Clinical Endoscopy

Systematic Review and Meta-analysises

Safety and effectiveness of endoscopic ultrasound-guided coil plus glue vs. direct endoscopic glue injection for the treatment of gastric varices: a systematic review and meta-analysis: Zahid Ijaz Tarar, Mustafa Gandhi, Umer Farooq, Gopala K. Konduri, Ahmad Zain, Zohaib Ahmed, Baltej Singh, Ryan J. Law, Nirav Thosani; Clin Endosc 2026;59(5):741-753. Published online September 28, 2026; DOI: https://doi.org/10.5946/ce.2025.251

Graphical Abstract Abstract PDF Supplementary Material: Background
/Aims: Although endoscopic glue injection is the conventional first-line treatment for gastric variceal (GV) bleeding, a large body of evidence supports the safety and effectiveness of endoscopic ultrasound (EUS)-guided coil and glue injections. We compared the safety and efficacy of these two modalities.
Methods
A random-effects model was used for the pooled estimates. The outcomes of interest were the odds of technical success, GV obliteration, adverse events, rebleeding, reintervention, and pulmonary embolization (PE).
Results
Eight studies involving 659 patients (EUS-guided coil+glue, n=200; endoscopic glue, n=459) were included in the meta-analysis. The rebleeding (odds ratio [OR], 0.28, 95% confidence interval [CI], 0.16–0.51; I2=0%) and reintervention (OR, 0.28; 95% CI, 0.15–0.52; I2=0%) rates were significantly lower in the EUS-guided coil+glue. EUS-guided coil+glue group had higher rates (OR, 4.56; 95% CI, 2.04 –10.19; I2=30%) of GV obliteration after the first session. No difference in the odds of technical success (OR, 2.03; 95% CI, 0.50–8.22; I2=0%), adverse events (OR, 1.19; 95% CI, 0.44–3.20; I2=45%), abdominal pain (OR, 1.17; 95% CI, 0.36–3.82; I2=44%) fever (OR, 1.09; 95% CI, 0.41–2.92; I2=0%), PE (OR, 0.52; 95% CI, 0.19–1.47; I2=0%) and all-cause mortality (OR, 0.67; 95% CI, 0.32–1.40; I2=0%) was identified.
Conclusions
EUS-guided coil and glue injections are safe and effective for the treatment of gastric varices.

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Hybrid endoscopic submucosal dissection enhances efficiency with comparable curative outcomes: a Bayesian meta-analysis, systematic review, and Monte Carlo simulation of randomized controlled trials: Ashesh Das, Arpitha Sirichandana Baggu, Param Darpan Sheth, Nihal Reddy Bandi, Chandana Priya Digumurthy, Urvashi Bharia, Shah Kavya Hiteshkumar, Krishna Sai Kiran Sakalabaktula, Shankar Biswas, Riyakumari Patel, Meenakshi Reddy Yathindra, Venkata Dileep Kumar Veldi; Clin Endosc 2026;59(5):754-764. Published online September 22, 2026; DOI: https://doi.org/10.5946/ce.2025.439

Graphical Abstract Abstract PDF Supplementary Material: Background
/Aims: Gastrointestinal (GI) cancers accounted for 3.24 million deaths worldwide in 2022. Endoscopic submucosal dissection (ESD) enables en bloc resection of early neoplasms but is time-intensive and technically challenging. Hybrid ESD (H-ESD), which combines dissection with snare polypectomy, may improve efficiency while maintaining efficacy.This Bayesian meta-analysis of randomized controlled trials (RCTs) compares the safety and efficacy of H-ESD with conventional ESD (C-ESD).
Methods
We searched the PubMed, Embase, Cochrane, Scopus databases for RCTs comparing hybrid and C-ESD for superficial GI neoplasms. Bayesian modeling in Just Another Gibbs Sampler used normal-normal hierarchies for procedure time and logRR for binary outcomes with weakly informative priors. Frequentist analyses were performed using Der-Simonian-Laird τ². Heterogeneity was assessed using I²/τ².
Results
H-ESD showed comparable en bloc (RR, 0.97; 95% [CrI], 0.92–1.03; I²=22.8%) and R0 resection rates (RR, 0.97; 95% CrI, 0.90–1.04; I²=0%). Procedure time decreased significantly with H-ESD (MD, –18.05; 95% CrI, –27.77 to –8.33 minutes; I²=66.5%). Adverse events (RR, 1.08; 95% CrI, 0.44–2.63) and perforations (RR, 1.05; 95% CrI, 0.34–3.19) were similar between the two procedures.
Conclusions
H-ESD matches C-ESD in curative resection while reducing the procedure time, offering a safer and more efficient alternative. Larger RCTs are needed to confirm the long-term benefits.

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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.

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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

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Systematic Review and Meta-analysises

Comparative efficacy and safety of supine versus prone positioning in endoscopic retrograde cholangiopancreatography: a systematic review and meta-analysis: Fariha Hasan, Muhammad Shahzil, Ayesha Liaquat, Taha Bin Arif, Muhammad Yafaa Naveed Chaudhary, Eugene Annor, Dushyant Singh Dahiya, Jay Patel, Rohini Maddigunta, Avneet Singh, Alexander Garcia, Babu P. Mohan, Rachel Frank, Adib Chaaya; Clin Endosc 2025;58(6):843-853. Published online August 26, 2025; DOI: https://doi.org/10.5946/ce.2025.072

Graphical Abstract Abstract PDF Supplementary Material

Background
/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is conventionally performed in the prone position (PP). Recent studies have shown that the supine position (SP) is an effective alternative, with comparable success rates. We conducted a meta-analysis to directly compare the safety and efficacy of the two ERCP positions.
Methods
In line with Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review was performed through a comprehensive search of PubMed, Embase, Web of Science, and the Cochrane Library. Statistical analyses were performed using RevMan, with results considered significant at p<0.05 and reported as odds ratios (ORs) and mean differences (MDs).
Results
Eleven studies (24,285 patients) were included in the final analysis. Procedural success was significantly higher in the PP (OR, 0.52; 95% confidence interval [CI], 0.36–0.75; p<0.0004) than the SP. However, no significant difference was observed in procedure times (MD, 0.22; 95% CI, –7.07 to 7.50; p=0.95), number of cardiopulmonary complications (OR, 1.08; 95% CI, 0.47–2.48; p=0.86), or post-ERCP pancreatitis (OR, 1.12; 95% CI, 0.52–2.42; p=0.31) between the two groups.
Conclusions
The PP demonstrates superior ERCP success compared to the SP, without prolonging procedure time or increasing the risk of adverse events. However, given the comparable procedure times, incidence of adverse events, and increased comfort for both patients and anesthesiologists, the SP may be a suitable alternative for a select group of patients in whom the PP is not feasible, such as those with morbid obesity or recent abdominal surgery.

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Sedation Safety in Advanced Endoscopy: A Comparative Analysis of ERCP and EUS Procedures
Ali Ümit Eşbah, Serkan Torun
Sağlık Bilimlerinde Değer.2026; 16(3): 520. CrossRef

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Efficacy of endoscopic vacuum therapy in esophageal luminal defects: a systematic review and meta-analysis: Ishaan Vohra, Harishankar Gopakumar, Neil R. Sharma, Srinivas R. Puli; Clin Endosc 2025;58(1):53-62. Published online October 10, 2024; DOI: https://doi.org/10.5946/ce.2023.282

Graphical Abstract Abstract PDF

Background
/Aims: Endoscopic vacuum-assisted closure (EVAC) is a novel technique used to repair esophageal perforation and leaks. Varying data have been reported on the overall success rate of EVAC. We aimed to conduct a meta-analysis of the available data on the clinical success rate of EVAC.
Methods
Electronic databases were searched for publications addressing the efficacy of EVAC in esophageal luminal defects. Pooling was conducted using both fixed and random-effects models. The overall clinical success of EVAC therapy was considered the primary outcome, whereas, overall complication rates, need for adjunct therapy, and mortality were considered secondary outcomes.
Results
In total, 366 patients were included in the study. On pooled analysis, the mean age was 66 years with 68.32% of patients being men. Overall pooled clinical success rate of EVAC therapy was 87.95%. Upon subgroup analysis, the pooled clinical success rate of postsurgical anastomotic leak and transmural esophageal perforation were found to be 86.57% and 88.89%, respectively. The all-cause hospital mortality was 14% and 4.2% in patients with esophageal perforation and EVAC, respectively.
Conclusions
This study demonstrates that EVAC therapy has a high overall clinical success rate, with low mortality. EVAC therapy seems to be a promising procedure with excellent outcomes in patients with luminal esophageal defects.

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Application of endoscopic vacuum-assisted closure therapy for oesophageal perforation: first case report in East Africa
Abdullahi Ahmed Ahmed, Abdirahman Ahmed Omar Alasso, Ismail Gedi Ibrahim, Nasteho Mohamed Sheikh Omar
Journal of Cardiothoracic Surgery.2026;[Epub] CrossRef
Endoscopic vacuum therapy for gastrointestinal transmural defects: clinical outcomes and treatment implications: a retrospective study from Korea
A Reum Choe, Ki-Nam Shim, Ju-Ran Byeon, Yehyun Park, Eun Mi Song, Chung Hyun Tae, Sung-Ae Jung
Ewha Medical Journal.2026; 49(1): e4. CrossRef
The 2025 top 10 list of endoscopy topics in medical publishing: an annual review by the American Society for Gastrointestinal Endoscopy Editorial Board
Melissa Martinez, Lara Dakhoul, Mahesh Kumar Goenka, Victoria Gómez, Lyndon V. Hernandez, Dennis Jensen, Inessa Khaykis, Luis F. Lara, Micheal Tadros, Edward Villa, John R. Saltzman
Gastrointestinal Endoscopy.2026; 103(5): 860. CrossRef
Interventional Endoscopy for the Management of Post-Surgical Leaks and Fistulas: A Scoping Review
Tommaso Pessarelli, Irene Maria Bambina Bergna, Cinzia Boemo, Alberta De Monti, Marta La Milia, Cristina Marfinati Hervoso, Michela Pagliarulo, Alessandra Piagnani, Mauro Zago, Arnaldo Amato
Journal of Clinical Medicine.2026; 15(6): 2291. CrossRef
Recurrent Cervical Esophageal Fistula and Retroesophageal Abscess Following Surgical Management of Zenker’s Diverticulum
Bogdan Mihnea Ciuntu, Andreea Ludusanu, Mara Teodora Zara, Mihaela Corlade-Andrei, Adelina Tanevski, Cristinel Ionel Stan, Dragos Andrei Chiran, Dan Vintila, Dan Andronic, Gheorghe Balan
Journal of Clinical Medicine.2026; 15(7): 2777. CrossRef
Negative Pressure - Positive Outcome: Endoscopic Vacuum Therapy in Failed Primary Surgical Repair of Boerhaave Syndrome
Arulprakash Sarangapani, Tarun J. George
Gastroenterology, Hepatology and Endoscopy Practice.2026; 6(2): 61. CrossRef
Upper Esophageal Perforation with Cervico-Mediastinal Extension Successfully Treated with Endoluminal Vacuum Therapy: A Case Report Highlighting Inflammatory Marker Dynamics
Bogdan Mihnea Ciuntu, Edwina-Elena Viciriuc, Andreea Ludusanu, Adelina Tanevski, Mihaela Corlade-Andrei, Sorin Nicolae Peiu, Raluca Alina Dragomir, Dan Vintila, Cristinel Ionel Stan, Gheorghe Balan
Life.2026; 16(4): 639. CrossRef
An Adaptive Method of Combined Stenting and Negative Pressure Therapy for Anastomotic Leakage After Upper Gastrointestinal Surgery
András Herczeg, Stephan Bennemann, Ákos Balázs, Veronika Papp, Attila Szijártó, Tamás Vass
Techniques and Innovations in Gastrointestinal Endoscopy.2026; 28(3): 250977. CrossRef
Indigenous endoscopic vacuum-assisted closure therapy for esophageal leaks: A novel technique
Parvesh Kumar Jain, Nithin Kaidabettu Ramesh, Anand Kumar Raghavendran
Indian Journal of Gastroenterology.2026;[Epub] CrossRef
Endoscopic Vacuum Therapy: When and How to Use It?
Nuno Gonçalves, Inês Marques de Sá
GE - Portuguese Journal of Gastroenterology.2026; 33(1): 499. CrossRef
Early‐Stage Esophago‐Mediastinal Fistula After Atrial Fibrillation Radiofrequency Ablation Successfully Treated With Endoscopic Vacuum Therapy
Rodrigo Melo Kulchetscki, Bruno da Costa Martins, Alberto Pereira Ferraz, Luan Vieira Rodrigues, Gabrieli Melissa Oissa, Muhieddine Omar Chokr, Carina Abgail Hardy, Esteban Wisnivesky Rocca Rivarola, Cristiano Faria Pisani, Maurício Scanavacca
Journal of Cardiovascular Electrophysiology.2026; 37(9): 2147. CrossRef
Endoscopic vacuum-assisted closure for pediatric esophageal perforations: a systematic review and individual patient data meta-analysis
Lucas Monteiro Delgado, Ashwin Pimpalwar
Pediatric Surgery International.2026;[Epub] CrossRef
Oesophageal cancer
Robert C Walker, James A Gossage
Surgery (Oxford).2026; 44(9): 622. CrossRef
FAILURE OF THE OESOPHAGOGASTRIC ANASTOMOSIS FOLLOWING MINIMALLY INVASIVE OESOPHAGECTOMY FOR CICATRICIAL OESOPHAGEAL STRICTURES
B. Toktogaziev
Euroasian Health Journal.2026; 18(2): 145. CrossRef
EVT-Inspired Simplified Negative-Pressure Nasoesophageal Drainage for Cervical Abscess Secondary to Esophageal Perforation
Lisha Yi, Linquan Zheng, Zelong Huang, Yuling Yang
American Journal of Case Reports.2026;[Epub] CrossRef
Advanced Endoscopic Management of a Full-Thickness Esophageal Perforation From Food Impaction: A Case of Successful Stent-Assisted Healing
Usman Bin Hameed, Mujtaba Moazzam, Joel Karsten, Fady Banno, Aleena Sharif
Cureus.2025;[Epub] CrossRef
Endoscopic Vacuum-Assisted Closure for Radiation-Induced Laryngotracheoesophageal Fistula
Mohammed F. Alateeq, Sang-Wook Park, Ji Yong Ahn, Yoon Se Lee
Journal of Craniofacial Surgery.2025; 36(7): e945. CrossRef
Esophageal Stenting and Endoscopic Vacuum Therapy for Esophageal Defects: A Systematic Review and Meta-Analysis
Muhammad Saqib, Muhammad Iftikhar, Khaqan Ahmed, Humna Shahid, Shehr I Yar Khan, Muhammad Aamir Iqbal, Hassan Mumtaz
ASIDE Internal Medicine.2025; 2(1): 23. CrossRef
Supportive and endoscopic therapies for acute oesophageal necrosis: a potpourri of options
Lefika Bathobakae, Rammy Bashir, Jorge L Lopez Cuello, Heba Farhan, Nischal Sharma, Jessica Escobar, Praneeth Bandaru, Yana Cavanagh, Jideofor Aniukwu
Frontline Gastroenterology.2025; : flgastro-2025-103131. CrossRef
Endoscopic Vacuum Therapy: A Boon for the Patients with Post-surgical Anastomotic Site Leaks
Aditya Kale, Sukanya Thakur, Vaneet Jearth
Journal of Digestive Endoscopy.2025; 16(03): 174. CrossRef
Esophageal stenting and endoscopic vacuum therapy for esophageal defects: a systematic review and meta-analysis of observational studies
Muhammad Saqib, Muhammad Iftikhar, Khaqan Ahmed, Humna Shahid, I Shehr, Yar Khan, Muhammad Aamir Iqbal, Hassan Mumtaz
Annals of Medicine & Surgery.2025; 87(9): 5963. CrossRef
Endoscopic vacuum therapy for esophageal transmural defects
Ji Hyun Kim, Sung Chul Park
Journal of Innovative Medical Technology.2025; 3(2): 45. CrossRef
Endoscopic management for gastrointestinal leaks, perforations, and fistulae: Technical tips and outcomes
Chhagan L Birda, Jahnvi Dhar, Naveen Kumar, Shubhra Mishra, Giuseppe Dell'Anna, Cherring Tandup, Satish S Nagaraj, Stefano F Crinò, Vikramjit Mitra, Zaheer Nabi, Jayanta Samanta
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef

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Systematic Review and Meta-Analysis

Outcomes of thin versus thick-wire snares for cold snare polypectomy: a systematic review and meta-analysis: Suprabhat Giri, Vaneet Jearth, Harish Darak, Sridhar Sundaram; Clin Endosc 2022;55(6):742-750. Published online November 9, 2022; DOI: https://doi.org/10.5946/ce.2022.141

Abstract PDF Supplementary Material

Background
/Aims: Cold snare polypectomy (CSP) is commonly used for the resection of colorectal polyps ≤10 mm. Data regarding the influence of snare type on CSP effectiveness are conflicting. Hence, this meta-analysis aimed to compare the outcomes and safety of thin- and thick-wire snares for CSP.
Methods
A comprehensive search of the literature published between 2000 and 2021 was performed of various databases for comparative studies evaluating the outcomes of thin- versus thick-wire snares for CSP.
Results
Five studies with data on 1,425 polyps were included in the analysis. The thick-wire snare was comparable to the thin-wire snare with respect to complete histological resection (risk ratio [RR], 1.03; 95% confidence interval [CI], 0.97–1.09), overall bleeding (RR, 0.98; 95% CI, 0.40–2.40), polyp retrieval (RR, 1.01; 95% CI, 0.97–1.04), and involvement of submucosa in the resection specimen (RR, 1.28; 95% CI, 0.72–2.28). There was no publication bias and a small study effect, and the relative effects remained the same in the sensitivity analysis.
Conclusions
CSP using a thin-wire snare has no additional benefit over thick-wire snares in small colorectal polyps. Factors other than snare design may play a role in improving CSP outcomes.

Citations

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High‐Performance Dedicated Snares with Tip Attachments can Overcome Current Disadvantages in Cold Snare Polypectomy
Ryohei Hirose, Naohisa Yoshida, Takuma Yoshida, Hiroki Mukai, Katsuma Yamauchi, Hajime Miyazaki, Naoto Watanabe, Risa Bandou, Ken Inoue, Osamu Dohi, Yoshikazu Inagaki, Yutaka Inada, Takaaki Murakami, Akio Yanagisawa, Hiroshi Ikegaya, Takaaki Nakaya, Yoshi
Advanced Materials Technologies.2025;[Epub] CrossRef
Endoscopic Resection for Superficial Non-Ampullary Duodenal Epithelial Tumors
Hye Kyung Jeon, Gwang Ha Kim
Gut and Liver.2025; 19(1): 19. CrossRef
Mechanisms of cutting soft tissues using snare-type tools
Jinghang Wang, Urara Satake, Toshiyuki Enomoto
Medical Engineering & Physics.2025; 138: 104314. CrossRef
Efficacy and safety of cold snare polypectomy for outpatient treatment of sessile polyps smaller than 10mm
Chunmei Li, Xinyu Xie, Jian Qin, Yufei Ding, Xiaojuan Ma, Shanshan Liu, Miao Chen, Dandan Dong, Jing Sun, Xuedan Deng, Lulu Liu, Hongyan Cui
BMC Gastroenterology.2025;[Epub] CrossRef
Resect and Retrieve Colorectal Polyps: Time for New Insights
Giulia Gibiino, Cecilia Binda, Matteo Secco, Lorenzo Cosentino, Francesco Poggioli, Stefania Cappetta, Davide Trama, Andrea Fabbri, Chiara Coluccio, Carlo Fabbri
Journal of Clinical Medicine.2025; 14(16): 5846. CrossRef
Factors determining the resection ability of snares in cold snare polypectomy: Construction of an ex vivo model for accurately evaluating resection ability
Ryohei Hirose, Takuma Yoshida, Naohisa Yoshida, Katsuma Yamauchi, Hajime Miyazaki, Naoto Watanabe, Risa Bandou, Ken Inoue, Hiroshi Ikegaya, Takaaki Nakaya, Yoshito Itoh
Digestive Endoscopy.2024; 36(5): 573. CrossRef
Effectiveness and safety of thin vs. thick cold snare polypectomy of small colorectal polyps: Systematic review and meta-analysis
Rishad Khan, Sunil Samnani, Marcus Vaska, Samir C Grover, Catharine M Walsh, Jeffrey Mosko, Michael J Bourke, Steven J Heitman, Nauzer Forbes
Endoscopy International Open.2024; 12(01): E99. CrossRef
International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Clinical Endoscopy.2024; 57(2): 141. CrossRef
IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
The Korean Journal of Gastroenterology.2024; 83(6): 217. CrossRef
International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Gut and Liver.2024; 18(5): 764. CrossRef
Advances in Endoscopic Resection
Mitsuru Esaki, Sonmoon Mohapatra, Norio Fukami
Gastroenterology Clinics of North America.2024; 53(4): 709. CrossRef
Comparative meta-analysis of cold snare polypectomy and endoscopic mucosal resection for colorectal polyps: assessing efficacy and safety
Shouqi Wang, Qi Zhang, Li Rong Meng, Ying Wu, Pedro Fong, Weixia Zhou
PeerJ.2024; 12: e18757. CrossRef
Does the wire diameter really determine the outcomes in cold snare polypectomy?
S Giri, S Sundaram
Journal of Gastroenterology and Hepatology.2023; 38(4): 665. CrossRef
Cold resection for colorectal polyps: where we are and where we are going?
Antonio Capogreco, Ludovico Alfarone, Davide Massimi, Alessandro Repici
Expert Review of Gastroenterology & Hepatology.2023; 17(7): 719. CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef

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Original Articles

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.

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Yoshiya Ohashi, Kohei Harada, Takeo Tanaka, Shun Hayasaka, Kizuku Ishibashi, Ryo Kasahara, Naoya Yama
Radiological Physics and Technology.2026; 19(2): 763. CrossRef
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Haidar Khan, Ramya Vasireddy, Mahnoor Khan, Rashmi Advani
Gastrointestinal Endoscopy Clinics of North America.2026; 36(4): 703. CrossRef
Preparation for Pediatric Gastrointestinal Endoscopy
Napapat Butsriphum, Songpon Getsuwan, Pornthep Tanpowpong, Chatmanee Lertudomphonwanit, Suporn Treepongkaruna
Gastroenterology Nursing.2026;[Epub] CrossRef
The PREFERENDO Delphi consensus: Minimum quality standards and core reporting elements for pediatric gastrointestinal endoscopy
Andrea Chiaro, Paolo Gandullia, Simona Faraci, Sara Renzo, Cecilia Mantegazza, Matteo Bramuzzo, Claudio Romano, Salvatore Oliva, Marco Deganello Saccomani, Annalisa Madeo, Giovanni Di Nardo, Paolo Quitadamo, Luca Maria Antoniello, Serena Arrigo, Jacopo Ba
Digestive and Liver Disease.2026;[Epub] CrossRef
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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
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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
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Endoscopic Submucosal Dissection versus Surgery for Undifferentiated-Type Early Gastric Cancer: A Systematic Review and Meta-Analysis: Cheal-Wung Huh, Dae Won Ma, Byung-Wook Kim, Joon Sung Kim, Seung Jae Lee; Clin Endosc 2021;54(2):202-210. Published online February 17, 2021; DOI: https://doi.org/10.5946/ce.2020.121

Abstract PDF

Background
/Aims: The use of endoscopic submucosal dissection (ESD) for treating undifferentiated-type early gastric cancer is controversial. The objective of this study was to perform a meta-analysis to compare the long-term outcomes of ESD and surgery for undifferentiated-type early gastric cancer.
Methods
The PubMed, Cochrane Library, and EMBASE databases were used to search for relevant studies comparing ESD and surgery for undifferentiated-type early gastric cancer. The methodological quality of the included publications was evaluated using the Risk of Bias Assessment tool for Nonrandomized Studies. The rates of overall survival, recurrence, adverse event, and complete resection were determined. Odds ratios (ORs) and 95% confidence intervals (CIs) were also evaluated.
Results
This meta-analysis enrolled five studies with 429 and 1,236 participants undergoing ESD and surgery, respectively. No significant difference was found in the overall survival rate between the ESD and surgery groups (OR, 2.29; 95% CI, 0.98–5.36; p=0.06). However, ESD was associated with a higher recurrence rate and a lower complete resection rate. The adverse event rate was similar between the two groups.
Conclusions
ESD with meticulous surveillance esophagogastroduodenoscopy may be as effective and safe as surgery in patients with undifferentiated-type early gastric cancer. Further large-scale, randomized, controlled studies from additional regions are required to confirm these findings.

Citations

Citations to this article as recorded by

Prognostic comparison of endoscopic submucosal dissection versus surgery for undifferentiated early gastric cancer: a Taiwan multicenter study
Chen-Huan Yu, Wei-Chen Tai, Wen-Hung Hsu, Ming-Yao Chen, Chung-Ying Lee, Tze-Yu Shieh, Chu-Kuang Chou, Hsu-Heng Yen, Hsi-Yuan Chien, Sz-Iuan Shiu, Jui-Wen Kang, Wei-Chih Su, Ching-Tai Lee, Chen-Shuan Chung
Surgical Endoscopy.2026; 40(6): 4625. CrossRef
Tackling similarities and differences in global practice guidelines for gastric cancer: a review on the latest Taiwan guidelines with Asia-Pacific, European and US guidelines
Chih-Chieh Yen, I-Chen Wu, Cheng-Chan Yu, Ming-Huang Chen, Nai-Jung Chiang, Wen-Liang Fang, Kuo-Hsing Chen, Chieh-Chang Chen, Tzu-Chan Hong, Yen-Cheng Chen, Ming-Wun Wong, De-Chuan Chan, I-Shu Chen, Yen-Yang Chen, Yueh-Wei Liu, Jiann-Ming Wu, Wen-Chi Chou
Gastric Cancer.2026; 29(4): 681. CrossRef
Is Endoscopic Submucosal Dissection Entering Into a New Era?
Kelly Schulte, Qiang Cai
Journal of Digestive Diseases.2026; 27(5-6): 186. CrossRef
Korean Practice Guidelines for Gastric Cancer 2024: An Evidence-based, Multidisciplinary Approach (Update of 2022 Guideline)
In-Ho Kim, Seung Joo Kang, Wonyoung Choi, An Na Seo, Bang Wool Eom, Beodeul Kang, Bum Jun Kim, Byung-Hoon Min, Chung Hyun Tae, Chang In Choi, Choong-kun Lee, Ho Jung An, Hwa Kyung Byun, Hyeon-Su Im, Hyung-Don Kim, Jang Ho Cho, Kyoungjune Pak, Jae-Joon Kim
Journal of Gastric Cancer.2025; 25(1): 5. CrossRef
A Comprehensive and Comparative Review of Global Gastric Cancer Treatment Guidelines: 2024 Update
Sang Soo Eom, Keun Won Ryu, Hye Sook Han, Seong-Ho Kong
Journal of Gastric Cancer.2025; 25(1): 153. CrossRef
Artificial intelligence-assisted diagnosis of early gastric cancer: present practice and future prospects
Changda Lei, Wenqiang Sun, Kun Wang, Ruixia Weng, Xiuji Kan, Rui Li
Annals of Medicine.2025;[Epub] CrossRef
Curative criteria for endoscopic treatment of gastric cancer
João A. Cunha Neves, Pedro G. Delgado-Guillena, Patrícia Queirós, Diogo Libânio, Enrique Rodríguez de Santiago
Best Practice & Research Clinical Gastroenterology.2024; 68: 101884. CrossRef
Optimal Surveillance of Metachronous Gastric Lesion after Endoscopic Resection of Early Gastric Cancer
Dong Chan Joo, Gwang Ha Kim
Gut and Liver.2024; 18(5): 781. CrossRef
Chinese national clinical practice guidelines on the prevention, diagnosis, and treatment of early gastric cancer
Peng Li, Ziyu Li, Enqiang Linghu, Jiafu Ji
Chinese Medical Journal.2024; 137(8): 887. CrossRef
Endoscopic Submucosal Dissection for Early Gastric Cancer Exceeding Expanded Criteria—Long-Term Outcomes from the German ESD Registry
Kathrin Riedl, Andreas Probst, Alanna Ebigbo, Ingo Steinbrück, Hans-Peter Allgaier, David Albers, Matthias Mende, Michael Anzinger, Joerg Schirra, Viktor Rempel, Albrecht Lorenz, Siegbert Faiss, Ingo Wallstabe, Ulrike Denzer, Andreas Wannhoff, Franz Ludwi
Journal of Clinical Medicine.2024; 13(18): 5538. CrossRef
Korean Practice Guidelines for Gastric Cancer 2022: An Evidence-based, Multidisciplinary Approach
Tae-Han Kim, In-Ho Kim, Seung Joo Kang, Miyoung Choi, Baek-Hui Kim, Bang Wool Eom, Bum Jun Kim, Byung-Hoon Min, Chang In Choi, Cheol Min Shin, Chung Hyun Tae, Chung sik Gong, Dong Jin Kim, Arthur Eung-Hyuck Cho, Eun Jeong Gong, Geum Jong Song, Hyeon-Su Im
Journal of Gastric Cancer.2023; 23(1): 3. CrossRef
Endoscopic Resection of Early Gastric Cancer and Pre-Malignant Gastric Lesions
Ana Clara Vasconcelos, Mário Dinis-Ribeiro, Diogo Libânio
Cancers.2023; 15(12): 3084. CrossRef
Performance of endoscopic submucosal dissection for undifferentiated early gastric cancer: a multicenter retrospective cohort
Apostolis Papaefthymiou, Michel Kahaleh, Arnaud Lemmers, Sandro Sferrazza, Maximilien Barret, Katsumi Yamamoto, Pierre Deprez, José C. Marín-Gabriel, George Tribonias, Hong Ouyang, Federico Barbaro, Oleksandr Kiosov, Stefan Seewald, Gaurav Patil, Shaimaa
Endoscopy International Open.2023; 11(07): E673. CrossRef
A meta-analysis of the impact on gastrectomy versus endoscopic submucosal dissection for early stomach cancer
Rajesh K. Singh
International Journal of Clinical Medical Research.2023; 1(3): 88. CrossRef
A meta-analysis of the impact on gastrectomy versus endoscopic submucosal dissection for early stomach cancer
Rajesh K. Singh
International Journal of Clinical Medical Research.2023;[Epub] CrossRef
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Gil Ho Lee, Eunyoung Lee, Bumhee Park, Jin Roh, Sun Gyo Lim, Sung Jae Shin, Kee Myung Lee, Choong-Kyun Noh
World Journal of Gastroenterology.2022; 28(8): 840. CrossRef
Comparison of long-term outcomes of endoscopic submucosal dissection and surgery for undifferentiated-type early gastric cancer meeting the expanded criteria: a systematic review and meta-analysis
Hyo-Joon Yang, Jie-Hyun Kim, Na Won Kim, Il Ju Choi
Surgical Endoscopy.2022; 36(6): 3686. CrossRef
Endoscopic submucosal dissection versus surgery for patients with undifferentiated early gastric cancer
Harold Benites-Goñi, Fernando Palacios-Salas, Andrea Carlin-Ronquillo, Carlos Díaz-Arocutipa, Alejandro Piscoya, Adrián Hernández
Revista Española de Enfermedades Digestivas.2022;[Epub] CrossRef
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Raquel Ortigão, Diogo Libânio, Mário Dinis‐Ribeiro
Journal of Surgical Oncology.2022; 125(7): 1110. CrossRef
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Ji Yong Ahn
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Eun Jeong Gong, Chang Seok Bang
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Chang Seok Bang
Clinical Endoscopy.2021; 54(2): 143. CrossRef

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22 Crossref

Survival Benefit of Intraductal Radiofrequency Ablation for Malignant Biliary Obstruction: A Systematic Review with Meta-Analysis: Byung Hyo Cha, Myoung-Jin Jang, Sang Hyub Lee; Clin Endosc 2021;54(1):100-106. Published online January 15, 2021; DOI: https://doi.org/10.5946/ce.2020.254

Abstract PDF

Background
/Aims: Cholangiocarcinoma (CCA) is a rare but aggressive disease with a poor survival. Recent trials have shown improved survival with intraductal radiofrequency ablation (RFA) therapy. We performed a systematic review with meta-analysis to determine the survival benefit of endoscopic RFA for unresectable extrahepatic CCA with malignant biliary obstruction (MBO).
Methods
A systematic search from 1970 to 2020 was performed in MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials. gov. We selected eligible studies reporting relative risks, hazard ratios (HRs), or odds ratios, adjusted by controlling for confounding factors of survival rate and stent patency duration, among patients with extrahepatic CCA with MBO treated with RFA with stent insertion or stent insertion only.
Results
A total of eight trials (three randomized and five nonrandomized) with a total of 420 patients were included in the metaanalysis. Pooled overall survival analysis favored RFA treatment with stent insertion (HR, 0.47; 95% confidence interval [CI], 0.34– 0.64; I²=47%; p=0.09); however, no significant difference was found in the duration of stent patency between the groups (HR, 0.79; 95% CI, 0.57–1.09; I²=7%; p=0.36).
Conclusions
RFA therapy with stent insertion may confer a survival benefit compared with stent insertion only in patients with CCA and MBO.

Citations

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