Clinical Endoscopy

Original Article

Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care: Jong-In Chang, Tae Jun Kim, Na Young Hwang, Insuk Sohn, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim; Clin Endosc 2022;55(1):77-85. Published online July 5, 2021; DOI: https://doi.org/10.5946/ce.2021.002

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Endoscopic submucosal dissection (ESD) of gastric tumors in the mid-to-upper stomach is a technically challenging procedure. This study compared the therapeutic outcomes and adverse events of ESD of tumors in the mid-to-upper stomach performed under general anesthesia (GA) or monitored anesthesia care (MAC).
Methods
Between 2012 and 2018, 674 patients underwent ESD for gastric tumors in the midbody, high body, fundus, or cardia (100 patients received GA; 574 received MAC). The outcomes of the propensity score (PS)-matched (1:1) patients receiving either GA or MAC were analyzed.
Results
The PS matching identified 94 patients who received GA and 94 patients who received MAC. Both groups showed high rates of en bloc resection (GA, 95.7%; MAC, 97.9%; p=0.68) and complete resection (GA, 81.9%; MAC, 84.0%; p=0.14). There were no significant differences between the rates of adverse events (GA, 16.0%; MAC, 8.5%; p=0.18) in the anesthetic groups. Logistic regression analysis indicated that the method of anesthesia did not affect the rates of complete resection or adverse events.
Conclusions
ESD of tumors in the mid-to-upper stomach at our high-volume center had good outcomes, regardless of the method of anesthesia. Our results demonstrate no differences between the efficacies and safety of ESD performed under MAC and GA.

Citations

Citations to this article as recorded by

General Anesthesia and Endoscopic Upper Gastrointestinal Tumor Resection
Seung Hyun Kim
Journal of Digestive Cancer Research.2023; 11(3): 125. CrossRef
Is General Anesthesia Needed in Endoscopic Submucosal Dissection for Lesions Located in the Mid to Upper Stomach?
Prasit Mahawongkajit, Jirawat Swangsri
Clinical Endoscopy.2022; 55(1): 43. CrossRef
Therapeutic approach to non-curative resection after endoscopic treatment in early gastric cancer
Eun Jeong Gong, Chang Seok Bang
Journal of the Korean Medical Association.2022; 65(5): 284. CrossRef
Paneth Cell Carcinoma of the Stomach
Jun Wan Kim, Gwang Ha Kim, Kyung Bin Kim
The Korean Journal of Gastroenterology.2022; 80(1): 34. CrossRef
Comparing Different Anesthesia Methods on Anesthetic Effect and Postoperative Pain in Patients with Early Gastric Cancer during Endoscopic Submucosal Dissection
Jie Zhang, Yanlei Chen, Zhiwu Liu, Zhihao Pan, Jinghua Pan
Journal of Oncology.2022; 2022: 1. CrossRef

3,708 View
173 Download
5 Web of Science
5 Crossref

Review

Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy: Hyun Lim, Eun Jeong Gong, Byung-Hoon Min, Seung Joo Kang, Cheol Min Shin, Jeong-Sik Byeon, Miyoung Choi, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun; Clin Endosc 2020;53(6):663-677. Published online November 26, 2020; DOI: https://doi.org/10.5946/ce.2020.192

Abstract PDF PubReader ePub

Antithrombotic agents, including antiplatelet agents and anticoagulants, are increasingly used in South Korea. The management of patients using antithrombotic agents and requiring gastrointestinal endoscopy is an important clinical challenge. Although clinical practice guidelines (CPGs) for the management of patients receiving antithrombotic agents and undergoing gastrointestinal endoscopy have been developed in the Unites States, Europe, and Asia Pacific region, it is uncertain whether these guidelines can be adopted in South Korea. After reviewing current CPGs, we identified unmet needs and recognized significant discrepancies in the clinical practice among regions. This is the first CPG in Korea providing information that may assist endoscopists in the management of patients on antithrombotic agents who require diagnostic or elective therapeutic endoscopy. This guideline was developed through the adaptation process as an evidence-based method, with four guidelines retrieved by systematic review. Eligible guidelines were evaluated according to the Appraisal of Guidelines for Research and Evaluation II process, and 13 statements were established using a grading system. This guideline was reviewed by external experts before an official. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.

Citations

Citations to this article as recorded by

Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Gut and Liver.2024; 18(1): 10. CrossRef
A systematic critical appraisal of clinical practice guidelines of antithrombotic agents in gastrointestinal endoscopy using the AGREE II tool
Denisse Camille Dayto, Wojciech Blonski, Tea Reljic, Farina Klocksieben, Jeffrey Gill, Rene D. Gomez‐Esquivel, Brijesh Patel, Pushpak Taunk, Andrew Sephien, Camille Thelin, Ambuj Kumar
Journal of Gastroenterology and Hepatology.2024; 39(5): 818. CrossRef
The Impact of Sedation on Cardio-Cerebrovascular Adverse Events after Surveillance Esophagogastroduodenoscopy in Patients with Gastric Cancer: A Nationwide Population-Based Cohort Study
Sang Yoon Kim, Jun Kyu Lee, Kwang Hyuck Lee, Jae-Young Jang, Byung-Wook Kim
Gut and Liver.2024; 18(2): 245. CrossRef
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
Clinical Endoscopy.2024; 57(2): 141. CrossRef
Top tips on the management of antithrombotic agents in the periendoscopic period
Alberto Tringali
Gastrointestinal Endoscopy.2024; 99(6): 1021. CrossRef
Assessment of delayed bleeding after endoscopic submucosal dissection of early-stage gastrointestinal tumors in patients receiving direct oral anticoagulants
Mitsushige Sugimoto, Masaki Murata, Takashi Kawai
World Journal of Gastroenterology.2023; 29(19): 2916. 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
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
Predicting the Bleeding Risk for Patients on Anticoagulant Therapy Prior to Gastric Endoscopic Submucosal Dissection
Jie-Hyun Kim
Journal of Gastric Cancer.2022; 22(1): 1. CrossRef
Utility of a deep learning model and a clinical model for predicting bleeding after endoscopic submucosal dissection in patients with early gastric cancer
Ji Eun Na, Yeong Chan Lee, Tae Jun Kim, Hyuk Lee, Hong-Hee Won, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim
World Journal of Gastroenterology.2022; 28(24): 2721. CrossRef

12,889 View
945 Download
9 Web of Science
10 Crossref

Original Articles

Endoscopic Submucosal Dissection for Early Gastric Neoplasia Occurring in the Remnant Stomach after Distal Gastrectomy: Ji Young Lee, Byung-Hoon Min, Jung Gyu Lee, Donghyo Noh, Jun Haeng Lee, Poong-Lyul Rhee, Jae J. Kim; Clin Endosc 2016;49(2):182-186. Published online February 11, 2016; DOI: https://doi.org/10.5946/ce.2015.049

Abstract PDF PubReader ePub

Background
/Aims: Endoscopic submucosal dissection (ESD) for tumors occurring in the remnant stomach is technically difficult to perform because of limited working space and severe fibrosis and staples present around the suture line. We aimed to elucidate the feasibility and clinical outcomes of performing ESD for tumors in the remnant stomach.
Methods
Between December 2007 and January 2013, 18 patients underwent ESD for tumors (six adenomas and 12 differentiated-type early gastric cancers [EGCs]) occurring in the remnant stomach after distal gastrectomy. Clinicopathologic features and clinical outcomes after ESD were retrospectively analyzed.
Results
Two-thirds of the lesions were located on the body, and half were located on the suture line. En bloc resection, R0 resection, and en bloc with R0 resection rates were 88.9%, 100%, and 88.9%, respectively. Curative resection rate for EGC was 91.7%. Perforation occurred in one patient (5.6%) and was successfully managed by endoscopic closure with metallic clips and conservative management. There was no significant bleeding after ESD. During a median follow-up of 47.5 months, no local, metachronous, or extragastric recurrence was seen for either EGC or adenoma lesions.
Conclusions
ESD is a feasible and effective treatment modality and can be considered a primary intervention for early gastric neoplasia occurring in the remnant stomach.

Citations

Citations to this article as recorded by

Long-Term Outcomes of Endoscopic Submucosal Dissection for Early Remnant Gastric Cancer: A Retrospective Multicenter Study
Kazunori Tsuda, Shinwa Tanaka, Tetsuya Yoshizaki, Yoshinobu Yamamoto, Takayuki Ose, Tsukasa Ishida, Yasuaki Kitamura, Daisuke Obata, Mineo Iwatate, Atsushi Ikeda, Ryusuke Ariyoshi, Fumiaki Kawara, Hiroshi Takihara, Hirofumi Abe, Toshitatsu Takao, Yoshinor
Digestion.2023; 104(5): 381. CrossRef
The Incidence and Risk Factors for Metachronous Gastric Cancer in the Remnant Stomach after Gastric Cancer Surgery
Yonghoon Choi, Nayoung Kim, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee, Young Suk Park, Sang-Hoon Ahn, Yun-Suhk Suh, Do Joong Park, Hyung Ho Kim
Gut and Liver.2022; 16(3): 366. CrossRef
Comparison of Endoscopic Submucosal Dissection and Radical Surgery for Early Gastric Cancer in Remnant Stomach
Yi Liu, Zhihao Chen, Hong Zhou, Yingtai Chen, Lizhou Dou, Yueming Zhang, Yong Liu, Shun He, Dongbing Zhao, Guiqi Wang
Journal of Clinical Medicine.2022; 11(18): 5403. CrossRef
Endoscopic Submucosal Dissection in Patients with Early Gastric Cancer in the Remnant Stomach
Mai Murakami, Takuto Hikichi, Jun Nakamura, Minami Hashimoto, Tsunetaka Kato, Ryoichiro Kobashi, Takumi Yanagita, Rei Suzuki, Mitsuru Sugimoto, Yuki Sato, Hiroki Irie, Mika Takasumi, Tadayuki Takagi, Yuko Hashimoto, Masao Kobayakawa, Hiromasa Ohira
Diagnostics.2022; 12(10): 2480. CrossRef
Intestinal Mucosal Wound Healing and Barrier Integrity in IBD–Crosstalk and Trafficking of Cellular Players
Katrin Sommer, Maximilian Wiendl, Tanja M. Müller, Karin Heidbreder, Caroline Voskens, Markus F. Neurath, Sebastian Zundler
Frontiers in Medicine.2021;[Epub] CrossRef
Clinical outcomes of endoscopic submucosal dissection for lesions on the proximal location between remnant and entire stomach
Su Jin Kim, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Hyeong Seok Nam, Dae Gon Ryu
Surgical Endoscopy.2020; 34(2): 880. CrossRef
Endoscopic submucosal dissection for early neoplastic lesions in the surgically altered stomach: a systematic review and meta-analysis
Mohamed Barakat, Mohamed Seif, Mohamed M. Abdelfatah, Andrew Ofosu, David L. Carr-Locke, Mohamed O. Othman
Surgical Endoscopy.2019; 33(8): 2381. CrossRef
Current controversies in treating remnant gastric cancer: Are minimally invasive approaches feasible?
Fu-Hai Ma, Hao Liu, Shuai Ma, Yang Li, Yan-Tao Tian
World Journal of Clinical Cases.2019; 7(21): 3384. CrossRef
Endoscopic Submucosal Dissection of Gastric Epithelial Neoplasms after Partial Gastrectomy: A Single-Center Experience
Byeong Gu Song, Gwang Ha Kim, Bong Eun Lee, Hye Kyung Jeon, Dong Hoon Baek, Geun Am Song
Gastroenterology Research and Practice.2017; 2017: 1. CrossRef

9,270 View
88 Download
13 Web of Science
9 Crossref

Usefulness of Ready-to-Use 0.4% Sodium Hyaluronate (Endo-Ease) in the Endoscopic Resection of Gastrointestinal Neoplasms: Eun Ran Kim, Yun Gyoung Park, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J. Kim, Jung Ho Park, Dong Il Park, Dong Kyung Chang; Clin Endosc 2015;48(5):392-398. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.392

Abstract PDF PubReader ePub

Background/Aims

Commercially available sodium hyaluronate solutions are usually too thick to inject through catheters and need dilution with normal saline (NS) before use, which increases the risk of contamination. We evaluated the usefulness of ready-to-use 0.4% sodium hyaluronate, Endo-Ease (EE; UNIMED Pharm. Inc., Seoul, Korea).

Methods

We performed a prospective multicenter randomized study from May 2011 to September 2012. Patients requiring endoscopic resection (ER) for gastric or colorectal neoplasm at two referral hospitals were enrolled.

Results

One hundred fifty-four patients (72 with a gastric neoplasm and 82 with a colorectal neoplasm) were included in intention-to-treat analysis. Thirty-seven gastric neoplasms and 43 colorectal neoplasms were enrolled in the EE group. The usefulness rate was significantly higher in the EE group than in the NS group (89.2% vs. 60.0% for gastric neoplasms and 95.3% vs. 67.7% for colorectal neoplasms, p<0.001). In the EE group, the ease of mucosal resection was significantly higher than in the NS group (p<0.001). The injected volume was smaller in the EE group than in the NS group (p<0.05).

Conclusions

The use of EE reduced the need for additional injections and improved the ease of ER. A submucosal injection of EE is useful for the ER of both gastric and colorectal neoplasms.

Citations

Citations to this article as recorded by

Efficacy and safety of a submucosal injection solution of sodium alginate for endoscopic resection in a porcine model
Kyung Uk Jung, Yeon Jae Lee, Jae-Young Jang, Joo Young Cho
Scientific Reports.2024;[Epub] CrossRef
Injectable temperature-sensitive hydrogel facilitating endoscopic submucosal dissection
Ruifen Xu, Xiaoyu Yang, Tong Yi, Tao Tan, Zhongqi Li, Xuyang Feng, Jing Rao, Pinghong Zhou, Hao Hu, Yonghua Zhan
Frontiers in Bioengineering and Biotechnology.2024;[Epub] CrossRef
Hypertonic solution as an optimal submucosal injection solution for endoscopic resection of gastrointestinal mucosal lesions: Systematic review and network meta‐analysis
Li Gao, Jiawei Bai, Kai Liu, Lulu Wang, Shaohua Zhu, Xin Zhao, Ying Han, Zhiguo Liu
Digestive Endoscopy.2023;[Epub] CrossRef
Injectable Thermosensitive Chitosan Solution with β-Glycerophosphate as an Optimal Submucosal Fluid Cushion for Endoscopic Submucosal Dissection
Seung Jeong, Han Jo Jeon, Kyoung-Je Jang, Sangbae Park, Hyuk Soon Choi, Jong Hoon Chung
Polymers.2021; 13(11): 1696. CrossRef

7,209 View
71 Download
4 Web of Science
4 Crossref

Case Report

Delayed Perforation Occurring after Endoscopic Submucosal Dissection for Early Gastric Cancer: Soo Hoon Kang, Kyungho Lee, Hyun Woo Lee, Ga Eun Park, Yun Soo Hong, Byung-Hoon Min; Clin Endosc 2015;48(3):251-255. Published online May 29, 2015; DOI: https://doi.org/10.5946/ce.2015.48.3.251

Abstract PDF PubReader ePub

Delayed perforation is a very rare complication of endoscopic submucosal dissection (ESD), with a reported incidence of 0.1% to 0.45%. Few reports exist on the clinical features and outcomes of delayed perforation after ESD, and it is unclear whether the optimal management strategy is emergency surgery or endoscopic closure with conservative treatment. Here, we report two cases of delayed perforation occurring after ESD for early gastric cancer. In both cases, lesions were located in the antrum, and tumor depths were confined to the mucosal layer. Total procedure times for ESD were 25 and 45 minutes, respectively. Because delayed perforation may be associated with excessive thermal damage and necrosis of the muscle layer, treatment with emergency surgery should be used instead of conservative management in cases of delayed perforation after ESD.

Citations

Citations to this article as recorded by

Delayed Perforation Occurring after Gastric Endoscopic Submucosal Dissection: Clinical Features and Management Strategy
Tae-Se Kim, Byung-Hoon Min, Yang Won Min, Hyuk Lee, Poong-Lyul Rhee, Jae J. Kim, Jun Haeng Lee
Gut and Liver.2024; 18(1): 40. CrossRef
Complications of endoscopic resection in the upper gastrointestinal tract
Takeshi Uozumi, Seiichiro Abe, Mai Ego Makiguchi, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Yutaka Saito
Clinical Endoscopy.2023; 56(4): 409. CrossRef
Novel image enhancement technology that helps find bleeding points during endoscopic submucosal dissection of gastric neoplasms
Kohei Funasaka, Ryoji Miyahara, Noriyuki Horiguchi, Takafumi Omori, Hayato Osaki, Dai Yoshida, Hyuga Yamada, Keishi Koyama, Mitsuo Nagasaka, Yoshiyuki Nakagawa, Senju Hashimoto, Tomoyuki Shibata, Yoshiki Hirooka
Journal of Gastroenterology and Hepatology.2022; 37(10): 1955. CrossRef
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
Intestinal Research.2021; 19(2): 127. CrossRef
Endoscopic Resection of Gastric Cancer
Ga Hee Kim, Hwoon-Yong Jung
Gastrointestinal Endoscopy Clinics of North America.2021; 31(3): 563. CrossRef
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
Clinical Endoscopy.2020; 53(2): 142. CrossRef
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
The Korean Journal of Gastroenterology.2020; 75(5): 264. CrossRef
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
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2020; 20(2): 117. CrossRef
Delayed perforation occurring on the 24th day after endoscopic submucosal dissection for early gastric cancer
Satoru Homma, Kazuaki Tokodai, Minami Watanabe, Kai Takaya, Eiji Hashizume
Clinical Journal of Gastroenterology.2017; 10(2): 124. CrossRef
Clinical Factors of Delayed Perforation after Endoscopic Submucosal Dissection for Gastric Neoplasms
Yoshinobu Yamamoto, Hogara Nishisaki, Hideki Sakai, Nagahiro Tokuyama, Hiroaki Sawai, Aya Sakai, Takuya Mimura, Saeko Kushida, Hidetaka Tsumura, Takeshi Sakamoto, Ikuya Miki, Masahiro Tsuda, Hideto Inokuchi
Gastroenterology Research and Practice.2017; 2017: 1. CrossRef
Management and associated factors of delayed perforation after gastric endoscopic submucosal dissection
Haruhisa Suzuki
World Journal of Gastroenterology.2015; 21(44): 12635. CrossRef

8,733 View
103 Download
9 Web of Science
11 Crossref

First
Prev
Page of 1
Next
Last

Search