linaclotide is a safe alternative to PEG alone, improving ADR, bowel preparation quality, and patient comfort.

Citations

Citations to this article as recorded by

Linaclotide combined with polyethylene glycol for bowel preparation in colonoscopy: a systematic review and meta-analysis of randomized controlled trials
Gilmara Coelho Meine, Gregory Thomas Brennan, Lucas Monteiro Delgado, Paula Santo, Olufemi Osikoya
Surgical Endoscopy.2026; 40(1): 31. CrossRef
Short-term linaclotide plus polyethylene glycol in patients at increased risk of inadequate bowel preparation: A randomized, double-blind, multicenter trial
Hui Chen, Jun Wang, Caixia Fan, Kun Zhuang, Lili Yuan, Hong Li, Yujie Jing, Nian Fang, Jiaqiang Dong, Ying Han, Zhiguo Liu
Digestive and Liver Disease.2026; 58(6): 773. CrossRef

4,346 View
85 Download
2 Web of Science
2 Crossref

Original Articles

Endoscopic assessment of terminal ileum in screening colonoscopy: is it worth the effort?: Krzysztof Dąbkowski, Maciej Tryba, Ernest Biesiada, Kamila Konczanin, Małgorzata Michalak, Magdalena Szczygłowska, Krzysztof Safranow, Teresa Starzyńska; Clin Endosc 2025;58(5):731-737. Published online July 17, 2025; DOI: https://doi.org/10.5946/ce.2025.018

Graphical Abstract Abstract PDF

Background
/Aims: Screening colonoscopies often do not include terminal ileum assessment. In this study, we examined how often endoscopists assessed the terminal ileum during screening colonoscopy, how it influenced the procedure time and patient comfort, and whether it revealed pathological findings.
Methods
We retrospectively analyzed the screening colonoscopy examinations performed in our department between 2017 and 2021. We retrieved the procedure duration (minutes), patient age and sex, pain scale, and screening colonoscopy results.
Results
A total of 2,449 screening colonoscopy examinations were performed between 2017 and 2021. The patients were classified into one of two groups: the cecum reached or the terminal ileum intubated. These two groups did not significantly differ in sex or reported pain score, while the patients were significantly younger (55.2±6.5 vs. 56.2±6 years, p=0.015) and the colonoscopy duration was longer (22.8±9.8 vs. 18±10.5 min, p<0.001) in the terminal ileum group. Pathological conditions (nonspecific inflammatory lesions) in the small intestine were reported in 5/297 patients.
Conclusions
Small intestine intubation was associated with a significantly longer colonoscopy duration and revealed pathological conditions of no apparent clinical significance.

Citations

Citations to this article as recorded by

Endoscopic assessment of terminal ileum in screening colonoscopy: insights from a retrospective analysis
Motij Kumar Dalai, Yogesh Bairwa, Rohit Wagh, Sanjay Jagdish Chandnani
Clinical Endoscopy.2026; 59(2): 323. CrossRef
Terminal ileum in screening colonoscopy: routine practice or risk-stratified approach?
Seong-Jung Kim
Clinical Endoscopy.2025; 58(5): 696. CrossRef

6,859 View
172 Download
2 Web of Science
2 Crossref

Impact of opioid addition on procedural conditions during colonoscopy: a randomized trial comparing propofol-based sedation protocols: David Novotny, Jan Palenik, Tomas Tyll, Nadija Brodyuk, Stepan Suchanek, Michal Sotak; Clin Endosc 2025;58(5):722-730. Published online July 4, 2025; DOI: https://doi.org/10.5946/ce.2024.347

Graphical Abstract Abstract PDF

Background
/Aims: Propofol is the most effective sedative for colonoscopy; however, opioids do have several adverse effects that need to be discussed. The objective of this study was to compare the ease of colonoscopy during propofol-based sedation with and without fentanyl, while closely monitoring ventilatory data and the safety of the procedure.
Methods
This prospective single-center trial randomized 50 patients who underwent minor colonoscopies. The propofol group received sedation exclusively via propofol, whereas the propofol+fentanyl group was premedicated with 1 µg/kg fentanyl. Patients were monitored using a bioimpedance ventilatory monitor, and both the patients and endoscopists were questioned regarding their level of satisfaction.
Results
The endoscopists reported a higher level of ease with the colonoscopy procedure (mean on a 5-point scale, 1.2 vs. 1.72; p=0.028) and the overall patient satisfaction score was higher (1.15 vs. 1.28, p=0.026) in the propofol+fentanyl group. No significant differences were observed in the ventilatory parameters between the groups. No major adverse events were reported in any of the groups.
Conclusions
The inclusion of fentanyl leads to enhanced levels of satisfaction for both the endoscopist and the patient, without any impact on ventilation and safety. The use of bioimpedance monitoring of ventilation during colonoscopy is a suitable approach that may enhance the safety of procedural sedation.

Citations

Citations to this article as recorded by

Comment on “Impact of opioid addition on procedural conditions during colonoscopy: a randomized trial comparing propofol-based sedation protocols”
Ekrem Aslan
Clinical Endoscopy.2026; 59(3): 481. CrossRef

5,439 View
169 Download
1 Web of Science
1 Crossref

Reviews

Advancing colonoscopy training: tailored strategies and simulation-based models for skill mastery: Nilanga Nishad, Malith Nandasena, Andreas Hadjinicolaou, Mo Hameed Thoufeeq; Clin Endosc 2025;58(6):808-816. Published online June 9, 2025; DOI: https://doi.org/10.5946/ce.2025.019

Abstract PDF: Effective endoscopy training begins by assessing the trainee’s experience and identifying their skill level: beginners, learners, independent practitioners, or experts. Beginners focus on basic tasks, such as cecal intubation, while advanced trainees refine efficiency and complex techniques. Training prioritizes conscious competence through deliberate practice, reflection, and verbalizing actions; this enhances mindfulness and procedural expertise. Clear communication, standardized terminology, and constructive feedback ensure safety, confidence, and skill retention. SMART objectives—specific, measurable, achievable, relevant, and timely—help structure sessions for skill development and mastery. Simulation-based models support training at all the levels. Beginners benefit from cost-effective low-fidelity bench models and virtual reality (VR) simulators, which offer realistic tactile feedback and customizable scenarios. Studies have shown that both low- and high-fidelity models can effectively teach basic skills, although VR is preferred for foundational training. Advanced trainees utilize animal-based models for therapeutic interventions, three-dimensional printed models for pathology-specific practice, and hybrid models that combine VR and physical elements for enhanced realism. Augmented reality and haptic feedback systems refine advanced skills, but face developmental and cost challenges. Mentored live patient models excel in real-world decision-making, but raise ethical concerns. Training is tailored to individual needs, and competency-based training ensures mastery at each stage, from beginners to advanced practitioners.

4,367 View
279 Download

Clinical significance of computer-aided quality assessment systems in colonoscopy: a comprehensive review: Wai Phyo Lwin, Katsuro Ichimasa, Shin-Ei Kudo, Yuta Kouyama, Taishi Okumura, Yasuharu Maeda, Yutaro Ide, Khay Guan Yeoh, Masashi Misawa; Clin Endosc 2025;58(5):638-645. Published online May 27, 2025; DOI: https://doi.org/10.5946/ce.2025.022

Abstract PDF

Colonoscopy is the primary tool for colorectal cancer screening. High-quality colonoscopy is crucial for the detection of precancerous adenomas; however, the adenoma detection rate varies depending on the skill and experience of the endoscopist. Computer-aided quality assessment (CAQ) uses artificial intelligence (AI) technology to evaluate the quality of colonoscopy examinations. It plays an important role in reducing variations in examination quality and obtaining high-quality colonoscopic images. In this review, we focus specifically on the speedometer, effective withdrawal time, fold examination quality, bowel preparation quality assessment, and cecal intubation with CAQ systems and discuss the role and effectiveness of these systems. CAQ systems are expected to contribute to increase in adenoma detection rates, improvement in endoscopist skills, and standardization of examination quality. However, challenges such as variability in AI performance across different clinical settings and potential overreliance on automated prompts remain key limitations.

Citations

Citations to this article as recorded by

Prospective Validation of the First US FDA-Approved Computer-Aided Quality Assessment Tool for Colonoscopy: An Initial Clinical Experience
Todd A. Brenner, Chris Labaki, Joseph D. Feuerstein, Tyler M. Berzin
American Journal of Gastroenterology.2026; 121(4): 1036. CrossRef
Artificial Intelligence and Its Role in Endoscopic Adenoma and Cancer Detection
Hannah R. Phillips, Wilfor J. Diaz Fernandez, Cadman L. Leggett
Clinics in Colon and Rectal Surgery.2026; 39(03): 209. CrossRef
Prospective evaluation of artificial intelligence-assisted monitoring of the effective withdrawal time on adenoma detection
Thomas Ka Luen Lui, Carla Pui-Mei Lam, Vivien Wai-Man Tsui, Rex Wan-Hin Hui, Elvis Wai-Pan To, Loey Lung-Yi Mak, Michael Kwan-Lung Ko, Kevin Sze-Hang Liu, Cynthia Ka-Yin Hui, Jing Jia Liu, Xiao Xiao, Wai K. Leung
Intestinal Research.2026;[Epub] CrossRef
Management of Appendiceal Inflammatory Mass: Nonoperative Treatment, Malignancy Risk, and Surveillance
İlyas Kudaş, Olgun Erdem, Fatih Başak, Zeynep Şevval Aliş, Hüsna Tosun, Yahya Kemal Calışkan, Aylin Acar, Tolga Canbak, Huseyin Kerem Tolan, Kemal Tekeşin
The American Surgeon™.2026;[Epub] CrossRef
Ethical and Legal Implications of Implementing AI in Gastrointestinal Endoscopy
Ahmed El‐Sayed, Syed Geelani, Sherif El‐Sayed, Hassan Ali Choudry, Laurence B. Lovat, Omer F. Ahmad
Digestive Endoscopy.2026;[Epub] CrossRef
Human-machine collaboration in colorectal cancer screening: a narrative review of artificial intelligence-assisted colonoscopy
Chi Zhang, Jinguo Liu, Zhou Zhang, Liangliang Yu
Frontiers in Medicine.2026;[Epub] CrossRef

6,186 View
234 Download
7 Web of Science
6 Crossref

Computer-aided diagnosis of colorectal polyps: assisted or autonomous?: Yuichi Mori, Cesare Hassan; Clin Endosc 2025;58(4):514-517. Published online May 22, 2025; DOI: https://doi.org/10.5946/ce.2024.338

Abstract PDF

Computer-aided diagnosis (CADx) in colonoscopy aims to improve the accuracy of diagnosing small polyps; however, its integration into clinical practice remains challenging. Human-artificial intelligence (AI) collaboration, which is expected to enhance optical diagnosis, has shown limited success in clinical trials, with studies indicating no significant improvement in human-only performance. Conversely, autonomous CADx systems that operate independently of clinicians have demonstrated superior diagnostic accuracy in some studies, suggesting their potential for efficiency, consistency, and standardization in healthcare. However, the adoption of autonomous AI raises ethical, legal, and practical concerns such as accountability for errors, loss of clinical context, and clinician or patient distrust. The decision between using CADx as an assistant or as an autonomous system may depend on the clinical scenario. Autonomous systems can standardize routine screening for low-risk patients, whereas assistive systems may complement expertise in complex cases. Regardless of the model used, robust regulatory frameworks and clinician training are essential to ensure safety and maintain trust. Balancing the strengths of AI with the critical role of human judgment is the key to optimizing outcomes and navigating the complex implications of integrating CADx technologies into colonoscopy practice.

Citations

Citations to this article as recorded by

Optical diagnosis of histopathology– is it implementable in the world of artificial intelligence?
Abraham Z. Cheloff, Prahan Chetlur, Emily B. Kagan, Seth A. Gross
Best Practice & Research Clinical Gastroenterology.2026; 80: 102044. CrossRef
Clinical Implementation of Artificial Intelligence in Endoscopy: A Human-Artificial Intelligence Interaction Perspective
Eun Jeong Gong, Chang Seok Bang
The Korean Journal of Gastroenterology.2026; 86(1): 1. CrossRef
Diagnostic Accuracy of ChatGPT Model 5.1 in the Optical Characterization of Colorectal Lesions
Alejandro Osorio-Euan, Katia Lopez Garcia, Yoeli M Escandon Espinoza
Cureus.2026;[Epub] CrossRef
Artificial intelligence in colonoscopy: Enhancing quality indicators for optimal patient outcomes
Konstantina Dimopoulou, Marianna Spinou, Alexandros Ioannou, Eleni Nakou, Petros Zormpas, George Tribonias
World Journal of Gastroenterology.2025;[Epub] CrossRef

4,050 View
142 Download
4 Web of Science
4 Crossref

Original Article

GI Genius increases small and right-sided adenoma and sessile serrated lesion detection rate when used with EndoCuff in a real-world setting: a retrospective United States study: Jeong Hoon Kim, Jade Wang, Colton Pence, Patrick Magahis, Enad Dawod, Felice Schnoll-Sussman, Reem Z. Sharaiha, David Wan; Clin Endosc 2025;58(3):438-447. Published online April 22, 2025; DOI: https://doi.org/10.5946/ce.2024.271

Graphical Abstract Abstract PDF

Background
/Aims: The real-world efficacy of computer-aided detection (CADe) systems, such as GI Genius (Medtronic), is unclear. We examined the colonoscopy metrics using CADe alone and with a mucosal exposure device (EndoCuff; Olympus) in a real-world setting.
Methods
We retrospectively reviewed screening and surveillance colonoscopies before, during, and after CADe use in a large tertiary care center. Outcomes included the adenomas per colonoscopy (APC), sessile serrated lesions per colonoscopy, adenoma detection rate (ADR), sessile serrated lesion detection rate (SSLDR), advanced ADR, total polyp detection rate, and true histology rate. The ADR and SSLDR were further examined according to size, colon location, and EndoCuff use.
Results
A total of 798 colonoscopies were performed, including 386 pre-CADe, 178 CADe, and 234 post-CADe. In cases where CADe was used with the EndoCuff, the 1 to 5 mm ADR increased from 36.3% (pre-CADe) to 52.1% (CADe) (p=0.01). The 1 to 5 mm SSLDR increased from 9.6% (pre-CADe) to 17.1% (CADe) (p=0.02). The right-sided ADR increased from 30.8% (pre-CADe) to 42.7% (CADe) (p=0.03). The right-sided SSLDR increased from 12.3% (pre-CADe) to 24.8% (CADe) (p<0.001). No significant changes were observed when only CADe was used. No differences were found in other outcome measures. Post-CADe metrics returned to pre-CADe levels.
Conclusions
GI Genius is useful for identifying small and right-sided polyps only when used with the EndoCuff.

Citations

Citations to this article as recorded by

Comparison of colon adenoma detection rate using cap-assisted and artificial intelligence-assisted colonoscopy at a tertiary hospital in the Philippines: a propensity score-matched analysis
Justin Ryan Lay Tan, Keith Brian Tan Enriquez, Kenneth Vergel Tecson Aballe, Mary Anne Gonzales Go, Michael Louie Ong Lim, Jonard Tan Co
Clinical Endoscopy.2026; 59(1): 106. CrossRef
Artificial intelligence with mucosal exposure devices versus artificial intelligence alone in detection of colorectal adenomas: a systematic review and meta-analysis
Aamir Saeed, Saira Yousuf, Ijlal Akbar Ali, Mark Radlinski, Faisal Kamal, Claudio R. Tombazzi, Leonard Baidoo, Mansour A. Parsi, Tyler M. Berzin, Sultan Mahmood
Surgical Endoscopy.2026; 40(8): 6462. CrossRef
The Use of Artificial Intelligence in Cancer Diagnosis
Arka Banerjee, Daphne Theresa Chia, Kai Yuen Wong
British Journal of Hospital Medicine.2026;[Epub] CrossRef
Where technology meets technique: computer-aided detection and mucosal exposure device to improve adenoma detection
James Weiquan Li
Clinical Endoscopy.2025; 58(3): 404. CrossRef
Use of Mechanical Enhanced Colonoscopy to Improve Polyp Detection During Colorectal Cancer Screening: A Real-World Healthcare Database Analysis
Abraham Z. Cheloff, Seth A. Gross
Journal of Clinical Medicine.2025; 14(17): 6346. CrossRef
Effectiveness of the GI Genius Computer-Aided Detection System Versus Standard Colonoscopy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Aliya Sattar, Arifa Sattar, Muhammad Haris Khan, Maheen Zahid, Simahir Tariq, Neha Choudhary, Muneeba Shaukat, Shermeen Usman, Shakeeba Zubair, Yeman Ahmed, Sarah Aijaz
Cureus.2025;[Epub] CrossRef
Diagnostic Challenges in Sessile Serrated Lesions: Progression to Adenocarcinoma in a High-Risk Patient
Shah Ahmed, Harshaman Kaur, Mohamad Omar Diab, Abdul Nadir
American Journal of Case Reports.2025;[Epub] CrossRef

5,360 View
138 Download
7 Web of Science
7 Crossref

Systematic Review and Meta-analysis

One-day low-residue diet is equally effective as the multiple-day low-residue diet in achieving adequate bowel cleansing: a meta-analysis of randomized controlled trials: Raeni Dwi Putri, Fiki Amalia, Festy Aldina Utami, Yunisa Pamela, Mas Rizky A.A. Syamsunarno; Clin Endosc 2025;58(1):63-76. Published online December 12, 2024; DOI: https://doi.org/10.5946/ce.2024.061

Graphical Abstract Abstract PDF Supplementary Material

Background
/Aims: Colonoscopy is widely used as a diagnostic and preventive procedure for colorectal diseases. The most recent guidelines advocate the use of a low-residue diet (LRD) for bowel preparation before colonoscopy. LRD duration varies considerably, with recommended 1-day and multiple-day regimens in clinical practice.
Methods
We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched multiple databases for randomized controlled trials (RCTs) and analyzed the outcomes using a fixed-effects model.
Results
Six RCTs with 2,469 subjects were included in this study. The rates of adequate bowel preparation for 1-day and >1-day were 87.2% and 87.1%, respectively. No statistically significant differences were observed between the 1-day and >1-day LRD in adequate bowel preparation (odds ratio [OR], 1.03; 95% confidence interval [CI], 0.76–1.41; p=0.84; I2=0%), polyp detection rate (OR, 0.91; 95% CI, 0.76–1.09; p=0.29; I2=16%), adenoma detection rate (OR, 0.87; 95% CI, 0.71–1.08; p=0.21; I2=0%), and withdrawal time (mean difference, –0.01; 95% CI, –0.25 to 0.24; p=0.97; I2=63%).
Conclusions
The efficacy of 1-day and multiple-day LRD is comparable in achieving satisfactory bowel preparation, highlighting their similar impact on the detection of polyps and adenomas during colonoscopy.

Citations

Citations to this article as recorded by

One-day vs two-day low-residue diets for bowel preparation: A randomized controlled trial assessing colonoscopy quality indicators
Azar Abiyev
Akademik Gastroenteroloji Dergisi.2026; 25(1): 72. CrossRef
Effect of single-day versus multi-day low-residue diet on colonoscopy bowel preparation: a systematic review and meta -analysis
Jing Du, Xueqian He, Peng Li
BMC Gastroenterology.2025;[Epub] CrossRef

13,240 View
252 Download
1 Web of Science
2 Crossref

Review

Post-polypectomy colorectal bleeding: current strategies and the way forward: Nilanga Nishad, Mo Hameed Thoufeeq; Clin Endosc 2025;58(2):191-200. Published online November 27, 2024; DOI: https://doi.org/10.5946/ce.2024.241

Abstract PDF

Post-endoscopic mucosal resection (EMR) bleeding, or clinically significant post-EMR bleeding, is influenced by factors such as polyp size, right-sided colonic lesions, laterally spreading tumors, anticoagulant use, and comorbidities like cardiovascular or chronic renal disease. The optimal prophylactic therapy for post-EMR bleeding remains unknown, with no consensus on specific criteria for its application. Moreover, prophylactic measures, including clipping, suturing, and coagulation, have produced mixed results. Selective clipping in high-risk patients is cost-effective, whereas universal clipping is not. Studies and meta-analyses indicate that routine prophylactic clipping does not generally reduce post-polypectomy bleeding but may be beneficial in cases of large proximal lesions. Some studies have revealed that the post-polypectomy bleeding risk after EMR of transverse colonic lesions is lower than that of the ascending colon and caecum, suggesting limited efficacy of clipping in the transverse colon. Cost-effectiveness studies support selective clipping in high-risk groups, and newer static agents such as PuraStat are alternatives; however, their cost-effectiveness is undetermined. Further research is required to establish clear guidelines and refine prophylactic strategies to prevent post-EMR bleeding.

Citations

Citations to this article as recorded by

Prophylactic clipping versus no clipping after endoscopic mucosal resection of large nonpedunculated colon polyps: a cost-effectiveness analysis
Sneh Sonaiya, Raj Patel, Charmy Parikh, Magnus Chun, Amrit Narwan, Karan Yagnik, Pranav Patel, Bradley Confer, Harshit Khara, Babu P. Mohan
Gastrointestinal Endoscopy.2026; 103(3): 494. CrossRef
Cold snare polypectomy versus hot snare polypectomy for small pedunculated polyps: a cost-effectiveness analysis
Sneh Sonaiya, Raj Patel, Dushyant Singh Dahiya, Shahryar Khan, Charmy Parikh, Mark Stasiewicz, Pranav D. Patel, Kyaw Min Tun, Bradley Confer, Harshit S. Khara, Sumant Inamdar, Vignan Manne, Babu P. Mohan, Douglas G. Adler
Gastrointestinal Endoscopy.2026; 103(4): 771. CrossRef
Cold Versus Hot Endoscopic Mucosal Resection for ≥15 mm Large Nonpedunculated Colorectal Polyps
Sneh Sonaiya, Dushyant S. Dahiya, Raj Patel, Shahryar Khan, Charmy Parikh, Karan Yagnik, Chun-Han Lo, Kyaw Min Tun, Pranav D. Patel, Bradley Confer, Harshit S. Khara, Sumant Inamdar, Babu P. Mohan
Journal of Clinical Gastroenterology.2026;[Epub] CrossRef
Iatrogenic colon perforation: endoscopic management or surgery
Seung Bum Lee
Clinical Endoscopy.2026; 59(1): 33. CrossRef
Distinct Clinical and Outcome Profiles Across Six Subtypes of Acute Gastrointestinal Bleeding: A Comprehensive Analysis of 1021 Patients
Nóra Vörhendi, Levente Frim, Orsolya Anna Simon, Eszter Boros, Brigitta Teutsch, Dániel Pálinkás, Edina Tari, Dávid Berki, Patrícia Kalló, Edina Ecsedy, Endre Botond Gagyi, Armand Csontos, Zoltán Sipos, Nelli Farkas, Áron Vincze, Ferenc Izbéki, Andrea Sze
Journal of Clinical Medicine.2026; 15(5): 1998. CrossRef
Immediate post-polypectomy bleeding is associated with an increased risk of delayed post-polypectomy bleeding: A large retrospective cohort study
Jin Ho Hwang, Hye Kyung Hyun, So Hyeon Gwon, Nak-Hoon Son, Cheal Wung Huh
World Journal of Gastroenterology.2026;[Epub] CrossRef
Use of clips to prevent delayed post-polypectomy bleeding in non-pedunculated colorectal lesions: protocol for a systematic review and meta-analysis
Yaping Wei, Shi Zhang, Hawa Suleiman Mabenga, Brenda John Ngowi, Zheng Jin
BMJ Open.2026; 16(6): e118581. CrossRef
Over-the-Scope Clip vs Standard Endoscopic Therapy as First-Line Intervention for Nonvariceal Upper Gastrointestinal Bleeding: A Cost-Effectiveness Analysis
Sneh Sonaiya, Sahib Singh, Tooba Laeeq, Vaishnavi Modi, Magnus Chun, Pranav Patel, Vignan Manne, Babu P. Mohan
Techniques and Innovations in Gastrointestinal Endoscopy.2025; 27(4): 250935. CrossRef

24,048 View
790 Download
8 Web of Science
8 Crossref

Systematic Review and Meta-analysis

The impact of linked color imaging on adenoma detection rate in colonoscopy: a systematic review and meta-analysis: Bruna Haueisen Figueiredo Zwetkoff, Luiz Ronaldo Alberti, Fábio Gontijo Rodrigues, Nelson Carvas Junior, José Celso Ardengh, Otavio Micelli Neto, Fernando Rodrigues Guzman, Marcelo Morganti Ferreira Dias, Guilherme Camarotti de Oliveira Canejo, Carlos Eduardo Oliveira dos Santos; Clin Endosc 2025;58(2):225-239. Published online October 24, 2024; DOI: https://doi.org/10.5946/ce.2024.072

Graphical Abstract Abstract PDF

Background
/Aims: Colorectal cancer prevention relies on surveillance colonoscopy, with the adenoma detection rate as a key factor in examination quality. Linked color imaging (LCI) enhances lesion contrast and improves the examination performance. This systematic review and meta-analysis aimed to evaluate the effect of LCI on adenoma detection rate in adults who underwent colonoscopy.
Methods
We searched the Medline, PubMed, BIREME, LILACS, and Scientific Electronic Library Online databases for randomized controlled trials comparing the use of LCI versus white light imaging (WLI), published up to March 2023. The outcomes included lesion characteristics, number of adenomas per patient, and the additional polyp detection rate.
Results
Sixteen studies were included in the analysis, which showed that LCI was more accurate than WLI in detecting adenomas, with an increased number of adenomas detected per patient. Although LCI performed well in terms of lesion size, morphology, and location, the subgroup analyses did not reveal any statistically significant differences between LCI and WLI. The addition of LCI did not result in significant improvements in the detection of serrated lesions, and there were no differences in the withdrawal time between groups.
Conclusions
LCI has been shown to be effective in detecting colonic lesions, improving the number of adenomas detected per patient and improving polyp detection rate without negatively affecting other quality criteria in colonoscopy.

Citations

Citations to this article as recorded by

Virtual chromoendoscopy with linked color imaging versus dye-chromoendoscopy in the surveillance of patients with long-standing colonic inflammatory bowel disease
Roberto Gabbiadini, Gianluca Franchellucci, Francesco Minini, Arianna Dal Buono, Giuseppe Privitera, Marco Spadaccini, Giulia Migliorisi, Lorenzo Petronio, Valeria Farinola, Antonio Di Martino, Cristina Bezzio, Cesare Hassan, Alessandro Repici, Alessandro
Journal of Crohn's and Colitis.2026;[Epub] CrossRef
Linked color imaging improves polyp miss rates in total colonoscopy in a multicenter randomized back to back trial
Ryo Shimoda, Daisuke Yamaguchi, Kazutoshi Hashiguchi, Kazuhiro Mizukami, Akira Aso, Takashi Akutagawa, Koichi Miyahara, Tetsuro Honda, Keiichi Hashiguchi, Tetsuya Ohira, Kensuke Fukuda, Masayuki Kabayama, Hideaki Miyamoto, Ryosuke Gushima, Yorinobu Sumida
Scientific Reports.2025;[Epub] CrossRef
Comparison of adenoma detection rate using the novel 5-LED vs xenon-light endoscopic system: Propensity score matching analysis
Tatsuhiro Ito, Satoshi Osawa, Takanori Yamada, Keisuke Inagaki, Tomohiro Takebe, Satoru Takahashi, Shunya Onoue, Kiichi Sugiura, Natsuki Ishida, Tomoharu Matsuura, Mihoko Yamade, Moriya Iwaizumi, Yasushi Hamaya, Ken Sugimoto
Endoscopy International Open.2025;[Epub] CrossRef

5,773 View
322 Download
4 Web of Science
3 Crossref

Original Articles

Novel regimen for colonoscopy bowel preparation with oral lactulose: a prospective comparative study: Josué Aliaga Ramos, Danilo Carvalho, Vitor N. Arantes; Clin Endosc 2024;57(6):775-782. Published online October 22, 2024; DOI: https://doi.org/10.5946/ce.2024.056

Graphical Abstract Abstract PDF

Background
/Aims: Polyethylene glycol (PEG) is considered the gold standard regimen for bowel preparation; however, due to the necessity of a large volume, patient tolerance is impaired. Therefore, lactulose is a novel alternative for colonoscopy preparation. This study aimed to investigate the efficacy and safety of lactulose-based bowel preparations in comparison with PEG for colonoscopy.
Methods
This is a prospective, non-blinded, comparative study. Outpatients were randomly divided into two groups: group 1 (111 patients), PEG; and group 2 (111 patients), lactulose. The following clinical outcomes were assessed in each group: degree of bowel clearance using the Boston bowel preparation score, colorectal polyp detection rate, adenoma detection rate, tolerability, and side effects.
Results
The rate of inadequate bowel preparation was 8.1% and 1.8% for the PEG and lactulose groups, respectively (p=0.030). The Boston bowel preparation score for the entire colon was 7.34±1.17 and 8.36±1.09 for the PEG and lactulose groups, respectively (p<0.001). The satisfactory overall experience rates were 27.9% and 62.2% for the PEG and lactulose groups, respectively (p<0.001).
Conclusions
The novel bowel preparation with oral lactulose was superior to that with PEG in terms of colon cleansing, adenoma detection rate, tolerance, and patient experience.

Citations

Citations to this article as recorded by

ERAS-based sequential olive oil-lactulose protocol in day-case laparoscopic inguinal hernia repair: a prospective comparison
Xiaoqin Zhou, Penghui Liu, Gengyu Tong Zhao, Deyan Bai, Wenqing Liu, Yueqian Zeng, Run Wan, Huijia Pan, Jie Mao
Frontiers in Surgery.2026;[Epub] CrossRef
Innovative schemes of colonoscopy bowel preparation with oral lactulose: Optimizing traditional standards to improve colonoscopy quality
Josué Aliaga Ramos, Danilo Carvalho, Vitor Nunes Arantes
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Bowel Preparation Agents: Balancing Efficacy for Colon Cleansing and Safety for Stomach Safety
Gwang Ha Kim
The Korean Journal of Gastroenterology.2024; 84(6): 293. CrossRef

18,181 View
506 Download
3 Web of Science
3 Crossref

Development of colonic stent simulator using three-dimensional printing technique: a simulator development study in Korea: Hyundam Gu, Suyoung Lee, Sol Kim, Hye-Lim Jang, Da-Woon Choi, Kyu Seok Kim, Yu Ri Shin, Dae Young Cheung, Bo-In Lee, Jin Il Kim, Han Hee Lee; Clin Endosc 2024;57(6):790-797. Published online September 23, 2024; DOI: https://doi.org/10.5946/ce.2024.110

Graphical Abstract Abstract PDF Supplementary Material

Background
/Aims: Colonic stenting plays a vital role in the management of acute malignant colonic obstruction. The increasing use of self-expandable metal stents (SEMS) and the diverse challenges posed by colonic obstruction at various locations underscore the importance of effective training for colonic stent placement.
Methods
All the components of the simulator were manufactured using silicone molding techniques in conjunction with three-dimensional (3D) printing. 3D images sourced from computed tomography scans and colonoscopy images were converted into a stereolithography format. Acrylonitrile butadiene styrene copolymers have been used in fused deposition modeling to produce moldings.
Results
The simulator replicated the large intestine from the rectum to the cecum, mimicking the texture and shape of the human colon. It enables training for colonoscopy insertion, cecum intubation, loop reduction, and stenting within stenotic areas. Interchangeable stenotic modules for four sites (rectum, sigmoid colon, descending colon, and ascending colon) were easily assembled for training. These modules integrate tumor contours and blood vessel structures with a translucent center, allowing real-time visualization during stenting. Successful and repeatable demonstrations of stent insertion and expansion using the reusable SEMS were consistently achieved.
Conclusions
This innovative simulator offers a secure colonic stenting practice across various locations, potentially enhancing clinical outcomes by improving operator proficiency during actual procedures.

Citations

Citations to this article as recorded by

3D Printing in Gastroenterology
Jack T. Gardner, Steve P. Bensen
Journal of Clinical Gastroenterology.2026; 60(1): 28. CrossRef
Novel minimally invasive strategies for achieving source control in intra-abdominal infections
Clayton Wyland, Desmond Zeng, Robert G. Sawyer
Current Opinion in Critical Care.2025; 31(2): 228. CrossRef
Comments on ‘Development of colonic stent simulator using three-dimensional printing technique: a simulator development study in Korea’
Dae Jin Jung, Gwang Ha Kim
Clinical Endoscopy.2025; 58(2): 334. CrossRef
Three-Dimensional-Printed Gastrointestinal Tract Models for Surgical Planning and Medical Education: A Systematic Review
Jing Lei, Lisa B. G. Tee, Krish Ragunath, Zhonghua Sun
Applied Sciences.2025; 15(13): 7384. CrossRef

8,254 View
222 Download
4 Web of Science
4 Crossref

Review

Alteration in gut microbiota after colonoscopy: proposed mechanisms and the role of probiotic interventions: Hyeong Ho Jo, Moon Young Lee, Se Eun Ha, Dong Han Yeom, Yong Sung Kim; Clin Endosc 2025;58(1):25-39. Published online September 2, 2024; DOI: https://doi.org/10.5946/ce.2024.147

Abstract PDF

Colonoscopy, a widely used procedure for diagnosing and treating colonic diseases, induces transient gastrointestinal symptoms and alterations in the gut microbiota. This review comprehensively examines the evidence on alterations in the gut microbiota following colonoscopy and their possible mechanisms. Factors such as rapid colonic evacuation, increased osmolality, and mucus thinning caused by bowel preparation and exposure to oxygen during the procedure contribute to these alterations. Typically, the alterations revert to the baseline within a short time. However, their long-term implications remain unclear, necessitating further investigation. Split-dose bowel preparation and CO2 insufflation during the procedure result in fewer alterations in the gut microbiota. Probiotic administration immediately after colonoscopy shows promise in reducing alterations and gastrointestinal symptoms. However, the widespread use of probiotics remains controversial due to the transient nature of both the symptoms and gut microbial alterations following a colonoscopy. Probiotics may offer greater benefits to individuals with preexisting gastrointestinal symptoms. Thus, probiotic administration may be a viable option for selected patients.

Citations

Citations to this article as recorded by

Re-evaluating post-polypectomy surveillance: The role of non-invasive modalities in colorectal cancer prevention
Ethna McFerran, Damian McKay, Maurice B. Loughrey, Mark Lawler, Stephen T. McSorley
Best Practice & Research Clinical Gastroenterology.2026; 80: 102092. CrossRef
Post-Colonoscopy Gut Microbiota Dysbiosis: Mechanisms, Clinical Consequences, and the Role of Diet in Microbiota Recovery
Patrycja Krynicka, Ariel Liebert, Luiza Frańczak, Wiktoria Moncznikowska, Marianna Hoffman, Amelia Żuchlińska, Wiktoria Dalak, Maria Kłopocka
Gastroenterology Insights.2026; 17(2): 27. CrossRef
Letter to the Editor: Probiotics counteract polyethylene glycol bowel preparation dysbiosis and infection risk
Yang Fu
World Journal of Gastroenterology.2026;[Epub] CrossRef
Response to Ge and Chen
Akira Higashimori, Natsumi Maeda, Yasuhiro Fujiwara
American Journal of Gastroenterology.2025; 120(11): 2731. CrossRef
Is It Advisable to Use Probiotics Routinely After a Colonoscopy? A Rapid Comprehensive Review of the Evidence
Matteo Piciucchi, Alice Rossi, Alissa Satriano, Raffaele Manta
Medical Sciences.2025; 13(2): 76. CrossRef
Modulation of Gut Microbiota and Antibiotic Resistance Genes by Heat-Killed Enterococcus faecalis EF-2001 in High-Fat Diet-Induced Obesity Mice: A Shotgun Metagenomics Study
Ranjith Kumar Manoharan, Kwon-Il Han, Hyun-Dong Shin, Yura Lee, Sunhwa Baek, Eunjung Moon, Youn Bum Park, Junhui Cho, Sathiyaraj Srinivasan
Bioengineering.2025; 12(7): 741. CrossRef
Impact of gut microbiome on outcomes following endoscopic interventions in gastrointestinal disease
Himanshu Agrawal, Nitin Agarwal, Nikhil Gupta
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Efficacy of Fecal Microbial Transplantation for Improving Symptoms of Irritable Bowel Syndrome - A Pilot Study for Voluntary Participants in Korea
Jung Won Lee, Nayoung Kim
The Korean Journal of Gastroenterology.2024; 84(4): 168. CrossRef

65,535 View
1,064 Download
8 Web of Science
8 Crossref

Original Articles

Assessing the potential of artificial intelligence to enhance colonoscopy adenoma detection in clinical practice: a prospective observational trial: Søren Nicolaj Rønborg, Suresh Ujjal, Rasmus Kroijer, Magnus Ploug; Clin Endosc 2024;57(6):783-789. Published online August 23, 2024; DOI: https://doi.org/10.5946/ce.2024.038

Graphical Abstract Abstract PDF

Background
/Aims: This study aimed to evaluate the effectiveness of the GI Genius (Medtronic) module in clinical practice, focusing on the adenoma detection rate (ADR) during colonoscopy. Computer-aided polyp detection (CADe) systems using artificial intelligence have been shown to improve adenoma detection in controlled trials. However, the effectiveness of these systems in clinical practice has recently been questioned.
Methods
This single-center prospective observational study was conducted at the University Hospital of Southern Denmark and included all individuals referred for colonoscopy between November 2020 and January 2021. The primary outcome was ADR, comparing patients examined with CADe to those examined without it. The selection of patients to be examined with the CADe module was completely random.
Results
A total of 502 patients were analyzed (318 in the control group and 184 in the CADe group). The overall ADR was 32.1% with a slight increase in the CADe group (34.7% vs. 30.5%). Multivariable analysis showed a very modest and statistically insignificant increase in ADR (risk ratio, 1.12; 95% confidence interval, 0.88–1.43).
Conclusions
The use of CADe in clinical practice did not increase ADR with statistical significance when compared to colonoscopy without CADe. These findings suggest that the impact of CADe systems in everyday clinical practice are modest.

Citations

Citations to this article as recorded by

Comparison of colon adenoma detection rate using cap-assisted and artificial intelligence-assisted colonoscopy at a tertiary hospital in the Philippines: a propensity score-matched analysis
Justin Ryan Lay Tan, Keith Brian Tan Enriquez, Kenneth Vergel Tecson Aballe, Mary Anne Gonzales Go, Michael Louie Ong Lim, Jonard Tan Co
Clinical Endoscopy.2026; 59(1): 106. CrossRef
Computer-aided polyp detection multicenter international randomized controlled study with a focus on community clinics: Gastroenterology Artificial INtelligence system for detecting colorectal polyps
Cadman L. Leggett, R. Scooter Plowman, Lindsey Surace, Emmanuel Gorospe, Jesse Lachter, Dana Ben-Ami Shor, Keith Friedenberg, David A. Leiman, Simon Schlachter, Anil Patwardhan, Roman Goldenberg, Ehud Rivlin, Leera Choi, Nayantara Coelho-Prabhu, Tonya Kal
Gastrointestinal Endoscopy.2026; 104(2): 277. CrossRef
Random forests algorithm using basic medical data for predicting the presence of colonic polyps
Mihaela-Flavia Avram, Nicolae Lupa, Dimitrios Koukoulas, Daniela-Cornelia Lazăr, Mihaela-Ioana Mariș, Marius-Sorin Murariu, Sorin Olariu
Frontiers in Surgery.2025;[Epub] CrossRef
Artificial intelligence in endoscopy and colonoscopy: a comprehensive bibliometric analysis of global research trends
Negin Letafatkar, Amr Ali Mohamed Abdelgawwad El-Sehrawy, KDV Prasad, Ahmad Alkhayyat, Ehsan Amini-Salehi, Maryam Hasanpour, Masoomeh Namdar Taleshani, Mohammad Hashemi, Hadi Alotaibi, Pegah Rashidian, Mohammad-Hossein Keivanlou, Soheil Hassanipour
Frontiers in Medicine.2025;[Epub] CrossRef
GI Genius increases small and right-sided adenoma and sessile serrated lesion detection rate when used with EndoCuff in a real-world setting: a retrospective United States study
Jeong Hoon Kim, Jade Wang, Colton Pence, Patrick Magahis, Enad Dawod, Felice Schnoll-Sussman, Reem Z. Sharaiha, David Wan
Clinical Endoscopy.2025; 58(3): 438. CrossRef
Concordance with CONSORT-AI guidelines in reporting of randomised controlled trials investigating artificial intelligence in oncology: a systematic review
David Chen, Kristen Arnold, Ronesh Sukhdeo, John Farag Alla, Srinivas Raman
BMJ Oncology.2025; 4(1): e000733. CrossRef
Artificial intelligence in colonoscopy: polyp fiction or clinical reality?
Eun Jeong Gong, Chang Seok Bang
Clinical Endoscopy.2025; 58(5): 784. CrossRef
Understanding the discrepancy in the effectiveness of artificial intelligence-assisted colonoscopy: from randomized controlled trials to clinical reality
Jung Ho Bae
Clinical Endoscopy.2024; 57(6): 765. CrossRef
Edge Artificial Intelligence Device in Real-Time Endoscopy for Classification of Gastric Neoplasms: Development and Validation Study
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
Biomimetics.2024; 9(12): 783. CrossRef

5,791 View
246 Download
10 Web of Science
9 Crossref

Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea: Jung-Bin Park, Jung Ho Bae; Clin Endosc 2025;58(1):112-120. Published online August 5, 2024; DOI: https://doi.org/10.5946/ce.2024.168

Graphical Abstract Abstract PDF

Background
/Aims: The real-world effectiveness of computer-aided detection (CADe) systems during colonoscopies remains uncertain. We assessed the effectiveness of the novel CADe system, ENdoscopy as AI-powered Device (ENAD), in enhancing the adenoma detection rate (ADR) and other quality indicators in real-world clinical practice.
Methods
We enrolled patients who underwent elective colonoscopies between May 2022 and October 2022 at a tertiary healthcare center. Standard colonoscopy (SC) was compared to ENAD-assisted colonoscopy. Eight experienced endoscopists performed the procedures in randomly assigned CADe- and non-CADe-assisted rooms. The primary outcome was a comparison of ADR between the ENAD and SC groups.
Results
A total of 1,758 sex- and age-matched patients were included and evenly distributed into two groups. The ENAD group had a significantly higher ADR (45.1% vs. 38.8%, p=0.010), higher sessile serrated lesion detection rate (SSLDR) (5.7% vs. 2.5%, p=0.001), higher mean number of adenomas per colonoscopy (APC) (0.78±1.17 vs. 0.61±0.99; incidence risk ratio, 1.27; 95% confidence interval, 1.13–1.42), and longer withdrawal time (9.0±3.4 vs. 8.3±3.1, p<0.001) than the SC group. However, the mean withdrawal times were not significantly different between the two groups in cases where no polyps were detected (6.9±1.7 vs. 6.7±1.7, p=0.058).
Conclusions
ENAD-assisted colonoscopy significantly improved the ADR, APC, and SSLDR in real-world clinical practice, particularly for smaller and nonpolypoid adenomas.

Citations

Citations to this article as recorded by

Clinical Efficacy of Real-Time Artificial Intelligence-Assisted Colonoscopy in Colorectal Polyp Detection: A Prospective Multicenter Randomized Controlled Trial
Han Jo Jeon, Bora Keum, Eui Sun Jeong, Seong-Eun Kim, Chang Mo Moon, Bomee Lee, Sanghyun Kim, Hyuk Soon Choi, Jae Min Lee, Eun Sun Kim, Yoon Tae Jeen
Gut and Liver.2026; 20(1): 97. CrossRef
Comparison of colon adenoma detection rate using cap-assisted and artificial intelligence-assisted colonoscopy at a tertiary hospital in the Philippines: a propensity score-matched analysis
Justin Ryan Lay Tan, Keith Brian Tan Enriquez, Kenneth Vergel Tecson Aballe, Mary Anne Gonzales Go, Michael Louie Ong Lim, Jonard Tan Co
Clinical Endoscopy.2026; 59(1): 106. CrossRef
Symbiosis in Health: The Powerful Alliance of AI and Propensity Score Matching in Real World Medical Data Analysis
Peter Kokol, Bojan Žlahtič, Helena Blažun Vošner, Jernej Završnik, Tadej Završnik
Applied Sciences.2026; 16(3): 1524. CrossRef
Artificial intelligence and digital transformation of gastroenterology and hepatology: A critical review of clinical applications and future challenges
Miguel Suarez, Raquel Martínez, Félix González-Martínez, Ana María Torres, Jorge Mateo
World Journal of Hepatology.2026;[Epub] CrossRef
Computer-aided polyp detection multicenter international randomized controlled study with a focus on community clinics: Gastroenterology Artificial INtelligence system for detecting colorectal polyps
Cadman L. Leggett, R. Scooter Plowman, Lindsey Surace, Emmanuel Gorospe, Jesse Lachter, Dana Ben-Ami Shor, Keith Friedenberg, David A. Leiman, Simon Schlachter, Anil Patwardhan, Roman Goldenberg, Ehud Rivlin, Leera Choi, Nayantara Coelho-Prabhu, Tonya Kal
Gastrointestinal Endoscopy.2026; 104(2): 277. CrossRef
Role of Artificial Intelligence in Improving Quality of Colonoscopy
Ji Hyun Kim, Sung Chul Park, Hyun-Soo Kim
The Korean Journal of Gastroenterology.2025; 85(2): 137. CrossRef
Usefulness of an artificial intelligence-based colonoscopy report generation support system
Tatsushi Naito, Takuto Nosaka, Tomoko Tanaka, Yu Akazawa, Kazuto Takahashi, Masahiro Ohtani, Yasunari Nakamoto
Clinical Endoscopy.2025; 58(2): 327. CrossRef
Edge Artificial Intelligence Device in Real-Time Endoscopy for the Classification of Colonic Neoplasms
Eun Jeong Gong, Chang Seok Bang
Diagnostics.2025; 15(12): 1478. CrossRef
Artificial intelligence in endoscopy and colonoscopy: a comprehensive bibliometric analysis of global research trends
Negin Letafatkar, Amr Ali Mohamed Abdelgawwad El-Sehrawy, KDV Prasad, Ahmad Alkhayyat, Ehsan Amini-Salehi, Maryam Hasanpour, Masoomeh Namdar Taleshani, Mohammad Hashemi, Hadi Alotaibi, Pegah Rashidian, Mohammad-Hossein Keivanlou, Soheil Hassanipour
Frontiers in Medicine.2025;[Epub] CrossRef
GI Genius increases small and right-sided adenoma and sessile serrated lesion detection rate when used with EndoCuff in a real-world setting: a retrospective United States study
Jeong Hoon Kim, Jade Wang, Colton Pence, Patrick Magahis, Enad Dawod, Felice Schnoll-Sussman, Reem Z. Sharaiha, David Wan
Clinical Endoscopy.2025; 58(3): 438. CrossRef
Clinical significance of computer-aided quality assessment systems in colonoscopy: a comprehensive review
Wai Phyo Lwin, Katsuro Ichimasa, Shin-Ei Kudo, Yuta Kouyama, Taishi Okumura, Yasuharu Maeda, Yutaro Ide, Khay Guan Yeoh, Masashi Misawa
Clinical Endoscopy.2025; 58(5): 638. CrossRef
Artificial intelligence in colonoscopy: polyp fiction or clinical reality?
Eun Jeong Gong, Chang Seok Bang
Clinical Endoscopy.2025; 58(5): 784. CrossRef
Artificial intelligence-assisted colonoscopy improves adenoma detection rates in routine colonoscopy practice: a single-center, retrospective, propensity score-matched study with concurrent controls
Da Yeon Ham, Jae Gon Lee, Chung Il Ahn, Sea Hyub Kae, Hyun Joo Jang
BMC Gastroenterology.2025;[Epub] CrossRef
Colorectal cancer worldwide: epidemiological trends, economic burden, and the promise of AI-driven solutions
Dinh T. P. Le, Tuan D. Pham
Exploration of Medicine.2025;[Epub] CrossRef
Impact of Artificial Intelligence on Polyp Size and Surveillance Colonoscopy: A Phantom Study
Muhammad N Yousaf, Neal Sharma, Michelle L Matteson-Kome, Srinivas Puli, Douglas Nguyen, Matthew L Bechtold
Cureus.2024;[Epub] CrossRef
Edge Artificial Intelligence Device in Real-Time Endoscopy for Classification of Gastric Neoplasms: Development and Validation Study
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
Biomimetics.2024; 9(12): 783. CrossRef

11,361 View
423 Download
15 Web of Science
16 Crossref

Review

Painless colonoscopy: fact or fiction?: Pieter Sinonquel, Alexander Jans, Raf Bisschops; Clin Endosc 2024;57(5):581-587. Published online June 27, 2024; DOI: https://doi.org/10.5946/ce.2024.001

Abstract PDF

Although colonoscopy is a routinely performed procedure, it is not devoid of challenges, such as the potential for perforation and considerable patient discomfort, leading to patients postponing the procedure with several healthcare risks. This review delves into preprocedural and procedural solutions, and emerging technologies aimed at addressing the drawbacks of colonoscopies. Insufflation and sedation techniques, together with various other methods, have been explored to increase patient satisfaction, and thereby, the quality of endoscopy. Recent advances in this field include the prevention of loop formation, encompassing the use of variable-stiffness endoscopes, computer-guided scopes, magnetic endoscopic imaging, robotics, and capsule endoscopy. An autonomous endoscope that relies on self-propulsion to completely avoid looping is a potentially groundbreaking technology for the next generation of endoscopes. Nevertheless, critical techniques need to be refined to ensure the development of effective and efficient endoscopes.

Citations

Citations to this article as recorded by

A Soft Growing Robotic Endoscope for Painless and Strain-Free Insertion
Nam Gyun Kim, Shinwoo Park, Dongoh Seo, Sanghun Lee, Hyuk Yoon, Jaihwan Kim, Jee-Hwan Ryu
Soft Robotics.2026; 13(1): 5. CrossRef
Iatrogenic colon perforation: endoscopic management or surgery
Seung Bum Lee
Clinical Endoscopy.2026; 59(1): 33. CrossRef
Etomidate-propofol combination in painless gastrointestinal endoscopy for elderly patients: A comparative study
Ying-Yan Zhang
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Impact of opioid addition on procedural conditions during colonoscopy: a randomized trial comparing propofol-based sedation protocols
David Novotny, Jan Palenik, Tomas Tyll, Nadija Brodyuk, Stepan Suchanek, Michal Sotak
Clinical Endoscopy.2025; 58(5): 722. CrossRef
Comparative Effectiveness of Pharmacological, Non-Pharmacological, and Combined Strategies for Pain Relief During Colonoscopy: A Bayesian Network Meta-Analysis of Randomized Trials
Xiaonan Huang, Shan Tian, Lifan Xu, Juhan Chen, Hao Wang, Tingting Mai, Lei Shi, Han Wang, Mengcheng Cai, Fanfu Fang
Journal of Pain Research.2025; Volume 18: 6165. CrossRef
Polyp Matching in Colon Capsule Endoscopy: Pioneering CCE-Colonoscopy Integration Towards an AI-Driven Future
Ian Io Lei, Ramesh Arasaradnam, Anastasios Koulaouzidis
Journal of Clinical Medicine.2024; 13(23): 7034. CrossRef

22,268 View
538 Download
6 Web of Science
6 Crossref

Original Article

Performance comparison between two computer-aided detection colonoscopy models by trainees using different false positive thresholds: a cross-sectional study in Thailand: Kasenee Tiankanon, Julalak Karuehardsuwan, Satimai Aniwan, Parit Mekaroonkamol, Panukorn Sunthornwechapong, Huttakan Navadurong, Kittithat Tantitanawat, Krittaya Mekritthikrai, Salin Samutrangsi, Peerapon Vateekul, Rungsun Rerknimitr; Clin Endosc 2024;57(2):217-225. Published online February 7, 2024; DOI: https://doi.org/10.5946/ce.2023.145

Graphical Abstract Abstract PDF Supplementary Material

Background
/Aims: This study aims to compare polyp detection performance of “Deep-GI,” a newly developed artificial intelligence (AI) model, to a previously validated AI model computer-aided polyp detection (CADe) using various false positive (FP) thresholds and determining the best threshold for each model.
Methods
Colonoscopy videos were collected prospectively and reviewed by three expert endoscopists (gold standard), trainees, CADe (CAD EYE; Fujifilm Corp.), and Deep-GI. Polyp detection sensitivity (PDS), polyp miss rates (PMR), and false-positive alarm rates (FPR) were compared among the three groups using different FP thresholds for the duration of bounding boxes appearing on the screen.
Results
In total, 170 colonoscopy videos were used in this study. Deep-GI showed the highest PDS (99.4% vs. 85.4% vs. 66.7%, p<0.01) and the lowest PMR (0.6% vs. 14.6% vs. 33.3%, p<0.01) when compared to CADe and trainees, respectively. Compared to CADe, Deep-GI demonstrated lower FPR at FP thresholds of ≥0.5 (12.1 vs. 22.4) and ≥1 second (4.4 vs. 6.8) (both p<0.05). However, when the threshold was raised to ≥1.5 seconds, the FPR became comparable (2 vs. 2.4, p=0.3), while the PMR increased from 2% to 10%.
Conclusions
Compared to CADe, Deep-GI demonstrated a higher PDS with significantly lower FPR at ≥0.5- and ≥1-second thresholds. At the ≥1.5-second threshold, both systems showed comparable FPR with increased PMR.

Citations

Citations to this article as recorded by

Comparison of colon adenoma detection rate using cap-assisted and artificial intelligence-assisted colonoscopy at a tertiary hospital in the Philippines: a propensity score-matched analysis
Justin Ryan Lay Tan, Keith Brian Tan Enriquez, Kenneth Vergel Tecson Aballe, Mary Anne Gonzales Go, Michael Louie Ong Lim, Jonard Tan Co
Clinical Endoscopy.2026; 59(1): 106. CrossRef
To CADe or not to CADe – evidence for the benefit of CAD for increased yield of colonoscopy
Rungsun Rerknimitr
Best Practice & Research Clinical Gastroenterology.2026; 80: 102091. CrossRef
Controversies in Computer-Assisted Detection in Colonoscopy
Martin Putera, Frederick Hong Xiang Koh, James Weiquan Li
Digestion.2026; : 1. CrossRef
Integrating Artificial Intelligence into Endoscopy Training
Nikko Gimpaya, Joshua Landy, William T. Tran, Samir C. Grover
Gastrointestinal Endoscopy Clinics of North America.2026; 36(3): 581. CrossRef
Artificial Intelligence in Gastrointestinal Endoscopy: Current Advances, Clinical Integration, and Future Directions: A Narrative Review
Vipul Yagnik, Prema Choudhary, Pankaj Garg
Clinical and Experimental Gastroenterology.2026; Volume 19: 1. CrossRef
Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea
Jung-Bin Park, Jung Ho Bae
Clinical Endoscopy.2025; 58(1): 112. CrossRef
GI Genius increases small and right-sided adenoma and sessile serrated lesion detection rate when used with EndoCuff in a real-world setting: a retrospective United States study
Jeong Hoon Kim, Jade Wang, Colton Pence, Patrick Magahis, Enad Dawod, Felice Schnoll-Sussman, Reem Z. Sharaiha, David Wan
Clinical Endoscopy.2025; 58(3): 438. CrossRef
Understanding the discrepancy in the effectiveness of artificial intelligence-assisted colonoscopy: from randomized controlled trials to clinical reality
Jung Ho Bae
Clinical Endoscopy.2024; 57(6): 765. CrossRef
Edge Artificial Intelligence Device in Real-Time Endoscopy for Classification of Gastric Neoplasms: Development and Validation Study
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
Biomimetics.2024; 9(12): 783. CrossRef

8,185 View
212 Download
8 Web of Science
9 Crossref

Reviews

Computer-aided polyp characterization in colonoscopy: sufficient performance or not?: Natalie Halvorsen, Yuichi Mori; Clin Endosc 2024;57(1):18-23. Published online January 5, 2024; DOI: https://doi.org/10.5946/ce.2023.092

Abstract PDF

Computer-assisted polyp characterization (computer-aided diagnosis, CADx) facilitates optical diagnosis during colonoscopy. Several studies have demonstrated high sensitivity and specificity of CADx tools in identifying neoplastic changes in colorectal polyps. To implement CADx tools in colonoscopy, there is a need to confirm whether these tools satisfy the threshold levels that are required to introduce optical diagnosis strategies such as “diagnose-and-leave,” “resect-and-discard” or “DISCARD-lite.” In this article, we review the available data from prospective trials regarding the effect of multiple CADx tools and discuss whether they meet these thresholds.

Citations

Citations to this article as recorded by

Artificial Intelligence for the Practicing Gastroenterologist: Foundations, Contemporary Applications, Real-World Constraints, and Future Directions
Aditya Ahuja, Sheza Malik, Saurabh Chawla
Journal of Digestive Endoscopy.2026;[Epub] CrossRef
Building Machine Learning Models in Gastrointestinal Endoscopy
Giulio Antonelli, Tom Eelbode, Touka Elsaman, Mrigya Sharma, Raf Bisschops, Cesare Hassan
Gastrointestinal Endoscopy Clinics of North America.2025; 35(2): 279. CrossRef
Cost-Effectiveness for Artificial Intelligence in Colonoscopy
Natalie Halvorsen, Yuichi Mori
Gastrointestinal Endoscopy Clinics of North America.2025; 35(2): 401. CrossRef
Role of Artificial Intelligence in Improving Quality of Colonoscopy
Ji Hyun Kim, Sung Chul Park, Hyun-Soo Kim
The Korean Journal of Gastroenterology.2025; 85(2): 137. CrossRef
Understanding the Role of Computer‐Aided Diagnosis in Colonoscopy
Natalie Halvorsen, Yuichi Mori
Digestive Endoscopy.2025; 37(11): 1227. CrossRef
Edge Artificial Intelligence Device in Real-Time Endoscopy for Classification of Gastric Neoplasms: Development and Validation Study
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
Biomimetics.2024; 9(12): 783. CrossRef

6,946 View
216 Download
4 Web of Science
6 Crossref

Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials: Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita; Clin Endosc 2023;56(5):553-562. Published online July 26, 2023; DOI: https://doi.org/10.5946/ce.2023.055

Abstract PDF

Colonoscopy plays an important role in reducing the incidence and mortality of colorectal cancer by detecting adenomas and other precancerous lesions. Image-enhanced endoscopy (IEE) increases lesion visibility by enhancing the microstructure, blood vessels, and mucosal surface color, resulting in the detection of colorectal lesions. In recent years, various IEE techniques have been used in clinical practice, each with its unique characteristics. Numerous studies have reported the effectiveness of IEE in the detection of colorectal lesions. IEEs can be divided into two broad categories according to the nature of the image: images constructed using narrowband wavelength light, such as narrowband imaging and blue laser imaging/blue light imaging, or color images based on white light, such as linked color imaging, texture and color enhancement imaging, and i-scan. Conversely, artificial intelligence (AI) systems, such as computer-aided diagnosis systems, have recently been developed to assist endoscopists in detecting colorectal lesions during colonoscopy. To better understand the features of each IEE, this review presents the effectiveness of each type of IEE and their combination with AI for colorectal lesion detection by referencing the latest research data.

Citations

Citations to this article as recorded by

Comment on “Comparison of the diagnostic performance of narrow-band imaging endocytoscopy and staining-based endocytoscopy for colorectal lesions”
Ehtisham Haider, Tuba Zia, Muddassir Khalid, Fred Segawa
Digestive and Liver Disease.2026; 58(2): 284. CrossRef
European cancer mortality predictions for the year 2026: the levelling of female lung cancer mortality
C. Santucci, S. Mignozzi, F. Levi, M. Malvezzi, P. Boffetta, E. Negri, C. La Vecchia
Annals of Oncology.2026; 37(4): 555. CrossRef
Evaluation of Visibility With an Eye‐tracking System: Effectiveness of Narrow‐Band Imaging for Detecting Colorectal Adenoma and Serrated Lesions
Moegi Mochizuki, Akiko Ohno, Shiori Tsubata, Ryutaro Sumi, Takahiro Shirakawa, Ryosuke Kaji, Yoko Jinbo, Yu Hada, Jun Miyoshi, Tadakazu Hisamatsu
DEN Open.2026;[Epub] CrossRef
High Detection Rates and Associated Factors of Colorectal Serrated Lesions: A Multicenter Prospective Study in the Asia-Pacific
Masau Sekiguchi, Yasuhiko Mizuguchi, Jun Konishi, Kenichiro Imai, Hyun-Soo Kim, Daizen Hirata, Rashid N. Lui, Jae Myung Cha, Li-Chun Chang, Tiing Leong Ang, Wei Jie Jonathan Lee, Keiko Nakamura, Yasuo Kakugawa, Nozomu Kobayashi, Yutaka Saito, Maki Konno,
American Journal of Gastroenterology.2026;[Epub] CrossRef
Screening for Colorectal Cancer with Colonoscopy
Akwi W. Asombang, Nkengeh Tazinkeng, Yakira David, Douglas K. Rex
Gastrointestinal Endoscopy Clinics of North America.2026;[Epub] CrossRef
Diagnostic accuracy of magnifying Image‐enhanced endoscopy for predicting the invasion depth of superficial esophageal neoplasm: a meta-analysis
Wanting Jiang, Yafang Huang, Jiale Pang, Simiao Yang, Runhua Chen
European Journal of Surgical Oncology.2026; 52(6): 111808. CrossRef
The slope of enlightenment: Towards a more realistic understanding of the strengths and weaknesses of artificial intelligence for colorectal polyp assessment
Pieter Sinonquel, Giulio Antonelli
Digestive and Liver Disease.2026;[Epub] CrossRef
Advanced Endoscopic Imaging for Detection of Dysplasia in Inflammatory Bowel Disease
Laura Alexandra Lucaciu, Edward John Despott
Gastrointestinal Endoscopy Clinics of North America.2025; 35(1): 141. CrossRef
Practical utility of linked color imaging in colonoscopy: Updated literature review
Fumiaki Ishibashi, Sho Suzuki
Digestive Endoscopy.2025; 37(2): 147. CrossRef
Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong-Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, Eun R
Gut and Liver.2025; 19(1): 77. CrossRef
European cancer mortality predictions for the year 2025 with focus on breast cancer
C. Santucci, S. Mignozzi, F. Levi, M. Malvezzi, P. Boffetta, E. Negri, C. La Vecchia
Annals of Oncology.2025; 36(4): 460. CrossRef
Classification of image-enhanced endoscopy in colon tumors
One-Zoong Kim
Clinical Endoscopy.2025; 58(3): 337. CrossRef
Advantages of new generation colonoscopes on adenoma detection: A propensity-score matching study
Toshihiro Nishizawa, Osamu Toyoshima, Shuntaro Yoshida, Yoshiyuki Takahashi, Hideki Nakagawa, Hiroya Mizutani, Yosuke Kataoka, Takamitsu Kanazawa, Hirotoshi Ebinuma, Keisuke Hata
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in Japan
Tsuyoshi Ishii, Toshihiro Nishizawa, Hidenobu Watanabe, Masaya Sano, Ai Fujimoto, Yoshiyuki Takahashi, Ryo Shimizu, Hirotoshi Ebinuma, Takahisa Matsuda, Osamu Toyoshima
Clinical Endoscopy.2025; 58(4): 577. CrossRef
Enhancing adenoma detection rates: The case for upgrading to advanced colonoscopy technology
Eyad Gadour
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Advancements in Image‐Based Analyses for Morphology and Staging of Colon Cancer: A Comprehensive Review
Samuel Arthur Ameyaw, Derrick Adu Afari, John Boateng, Marcello Maida
BioMed Research International.2025;[Epub] CrossRef
Optical Imaging Technologies and Clinical Applications in Gastrointestinal Endoscopy
Khyati Bidani, Vishali Moond, Madhvi Nagar, Arkady Broder, Nirav Thosani
Diagnostics.2025; 15(20): 2625. CrossRef
Efficacy of Texture and Color Enhancement Imaging for Detecting Colorectal Lesions: A Multicenter Randomized Controlled Trial
Byung Wook Jung
The Korean Journal of Gastroenterology.2025; 85(4): 579. CrossRef
Evaluation of linked-color imaging endoscopy combined with CAD EYE for the detection and characterization of right-sided colon polyps
Phuoc Huu Tran, Thi Huyen Thuong Nguyen, Van Huy Tran
Arab Journal of Gastroenterology.2025; 26(4): 452. CrossRef
Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
Yunho Jung
The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef
The Past, Present and Future of Imaging Enhanced Endoscopy in Colon Tumor
Kyueng-Whan Min, One-Zoong Kim
Journal of Digestive Cancer Research.2024; 12(2): 90. CrossRef
Texture and color enhancement imaging versus white light imaging for the detection of colorectal adenomas: Systematic review and meta-analysis
Stefan Mitev, Humza Saeed, Ch Faizan Rasheed, Abdullah, Stefan Murvakov, Vassil Sirakov, Stefan Tchernodrinski, Zoya Spassova
Endoscopy International Open.2024;[Epub] CrossRef
Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
Journal of the Korean Medical Association.2023; 66(11): 652. CrossRef
AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef

12,295 View
344 Download
21 Web of Science
24 Crossref

Systematic Review and Meta-analysis

Use of abdominal compression device in colonoscopy: a systematic review and meta-analysis: Yousaf Zafar, Ahmed Mustafa Rashid, Syed Sarmad Javaid, Ahmed Kamal Siddiqi, Adnan Zafar, Arsalan Zafar Iqbal, Jagpal Singh Klair, Rajesh Krishnamoorthi; Clin Endosc 2023;56(4):446-452. Published online May 26, 2023; DOI: https://doi.org/10.5946/ce.2022.304

Graphical Abstract Abstract PDF Supplementary Material

Background
/Aims: Colonoscopy for screening is associated with unpleasant experiences for patients, and abdominal compression devices have been developed to minimize these problems. However, there is a paucity of data supporting the therapeutic benefits of this strategy. This study examined the effects of using an abdominal compression device during colonoscopy on the cecal intubation time (CIT), abdominal compression, patient comfort, and postural changes.
Methods
We searched PubMed and Scopus (from inception to November 2021) for randomized controlled trials that assessed the effects of an abdominal compression device during colonoscopy on CIT, abdominal compression, patient comfort, and postural change. A random-effects meta-analysis was performed. Weighted mean differences (WMDs) and Mantel-Haenszel odds ratios (ORs) were calculated.
Results
Our pooled analysis of seven randomized controlled trials revealed that abdominal compression devices significantly reduced CIT (WMD, –0.76 [–1.49 to –0.03] minutes; p=0.04), abdominal compression (OR, 0.52; 95% confidence interval [CI], 0.28–0.94; p=0.03), and postural changes (OR, 0.46; 95% CI, 0.27–0.78; p=0.004) during colonoscopy. However, our results did not show a significant change in patient comfort (WMD, –0.48; 95% CI, –1.05 to 0.08; p=0.09) when using an abdominal compression device.
Conclusions
Our findings demonstrate that employing an abdominal compression device may reduce CIT, abdominal compression, and postural change but have no impact on patient comfort.

Citations

Citations to this article as recorded by

Optimizing colonoscopy with abdominal compression devices: an updated meta-analysis of randomized controlled trials
Abdallfatah Abdallfatah, Mohamed A. Aldemerdash, Ahmed W. Hageen, Samaa Daoud, Mahmoud Elbaklish, Mohammed Hassan Morsy, Ahmed R. A. Abou-Shanab, Islam Mohamed, Hazem Abosheaishaa
Baylor University Medical Center Proceedings.2026; 39(1): 96. CrossRef
Abdominal binders improve colonoscopy outcomes: a systematic review and meta-analysis of randomized controlled trials with BMI-stratified subgroup analysis
Yu-Kuang Kang, Tien-Yu Huang, Meng-Chuan Lu, Peng-Jen Chen, Po-Feng Huang
Therapeutic Advances in Gastroenterology.2026;[Epub] CrossRef
Use of an abdominal binder in colonoscopies performed by trainees in gastrointestinal endoscopy: a randomized, double-blind, sham-controlled trial
Antonio Marmolejo, Sinue Cázarez, Carlos J. Mata, Sergio Ayala, Jorge Farell, Nubia A. Ramírez, Carlos A. Navarro Castañeda, Luis García
Surgical Endoscopy.2025; 39(5): 3236. CrossRef
Terminal ileum in screening colonoscopy: routine practice or risk-stratified approach?
Seong-Jung Kim
Clinical Endoscopy.2025; 58(5): 696. CrossRef

7,476 View
151 Download
4 Web of Science
4 Crossref

Reviews

Simulator-based training method in gastrointestinal endoscopy training and currently available simulators: Yuri Kim, Jeong Hoon Lee, Gin Hyug Lee, Ga Hee Kim, Gunn Huh, Seung Wook Hong, Hwoon-Yong Jung; Clin Endosc 2023;56(1):1-13. Published online January 6, 2023; DOI: https://doi.org/10.5946/ce.2022.191

Abstract PDF

The apprenticeship-based training method (ABTM) is highly effective for gastrointestinal (GI) endoscopic training. However, the conventional ABTM has significant issues. Although many supplementary training methods (TMs) have been developed and utilized, they cannot entirely replace the ABTM, which remains the major TM strategy. Currently, new TM construction is crucial and necessary due to financial constraints, difficulty of obtaining sufficient training time due to patient safety-related regulations, and catastrophic damage caused by disasters such as the coronavirus disease 2019 pandemic. The simulator-based TM (SBTM) is widely accepted as an alternative to the ABTM, owing to the SBTM’s advantages. Since the 1960s, many GI endoscopy training simulators have been developed and numerous studies have been published on their effectiveness. While previous studies have focused on the simulator’s validity, this review focused on the accessibility of simulators that were introduced by the end of 2021. Although the current SBTM is effective in GI endoscopic education, extensive improvements are needed to replace the ABTM. Incorporating simulator-incorporated TMs into an improved ABTM is an attempt to overcome the incompleteness of the current SBTM. Until a new simulator is developed to replace the ABTM, it is desirable to operate a simulator-integrated and well-coordinated TM that is suitable for each country and institution.

Citations

Citations to this article as recorded by

Effectiveness of Simulation‐based Training on Emergency Response Knowledge Among Inter‐Professional Staff Involved in Gastrointestinal Endoscopic Practice
Mitsuru Otsuka, Tsunetaka Kato, Takuto Hikichi, Jun Nakamura, Takumi Yanagita, Eisuke Kameoka, Daiki Nemoto, Rei Suzuki, Mitsuru Sugimoto, Hiroyuki Asama, Hiroshi Shimizu, Kento Osawa, Rei Ohira, Keisuke Kudo, Masao Kobayakawa, Hiromasa Ohira
DEN Open.2027;[Epub] CrossRef
A Soft-Robotic Biomimetic Benchtop Model for Esophageal Motility Simulation
Seán Kilroy, Neelesh A. Patankar, Walter W. Chan, Giovanni Traverso, Eoin D. O’Cearbhaill
Nature Communications.2026;[Epub] CrossRef
A Pilot Randomized Cross-Over Trial Focused on Colonoscopy Skill Acquisition Using High Fidelity Versus Low Fidelity Simulators in Nigeria
Olusegun Alatise, Alex Doyle, Tajudeen Mohammed, Olujide Arije, Funmilola Wuraola, Oluwaseyi Olanrewaju, Israel Owoade, Matthew O. Bojuwoye, Rivka Kahn, Cristina Olcesse, Jason Esdaille, Sahle Griffith, Gregory Knapp, Richard Spence, Titilayo Ojumu, T. Pe
Journal of Surgical Education.2026; 83(6): 103932. CrossRef
Training in diagnostic and interventional endoscopic ultrasound: a state-of-the-art review
Giulia Palumbo, Gianenrico Rizzatti, Fabrizio Termite, Andrea Tringali, Giulia Tripodi, Ivo Boskoski, Cristiano Spada
Expert Review of Gastroenterology & Hepatology.2026; 20(5): 449. CrossRef
Simulation in Endoscopy
Abraham Z. Cheloff, Seth A. Gross, Suraj Pai, Sheryl A. Pfeil
Gastrointestinal Endoscopy Clinics of North America.2026; 36(3): 537. CrossRef
A Hybrid Sensor-Based Colonoscopy Training System for Real-Time Loop Detection and Force Feedback
Hang-Ling Wu, Isra Elsaadany, Scarlett Miller, Jason Moore
Journal of Medical Devices.2026;[Epub] CrossRef
Meaningful progress towards a high-fidelity endoscopic submucosal dissection training simulator model
Gin Hyug Lee, So Young Byun
Clinical Endoscopy.2025; 58(1): 77. CrossRef
Effects of a training system that tracks the operator’s gaze pattern during endoscopic submucosal dissection on hemostasis
Takao Tonishi, Fumiaki Ishibashi, Kosuke Okusa, Kentaro Mochida, Sho Suzuki
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Comments on ‘Development of colonic stent simulator using three-dimensional printing technique: a simulator development study in Korea’
Dae Jin Jung, Gwang Ha Kim
Clinical Endoscopy.2025; 58(2): 334. CrossRef
Simulators and training models for diagnostic and therapeutic gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review
Chiara Coluccio, Jérémie Jacques, Istvan Hritz, Ivo Boskoski, Mohamed Abdelrahim, Vincenzo Bove, João A. Cunha Neves, Pieter J. F. de Jonge, Giuseppe Dell’Anna, Gianluca Esposito, Antonio Facciorusso, Rodica Gincul, Paolo Giuffrida, Rakesh Kalapala, Chris
Endoscopy.2025; 57(07): 796. CrossRef
Curriculum for training in peroral endoscopic myotomy (POEM) in Europe (Part I): European Society of Gastrointestinal Endoscopy (ESGE) Position Statement
Enrique Rodríguez de Santiago, David J. Tate, João Santos-Antunes, Sandra Nagl, Zuzana Vacková, Marcel Tantau, Isis K. Araujo, Eduardo Guimarães Hourneaux de Moura, Pietro Familiari, Helmut Messmann, Alanna Ebigbo, Paul Fockens, Raf Bisschops, Henriette H
Endoscopy.2025; 57(07): 778. CrossRef
Artificial intelligence in simulation-based training for Health Professions Education: Navigating the rabbit hole
Rakhi Negi, Deepti Chopra, Komal Maheshwari, Anushi Mahajan, Dinesh Badyal, Padmini Venkataramani
Medical Journal Armed Forces India.2025; 81(6): 637. CrossRef
Digital platforms, virtual reality, and augmented reality in gastrointestinal endoscopy training
Wilfredo Pagani, Tavia Buysse, Kulwinder S. Dua
Clinical Endoscopy.2025; 58(5): 653. CrossRef
Impact and assessment of training models in interventional endoscopic ultrasound
Bogdan Miutescu, Vinay Dhir
Digestive Endoscopy.2024; 36(1): 59. CrossRef
A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
Gut and Liver.2024; 18(1): 77. CrossRef
Exploring Endoscopic Competence in Gastroenterology Training: A Simulation-Based Comparative Analysis of GAGES, DOPS, and ACE Assessment Tools
Faisal Wasim Ismail, Azam Afzal, Rafia Durrani, Rayyan Qureshi, Safia Awan, Michelle R Brown
Advances in Medical Education and Practice.2024; Volume 15: 75. CrossRef
Assemblage of a functional and versatile endoscopy trainer reusing medical waste: Step‐by‐step video tutorial
Riccardo Vasapolli, Jörg Schirra, Christian Schulz
Digestive Endoscopy.2024; 36(5): 634. CrossRef
Navigating the learning landscape: Comprehensive training in third space endoscopy - training, techniques, and practical recommendations
D. Roser, S. Nagl, A. Ebigbo
Best Practice & Research Clinical Gastroenterology.2024; 71: 101918. CrossRef
Systematic review of subjective validation methods for computerized colonoscopy simulators
Adrián Lugilde-López, Manuel Caeiro-Rodríguez, Fernando A. Mikic-Fonte, Martín Llamas-Nistal
Health Informatics Journal.2024;[Epub] CrossRef
Development of colonic stent simulator using three-dimensional printing technique: a simulator development study in Korea
Hyundam Gu, Suyoung Lee, Sol Kim, Hye-Lim Jang, Da-Woon Choi, Kyu Seok Kim, Yu Ri Shin, Dae Young Cheung, Bo-In Lee, Jin Il Kim, Han Hee Lee
Clinical Endoscopy.2024; 57(6): 790. CrossRef
EUS and ERCP training in Europe: Time for simulation, optimization, and standardization
Selma J. Lekkerkerker, Rogier P. Voermans
United European Gastroenterology Journal.2023; 11(5): 407. CrossRef
There is no royal road: a shortcut for endoscopic submucosal dissection training
Seong Woo Jeon
Clinical Endoscopy.2023; 56(5): 590. CrossRef
Enhancing the Quality of Upper Gastrointestinal Endoscopy: Current Indicators and Future Trends
Caesar Ferrari, Micheal Tadros
Gastroenterology Insights.2023; 15(1): 1. CrossRef

12,206 View
372 Download
21 Web of Science
23 Crossref

Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition: Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases; Clin Endosc 2022;55(6):703-725. Published online October 13, 2022; DOI: https://doi.org/10.5946/ce.2022.136

Abstract PDF Supplementary Material

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

Citations

Citations to this article as recorded by

Impact of Guideline-Concordant Post-Polypectomy Colonoscopy Surveillance on Colorectal Cancer Incidence and Mortality
Samir Gupta, Joshua Demb, Jiyue Qin, Ashley Earles, Mark Lamm, Chyke A. Doubeni, Maria Elena Martinez, Tonya R. Kaltenbach, Andrew J. Gawron, Shailja C. Shah, Karen Messer, Lin Liu
Clinical Gastroenterology and Hepatology.2026; 24(6): 1709. CrossRef
Prognosis of Korean patients with familial adenomatous polyposis who did not undergo colectomy: a retrospective study
Min Kwan Kwon, Jin Hee Noh, Ji Yong Ahn, Woochang Lee, Seok-Byung Lim, Yong Sang Hong, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
Clinical Endoscopy.2026; 59(2): 254. CrossRef
Korean clinical practice guidelines for bowel preparation before colonoscopy
Jae Hyun Kim, Seung-Joo Nam, Beom Jae Lee, Eun Ran Kim, Eun Sun Kim, Eun Soo Kim, Chang Kyun Lee, Yehyun Park, Geom Seog Seo, Jong-Jae Park, Hyun-Soo Kim
Clinical Endoscopy.2026; 59(4): 529. CrossRef
Influence of Lifestyles on Polyp Burden and Cancer Development in Hereditary Colorectal Cancer Syndromes
Hye Kyung Hyun, Ji Soo Park, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
Journal of Gastroenterology and Hepatology.2025; 40(2): 433. CrossRef
Minimum Platelet Count Threshold for Safe Colonoscopic Polypectomy: A Large-Scale Propensity Scored-Matched Analysis
Hye Kyung Hyun, Nak-Hoon Son, Cheal Wung Huh, Hyun Chul Lim, So Hyeon Gwon, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
American Journal of Gastroenterology.2025; 120(12): 2918. CrossRef
Role of Artificial Intelligence in Improving Quality of Colonoscopy
Ji Hyun Kim, Sung Chul Park, Hyun-Soo Kim
The Korean Journal of Gastroenterology.2025; 85(2): 137. CrossRef
Prevalence and Characteristics of Colorectal Serrated Polyps
Soo-Young Na
Journal of Digestive Cancer Research.2025; 13(1): 47. CrossRef
Association between Atherosclerosis and High-Risk Colorectal Adenomas based on Cardio-Ankle Vascular Index and Ankle-Brachial Index
Jung Ho Lee, Hyunseok Cho, Sang Hoon Lee, Sung Joon Lee, Chang Don Kang, Dae Hee Choi, Jin Myung Park, Seung-Joo Nam, Tae Suk Kim, Ji Hyun Kim, Sung Chul Park
The Korean Journal of Gastroenterology.2024; 83(4): 143. CrossRef
A survey of current practices in post-polypectomy surveillance in Korea
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
Intestinal Research.2024; 22(2): 186. CrossRef
Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
Yunho Jung
The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef
Utilizing ChatGPT4 in Deciding Follow-up Examination Intervals After Colonoscopy
Hyung-Hoon Oh
The Korean Journal of Gastroenterology.2024; 84(5): 239. CrossRef
Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revision
Su Young Kim
The Korean Journal of Medicine.2023; 98(3): 102. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
Understanding colorectal polyps to prevent colorectal cancer
Dong-Hoon Yang
Journal of the Korean Medical Association.2023; 66(11): 626. CrossRef
Classification and endoscopic diagnosis of colorectal polyps
Ji Hyun Kim, Sung Chul Park
Journal of the Korean Medical Association.2023; 66(11): 633. CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef
Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
Journal of the Korean Medical Association.2023; 66(11): 652. CrossRef

15,255 View
664 Download
15 Web of Science
17 Crossref

Original Article

Factors influencing endoscopic estimation of colon polyp size in a colon model: Koen Robert Beukema, Jaimy A. Simmering, Marjolein Brusse-Keizer, Sneha John, Rutger Quispel, Peter B. Mensink; Clin Endosc 2022;55(4):540-548. Published online July 28, 2022; DOI: https://doi.org/10.5946/ce.2022.017

Abstract PDF

Background
/Aims: Colorectal polyps are removed to prevent progression to colorectal cancer. Polyp size is an important factor for risk stratification of malignant transformation. Endoscopic size estimation correlates poorly with pathological reports and several factors have been suggested to influence size estimation. We aimed to gain insight into the factors influencing endoscopic polyp size estimation.
Methods
Images of polyps in an artificial model were obtained at 1, 3, and 5 cm from the colonoscope’s tip. Participants were asked to estimate the diameter and volume of each polyp.
Results
Fifteen endoscopists from three large-volume centers participated in this study. With an intraclass correlation coefficient of 0.66 (95% confidence interval [CI], 0.62–0.71) for diameter and 0.56 (95% CI, 0.50–0.62) for volume. Polyp size estimated at 3 cm from the colonoscope’s tip yielded the best results. A lower distance between the tip and the polyp was associated with a larger estimated polyp size.
Conclusions
Correct endoscopic estimation of polyp size remains challenging. This finding can affect size estimation skills and future training programs for endoscopists.

Citations

Citations to this article as recorded by

Recent advancement in size measurement during endoscopy
Hye Kyung Jeon, Gwang Ha Kim
Clinical Endoscopy.2026; 59(1): 1. CrossRef
Endoscopic size measurement of colorectal polyps: a systematic review of techniques
Mahsa Taghiakbari, Roupen Djinbachian, Juliette Labelle, Daniel von Renteln
Endoscopy.2025; 57(05): 460. CrossRef
Taking the Guess Work Out of Endoscopic Polyp Measurement
Anthony Kerbage, Tarek Souaid, Kailash Singh, Carol A. Burke
Journal of Clinical Gastroenterology.2025; 59(6): 497. CrossRef
Accuracy of Visual Estimation for Measuring Colonic Polyp Size: A Systematic Review and Meta-Analysis
Abraham Z. Cheloff, Leah Kim, Mark B. Pochapin, Aasma Shaukat, Violeta Popov
American Journal of Gastroenterology.2025; 120(10): 2251. CrossRef
Usefulness and Educational Benefit of a Virtual Scale Endoscope in Measuring Colorectal Polyp Size
Yudai Takehara, Ken Yamashita, Shin Morimoto, Fumiaki Tanino, Noriko Yamamoto, Yuki Kamigaichi, Hidenori Tanaka, Hidehiko Takigawa, Ryo Yuge, Yuji Urabe, Shiro Oka
Digestion.2024; 105(2): 73. CrossRef
Expert endoscopist assessment of colorectal polyp size using virtual scale endoscopy, visual or snare-based estimation: a prospective video-based study
Ioana Popescu Crainic, Roupen Djinbachian, Douglas K. Rex, Alan Barkun, Aasma Shaukat, James East, Cesare Hassan, Yuichi Mori, Heiko Pohl, Amit Rastogi, Prateek Sharma, Joseph C. Anderson, Mahsa Taghiakbari, Edgard Medawar, Daniel von Renteln
Scandinavian Journal of Gastroenterology.2024; 59(5): 608. CrossRef

8,255 View
157 Download
6 Web of Science
6 Crossref

Review

Post-polypectomy surveillance: the present and the future: Masau Sekiguchi, Takahisa Matsuda, Kinichi Hotta, Yutaka Saito; Clin Endosc 2022;55(4):489-495. Published online July 11, 2022; DOI: https://doi.org/10.5946/ce.2022.097

Abstract PDF

An appropriate post-polypectomy surveillance program requires the effectiveness of reducing colorectal cancer and safety. In addition, the post-polypectomy surveillance program should consider the burden of limited medical resource capacity, cost-effectiveness, and patient adherence. In this sense, a risk-stratified surveillance program based on baseline colonoscopy results is ideal. Major international guidelines for post-polypectomy surveillance, such as those from the European Union and the United States, have recommended risk-stratified surveillance programs. Both guidelines have recently been updated to better differentiate between high- and low-risk individuals. In both updated guidelines, more individuals have been downgraded to lower-risk groups that require less frequent or no surveillance. Furthermore, increased attention has been paid to the surveillance of patients who undergo serrated polyp removal. Previous guidelines in Japan did not clearly outline the risk stratification in post-polypectomy surveillance. However, the new colonoscopy screening and surveillance guidelines presented by the Japan Gastroenterological Endoscopy Society include a risk-stratified post-polypectomy surveillance program. Further discussion and analysis of unresolved issues in this field, such as the optimal follow-up after the first surveillance, the upper age limit for surveillance, and the ideal method for improving adherence to surveillance guidelines, are warranted.

Citations

Citations to this article as recorded by

Integrated bioinformatics and experimental validation identify FOXQ1, GRIN2D, and SCNN1B as novel biomarkers for distinguishing high-risk sessile serrated lesions from hyperplastic polyps
Nayeralsadat Fatemi, Zeynab Piryaei, Elahe Daskar Abkenar, Elham Zonoobi, Nada Badr, Ali Aghaei, Seyedeh Nasim Mirbahari, Ebrahim Mirzaei, Maryam Parvizi, Mahsa Saeedi Niasar, Pardis Ketabi Moghadam, Amir Sadeghi, Peter J. K. Kuppen, Ehsan Nazemalhosseini
Journal of Molecular Histology.2026;[Epub] CrossRef
Korean clinical practice guidelines for bowel preparation before colonoscopy
Jae Hyun Kim, Seung-Joo Nam, Beom Jae Lee, Eun Ran Kim, Eun Sun Kim, Eun Soo Kim, Chang Kyun Lee, Yehyun Park, Geom Seog Seo, Jong-Jae Park, Hyun-Soo Kim
Clinical Endoscopy.2026; 59(4): 529. CrossRef
The Impact of Age on Preferences for Colorectal Cancer Surveillance Strategies: Are Fecal Immunochemical Tests FIT for Surveillance?
Maddison Dix, Sarah Cohen‐Woods, Molla M. Wassie, Jean M. Winter, Carlene J. Wilson, Graeme P. Young, Charles Cock, Erin L. Symonds
Cancer Medicine.2025;[Epub] CrossRef
Determinants of Shorter Surveillance Colonoscopy Intervals: A Nationwide Real‐World Study in Japan
Munenori Honda, Ryosuke Gushima, Kotaro Waki, Kenshi Matsuno, Yoki Furuta, Hideaki Miyamoto, Katsuya Nagaoka, Hideaki Naoe, Yasuhito Tanaka
Journal of Gastroenterology and Hepatology.2025; 40(12): 2944. CrossRef
Protocolo diagnóstico del seguimiento de pólipos colónicos
S. Redondo Evangelista, M. Sierra Morales, I. Bartolomé Oterino, P. García Centeno, A. Santos Rodríguez
Medicine - Programa de Formación Médica Continuada Acreditado.2024; 14(4): 219. CrossRef
Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
Yunho Jung
The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef
Efficacy of Oral Sulfate Tablet and 2 L-Polyethylene Glycol With Ascorbic Acid for Bowel Preparation: A Prospective Randomized KASID Multicenter Trial
Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
Metabolic‐associated fatty liver disease is associated with colorectal adenomas in young and older Korean adults
Jiwon Chang, Yoosoo Chang, Yoosun Cho, Hyun‐Suk Jung, Dong‐Il Park, Soo‐Kyung Park, Soo‐Youn Ham, Sarah H. Wild, Christopher D. Byrne, Seungho Ryu
Liver International.2023; 43(11): 2548. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
Journal of the Korean Medical Association.2023; 66(11): 652. CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef
Understanding colorectal polyps to prevent colorectal cancer
Dong-Hoon Yang
Journal of the Korean Medical Association.2023; 66(11): 626. CrossRef

11,530 View
356 Download
10 Web of Science
12 Crossref

Systematic Review and Meta-Analysis

Does computer-aided diagnostic endoscopy improve the detection of commonly missed polyps? A meta-analysis: Arun Sivananthan, Scarlet Nazarian, Lakshmana Ayaru, Kinesh Patel, Hutan Ashrafian, Ara Darzi, Nisha Patel; Clin Endosc 2022;55(3):355-364. Published online May 12, 2022; DOI: https://doi.org/10.5946/ce.2021.228

Abstract PDF

Background
/Aims: Colonoscopy is the gold standard diagnostic method for colorectal neoplasia, allowing detection and resection of adenomatous polyps; however, significant proportions of adenomas are missed. Computer-aided detection (CADe) systems in endoscopy are currently available to help identify lesions. Diminutive (≤5 mm) and nonpedunculated polyps are most commonly missed. This meta-analysis aimed to assess whether CADe systems can improve the real-time detection of these commonly missed lesions.
Methods
A comprehensive literature search was performed. Randomized controlled trials evaluating CADe systems categorized by morphology and lesion size were included. The mean number of polyps and adenomas per patient was derived. Independent proportions and their differences were calculated using DerSimonian and Laird random-effects modeling.
Results
Seven studies, including 2,595 CADe-assisted colonoscopies and 2,622 conventional colonoscopies, were analyzed. CADe-assisted colonoscopy demonstrated an 80% increase in the mean number of diminutive adenomas detected per patient compared with conventional colonoscopy (0.31 vs. 0.17; effect size, 0.13; 95% confidence interval [CI], 0.09–0.18); it also demonstrated a 91.7% increase in the mean number of nonpedunculated adenomas detected per patient (0.32 vs. 0.19; effect size, 0.05; 95% CI, 0.02–0.07).
Conclusions
CADe-assisted endoscopy significantly improved the detection of most commonly missed adenomas. Although this method is a potentially exciting technology, limitations still apply to current data, prompting the need for further real-time studies.

Citations

Citations to this article as recorded by

PICO-based assessment and categorization of evidence for digital health interventions: an inductive framework development
Uwe Buddrus, Jan-Oliver Kutza, Johannes Thye, Moritz Esdar, Ursula Hertha Hübner, Jan-David Liebe
Frontiers in Digital Health.2026;[Epub] CrossRef
HERALDS: a flexible, high-resolution volumetric endoscopy—design, calibration, and performance evaluation
Deer Su, Chen Hu, Guanying Liang, Junyu Zhao, Zhenqian Han, Zhipeng Ma, Liang Li, Changliang Guo, Weida Gao, Liying Qu, Guanyu Shang, Bo Qu, Xiangyan Ding, Haoyu Li, Weisong Zhao, Wenhao Liu
Optics Express.2026; 34(8): 15664. CrossRef
Instant mapping of digestive morphology via spatio-angular disparity-resolved endoscopy
Deer Su, Chen Hu, Guanying Liang, Junyu Zhao, Zhenqian Han, Zhipeng Ma, Changliang Guo, Weida Gao, Liang Li, Liying Qu, Guanyu Shang, Bo Qu, Xiangyan Ding, Haoyu Li, Weisong Zhao, Wenhao Liu
Optics and Lasers in Engineering.2026; 204: 109856. CrossRef
Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea
Jung-Bin Park, Jung Ho Bae
Clinical Endoscopy.2025; 58(1): 112. CrossRef
Colorectal Cancer after Colonoscopy: Causes and Prevention Strategies
Seongwoo Choi, Yunho Jung
The Korean Journal of Medicine.2025; 100(1): 19. CrossRef
Role of Artificial Intelligence in Improving Quality of Colonoscopy
Ji Hyun Kim, Sung Chul Park, Hyun-Soo Kim
The Korean Journal of Gastroenterology.2025; 85(2): 137. CrossRef
Polyp of the colon and rectum (K62.1, K63.5, D37.4, D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.6, D12.7, D12.8), adults, children (PROJECT)
Yu. A. Shelygin, S. I. Achkasov, E. D. Fedorov, V. V. Veselov, A. A Likutov, E. G. Rybakov, I. V. Nazarov, M. Y. Agapov, N. V. Ageikina, Yu. E. Vaganov, A. V. Vasilchenko, E. V. Gorbachev, O. V. Ivinskaya, I. Yu. Korzheva, M. P. Korolev, A. G. Korotkevich
Koloproktologia.2025; 24(4): 11. CrossRef
Evaluation of linked-color imaging endoscopy combined with CAD EYE for the detection and characterization of right-sided colon polyps
Phuoc Huu Tran, Thi Huyen Thuong Nguyen, Van Huy Tran
Arab Journal of Gastroenterology.2025; 26(4): 452. CrossRef
Use of artificial intelligence in the management of T1 colorectal cancer: a new tool in the arsenal or is deep learning out of its depth?
James Weiquan Li, Lai Mun Wang, Katsuro Ichimasa, Kenneth Weicong Lin, James Chi-Yong Ngu, Tiing Leong Ang
Clinical Endoscopy.2024; 57(1): 24. CrossRef
As how artificial intelligence is revolutionizing endoscopy
Jean-Francois Rey
Clinical Endoscopy.2024; 57(3): 302. CrossRef
Understanding the discrepancy in the effectiveness of artificial intelligence-assisted colonoscopy: from randomized controlled trials to clinical reality
Jung Ho Bae
Clinical Endoscopy.2024; 57(6): 765. CrossRef
Eye tracking technology in endoscopy: Looking to the future
Arun Sivananthan, Jabed Ahmed, Alexandros Kogkas, George Mylonas, Ara Darzi, Nisha Patel
Digestive Endoscopy.2023; 35(3): 314. CrossRef
Artificial intelligence and the push for small adenomas: all we need?
Katharina Zimmermann-Fraedrich, Thomas Rösch
Endoscopy.2023; 55(04): 320. CrossRef
Recent advances in devices and technologies that might prove revolutionary for colonoscopy procedures
Jonathan S. Galati, Kevin Lin, Seth A. Gross
Expert Review of Medical Devices.2023; 20(12): 1087. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
KI-Werkzeuge als smarte Helfer in Klinik und Forschung

Zeitschrift für Gastroenterologie.2023; 61(11): 1544. CrossRef
AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef
The Role of Artificial Intelligence in Colorectal Cancer Screening: Lesion Detection and Lesion Characterization
Edward Young, Louisa Edwards, Rajvinder Singh
Cancers.2023; 15(21): 5126. CrossRef
Artificial intelligence for colorectal neoplasia detection during colonoscopy: a systematic review and meta-analysis of randomized clinical trials
Shenghan Lou, Fenqi Du, Wenjie Song, Yixiu Xia, Xinyu Yue, Da Yang, Binbin Cui, Yanlong Liu, Peng Han
eClinicalMedicine.2023; 66: 102341. CrossRef
Pouring some water into the wine—Poor performance of endoscopists in artificial intelligence studies
Jochen Weigt
United European Gastroenterology Journal.2022; 10(8): 793. CrossRef

8,777 View
180 Download
18 Web of Science
20 Crossref

Reviews

Quality indicators in colonoscopy: the chasm between ideal and reality: Su Bee Park, Jae Myung Cha; Clin Endosc 2022;55(3):332-338. Published online April 4, 2022; DOI: https://doi.org/10.5946/ce.2022.037

Abstract PDF

Continuous measurement of quality indicators (QIs) should be a routine part of colonoscopy, as a wide variation still exists in the performance and quality levels of colonoscopy in Korea. Among the many QIs of colonoscopy, the adenoma detection rate, average withdrawal time, bowel preparation adequacy, and cecal intubation rate should be monitored in daily clinical practice to improve the quality of the procedure. The adenoma detection rate is the best indicator of the quality of colonoscopy; however, it has many limitations for universal use in daily practice. With the development of natural language processing, the adenoma detection rate is expected to become more effective and useful. It is important that colonoscopists do not strictly and mechanically maintain an average withdrawal time of 6 minutes but instead perform careful colonoscopy to maximally expose the colonic mucosa with a withdrawal time of at least 6 minutes. To achieve adequate bowel preparation, documentation of bowel preparation with the Boston Bowel Preparation Scale (BBPS) should be a routine part of colonoscopy. When colonoscopists routinely followed the bowel preparation protocols, ≥85% of outpatient screening colonoscopies had a BBPS score of ≥6. In addition, the cecal intubation rate should be ≥95% of all screening colonoscopies. The first step in improving colonoscopy quality in Korea is to apply these key performance measurements in clinical practice.

Citations

Citations to this article as recorded by

Iatrogenic colon perforation: endoscopic management or surgery
Seung Bum Lee
Clinical Endoscopy.2026; 59(1): 33. CrossRef
External Validation of an AI-Based Colonoscopy Quality Assessment Tool in Japanese Clinical Practice: A Pilot Study
Hiroaki Saito, Evandros Kalamanos, Kristjana Kristinsdottir, Matthew Wittbrodt, Satoshi Ito, Hidetaka Hamamoto, Yoshika Saito, John E. Pandolfino, Rajesh N. Keswani, Mozziyar Etemadi, Tomoki Matsuda
Digestive Diseases and Sciences.2026; 71(7): 3107. CrossRef
Prospective evaluation of artificial intelligence-assisted monitoring of the effective withdrawal time on adenoma detection
Thomas Ka Luen Lui, Carla Pui-Mei Lam, Vivien Wai-Man Tsui, Rex Wan-Hin Hui, Elvis Wai-Pan To, Loey Lung-Yi Mak, Michael Kwan-Lung Ko, Kevin Sze-Hang Liu, Cynthia Ka-Yin Hui, Jing Jia Liu, Xiao Xiao, Wai K. Leung
Intestinal Research.2026;[Epub] CrossRef
Updated bowel preparation regimens for colonoscopy: benefits and drawbacks
Seung Min Hong, Dong Hoon Baek
Clinical Endoscopy.2026; 59(3): 345. CrossRef
Quality Control indicators for Endoscopy’s success evaluation
Flávio Ribeiro, Tiago Jesus, Diogo Rodrigues, Mónica Martins, André Ferreira, Mariana Ribeiro, Daniel Sá, Manuel Santos, Alda João Andrade, Luis Lopes, Victor Alves
Procedia Computer Science.2026; 280: 1181. CrossRef
Interobserver variability in colonoscopy quality assessment: a retrospective standardized multicenter video-based study
Radu Alexandru Vulpoi, Tudor Stefan Rotaru , Mihaela Luca
Archive of Clinical Cases.2026; 13(2): 30. CrossRef
Korean clinical practice guidelines for bowel preparation before colonoscopy
Jae Hyun Kim, Seung-Joo Nam, Beom Jae Lee, Eun Ran Kim, Eun Sun Kim, Eun Soo Kim, Chang Kyun Lee, Yehyun Park, Geom Seog Seo, Jong-Jae Park, Hyun-Soo Kim
Clinical Endoscopy.2026; 59(4): 529. CrossRef
Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea
Jung-Bin Park, Jung Ho Bae
Clinical Endoscopy.2025; 58(1): 112. CrossRef
Artificial intelligence to revolutionize IBD clinical trials: a comprehensive review
Rocio Sedano, Virginia Solitano, Sudheer K. Vuyyuru, Yuhong Yuan, Jurij Hanžel, Christopher Ma, Olga Maria Nardone, Vipul Jairath
Therapeutic Advances in Gastroenterology.2025;[Epub] CrossRef
Clinical Trial: Effect of Abdominal Vibration Combined With Walking Exercise Programme on Bowel Preparation in Older Patients With Constipation
Yuan‐Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi
Alimentary Pharmacology & Therapeutics.2025; 61(9): 1447. CrossRef
Innovative schemes of colonoscopy bowel preparation with oral lactulose: Optimizing traditional standards to improve colonoscopy quality
Josué Aliaga Ramos, Danilo Carvalho, Vitor Nunes Arantes
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Efficacy and safety of lubiprostone combined with polyethylene glycol electrolyte powder for bowel preparation in patients classified by risk level: a randomised trial
Jian Song, Hong-Liang Li, Xu-Fei Qi, Chang-Xi Chen, Yue-Mei Xu
Frontiers in Oncology.2025;[Epub] CrossRef
Artificial intelligence in colonoscopy: Enhancing quality indicators for optimal patient outcomes
Konstantina Dimopoulou, Marianna Spinou, Alexandros Ioannou, Eleni Nakou, Petros Zormpas, George Tribonias
World Journal of Gastroenterology.2025;[Epub] CrossRef
Post-colonoscopy Appendicitis: A Literature Review and Guidelines for Management
Navid Moghimi, Lars Joachim Lindberg
Cureus.2025;[Epub] CrossRef
What are the priority quality indicators for colonoscopy in real‐world clinical practice?
Kasenee Tiankanon, Satimai Aniwan
Digestive Endoscopy.2024; 36(1): 30. CrossRef
Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef
Novel regimen for colonoscopy bowel preparation with oral lactulose: a prospective comparative study
Josué Aliaga Ramos, Danilo Carvalho, Vitor N. Arantes
Clinical Endoscopy.2024; 57(6): 775. CrossRef
Bowel Preparation Agents: Balancing Efficacy for Colon Cleansing and Safety for Stomach Safety
Gwang Ha Kim
The Korean Journal of Gastroenterology.2024; 84(6): 293. CrossRef
A Systematic Review of Exercise Therapy for Bowel Preparation
Yuan-Yuan Zhang, Ramoo Vimala, Ping Lei Chui, Ida Normiha Hilmi
Gastroenterology Nursing.2023; 46(5): 393. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef

9,937 View
340 Download
18 Web of Science
21 Crossref

Can Computed Tomography Colonography Replace Optical Colonoscopy in Detecting Colorectal Lesions?: State of the Art: Alessia Chini, Michele Manigrasso, Grazia Cantore, Rosa Maione, Marco Milone, Francesco Maione, Giovanni Domenico De Palma; Clin Endosc 2022;55(2):183-190. Published online February 24, 2022; DOI: https://doi.org/10.5946/ce.2021.254

Abstract PDF

Colorectal cancer is an important cause of morbidity and mortality worldwide. Optical colonoscopy (OC) is widely accepted as the reference standard for the screening of colorectal polyps and cancers, and computed tomography colonography (CTC) is a valid alternative to OC. The purpose of this review was to assess the diagnostic accuracy of OC and CTC for colorectal lesions. A literature search was performed in PubMed, Embase, and Cochrane Library, and 18 articles were included. CTC has emerged in recent years as a potential screening examination with high accuracy for the detection of colorectal lesions. However, the clinical application of CTC as a screening technique is limited because it is highly dependent on the size of the lesions and has poor performance in detecting individual lesions <5 mm or flat lesions, which, although rarely, can have a malignant potential.

Citations

Citations to this article as recorded by

Diagnostic performance of photon-counting detector CT versus energy-integrating detector CT for colorectal polyp detection: a phantom study
Xiaofei Wu, Huiqing Gao, Yuanyuan Gao, Huimin Zha, Xinyi Zhou, Shudong Hu, Weifeng Han, Yuxi Ge
Abdominal Radiology.2026; 51(8): 3767. CrossRef
Research advances in early screening for colorectal cancer (Review)
Jiaojiao Jiang
Molecular and Clinical Oncology.2026; 24(4): 1. CrossRef
Virtual Colonoscopy: Retrospective Comparison of the Findings in Supine and Prone Positions
Mehmet Gürdal Demirci, Yasir Musa Kesgin
Surgical Innovation.2025; 32(3): 242. CrossRef
Spectroscopic Nuclear Magnetic Resonance and Fourier Transform–Infrared Approach Used for the Evaluation of Healing After Surgical Interventions for Patients with Colorectal Cancer: A Pilot Study
Lavinia Raluca Șaitiș, David Andras, Ioana-Alina Pop, Cătălin Șaitiș, Ramona Crainic, Radu Fechete
Cancers.2025; 17(5): 887. CrossRef
DIVERT-Ca: unveiling the hidden link between acute diverticulitis and colorectal cancer risk—multicentre retrospective study
Mohamed Talaat Issa, Emiko Sultana, Mohammed Hamid, Ali Yasen Mohamedahmed, Mohamed Albendary, Shafquat Zaman, Santosh Bhandari, William Ball, Sangara Narayanasamy, Pradeep Thomas, Najam Husain, Rajeev Peravali, Diwakar Sarma
International Journal of Colorectal Disease.2025;[Epub] CrossRef
Advances in colorectal cancer screening and detection: a narrative review on biomarkers, imaging and preventive strategies
Adil khan, Uswa Hasana, Iman Anum Nadeem, Swara Punit Khatri, Shayan Nawaz, Qurat Ulain Makhdoom, Shahab Wazir, Kirtan Patel, Mohamd Ghaly
Journal of the Egyptian National Cancer Institute.2025;[Epub] CrossRef
Ways to improve the diagnosis and treatment of early colorectal cancer: a literature review and a clinical case study
V. O. Gaulikà, A. M. Parsadanyan, K. K. Kostanyan
Siberian journal of oncology.2025; 24(3): 114. CrossRef
GFANet: Global Feature Attention Network for Polyp Segmentation
Leping Lin, Wenjie Huang, Ning Ouyang
Journal of Imaging Informatics in Medicine.2025;[Epub] CrossRef
Implications of Computerized Tomography Colonography in Fully Intended but Aborted Optical Colonoscopy – a Retrospective Case-Control Study
Constanze Jakob, Thomas Arens, Annett Borkenhagen, Christina Nikolaus, Tobias Klugmann, Chris Klecker, Peter Dietel, Philipp A. Reuken, Andreas Stallmach, Niels Teich
Zeitschrift für Gastroenterologie.2025; 63(12): 1253. CrossRef
Multi-view orientational attention network combining point-based affinity for polyp segmentation
Yan Liu, Yan Yang, Yongquan Jiang, Zhuyang Xie
Expert Systems with Applications.2024; 249: 123663. CrossRef
The Influence of Mechanical Bowel Preparation on Volatile Organic Compounds for the Detection of Gastrointestinal Disease—A Systematic Review
Ashwin Krishnamoorthy, Subashini Chandrapalan, Sofie Bosch, Ayman Bannaga, Nanne K.H. De Boer, Tim G.J. De Meij, Marcis Leja, George B. Hanna, Nicoletta De Vietro, Donato Altomare, Ramesh P. Arasaradnam
Sensors.2023; 23(3): 1377. CrossRef
The Detection of Colorectal Cancer through Machine Learning-Based Breath Sensor Analysis
Inese Poļaka, Linda Mežmale, Linda Anarkulova, Elīna Kononova, Ilona Vilkoite, Viktors Veliks, Anna Marija Ļeščinska, Ilmārs Stonāns, Andrejs Pčolkins, Ivars Tolmanis, Gidi Shani, Hossam Haick, Jan Mitrovics, Johannes Glöckler, Boris Mizaikoff, Mārcis Lej
Diagnostics.2023; 13(21): 3355. CrossRef

11,174 View
303 Download
14 Web of Science
12 Crossref

Original Article

Comparison of conventional and new endoscopic band ligation devices for colonic diverticular bleeding: Ayaka Takasu, Takashi Ikeya, Yasutoshi Shiratori; Clin Endosc 2022;55(3):408-416. Published online February 18, 2022; DOI: https://doi.org/10.5946/ce.2021.200

Abstract PDF

Background
/Aims: Endoscopic band ligation (EBL) is used to treat colonic diverticular bleeding (CDB). An endoscopic variceal ligation device for esophageal varices is used as a conventional EBL device (C-EBL). A new EBL device (N-EBL) was developed by Sumitomo Bakelite Co. in August 2018. We aimed to evaluate the clinical outcomes of N-EBL compared with those of C-EBL.
Methods
Seventy-nine patients who underwent EBL for CDB at St. Luke’s International Hospital, Japan, between 2017 and 2020 were included in this retrospective study. Patients were divided into the C-EBL and N-EBL groups. Their clinical outcomes, including achieving initial hemostasis, early rebleeding, procedure time, and EBL-associated adverse events, were evaluated.
Results
Of the 79 patients, 36 (45.6%) were in the C-EBL group and 43 (54.4%) were in the N-EBL group. The rate of achieving initial hemostasis was 100% in the C-EBL group and 93.0% in the N-EBL group. No significant difference was noted in the early rebleeding rate between the groups (p=0.24). The N-EBL group achieved a shorter median EBL procedure time than the C-EBL group (18.2 minutes vs. 14.2 minutes, p=0.02). No adverse events were observed in either group.
Conclusions
The N-EBL device is safe and useful and may reduce EBL procedure time.

Citations

Citations to this article as recorded by

Clinical utility of a novel double-band endoscopic band ligation device for consecutive ligation in the management of diverticular bleeding
Sayo Daidoji, Yugo Suzuki, Daisuke Kikuchi, Shu Hoteya
VideoGIE.2026; 11(1): 21. CrossRef
Endoscopic therapies for colonic diverticular bleeding: a systematic review and meta-analysis
Gilmara Coelho Meine, Paula Santo, Lucas Monteiro Delgado, Gregory Thomas Brennan
Surgical Endoscopy.2026; 40(2): 902. CrossRef
Advances in endoscopic management of colonic diverticular bleeding
Yasutoshi Shiratori, Syed Matthew Kodilinye, Ahmed E. Salem
Current Opinion in Gastroenterology.2024; 40(5): 363. CrossRef
Endoscopic Hemostasis and Antithrombotic Management
Jamie Bering, Mashal J. Batheja, Neena S. Abraham
Gastroenterology Clinics of North America.2024; 53(4): 573. CrossRef
Management of Patients With Acute Lower Gastrointestinal Bleeding: An Updated ACG Guideline
Neil Sengupta, Joseph D. Feuerstein, Vipul Jairath, Amandeep K. Shergill, Lisa L. Strate, Robert J. Wong, David Wan
American Journal of Gastroenterology.2023; 118(2): 208. CrossRef
Effective endoscopic band ligation for diverticular perforation with a refractory pelvic abscess
Koichi Soga, Atsushi Majima
Clinical Endoscopy.2023; 56(2): 252. CrossRef
A new band ligation device to treat colonic diverticular bleeding
Yunho Jung
Clinical Endoscopy.2022; 55(3): 367. CrossRef

8,348 View
284 Download
6 Web of Science
7 Crossref

Special Article: Celebrating the 10th Anniversary of Clinical Endoscopy

Document Network and Conceptual and Social Structures of Clinical Endoscopy from 2015 to July 2021 Based on the Web of Science Core Collection: A Bibliometric Study: Sun Huh; Clin Endosc 2021;54(5):641-650. Published online September 30, 2021; DOI: https://doi.org/10.5946/ce.2021.207

Abstract PDF Supplementary Material

Background
/Aims: The present study investigated the relevance and network of institutions, keywords, and authors’ countries of the articles in Clinical Endoscopy published from 2015 to May 2021 based on the Web of Science Core Collection.
Methods
The Web of Science Core Collection was searched with the term Clinical Endoscopy as the publication title on July 12, 2021. All 776 citations published from 2015 to May 2021 and 2,964 articles citing those 776 articles were analyzed using Biblioshiny.
Results
The corresponding authors were from 73 countries. Document coupling showed that the colorectal cancer-colonoscopyrandomized controlled trial cluster had the most significant impact and highest centrality. There were 442 articles with corresponding authors from Korea (57.0%). The number of collaborative works by Korean authors with the authors of other countries was 33 (7.5%). The articles were cited 2,964 times by corresponding authors from 37 countries.
Conclusions
The above results show that Clinical Endoscopy has published several studies on gastrointestinal endoscopy. A large proportion of citations (84.7 %) were from outside Korea, indicating that the journal content is useful for global physicians. Collaborative work between authors from Korea and other countries should be encouraged to promote the journal.

Citations

Citations to this article as recorded by

Mapping Key Nodes and Global Trends in AI and Large Language Models for Medical Education: A Bibliometric Study
Kaining Lu, Shuben Sun, Wanzhang Liu, Junhui Jiang, Zejun Yan
Advances in Medical Education and Practice.2025; Volume 16: 1421. CrossRef
Research Progress in Land Consolidation and Rural Revitalization: Current Status, Characteristics, Regional Differences, and Evolution Laws
Shuchang Li, Wei Song
Land.2023; 12(1): 210. CrossRef
Journal metrics, document network, and conceptual and social structures of the Korean Journal of Anesthesiology from 2017 to July 2022: a bibliometric study
Sun Huh
Korean Journal of Anesthesiology.2023; 76(1): 3. CrossRef
Promotion to Top-Tier Journal and Development Strategy of the Annals of Laboratory Medicine for Strengthening its Leadership in the Medical Laboratory Technology Category: A Bibliometric Study
Sun Huh
Annals of Laboratory Medicine.2022; 42(3): 321. CrossRef
Research trends on endoscopic mucosal resection: A bibliometric analysis from 1991 to 2021
Yihan Yang, Xuan Xu, Menghui Wang, Yang Zhang, Pinglang Zhou, Sifan Yang, Xu Shu, Chuan Xie
Frontiers in Surgery.2022;[Epub] CrossRef
Riesgo de sangrado gastrointestinal por uso de anticoagulantes directos orales: ¿cuál es más seguro?
Ivan David Lozada Martinez, Luis Carlos Solano Díaz, Marcela Barbosa Pérez, Víctor Andrés Rueda Oviedo, Brainerd Lenin Caicedo Moncada, Gustavo Andrés Diaz Cruz, Adriana cristina Ceballos Espitia, David Esteban Diaz Gómez, Daiana Andrea Rojas Ramí
Revista Cuarzo.2022; 28(2): 31. CrossRef

7,315 View
92 Download
5 Web of Science
6 Crossref

Original Article

Colorectal Cancer Screening with Computed Tomography Colonography: Single Region Experience in Kazakhstan: Jandos Amankulov, Dilyara Kaidarova, Zhamilya Zholdybay, Marianna Zagurovskaya, Nurlan Baltabekov, Madina Gabdullina, Akmaral Ainakulova, Dias Toleshbayev, Alexandra Panina, Elvira Satbayeva, Zhansaya Kalieva; Clin Endosc 2022;55(1):101-112. Published online July 15, 2021; DOI: https://doi.org/10.5946/ce.2021.066

Abstract PDF: Background
/Aims: The aim of our study was to determine the efficacy of computed tomography colonography (CTC) in screening for colorectal cancer (CRC).
Methods
A total of 612 females and 588 males aged 45 to 75 years were enrolled in CTC screening. CTC was performed following standard bowel preparation and colonic insufflation with carbon dioxide. The main outcomes were the detection rate of CRC and advanced adenoma (AA), prevalence of colorectal lesions in relation to socio-demographic and health factors, and overall diagnostic performance of CTC.
Results
Overall, 56.5% of the 1,200 invited subjects underwent CTC screening. The sensitivity for CRC and AA was 0.89 and 0.97, respectively, while the specificity was 0.71 and 0.99, respectively. The prevalence of CRC and AA was 3.0% (18/593) and 7.1% (42/593), respectively, with the highest CRC prevalence in the 66-75 age group (≥12 times; odds ratio [OR], 12.11; 95% confidence interval [CI], 4.45-32.92). CRC and AA prevalence were inversely correlated with Asian descent, physical activity, and negative fecal immunochemical test results (OR=0.43; 95% CI, 0.22-0.83; OR=0.16; 95% CI, 0.04-0.68; OR=0.5; 95% CI, 0.07-3.85, respectively).
Conclusions
Our study revealed high accuracy of CTC in diagnosing colonic neoplasms, good compliance with CTC screening, and high detection rate of CRC.

10,121 View
243 Download
1 Web of Science

Focused Review Series: Image-Enhanced Endoscopy: Update on Clinical Practice

Clinical Applications of Linked Color Imaging and Blue Laser/Light Imaging in the Screening, Diagnosis, and Treatment of Superficial Colorectal Tumors: Taku Sakamoto, Hourin Cho, Yutaka Saito; Clin Endosc 2021;54(4):488-493. Published online July 14, 2021; DOI: https://doi.org/10.5946/ce.2021.157

Abstract PDF

Considering its contribution to reducing colorectal cancer morbidity and mortality, the most important task of colonoscopy is to find all existing polyps. Moreover, the accurate detection of existing polyps determines the risk of colorectal cancer morbidity and is an important factor in deciding the appropriate surveillance program for patients. Image-enhanced endoscopy is an easy-to-use modality with improved lesion detection. Linked color imaging (LCI) and blue laser/light imaging (BLI) are useful modalities for improving colonoscopy quality. Each mode has unique optical features; therefore, their intended use differs. LCI contributes to improved polyp detection due to its brightness and high color contrast between the lesion and normal mucosa, while BLI contributes to the characterization of detected polyps by evaluating the vessel and surface patterns of detected lesions. The proper use of these observation modes allows for more efficient endoscopic diagnosis. Moreover, recent developments in artificial intelligence will soon change the clinical practice of colonoscopy and this system will provide an efficient education modality for novice endoscopists.

Citations

Citations to this article as recorded by

Randomized Trial of Hood With or Without Wing Attachment-Assisted Colonoscopy With Linked Color Imaging and Computer-Aided in Adenoma Detection
Kazuya Miyaguchi, Hisashi Matsumoto, Maiko Osawa, Yuki Shiko, Yoshikazu Tsuzuki, Rie Shiomi, Keiji Yamamoto, Yohei Kawasaki, Hiroyuki Imaeda
Endoscopy International Open.2026;[Epub] CrossRef
Improvement of Colonoscopic Image Quality Using a New LED Endoscopic System with Specialized Noise Reduction
Naohisa Yoshida, Masahiro Okada, Yoshikazu Hayashi, Reo Kobayashi, Ken Inoue, Osamu Dohi, Yoshito Itoh, Ryohei Hirose, Lucas Cardoso, Kohei Suzuki, Tomonori Yano, Hironori Yamamoto
Diagnostics.2025; 15(12): 1569. CrossRef
Classification of image-enhanced endoscopy in colon tumors
One-Zoong Kim
Clinical Endoscopy.2025; 58(3): 337. CrossRef
Texture and Color Enhanced Imaging in the Diagnosis of Colonic Neoplasia: A Systematic Review and Analysis
Ciaran Judge, David Law, Glynis Jones, Sherman Picardo, Krish Ragunath
JGH Open.2025;[Epub] CrossRef
Evaluation of the effectiveness of endoscopic diagnostics of esophagogastric junction pathology using blue light imaging (BLI)
Evgeniy O. Ilyushnikov, Dmitriy V. Sazonov, Dmitriy N. Panchenkov
Journal of Experimental and Clinical Surgery.2025; 18(4): 226. CrossRef
Endoscopic features with associated histological and molecular alterations in serrated polyps with dysplasia: Retrospective analysis of a tertiary case series
Antonello Trecca, Raffaele Borghini, Daniela Medicina, Rachele Del Sordo, Giulio Mandelli, Antonino Bella, Giuseppe Galloro, Kuang-I Fu, Vincenzo Villanacci
Digestive and Liver Disease.2024; 56(4): 687. CrossRef
Linked-color imaging with or without artificial intelligence for adenoma detection: a randomized trial
Kazuya Miyaguchi, Yoshikazu Tsuzuki, Nobutaka Hirooka, Hisashi Matsumoto, Hideki Ohgo, Hidetomo Nakamoto, Hiroyuki Imaeda
Endoscopy.2024; 56(05): 376. CrossRef
The Diagnostic Performance of Linked Color Imaging Compared to White Light Imaging in Endoscopic Diagnosis of Helicobacter pylori Infection: A Systematic Review and Meta-Analysis
Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee
Gut and Liver.2024; 18(3): 444. CrossRef
Linked color imaging improves the diagnostic accuracy of eosinophilic esophagitis
Yasuhiko Abe, Yu Sasaki, Makoto Yagi, Naoko Mizumoto, Yusuke Onozato, Takashi Kon, Masakuni Shoji, Kazuhiro Sakuta, Takayuki Sakai, Matsuki Umehara, Minami Ito, Shuhei Nakamura, Hidemoto Tsuchida, Yoshiyuki Ueno
DEN Open.2023;[Epub] CrossRef
Comparison of LED and LASER Colonoscopy About Linked Color Imaging and Blue Laser/Light Imaging of Colorectal Tumors in a Multinational Study
Naohisa Yoshida, Peter V. Draganov, Sneha John, Helmut Neumann, Rafiz Abdul Rani, Wen-Hsin Hsu, Nilesh Fernandopulle, Kewin Tien Ho Siah, Ricardo Morgenstern, Yuri Tomita, Ken Inoue, Osamu Dohi, Ryohei Hirose, Yoshito Itoh, Takaaki Murakami, Yoshikazu Ina
Digestive Diseases and Sciences.2023; 68(10): 3943. CrossRef
Classification and endoscopic diagnosis of colorectal polyps
Ji Hyun Kim, Sung Chul Park
Journal of the Korean Medical Association.2023; 66(11): 633. CrossRef
Role of linked color imaging for upper gastrointestinal disease: present and future
Sang Pyo Lee
Clinical Endoscopy.2023; 56(5): 546. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
Images of laser and light‐emitting diode colonoscopy for comparing large colorectal lesion visibility with linked color imaging and white‐light imaging
Naohisa Yoshida, Yoshikazu Hayashi, Hiroshi Kashida, Yuri Tomita, Osamu Dohi, Ken Inoue, Ryohei Hirose, Yoshito Itoh, Masahiro Okada, Shiori Yoshimoto, Toshihiro Fujinuma, Hirotsugu Sakamoto, Keijiro Sunada, Yoriaki Komeda, Ikue Sekai, Natsuki Okai, Hiron
Digestive Endoscopy.2022; 34(7): 1413. CrossRef

9,687 View
226 Download
13 Web of Science
14 Crossref

Case Report

Endoscopic Treatment of Iatrogenic Perforation of Sigmoid Diverticulum: A Case Report of Multidisciplinary Management: Giacomo Emanuele Maria Rizzo, Giuseppina Ferro, Giovanna Rizzo, Giovanni Di Carlo, Alessandro Cantone, Gaetano Giuseppe Di Vita, Carmelo Sciumè; Clin Endosc 2022;55(2):292-296. Published online June 7, 2021; DOI: https://doi.org/10.5946/ce.2021.005

Abstract PDF: Iatrogenic perforations are severe complications of gastrointestinal endoscopy; therefore, their management should be adequately planned. A 77-year-old man with a history of diverticulosis underwent a colonoscopy for anemia. During the procedure, an iatrogenic perforation occurred suddenly in the sigmoid colon, near a severe angle among the numerous diverticula. Through-the-scope clips were immediately applied to treat it and close mucosal edges. Laboratory tests showed increased levels of inflammation and infection, and although there were no complaints of abdominal pain, the patient had an extremely distended abdomen. A multidisciplinary board began management based on a conservative approach. Pneumoperitoneum was treated with computed tomography-assisted drainage. After 72 hours, his intestinal canalization and laboratory tests were normal. Though this adverse event is rare, a multidisciplinary board should be promptly gathered upon occurrence, even if the patient appears clinically stable, to consider a conservative approach and avoid surgical treatment.

6,906 View
185 Download

Original Article

Insufflation of Carbon Dioxide versus Air During Colonoscopy Among Pediatric Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials: John Alexander Lata Guacho, Diogo Turiani Hourneaux de Moura, Igor Braga Ribeiro, Bruna Furia Buzetti Hourneaux de Moura, Megui Marilia Mansilla Gallegos, Thomas McCarty, Ricardo Katsuya Toma, Eduardo Guimarães Hourneaux de Moura; Clin Endosc 2021;54(2):242-249. Published online March 25, 2021; DOI: https://doi.org/10.5946/ce.2020.275

Abstract PDF Supplementary Material

Background
/Aims: Carbon dioxide is increasingly used in insufflation during colonoscopy in adult patients; however, air insufflation remains the primary practice among pediatric gastroenterologists. This systematic review and meta-analysis aims to evaluate insufflation using CO₂ versus air in colonoscopies in pediatric patients.
Methods
Individualized search strategies were performed using MEDLINE, Cochrane Library, EMBASE, and LILACS databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Cochrane working methodology. Randomized control trials (RCTs) were selected for the present meta-analysis. Pooled proportions were calculated for outcomes including procedure time and abdominal pain immediately and 24 hours post-procedure.
Results
The initial search yielded 644 records, of which five RCTs with a total of 358 patients (CO₂: n=178 versus air: n=180) were included in the final analysis. The procedure time was not different between the CO₂ and air insufflation groups (mean difference, 10.84; 95% confidence interval [CI], -2.55 to 24.22; p=0.11). Abdominal pain immediately post-procedure was significantly lower in the CO₂ group (risk difference, -0.15; 95% CI; -0.26 to -0.03; p=0.01) while abdominal pain at 24 hours post-procedure was similar (risk difference, -0.05; 95% CI; -0.11 to 0.01; p=0.11).
Conclusions
Based on this systematic review and meta-analysis of RCT data, CO₂ insufflation reduced abdominal pain immediately following the procedure, while pain was similar at 24 hours post-procedure. These results suggest that CO₂ is a preferred insufflation technique when performing colonoscopy in pediatric patients.

Citations

Citations to this article as recorded by

Effect of carbon dioxide insufflation on the delay–attenuation relationship of mesenteric veins in contrast-enhanced CT colonography
Yoshiya Ohashi, Kohei Harada, Takeo Tanaka, Shun Hayasaka, Kizuku Ishibashi, Ryo Kasahara, Naoya Yama
Radiological Physics and Technology.2026; 19(2): 763. CrossRef
Advances and Challenges to Colonoscopy Quality
Haidar Khan, Ramya Vasireddy, Mahnoor Khan, Rashmi Advani
Gastrointestinal Endoscopy Clinics of North America.2026;[Epub] CrossRef
Preparation for Pediatric Gastrointestinal Endoscopy
Napapat Butsriphum, Songpon Getsuwan, Pornthep Tanpowpong, Chatmanee Lertudomphonwanit, Suporn Treepongkaruna
Gastroenterology Nursing.2026;[Epub] CrossRef
Gel immersion in endoscopy: Exploring potential applications
Hiroki Sato, Hidemasa Kawabata, Mikihiro Fujiya
World Journal of Gastroenterology.2025;[Epub] CrossRef
Efficacy of water infusion combined with defoamers in colonoscopy
Jian Li, Jun-Ping Chen, Chun-Han Lai, Lian Fu, Yong Ji
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Polyp of the colon and rectum (K62.1, K63.5, D37.4, D12.0, D12.1, D12.2, D12.3, D12.4, D12.5, D12.6, D12.7, D12.8), adults, children (PROJECT)
Yu. A. Shelygin, S. I. Achkasov, E. D. Fedorov, V. V. Veselov, A. A Likutov, E. G. Rybakov, I. V. Nazarov, M. Y. Agapov, N. V. Ageikina, Yu. E. Vaganov, A. V. Vasilchenko, E. V. Gorbachev, O. V. Ivinskaya, I. Yu. Korzheva, M. P. Korolev, A. G. Korotkevich
Koloproktologia.2025; 24(4): 11. CrossRef
Elevations in End‐Tidal CO2 With CO2 Use During Pediatric Endoscopy With Airway Protection
Chinenye R. Dike, Andrew Huang Pacheco, Elizabeth Lyden, David Freestone, Ojasvini Choudhry, Warren P. Bishop, Mohanad Shukry
Journal of Pediatric Gastroenterology and Nutrition.2023; 76(5): 660. CrossRef
ERCP in infants, children and adolescents – Experiences of a pediatric centre
D. Brookman-Amissah, T. Lang, O. Pech
Endoscopy.2023; 55(S 02): S308. CrossRef

12,907 View
197 Download
4 Web of Science
8 Crossref

Reviews

Current Status of Colorectal Cancer and Its Public Health Burden in Thailand: Kasenee Tiankanon, Satimai Aniwan, Rungsun Rerknimitr; Clin Endosc 2021;54(4):499-504. Published online March 15, 2021; DOI: https://doi.org/10.5946/ce.2020.245-IDEN

Abstract PDF

Colorectal cancer (CRC) accounts for approximately 10.3% of new cancer cases in Thailand and is currently the 3rd most prevalent cancer found among the Thai population. Starting in 2017, the Thai government announced the national CRC screening program as a response to this important issue. Among the 70 million people currently residing in Thailand, 14 million require screening, while there are approximately a total of 1,000 endoscopists available to perform colonoscopy. Due to the limited resources and shortage of endoscopists in Thailand, applying a population-based one-step colonoscopy program as a primary screening method is not feasible. To reduce colonoscopy workload, with the help of others, including village health volunteers, institution-based health personnel, reimbursement coders, pathologists, and patients due for CRC screening, a two-step approach of one-time fecal immunochemical test (FIT), which prioritizes and filters out subjects for colonoscopy, is chosen. Moreover, additional adjustments to the optimal FIT cutoff value and the modified Asia-Pacific Colorectal Screening risk score, including body weight, were proposed to stratify the priority of colonoscopy schedule. This article aims to give an overview of the past and current policy developmental strategies and the current status of the Thailand CRC screening program.

Citations

Citations to this article as recorded by

Mixed lesions in premalignant colorectal polyps
Toru Arano, Toshihiro Nishizawa, Hidenobu Watanabe, Mari Mizutani, Teppei Akimoto, Masaya Sano, Hirotoshi Ebinuma, Hidekazu Suzuki, Keisuke Hata, Osamu Toyoshima
Journal of Clinical Biochemistry and Nutrition.2026; 78(1): 83. CrossRef
Risk‐Based Colonoscopy Prioritization Model for Advanced Colorectal Neoplasia: Development and Validation Study
Chote Wongkanong, Thawee Ratanachu‐ek, Rusta Salaeh, Jayanton Patumanond
Journal of Gastroenterology and Hepatology.2026; 41(5): 1556. CrossRef
Relationship between the protein expression of ARID1A, ARID1B and ARID2 with the clinicopathological characteristics of colorectal cancer
Wariya Mongkolwat, Phattarapon Sonthi, Keerakarn Somsuan, Siripat Aluksanasuwan, Ratirath Samol, Natthiya Sakulsak, Sasithorn Wanna‑Udom
Biomedical Reports.2025; 23(1): 1. CrossRef
The Effect of the Ethanolic Extracts from Syzygium aromaticum and Syzygium nervosum on Antiproliferative Activity and Apoptosis in HCT116 and HT-29 Cells
Thunyatorn Yimsoo, Weerakit Taychaworaditsakul, Sunee Chansakaow, Sumet Kongkiatpaiboon, Ngampuk Tayana, Teera Chewonarin, Parirat Khonsung, Seewaboon Sireeratawong
International Journal of Molecular Sciences.2025; 26(14): 6826. CrossRef
Efficacy of additional tissue sections for diminutive colorectal adenomas pathologically diagnosed as normal mucosa: a retrospective, cross-sectional study in Japan
Tsuyoshi Ishii, Toshihiro Nishizawa, Hidenobu Watanabe, Masaya Sano, Ai Fujimoto, Yoshiyuki Takahashi, Ryo Shimizu, Hirotoshi Ebinuma, Takahisa Matsuda, Osamu Toyoshima
Clinical Endoscopy.2025; 58(4): 577. CrossRef
Colonic neoplasm detection in patients with Streptococcus gallolyticus septicaemia versus average-risk individuals: a retrospective matched cohort study from a tertiary care center in Thailand
Pongnarin Nawalerspunya, Tanawat Pattarapuntakul, Thanawin Wong, Pimsiri Sripongpun, Swangjit Saejaow, Tanawat Jongraksak
BMJ Open.2025; 15(10): e103612. CrossRef
Impacts of polymorphisms in drug-metabolizing enzyme and transporter genes on irinotecan toxicity and efficacy in Thai colorectal cancer patients
Natthakul Akarapredee, Chalirmporn Atasilp, Chonlaphat Sukasem, Pimonpan Jinda, Rattanaporn Sukprasong, Jiraporn Jensuriyarkun, Soravit Wongjitjanyong, Patompong Satapornpong, Natchaya Vanwong, Germana Bancone
PLOS One.2025; 20(12): e0338442. CrossRef
Integrated Care Model by the Village Health Volunteers to Prevent and Slow down Progression of Chronic Kidney Disease in a Rural Community, Thailand
Ampornpan Theeranut, Nonglak Methakanjanasak, Sunee Lertsinudom, Pattama Surit, Nichanun Panyaek, Saisamon Leeladapattarakul, Peangtikumporn Nilpetch, Pattapong Kessomboon, Chalongchai Chalermwat, Watcharapong Rintara, Wudipong Khongtong, Pawich Paktipat,
Journal of Primary Care & Community Health.2024;[Epub] CrossRef
Cost-Effectiveness of Increasing Access to Colorectal Cancer Diagnosis: Analysis From Thailand
Peeradon Wongseree, Zeynep Hasgul, Mohammad S. Jalali
Value in Health Regional Issues.2024; 43: 101010. CrossRef
Dynamics of colorectal cancer screening in low and middle-income countries: A modeling analysis from Thailand
Peeradon Wongseree, Zeynep Hasgul, Borwornsom Leerapan, Cherdsak Iramaneerat, Pochamana Phisalprapa, Mohammad S. Jalali
Preventive Medicine.2023; 175: 107694. CrossRef
An Assessment of Physicians’ Recommendations for Colorectal Cancer Screening and International Guidelines Awareness and Adherence: Results From a Thai National Survey
Nonthalee Pausawasdi, Pongkamon Tongpong, Tanawat Geeratragool, Phunchai Charatcharoenwitthaya
Frontiers in Medicine.2022;[Epub] CrossRef
Cytotoxic effect of metformin on butyrate-resistant PMF-K014 colorectal cancer spheroid cells
Kesara Nittayaboon, Kittinun Leetanaporn, Surasak Sangkhathat, Sittirak Roytrakul, Raphatphorn Navakanitworakul
Biomedicine & Pharmacotherapy.2022; 151: 113214. CrossRef

11,533 View
244 Download
14 Web of Science
12 Crossref

Artificial Intelligence in Lower Gastrointestinal Endoscopy: The Current Status and Future Perspective: Sebastian Manuel Milluzzo, Paola Cesaro, Leonardo Minelli Grazioli, Nicola Olivari, Cristiano Spada; Clin Endosc 2021;54(3):329-339. Published online January 13, 2021; DOI: https://doi.org/10.5946/ce.2020.082

Abstract PDF

The present manuscript aims to review the history, recent advances, evidence, and challenges of artificial intelligence (AI) in colonoscopy. Although it is mainly focused on polyp detection and characterization, it also considers other potential applications (i.e., inflammatory bowel disease) and future perspectives. Some of the most recent algorithms show promising results that are similar to human expert performance. The integration of AI in routine clinical practice will be challenging, with significant issues to overcome (i.e., regulatory, reimbursement). Medico-legal issues will also need to be addressed. With the exception of an AI system that is already available in selected countries (GI Genius; Medtronic, Minneapolis, MN, USA), the majority of the technology is still in its infancy and has not yet been proven to reach a sufficient diagnostic performance to be adopted in the clinical practice. However, larger players will enter the arena of AI in the next few months.

Citations

Citations to this article as recorded by

Automatic metrics from a new colon phantom can ensure basic competency in colonoscopy
Anishan Vamadevan, Linea Mikkeline Lissner, Kristoffer Mazanti Cold, Lars Konge, Mustafa Bulut
Surgical Endoscopy.2026; 40(3): 2650. CrossRef
Re-investigation rate following colon capsule endoscopy stratified by faecal haemoglobin concentration in a screening population
Ulrik Deding, Benedicte Schelde-Olesen, Thomas Bjørsum-Meyer, Lasse Kaalby, Issam Al-Najami, Anastasios Koulaouzidis, Morten Kobaek-Larsen, Gunnar Baatrup
Therapeutic Advances in Gastroenterology.2026;[Epub] CrossRef
Improvement in adenoma detection rate by artificial intelligence-assisted colonoscopy: Multicenter quasi-randomized controlled trial
Ronja Maria Birgitta Lagström, Karoline Bendix Bräuner, Julia Bielik, Andreas Weinberger Rosen, Julie Gräs Crone, Ismail Gögenur, Mustafa Bulut
Endoscopy International Open.2025;[Epub] CrossRef
GI Genius increases small and right-sided adenoma and sessile serrated lesion detection rate when used with EndoCuff in a real-world setting: a retrospective United States study
Jeong Hoon Kim, Jade Wang, Colton Pence, Patrick Magahis, Enad Dawod, Felice Schnoll-Sussman, Reem Z. Sharaiha, David Wan
Clinical Endoscopy.2025; 58(3): 438. CrossRef
Artificial intelligence in colonoscopy: Enhancing quality indicators for optimal patient outcomes
Konstantina Dimopoulou, Marianna Spinou, Alexandros Ioannou, Eleni Nakou, Petros Zormpas, George Tribonias
World Journal of Gastroenterology.2025;[Epub] CrossRef
Innovations in gastroenterology
N. V. Baryshnikova, N. A. Shchapkov
Medical alphabet.2025; (25): 8. CrossRef
“AI for the new GI”: What role does artificial intelligence have in early colonoscopy training?
Lawrence Hookey
Gastrointestinal Endoscopy.2024; 99(1): 100. CrossRef
Colonoscopy Quality, Innovation, and the Assessment of New Technology
Sanjay R.V. Gadi, Sriya S. Muralidharan, Jeremy R. Glissen Brown
Techniques and Innovations in Gastrointestinal Endoscopy.2024; 26(2): 177. CrossRef
GI genius endoscopy module: a clinical profile
Alberto Savino, Emanuele Rondonotti, Simone Rocchetto, Alessandra Piagnani, Niccolò Bina, Pasquale Di Domenico, Francesco Segatta, Franco Radaelli
Expert Review of Medical Devices.2024; 21(5): 359. CrossRef
The Role of Artificial Intelligence in the Diagnosis of Melanoma
Sadhana Kalidindi
Cureus.2024;[Epub] CrossRef
Computer-Aided Gastrointestinal Disease Analysis Based on Artificial Intelligence Method
Rui Su, Bingmei Liu
International Journal of Cognitive Informatics and Natural Intelligence.2024; 19(1): 1. CrossRef
Colon capsule endoscopy polyp detection rate vs colonoscopy polyp detection rate: Systematic review and meta-analysis
Marc Woods, Jonathan Soldera
World Journal of Meta-Analysis.2024;[Epub] CrossRef
Application of artificial intelligence in gastrointestinal endoscopy in Vietnam: a narrative review
Hang Viet Dao, Binh Phuc Nguyen, Tung Thanh Nguyen, Hoa Ngoc Lam, Trang Thi Huyen Nguyen, Thao Thi Dang, Long Bao Hoang, Hung Quang Le, Long Van Dao
Therapeutic Advances in Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Advancing cancer care with artificial intelligence: early detection initiatives
Daniyah Zehra Hussain, Amna Zaheer, Ahmad Akhtar
The Evidence.2024;[Epub] CrossRef
Real-time artificial intelligence (AI)-aided endoscopy improves adenoma detection rates even in experienced endoscopists: a cohort study in Singapore
Frederick H. Koh, Jasmine Ladlad, Fung-Joon Foo, Winson J. Tan, Sharmini S. Sivarajah, Leonard M. L. Ho, Jia-Lin Ng, Frederick H. Koh, Cheryl Chong, Darius Aw, Juinn-Haur Kam, Alvin Y. H. Tan, Choon-Chieh Tan, Baldwin P. M. Yeung, Wai-Keong Wong, Bin-Chet
Surgical Endoscopy.2023; 37(1): 165. CrossRef
Systematic meta-analysis of computer-aided detection to detect early esophageal cancer using hyperspectral imaging
Wei-Chih Liao, Arvind Mukundan, Cleorita Sadiaza, Yu-Ming Tsao, Chien-Wei Huang, Hsiang-Chen Wang
Biomedical Optics Express.2023; 14(8): 4383. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
Accuracy of polyp characterization by artificial intelligence and endoscopists: a prospective, non-randomized study in a tertiary endoscopy center
Sebastian Baumer, Kilian Streicher, Saleh A. Alqahtani, Dominic Brookman-Amissah, Monika Brunner, Christoph Federle, Klaus Muehlenberg, Lukas Pfeifer, Andrea Salzberger, Wolfgang Schorr, Jozef Zustin, Oliver Pech
Endoscopy International Open.2023; 11(09): E818. CrossRef
AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef
Artificial Intelligence in Colonoscopic Polyp Detection and Characterization: Merging Computer Technology and Endoscopic Skill for Better Patient Care
Uday C. Ghoshal, Saikat Chakrabarti, Mahesh K. Goenka
Journal of Digestive Endoscopy.2023; 14(04): 239. CrossRef
Diagnostic accuracy of a novel artificial intelligence system for adenoma detection in daily practice: a prospective nonrandomized comparative study
Carolin Zippelius, Saleh A. Alqahtani, Jörg Schedel, Dominic Brookman-Amissah, Klaus Muehlenberg, Christoph Federle, Andrea Salzberger, Wolfgang Schorr, Oliver Pech
Endoscopy.2022; 54(05): 465. CrossRef
Development and validation of a deep learning-based algorithm for colonoscopy quality assessment
Yuan-Yen Chang, Pai-Chi Li, Ruey-Feng Chang, Yu-Yao Chang, Siou-Ping Huang, Yang-Yuan Chen, Wen-Yen Chang, Hsu-Heng Yen
Surgical Endoscopy.2022; 36(9): 6446. CrossRef
Innovation in Gastroenterology—Can We Do Better?
Eyal Klang, Shelly Soffer, Abraham Tsur, Eyal Shachar, Adi Lahat
Biomimetics.2022; 7(1): 33. CrossRef
Hybrid and Deep Learning Approach for Early Diagnosis of Lower Gastrointestinal Diseases
Suliman Mohamed Fati, Ebrahim Mohammed Senan, Ahmad Taher Azar
Sensors.2022; 22(11): 4079. CrossRef
No-Code Platform-Based Deep-Learning Models for Prediction of Colorectal Polyp Histology from White-Light Endoscopy Images: Development and Performance Verification
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Seung In Seo, Young Joo Yang, Gwang Ho Baik, Jong Wook Kim
Journal of Personalized Medicine.2022; 12(6): 963. CrossRef
Impact of the Volume and Distribution of Training Datasets in the Development of Deep-Learning Models for the Diagnosis of Colorectal Polyps in Endoscopy Images
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Young Joo Yang, Gwang Ho Baik
Journal of Personalized Medicine.2022; 12(9): 1361. CrossRef
Preparation of image databases for artificial intelligence algorithm development in gastrointestinal endoscopy
Chang Bong Yang, Sang Hoon Kim, Yun Jeong Lim
Clinical Endoscopy.2022; 55(5): 594. CrossRef
Artificial Intelligence-Based Colorectal Polyp Histology Prediction: High Accuracy in Larger Polyps
Naoki Muguruma, Tetsuji Takayama
Clinical Endoscopy.2022; 55(1): 45. CrossRef
Artificial Intelligence and Advanced Melanoma: Treatment Management Implications
Antonino Guerrisi, Italia Falcone, Fabio Valenti, Marco Rao, Enzo Gallo, Sara Ungania, Maria Teresa Maccallini, Maurizio Fanciulli, Pasquale Frascione, Aldo Morrone, Mauro Caterino
Cells.2022; 11(24): 3965. CrossRef
Clinical feasibility of panintestinal (or panenteric) capsule endoscopy: a systematic review
Pablo Cortegoso Valdivia, Alfonso Elosua, Charles Houdeville, Marco Pennazio, Ignacio Fernández-Urién, Xavier Dray, Ervin Toth, Rami Eliakim, Anastasios Koulaouzidis
European Journal of Gastroenterology & Hepatology.2021; 33(7): 949. CrossRef
Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis
Wonshik Kim, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo, Jong-Jae Park
Diagnostics.2021; 11(11): 2123. CrossRef

10,314 View
294 Download
27 Web of Science
31 Crossref

Original Article

Comparative Study of Narrow-Band Imaging and i-scan for Predicting the Histology of Intermediate-to-Large Colorectal Polyps: A Prospective, Randomized Pilot Study: Joon Seop Lee, Seong Woo Jeon, Yong Hwan Kwon; Clin Endosc 2021;54(6):881-887. Published online January 6, 2021; DOI: https://doi.org/10.5946/ce.2020.257

Abstract PDF

Background
/Aims: To date, no reports have compared the diagnostic efficacy of narrow-band imaging (NBI) and i-scan for the histologic prediction of intermediate-to-large colorectal polyps. We aimed to compare the diagnostic accuracy of NBI and i-scan in predicting histology, and their inter-/intra-observer agreement.
Methods
We performed a prospective, randomized study that included 66 patients (NBI, n=33 vs. i-scan, n=33) with colorectal polyps (size >10 mm but <50 mm) who underwent colonoscopic resection. During the procedure, three endoscopists documented their prediction using the Japan NBI Expert Team (JNET) classification. Two months after study completion, the endoscopists reviewed still images and video clips for analysis.
Results
The overall diagnostic accuracies in the NBI and i-scan groups were 73.7% (73/99) and 75.8% (75/99), respectively, and there was no statistical significance between the two groups (p=0.744). The JNET classification as applied to NBI and i-scan showed substantial inter-observer agreement (NBI κ-value 0.612, p=0.001 vs. i-scan κ-value 0.662, p=0.002). Additionally, the κ-values of intra-observer agreement were in the range of 0.385–0.660 with NBI and 0.364–0.741 with i-scan.
Conclusions
NBI and i-scan have similar diagnostic accuracies for the histologic prediction of intermediate-to-large colorectal polyps. Furthermore, the inter-/intra-observer agreement was acceptable for both modalities when the JNET classification was applied.

Citations

Citations to this article as recorded by

Compatibility of endoscopic examination using i-scan technology with histopathology results in laryngeal carcinoma: prospective observational study
Gracia Cintia Massie, Agung Dinasti Permana, Shinta Fitri Boesoirie, Lina Lasminingrum, Melati Sudiro, Yussy Afriani Dewi
PeerJ.2025; 13: e19552. CrossRef
Advances in endoscopic techniques for early detection and treatment of gastrointestinal cancers: A systematic review
Mehak Gul Mastoi, Ali Karim, Fnu Jaslok, Muhammad Bari Hassan, Fnu Neelam, Fnu Prity, Hina Kumari, Sadia Manan, Sadia Siddique, Sana Danish, Sitara Jabeen, Aniket Tara, Ali Umair, Kirshan Lal, Fnu Arti, Abida Parveen
Medicine.2025; 104(42): e45315. CrossRef
Ultra-minimally invasive endoscopic techniques and colorectal diseases: Current status and its future
Nalini Kanta Ghosh, Ashok Kumar
Artificial Intelligence in Gastrointestinal Endoscopy.2024;[Epub] CrossRef
The Utility of Narrow-Band Imaging International Colorectal Endoscopic Classification in Predicting the Histologies of Diminutive Colorectal Polyps Using I-Scan Optical Enhancement: A Prospective Study
Yeo Wool Kang, Jong Hoon Lee, Jong Yoon Lee
Diagnostics.2023; 13(16): 2720. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
Classification and endoscopic diagnosis of colorectal polyps
Ji Hyun Kim, Sung Chul Park
Journal of the Korean Medical Association.2023; 66(11): 633. CrossRef
Usefulness of optical enhancement endoscopy combined with magnification to improve detection of intestinal metaplasia in the stomach
Sergio Sobrino-Cossío, Oscar Teramoto-Matsubara, Fabian Emura, Raúl Araya, Vítor Arantes, Elymir S. Galvis-García, Marisi Meza-Caballero, Blanca Sinahi García-Aguilar, Arturo Reding-Bernal, Noriya Uedo
Endoscopy International Open.2022; 10(04): E441. CrossRef
Interventions to improve adenoma detection rates for colonoscopy
Aasma Shaukat, Anne Tuskey, Vijaya L. Rao, Jason A. Dominitz, M. Hassan Murad, Rajesh N. Keswani, Fateh Bazerbachi, Lukejohn W. Day
Gastrointestinal Endoscopy.2022; 96(2): 171. CrossRef
A modified fujinon intelligent color enhancement (FICE) in the diagnostics of superficial epithelial neoplasms of the colon
V. A. Duvanskiy, A. V. Belkov
Experimental and Clinical Gastroenterology.2022; (5): 154. CrossRef
Mucosal imaging in colon polyps: New advances and what the future may hold
Edward John Young, Arvinf Rajandran, Hamish Lachlan Philpott, Dharshan Sathananthan, Sophie Fenella Hoile, Rajvinder Singh
World Journal of Gastroenterology.2022; 28(47): 6632. CrossRef
Commentary on “Comparative Study of Narrow-Band Imaging and i-scan for Predicting the Histology of Intermediate-to-Large Colorectal Polyps: A Prospective, Randomized Pilot Study”
Yunho Jung, Masayuki Kato
Clinical Endoscopy.2021; 54(6): 781. CrossRef

10,133 View
204 Download
10 Web of Science
11 Crossref

Case Report

Fatal Necrotizing Fasciitis Following Uncomplicated Colonoscopic Polypectomy: A Case Report: Min Kyu Chae, Sang Youn Shin, Min Seob Kwak, Jin Young Yoon, Ha Il Kim, Jae Myung Cha; Clin Endosc 2021;54(2):280-284. Published online December 11, 2020; DOI: https://doi.org/10.5946/ce.2020.117

Abstract PDF: Necrotizing fasciitis (NF) is a life-threatening infection that can be caused by various procedures or surgery and may develop in healthy elderly patients. Here, we report a case of a 66-year-old man with diabetes mellitus who underwent colonoscopic polypectomy, without complications. However, he visited the emergency department 24 hours after the procedure complaining of abdominal pain. Abdominopelvic computed tomography revealed multiple air bubbles in the right lateral abdominal muscles. After a diagnosis of NF was made, immediate surgical debridement was performed. However, despite three sessions of extensive surgical debridement and best supportive care at the intensive care unit, the patient died because of sepsis and NF-associated multiple-organ failure. In conclusion, physicians should pay special attention to the possibility of NF if a patient with risk factors for NF develops sepsis after colonoscopic polypectomy.

6,107 View
127 Download

First
Prev
Page of 6
Next
Last

Search