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Hee Kyong Na 7 Articles
Endoscopic resection of gastric gastrointestinal stromal tumor using clip-and-cut endoscopic full-thickness resection: a single-center, retrospective cohort in Korea
Yuri Kim, Ji Yong Ahn, Hwoon-Yong Jung, Seokin Kang, Ho June Song, Kee Don Choi, Do Hoon Kim, Jeong Hoon Lee, Hee Kyong Na, Young Soo Park
Clin Endosc 2024;57(3):350-363.   Published online February 15, 2024
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
/Aims: To overcome the technical limitations of classic endoscopic resection for gastric gastrointestinal stromal tumors (GISTs), various methods have been developed. In this study, we examined the role and feasibility of clip-and-cut procedures (clip-and-cut endoscopic full-thickness resection [cc-EFTR]) for gastric GISTs.
Medical records of 83 patients diagnosed with GISTs after endoscopic resection between 2005 and 2021 were retrospectively reviewed. Moreover, clinical characteristics and outcomes were analyzed.
Endoscopic submucosal dissection (ESD) and cc-EFTR were performed in 51 and 32 patients, respectively. The GISTs were detected in the upper third of the stomach for ESD (52.9%) and cc-EFTR (90.6%). Within the cc-EFTR group, a majority of GISTs were located in the deep muscularis propria or serosal layer, accounting for 96.9%, as opposed to those in the ESD group (45.1%). The R0 resection rates were 51.0% and 84.4% in the ESD and cc-EFTR groups, respectively. Seven (8.4%) patients required surgical treatment (six patients underwent ESD and one underwent cc-EFTR,) due to residual tumor (n=5) and post-procedure adverse events (n=2). Patients undergoing R0 or R1 resection did not experience recurrence during a median 14-month follow-up period, except for one patient in the ESD group.
cc-EFTR displayed a high R0 resection rate; therefore, it is a safe and effective therapeutic option for small gastric GISTs.


Citations to this article as recorded by  
  • Endoscopic resection penetrating the muscularis propria for gastric gastrointestinal stromal tumors: advances and challenges
    Jin Woong Cho
    Clinical Endoscopy.2024; 57(3): 329.     CrossRef
  • 2,955 View
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Outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms in patients with liver cirrhosis
Young Kwon Choi, Jin Hee Noh, Do Hoon Kim, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Clin Endosc 2022;55(3):381-389.   Published online April 20, 2022
AbstractAbstract PDFSupplementary MaterialPubReaderePub
/Aims: The treatment of superficial esophageal neoplasms (SENs) in cirrhotic patients is challenging and rarely investigated. We evaluated the outcomes of endoscopic submucosal dissection (ESD) to determine the efficacy and safety of treating SENs in patients with liver cirrhosis.
The baseline characteristics and treatment outcomes of patients who underwent ESD for SENs between November 2005 and December 2017 were retrospectively reviewed.
ESD was performed in 437 patients with 481 SENs, including 15 cirrhotic patients with 17 SENs. En bloc resection (88.2% vs. 97.0%) and curative resection (64.7% vs. 78.9%) rates were not different between the cirrhosis and non-cirrhosis groups (p=0.105 and p=0.224, respectively). Bleeding was more common in cirrhotic patients (p=0.054), and all cases were successfully controlled endoscopically. The median procedure and hospitalization duration did not differ between the groups. Overall survival was lower in cirrhotic patients (p=0.003), while disease-specific survival did not differ between the groups (p=0.85).
ESD could be a safe and effective treatment option for SENs in patients with cirrhosis. Detailed preprocedural assessments are needed, including determination of liver function, esophageal varix status, and remaining life expectancy, to identify patients who will obtain the greatest benefit.


Citations to this article as recorded by  
  • Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasia in close proximity to esophageal varices: a multicenter international experience
    Shruti Mony, Bing Hu, Abel Joseph, Hiroyuki Aihara, Lorenzo Ferri, Amit Bhatt, Amit Mehta, Peng-Sheng Ting, Alex Chen, Andrew Kalra, Jad Farha, Manabu Onimaru, Long He, Qi Luo, Andrew Y. Wang, Haruhiro Inoue, Saowanee Ngamruengphong
    Endoscopy.2024; 56(02): 119.     CrossRef
  • Risk associated with endoscopic treatment of early upper gastrointestinal cancer in patients with liver cirrhosis and management strategies
    Yu-Yong Tan, Yu-Min Qing, Jian Gong, De-Liang Liu
    World Chinese Journal of Digestology.2024; 32(2): 102.     CrossRef
  • Endoscopic submucosal dissection for early cancers or precancerous lesions of the upper GI tract in cirrhotic patients with esophagogastric varices: 10-year experience from a large tertiary center in China
    Shuai Zhang, Ying-Di Liu, Ning-Li Chai, Yi Yao, Fei Gao, Bo Liu, Zhan-Di He, Lu Bai, Xin Huang, Chao Gao, En-Qiang Linghu, Lian-Yong Li
    Gastrointestinal Endoscopy.2023; 97(6): 1031.     CrossRef
  • Clinical outcomes of endoscopic submucosal dissection for esophageal squamous cell carcinoma with esophageal varices: Multicenter retrospective study
    Yosuke Toya, Waku Hatta, Tomohiro Shimada, Tamotsu Matsuhashi, Takeharu Shiroki, Yu Sasaki, Tetsuya Tatsuta, Jun Nakamura, Norihiro Hanabata, Yohei Horikawa, Ko Nagino, Tomoyuki Koike, Atsushi Masamune, Yoshihiro Harada, Tetsuya Ohira, Katsunori Iijima, Y
    Digestive Endoscopy.2023;[Epub]     CrossRef
  • Endoscopic Submucosal Dissection for Treatment of Early-Stage Cancer or Precancerous Lesion in the Upper Gastrointestinal Tract in Patients with Liver Cirrhosis
    Yuyong Tan, Yumin Qing, Deliang Liu, Jian Gong
    Journal of Clinical Medicine.2023; 12(20): 6509.     CrossRef
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Various Novel and Emerging Technologies in Endoscopic Bariatric and Metabolic Treatments
Hee Kyong Na, Diogo Turiani Hourneaux De Moura, The Study Group for Endoscopic Bariatric and Metabolic Therapies of the Korean Society of Gastrointestinal Endoscopy
Clin Endosc 2021;54(1):25-31.   Published online January 29, 2021
AbstractAbstract PDFPubReaderePub
Obesity, along with its comorbidities, has become a significant public health concern worldwide. Bariatric surgery is considered the most effective treatment modality; however, only 2% of patients with obesity undergo bariatric surgery. Endoscopic bariatric and metabolic therapies (EBMTs) are emerging alternatives to traditional bariatric surgery for patients who are not eligible for or do not prefer surgical treatment. EBMTs are generally categorized as space-occupying, gastric restrictive, aspiration, and small bowel therapies. We aimed to review various non-balloon and non-gastroplasty devices with available clinical data and discuss the possible mechanisms of action, efficacy, and safety profile of these EMBTs.


Citations to this article as recorded by  
  • Role of endoscopic duodenojejunal bypass liner in obesity management and glycemic control
    Willian Ferreira Igi, Victor Lira de Oliveira, Ayah Matar, Diogo Turiani Hourneaux de Moura
    Clinical Endoscopy.2024; 57(3): 309.     CrossRef
  • Intragastric Balloons
    D.T.H. de Moura, Sergio A. Sánchez-Luna, Adriana Fernandes Silva, Alexandre Moraes Bestetti
    Gastrointestinal Endoscopy Clinics of North America.2024;[Epub]     CrossRef
  • The Effectiveness and Safety of the Duodenal-Jejunal Bypass Liner (DJBL) for the Management of Obesity and Glycaemic Control: a Systematic Review and Meta-Analysis of Randomized Controlled Trials
    Erika Yuki Yvamoto, Diogo Turiani Hourneaux de Moura, Igor Mendonça Proença, Epifanio Silvino do Monte Junior, Igor Braga Ribeiro, Pedro Henrique Boraschi Vieira Ribas, Matheus Cândido Hemerly, Victor Lira de Oliveira, Sergio A. Sánchez-Luna, Wanderley Ma
    Obesity Surgery.2023; 33(2): 585.     CrossRef
  • A Comprehensive Review on Bariatric Endoscopy: Where We Are Now and Where We Are Going
    Aurelio Mauro, Francesca Lusetti, Davide Scalvini, Marco Bardone, Federico De Grazia, Stefano Mazza, Lodovica Pozzi, Valentina Ravetta, Laura Rovedatti, Carmelo Sgarlata, Elena Strada, Francesca Torello Viera, Letizia Veronese, Daniel Enrique Olivo Romero
    Medicina.2023; 59(3): 636.     CrossRef
  • Endoscopic Bariatric Therapy for Obesity and Metabolic Syndrome
    Sang Pyo Lee
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(4): 247.     CrossRef
  • The Effect of Endoscopic Bariatric and Metabolic Therapies on Gastroesophageal Reflux Disease
    Su-Young Kim
    Medicina.2021; 57(8): 737.     CrossRef
  • 4,670 View
  • 158 Download
  • 4 Web of Science
  • 6 Crossref
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Clinical Outcomes of Percutaneous Endoscopic Gastrostomy in the Surgical Intensive Care Unit
Gyu Young Pih, Hee Kyong Na, Suk-Kyung Hong, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Clin Endosc 2020;53(6):705-716.   Published online March 31, 2020
AbstractAbstract PDFPubReaderePub
/Aims: Percutaneous endoscopic gastrostomy (PEG) is usually performed on patients with chronic underlying diseases in the general ward (GW). This study evaluated the clinical outcomes of PEG performed on patients in the surgical intensive care unit (SICU) compared with those of PEG performed in the GW.
The medical records of 27 patients in the SICU and 263 in the GW, who underwent PEG between January 2013 and July 2017, were retrospectively reviewed.
The median age of the 27 SICU patients was 66 years, and their median body mass index was 21.1 kg/m2. In the SICU group, the median baseline Sequential Organ Failure Assessment (SOFA) score was 4, and the median Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 16. The median interval between surgery and PEG in SICU patients was 30 days, with a PEG failure rate of 3.7%. Acute complications in SICU patients included bleeding (7.4%) and ileus (11.1%), while chronic complications included aspiration pneumonia (7.4%) and tube obstruction (3.7%). The rates of acute and chronic complications did not differ significantly between the SICU and GW groups. The 30-day mortality rate was 14.8% in SICU patients and 5.3% in GW patients (p=0.073).
PEG is a safe and feasible method of enteral feeding for critically ill patients who require ICU care after surgery.


Citations to this article as recorded by  
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Gut and Liver.2024; 18(1): 10.     CrossRef
  • A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
    Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
    Gut and Liver.2024; 18(1): 77.     CrossRef
  • Clinical practice guidelines for percutaneous endoscopic gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    Clinical Endoscopy.2023; 56(4): 391.     CrossRef
  • Risk factors and natural history of bedside percutaneous endoscopic versus fluoroscopy-guided gastrostomy tubes in intensive care unit patients
    Lucy Ching Chau, Ryan Soheim, Michael Dix, Sarah Chung, Nadia Obeid, Arielle Hodari-Gupta, Cletus Stanton
    Surgical Endoscopy.2023; 37(11): 8742.     CrossRef
  • Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
    Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
    The Korean Journal of Gastroenterology.2023; 82(3): 107.     CrossRef
  • Relative contraindications to percutaneous endoscopic gastrostomy (review of literature)
    Yu. O. Zharikov, M. Kh. Gurtsiev, S. Zh. Antonyan, S. F. Askerova, E. I. Chairkina, P. A. Yartsev
    Grekov's Bulletin of Surgery.2022; 180(6): 105.     CrossRef
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Gastrocolocutaneous Fistula: An Unusual Case of Gastrostomy Tube Malfunction with Diarrhea
Junghwan Lee, Jinyoung Kim, Ha il Kim, Chung Ryul Oh, Sungim Choi, Soomin Noh, Hee Kyong Na, Hwoon-Yong Jung
Clin Endosc 2018;51(2):196-200.   Published online August 31, 2017
AbstractAbstract PDFPubReaderePub
A gastrocolocutaneous fistula is a rare complication of percutaneous endoscopic gastrostomy (PEG). We report a case of a gastrocolocutaneous fistula presenting with intractable diarrhea and gastrostomy tube malfunction. A 62-year-old woman with a history of multiple system atrophy was referred to us because of PEG tube malfunction. Twenty days prior to presentation, the patient started developing sudden diarrhea within minutes after starting PEG feeding. Fluoroscopy revealed that the balloon of the PEG tube was located in the lumen of the transverse colon with the contrast material filling the colon. Subsequently, the PEG tube was removed and the opening of the gastric site was endoscopically closed using hemoclips. Clinicians should be aware of gastrocolocutaneous fistula as one of the complications of PEG insertion. Sudden onset of diarrhea, immediately after PEG feedings, might suggest this complication, which can be effectively treated with endoscopic closure.


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    Maria Elena Pugliese, Riccardo Battaglia, Antonio Cerasa, Lucia Francesca Lucca
    Healthcare.2023; 11(9): 1263.     CrossRef
  • An unusual complication of percutaneous endoscopic gastrostomy and its endoscopic treatment
    Noble Thomas, Cherukara Philip Thomas, C. Ganesh Pai
    Indian Journal of Gastroenterology.2023; 42(4): 580.     CrossRef
  • How far is the endoscopist to blame for a percutaneous endoscopic gastrostomy complication?
    George Stavrou, Persefoni Gionga, George Chatziantoniou, Georgios Tzikos, Alexandra Menni, Stavros Panidis, Anne Shrewsbury, Katerina Kotzampassi
    World Journal of Gastrointestinal Surgery.2023; 15(5): 940.     CrossRef
  • Misplacement of the PEG tube through the transverse colon, an uncommon but possible complication
    David Viso Vidal, Francisco Jorquera Plaza
    Revista Española de Enfermedades Digestivas.2022;[Epub]     CrossRef
  • Endoscopic management of enteral tubes in adult patients – Part 2: Peri- and post-procedural management. European Society of Gastrointestinal Endoscopy (ESGE) Guideline
    Paraskevas Gkolfakis, Marianna Arvanitakis, Edward J. Despott, Asuncion Ballarin, Torsten Beyna, Kurt Boeykens, Peter Elbe, Ingrid Gisbertz, Alice Hoyois, Ofelia Mosteanu, David S. Sanders, Peter T. Schmidt, Stéphane M. Schneider, Jeanin E. van Hooft
    Endoscopy.2021; 53(02): 178.     CrossRef
  • Een laattijdige complicatie na het plaatsen van een PEG-sonde
    Tijdschrift voor Geneeskunde.2021;[Epub]     CrossRef
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    Maha Al Shaibi, Mohamed Al Abri, Ghaitha Al Mahruqi, Alok Mittal
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    Case Reports in Gastroenterology.2020; 14(3): 637.     CrossRef
  • Long-Term Gastrocolocutaneous Fistula after Endoscopic Gastrostomy: How Concerned Should We Be?
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Characteristics of Missed Simultaneous Gastric Lesions Based on Double-Check Analysis of the Endoscopic Image
Eun Jeong Gong, Jeong Hoon Lee, Kyoungwon Jung, Charles J. Cho, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin-Ho Kim
Clin Endosc 2017;50(3):261-269.   Published online August 22, 2016
AbstractAbstract PDFPubReaderePub
/Aims: The detection of multifocal lesions is important for the successful management of gastric neoplasms. We investigated the characteristics of missed simultaneous lesions and the reason for the missed diagnoses.
A total of 140 patients who underwent repeat endoscopy before endoscopic resection between June 2013 and June 2014 were retrospectively reviewed. We classified simultaneous lesions into three groups based on a review of earlier images: group 1, no images of the location of simultaneous lesions were taken; group 2, no corresponding lesion was evident in the previous images; and group 3, simultaneous lesions were visible in the earlier images but a biopsy was not performed.
Simultaneous lesions were found in 12 patients (8.6%) with 13 lesions, comprising 10 dysplasia (76.9%) and three adenocarcinoma (23.1%). Regarding the reasons for missed diagnoses, seven lesions (53.8%) were classified as group 3, five (38.5%) as group 1, and the remaining lesion (7.7%) as group 2. There were no significant differences in the characteristics of the patients with and without simultaneous lesions.
Lesions disregarded or unnoticed during endoscopic examination were the main reason for missed diagnosis of simultaneous lesions. Endoscopists should consider the possibility of simultaneous lesions and attempt to meticulously evaluate the entire gastric mucosa.


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    Eun Jeong Gong, Hye‐Kyung Jung
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    Gastric Cancer.2022; 25(2): 392.     CrossRef
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    Won Shik Kim, Hayeon Kim, Moon Kyung Joo, Byung Il Choi, Ah Young Yoo, Jong-Jae Park, Beom Jae Lee, Seung Han Kim, Hoon Jai Chun
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    Bong Eun Lee
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Yields and Utility of Endoscopic Ultrasonography-Guided 19-Gauge Trucut Biopsy versus 22-Gauge Fine Needle Aspiration for Diagnosing Gastric Subepithelial Tumors
Hee Kyong Na, Jeong Hoon Lee, Young Soo Park, Ji Yong Ahn, Kwi-Sook Choi, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Jin-Ho Kim
Clin Endosc 2015;48(2):152-157.   Published online March 27, 2015
AbstractAbstract PDFPubReaderePub

To evaluate the yields and utility of 19-gauge (G) Trucut biopsy (TCB) versus 22 G fine needle aspiration (FNA) for diagnosing gastric subepithelial tumors (SETs).


We retrieved data for 152 patients with a gastric SET larger than 2 cm who had undergone endoscopic ultrasonography (EUS)-guided 19 G TCB (n=90) or 22 G FNA (n=62). Relevant clinical, tumor-specific, and EUS procedural information was reviewed retrospectively.


A specific diagnosis was made for 76 gastrointestinal stromal tumors (GISTs) and 51 non-GIST SETs. The diagnostic yield of TCB was greater than that of FNA (77.8% vs. 38.7%, p<0.001). The percentage of non-diagnostic specimens (suspicious and insufficient) was significantly lower in the TCB group (6.7% and 15.5%, respectively) than in the FNA group (22.6% and 38.7%, respectively; both p<0.001). TCB accurately diagnosed 90.9% of GISTs and 81.1% of non-GIST SETs, whereas FNA accurately diagnosed 68.8% of GISTs and 14.3% of non-GIST SETs. There were nine technical failures with TCB, and the rate of adverse events did not differ between the groups (TCB vs. FNA, 3.3% vs. 8.1%; p=0.27).


Nineteen-gauge TCB is safe and highly valuable for diagnosing gastric SETs larger than 2 cm if technical failure can be avoided.


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