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Shai Friedland 5 Articles
Over-the-Scope Clip in the Treatment of Gastrointestinal Leaks and Perforations
Mike T. Wei, Ji Yong Ahn, Shai Friedland
Clin Endosc 2021;54(6):798-804.   Published online November 30, 2021
AbstractAbstract PDFPubReaderePub
While perforations, postoperative fistulas, and leaks have traditionally led to surgical or interventional radiology consultation for management, the introduction of the over-the-scope clip has allowed increased therapeutic possibilities for endoscopists. While primarily limited to case reports and series, the over-the-scope clip successfully manages gastrointestinal bleeding, perforations, as well as postoperative leaks and fistulas. Retrospective studies have demonstrated a relatively high success rate and a low complication rate. Given the similarity to variceal banding equipment, the learning curve with the over-the-scope clip is rapid. However, given the higher risk of procedures involving the use of the over-the-scope clip, it is essential to obtain the scope in a stable position and grasp sufficient tissue with the cap using a grasping tool and/or suction. From our experience, while closure may be successful in lesions sized up to 3 cm, successful outcomes are obtained for lesions sized <1 cm. Ultimately, given the limited available data, prospective randomized trials are needed to better evaluate the utility of the over-the-scope clip in various clinical scenarios, including fistula and perforation management.


Citations to this article as recorded by  
  • 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 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
  • Metabolic and Bariatric Surgery
    Bao-Ngoc Nasri, Robert B. Lim, James Ellsmere, Alisha R. Fernandes, Daniel B. Jones
    Current Problems in Surgery.2024; : 101549.     CrossRef
  • Use of anchor pronged clips to close complex polyp resection defects
    Mike Tzuhen Wei, Shai Friedland
    VideoGIE.2023; 8(6): 245.     CrossRef
  • Novel endoscopic management of gastroenterological anastomosis leakage by injecting gel-forming solutions: an experimental animal study
    Yusuke Watanabe, Keiko Yamamoto, Zijian Yang, Haruna Tsuchibora, Masakazu Fujii, Masayoshi Ono, Shoko Ono, Takayuki Kurokawa, Naoya Sakamoto
    Surgical Endoscopy.2023; 37(10): 8029.     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
  • Management of complications related to colorectal endoscopic submucosal dissection
    Tae-Geun Gweon, Dong-Hoon Yang
    Clinical Endoscopy.2023; 56(4): 423.     CrossRef
  • Gastroesophageal Reflux Disease in Obesity: Bariatric Surgery as Both the Cause and the Cure in the Morbidly Obese Population
    Muaaz Masood, Donald Low, Shanley B. Deal, Richard A. Kozarek
    Journal of Clinical Medicine.2023; 12(17): 5543.     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
  • Endoscopic Management of Esophageal Cancer
    Christopher Paiji, Alireza Sedarat
    Cancers.2022; 14(15): 3583.     CrossRef
  • Use of a novel dual-action clip for closure of complex endoscopic resection defects
    Mike Tzuhen Wei, Shai Friedland
    VideoGIE.2022; 7(11): 389.     CrossRef
  • 3,805 View
  • 124 Download
  • 8 Web of Science
  • 11 Crossref
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Is Submucosal Injection Helpful in Cold Snare Polypectomy for Small Colorectal Polyps?
Ji Hyun Song, Shai Friedland
Clin Endosc 2021;54(3):397-403.   Published online February 9, 2021
AbstractAbstract PDFPubReaderePub
/Aims: Cold snare polypectomy (CSP) is an effective method of polyp removal for small colorectal polyps. However, the effect of submucosal injection in cold snare endoscopic mucosal resection (CS-EMR) for small polyps is unclear. Therefore, this study aimed to evaluate the effect of submucosal injection in CS-EMR for small polyps.
Between 2018 and 2019, 100 consecutive small colorectal polyps (5–10 mm) were identified in 58 patients. The first 50 consecutive polyps were removed by CS-EMR, and the remaining 50 were removed by CSP. Demographic data, clinical data, endoscopic findings, procedure times, complication rates, and pathology data were collected.
No difference in the complete resection rate was observed between the CS-EMR and CSP groups. A total of 9 polyps showed post-polypectomy bleeding (7 had immediate bleeding, 1 had delayed bleeding, and 1 had both immediate and delayed bleeding). No difference in the bleeding rate was observed between the two groups. In multivariate analysis, warfarin (odds ratio [OR], 42.334; 95% confidence interval [CI], 1.006–1,781.758) and direct-acting oral anticoagulants (OR, 35.244; 95% CI, 3.853–322.397) showed a significantly increased risk of bleeding.
The effect of submucosal injection in CSP was not significant for small colorectal polyps.


Citations to this article as recorded by  
  • Cold sub-mucosal injection versus traditional cold snare polypectomy for diminutive and small colorectal polyps: A systematic review and meta-analysis
    Yong-Cai Lv, Quan Dong, Yan-Hua Yao, Jing-Jing Lei
    Indian Journal of Gastroenterology.2024;[Epub]     CrossRef
  • Colorectal cold snare polypectomy: Current standard technique and future perspectives
    Fumiaki Ishibashi, Sho Suzuki, Mizuki Nagai, Kentaro Mochida, Tetsuo Morishita
    Digestive Endoscopy.2023; 35(3): 278.     CrossRef
  • The efficacy and safety of cold snare polypectomy with submucosal injection for the removal of polyps less than 20 mm in size: a systematic review and meta‐analysis
    Zheng Liang, Yongqiu Wei, Shutian Zhang, Peng Li
    Journal of Gastroenterology and Hepatology.2023; 38(11): 1892.     CrossRef
  • Impact of Submucosal Saline Injection During Cold Snare Polypectomy for Colorectal Polyps Sized 3–9 mm: A Multicenter Randomized Controlled Trial
    Yi Mou, Liansong Ye, Xiaobo Qin, Rui Feng, Lifan Zhang, Qin Hu, Tingting Cao, Xinyue Zhou, Wu Wen, Chuanming Zhang, Zonghua Chen, Yi Liu, Zhimin Yang, Tao Huo, Fang Pan, Xuelian Li, Bing Hu
    American Journal of Gastroenterology.2023; 118(10): 1848.     CrossRef
  • Cold resection for colorectal polyps: where we are and where we are going?
    Antonio Capogreco, Ludovico Alfarone, Davide Massimi, Alessandro Repici
    Expert Review of Gastroenterology & Hepatology.2023; 17(7): 719.     CrossRef
  • Cold snare endoscopic mucosal resection for colon polyps: a systematic review and meta-analysis
    Mohamed Abdallah, Khalid Ahmed, Daniyal Abbas, Mouhand F. H. Mohamed, Gaurav Suryawanshi, Nicholas McDonald, Natalie Wilson, Shifa Umar, Aasma Shaukat, Mohammad Bilal
    Endoscopy.2023; 55(12): 1083.     CrossRef
  • Endoscopic treatment of colorectal polyps and early colorectal cancer
    Yunho Jung
    Journal of the Korean Medical Association.2023; 66(11): 642.     CrossRef
  • 4,450 View
  • 167 Download
  • 8 Web of Science
  • 7 Crossref
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Ideal Method for Small Bowel Preparation before Video Capsule Endoscopy
Jun Lee, Shai Friedland
Clin Endosc 2020;53(6):631-632.   Published online November 6, 2020
  • 3,197 View
  • 81 Download
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Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences
Dong-Hoon Yang, Min-Seob Kwak, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Hyun Gun Kim, Shai Friedland
Clin Endosc 2017;50(4):379-387.   Published online March 7, 2017
AbstractAbstract PDFPubReaderePub
/Aims: Endoscopic mucosal resection with circumferential mucosal incision (CMI-EMR) may offer benefits comparable to those of endoscopic submucosal dissection (ESD), while requiring less technical proficiency than ESD.
We retrospectively compared the outcomes of CMI-EMR (n=34) and size-matched ESD (n=102), which were performed by a Korean endoscopist for colorectal epithelial lesions of 20–35 mm. Procedural parameters of CMI-EMRs performed by an American ESD novice ((n=30) were compared with those performed by the Korean endoscopist.
The lesion size was 22.3±3.9 mm and 22.9±2.4 mm in the CMI-EMR and size-matched ESD groups, respectively (p=0.730). The resection time was 12.7±7.0 minutes in the CMI-EMR group and 45.6±30.1 minutes in the ESD group (p<0.001). The en bloc resection rate was 94.1% in the CMI-EMR group and 100% in the ESD group (p=0.061). There were no differences in the en bloc resection and complication rates of CMI-EMRs between a Korean and an American endoscopist.
For the treatment of moderate-size colorectal lesions, CMI-EMR showed a trend toward lower en bloc resection rate, but required shorter procedure time than ESD. CMI-EMR outcomes were similar when performed by a Korean ESD expert and an American ESD novice.


Citations to this article as recorded by  
  • Endoscopic mucosal resection with a circumferential incision in the removal of colon neoplasms. Results of a randomized trial.
    E. U. Abdulzhalieva, A. A. Likutov, V. V. Veselov, D. A. Mtvralashvili, O. M. Yugai, E. A. Khomyakov, S. V. Chernyshov, O. I. Sushkov
    Koloproktologia.2024; 23(1): 21.     CrossRef
  • Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
    Yunho Jung
    The Korean Journal of Internal Medicine.2024; 39(4): 563.     CrossRef
  • Hybrid Endoscopic Resection With Endo-knife and Snare for Colorectal Lesions: A Systematic Review and Meta-analysis
    Shinji Yoshii, Takefumi Kikuchi, Yuki Hayashi, Masahiro Nojima, Hiro-o Yamano, Hiroshi Nakase
    Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(2): 135.     CrossRef
  • Multicenter evaluation of recurrence in endoscopic submucosal dissection and endoscopic mucosal resection in the colon: A Western perspective
    Mike T Wei, Margaret J Zhou, Andrew A Li, Andrew Ofosu, Joo Ha Hwang, Shai Friedland
    World Journal of Gastrointestinal Endoscopy.2023; 15(6): 458.     CrossRef
  • Comparison of precutting endoscopic mucosal resection and endoscopic submucosal dissection for large (20–30 mm) flat colorectal lesions
    Chang Kyo Oh, Young Wook Cho, In Hyoung Choi, Han Hee Lee, Chul‐Hyun Lim, Jin Su Kim, Bo‐In Lee, Young‐Seok Cho
    Journal of Gastroenterology and Hepatology.2022; 37(3): 568.     CrossRef
  • A systematic review and meta-analysis of endoscopic mucosal resection vs endoscopic submucosal dissection for colorectal sessile/non-polypoid lesions
    Endrit Shahini, Roberto Passera, Giacomo Lo Secco, Alberto Arezzo
    Minimally Invasive Therapy & Allied Technologies.2022; 31(6): 835.     CrossRef
  • Endoscopic mucosal resection with a circumferential incision in the removal of colorectal neoplasms (preliminary results of the prospective randomized study)
    A. U. Abdulzhalieva, A. A. Likutov, D. A. Mtvralashvili, V. V. Veselov, Yu. E. Vaganov, S. V. Chernyshov, O. A. Mainovskaya, O. I. Sushkov
    Koloproktologia.2022; 21(4): 21.     CrossRef
  • Efficacy and Safety of Complete Endoscopic Resection of Colorectal Neoplasia Using a Stepwise Endoscopic Protocol with SOUTEN, a Novel Multifunctional Snare
    Shinji Yoshii, Marina Kubo, Mio Matsumoto, Takefumi Kikuchi, Yasunari Takakuwa
    Clinical Endoscopy.2020; 53(2): 206.     CrossRef
  • Tip-in versus conventional endoscopic mucosal resection for flat colorectal neoplasia 10 mm or larger in size
    Soo Min Noh, Jin Yong Kim, Jae Cheol Park, Eun Hye Oh, Jeongseok Kim, Nam Seok Ham, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
    International Journal of Colorectal Disease.2020; 35(7): 1283.     CrossRef
  • Long‐term clinical outcomes of endoscopic submucosal dissection for colorectal neoplasia with or without the hybrid technique
    DU Kang, JC Park, SW Hwang, SH Park, DH Yang, KJ Kim, BD Ye, SJ Myung, SK Yang, JS Byeon
    Colorectal Disease.2020; 22(12): 2008.     CrossRef
  • Pyogenic Liver Abscess Caused by Endoscopic Submucosal Dissection for Early Colon Cancer
    Joon Seop Lee, Yong Hwan Kwon
    Clinical Endoscopy.2019; 52(6): 620.     CrossRef
  • Endoscopic submucosal dissection in the West: Current status and future directions
    Michael X. Ma, Michael J. Bourke
    Digestive Endoscopy.2018; 30(3): 310.     CrossRef
  • Introduction of endoscopic submucosal dissection in the West
    David Friedel, Stavros Nicholas Stavropoulos
    World Journal of Gastrointestinal Endoscopy.2018; 10(10): 225.     CrossRef
  • Filling the Technical Gap between Standard Endoscopic Mucosal Resection and Full Endoscopic Submucosal Dissection for 20–35 mm Sized Colorectal Neoplasms
    Sung Noh Hong
    Clinical Endoscopy.2017; 50(4): 313.     CrossRef
  • 8,904 View
  • 233 Download
  • 13 Web of Science
  • 14 Crossref
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Endoscopic Mucosal Resection versus Endoscopic Submucosal Dissection for Large Polyps: A Western Colonoscopist’s View
Ian Holmes, Shai Friedland
Clin Endosc 2016;49(5):454-456.   Published online August 26, 2016
AbstractAbstract PDFPubReaderePub
To discuss the rationale for the widespread application of endoscopic mucosal resection (EMR) rather than endoscopic submucosal dissection (ESD) in Western centers. In Western centers, EMR is the treatment of choice for most non-pedunculated colorectal adenomas >2 cm in size. EMR is sufficiently effective and safe to be performed without post-procedure hospitalization. Advances in EMR have led to reduced recurrence rates, and recent studies have demonstrated excellent outcomes with endoscopic treatment of recurrent adenomas. While studies from Asia have demonstrated lower recurrence rates with ESD, concern about the higher perforation risk and lengthy procedure time of ESD are two of the barriers preventing widespread adoption of ESD in the West. EMR is likely to continue as the dominant method for the treatment of large colorectal adenomas in Western centers until the limitations of ESD are overcome.


Citations to this article as recorded by  
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    Journal of Pediatric Gastroenterology & Nutrition.2023; 77(3): 401.     CrossRef
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    Digestive Endoscopy.2023; 35(2): 232.     CrossRef
  • Endoscopic mucosal resection and endoscopic submucosal dissection with an external additional working channel (EMR+ and ESD+) are equivalent to using a double-channel endoscope: a systematic evaluation in a porcine ex vivo model
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    Surgical Endoscopy.2023; 37(10): 7749.     CrossRef
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    Gastroenterology Insights.2022; 13(2): 162.     CrossRef
  • Risk factors for local recurrence of large gastrointestinal lesions after endoscopic mucosal resection
    Yasar Colak, Badar Hasan, Walid Hassaballa, Mamoon Ur Rashid, Victor Strassmann, Giovanna DaSilva, Steven D. Wexner, Tolga Erim
    Techniques in Coloproctology.2022; 26(7): 545.     CrossRef
  • From advanced diagnosis to advanced resection in early neoplastic colorectal lesions: Never-ending and trending topics in the 2020s
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    World Journal of Gastrointestinal Surgery.2022; 14(7): 632.     CrossRef
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    Richard F. Knoop, Edris Wedi, Golo Petzold, Sebastian C. B. Bremer, Ahmad Amanzada, Volker Ellenrieder, Albrecht Neesse, Steffen Kunsch
    Surgical Endoscopy.2021; 35(7): 3506.     CrossRef
  • The Mettle to Use the Petals: Using Over-the-Scope Rings to Optimize Endoscopic Submucosal Dissection
    Mike T. Wei, George Triadafilopoulos, Shai Friedland
    Digestive Diseases and Sciences.2021; 66(4): 989.     CrossRef
  • Current Endoscopic Resection Techniques for Gastrointestinal Lesions: Endoscopic Mucosal Resection, Submucosal Dissection, and Full-Thickness Resection
    Arthur Hoffman, Raja Atreya, Timo Rath, Markus Ferdinand Neurath
    Visceral Medicine.2021; 37(5): 358.     CrossRef
  • Japan Gastroenterological Endoscopy Society guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection
    Shinji Tanaka, Hiroshi Kashida, Yutaka Saito, Naohisa Yahagi, Hiroo Yamano, Shoichi Saito, Takashi Hisabe, Takashi Yao, Masahiko Watanabe, Masahiro Yoshida, Yusuke Saitoh, Osamu Tsuruta, Ken‐ichi Sugihara, Masahiro Igarashi, Takashi Toyonaga, Yoichi Ajiok
    Digestive Endoscopy.2020; 32(2): 219.     CrossRef
  • Features of endoscopic procedure site reaction associated with a recently approved submucosal lifting agent
    Carlos A. Castrodad-Rodríguez, Nicole C. Panarelli, Adam J. Gersten, Qiang Liu, Michael Feely, Tony El Jabbour
    Modern Pathology.2020; 33(8): 1581.     CrossRef
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    Dazhou Li, Wen Wang, Jiao Xie, Gang Liu, Rong Wang, Chuanshen Jiang, Zhou Ye, Binbin Xu, Xiaojian He, Donggui Hong
    Scandinavian Journal of Gastroenterology.2020; 55(3): 362.     CrossRef
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    Clinics in Colon and Rectal Surgery.2020; 33(06): 329.     CrossRef
  • Long‐term clinical outcomes of endoscopic submucosal dissection for colorectal neoplasia with or without the hybrid technique
    DU Kang, JC Park, SW Hwang, SH Park, DH Yang, KJ Kim, BD Ye, SJ Myung, SK Yang, JS Byeon
    Colorectal Disease.2020; 22(12): 2008.     CrossRef
  • Evaluation of recurrence and surgical complementation rates after endoscopic resection of large colorectal non-pedunculated lesions
    Alanna Alexandre Silva de Azevedo, Maria Cecilia del Picchia Novaes Ribeiro, Fernando Lander Mota, Paulo Alberto Falco Pires Correa, Jarbas Faraco Maldonado Loureiro
    Revista Española de Enfermedades Digestivas.2020;[Epub]     CrossRef
  • How Is Endoscopic Submucosal Dissection for Gastrointestinal Lesions Being Implemented? Results from an International Survey
    Miguel Araújo-Martins, Pedro Pimentel-Nunes, Diogo Libânio, Marta Borges-Canha, Mário Dinis-Ribeiro
    GE - Portuguese Journal of Gastroenterology.2020; 27(1): 1.     CrossRef
  • Comparison of Endoscopic Submucosal Dissection for Primary and Recurrent Colorectal Lesions: A Single-Center European Study
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    Andrew Emmanuel, Shraddha Gulati, Margaret Burt, Bu’Hussain Hayee, Amyn Haji
    Diseases of the Colon & Rectum.2018; 61(6): 743.     CrossRef
  • Endoscopic resection of large colorectal adenomas – clinical experience of a tertiary referral centre
    L. Mlynarsky, S. Zelber‐Sagi, E. Miller, R. Kariv
    Colorectal Disease.2018; 20(5): 391.     CrossRef
  • Implementation of mentor-assisted colorectal endoscopic submucosal dissection in Sweden; learning curve and clinical outcomes
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    Scandinavian Journal of Gastroenterology.2018; 53(9): 1146.     CrossRef
  • 8,829 View
  • 283 Download
  • 29 Web of Science
  • 24 Crossref
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