Clinical Endoscopy

Original Article

Bleeding after Endoscopic Resection in Patients with End-Stage Renal Disease on Dialysis: A Multicenter Propensity Score-Matched Analysis: In Kyung Yoo, Chan Gyoo Kim, Young Ju Suh, Younkyung Oh, Gwang Ho Baik, Sun Moon Kim, Young Dae Kim, Chul-Hyun Lim, Jung Won Jeon, Su Jin Hong, Byoung Wook Bang, Joon Sung Kim, Jun-Won Chung; Clin Endosc 2020;53(4):452-457. Published online October 25, 2019; DOI: https://doi.org/10.5946/ce.2019.107

Background
/Aims: Frequent bleeding after endoscopic resection (ER) has been reported in patients with end-stage renal disease (ESRD). We aimed to evaluate the association and clinical significance of bleeding with ER in ESRD patients on dialysis.
Methods
Between February 2008 and December 2018, 7,571 patients, including 47 ESRD patients on dialysis who underwent ER for gastric neoplasia, were enrolled. A total of 47 ESRDpatients on dialysis were propensity score-matched 1:10 to 470 non-ESRD patients, to adjust for between-group differences in variables such as age, sex, comorbidities, anticoagulation use, tumor characteristics, and ER method. Matching was performed using an optimal matching algorithm. For the matched data, clustered comparisons were performed using the generalized estimating equation method. Medical records were retrospectively reviewed. Frequency and outcomes of post-ER bleeding were evaluated.
Results
Bleeding was more frequent in the ESRD with dialysis group than in the non-ESRD group. ESRD with dialysis conferred a significant risk of post-ER bleeding (odds ratio, 6.1; 95% confidence interval, 2.7–13.6; p<0.0001). All post-ER bleeding events were controlled using endoscopic hemostasis except in 1 non-ESRD case that needed surgery.
Conclusions
ESRD with dialysis confers a bleeding risk after ER. However, all bleeding events could be managed endoscopically without sequelae. Concern about bleeding should not stop endoscopists from performing ER in ESRD patients on dialysis.

Citations

Citations to this article as recorded by

Chronic Kidney Disease Increases Risk of Delayed Post‐Polypectomy Bleeding: A Large‐Scale Propensity Score‐Matched Analysis
Hye Kyung Hyun, Nak‐Hoon Son, So Hyeon Gwon, Hyun Chul Lim, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim, Tae‐Hyun Yoo, Shin‐Wook Kang, Hae‐Ryong Yun, Cheal Wung Huh
United European Gastroenterology Journal.2025;[Epub] CrossRef
Prediction and prevention of post-procedural bleedings in patients with cirrhosis
Alix Riescher-Tuczkiewicz, Pierre-Emmanuel Rautou
Clinical and Molecular Hepatology.2025; 31(Suppl): S205. CrossRef
Risk of Post-polypectomy Bleeding After Colorectal Endoscopic Mucosal Resection in Patients with Chronic Kidney Disease: A Propensity-Matched Analysis of the US Collaborative Network
Azizullah Beran, Khaled Elfert, Feenalie N. Patel, Mouhand Mohamed, Daryl Ramai, Almaza Albakri, Nasir Saleem, Faisal Kamal, Andrew Canakis, Khaled Srour, Danial H. Shaikh, Shyam Thakkar, Douglas K. Rex, Indira Bhavsar-Burke, John J. Guardiola
Digestive Diseases and Sciences.2025;[Epub] CrossRef
The Outcomes of Colorectal Endoscopic Submucosal Dissection in Patients with Chronic Kidney Disease: A Honam Association for the Study of Intestinal Disease (HASID) Multicenter Study
Byung Chul Jin, Dong Hyun Kim, Geom-Seog Seo, Sang-Wook Kim, Hyung-Hoon Oh, Hyo-Yeop Song, Seong-Jung Kim, Young-Eun Joo, Jun Lee, Hyun-Soo Kim
Diagnostics.2024; 14(13): 1459. CrossRef
Characteristics of factors contributing to follow-up for suspected delayed bleeding after colorectal endoscopic submucosal dissection
Satsuki Takahashi, Kenichiro Okimoto, Tomoaki Matsumura, Yuhei Oyama, Hayato Nakazawa, Yukiyo Mamiya, Chihiro Goto, Ryosuke Horio, Akane Kurosugi, Michiko Sonoda, Tatsuya Kaneko, Naoki Akizue, Yuki Ohta, Takashi Taida, Keiko Saito, Jun Kato, Naoya Kato
Gastrointestinal Endoscopy.2024; 100(4): 718. CrossRef
Effect of renal insufficiency on the short‐ and long‐term outcomes of endoscopic submucosal dissection for early gastric cancer: Propensity score‐matched analysis
Tae‐Se Kim, Byung‐Hoon Min, Sun‐Young Baek, Kyunga Kim, Yang Won Min, Hyuk Lee, Poong‐Lyul Rhee, Jae J. Kim, Jun Haeng Lee
Digestive Endoscopy.2023; 35(7): 869. CrossRef
Safeness of Endoscopic Resection in Patients with End-Stage Renal Disease on Dialysis
Sun-Jin Boo
Clinical Endoscopy.2020; 53(4): 381. CrossRef

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Case Report

A Case of Primary Small Bowel Melanoma Diagnosed by Single-Balloon Enteroscopy: Jun Young Shin, In Suh Park, Byoung Wook Bang, Hyung Kil Kim, Yong Woon Shin, Kye Sook Kwon; Clin Endosc 2017;50(4):395-399. Published online June 2, 2017; DOI: https://doi.org/10.5946/ce.2016.153

Abstract PDF PubReader ePub

Although metastasis from cutaneous malignant melanoma to the small intestine is not uncommon, primary small bowel melanoma (SBM) is extremely rare. This case report describes a rare case of primary SBM, diagnosed by single-balloon enteroscopy. A 74-year-old man presented with recurrent melena. Upper endoscopy and colonoscopy were unremarkable. Abdominal computed tomography (CT) revealed an ileal mass with ileo-ileal intussusception. Subsequent single-balloon enteroscopy identified an ileal tumor, which was histologically diagnosed as melanoma. Extensive clinical examination did not reveal any primary cutaneous lesions. To the best of our knowledge, this is the first case of primary SBM in South Korea.

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Small Bowel Intussusception Secondary to Malignant Melanoma 11 Years After Melanoma-In-Situ Excision
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The American Surgeon™.2023; 89(7): 3275. CrossRef
Primary Small Bowel Melanoma: A Case Report and Review of Literature
Amanda M. Graças, Willy P. Souza, Ana Carolina A. Canut, Maurice Y. Franciss, Bruno Zilberstein
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Kavya M. Reddy, Tinashe Maduke, Francis Wade, Christine Hachem
Clinical Journal of Gastroenterology.2021; 14(5): 1376. CrossRef
Effect of Double-Balloon Enteroscopy on Diagnosis and Treatment of Small-Bowel Diseases
Li Tang, Liu-Ye Huang, Jun Cui, Cheng-Rong Wu
Chinese Medical Journal.2018; 131(11): 1321. CrossRef

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Original Article

Twenty-Second versus Sixty-Second Dilation Duration in Endoscopic Papillary Balloon Dilation for the Treatment of Small Common Bile Duct Stones: A Prospective Randomized Controlled Multicenter Trial: Byoung Wook Bang, Tae Hoon Lee, Tae Jun Song, Joung-Ho Han, Hyun Jong Choi, Jong Ho Moon, Chang-Il Kwon, Seok Jeong; Clin Endosc 2015;48(1):59-65. Published online January 31, 2015; DOI: https://doi.org/10.5946/ce.2015.48.1.59

Abstract PDF PubReader ePub

Background/Aims

Endoscopic papillary balloon dilation (EPBD) has been advocated as an alternative therapy to endoscopic sphincterotomy for the treatment of common bile duct (CBD) stones. However, there is no established consensus on the optimal balloon dilation duration (BDD). We prospectively evaluated the efficacy and post-endoscopic retrograde cholangiopancreatography (ERCP) complications between the 20- and 60-second EPBD groups.

Methods

A total of 228 patients with small CBD stones (≤12 mm) were randomly assigned to undergo EPBD with a 20- or 60-second duration at six institutions. We evaluated baseline patient characteristics, endoscopic data, clinical outcomes, and procedure-related complications. In addition, we analyzed risk factors for postprocedural pancreatitis.

Results

CBD stones were removed successfully in 107 of 109 patients (98.1%) in the 20-second group and in 112 of 119 patients (94.1%) in the 60-second group (p=0.146). Post-ERCP pancreatitis developed in seven patients (6.4%) in the 20-second group and nine patients (7.5%) in the 60-second group (p=0.408). In multivariate analysis, contrast dye injection into the pancreatic duct is a significant risk factor for post-EPBD pancreatitis.

Conclusions

Based on the data showing that there were no significant differences in safety and efficacy between the two BDD groups, 20 seconds of BDD may be adequate for treatment of small CBD stones with EPBD.

Citations

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The therapeutic effect of balloon dilatation with different duration for biliary duct calculi
Zhi Yuan Yu, Chen Liang, Shi Yu Yang, Xu Zhang, Yan Sun
Journal of Minimal Access Surgery.2022; 18(3): 327. CrossRef
The ballooning time in endoscopic papillary balloon dilation for removal of bile duct stones
Qiang Wang, Luyao Fu, Tao Wu, Xiong Ding
Medicine.2021; 100(11): e24735. CrossRef
Nouveautés dans la prise en charge des calculs biliaires à l’UEGW 2015
E. Bories, C. Lefort
Acta Endoscopica.2016; 46(1-2): 20. CrossRef
Is endoscopic papillary balloon dilatation really a risk factor for post-ERCP pancreatitis?
Toshio Fujisawa, Koichi Kagawa, Kantaro Hisatomi, Kensuke Kubota, Atsushi Nakajima, Nobuyuki Matsuhashi
World Journal of Gastroenterology.2016; 22(26): 5909. CrossRef
Is the Balloon Dilation Duration in Endoscopic Papillary Balloon Dilation (EPBD) Related to the Occurrence of Post-EPBD Pancreatitis?
Dong Uk Kim
Clinical Endoscopy.2015; 48(1): 6. CrossRef

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4 Web of Science
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Case Report

A Case of Esophageal Fibrovascular Polyp That Induced Asphyxia during Sleep: Jin-Seok Park, Byoung Wook Bang, Junyoung Shin, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin, Suk Jin Choi; Clin Endosc 2014;47(1):101-103. Published online January 24, 2014; DOI: https://doi.org/10.5946/ce.2014.47.1.101

Abstract PDF PubReader ePub

Esophageal fibrovascular polyps are rare, benign, submucosal tumors of the upper digestive tract that usually have an indolent course until the lesion attains a very large size. The most frequent complaints associated with these tumors include dysphagia and foreign body sensation. However, a long pedunculated polyp can regurgitate into the pharynx or oral cavity and cause asphyxia and sudden death if the larynx is occluded. We describe the case of a 51-year-old man who experienced snoring and occasional asphyxia during sleep. Upper endoscopy was performed, which indicated the presence of a pedunculated esophageal polyp that regurgitated into the vocal cords. The polyp was removed using a polypectomy snare and was confirmed to be a fibrovascular polyp based on pathologic examination findings. Three months after the excision of the polyp, the patient was found to be doing well without any further occurrence of asphyxia or sleep disturbances.

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Hybrid laparo-endoscopic access: New approach to surgical treatment for giant fibrovascular polyp of esophagus: A case report and review of literature
Seda Dzhantukhanova, Lyudmila Grigori Avetisyan, Amina Badakhova, Yury Starkov, Andrey Glotov
World Journal of Gastrointestinal Endoscopy.2023; 15(11): 666. CrossRef
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Davide Ferrari, Daniele Bernardi, Stefano Siboni, Veronica Lazzari, Emanuele Asti, Luigi Bonavina
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Scientific Programming.2021; 2021: 1. CrossRef
Difficult endoscopic resection of a giant esophageal fibrovascular polyp: case report and literature review
Dan Nie, Ye Zong, Jielin Li
Journal of International Medical Research.2021;[Epub] CrossRef
Endoscopic resection for giant oesophageal fibrovascular polyp
N Acar, T Acar, F Cengiz, B Şuataman, C Tavusbay, M Haciyanli
The Annals of The Royal College of Surgeons of England.2020; 102(4): e89. CrossRef
Well-Differentiated Liposarcoma (Atypical Lipomatous Tumor) Presenting as an Esophageal Polyp
Aoife J. McCarthy, Paul Carroll, Rajkumar Vajpeyi, Gail Darling, Runjan Chetty
Journal of Gastrointestinal Cancer.2019; 50(3): 589. CrossRef
First Characterization with Ultrasound Contrast Agent of a Fibrovascular Polyp Before Its Endoscopic Resection: A Case Report (with Videos)
Nicolas Williet, Radwan Kassir, Francois Casteillo, Violaine Yvorel, Cyril Habougit, Xavier Roblin, Jean-Marc Phelip
Clinical Endoscopy.2019; 52(2): 186. CrossRef
Asphyxia Caused by a Giant Fibrovascular Polyp of the Esophagus
Santiago A. Endara, Gerardo A. Dávalos, Ramiro J. Yepez, Diego F. Luna, Fabián B. Corral, Gabriel A. Molina, W. Javier Cisneros
ACG Case Reports Journal.2019; 6(7): e00126. CrossRef
Polypoid fibroadipose tumors of the esophagus: ‘giant fibrovascular polyp’ or liposarcoma? A clinicopathological and molecular cytogenetic study of 13 cases
Rondell P Graham, Saba Yasir, Karen J Fritchie, Michelle D Reid, Patricia T Greipp, Andrew L Folpe
Modern Pathology.2018; 31(2): 337. CrossRef
Presentation and Management of Giant Fibrovascular Polyps of the Hypopharynx and Esophagus
Julina Ongkasuwan, C. Lane Anzalone, Esperanza Salazar, Donald T. Donovan
Annals of Otology, Rhinology & Laryngology.2017; 126(1): 29. CrossRef
Giant Esophageal Fibrovascular Polyp: A Rare Cause of Dysphagia
Joseph Cano, Clark Hair, Robert Jay Sealock
Clinical Gastroenterology and Hepatology.2017; 15(5): e93. CrossRef
Gastroscopic removal of a giant fibrovascular polyp from the esophagus
Jie Li, Hua Yu, Renfu Pu, Zhongsheng Lu
Thoracic Cancer.2016; 7(3): 363. CrossRef
A Case of Giant Fibrovascular Polyp of the Esophagus, Treated Successfully by Endoscopic Resection
Jong Wook Lee, Gwang Ha Kim, Joong Keun Kim, Chul Hong Park, Byeong Gu Song, Dong Hun Shin, Dong Woo Ha, Geun Am Song
The Korean Journal of Gastroenterology.2016; 67(5): 253. CrossRef
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Original Article

Peroral Endoscopic Myotomy for Treating Achalasia in an Animal Model: A Feasibility Study: Byoung Wook Bang, Young Chul Choi, Hyung Gil Kim, Kye Sook Kwon, Yong Woon Shin, Don Haeng Lee, Joon Mee Kim; Clin Endosc 2013;46(1):54-58. Published online January 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.1.54

Abstract PDF PubReader ePub

Background/Aims

Laparoscopic Heller myotomy with antireflux procedure is considered to be a standard treatment for achalasia. Recently, peroral endoscopic myotomy (POEM) was developed and performed on patients with achalasia. However, there is no report on POEM use in South Korea. The aim of this study was to evaluate the technical feasibility of POEM in a porcine model.

Methods

POEM was performed on two mini pigs. We performed upper endoscopy under general anesthesia. A submucosal tunnel was created and the circular muscle layer was incised using several knives. The mucosal entry was closed using resolution clips. We performed a follow-up endoscopy and sacrificed the pigs 2 weeks after the POEM. The myotomy site was evaluated grossly and histologically.

Results

POEM was successfully performed on the two mini pigs. No injuries to any abdominal or mediastinal structures occurred. Two weeks after the POEM, the esophageal mucosa healed without any endoscopic evidence of complications. Necropsy revealed that the circular muscle layer was completely lost and replaced with fibrotic tissue.

Conclusions

We found that POEM is a technically feasible method which can be performed on an animal model. However, to ensure safe use on patients with achalasia, further studies on technical methods and long-term follow-up examinations are required.

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A. Peñaloza-Ramírez, J. Suárez-Correa, J. Báez-Blanco, C. Sabogal-Gómez, H. Kuan-Casas, C. Sánchez-Pignalosa, P. Aponte-Ordóñez
Revista de Gastroenterología de México.2018; 83(2): 86. CrossRef
In vivo experience with peroral endoscopic myotomy: An essential activity for developing the technique in humans
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Revista de Gastroenterología de México (English Edition).2018; 83(2): 86. CrossRef
Factors predicting the technical difficulty of peroral endoscopic myotomy for achalasia
Xiaowei Tang, Yutang Ren, Zhengjie Wei, Jieqiong Zhou, Zhiliang Deng, Zhenyu Chen, Bo Jiang, Wei Gong
Surgical Endoscopy.2016; 30(9): 3774. CrossRef
Peroral endoscopic myotomy for treatment of achalasia in children and adolescents
Chenjie Li, Yuyong Tan, Xuehong Wang, Deliang Liu
Journal of Pediatric Surgery.2015; 50(1): 201. CrossRef
The Ideal Experimental Training Session for Minimally Invasive Endoluminal Techniques
Sakai P
Gastroenterology & Hepatology: Open Access.2015;[Epub] CrossRef
International Digestive Endoscopy Network 2014: Turnpike to the Future
Eun Young Kim, Kwang An Kwon, Il Ju Choi, Ji Kon Ryu, Ki Baik Hahm
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Training for peroral endoscopic myotomy
Daniel von Renteln, Melina C. Vassiliou, Thomas Rösch
Techniques in Gastrointestinal Endoscopy.2013; 15(3): 153. CrossRef
Peroral Endoscopic Myotomy for the Treatment of Achalasia: An Analysis
Dennis Yang, Mihir S. Wagh
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Su Jin Hong
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Case Report

Two Cases of Ileal Dieulafoy Lesion with Massive Hematochezia Treated by Single Balloon Enteroscopy: Young Chul Choi, Sang Hyun Park, Byoung Wook Bang, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin; Clin Endosc 2012;45(4):440-443. Published online November 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.4.440

Abstract PDF PubReader ePub

Ileal Dieulafoy lesion is an unusual vascular abnormality that can cause gastrointestinal bleeding. It can be associated with massive, life-threatening hemorrhage and requires urgent angiographic intervention or surgery. Ileal Dieulafoy lesion is hard to recognize due to inaccessibility and normal-appearing mucosa. With advances in endoscopy, aggressive diagnostic and therapeutic approaches including enteroscopy have recently been performed for small bowel bleeding. We report two cases of massive ileal Dieulafoy lesion bleeding diagnosed and treated successfully by single balloon enteroscopy with a review of the literature.

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Aisha Rummaan, Irene Lee, Deepa Rattehalli, Prajesh Kumar, Sauid Ishaq
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Aleena Jain, Manjusha Karegar, Amita Joshi, Amey Rojekar
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Terence C. Chua, Anthony J. Gill, Jaswinder S. Samra
Gastroenterology.2015; 148(5): e10. CrossRef

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