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Volume 51(1); January 2018
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Commentarys
Is Percutaneous Endoscopic Gastrostomy Acceptable in Centenarian Patients?
Cheol Min Shin, Dong Ho Lee
Clin Endosc 2018;51(1):1-2.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2018.018
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Balloon-Assisted Endoscopy: A Powerful Tool for Complete Colonoscopy
Kyung Hwan Song, Beom Jae Lee
Clin Endosc 2018;51(1):3-4.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2018.027
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Citations

Citations to this article as recorded by  
  • Use of a novel endoscopic overtube with bilateral tool channels for endoscopic resection of experimental lesions and repair of intestinal defects in the right colon: preclinical trial
    Shinya Urakawa, Teijiro Hirashita, Yuka Hirashita, Kentaro Matsuo, Lea Lowenfeld, Jeffrey W. Milsom
    Surgical Endoscopy.2023; 37(2): 1593.     CrossRef
  • Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial
    Shinya Urakawa, Teijiro Hirashita, Yuka Hirashita, Lea Lowenfeld, Krishna C. Gurram, Makoto Nishimura, Jeffrey W. Milsom
    Scientific Reports.2021;[Epub]     CrossRef
  • 4,595 View
  • 107 Download
  • 2 Web of Science
  • 2 Crossref
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Can Contrast-Enhanced Harmonic Endoscopic Ultrasonography Differentiate Malignancy from Benign Disease?
Tae Hoon Lee
Clin Endosc 2018;51(1):5-7.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2018.016
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  • Diagnostic value of contrast-enhanced harmonic endoscopic ultrasonography in predicting the malignancy potential of submucosal tumors: a systematic review and meta-analysis
    Yong-tao Yang, Neng Shen, Fei Ao, Wei-qing Chen
    Surgical Endoscopy.2020; 34(9): 3754.     CrossRef
  • Current Status of Endoscopic Ultrasound Techniques for Pancreatic Neoplasms
    Yousuke Nakai, Naminatsu Takahara, Suguru Mizuno, Hirofumi Kogure, Kazuhiko Koike
    Clinical Endoscopy.2019; 52(6): 527.     CrossRef
  • 4,841 View
  • 94 Download
  • 3 Web of Science
  • 2 Crossref
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Focused Review Series: The New Eras of Therapeutic Endoscopy - Endoscopic Submucosal Surgery
Introduction to Endoscopic Submucosal Surgery
Weon Jin Ko, Joo Young Cho
Clin Endosc 2018;51(1):8-12.   Published online January 23, 2018
DOI: https://doi.org/10.5946/ce.2017.154
AbstractAbstract PDFPubReaderePub
The concept of using natural orifices to reduce the complications of surgery, Natural Orifices Transluminal Endoscopic Surgery, has also been applied to therapeutic endoscopy. Endoscopic submucosal surgery (ESS) provides more treatment options for various gastrointestinal diseases than traditional therapeutic endoscopy by using the submucosal layer as a working space. ESS has been performed in various fields ranging from transluminal peritoneoscopy to peroral endoscopic myotomy. With further advances in technology, ESS will be increasingly useful for diagnosis and treatment of gastrointestinal diseases.

Citations

Citations to this article as recorded by  
  • Design and validation of performance-oriented injectable chitosan thermosensitive hydrogels for endoscopic submucosal dissection
    Jia Liu, Panxianzhi Ni, Yi Wang, Zhengkui Zhou, Junlin Li, Tianxu Chen, Tun Yuan, Jie Liang, Yujiang Fan, Jing Shan, Xiaobin Sun, Xingdong Zhang
    Biomaterials Advances.2023; 146: 213286.     CrossRef
  • Comparison of peroral endoscopic myotomy between de-novo achalasia and achalasia with prior treatment
    Abdullah Ozgur Yeniova, In kyung Yoo, Eunju Jeong, Joo Young Cho
    Surgical Endoscopy.2021; 35(1): 200.     CrossRef
  • Tunnel endoscopic interventions in esophageal diseases
    E. A. Drobyazgin, Yu. V. Chikinev, D. A. Arkhipov, N. I. Mit’ko, M. N. Chekanov, E. I. Vereshchagin, I. V. Peshkova, A. S. Polyakevich
    Experimental and Clinical Gastroenterology.2021; 1(6): 75.     CrossRef
  • 5,425 View
  • 158 Download
  • 3 Web of Science
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Current Status of Peroral Endoscopic Myotomy
Young Kwan Cho, Seong Hwan Kim
Clin Endosc 2018;51(1):13-18.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2017.165
AbstractAbstract PDFPubReaderePub
Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders.

Citations

Citations to this article as recorded by  
  • Quality of Life of Patients with Achalasia After Minimally Invasive Interventions
    E.A. Drobyazgin, Yu.V. Chikinev, N.I. Mitko
    Dokazatel'naya gastroenterologiya.2023; 12(3): 43.     CrossRef
  • Colorectal Endoscopic Submucosal Dissection: Performance of a Novel Hybrid-Technology Knife in an Animal Trial
    Jérémie Jacques, Horst Neuhaus, Markus D. Enderle, Ulrich Biber, Walter Linzenbold, Martin Schenk, Kareem Khalaf, Alessandro Repici
    Diagnostics.2023; 13(21): 3347.     CrossRef
  • Outcomes of Per-Oral Endoscopic Myotomy in the Treatment of Esophageal Achalasia: Over One Hundred Cases in a Single Tertiary Center
    Kannikar Laohavichitra, Jerasak Wannaprasert, Thawee Raranachu-ek
    Siriraj Medical Journal.2023; 75(9): 629.     CrossRef
  • Geriatric patients with esophageal motility disorders benefit more from minimally invasive peroral endoscopic myotomy: a multicenter study in Japan
    Naoto Ujiie, Hiroki Sato, Mary Raina Angeli Fujiyoshi, Shinwa Tanaka, Hironari Shiwaku, Junya Shiota, Ryo Ogawa, Hiroshi Yokomichi, Takashi Kamei, Haruhiro Inoue
    Diseases of the Esophagus.2022;[Epub]     CrossRef
  • Nonachalasic esophageal motor disorders, from diagnosis to therapy
    Mentore Ribolsi, Matteo Ghisa, Edoardo Savarino
    Expert Review of Gastroenterology & Hepatology.2022; 16(3): 205.     CrossRef
  • Peroral endoscopic longer vs shorter esophageal myotomy for achalasia treatment: A systematic review and meta-analysis
    Chun-Yan Weng, Cheng-Hai He, Ming-Yang Zhuang, Jing-Li Xu, Bin Lyu
    World Journal of Gastrointestinal Surgery.2022; 14(3): 247.     CrossRef
  • Features and results of minimally invasive treatment of recurrent achalasia
    E.A. Gallyamov, S.A. Erin, G.Yu. Gololobov, A.I. Burmistrov, M.A. Chicherina, A.A. Rikunova
    Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (3): 16.     CrossRef
  • Anesthesia for Per-oral endoscopic myotomy (POEM) – not so poetic!
    Soumya Sarkar, Puneet Khanna, Deepak Gunjan
    Journal of Anaesthesiology Clinical Pharmacology.2022; 38(1): 28.     CrossRef
  • A rare complication: Tension pneumothorax after peroral endoscopic myotomy
    Seokin Kang, Yuri Kim, Do Hoon Kim
    International Journal of Gastrointestinal Intervention.2022; 11(3): 139.     CrossRef
  • Endoscopic management of mucosal incision site dehiscence following peroral endoscopic myotomy
    Suryaprakash Bhandari, Darshan Parekh, Smita Bhandari
    Endoscopy International Open.2022; 10(09): E1307.     CrossRef
  • The POEM bottom-up technique for achalasia
    Gad Marom, Harold Jacob, Ariel Benson, Tiberiu Hershcovici, Rachel Gefen, Jonathan B. Yuval, Ronit Brodie, Avraham I Rivkind, Yoav Mintz
    Surgical Endoscopy.2021; 35(11): 6117.     CrossRef
  • Per-oral endoscopic myotomy for esophageal diverticula with or without esophageal motility disorders
    Beatrice Orlandini, Maximilien Barret, Marie-Anne Guillaumot, Chloé Léandri, Sarah Leblanc, Frédéric Prat, Stanislas Chaussade
    Clinics and Research in Hepatology and Gastroenterology.2020; 44(1): 82.     CrossRef
  • Experience with Peroral Endoscopic Myotomy for Achalasia and Spastic Esophageal Motility Disorders at a Tertiary U.S. Center
    Maen Masadeh, Peter Nau, Subhash Chandra, Jagpal Klair, John Keech, Kalpaj Parekh, Rami El Abiad, Henning Gerke
    Clinical Endoscopy.2020; 53(3): 321.     CrossRef
  • Intraoperative use of a functional lumen imaging probe during peroral endoscopic myotomy in patients with achalasia: A single-institute experience and systematic review
    Hyeon Jeong Goong, Su Jin Hong, Shin Hee Kim, Shawn Groth
    PLOS ONE.2020; 15(6): e0234295.     CrossRef
  • How does per-oral endoscopic myotomy compare to Heller myotomy? The Latin American perspective
    Michel Kahaleh, Amy Tyberg, Supriya Suresh, Arnon Lambroza, Monica Gaidhane, Felipe Zamarripa, Guadalupe Ma Martínez, Juan C. Carames, Eduardo T. Moura, Galileu F. Farias, Maria G. Porfilio, Jose Nieto, Mario Rey, Fernando Rodriguez Casas, Oscar V. Mondra
    Endoscopy International Open.2020; 08(10): E1392.     CrossRef
  • Endoscopic Equipment—From Simple to Advanced
    Sarah Choi, Kevin El-Hayek
    Surgical Clinics of North America.2020; 100(6): 993.     CrossRef
  • Peroral Endoscopic Myotomy for Esophageal Motility Disorders
    Jun Young Kim, Yang Won Min
    Clinical Endoscopy.2020; 53(6): 638.     CrossRef
  • Anesthesia for peroral endoscopic myotomy in Japan
    Hiroaki Murata, Taiga Ichinomiya, Tetsuya Hara
    Current Opinion in Anaesthesiology.2019; 32(4): 511.     CrossRef
  • Anesthetic Consideration for Peroral Endoscopic Myotomy
    Yun-Sic Bang, Chunghyun Park
    Clinical Endoscopy.2019; 52(6): 549.     CrossRef
  • 8,773 View
  • 318 Download
  • 20 Web of Science
  • 19 Crossref
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Endoscopic Treatment of Subepithelial Tumors
Su Young Kim, Kyoung-Oh Kim
Clin Endosc 2018;51(1):19-27.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2018.020
AbstractAbstract PDFPubReaderePub
Gastrointestinal subepithelial tumors (SETs) are generally found during endoscopy and their incidence has gradually increased. Although the indications for the endoscopic treatment of patients with SETs remain to be established, the feasibility and safety of endoscopic dissection, including the advantages of this method compared with surgical treatment, have been validated in many studies. The development of endoscopic techniques, such as endoscopic submucosal dissection, endoscopic enucleation, endoscopic excavation, endoscopic submucosal tunnel dissection, submucosal tunnel endoscopic resection, and endoscopic full-thickness resection has enabled the removal of SETs while reducing the occurrence of complications. Here, we discuss the endoscopic treatment of patients with SETs, outcomes for endoscopic treatment, and procedure-related complications. We also consider the advantages and disadvantages of the various endoscopic techniques.

Citations

Citations to this article as recorded by  
  • Present situation of minimally invasive surgical treatment for early gastric cancer
    Chun-Yan Li, Yi-Feng Wang, Li-Kang Luo, Xiao-Jun Yang
    World Journal of Gastrointestinal Oncology.2024; 16(4): 1154.     CrossRef
  • ENDOSCOPIC REMOVAL OF GASTROINTESTINAL LESIONS BY USING THIRD SPACE ENDOSCOPY TECHNIQUES
    Paolo Cecinato, Emanuele Sinagra, Liboria Laterza, Federica Pianigiani, Giuseppe Grande, Romano Sassatelli, Giovanni Barbara
    Best Practice & Research Clinical Gastroenterology.2024; : 101931.     CrossRef
  • Cold snare endoscopic resection for subepithelial tumors of the upper third of the esophagus
    Xiaosan Hu, Lifeng Zhou, Jian Chen, Yunlin Yue
    Revista Española de Enfermedades Digestivas.2023;[Epub]     CrossRef
  • An Atypical Presentation of a Colonic Lipoma: Avoiding Surgery with a Deeper Endoscopic Look
    Mafalda João, Inês Cunha, Elisa Gravito-Soares, Marta Gravito-Soares, Pedro Amaro, Pedro Figueiredo
    GE - Portuguese Journal of Gastroenterology.2022; 29(1): 45.     CrossRef
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    Mehmet Zeki Buldanlı, Oktay Yener
    Prague Medical Report.2022; 123(1): 20.     CrossRef
  • Natural History of Asymptomatic Esophageal Subepithelial Tumors of 30 mm or Less in Size
    Seokin Kang, Do Hoon Kim, Yuri Kim, Dongsub Jeon, Hee Kyong Na, Jeong Hoon Lee, Ji Yong Ahn, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
    Journal of Korean Medical Science.2022;[Epub]     CrossRef
  • Risk stratification in patients with upper gastrointestinal submucosal tumors undergoing submucosal tunnel endoscopic resection
    Yong Lv, Shaohua Li, Xiuhe Lv, Qing Liu, Yu Zheng, Yang Su, Changbin Yang, Yanglin Pan, Liping Yao, Huahong Xie
    Frontiers in Medicine.2022;[Epub]     CrossRef
  • Endoscopic versus surgical resection in the management of gastric schwannomas
    Ya-qi Zhai, Ning-li Chai, Wen-gang Zhang, Hui-kai Li, Zhong-sheng Lu, Xiu-xue Feng, Sheng-zhen Liu, En-qiang Linghu
    Surgical Endoscopy.2021; 35(11): 6132.     CrossRef
  • Endoscopic Full-Thickness Resection for Gastric Subepithelial Lesions Arising from the Muscularis Propria
    Ah Lon Jung, Sang Wook Park, Gun Young Hong, Hyeong Chul Moon, Seo Joon Eun
    Clinical Endoscopy.2021; 54(1): 131.     CrossRef
  • A Review of Endoscopic Full-thickness Resection, Submucosal Tunneling Endoscopic Resection, and Endoscopic Submucosal Dissection for Resection of Subepithelial Lesions
    Vicky H. Bhagat, Marina Kim, Michel Kahaleh
    Journal of Clinical Gastroenterology.2021; 55(4): 309.     CrossRef
  • A modified endoscopic full thickness resection for gastric subepithelial tumors from muscularis propria layer: Novel method
    Jung Min Lee, In Kyung Yoo, Sung Pyo Hong, Joo Young Cho, Young Kwan Cho
    Journal of Gastroenterology and Hepatology.2021; 36(9): 2558.     CrossRef
  • Endoscopic resection of esophageal and gastric submucosal tumors from the muscularis propria layer: submucosal tunneling endoscopic resection versus endoscopic submucosal excavation: A systematic review and meta-analysis
    Fernando Lopes Ponte Neto, Diogo Turiani Hourneaux de Moura, Vitor Massaro Takamatsu Sagae, Igor Braga Ribeiro, Fabio Catache Mancini, Mateus Bond Boghossian, Thomas R. McCarty, Nelson Tomio Miyajima, Edson Ide, Wanderley Marques Bernardo, Eduardo Guimarã
    Surgical Endoscopy.2021; 35(12): 6413.     CrossRef
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    Yingtong Chen, Min Wang, Lili Zhao, He Chen, Li Liu, Xiang Wang, Zhining Fan
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    Diseases of the Esophagus.2020;[Epub]     CrossRef
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    Hung Leng Kaan, Khek Yu Ho
    Clinical Endoscopy.2020; 53(5): 541.     CrossRef
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    Tanja Miltner
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    Sufang Tu, Silin Huang, Guohua Li, Xiaowei Tang, Haitao Qing, Qiaoping Gao, Jingwen Fu, Guoping Du, Wei Gong
    Gastroenterology Research and Practice.2018; 2018: 1.     CrossRef
  • 7,590 View
  • 273 Download
  • 16 Web of Science
  • 17 Crossref
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Gastric Peroral Endoscopic Myotomy
Hyunsoo Chung, Mouen A Khashab
Clin Endosc 2018;51(1):28-32.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2018.001
AbstractAbstract PDFPubReaderePub
Gastroparesis (GP) is a syndrome characterized by delayed gastric emptying in the absence of mechanical obstruction of the stomach or proximal small bowel. Currently available dietary and medical therapies are limited and have suboptimal efficacy. Pylorus-directed therapies have showed promising results. Gastric peroral endoscopic myotomy (G-POEM) has been reported for the treatment of GP refractory to standard therapy with promising results. This article reviews the current applications and results of G-POEM for the treatment of refractory GP.

Citations

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    Rami El Abiad, Munish Ashat, Mouen Khashab
    Best Practice & Research Clinical Gastroenterology.2024; : 101908.     CrossRef
  • Prospective study on the efficacy of endoscopic through-the-scope tack and suture system for gastric peroral endoscopic myotomy mucosal incision site closure
    Hafiz M. Khan, Tony S. Brar, Muhammad K. Hasan, Kambiz Kadkhodayan, Mustafa A. Arain, Maham Hayat, Aimen Farooq, Gurdeep Singh, Dennis Yang
    Endoscopy International Open.2023; 11(02): E187.     CrossRef
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    Faisal Kamal, Muhammad Ali Khan, Wade Lee‐Smith, Sachit Sharma, Ashu Acharya, Dawit Jowhar, Umer Farooq, Muhammad Aziz, Abdul Kouanda, Sun‐Chuan Dai, Colin W. Howden, Craig A. Munroe
    Alimentary Pharmacology & Therapeutics.2022; 55(2): 168.     CrossRef
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    Mishal Reja, Avantika Mishra, Amy Tyberg, Iman Andalib, Guadalupe M. Martínez, Felipe Zamarripa, Monica Gaidhane, Jose Nieto, Michel Kahaleh
    Journal of Clinical Gastroenterology.2022; 56(4): 339.     CrossRef
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    Briette Karanfilian, Michel Kahaleh
    Journal of Clinical Gastroenterology.2022; 56(6): 465.     CrossRef
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    Won Dong Lee, Jae Sun Song, Byung Sun Kim, Min A. Yang, Young Jae Lee, Gum Mo Jung, Ji Woong Kim, Yong Keun Cho, Jin Woong Cho
    Journal of Digestive Diseases.2022; 23(4): 220.     CrossRef
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    Parit Mekaroonkamol, Kasenee Tiankanon, Rungsun Rerknimitr
    Gut and Liver.2022; 16(6): 825.     CrossRef
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    Roman V. Petrov, Charles T. Bakhos, Abbas E. Abbas, Zubair Malik, Henry P. Parkman
    Gastroenterology Clinics of North America.2020; 49(3): 539.     CrossRef
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    Parit Mekaroonkamol, Rushikesh Shah, Qiang Cai
    World Journal of Gastroenterology.2019; 25(8): 909.     CrossRef
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    Nasim Parsa, Mouen A. Khashab
    Current Opinion in Gastroenterology.2019; 35(5): 416.     CrossRef
  • 6,748 View
  • 210 Download
  • 11 Web of Science
  • 10 Crossref
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Endoscopic Full-Thickness Resection Combined with Laparoscopic Surgery
Chan Gyoo Kim
Clin Endosc 2018;51(1):33-36.   Published online January 12, 2018
DOI: https://doi.org/10.5946/ce.2017.153
AbstractAbstract PDFPubReaderePub
Endoscopic full-thickness resection combined with laparoscopic surgery was recently developed. These procedures could be categorized as “Cut first and then suture” and “Suture first and then cut”. “Cut first and then suture” includes laparoscopic and endoscopic cooperative surgery (LECS) and laparoscopy-assisted endoscopic full-thickness resection (LAEFR). Recent studies have demonstrated the safety and efficacy of LECS and LAEFR. However, these techniques are limited by the related exposure of the tumor and gastric mucosa to the peritoneal cavity and manipulation of these organs, which could lead to viable cancer cell seeding and the spillage of gastric juice into the peritoneal cavity. In the “Suture first and then cut” technique, the serosal side of the stomach is sutured to invert the stomach and subsequently endoscopic resection is performed. In this article, details of these techniques, including their advantages and limitations, are described.

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    Partha Pal, Mohan Ramchandani, Pradev Inavolu, Duvvuru Nageshwar Reddy, Manu Tandan
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    Eva Intagliata, Rosario Vecchio
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    Yuki Aisu, Daiki Yasukawa, Yusuke Kimura, Tomohide Hori
    World Journal of Gastrointestinal Oncology.2018; 10(11): 381.     CrossRef
  • 5,832 View
  • 202 Download
  • 8 Web of Science
  • 6 Crossref
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Reviews
Colorectal Cancer Screening—Who, How, and When?
Roisin Bevan, Matthew D Rutter
Clin Endosc 2018;51(1):37-49.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2017.141
AbstractAbstract PDFPubReaderePub
Colorectal cancer (CRC) is the third most common cancer worldwide. It is amenable to screening as it occurs in premalignant, latent, early, and curable stages. PubMed, Cochrane Database of Systematic Reviews, and national and international CRC screening guidelines were searched for CRC screening methods, populations, and timing. CRC screening can use direct or indirect tests, delivered opportunistically or via organized programs. Most CRCs are diagnosed after 60 years of age; most screening programs apply to individuals 50–75 years of age. Screening may reduce disease-specific mortality by detecting CRC in earlier stages, and CRC incidence by detecting premalignant polyps, which can subsequently be removed. In randomized controlled trials (RCTs) guaiac fecal occult blood testing (gFOBt) was found to reduce CRC mortality by 13%–33%. Fecal immunochemical testing (FIT) has no RCT data comparing it to no screening, but is superior to gFOBt. Flexible sigmoidoscopy (FS) trials demonstrated an 18% reduction in CRC incidence and a 28% reduction in CRC mortality. Currently, RCT evidence for colonoscopy screening is scarce. Although not yet corroborated by RCTs, it is likely that colonoscopy is the best screening modality for an individual. From a population perspective, organized programs are superior to opportunistic screening. However, no nation can offer organized population-wide colonoscopy screening. Thus, organized programs using cheaper modalities, such as FS/FIT, can be tailored to budget and capacity.

Citations

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    David Obadina, Haider Haider, Dejan Micic, Atsushi Sakuraba
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Quality is the Key for Emerging Issues of Population-Based Colonoscopy Screening
Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen, on behalf of Medical Policy Committee of Korean Association for the Study of Intestinal Diseases (KASID), Quality Improvement Committee of Korean Society of Gastrointestinal Endoscopy (KSGE)
Clin Endosc 2018;51(1):50-55.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2018.010
AbstractAbstract PDFPubReaderePub
Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.

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Original Articles
Safety of Percutaneous Endoscopic Gastrostomy Tubes in Centenarian Patients
Zain A Sobani, Kevin Tin, Steven Guttmann, Anna A Abbasi, Ira Mayer, Yuriy Tsirlin
Clin Endosc 2018;51(1):56-60.   Published online July 21, 2017
DOI: https://doi.org/10.5946/ce.2017.059
AbstractAbstract PDFPubReaderePub
Background
/Aims: Percutaneous endoscopic gastrostomy (PEG) is a relatively safe procedure; however, no study has evaluated the safety of PEG tube placement in patients over the age of 100 years.
Methods
We conducted a retrospective review of patient records for patients who underwent PEG tube placement. Thirty patients aged 100 years and older were identified and a random sample of 275 patients was selected for comparison.
Results
The mean age of the patients was 80.6±16.2 years. No procedure-related deaths or major complications were identified; the overall inpatient mortality rate was 7.6%. Minor complications were noted in 4% (n=12) of the patients. Centenarian patients were predominantly female (80% [n=24] vs. 54% [n=147], p=0.006), with a mean age of 100.5±0.9 years. There was no significant difference in procedural success rates (93.3% vs. 97.4%, p=0.222) or inpatient mortality (6.7% [n=2] vs. 7.7% [n=21], p=1.000) between the two groups. However, a higher minor complication rate was noted in the older patients (13.3% [n=4] vs. 2.9% [n=8], p=0.022).
Conclusions
Success rates, major complications and inpatient mortality associated with PEG tubes in patients aged over 100 years are comparable to those observed in relatively younger patients at our center; however minor complication rates are relatively higher. These findings lead us to believe that PEG tubes may be safely attempted in carefully selected patients in this subset of the population.

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Efficacy of the Over-the-Scope Clip System for Treatment of Gastrointestinal Fistulas, Leaks, and Perforations: A Korean Multi-Center Study
Hang Lak Lee, Joo Young Cho, Jun-Hyung Cho, Jong Jae Park, Chan Gyoo Kim, Seong Hwan Kim, Joung-Ho Han
Clin Endosc 2018;51(1):61-65.   Published online August 29, 2017
DOI: https://doi.org/10.5946/ce.2017.027
AbstractAbstract PDFPubReaderePub
Background
/Aims: Currently, a new over-the-scope clip (OTSC) system has been introduced. This system has been used for gastrointestinal perforations and fistulas in other countries. The aim of our study is to examine the therapeutic success rate of endoscopic treatment using the OTSC system in Korea.
Methods
This was a multicenter prospective study. A total of seven endoscopists at seven centers performed this procedure.
Results
A total of 19 patients were included, with gastrointestinal leakages from anastomosis sites, fistulas, or esophageal perforations due to Boerhaave’s syndrome. Among these, there were three gastrojejunostomy sites, three esophagojejunostomy sites, four esophagogastrostomy sites, one esophagocolonostomy site, one jejuno-jejunal site, two endoscopic full thickness resection site closures, one Boerhaave’s syndrome, two esophago-bronchial fistulas, one gastrocolonic fistula, and one colonopseudocyst fistula. The size of the leakage ranged from 5 to 30 mm. The median procedure time was 16 min. All cases were technically successful. Complete closure of the leak was achieved in 14 of 19 patients using OTSC alone.
Conclusions
The OTSC system is a safe and effective method for the management of gastrointestinal leakage, especially in cases of anastomotic leakage after surgery.

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Double-Balloon Endoscopy after Incomplete Colonoscopy and Its Comparison with Computed Tomography Colonography
Carlijn Hermans, Dennis van der Zee, Lennard Gilissen
Clin Endosc 2018;51(1):66-71.   Published online January 10, 2018
DOI: https://doi.org/10.5946/ce.2017.011
AbstractAbstract PDFPubReaderePub
Background
/Aims: Because of the national screening program for colorectal carcinoma in The Netherlands, the number of colonoscopies has increased. In case of incomplete colonoscopy, computed tomography colonography (CTC) and double-balloon colonoscopy (DBc) are alternative options. This study evaluated cecal intubation rate and pathology detection rate in the previously unexplored part of the colon, complication rate of DBc, and CTC results after incomplete colonoscopy.
Methods
Retrospective observational study in a tertiary referral hospital regarding DBc and CTC reports from cases with incomplete colonoscopy.
Results
Sixty-three DBcs were performed after incomplete colonoscopy. Cecal intubation rate was 95%. Detection rate was 58% (5% carcinoma and 3% high-grade dysplastic adenoma). CTC preceded 54% of DBcs and 62% of CTC findings were confirmed. In 16%, a biopsy was taken, and in 60%, an intervention (mostly polypectomy) was performed. One major complication (1.5%) occurred, i.e., arterial bleeding due to polypectomy necessitating right hemicolectomy. CTC (n=213) showed a possible lesion in 35%, and could be confirmed by follow-up endoscopy or surgery in 65%.
Conclusions
DBc is effective and safe for completion of colon inspection in incomplete colonoscopy. In patients with a high likelihood of pathology, DBc is preferred over CTC.

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    Mohit Girotra, Saurabh Sethi, Monique T. Barakat, Robert J. Huang, Shai Friedland, Uri Ladabaum, Subhas Banerjee
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    Kyung Hwan Song, Beom Jae Lee
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Is There a Change in Patient Preference for a Female Colonoscopist during the Last Decade in Korea?
Jung Min Lee, Eun Sun Kim, Hoon Jai Chun, In Kyung Yoo, Jae Min Lee, Seung Han Kim, Hyuk Soon Choi, Bora Keum, Yeon Seok Seo, Hong Sik Lee, Yoon Tae Jeen, Jong-Jae Park, Sang Woo Lee, Soon Ho Um, Chang Duck Kim
Clin Endosc 2018;51(1):72-79.   Published online October 10, 2017
DOI: https://doi.org/10.5946/ce.2017.057
AbstractAbstract PDFPubReaderePub
Background
/Aims: Patients may feel embarrassed during colonoscopy. Our study aimed to assess changes in patient preference, over the past decade, for the sex of their colonoscopist.
Methods
Prospective studies were performed at a single health center from July to September 2008, and from July to September 2016. Subjects included colonoscopy patients (2008: 354, 2016: 304) who were asked to complete a questionnaire before colonoscopy.
Results
In 2016, 69 patients (24.9%) expressed a sex preference, compared with 46 patients (14.6%) in 2008. By 2016, female patient preference for a female colonoscopist had significantly increased to 95% (odds ratio [OR], 2.678; 95% confidence interval [CI], 1.418– 5.057; P=0.002). In multivariate analysis, patient sex (OR, 4.404; P=0.000), patient age (OR, 0.977; 95% CI, 0.961–0.992; P=0.004), and year of procedure (OR, 1.674; 95% CI, 1.028–2.752) were statistically significant factors in sex preference. Between 2008 and 2016, female patients preferred a female colonoscopist because of embarrassment. Male patients also preferred a male colonoscopist, and the primary reason shifted from expertise to patient embarrassment (2008: 29%, 2016: 63%).
Conclusions
Patients have an increased gender preference for the colonoscopist because of embarrassment. Taking this into account can increase patient satisfaction during colonoscopy.

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Clinical Value of Contrast-Enhanced Harmonic Endoscopic Ultrasonography in the Differential Diagnosis of Pancreatic and Gallbladder Masses
Galam Leem, Moon Jae Chung, Jeong Youp Park, Seungmin Bang, Si Young Song, Jae Bock Chung, Seung Woo Park
Clin Endosc 2018;51(1):80-88.   Published online September 20, 2017
DOI: https://doi.org/10.5946/ce.2017.044
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Recent studies have revealed that contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) is beneficial in the differential diagnosis of malignant neoplasms of the pancreas and gallbladder from benign masses, in terms of the evaluation of microvasculature and real-time perfusion. In this study, we aimed to prove the clinical value of CEH-EUS in the differential diagnosis of pancreatic and gallbladder masses by direct comparison with that of conventional EUS.
Methods
We reviewed the sonographic images and medical information of 471 patients who underwent conventional EUS and CEH-EUS for the diagnosis of pancreatic and gallbladder masses at a single medical center (Severance Hospital, Seoul, Korea) between March 2010 and March 2016.
Results
The enhancement pattern of CEH-EUS of the pancreatic solid masses showed higher sensitivity and specificity in differentiating pancreatic adenocarcinoma and neuroendocrine tumors (82.0% and 87.9% for pancreatic adenocarcinoma and 81.1% and 90.9% for neuroendocrine tumors, respectively), and the area under the receiver operating characteristic curves was higher than that of conventional EUS. The enhancement texture of CEH-EUS of the gallbladder masses showed a higher sensitivity in differentiating malignant masses than that of conventional EUS; however, the difference between the areas under the receiver operating characteristic curves was not statistically significant.
Conclusions
CEH-EUS can complement conventional EUS in the diagnosis of pancreatic and gallbladder masses, in terms of the limitations of the latter.

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Case Reports
Ménétrier’s Disease as a Gastrointestinal Manifestation of Active Cytomegalovirus Infection in a 22-Month-Old Boy: A Case Report with a Review of the Literature of Korean Pediatric Cases
Jeana Hong, Seungkoo Lee, Yoonjung Shon
Clin Endosc 2018;51(1):89-94.   Published online June 13, 2017
DOI: https://doi.org/10.5946/ce.2017.038
AbstractAbstract PDFPubReaderePub
Ménétrier’s disease (MD), which is characterized by hypertrophic gastric folds and foveolar cell hyperplasia, is the most common gastrointestinal (GI) cause of protein-losing enteropathy (PLE). The clinical course of MD in childhood differs from that in adults and has often been reported to be associated with cytomegalovirus (CMV) infection. We present a case of a previously healthy 22-month-old boy presenting with PLE, who was initially suspected to have an eosinophilic GI disorder (EGID). However, he was eventually confirmed, by detection of CMV DNA using polymerase chain reaction (PCR) with gastric tissue, to have MD associated with an active CMV infection. We suggest that endoscopic and pathological evaluation is necessary for the differential diagnosis of MD. In addition, CMV DNA detection using PCR analysis of biopsy tissue is recommended to confirm the etiologic agent of MD regardless of the patient’s age or immune status.

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    Claire Ferrua, Anais Lemoine, Alexis Mosca, Anne-Aurélie Lopes
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    Sofia Rao, Anna Viola, Omar Ksissa, Walter Fries
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Gastric Adenocarcinoma with Systemic Metastasis Involving the Intraocular Choroid and Duodenum
Soon Young Kim, Kee-Taek Jang, Jun Haeng Lee
Clin Endosc 2018;51(1):95-98.   Published online May 22, 2017
DOI: https://doi.org/10.5946/ce.2017.049
AbstractAbstract PDFPubReaderePub
Gastric cancer with double metastasis to the orbit and duodenum is extremely rare. We report the case of a patient with gastric adenocarcinoma who presented with synchronous orbital and duodenal metastases at the time of initial diagnosis. A 60-year-old man presented with a 1-month history of visual disorder and pain in his right eye. He underwent ophthalmological examinations. The biopsy results suggested intraocular metastatic carcinoma. We conducted a systemic evaluation to identify primary malignancy. Finally, a diagnosis of advanced gastric adenocarcinoma with multi-organ metastasis was made. He planned to be treated with systemic chemotherapy.

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Management of Percutaneous Endoscopic Gastrostomy Site Gastric Ulcer in a Patient with an Esophageal Stricture and Hiatus Hernia
Clement C H Wu, James W Li, Keng Sin Ng, Daphne S Ang
Clin Endosc 2018;51(1):99-102.   Published online May 22, 2017
DOI: https://doi.org/10.5946/ce.2017.035
AbstractAbstract PDFPubReaderePub
Percutaneous endoscopic gastrostomy (PEG) is commonly performed for feeding difficulties, in patients suffering from complications of nasopharyngeal carcinoma (NPC) and its treatment, namely radiotherapy and surgery. This case report describes the challenges in hemostasis and subsequent re-establishment of enteral access for feeding, in an elderly patient with a history of NPC, treated surgically, followed by radiotherapy, who presented with massive hematemesis following reinsertion of her PEG shortly after an accidental dislodgement. Her previous nasopharyngectomy, wide field radiation therapy, and radical neck dissection precluded nasogastric tube (NGT) feeding, and the presence of a large hiatus hernia made reinsertion of a new PEG technically challenging. This case highlights the methods used to overcome the above challenges.

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    Jorge Romero, Kavisha Patel, Dhanunjaya Lakkireddy, Isabella Alviz, Alejandro Velasco, Daniel Rodriguez, Joseph Karpenos, Xiao‐Dong Zhang, Andrea Natale, Luigi Di Biase
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Full-Thickness Resection Device for Complex Colorectal Lesions in High-Risk Patients as a Last-Resort Endoscopic Treatment: Initial Clinical Experience and Review of the Current Literature
Edris Wedi, Beatrice Orlandini, Mark Gromski, Carlo Felix Maria Jung, Irina Tchoumak, Stephanie Boucher, Volker Ellenrieder, Jürgen Hochberger
Clin Endosc 2018;51(1):103-108.   Published online January 31, 2018
DOI: https://doi.org/10.5946/ce.2017.093
AbstractAbstract PDFPubReaderePub
The full-thickness resection device (FTRD) is a novel endoscopic device approved for the resection of colorectal lesions. This case-series describes the device and its use in high-risk patients with colorectal lesions and provides an overview of the potential indications in recently published data.
Between December 2014 and September 2015, 3 patients underwent endoscopic full thickness resection using the FTRD for colorectal lesions: 1 case for a T1 adenocarcinoma in the region of a surgical anastomosis after recto-sigmoidectomy, 1 case for a non-lifting colonic adenoma with low-grade dysplasia in an 89-year old patient and 1 for a recurrent adenoma with high-grade dysplasia in a young patient with ulcerative rectocolitis who was under immunosuppression after renal transplantation. Both technical and clinical success rates were achieved in all cases. The size of removed lesions ranged from 9 to 30 mm.
Overall, the most frequent indication in the literature has been for lifting or non-lifting adenoma, submucosal tumors, neuroendocrin tumors, incomplete endoscopic resection (R1) or T1 carcinoma.
Colorectal FTRD is a feasible technique for the treatment of colorectal lesions and represents a minimally invasive alternative for either surgical or conventional endoscopic resection strategies.

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Brief Report
White Bile in Malignant Biliary Obstruction: A Poor Prognostic Marker
Anas Gremida, Tarun Rustagi
Clin Endosc 2018;51(1):109-110.   Published online October 16, 2017
DOI: https://doi.org/10.5946/ce.2017.111
PDFSupplementary MaterialPubReaderePub

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