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Suzuki K, Kikuchi D, Yamashita S, Kono K, Takazawa Y. Gel immersion endoscopic mucosal resection of a duodenal adenoma with gastric phenotype. Endoscopy 2024; 56:E480-E481. [PMID: 38838732 PMCID: PMC11152920 DOI: 10.1055/a-2325-2143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Affiliation(s)
- Kensuke Suzuki
- Gastroenterology, Toranomon Hospital Branch, Kawasaki, Japan
- Gastroenterology, Toranomon Hospital, Tokyo, Japan
| | - Daisuke Kikuchi
- Gastroenterology, Toranomon Hospital Branch, Kawasaki, Japan
- Gastroenterology, Toranomon Hospital, Tokyo, Japan
| | - Satoshi Yamashita
- Gastroenterology, Toranomon Hospital Branch, Kawasaki, Japan
- Gastroenterology, Toranomon Hospital, Tokyo, Japan
| | - Kei Kono
- Pathology, Toranomon Hospital, Tokyo, Japan
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2
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Li DF, Tian YH, Shi RY, Zhang DG. A novel three traction rings device with endoscopic submucosal dissection (ESD) in the removal of a large superficial duodenal adenoma. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2024. [PMID: 39235172 DOI: 10.17235/reed.2024.10652/2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
Endoscopic treatment is generally recommended for the duodenal epithelial adenoma. Although underwater endoscopic mucosal resection (UEMR) has become established as an effective modality for the superficial duodenal adenoma. However, it is difficult to completely remove a large superficial duodenal adenoma with en bloc resection. Endoscopic submucosal dissection (ESD) is commonly performed to remove a large superficial duodenal adenoma, whereas which is technically challenged with severe adverse events. It has reported that entire traction using clip-and-nylon ring with ESD was effective and safe in the removal of a large rectal sessile serrated adenoma (SSA). Herein, we shared our experience of the novel three traction rings device in the treatment of a large superficial duodenal adenoma.
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Affiliation(s)
- De-Feng Li
- Gastroenterology, Shenzhen People's Hospital, China
| | | | - Rui-Yue Shi
- Gastroenterology, Shenzhen People's Hospital, China
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3
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Yano T, Yamamoto H. Endoscopic Diagnosis of Small Bowel Tumor. Cancers (Basel) 2024; 16:1704. [PMID: 38730658 PMCID: PMC11083951 DOI: 10.3390/cancers16091704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/13/2024] Open
Abstract
Recent technological advances, including capsule endoscopy (CE) and balloon-assisted endoscopy (BAE), have revealed that small intestinal disease is more common than previously thought. CE has advantages, including a high diagnostic yield, discomfort-free, outpatient basis, and physiological images. BAE enabled endoscopic diagnosis and treatment in the deep small bowel. Computed tomography (CT) enterography with negative oral contrast can evaluate masses, wall thickening, and narrowing of the small intestine. In addition, enhanced CT can detect abnormalities outside the gastrointestinal tract that endoscopy cannot evaluate. Each modality has its advantages and disadvantages, and a good combination of multiple modalities leads to an accurate diagnosis. As a first-line modality, three-phase enhanced CT is preferred. If CT shows a mass, stenosis, or wall thickening, a BAE should be selected. If there are no abnormal findings on CT and no obstructive symptoms, CE should be selected. If there are significant findings in the CE, determine the indication for BAE and its insertion route based on these findings. Early diagnosis of small intestinal tumors is essential for favorable outcomes. For early diagnosis, the possibility of small bowel lesions should be considered in patients with unexplained symptoms and signs after examination of the upper and lower gastrointestinal tract.
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Affiliation(s)
| | - Hironori Yamamoto
- Department of Medicine, Division of Gastroenterology, Jichi Medical University, Shimotsuke 329-0498, Japan;
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Kimura H, Yamamoto Y, Yabuuchi Y, Shigeta K, Yoshida M, Nagao S, Noguchi A, Morita Y, Shintani S, Inatomi O, Ono H, Andoh A. Gel immersion endoscopic mucosal resection for early gastric neoplasms: a multicenter case series study. Endosc Int Open 2024; 12:E435-E439. [PMID: 38504747 PMCID: PMC10948274 DOI: 10.1055/a-2271-2411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 02/15/2024] [Indexed: 03/21/2024] Open
Abstract
Several cases have been reported that suggest the efficacy of gel immersion endoscopic mucosal resection (GI-EMR) for gastric neoplasms. However, no study has evaluated treatment outcomes of GI-EMR for gastric neoplasms. This study aimed to investigate the efficacy and safety of GI-EMR for early gastric neoplasms. Nine patients (17 lesions) undergoing gastric GI-EMR were included, with a median lesion size of 10 mm (interquartile range [IQR] 5-13 mm). All lesions were protruding or flat elevated. The median procedure time was 3 minutes (IQR 2-5) and en bloc resection was achieved in all cases. Among 15 neoplastic lesions, the R0 resection rate was 86.7% (13/15 lesions). Adverse events included immediate bleeding requiring hemostasis in two cases, which was controlled endoscopically. No delayed bleeding or perforation occurred. In conclusion, GI-EMR may be a safe and effective treatment for early, small gastric neoplasms. However, due to the small sample in the present study, further investigation is required regarding the indication for this technique.
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Affiliation(s)
- Hidenori Kimura
- Division of Digestive Endoscopy, Shiga University of Medical Science, Otsu, Japan
| | - Yoichi Yamamoto
- Division of Endoscopy, Shizuoka Cancer Center, Sunto-gun, Japan
| | - Yohei Yabuuchi
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kohei Shigeta
- Division of Endoscopy, Shizuoka Cancer Center, Sunto-gun, Japan
| | - Masao Yoshida
- Division of Endoscopy, Shizuoka Cancer Center, Sunto-gun, Japan
| | - Soichiro Nagao
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Akito Noguchi
- Division of Gastroenterology, Shiga University of Medical Science, Otsu, Japan
| | - Yukihiro Morita
- Division of Gastroenterology, Shiga University of Medical Science, Otsu, Japan
| | - Shuhei Shintani
- Division of Gastroenterology, Shiga University of Medical Science, Otsu, Japan
| | - Osamu Inatomi
- Division of Gastroenterology, Shiga University of Medical Science, Otsu, Japan
| | - Hiroyuki Ono
- Division of Endoscopy, Shizuoka Cancer Center, Sunto-gun, Japan
| | - Akira Andoh
- Division of Gastroenterology, Shiga University of Medical Science, Otsu, Japan
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Mulki R, Qayed E, Yang D, Chua TY, Singh A, Yu JX, Bartel MJ, Tadros MS, Villa EC, Lightdale JR. The 2022 top 10 list of endoscopy topics in medical publishing: an annual review by the American Society for Gastrointestinal Endoscopy Editorial Board. Gastrointest Endosc 2023; 98:1009-1016. [PMID: 37977661 DOI: 10.1016/j.gie.2023.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/09/2023] [Accepted: 08/29/2023] [Indexed: 11/19/2023]
Abstract
Using a systematic literature search of original articles published during 2022 in Gastrointestinal Endoscopy and other high-impact medical and gastroenterology journals, the 10-member Editorial Board of the American Society for Gastrointestinal Endoscopy composed a list of the 10 most significant topic areas in GI endoscopy during the study year. Each Editorial Board member was directed to consider 3 criteria in generating candidate lists-significance, novelty, and global impact on clinical practice-and subject matter consensus was facilitated by the Chair through electronic voting. The 10 identified areas collectively represent advances in the following endoscopic spheres: artificial intelligence, endoscopic submucosal dissection, Barrett's esophagus, interventional EUS, endoscopic resection techniques, pancreaticobiliary endoscopy, management of acute pancreatitis, endoscopic environmental sustainability, the NordICC trial, and spiral enteroscopy. Each board member was assigned a consensus topic area around which to summarize relevant important articles, thereby generating this précis of the "top 10" endoscopic advances of 2022.
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Affiliation(s)
- Ramzi Mulki
- Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Emad Qayed
- Division of Digestive Diseases, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Dennis Yang
- Center of Interventional Endoscopy (CIE) Advent Health, Orlando, Florida, USA
| | - Tiffany Y Chua
- Division of Digestive Diseases, Harbor-University of California Los Angeles, Torrance, California, USA
| | - Ajaypal Singh
- Division of Digestive Diseases and Nutrition, Rush University Medical Center, Chicago, Illinois, USA
| | - Jessica X Yu
- Division of Gastroenterology and Hepatology, Oregon Health & Science University, Portland, Oregon, USA
| | | | | | - Edward C Villa
- NorthShore University Health System, Chicago, Illinois, USA
| | - Jenifer R Lightdale
- Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
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Michigami A, Maeda S, Hioka T, Ichihara S. Successful gel immersion endoscopic mucosal resection for gastric metastasis from a renal cell carcinoma. Dig Liver Dis 2023; 55:1767-1769. [PMID: 37648643 DOI: 10.1016/j.dld.2023.08.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023]
Affiliation(s)
- Atsushi Michigami
- Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, Hokkaido, Japan.
| | - Satoshi Maeda
- Department of Gastroenterology, Sapporo Kosei General Hospital, Sapporo, Hokkaido, Japan
| | - Takaya Hioka
- Department of Urology, Sapporo Kosei General Hospital, Sapporo, Hokkaido, Japan
| | - Shin Ichihara
- Department of Surgical Pathology, Sapporo Kosei General Hospital, Sapporo, Hokkaido, Japan
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Inoue T, Katada C, Shimizu T, Nikaido M, Higuchi H, Kishimoto Y, Muto M. Endoscopic resection combined with gel immersion and curved laryngoscope for superficial hypopharyngeal cancer. Endoscopy 2023; 55:E831-E832. [PMID: 37348547 PMCID: PMC10287509 DOI: 10.1055/a-2099-4084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Affiliation(s)
- Takahiro Inoue
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Chikatoshi Katada
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahiro Shimizu
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Mitsuhiro Nikaido
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hirokazu Higuchi
- Department of Medical Equipment, Kyoto University Hospital, Kyoto, Japan
| | - Yo Kishimoto
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Hirose T, Kato M, Hatta W, Abe S, Takizawa K, Yano T. Superficial non-ampullary duodenal epithelial tumors now: endoscopic diagnosis and therapy. Jpn J Clin Oncol 2023; 53:877-884. [PMID: 37394910 DOI: 10.1093/jjco/hyad073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/15/2023] [Indexed: 07/04/2023] Open
Abstract
With the recent increase in the frequency of duodenal tumor detection, significant progress has been made in endoscopic diagnosis and treatment. Although the first guidelines were issued in Japan, patient treatment varies widely among institutions. There is a need for improving the quality of endoscopic diagnosis and more curative and safer treatments. Biopsy is the standard diagnostic method; however, the diagnostic accuracy of endoscopic biopsy is not so high. Therefore, the differentiation of superficial non-ampullary duodenal epithelial tumors from non-neoplastic lesions is being developed. The incidence of lymph node and distant metastases of duodenal epithelial tumors is extremely rare in intramucosal carcinomas, and they are considered good candidates for endoscopic treatment if the technical difficulties can be resolved. Adverse events associated with endoscopic treatment are greatly reduced at advanced facilities through novel resection and closure methods, and further improvements are expected in the future. Clarifying the risk of metastatic recurrence may lead to the development of more appropriate treatments and curative resection criteria.
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Affiliation(s)
- Takashi Hirose
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
| | - Motohiko Kato
- Department of Gastroenterology and Hepatology, Keio University Graduate School of Medicine, Tokyo, Japan
| | - Waku Hatta
- Department of Gastroenterology and Hepatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Seiichiro Abe
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Kohei Takizawa
- Department of Endoscopy, Koyukai Shin-Sapporo Hospital, Hokkaido, Japan
| | - Tomonori Yano
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan
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Ashizawa H, Hotta K, Imai K, Ito S, Kishida Y, Takada K, Okumura T, Kawata N, Yoshida M, Maeda Y, Yamamoto Y, Minamide T, Sato J, Ishiwatari H, Matsubayashi H, Ono H. Efficacy and Safety of Gel Immersion Endoscopic Mucosal Resection for Non-Pedunculated Colorectal Polyps. Life (Basel) 2023; 13:life13030711. [PMID: 36983866 PMCID: PMC10051202 DOI: 10.3390/life13030711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/31/2023] [Accepted: 03/02/2023] [Indexed: 03/08/2023] Open
Abstract
Underwater endoscopic mucosal resection (UEMR) has become a popular endoscopic resection method for large colorectal neoplasms. However, visualization can be poor during UEMR due to the presence of intestinal fluid. Gel immersion endoscopic mucosal resection (GIEMR), using a specially developed gel (Viscoclear®, Otsuka Pharmaceutical Factory, Tokushima, Japan), can improve the visual field. However, reports of GIEMR for colorectal polyps are limited. Herein, we evaluated the short-term outcomes of GIEMR for non-pedunculated colorectal neoplasms (NPCRN). This single-center, retrospective, and observational study includes 25 lesions in 20 patients with NPCRN who underwent GIEMR between January and October 2022. The short-term outcomes and adverse events were evaluated. The lesion locations were as follows: right colon, 18 lesions; left colon, 7 lesions; and rectum, none. The median tumor diameter was 15 (IQR, 10–18) mm. Histological classification was as follows: sessile serrated lesion, 9 cases; adenoma, 12 cases; and intramucosal adenocarcinoma, 4 cases. The overall en bloc resection rates and R0 resection rates were 80% (20/25) and 72% (18/25). For NPCRN in 10–19 mm, the en bloc resection rate was 75% (12/16), with an R0 resection rate of 69% (11/16). No post-polypectomy bleeding, perforation, or post-coagulation syndrome were observed. The findings of our study provide preliminary evidence of the efficacy and safety of GIEMR for NPCRN. Therefore, GIEMR may be a promising novel endoscopic resection method for NPCRN.
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Affiliation(s)
| | - Kinichi Hotta
- Correspondence: ; Tel.: +81-55-989-5222; Fax: +81-55-989-5783
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Hashiguchi K, Yamaguchi N, Shiota J, Akashi T, Ogihara K, Tabuchi M, Kitayama M, Matsushima K, Akazawa Y, Ohnita K, Nakao K. 'Underwater endoscopic mucosal resection with submucosal injection and marking' for superficial non-ampullary duodenal epithelial tumors to achieve R0 resection: a single-center case series. Scand J Gastroenterol 2023:1-9. [PMID: 36708197 DOI: 10.1080/00365521.2023.2171315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
OBJECTIVES To describe an endoscopic technique named 'underwater endoscopic mucosal resection (UEMR) with submucosal injection and marking (UEMR-SIM)' and to evaluate the therapeutic characteristics of superficial non-ampullary duodenal epithelial tumors (SNADETs) < 20 mm vis-a-vis classical EMR (CEMR) and UEMR techniques. MATERIALS AND METHODS This retrospective study included 103 consecutive SNADET patients (103 lesions) who underwent CEMR, UEMR, or UEMR-SIM. The UEMR-SIM procedure included (1) marking and submucosal injection, (2) filling of the duodenal lumen with 0.9% saline, (3) snaring of the lesion, and (4) electrosurgical removal. The procedural outcomes were compared between the UEMR-SIM and other-procedure groups. RESULTS The en bloc resection rate was significantly higher in the UEMR-SIM group (100%) than in the CEMR group (76.8%) (p = 0.015) but was not statistically different between the UEMR-SIM and UEMR groups (88.0%) (p = 0.236). The R0 resection rate was significantly higher in the UEMR-SIM group (90.9%) than in the UEMR group (48.0%) (p = 0.001) but was not statistically different between the UEMR-SIM and CEMR groups (76.8%) (p = 0.209). CONCLUSIONS Our study indicates that the proposed method, UEMR-SIM for SNADETs, is feasible to achieve a high R0 resection rate and a potentially low local recurrence rate.
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Affiliation(s)
- Keiichi Hashiguchi
- Department of Endoscopy, Nagasaki University Hospital, Nagasaki, Japan.,Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Naoyuki Yamaguchi
- Department of Endoscopy, Nagasaki University Hospital, Nagasaki, Japan
| | - Junya Shiota
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Taro Akashi
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kumi Ogihara
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Maiko Tabuchi
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Moto Kitayama
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kayoko Matsushima
- Medical Education Development Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Yuko Akazawa
- Department of Histology and Biomedical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ken Ohnita
- Department of Gastroenterology, Inoue Hospital, Nagasaki, Japan
| | - Kazuhiko Nakao
- Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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