Submucosal saline injection and mini-probe endoscopic ultrasound to assess endoscopic resectability of colorectal subepithelial tumors.

Background/aims: This study aimed to evaluate the feasibility and outcomes of mini-probe endoscopic ultrasound (mEUS) followed by submucosal saline injection (SSI-mEUS) for assessing the endoscopic resectability of colorectal subepithelial lesions (SELs).

Methods: From January 2020 to December 2023, the medical records of 391 SELs (364 patients) were retrospectively reviewed and categorized into no EUS, mEUS-only, and SSI-mEUS groups according to the procedure used. To compare variables between the SSI-mEUS and other groups, the no EUS and mEUS-only groups were combined into the non-SSI-mEUS group.

Assessment of Small Bowel Motility Using Cine-magnetic Resonance Imaging in Patients Suspected With Chronic Intestinal Pseudo-obstruction.

Background/aims: Chronic intestinal pseudo-obstruction (CIPO), characterized by dilated small or large intestine on CT, has a high postoperative recurrence rate. In contrast, focal hypoganglionosis with adult-onset megacolon (FHAM) generally shows a good postoperative prognosis. This study aims to evaluate the utility of cine-MRI in differentiating between these 2 diseases by assessing small bowel (SB) motility and its correlation with clinical outcomes.

Clinical Utility of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Biopsy for Rectal and Perirectal Lesions With Categorization of Their Indications.

Objectives: Endoscopic ultrasound-guided fine-needle aspiration and/or biopsy (EUS-FNA/B) is a diagnostic tool for gastrointestinal (GI) lesions. However, its effectiveness in the lower GI tract remains underreported. In this study, we aimed to evaluate the clinical utility of EUS-FNA/B for rectal and perirectal lesions.

Comparative efficacy of subcutaneous infliximab switching in remission and non-remission patients with inflammatory bowel disease after intravenous maintenance: 1-year outcome from a multicentre cohort study.

Background: Elective switching from intravenous (IV) to subcutaneous (SC) infliximab (IFX) has shown efficacy in patients with inflammatory bowel disease (IBD). However, long-term outcomes for patients not in remission remain unclear.

Objectives: We evaluated the effectiveness of SC IFX switching in both remission and non-remission patients.

Risk factors for residual tumors in histologically incompletely resected rectal neuroendocrine tumors.

Background: Rectal neuroendocrine tumors (r-NETs) are often misidentified as polyps, leading to inappropriate endoscopic treatment and incomplete resection.

Aims: This study investigated the occurrence and risk factors of residual r-NETs following salvage local resection (SLR) after incomplete resection.

Methods: The medical records of 95 patients who underwent SLR for histologically incompletely resected (R1/Rx-resected) r-NETs referred from other hospitals between January 2020 and August 2023 were analyzed.

Validation of the London Classification for Rectal Hyposensitivity in an Anorectal Manometry Database of 2540 Patients With Functional Defecatory Disorder.

Background/aims: Rectal hyposensitivity (RH), as defined by the London Classification, has been linked to sensory dysfunction caused by diabetes mellitus and Parkinson's disease (PD); however, its clinical interpretation has not been sufficiently validated. In this study, we aim to explore the correlations between rectal sensory thresholds and the clinical characteristics of patients with functional defecatory disorders.

Methods: We reviewed data from patients who underwent high-resolution anorectal manometry and acquired their clinical characteristics using a standardized questionnaire.

Long-Term Outcomes of Double-Balloon Enteroscopy Polypectomy for Large Small Bowel Polyps Detected During Surveillance Imaging in Patients With Peutz-Jeghers Syndrome.

Objectives: Double-balloon enteroscopy (DBE) is effective for managing small bowel (SB) diseases. We aimed to evaluate the patient outcomes of DBE polypectomy in Peutz-Jeghers syndrome (PJS) with large SB polyps at surveillance imaging studies and to identify the risk factors for SB surgery.

Methods: Forty-five PJS patients who underwent regular SB surveillance imaging studies from 2005 to 2023 were retrospectively included.

Temporal trends in obesity and its prognostic impact in Korean patients with inflammatory bowel disease.

Background: To assess the changes in body mass index (BMI) among Korean patients with inflammatory bowel disease (IBD) over a 14-year period and to explore how BMI at diagnosis impacts prognosis.

Methods: We retrospectively collected BMI and laboratory data from patients with IBD who visited the Asan Medical Center between 2008 and 2021 (Cohort 1). Clinical outcomes, including intestinal resection and medication use, were analyzed in patients with a recorded BMI at diagnosis who were followed up in a prospectively maintained cohort (Cohort 2).

Fecal calprotectin from ileostomy output in patients with Crohn's disease.

Background: Fecal calprotectin (FC) is a reliable biomarker widely used for assessing disease activity and postoperative monitoring in patients with Crohn's disease (CD); however, its efficacy in patients with an ileostomy is poorly understood. Our study evaluated whether FC from the ileostomy output can be used to predict postoperative small bowel inflammation in patients with CD.

Methods: Data from patients with CD and an ileostomy who had undergone FC measurement between January 1, 2015, and December 30, 2022, were analyzed retrospectively.

Artificial Intelligence Models May Aid in Predicting Lymph Node Metastasis in Patients with T1 Colorectal Cancer.

Background/aims: Inaccurate prediction of lymph node metastasis (LNM) may lead to unnecessary surgery following endoscopic resection of T1 colorectal cancer (CRC). We aimed to validate the usefulness of artificial intelligence (AI) models for predicting LNM in patients with T1 CRC.

Methods: We analyzed the clinical data, laboratory results, pathological reports, and endoscopic findings of patients who underwent radical surgery for T1 CRC.

CD8+ cell dominance in immune checkpoint inhibitor-induced colitis and its heterogeneity across endoscopic features.

Background: Immune checkpoint inhibitor (ICI)-induced colitis is a significant adverse event associated with ICI therapy, known to be linked to increased cytotoxic T-cell activity.

Objectives: To compare T-cell subsets based on the endoscopic features of ICI-induced colitis and to compare these findings with those of inflammatory bowel disease (IBD).

Design: Prospective cohort study.

Characteristics and outcomes of portal vein thrombosis in patients with inflammatory bowel disease in Korea.

Background/aims: Portal vein thrombosis (PVT) frequently occurs in patients with inflammatory bowel disease (IBD), particularly when influenced by factors such as abdominal infections, IBD flare-ups, or surgical procedures. The implications of PVT range from immediate issues such as intestinal ischemia to long-term concerns including portal hypertension and its complications. However, there is a notable gap in comprehensive studies on PVT in IBD, especially with the increasing incidence of IBD in Asia.

Comparison of L L Polyethylene Glycol Plus Ascorbic Acid and Oral Sodium Sulfate Tablets for Colonoscopy Bowel Preparation.

A low-volume (1 L) polyethylene glycol plus ascorbic acid (PEG-A) solution and an oral sodium sulfate tablet (OST) formulation are recently introduced agents for colonoscopy bowel preparation. This study investigated the efficacy, safety, and tolerability of 1 L PEG-A vs. OST.

Incidence, Risk Factors, and Outcomes of Chronic Antibiotic-Refractory Pouchitis in Korean Patients with Ulcerative Colitis.

Background/aims: The study investigated the incidence, risk factors, and clinical outcomes of chronic antibiotic-refractory pouchitis (CARP) in Korean patients with ulcerative colitis (UC).

Methods: This single-center retrospective study included patients with UC who underwent total proctocolectomy with ileal pouch-anal anastomosis at the Asan Medical Center in Korea between January 1987 and December 2022. The primary outcomes were endoscopic remission and pouch failure.

Fluorescence-guided tumor visualization of colorectal cancer using tumor-initiating probe yellow in preclinical models.

Fluorescence-guided surgery has emerged as an innovative technique with promising applications in the treatment of various tumors, including colon cancer. Tumor-initiating probe yellow (TiY) has been discovered for identifying tumorigenic cells by unbiased phenotypic screening with thousands of diversity-oriented fluorescence library (DOFL) compounds in a patient-derived lung cancer cell model. This study demonstrated the clinical feasibility of TiY for tumor-specific fluorescence imaging in the tissues of patients with colorectal cancer (CRC).

Artificial intelligence-aided colonoscopic differential diagnosis between Crohn's disease and gastrointestinal tuberculosis.

Background And Aim: Differentiating between Crohn's disease (CD) and gastrointestinal tuberculosis (GITB) is challenging. We aimed to evaluate the clinical applicability of an artificial intelligence (AI) model for this purpose.

Methods: The AI model was developed and assessed using an internal dataset comprising 1,132 colonoscopy images of CD and 1,045 colonoscopy images of GITB at a tertiary referral center.

Clinical characteristics and long-term disease course in patients with Crohn's disease as diagnosed by video capsule endoscopy: a multicenter retrospective matched case-control study.

Background/aims: Video capsule endoscopy is rarely used to diagnose Crohn's disease in patients with negative ileocolonoscopy or cross-sectional image findings. We evaluated clinical characteristics and long-term outcomes of these rare cases.

Methods: This multicenter study included patients with Crohn's disease from 3 tertiary hospitals from January 2007 to October 2022.

Continuing or stopping 5-aminosalicylates in patients with inflammatory bowel disease on anti-TNF therapy: A nationwide population-based study.

Background: The impact of continuing or stopping 5-aminosalicylates (5-ASA) after commencing anti-tumour necrosis factor (anti-TNF) therapy in patients with inflammatory bowel disease (IBD) remains unclear.

Aims: To compare the outcomes of patients with IBD who stopped or continued 5-ASA after starting anti-TNF therapy.

Methods: We analysed data from the Korean National Health Insurance claims database between 2007 and 2020.

Effectiveness of Switching to Subcutaneous Infliximab in Ulcerative Colitis Patients Experiencing Intravenous Infliximab Failure.

Background/aims: Studies on elective switching to the subcutaneous (SC) formulation of infliximab revealed comparable efficacy and safety and higher infliximab level than those exhibited by intravenous (IV) infliximab. However, no studies have reported on the effectiveness of SC switching in ulcerative colitis (UC) patients who experienced IV infliximab failure during maintenance treatment.

Methods: This retrospective study included UC patients who had been switched to SC infliximab because of IV infliximab failure, between January 2021 and January 2023.

Automatic assessment of bowel preparation by an artificial intelligence model and its clinical applicability.

Background And Aim: Reliable bowel preparation assessment is important in colonoscopy. However, current scoring systems are limited by laborious and time-consuming tasks and interobserver variability. We aimed to develop an artificial intelligence (AI) model to assess bowel cleanliness and evaluate its clinical applicability.

Fecal Calprotectin in Patients with Crohn's Disease: A Study Based on the History of Bowel Resection and Location of Disease.

Fecal calprotectin (FC) is commonly used to assess Crohn's disease (CD) activity. However, standardized cut-off values accounting for bowel resection history and disease location are lacking. In this study, we analyzed data from patients with CD who underwent magnetic resonance enterography, ileocolonoscopy, and FC measurements from January 2017 to December 2018.

Safety of Biologics and Small Molecules for Inflammatory Bowel Diseases in Organ Transplant Recipients.

Purpose: This study aimed to evaluate the safety of biologics and small molecules for the treatment of inflammatory bowel diseases (IBD) in patients receiving antirejection therapies after organ transplants.

Materials And Methods: We reviewed the medical records of patients with IBD who received organ transplants at the Asan Medical Center between January 1989 and December 2021. We compared the parameters of patients receiving biologics or small molecules to those of patients without those therapies.

Risk factors for the failure of endoscopic balloon dilation to manage anastomotic stricture from colorectal surgery: retrospective cohort study.

Background: An anastomotic stricture after colorectal surgery is principally managed by endoscopic balloon dilation (EBD). Although this intervention is effective, however, subsequent procedures or surgical interventions are often required. This study aimed to assess the long-term outcomes of EBD for anastomotic stricture arising from colorectal cancer surgery.

Endoscopic mucosal resection using anchored snare Tip-in versus precut technique for small rectal neuroendocrine tumors.

Background/aims: Small rectal neuroendocrine tumors (NETs) can be treated with modified endoscopic mucosal resection (EMR). However, an optimal EMR method remains to be established. We aimed to assess the non-inferiority of Tip-in EMR versus precut EMR (EMR-P) for treating rectal NETs.