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Kobara H, Mori H, Rafiq K, Fujihara S, Nishiyama N, Kato K, Oryu M, Tani J, Miyoshi H, Masaki T. Successful endoscopic treatment of Boerhaave syndrome using an over-the-scope clip. Endoscopy 2014; 46 Suppl 1 UCTN:E82-3. [PMID: 24676827 DOI: 10.1055/s-0032-1326454] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- H Kobara
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - H Mori
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - K Rafiq
- Department of Pharmacology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - S Fujihara
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - N Nishiyama
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - K Kato
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - M Oryu
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - J Tani
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - H Miyoshi
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - T Masaki
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Fujihara S, Mori H, Kobara H, Nishiyama N, Kobayashi M, Masaki T. Esophageal natural killer (NK)/T cell lymphoma of true natural killer cell origin. Endoscopy 2014; 46 Suppl 1 UCTN:E77-8. [PMID: 24676825 DOI: 10.1055/s-0032-1309852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- S Fujihara
- Department of Gastroenterology and Neurology, Kagawa University, Faculty of Medicine, Kagawa, Japan
| | - H Mori
- Department of Gastroenterology and Neurology, Kagawa University, Faculty of Medicine, Kagawa, Japan
| | - H Kobara
- Department of Gastroenterology and Neurology, Kagawa University, Faculty of Medicine, Kagawa, Japan
| | - N Nishiyama
- Department of Gastroenterology and Neurology, Kagawa University, Faculty of Medicine, Kagawa, Japan
| | - M Kobayashi
- Department of Gastroenterology and Neurology, Kagawa University, Faculty of Medicine, Kagawa, Japan
| | - T Masaki
- Department of Gastroenterology and Neurology, Kagawa University, Faculty of Medicine, Kagawa, Japan
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Nishiyama N, Mori H, Rafiq K, Kobara H, Fujihara S, Kobayashi M, Masaki T. Over-the-scope clip system is effective for the closure of post-endoscopic submucosal dissection ulcer, especially at the greater curvature. Endoscopy 2014; 46 Suppl 1 UCTN:E130-1. [PMID: 24756257 DOI: 10.1055/s-0032-1325980] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- N Nishiyama
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
| | - H Mori
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
| | - K Rafiq
- Pharmacology, Faculty of Medicine, Kagawa University, Japan
| | - H Kobara
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
| | - S Fujihara
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
| | - M Kobayashi
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
| | - T Masaki
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Japan
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Mori H, Kobara H, Rafiq K, Nishiyama N, Fujihara S, Kobayashi M, Oryu M, Fujiwara M, Suzuki Y, Masaki T. New flexible endoscopic full-thickness suturing device: a triple-arm-bar suturing system. Endoscopy 2013; 45:649-54. [PMID: 23881805 DOI: 10.1055/s-0033-1344156] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND STUDY AIM A reliable full-thickness suturing device is necessary for pure natural orifice transluminal endoscopic surgery (NOTES). The present study focused on assessing the reliability of a new suturing device. METHODS A total of 60 single sutures were tested to close 5-cm incisions in 8-cm square pieces of resected swine stomach. Each incision was sutured by an over-the-scope clip (OTSC; n = 20), a single hand-sewn stitch (n = 20), or a single triple-arm-bar suturing system (TBSS) stitch. The maximum pulling force durability (MPD) of each suture was tested. To assess the reliability of the TBSS for endoscopic full-thickness resection (EFTR), 60 EFTRs of 50 mm diameter were performed on excised swine stomachs. After EFTR, full-thickness sutures were made using 3-stitch OTSCs (n = 20), 10-stitch hand-sewn sutures (n = 20), or 10-stitch TBSS sutures (n = 20). Outcomes were the MPD test for both single stitch and multiple stitch applications and the suturing time for single-stitch sutures. RESULTS In the single-stitch MPD tests, there were significant differences between OTSCs and hand-sewn sutures (P = 0.0002) and between OTSCs and TBSS sutures (P = 0.0001), but no significant difference between hand-sewn and TBSS sutures. The multiple-stitch sutures revealed significant differences between OTSCs and hand-sewn sutures (P = 0.0039), and between OTSCs and TBSS sutures (P = 0.013). There was no significant difference between hand-sewn and TBSS sutures. There were significant differences in suture times between OTSC, hand-sewn sutures, and TBSS sutures (P < 0.05). CONCLUSIONS Both single-stitch and multiple-stitch sutures using TBSS have similar strength to hand-sewn sutures. TBSS is a reliable suturing device.
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Affiliation(s)
- H Mori
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan.
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Kobara H, Mori H, Fujiwara S, Nishiyama N, Kobayashi M, Masaki T. Bloc biopsy by tunneling method using endoscopic submucosal dissection for an upper gastrointestinal submucosal tumor. Endoscopy 2012; 44 Suppl 2 UCTN:E197-8. [PMID: 22622742 DOI: 10.1055/s-0031-1291821] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- H Kobara
- Department of Gastroenterology and Neurology, Kagawa Medical University School of Medicine, Kagawa, Japan.
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Affiliation(s)
- H Kobara
- Department of Gastroenterology and Neurology, Kagawa Medical University School of Medicine, Japan.
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Mori H, Rafiq K, Kobara H, Fujihara S, Nishiyama N, Kobayashi M, Himoto T, Haba R, Hagiike M, Izuishi K, Okano K, Suzuki Y, Masaki T. Local steroid injection into the artificial ulcer created by endoscopic submucosal dissection for gastric cancer: prevention of gastric deformity. Endoscopy 2012; 44:641-8. [PMID: 22696191 DOI: 10.1055/s-0032-1309815] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND STUDY AIMS Endoscopic submucosal dissection (ESD) of large gastric lesions results in an extensive artificial ulcer that can lead to marked gastric deformity. The aim of the current study was to evaluate therapeutic efficacy in the prevention of gastric deformity of local triamcinolone acetonide (TCA) injection into the extensive artificial ulcer following ESD. PATIENTS AND METHODS A total of 45 patients who were diagnosed with early gastric cancer were enrolled. Patients were randomly assigned by the sealed-envelope randomization method to either local TCA injections (n = 21) or sham-control (n = 20) groups. Two clips were placed at the two maximum outer edges of the artificial ulcer after the lesion had been resected (Day 0). Local TCA injections were performed on postoperative Day 5 and Day 12. The distance between the two clips was measured by endoscopic measuring forceps on Days 5, 12, 30, and 60. Granulation formation and gastric deformity were evaluated by visual analog scale (VAS) on Days 30 and 60. RESULTS Local TCA injection did not alter clip-to-clip distance on postoperative Day 60, and formation of flat granulation tissue over the ulcer was followed by regenerative mucosa without any gastric deformity. The sham-control group showed significant shortening of clip-to-clip distance compared with the local steroid-injected group and protruded forms of granulation tissue with mucosal convergence. Histological evaluation revealed prominent growth of neovessels, swelling, and marked increases in endothelial cells in the local steroid-injected group compared with the sham-control group. CONCLUSIONS Local steroid injection into the floor of a post-ESD artificial ulcer promotes the formation of granulation tissue at an early stage of the healing process leading to regeneration of gastric mucosa without mucosal convergence or gastric deformity.
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Affiliation(s)
- H Mori
- Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa University, Kagawa, Japan.
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Mori H, Kobara H, Kobayashi M, Muramatsu A, Nomura T, Hagiike M, Izuishi K, Suzuki Y, Masaki T. Establishment of pure NOTES procedure using a conventional flexible endoscope: review of six cases of gastric gastrointestinal stromal tumors. Endoscopy 2011; 43:631-4. [PMID: 21611948 DOI: 10.1055/s-0030-1256227] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
An increasing number of reports have recently been published on hybrid natural orifice transluminal endoscopic surgery (NOTES). These reports do not address how to complete an operation with a flexible endoscope alone (pure NOTES), but rather how to combine use of an endoscope and a laparoscope. Surgical procedures using flexible and rigid endoscopes have been developed using different processes and concepts. Recognizing this conceptual difference, we conducted a study to address how to establish a pure NOTES procedure. Six patients with gastric gastrointestinal stromal tumors (GISTs) underwent hybrid NOTES. Each case was retrospectively reviewed to determine the appropriateness of the treatment and the usefulness of the endoscopic submucosal dissection (ESD) method, double-scope method, spaced perforation method, duodenal balloon occlusion method, and loop clip technique. The development of operative procedures that take advantage of the characteristics of flexible endoscopes, even with conventional flexible endoscopic devices and conventional endoscopes alone, may contribute to the realization of pure NOTES.
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Affiliation(s)
- H Mori
- Department of Gastroenterology and Neurology, Kagawa Medical University School of Medicine, Kagawa, Japan.
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Mori H, Kobara H, Kobayashi M, Muramatsu A, Nomura T, Yachida T, Izuishi K, Suzuki Y, Gong J, Masaki T. Rectal perforation from cholesterol embolization syndrome. Endoscopy 2011; 42 Suppl 2:E352-3. [PMID: 21170845 DOI: 10.1055/s-0030-1255979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- H Mori
- Department of Gastroenterology and Neurology, Kagawa Medical University School of Medicine, Kagawa, Japan.
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Uchida N, Tsutsui K, Kobara H, Ezaki T, Fukuma H, Yachida M, Masaki T, Watanabe S, Nakatsu T, Nakano H, Kuriyama S. A case of gallbladder carcinoma diagnosed preoperatively by the detection of human telomerase reverse transcriptase mRNA in endoscopically obtained gallbladder bile. Endoscopy 2003; 35:185-8. [PMID: 12561014 DOI: 10.1055/s-2003-37007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
It is difficult to accurately diagnose the nature of polypoid lesions in the gallbladder. To increase diagnostic accuracy, we have developed an endoscopic technique for obtaining gallbladder bile, termed endoscopic transpapillary catheterization into the gallbladder (ETCG). We describe here a case of gallbladder carcinoma diagnosed preoperatively by the detection of human telomerase reverse transcriptase (hTERT) mRNA, a catalytic subunit of telomerase, in gallbladder bile obtained using the ETCG technique. A patient with a polypoid lesion 15 mm in diameter in the gallbladder was admitted to our hospital for further examinations. Gallbladder bile collected by the ETCG technique was evaluated cytologically and also analyzed for telomerase activity and hTERT mRNA. Although the results for cytology and telomerase activity were negative, that for hTERT mRNA was positive. Open surgery was carried out and it was confirmed that the lesion was an adenocarcinoma invading the subserosa. The molecular biological analysis of gallbladder bile collected using the ETCG technique was shown to be effective for diagnosing the nature of the polypoid lesion in the gallbladder.
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Affiliation(s)
- N Uchida
- Third Department of Internal Medicine, Kagawa Medical University, Kagawa, Japan.
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Uchida N, Ezaki T, Fukuma H, Tsutsui K, Kobara H, Bang MH, Ogawa M, Watanabe K, Ono M, Morishita A, Ogi T, Kamata H, Masaki T, Watanabe S, Kuriyama S. Conversion of endoscopic nasobiliary drainage to internal drainage by means of endoscopic scissor forceps. Endoscopy 2002; 34:180. [PMID: 11822021 DOI: 10.1055/s-2002-19841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- N Uchida
- Third Dept. of Internal Medicine, Kagawa Medical University, Kagawa, Japan.
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