Clinical Endoscopy

Original Articles

External Validation of the Endoscopic Features of Sessile Serrated Adenomas in Expert and Trainee Colonoscopists: Hyo-Joon Yang, Jeong In Lee, Soo-Kyung Park, Yoon Suk Jung, Jin Hee Sohn, Kyu Yong Choi, Dong Il Park; Clin Endosc 2017;50(3):279-286. Published online September 13, 2016; DOI: https://doi.org/10.5946/ce.2016.107

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Background
/Aims: It is unclear whether the endoscopic features of sessile serrated adenomas (SSAs) would be useful to trainee colonoscopists to predict SSA. Therefore, the present study aimed to identify features that expert and trainee colonoscopists can use to independently and reliably predict SSA by using high-resolution white-light endoscopy.
Methods
Endoscopic images of 81 polyps (39 SSAs, 22 hyperplastic polyps, and 20 tubular adenomas) from 43 patients were retrospectively evaluated by 10 colonoscopists (four experts and six trainees). Eight endoscopic features of SSAs were assessed for each polyp.
Results
According to multivariable analysis, a mucous cap (odds ratio [OR], 10.44; 95% confidence interval [CI], 5.72 to 19.07), indistinctive borders (OR, 4.21; 95% CI, 2.74 to 7.16), dark spots (OR, 3.64; 95% CI, 1.89 to 7.00), and cloud-like surface (OR, 2.43; 95% CI, 1.27 to 4.668) were independent predictors of SSAs. Among these, a mucous cap, indistinctive borders, and cloud-like surface showed moderate interobserver agreement (mean κ >0.40) among experts and trainees. When ≥1 of the three predictors was observed, the sensitivity and specificity for diagnosing SSAs were 79.0% and 81.4%, respectively.
Conclusions
Colonoscopy trainees and experts can use several specific endoscopic features to independently and reliably predict SSAs.

Citations

Citations to this article as recorded by

Accuracy and Inter-observer Agreement Among Endoscopists for Visual Identification of Colorectal Polyps Using Endoscopy Images
Thi Khuc, Amol Agarwal, Feng Li, Sergey Kantsevoy, Bryan Curtin, Matilda Hagan, Mary Harris, Anurag Maheshwari, Amit Raina, Elinor Zhou, Paul Thuluvath
Digestive Diseases and Sciences.2023; 68(2): 616. CrossRef
Polyp Fact or Polyp Fiction: Endoscopic Identification of Polyps Using Established Criteria to Improve the Quality of Endoscopic Evaluation and Cost Effectiveness
Ihsan Al Bayati, Sarah Al Obaidi, Mohammed Bashashati
Digestive Diseases and Sciences.2023; 68(2): 344. CrossRef
Risk factors for sessile serrated lesions among Chinese patients undergoing colonoscopy
Ru Zhang, Yunbi Ni, Cosmos LT Guo, Rashid NS Lui, William KK Wu, Joseph JY Sung, Vincent WS Wong, Sunny H Wong
Journal of Gastroenterology and Hepatology.2023; 38(9): 1468. CrossRef
Risk factors of traditional serrated adenoma and clinicopathologic characteristics of synchronous conventional adenoma
Jeongseok Kim, Ji Young Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Ja Eun Koo, Hyo Jeong Lee, Jaewon Choe, Jeong-Sik Byeon
Gastrointestinal Endoscopy.2019; 90(4): 636. CrossRef
Identification of risk factors for sessile and traditional serrated adenomas of the colon by using big data analysis
Jeung Hui Pyo, Sang Yun Ha, Sung Noh Hong, Dong Kyung Chang, Hee Jung Son, Kyoung‐Mee Kim, Hyeseung Kim, Kyunga Kim, Jee Eun Kim, Yoon‐Ho Choi, Young‐Ho Kim
Journal of Gastroenterology and Hepatology.2018; 33(5): 1039. CrossRef
Sessile Serrated Adenoma; the Hard-to-Catch Culprit of Interval Cancer
Suk Pyo Shin
Clinical Endoscopy.2017; 50(3): 215. CrossRef
Proximal Sessile Serrated Adenomas Are More Prevalent in Caucasians, and Gastroenterologists Are Better Than Nongastroenterologists at Their Detection
Malav P. Parikh, Sujit Muthukuru, Yash Jobanputra, Kushal Naha, Niyati M. Gupta, Vaibhav Wadhwa, Rocio Lopez, Prashanthi N. Thota, Madhusudhan R. Sanaka
Gastroenterology Research and Practice.2017; 2017: 1. CrossRef

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Performance and Clinical Role of Endoscopic Ultrasound Fine Needle Aspiration for Diagnosing Gastrointestinal Intramural Lesions: Hea Jung Sung, Yu Kyung Cho, Eun Young Park, Sung Jin Moon, Chul Hyun Lim, Jin Su Kim, Jae Myung Park, In Seok Lee, Sang Woo Kim, Myung-Gyu Choi, Kyu Yong Choi; Clin Endosc 2013;46(6):627-632. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.627

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Background/Aims

We evaluated the performance, clinical role, and diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in gastrointestinal intramural lesions.

Methods

Procedural and pathologic data were reviewed from consecutive patients undergoing EUS-FNA for intramural lesions. Final diagnoses were determined by surgical histopathologic conformation and the diagnosis of malignancy, including clinical follow-up with repeat imaging.

Results

Forty-six patients (mean age, 47 years; 24 males) underwent EUS-FNA. Lesions were located in the stomach (n=31), esophagus (n=5), and duodenum (n=10). The median lesion size was 2 cm (range, 1 to 20.6). Final diagnoses were obtained in 22 patients (48%). EUS-FNA was diagnostic in 40 patients (87%). The diagnostic accuracy of cytology for differentiating between benign and malignant lesions was 82%; diagnostic error occurred in three patients (6%). The cytologic results influenced clinical judgment in 78% cases. The primary reasons for negative or no clinical impact were false-negative results, misdirected patient management, and inconclusive cytology.

Conclusions

EUS-FNA exhibited an 87% diagnostic yield for gastrointestinal intramural lesions; the accuracy of cytology for differentiating malignancy was 82%. The limitations of EUS-FNA were primarily because of nondiagnostic sampling (9%) and probable diagnostic error (6%); these factors may influence the clinical role of EUS-FNA.

Citations

Citations to this article as recorded by

Feasibility and clinical value of linear endoscopic ultrasonography imaging in the lower gastrointestinal subepithelial lesions
Li Tao, Yajun Chen, Qianqian Fang, Fan Xu, Qianwei Yu, Lijiu Zhang, Xiangpeng Hu
Scientific Reports.2024;[Epub] CrossRef
Endoscopic ultrasound‐guided fine needle aspiration cytology diagnosis of upper gastrointestinal tract mesenchymal tumors: Impact of rapid onsite evaluation and correlation with histopathologic follow‐up
Syed M. Gilani, Thiruvengadam Muniraj, Harry R. Aslanian, Guoping Cai
Diagnostic Cytopathology.2021; 49(2): 203. CrossRef
Diagnosis of Gastric Subepithelial Tumor: Focusing on Endoscopic Ultrasonography
Eun Young Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2015; 15(1): 9. CrossRef
Endoscopic Ultrasound-Guided Fine Needle Biopsy without Rapid On-Site Cytologic Examination: A Time to Change the Paradigm?
Yeon Suk Kim
Clinical Endoscopy.2014; 47(3): 207. CrossRef

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Diagnostic Accuracy and Interobserver Agreement in Predicting the Submucosal Invasion of Colorectal Tumors Using Gross Findings, Pit Patterns, and Microvasculatures: Hye Jung Choi, Bo-In Lee, Hwang Choi, Kyu Yong Choi, Sang-Woo Kim, Joo Yong Song, Jeong Seon Ji, Byung-Wook Kim; Clin Endosc 2013;46(2):168-171. Published online March 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.2.168

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Background/Aims

Depth of invasion is one of the most important factors for establishing treatment strategy for colorectal tumors.

Methods

Three blinded experts reviewed electronic photos and video clips of 33 early colorectal cancer-like lesions. They estimated the depth of invasion based on conventional white light endoscopy (CWE), magnifying chromoendoscopy (MCE), and magnifying narrow band imaging endoscopy (MNE).

Results

The lesions included nine mucosal low-grade neoplasias, 16 mucosal high grade neoplasias, and eight carcinomas with invasion to the submucosal layer or beyond. The diagnostic accuracy for submucosal invasion by CWE ranged from 67% to 82%, while those by MCE and MNE ranged from 85% to 88% and 85% to 88%, respectively. The diagnostic accuracy significantly differed between CWE and MCE (p=0.034) and between CWE and MNE (p=0.039). The kappa values for CWE, MCE, and MNE among the endoscopists were 0.564, 0.673, and 0.673, respectively.

Conclusions

The estimation of submucosal invasion for early colorectal cancer-like lesions based on MCE or MNE is more accurate than CWE. MCE and MNE were demonstrated to have substantial agreement for predicting submucosal invasion.

Citations

Citations to this article as recorded by

Estimation of Invasion Depth: The First Key to Successful Colorectal ESD
Bo-In Lee, Takahisa Matsuda
Clinical Endoscopy.2019; 52(2): 100. CrossRef
Comparison of endoscopic ultrasonography and magnifying endoscopy for assessment of the invasion depth of shallow gastrointestinal neoplasms: a systematic review and meta-analysis
Zhang Tao, Chen Yan, He Zhao, Jiawei Tsauo, Xiaowu Zhang, Bing Qiu, Yanqing Zhao, Xiao Li
Surgical Endoscopy.2017; 31(12): 4923. CrossRef
Use of confocal laser endomicroscopy with a fluorescently labeled fatty acid to diagnose colorectal neoplasms
Feihong Deng, Yuan Fang, Zhiyong Shen, Wei Gong, Tao Liu, Jing Wen, Wanling Zhang, Xianjun Zhu, Hui Zhong, Tong Wang, Fachao Zhi, Biao Nie
Oncotarget.2017; 8(35): 58934. CrossRef
Higher net change of index of hemoglobin values between colon polyp and nonpolyp mucosa correlates with the presence of an advanced colon adenoma
Wei‐Chun Cheng, Hsiu‐Chi Cheng, Po‐Jun Chen, Jui‐Wen Kang, Er‐Hsiang Yang, Bor‐Shyang Sheu, Wei‐Ying Chen
Advances in Digestive Medicine.2016; 3(4): 161. CrossRef
Brief Education on Microvasculature and Pit Pattern for Trainees Significantly Improves Estimation of the Invasion Depth of Colorectal Tumors
Joon Sung Kim, Bo-In Lee, Hwang Choi, Bong Koo Kang, Jong In Kim, Hae Mi Lee, Eun-Joo Im, Byung-Wook Kim, Sang-Woo Kim, Myung-Gyu Choi, Kyu Yong Choi
Gastroenterology Research and Practice.2014; 2014: 1. CrossRef
Clinical Usefulness of Magnifying Chromoendoscopy and Magnifying Narrow Band Imaging Endoscopy for Predicting the Submucosal Invasion of Early Colorectal Cancers
Kwang An Kwon, Yang Suh Ku
Clinical Endoscopy.2013; 46(2): 113. CrossRef

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Performance and Cost of Disposable Biopsy Forceps in Upper Gastrointestinal Endoscopy: Comparison with Reusable Biopsy Forceps: Chul-Hyun Lim, Myung-Gyu Choi, Won Chul Kim, Jin Soo Kim, Yu Kyung Cho, Jae Myung Park, In Seok Lee, Sang Woo Kim, Kyu Yong Choi, In-Sik Chung; Clin Endosc 2012;45(1):62-66. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.62

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Background/Aims

It is believed that disposable biopsy forceps are more costly than reusable biopsy forceps. In this study, we evaluated performance and cost of disposable forceps versus reusable forceps in esophagogastroduodenoscopic biopsy.

Methods

Between October 2009 and July 2010, we enrolled 200 patients undergoing esophagogastroduodenoscopic biopsy at Seoul St. Mary's Hospital. Biopsies were performed with 100 disposable or 5 reusable forceps by random assignment. Seventy-five additional patients were studied to estimate durability of reusable forceps. The assisting nurses estimated the performance of the forceps. The evaluation of costs included purchase prices and reprocessing costs. The adequacy of the sample was estimated according to the diameter of the obtained tissue.

Results

Performance of disposable forceps was estimated as excellent in 97.0%, good in 2.0% and adequate in 1.0%. Reusable forceps were estimated as excellent in 36.0%, good in 36.0%, adequate in 25.1% and inadequate in 2.9%. The performance of reusable forceps declined with the number of uses. The reprocessing cost of reusable forceps for one biopsy session was calculated as ₩8,021. The adequacy of the sample was excellent for both forceps.

Conclusions

Disposable forceps showed excellent performance. Considering the reprocessing costs of reusable forceps, usage of disposable forceps with a low price should be considered.

Citations

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International Delphi Consensus Study on disposable single-use endoscopy: A path to clinical adoption
Alessandro Repici, Kareem Khalaf, Edoardo Troncone, Sharmila Subramaniam, Cesare Hassan, Pradeep Bhandari, Lars AABAKKEN, Sarah ABERE, Maisam W. AKROUSH, Abed AL-LEHIBI, Eduardo ALBÉNIZ, Asma ALKANDARI, Majid A. ALMADI, Andrea ANDERLONI, Amol BAPAYE, Napo
Digestive and Liver Disease.2024; 56(2): 322. CrossRef
Single‐use accessories and endoscopes in the era of sustainability and climate change—A balancing act
Zaheer Nabi, Raymond S. Y. Tang, Sridhar Sundaram, Sundeep Lakhtakia, D. Nageshwar Reddy
Journal of Gastroenterology and Hepatology.2024; 39(1): 7. CrossRef
Ressourcenschonung aus Sicht der Hygiene
Susanne Kolbe-Busch, Iris F. Chaberny
Die Chirurgie.2023; 94(3): 220. CrossRef
An Economic Analysis of Direct Costs of Distal Radius Fixation and the Implications of a Disposable Distal Radius Kit
Jonathan Lans, Ritsaart F. Westenberg, Svenna H.W.L. Verhiel, Rohit Garg, Jesse B. Jupiter, Neal C. Chen
Journal of Orthopaedic Trauma.2021; 35(9): e346. CrossRef
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 Ch
Clinical Endoscopy.2020; 53(3): 276. CrossRef
Multidisciplinary and Multisociety Practice Guidelines for Reprocessing Flexible Gastrointestinal Endoscopes and Endoscopic Accessories; Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobact
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 Ch
The Korean Journal of Medicine.2020; 95(5): 325. CrossRef
Korean Society of Gastrointestinal Endoscopy Guidelines for Endoscope Reprocessing
Byoung Kwan Son, Byung-Wook Kim, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang
Clinical Endoscopy.2017; 50(2): 143. CrossRef
Korean Society of Gastrointestinal Endoscopy (KSGE) Guidelines for Endoscope Reprocessing
Byung-Wook Kim, Byoung Kwan Son, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang
The Korean Journal of Medicine.2017; 92(3): 239. CrossRef
Evaluating Quality and Adequacy of Gastrointestinal Samples Collected using Reusable or Disposable Forceps
J.A. Cartwright, T.L. Hill, S. Smith, D. Shaw
Journal of Veterinary Internal Medicine.2016; 30(4): 1002. CrossRef
Current Status of Endoscope Reprocessing in Korea
Young-Seok Cho
Clinical Endoscopy.2015; 48(1): 1. CrossRef
Role of Clinical Endoscopy in Emphasizing Endoscope Disinfection
Ji Kon Ryu, Eun Young Kim, Kwang An Kwon, Il Ju Choi, Ki Baik Hahm
Clinical Endoscopy.2015; 48(5): 351. CrossRef
High-level disinfection of gastrointestinal endoscope reprocessing
King-Wah Chiu
World Journal of Experimental Medicine.2015; 5(1): 33. CrossRef
Is non-woven fabric a useful method of packaging instruments for operation theatres in resource constrained settings?
GS Devadiga, VMP Thomas, S Shetty, MS Setia
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