Clinical Endoscopy

Kee Don Choi

15 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; DOI: https://doi.org/10.5946/ce.2023.144

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Background
/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.
Methods
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.
Results
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.
Conclusions
cc-EFTR displayed a high R0 resection rate; therefore, it is a safe and effective therapeutic option for small gastric GISTs.

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Endoscopic resection penetrating the muscularis propria for gastric gastrointestinal stromal tumors: advances and challenges
Jin Woong Cho
Clinical Endoscopy.2024; 57(3): 329. CrossRef

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International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy: Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee, The Korean Society of Gastrointestinal Endoscopy Task Force on Clinical Practice Guidelines; Clin Endosc 2024;57(2):141-157. Published online March 14, 2024; DOI: https://doi.org/10.5946/ce.2024.002

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Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020. However, new evidence on the use of dual antiplatelet therapy and direct anticoagulant management has emerged, and revised guidelines have been issued in the United States and Europe. Accordingly, the previous guidelines were revised. Cardiologists were part of the group that developed the guideline, and the recommendations went through a consensus-reaching process among international experts. This guideline presents 14 recommendations made based on the Grading of Recommendations, Assessment, Development, and Evaluation methodology and was reviewed by multidisciplinary experts. These guidelines provide useful information that can assist endoscopists in the management of patients receiving antithrombotic agents who require diagnostic and elective therapeutic endoscopy. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

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EUS-guided gallbladder drainage for patients with antithrombotic therapy: Intervention or medication?
Liqi Sun, Jiang Liu
Gastrointestinal Endoscopy.2025; 101(1): 226. CrossRef
Prediction of immediate bleeding after cold snare polypectomy: A prospective observational study
Shin Ju Oh, Yunho Jung, Young Hwangbo, Young Sin Cho, Il Kwun Chung, Chang Kyun Lee
Medicine.2024; 103(36): e39597. CrossRef

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Bronchoesophageal fistula in a patient with Crohn’s disease receiving anti-tumor necrosis factor therapy: Kyunghwan Oh, Kee Don Choi, Hyeong Ryul Kim, Tae Sun Shim, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park; Clin Endosc 2023;56(2):239-244. Published online December 21, 2021; DOI: https://doi.org/10.5946/ce.2021.215

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Tuberculosis is an adverse event in patients with Crohn’s disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn’s disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient’s condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

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(Re-)introduction of TNF antagonists and JAK inhibitors in patients with previous tuberculosis: a systematic review
Thomas Theo Brehm, Maja Reimann, Niklas Köhler, Christoph Lange
Clinical Microbiology and Infection.2024; 30(8): 989. CrossRef
Azathioprine/infliximab/methylprednisolone

Reactions Weekly.2023; 1963(1): 114. CrossRef

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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; DOI: https://doi.org/10.5946/ce.2021.242

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Background
/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.
Methods
The baseline characteristics and treatment outcomes of patients who underwent ESD for SENs between November 2005 and December 2017 were retrospectively reviewed.
Results
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).
Conclusions
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.

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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.2024; 36(3): 314. CrossRef
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
Radical chemoradiotherapy for superficial esophageal cancer complicated with liver cirrhosis
Hejing Bao, Hehong Bao, Liping Lin, Yuhuan Wang, Longbin Zhang, Li Zhang, Han Zhang, Lingxiang Liu, Xiaolong Cao
PeerJ.2024; 12: e18065. CrossRef
Endoscopic management of early esophageal cancer in patients with concomitant cirrhosis
Zhenming Zhang, Linlin Zhu
Chinese Medical Journal.2024;[Epub] 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
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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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; DOI: https://doi.org/10.5946/ce.2019.196

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Background
/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.
Methods
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.
Results
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).
Conclusions
PEG is a safe and feasible method of enteral feeding for critically ill patients who require ICU care after surgery.

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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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Multidisciplinary and Multisociety Practice Guideline on Reprocessing Flexible Gastrointestinal Endoscopes and Endoscopic Accessories: Dae Young Cheung, Byung Ik Jang, Sang Wook Kim, Jie-Hyun Kim, Hyung Keun Kim, Jeong Eun Shin, Won Jae Yoon, Yong Kang Lee, Kwang Hyun Chung, Soo-Jeong Cho, Hyun Phil Shin, Sun Young Cho, Woon Geon Shin, Kee Don Choi, Byung-Wook Kim, Joong Goo Kwon, Hee Chan Yang, Tae-Geun Gweon, Hyun Gun Kim, Dong-Won Ahn, Kwang Bum Cho, Sun Hee Kim, Kyong Hwa Hwang, Hee Hyuk Im; Clin Endosc 2020;53(3):276-285. Published online May 29, 2020; DOI: https://doi.org/10.5946/ce.2020.106

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The area of endoscopic application has been continuously expanded since its introduction in the last century and the frequency of its use also increased stiffly in the last decades. Because gastrointestinal endoscopy is naturally exposed to diseased internal organs and contact with pathogenic materials, endoscopy mediated infection or disease transmission becomes a major concern in this field. Gastrointestinal endoscopy is not for single use and the proper reprocessing process is a critical factor for safe and reliable endoscopy procedures. What needed in these circumstances is a practical guideline for reprocessing the endoscope and its accessories which is feasible in the real clinical field to guarantee acceptable prevention of pathogen transmission. This guideline contains principles and instructions of the reprocessing procedure according to the step by step. And it newly includes general information and updated knowledge about endoscopy-mediated infection and disinfection. Multiple societies and working groups participated to revise; Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Society of Gastroenterology, Korean Society of Gastrointestinal Cancer, Korean Association for the Study of Intestinal Diseases, Korean Pancreatobiliary Association, the Korean Society of Gastrointestinal Endoscopy Nurses and Associates and Korean Society of Gastrointestinal Endoscopy. Through this cooperation, we enhanced communication and established a better concordance. We still need more researches in this field and fill up the unproven area. And our guidelines will be renewed accordingly.

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Efficacy and safety of three-dimensional magnetically assisted capsule endoscopy for upper gastrointestinal and small bowel examination
Dong Jun Oh, Yea Je Lee, Sang Hoon Kim, Joowon Chung, Hyun Seok Lee, Ji Hyung Nam, Yun Jeong Lim, Thomas Lui Ka Luen
PLOS ONE.2024; 19(5): e0295774. CrossRef
EUS-Guided Vascular Interventions: Recent Advances
Sahib Singh, Saurabh Chandan, Sumant Inamdar, Kambiz S. Kadkhodayan, Jahnvi Dhar, Jayanta Samanta, Antonio Facciorusso
Journal of Clinical Medicine.2024; 13(16): 4835. CrossRef
A New Drying Method of Thermolabile Flexible Endoscope Channels by Laminar and Turbulent Airflow: A Prospective, Randomized-Controlled, Single-Center, Proof-of-Concept Trial
Florian A. Michael, Michael Jung, Mike Reimers, Clara Oschwald, Ulrike Mihm, Christoph Welsch, Dirk Walter, Fabian Finkelmeier, Johannes Masseli, Anita Pathil, Georg Dultz, Danuta Puhlmann, Laura Diaz-Martinez, Daniel Hack, Neelam Lingwal, Jörg Bojunga, V
American Journal of Gastroenterology.2024;[Epub] CrossRef
Endoscope Cleaning and Disinfection Guidelines for Primary Care Physicians
Yoo-Bin Seo, Seung Hee Kim, Eon Sook Lee, Seung Jin Jung, Sang Keun Hahm
Korean Journal of Family Practice.2024; 14(4): 165. CrossRef
Current status of the gastric cancer screening program in Korea
Young-Il Kim, Il Ju Choi
Journal of the Korean Medical Association.2022; 65(5): 250. CrossRef
Reducing the environmental footprint of gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) Position Statement
Enrique Rodríguez de Santiago, Mario Dinis-Ribeiro, Heiko Pohl, Deepak Agrawal, Marianna Arvanitakis, Robin Baddeley, Elzbieta Bak, Pradeep Bhandari, Michael Bretthauer, Patricia Burga, Leigh Donnelly, Axel Eickhoff, Bu'Hussain Hayee, Michal F. Kaminski,
Endoscopy.2022; 54(08): 797. CrossRef
Current Evidence for a Paradigm Shift in Gastric Cancer Prevention From Endoscopic Screening toHelicobacter pyloriEradication in Korea
Young-Il Kim, Il Ju Choi
Journal of Gastric Cancer.2022; 22(3): 169. CrossRef
General guideline in the endoscopy room to avoid air-borne infection during the COVID-19 pandemic
Kwang Hyun Chung, Soo-Jeong Cho
Clinical Endoscopy.2022; 55(5): 688. CrossRef
Efficacy of a novel channel-cleaning ball brush for endoscope reprocessing: a randomized controlled trial
Kwang Hyun Chung, Jeong Don Chae, Wonho Choe, Hyo Young Lee, Il Hwan Oh, Byoung Kwan Son
Clinical Endoscopy.2022; 55(5): 674. CrossRef
Endoscopes that Complete Pre-Cleaning may be Stored Overnight until Next Morning for the Subsequent Reprocessing
Soo-Jeong Cho
Clinical Endoscopy.2021; 54(4): 449. CrossRef
Accreditation program for gastrointestinal endoscopes reprocessing in Italy: An on-site survey
Giancarlo Spinzi, Angelo Milano, Piero Brosolo, Paola Da Massa Carrara, Maurizio Labardi, Alberto Merighi, Luisa Riccardi, Francesco Torresan, Maurizio Capelli
Endoscopy International Open.2021; 09(11): E1627. CrossRef
Sans Standardization: Effective Endoscope Reprocessing
Sameer K. Avasarala, Lawrence F. Muscarella, Atul C. Mehta
Respiration.2021; 100(12): 1208. CrossRef

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Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer: Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong Yeul Lee, Jeong-Sik Byeon, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Hoon Jai Chun; Clin Endosc 2020;53(2):142-166. Published online March 30, 2020; DOI: https://doi.org/10.5946/ce.2020.032

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Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

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A Modified eCura System to Stratify the Risk of Lymph Node Metastasis in Undifferentiated-Type Early Gastric Cancer After Endoscopic Resection
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World Journal of Gastroenterology.2024; 30(10): 1291. CrossRef
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World Journal of Clinical Cases.2024; 12(22): 5229. CrossRef
Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
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The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef
Optimal Surveillance of Metachronous Gastric Lesion after Endoscopic Resection of Early Gastric Cancer
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Gut and Liver.2024; 18(5): 781. CrossRef
Expanding Horizons: Unveiling the Clinical Features of Early Gastric Lymphoepithelioma-Like Carcinoma and the Potential of Endoscopic Resection as Curative Therapy
Jae Yong Park
Gut and Liver.2024; 18(5): 761. CrossRef
Histological Risk Factors for Lymph Node Metastasis in pT1 Colorectal Cancer: Does Submucosal Invasion Depth Really Matter?
Bing Yue, Mei Jia, Rui Xu, Guang-yong Chen, Mu-lan Jin
Current Medical Science.2024; 44(5): 1026. CrossRef
The risk factors of lymph node metastasis in early colorectal cancer: a predictive nomogram and risk assessment
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International Journal of Colorectal Disease.2024;[Epub] CrossRef
Position statement of the World Endoscopy Organization: Role of endoscopy in screening, diagnosis, and treatment of esophageal superficial squamous neoplasia
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Venous invasion and lymphatic invasion are correlated with the postoperative prognosis of pancreatic neuroendocrine neoplasm
Sho Kiritani, Junichi Arita, Yuichiro Mihara, Rihito Nagata, Akihiko Ichida, Yoshikuni Kawaguchi, Takeaki Ishizawa, Nobuhisa Akamatsu, Junichi Kaneko, Kiyoshi Hasegawa
Surgery.2023; 173(2): 365. CrossRef
Long-term outcomes after endoscopic versus surgical resection of T1 colorectal carcinoma
Hyun Jin Bae, Hoyeon Ju, Han Hee Lee, Jinsu Kim, Bo-In Lee, Sung Hak Lee, Daeyoun David Won, Yoon Suk Lee, In Kyu Lee, Young-Seok Cho
Surgical Endoscopy.2023; 37(2): 1231. CrossRef
Resection speed of endoscopic submucosal dissection according to the location of gastric neoplasia: a learning curve using cumulative sum analysis
Jun-Hyung Cho, So-Young Jin, Suyeon Park
Surgical Endoscopy.2023; 37(4): 2969. CrossRef
Endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: long-term follow-up in a Western center
Andreas Probst, Alanna Ebigbo, Stefan Eser, Carola Fleischmann, Tina Schaller, Bruno Märkl, Stefan Schiele, Bernd Geissler, Gernot Müller, Helmut Messmann
Clinical Endoscopy.2023; 56(1): 55. CrossRef
A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection
Hyun Deok Lee, Eunwoo Lee, Sang Gyun Kim, Cheol Min Shin, Jun Chul Park, Kee Don Choi, Seokyung Hahn, Soo-Jeong Cho
American Journal of Gastroenterology.2023; 118(5): 892. CrossRef
Endoscopic Resection of Undifferentiated Early Gastric Cancer
Yuichiro Hirai, Seiichiro Abe, Mai Ego Makiguchi, Masau Sekiguchi, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Yutaka Saito
Journal of Gastric Cancer.2023; 23(1): 146. CrossRef
Pre-procedure oral administration of pronase improves efficacy of lugol chromoendoscopy in esophageal squamous cell carcinoma screening: a prospective, double-blinded, randomized, controlled trial
Xin Zhao, Meng Guo, Shaohua Zhu, Linhui Zhang, Tao Dong, Hui Luo, Weihua Yu, Jiangyi Zhu, Xiaotong Fan, Ying Han, Zhiguo Liu
Surgical Endoscopy.2023; 37(6): 4421. CrossRef
Endoscopic advances in the management of gastric cancer and premalignant gastric conditions
Erica Park, Makoto Nishimura, Priya Simoes
World Journal of Gastrointestinal Endoscopy.2023; 15(3): 114. CrossRef
Comparative Cost Analysis Between Endoscopic Resection and Surgery for Submucosal Colorectal Cancer
Soo Min Noh, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, In Ja Park, Seok-Byung Lim, Jeong-Sik Byeon
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Byeong Geun Song, Ga Hee Kim, Charles J. Cho, Hyeong Ryul Kim, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Ho June Song, Yong-Hee Kim, Jun Haeng Lee, Hwoon-Yong Jung, Jae Ill Zo, Young Mog Shim
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Long-Term Survival and Tumor Recurrence in Patients with Superficial Esophageal Cancer after Complete Non-Curative Endoscopic Resection: A Single-Center Case Series: Ji Wan Lee, Charles J. Cho, Do Hoon Kim, Ji Yong Ahn, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Sook Ryun Park, Hyun Joo Lee, Yong Hee Kim, Gin Hyug Lee, Hwoon-Yong Jung, Sung-Bae Kim, Jong Hoon Kim, Seung-Il Park; Clin Endosc 2018;51(5):470-477. Published online June 1, 2018; DOI: https://doi.org/10.5946/ce.2018.025

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Background
/Aims: To report the long-term survival and tumor recurrence outcomes in patients with superficial esophageal cancer (SEC) after complete non-curative endoscopic resection (ER).
Methods
We retrieved ER data for 24 patients with non-curatively resected SEC. Non-curative resection was defined as the presence of submucosal and/or lymphovascular invasion on ER pathology. Relevant clinical and tumor-specific parameters were reviewed.
Results
The mean age of the 24 study patients was 66.3±8.3 years. Ten patients were closely followed up without treatment, while 14 received additional treatment. During a mean follow-up of 59.0±33.2 months, the 3- and 5-year survival rates of all cases were 90.7% and 77.6%, respectively. The 5-year overall survival rates were 72.9% in the close observation group and 82.1% in the additional treatment group (p=0.958). The 5-year cumulative incidences of all cases of recurrence (25.0% vs. 43.3%, p=0.388), primary EC recurrence (10.0% vs. 16.4%, p=0.558), and metachronous EC recurrence (16.7% vs. 26.7%, p=0.667) were similar between the two groups.
Conclusions
Patients with non-curatively resected SEC showed good long-term survival outcomes. Given the similar oncologic outcomes, close observation may be an option with appropriate caution taken for patients who are medically unfit to receive additional therapy.

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Close Observation versus Additional Surgery after Noncurative Endoscopic Resection of Esophageal Squamous Cell Carcinoma
Byeong Geun Song, Ga Hee Kim, Charles J. Cho, Hyeong Ryul Kim, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Ho June Song, Yong-Hee Kim, Jun Haeng Lee, Hwoon-Yong Jung, Jae Ill Zo, Young Mog Shim
Digestive Surgery.2021; 38(3): 247. CrossRef
Non-Curative Endoscopic Resection for Superficial Esophageal Cancer
Eun Hye Kim, Jun Chul Park
Clinical Endoscopy.2018; 51(5): 399. CrossRef

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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; DOI: https://doi.org/10.5946/ce.2016.056

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Background
/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.
Methods
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.
Results
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.
Conclusions
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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Hyun Jik Lee, Yoo Jin Lee, Ju Yup Lee, Eun Soo Kim, Woo Jin Chung, Byoung Kuk Jang, Kyung Sik Park, Jae Seok Hwang, Kwang Bum Cho
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Is Endoscopic Ultrasonography Adequate for the Diagnosis of Gastric Schwannomas?: Eun Jeong Gong, Kee Don Choi; Clin Endosc 2016;49(6):498-499. Published online November 17, 2016; DOI: https://doi.org/10.5946/ce.2016.134

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Gastric granular cell tumor: A case report and literature review
Huixi Li, Miao Zhang, Youyou Zheng, Hong Zhang
Oncology Letters.2024;[Epub] CrossRef

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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; DOI: https://doi.org/10.5946/ce.2015.48.2.152

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Background/Aims

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).

Methods

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.

Results

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).

Conclusions

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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Lymph Node Metastases in Esophageal Carcinoma: An Endoscopist's View: Jin Woong Cho, Suck Chei Choi, Jae Young Jang, Sung Kwan Shin, Kee Don Choi, Jun Haeng Lee, Sang Gyun Kim, Jae Kyu Sung, Seong Woo Jeon, Il Ju Choi, Gwang Ha Kim, Sam Ryong Jee, Wan Sik Lee, Hwoon-Yong Jung, Korean ESD Study Group; Clin Endosc 2014;47(6):523-529. Published online November 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.6.523

Abstract PDF PubReader ePub

One of the most important prognostic factors in esophageal carcinoma is lymph node metastasis, and in particular, the number of affected lymph nodes, which influences long-term outcomes. The esophageal lymphatic system is connected longitudinally and transversally; thus, the pattern of lymph node metastases is very complex. Early esophageal cancer frequently exhibits skipped metastasis, and minimal surgery using sentinel node navigation cannot be performed. In Korea, most esophageal cancer cases are squamous cell carcinoma (SCC), although the incidence of adenocarcinoma has started to increase recently. Most previous reports have failed to differentiate between SCC and adenocarcinoma, despite the fact that the Union for International Cancer Control (7th edition) and American Joint Committee on Cancer staging systems both consider these separately because they differ in cause, biology, lymph node metastasis, and outcome. Endoscopic tumor resection is an effective and safe treatment for lesions with no associated lymph node metastasis. Esophageal mucosal cancer confined to the lamina propria is an absolute indication for endoscopic resection, and a lesion that has invaded the muscularis mucosae can be cured by local resection if invasion to the lymphatic system has not occurred.

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Stricture Occurring after Endoscopic Submucosal Dissection for Esophageal and Gastric Tumors: Gwang Ha Kim, Sam Ryong Jee, Jae Young Jang, Sung Kwan Shin, Kee Don Choi, Jun Haeng Lee, Sang Gyun Kim, Jae Kyu Sung, Suck Chei Choi, Seong Woo Jeon, Byung Ik Jang, Kyu Chan Huh, Dong Kyung Chang, Sung-Ae Jung, Bora Keum, Jin Woong Cho, Il Ju Choi, Hwoon-Yong Jung, Korean ESD Study Group; Clin Endosc 2014;47(6):516-522. Published online November 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.6.516

Abstract PDF PubReader ePub

Endoscopic submucosal dissection (ESD) is a widely accepted treatment for early gastric and esophageal cancer. Compared to endoscopic mucosal resection, ESD has the advantage of enabling en bloc removal of tumors regardless of their size. However, ESD can result in a large artificial ulcer, which may lead to a considerable deformity. Circumferential mucosal defects of more than three-fourths the esophageal circumference, long longitudinal mucosal defects (>30 mm), and lesions in the upper esophagus are significant risk factors for the development of post-ESD strictures of the esophagus. In the stomach, a circumferential mucosal defects more than three-fourths in extent and longitudinal mucosal defects >5 cm are risk factors of post-ESD stricture. If scheduled early, regular endoscopic balloon dilation is effective in controlling and preventing post-ESD stricture. Moreover, intralesional steroid injections or oral steroids can achieve remission of dysphagia or reduce the need for repeated endoscopic balloon dilation. However, further study is needed to improve the prevention of stricture formation.

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The efficacy and safety of snare traction-assisted endoscopic submucosal dissection for circumferential superficial esophageal cancer
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Risk factors of refractory post-endoscopic submucosal dissection esophageal strictures
Enrique Pérez-Cuadrado Robles, Tom G. Moreels , Hubert Piessevaux , Ralph Yeung, Tarik Aouattah , Pierre H. Deprez
Revista Española de Enfermedades Digestivas.2021;[Epub] CrossRef
Early Esophageal Cancer
Mike T. Wei, Shai Friedland
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Yang Won Min
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Comparison of Clinical Outcomes Associated with Pull-Type and Introducer-Type Percutaneous Endoscopic Gastrostomies: Sin Won Lee, Jeong Hoon Lee, Hyungjin Cho, Yeonjung Ha, Hyun Lim, 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 2014;47(6):530-537. Published online November 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.6.530

Abstract PDF PubReader ePub

Background/Aims

Percutaneous endoscopic gastrostomy (PEG) is a method of providing enteral nutrition using endoscopy. The PEG techniques differ according to the insertion method, and include the pull type, push type, and introducer type. The aim of this study was to compare the clinical outcomes associated with the pull-type and introducer-type PEG insertion techniques, which included the adverse events, at our tertiary care center in Korea.

Methods

We retrospectively reviewed 141 cases that had undergone PEG insertion at our center from January 2009 to June 2012. The indications for PEG insertion and the acute and chronic complications caused by each type of PEG insertion were analyzed.

Results

The indications for PEG insertion in our cohort included neurologic disease (58.7%), malignancy (21.7%), and other indications (19.6%). Successful PEG insertions were performed on 136 cases (96.5%), and there were no PEG-associated deaths. Bleeding was the most frequent acute complication (12.8%), and wound problems were the most frequent chronic complications (8.8%). There were no statistically significant differences between the pull-type and introducer-type PEG insertion techniques in relation to complication rates in our study population.

Conclusions

PEG insertion is considered a safe procedure. The pull-type and introducer-type PEG insertion techniques produce comparable outcomes, and physicians may choose either of these approaches according to the circumstances.

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Intralesional Steroid Injection to Prevent Stricture after Near-Circumferential Endosopic Submucosal Dissection for Superficial Esophageal Cancer: Wook Jin Lee, Hwoon-Yong Jung, Do Hoon Kim, Jeong Hoon Lee, Kee Don Choi, Ho June Song, Gin Hyug Lee, Jin-Ho Kim; Clin Endosc 2013;46(6):643-646. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.643

Abstract PDF PubReader ePub

Stricture frequently occurs after endoscopic submucosal dissection (ESD) for superficial esophageal carcinoma with near- or whole-circumferential mucosal defects, and post-ESD stricture is difficult to treat and usually requires multiple sessions of endoscopic balloon dilatation. Intralesional steroid injection has previously been used to prevent stricture; however, there have been few experiences with this method after near- or whole-circumferential ESD. We present a case of a single session of intralesional steroid injection performed immediately after near-circumferential ESD to prevent post-ESD stricture. After a follow-up period of 6 months, the patient showed good outcome without dysphagia.

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