Atrophic gastritis and intestinal metaplasia may progress to gastric malignancy. Non-invasive serum biomarkers have been extensively studied and proven to be useful as a screening tool to stratify risk and identify patients for endoscopy to detect early gastric cancer. These non-invasive biomarkers have been endorsed and recommended by many international consensus guidelines. In this letter, we reviewed the literature and evidence supporting the use of serum biomarkers as a dynamic test to monitor the status of atrophic gastritis.

• Atrophic gastritis
• Pepsinogen
• Gastrin-17
• Gastric cancer
• Biomarkers

In this editorial, we comment on the in-press article in the World Journal of Gastrointestinal Endoscopy concerning the treatment of malignant gastric outlet obstruction (mGOO). The original theory of treatment involves bypassing the obstruction or reenabling the patency of the passage. Conventional surgical gastroenterostomy provides long-term relief of symptoms in selected patients, with substantial morbidity and a considerable rate of delayed gastric emptying. Endoscopic stenting was introduced as an alternative minimally invasive procedure with less procedural morbidity and rapid clinical improvement; however, it presented a high rate of long-term recurrence. Therefore, challenges remain in the treatment of mGOO patients to improve clinical outcomes. Endoscopic ultrasound-guided gastroenterostomy has recently emerged as a promising method because of the combined effects of surgery and endoscopy, whereas stomach-partitioning gastrojejunostomy has been reported as a modified surgical procedure to reduce the rate of delayed gastric emptying. In decision-making regarding the treatment of choice, it should be taken into account that mGOO might be accompanied by a variety of pathological conditions, including cancer cachexia, anorexia, malabsorption, and etc., all of which can also lead to the characteristic symptoms and poor nutritional status of mGOO. The treatment plan should consider comprehensive aspects of patients to achieve practical improvements in prognosis and the quality of life.

• Malignant gastric outlet obstruction
• Surgical gastroenterostomy
• Endoscopic stenting
• Endoscopic ultrasound-guided gastroenterostomy
• Stomach-partitioning gastrojejunostomy
• Anorexia‒cachexia syndrome

Ulcerative colitis (UC) with concomitant primary sclerosing cholangitis (PSC) represents a distinct disease entity (PSC-UC). Mayo endoscopic subscore (MES) is a standard tool for assessing disease activity in UC but its relevance in PSC-UC remains unclear.

To assess the accuracy of MES in UC and PSC-UC patients, we performed histological scoring using Nancy histological index (NHI).

MES was assessed in 30 PSC-UC and 29 UC adult patients during endoscopy. NHI and inflammation were evaluated in biopsies from the cecum, rectum, and terminal ileum. In addition, perinuclear anti-neutrophil cytoplasmic antibodies, fecal calprotectin, body mass index, and other relevant clinical characteristics were collected.

The median MES and NHI were similar for UC patients (MES grade 2 and NHI grade 2 in the rectum) but were different for PSC-UC patients (MES grade 0 and NHI grade 2 in the cecum). There was a correlation between MES and NHI for UC patients (Spearman's r = 0.40, P = 0.029) but not for PSC-UC patients. Histopathological examination revealed persistent microscopic inflammation in 88% of PSC-UC patients with MES grade 0 (46% of all PSC-UC patients). Moreover, MES overestimated the severity of active inflammation in an additional 11% of PSC-UC patients.

MES insufficiently identifies microscopic inflammation in PSC-UC. This indicates that histological evaluation should become a routine procedure of the diagnostic and grading system in both PSC-UC and PSC.

• Primary sclerosing cholangitis
• Ulcerative colitis
• Diagnosis
• Nancy histological index
• Mayo endoscopic subscore

With the continuous advancement in medical technology, endoscopy has gained significant attention as a crucial diagnostic tool. The introduction of motorized spiral enteroscopy (MSE) represents a significant advancement in the diagnosis and treatment of small bowel diseases. While there are safety concerns and a high reliance on the operator’s skills, MSE should not be disregarded entirely. Instead, it should be considered as a supplementary endoscopic technique, particularly in situations where conventional endoscopy proves ineffective. Through continuous research and technical optimization, MSE has the potential to become an important addition to the endoscopy toolbox in the future. We call on colleagues in the industry to work together to promote the improvement of MSE technology through continuous research and practice, with the aim to bring out its unique value in endoscopy while ensuring patient safety.

• Motorized spiral enteroscopy
• Spiral enteroscopy
• Device-assisted enteroscopy
• Endoscopy
• Small bowel diseases

The concept of macroscopic on-site evaluation (MOSE) was introduced in 2015 when the endoscopist observed better diagnostic yield when the macroscopically visible core on MOSE was superior to 4 mm. Recent studies suggest that MOSE by the endoscopist may be an excellent alternative to rapid on-site evaluation, and some classifications have been published. Few studies have assessed the adequacy of histologic cores in MOSE during endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/FNB).

To evaluate the performance of MOSE during EUS-FNA/FNB.

This multicentric prospective study was conducted in 16 centers in 3 countries (Egypt, Iraq, and Morocco) and included 1108 patients with pancreatic, biliary, or gastrointestinal pathology who were referred for EUS examination. We prospectively analyzed the MOSE in 1008 patients with available histopathological reports according to 2 classifications to determine the adequacy of the histological core samples. Data management and analysis were performed using a Statistical Package for Social Sciences (SPSS) version 27.

A total of 1074 solid lesions were biopsied in 1008 patients with available cytopathological reports. Mean age was 59 years, and 509 patients (50.5%) were male. The mean lesion size was 38 mm. The most frequently utilized needles were FNB-Franseen (74.5%) and 22 G (93.4%), with a median of 2 passes. According to 2 classifications, 618 non-bloody cores (61.3%) and 964 good samples (95.6%) were adequate for histological evaluation. The overall diagnostic yield of cytopathology was 95.5%. The cytological examination confirmed the diagnosis of malignancy in 861 patients (85.4%), while 45 samples (4.5%) were inconclusive. Post-procedural adverse events occurred in 33 patients (3.3%). Statistical analysis showed a difference between needle types (P = 0.035) with a high sensitivity of FNB (97%). The analysis of the relationship between the MOSE-score and the final diagnosis showed a significant difference between the different scores of the MOSE (P < 0.001).

MOSE is a simple method that allows endoscopists to increase needle passes to improve sample quality. There is significantly higher FNB sensitivity and cytopathology diagnostic yield with good MOSE cores.

• Macroscopic on-site evaluation
• Fine-needle aspiration
• Fine-needle biopsy
• Endoscopic ultrasound
• Specimen adequacy

Endoscopic retrograde cholangiopancreatography (ERCP) is a key procedure for diagnosing and treating biliary and pancreatic disorders. Although effective, it carries risks, including rare but severe complications such as air embolism.

We report a case of a 58-year-old man who developed extensive air embolism during ERCP. He previously underwent a Whipple procedure and experienced a sudden drop in vital signs and loss of consciousness. Immediate intervention with hyperbaric oxygen therapy and supportive care led to gradual recovery. Imaging confirmed widespread air embolism, which resolved with continued treatment.

Air embolism is a rare, critical complication of ERCP, especially in patients with prior surgery such as pancreaticoduodenectomy. Early detection and prompt treatment, including hyperbaric oxygen therapy, are crucial for favorable outcomes.

• Endoscopic retrograde cholangiopancreatography
• Air embolism
• Hyperbaric oxygen therapy
• Pancreaticoduodenectomy Complications
• Intracardiac pneumatosis
• Case report

Gastric mesenchymal tumors (GMT) are identified as soft tissue neoplasms that arise from mesenchymal stem cells within the gastrointestinal tract. GMT primarily encompass gastric stromal tumors (GST), gastric leiomyomas, and gastric schwannomas. Although most GMT are benign, there are still potential malignant changes, especially GST. Thus, early surgical intervention is the primary treatment for GMT. We have designed a simple endoscopic “calabash” ligation and resection (ECLR) procedure to treat GMT. Its efficacy and safety need to be compared with those of traditional endoscopic techniques, such as endoscopic submucosal excavation (ESE).

To assess the safety and effectiveness of ECLR in managing small GMT (sGMT) with a maximum diameter ≤ 20 mm by comparing to ESE.

This retrospective analysis involved patients who were hospitalized in our institution between November 2021 and March 2023, underwent endoscopic resection, and received a pathological diagnosis of GMT. Cases with a tumor diameter ≤ 20 mm were chosen and categorized into two cohorts: Study and control groups. The study group was composed of patients treated with ECLR, whereas the control group was composed of those treated with ESE. Data on general clinical characteristics (gender, age, tumor diameter, tumor growth direction, tumor pathological type, and risk grade), surgery-related information (complete tumor resection rate, operation duration, hospitalization duration, hospitalization cost, and surgical complications), and postoperative follow-up were collected for both groups. The aforementioned data were subsequently analyzed and compared.

Five hundred and eighty-nine individuals were included, with 297 cases in the control group and 292 in the study group. After propensity score matching, the final analysis incorporated 260 subjects in each cohort. The findings indicated that the study group exhibited shorter operation duration and lowered medical expenses relative to the control group. Furthermore, the study group reported less postoperative abdominal pain and had a lower incidence of intraoperative perforation and postoperative electrocoagulation syndrome than the control group. There were no substantial variations observed in other parameters among the two cohorts.

ECLR is a viable and effective approach for managing sGMT.

• Endoscopic “calabash” ligation and resection
• Endoscopic submucosal excavation
• Gastric mesenchymal tumors
• Gastric stromal tumors
• Leiomyoma
• Schwannoma

Gastric fundoplication with endoscopic technique (GFET) is an innovative approach to managing gastroesophageal reflux disease (GERD). This minimally invasive procedure utilizes the GEN-2 Apollo endosuture device and Olympus H2T180 gastroscope to perform partial fundoplication by strategically placing Prolene 2-0 sutures at the 11, 7, 5, 1, and 3 o’clock positions around the gastroesophageal junction.

To evaluate whether GFET enhances the lower esophageal sphincter function by creating comprehensive plication to improve the barrier against reflux.

This single-center prospective study included patients undergoing GFET. Before beginning GFET, pH metrics and subsequent manometric measurements were obtained. An analysis of variance was performed to determine statistically significant differences between quality of life (QOL) and DeMeester scores at the time of the procedure and 6 and 12 months postoperatively. Pearson’s χ² test was performed to identify statistically significant differences between categorical variables at the time of the procedure and 6 and 12 months postoperatively.

Eighteen participants were enrolled (11 males and 7 females; mean age, 35 years). More than 70% had an initial Hill grade of IIb. One adverse event was recorded after the procedure. One patient underwent valve reinforcement at 12 months. The mean QOL score was markedly higher at the time of the procedure (39.9 ± 4.0) compared to those at 6 and 12 months postoperatively (P < 0.001). Scores at 12 months were slightly higher than those at 6 months. The highest mean QOL score was observed at the time of the procedure, followed by those at 6 and 12 months postoperatively (P < 0.001). A similar trend was noted for the mean DeMeester scores (P < 0.001).

GFET is a minimally invasive alternative to traditional surgical interventions and endoscopic techniques for managing GERD. Further research is warranted to validate its long-term efficacy and effectiveness over existing treatments.

• Gastric fundoplication with endoscopic technique
• Gastroesophageal reflux disease
• Therapeutic endoscopy

As a less invasive technique, peroral endoscopic myotomy (POEM) has recently been widely accepted for treating achalasia with an excellent safety profile, durability, and efficacy in adults. In pediatric and geriatric patients, the treatment is more difficult.

To discuss the clinical outcomes of POEM in pediatric and geriatric patients with achalasia.

We conducted a comprehensive search of PubMed, Embase and Cochrane Library databases from inception to July 2024. The primary outcomes were technical and clinical success. Secondary outcomes of interest included adverse events and gastroesophageal reflux disease (GERD). The pooled event rates were calculated by comprehensive meta-analysis software.

A total of 32 studies with 547 pediatric patients and 810 geriatric patients were included in this study. The pooled event rates of technical success, clinical success, GERD and adverse events of POEM for treating achalasia in pediatric patients were 97.1% [95% confidence interval (CI): 95.0%-98.3%; I² = 0%; P < 0.000], 93.2% (95%CI: 90.5%-95.2%; I² = 0%; P < 0.000), 22.3% (95%CI: 18.4%-26.7%; I² = 43.874%; P < 0.000) and 20.4% (95%CI: 16.6%-24.8%; I² = 67.217%; P < 0.000), respectively. Furthermore, in geriatric patients, the pooled event rates were 97.7% (95%CI: 95.8%-98.7%; I² = 15.200%; P < 0.000), 93.2% (95%CI: 90.3%-95.2%; I² = 0%; P < 0.000), 23.9% (95%CI: 19.4%-29.1%; I² = 75.697%; P < 0.000) and 10.8% (95%CI: 8.3%-14.0%; I² = 62.938%; P < 0.000], respectively.

Our findings demonstrated that POEM was an effective and safe technique for pediatric and geriatric patients with achalasia.

• Achalasia
• Peroral endoscopic myotomy
• Pediatric
• Geriatric
• Meta-analysis

• Endoscopic submucosal dissection
• Esophageal stricture
• Oral steroids
• Predictors
• Triamcinolone acetonide

• Case report
• Endoscopic vacuum assisted closure
• Esophageal atresia
• Esophagopericardial fistula
• Multidisciplinary approach
• Pleural effusion

• Confocal laser endomicroscopy
• Diagnostic yield
• Gastric cancer
• Narrow band imaging

• Disparity
• Gastritis
• Helicobacter pylori
• Hispanic
• Prevalence
• Proton pump inhibitors
• Race/racial
• Resistance

• Endoscopic retrograde cholangiopancreatography
• Needle-knife precut papillotomy
• Post-endoscopic retrograde cholangiopancreatography pancreatitis
• Precut

• Endoscopic and histologic poor prognostic criteria
• Histological recurrence rate of pT1 adenocarcinoma
• pT1 adenocarcinoma polyps
• pT1 follow up management

• Early gastric cancer
• Endoscopic submucosal dissection
• Multidisciplinary approach
• Non-curative resection
• eCura

• Abdominal injuries
• Abdominal pain
• Case report
• Heterotopic ossification
• Mesentery

• Case report
• Coil embolization
• Cyanoacrylate
• Interventional endoscopic ultrasound
• Isolated gastric varices

• Adenoma
• Cold snare polypectomy
• Colon polyp
• Endoscopic mucosal resection
• Hot snare polypectomy
• Polypectomy
• Sessile serrated lesion

• Case report
• Esophageal ulcer
• Gastrointestinal bleeding
• Multisystem inflammatory syndrome
• SARS-CoV-2

• Retraction note
• World Journal of Gastrointestinal Endoscopy

• Atrophic gastritis
• Gastric cancer
• Gastrin-17
• Kimura-Takemoto classification
• Pepsonogen-1
• Prevention
• Updated Sydney system

• Body composition
• Endoscopic ultrasound-guided gastroenterostomy
• Malignant gastric outlet obstruction
• Nutrition
• Patient-reported outcomes
• Quality of life

• Case report
• Colon
• Ethiopia
• Polyp
• Schistosoma
• Schistosomiasis

• Doppler probe
• Endoscopic ultrasound
• Endoscopy techniques
• Gastrointestinal bleeding
• Hemospray
• Hemostasis
• Hemostatic agents
• Over-the-scope clips
• Ovesco