Evidence map›Paper›PMID 41920315›Full record

ArticleJournal of gastroenterology2026

Identification of the distal end of the palisade vessels under sedation: a multicenter prospective study in Japan.

Waku Hatta, Tomoyuki Koike, Ayaka Takasu, Satoshi Ono, Fumiaki Ishibashi, Tsutomu Takeda, Chika Kusano, Yuto Shimamura, Masakatsu Fukuzawa, Keiko Yamamoto and 13 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

Waku HattaDivision of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan.
Tomoyuki KoikeDivision of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan. tkoike@rd5.so-net.ne.jp.ORCID 0000-0001-6472-3257
Ayaka TakasuDivision of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-Ku, Tokyo, 173-0034, Japan.
Satoshi OnoDepartment of Gastroenterology and Gastrointestinal Endoscopy, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakaecho, Itabashi-Ku, Tokyo , 173-0015, Japan.
Fumiaki IshibashiDepartment of Gastroenterology, International University of Health and Welfare Ichikawa Hospital, 6-1-14 Konodai, Ichikawa, Chiba, 272-0827, Japan.
Tsutomu TakedaDepartment of Gastroenterology, Juntendo University School of Medicine, 3-1-3 Hongo, Bunkyo-Ku, Tokyo, 113-8431, Japan.
Chika KusanoDepartment of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-Ku, Sagamihara, Kanagawa, 252-0375, Japan.
Yuto ShimamuraDigestive Diseases Center, Showa Medical University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-Ku, Tokyo, 135-0061, Japan.
Masakatsu FukuzawaDepartment of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-Ku, Tokyo, 160-0023, Japan.
Keiko YamamotoDepartment of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, 15-7 Kita 15-Jo Nishi, Kita-Ku, Sapporo, Hokkaido, 060-8648, Japan.
Yuji InoDepartment of Medicine, Division of Gastroenterology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke , Tochigi, 329-0498, Japan.
Naomi KakushimaDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Ai FujimotoGastroenterology and Hepatology, Omori Medical Center, Toho University, 6-11-1 Omorinishi, Ota-Ku, Tokyo, 143-0015, Japan.
Shiko KuribayashiDepartment of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-15 Showamachi, Maebashi, Gunma, 371-8511, Japan.
Taro IwatsuboSecond Department of Internal Medicine, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan.
Yuji UrabeDepartment of Gastroenterology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan.
Hideki IshikawaMolecular-Targeting Prevention, Kyoto Prefectural University of Medicine, 3-1-14 Koraibashi, Chuo-Ku, Osaka, 541-0043, Japan.
Tomohiro NakamuraFaculty of Data Science, Kyoto Women's University, 35 Imakumano Kitahiyoshicho, Higashiyama-Ku, Kyoto, 605-8501, Japan.
Naoki NakayaDepartment of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, 2-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8575, Japan.
Atsushi MasamuneDivision of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-Machi, Aoba-Ku, Sendai, Miyagi, 980-8574, Japan.
Yoshimasa MiuraDivision of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-Ku, Tokyo, 173-0034, Japan.
Mitsuhiro FujishiroDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
Kentaro SuganoDepartment of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough the distal end of palisade vessels (DEPV) has recently been proposed as an anatomically appropriate endoscopic landmark for defining the gastroesophageal junction (GEJ), its evidence under sedation remains limited. This study aimed to evaluate DEPV visualization under sedation, including its detectability and related factors.

methodsThis was a multicenter prospective cohort study conducted at 15 institutions across Japan. Patients underwent real-time endoscopic GEJ observation under sedation in three views: forward view on insertion, retroflex view, and forward view on withdrawal. The primary endpoint was the DEPV identification rate. The secondary endpoints included the DEPV identification rates across three sedation levels and factors associated with unsuccessful DEPV identification.

resultsA total of 638 patients were enrolled. The DEPV identification rate was highest in the forward view on insertion (77.0%). When the retroflex view and/or the forward view on withdrawal were additionally considered, the overall identification rate increased to 85.3%. The identification rate declined with deeper sedation, while combining all three views yielded identification rates ranging from 80.1% under deep sedation to 100% under minimal sedation. In multivariate analysis, risk factors for unsuccessful DEPV identification were deep sedation (odds ratio [OR], 3.83), reflux esophagitis (OR, 2.24-16.37), and incomplete GEJ distention (OR, 8.87), whereas hiatus hernia was protective (OR, 0.52).

conclusionsThis largest multicenter prospective study demonstrated that early DEPV identification during insertion is most effective, whereas deep sedation adversely affects visualization, supporting a standardized approach for routine GEJ assessment.

Indexed as

Deep SedationEsophagogastric JunctionProcedural SedationAgedFemaleHumansJapanMaleMiddle AgedProspective StudiesRisk FactorsDistal end of palisade vesselGastroesophageal junctionProximal end of gastric fold

Identifiers

PMID41920315
PMCPMC13219092

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