Clinical Endoscopy

Reviews

New sedatives and analgesic drugs for gastrointestinal endoscopic procedures: Jae Min Lee, Yehyun Park, Jin Myung Park, Hong Jun Park, Jun Yong Bae, Seung Young Seo, Jee Hyun Lee, Hyung Ku Chon, Jun-Won Chung, Hyun Ho Choi, Jun Kyu Lee, Byung-Wook Kim, Endoscopic Sedation Committee of the Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2022;55(5):581-587. Published online August 29, 2022; DOI: https://doi.org/10.5946/ce.2021.283

Procedural sedation has become increasingly common in endoscopy. Sedatives and analgesics induce anxiolysis and amnesia. In addition, an appropriate level of sedation is necessary for safe procedures including therapeutic endoscopy. Midazolam and propofol are the most commonly used drugs in sedative endoscopy. In recent years, the need to ascertain the safety and effectiveness of sedation has increased in practice. Therefore, new sedatives and analgesic drugs for optimal sedative endoscopy, have recently emerged. This article reviews the characteristics of sedatives and analgesics, and describes their clinical use in gastrointestinal endoscopy.

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Comparative effects of ciprofol and propofol on perioperative outcomes: a systematic review and meta-analysis of randomized controlled trials
Jiazheng Qi, Lingjing Zhang, Fanhua Meng, Xiaoyu Yang, Baoxuan Chen, Lingqi Gao, Xu Zhao, Mengqiang Luo
Brazilian Journal of Anesthesiology (English Edition).2025; 75(2): 844578. CrossRef
Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Gut and Liver.2024; 18(1): 10. CrossRef
RETRACTED: Assessing wound complications in gastroscopy with Streptomyces protease enzyme combined with Shutai
Qihui Chen, Hangfei Li, Lijuan Zhou, Zhanbo Yang
International Wound Journal.2024;[Epub] CrossRef
Characterization of Pediatric Rectal Absorption, Drug Disposition, and Sedation Level for Midazolam Gel Using Physiologically Based Pharmacokinetic/Pharmacodynamic Modeling
Jinying Zhu, Sufeng Zhou, Lu Wang, Yuqing Zhao, Jie Wang, Tangping Zhao, Tongtong Li, Feng Shao
Molecular Pharmaceutics.2024; 21(5): 2187. CrossRef
Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea
Jung Wan Choe, Jong Jin Hyun, Seong-Jin Son, Seung-Hak Lee
Clinical Endoscopy.2024; 57(4): 476. CrossRef
Optimal Surveillance of Metachronous Gastric Lesion after Endoscopic Resection of Early Gastric Cancer
Dong Chan Joo, Gwang Ha Kim
Gut and Liver.2024; 18(5): 781. 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
Quality of recovery and pre-existing impaired cognition in patients undergoing advanced GI endoscopic procedures with patient-controlled sedation: a prospective observational cohort study
Sara Lyckner, Michelle S. Chew, Andreas Nilsson
iGIE.2023; 2(3): 292. 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
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef

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2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation: Hong Jun Park, Byung-Wook Kim, Jun Kyu Lee, Yehyun Park, Jin Myung Park, Jun Yong Bae, Seung Young Seo, Jae Min Lee, Jee Hyun Lee, Hyung Ku Chon, Jun-Won Chung, Hyun Ho Choi, Myung Ha Kim, Dong Ah Park, Jae Hung Jung, Joo Young Cho, Endoscopic Sedation Committee of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2022;55(2):167-182. Published online February 22, 2022; DOI: https://doi.org/10.5946/ce.2021.282

Abstract PDF Supplementary Material PubReader ePub

Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

Citations

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Core curriculum for sedation in gastrointestinal endoscopy with a focus on practice: a proposal from the Korean Society of Gastrointestinal Endoscopy
Hong Sub Lee, Yun Jeong Lim, Jong-Jae Park
Clinical Endoscopy.2025; 58(2): 218. CrossRef
Using Clinical-based Discharge Criteria to Discharge Patients After Endoscopy Procedures Under Drug-induced Intravenous Sedation in the Outpatient Care Unit: An Observational Study
Liangyu Fang, Lina Chen, Bingbing Wu, Yinchuan Xu, Laijuan Chen
Journal of PeriAnesthesia Nursing.2024; 39(5): 859. CrossRef
Development and Effectiveness Evaluation of 360-Degree Virtual Reality-Based Educational Intervention for Adult Patients Undergoing Colonoscopy
Minju Gwag, Jaeyong Yoo
Healthcare.2024; 12(14): 1448. CrossRef
Development of a predictive model for hypoxia due to sedatives in gastrointestinal endoscopy: a prospective clinical study in Korea
Jung Wan Choe, Jong Jin Hyun, Seong-Jin Son, Seung-Hak Lee
Clinical Endoscopy.2024; 57(4): 476. CrossRef
Comparison of Synergistic Sedation with Midazolam and Propofol Versus Midazolam and Pethidine in Colonoscopies: A Prospective, Randomized Controlled Study
Jae Woong Lim, Min Jae Kim, Gang Han Lee, Dae Sol Kim, Sang Hyuk Jung, Yu Yeon Kim, Jin Won Kim, Yohan Lee, Hyun Soo Kim, Seon Young Park, Dong Hyun Kim
Chonnam Medical Journal.2024; 60(3): 192. CrossRef
Nasal mask versus conventional oxygen supply for endoscopy under intravenous sedation: protocol for a systematic review and meta-analysis
Wentao Ji, Yu Deng, Min Zheng, Xiaoting Zhang, Jun Lu, Jinhai Liu, Bo Li, Lulong Bo
BMJ Open.2024; 14(12): e092868. CrossRef
Experience of organizing outpatient anesthetic care at Endoscopy centre of Multidisciplinary city clinic
O. V. Makarov, S. A. Osipov, E. P. Rodionov, A. A. Malyshev, I. Yu. Korzheva, L. M. Avramenko, Z. Z. Loseva, I. V. Balykov, L. A. Baichorova, E. I. Alikhanova, A. V. Vlasenko, E. A. Evdokimov, V. I. Makovey, V. V. Erofeev
Medical alphabet.2023; (6): 50. CrossRef
Anesthesia care provider sedation versus conscious sedation for endoscopic ultrasound–guided tissue acquisition: a retrospective cohort study
Sneha Shaha, Yinglin Gao, Jiahao Peng, Kendrick Che, John J. Kim, Wasseem Skef
Clinical Endoscopy.2023; 56(5): 658. CrossRef
Current status of the gastric cancer screening program in Korea
Young-Il Kim, Il Ju Choi
Journal of the Korean Medical Association.2022; 65(5): 250. CrossRef
In pursuit of the right plan for airway management in gastrointestinal endoscopic procedures…the battle half won?
Upender Gowd, Sukhminder Jit Singh Bajwa, Madhuri Kurdi, Gaurav Sindwani
Indian Journal of Anaesthesia.2022; 66(10): 683. CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef

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10 Web of Science
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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

Abstract PDF PubReader ePub

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

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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
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 Reports

Strongyloidiasis Presenting as Yellowish Nodules in Colonoscopy of an Immunocompetent Patient: Hannah Ra, Jun-Won Chung, Dong Hae Chung, Jung Ho Kim, Yoon Jae Kim, Kyoung Oh Kim, Kwang An Kwon, Dong Kyun Park; Clin Endosc 2019;52(1):80-82. Published online August 30, 2018; DOI: https://doi.org/10.5946/ce.2018.078

Abstract PDF PubReader ePub

Strongyloides stercoralis is endemic to tropical and subtropical regions, and infections are usually asymptomatic. However, immunocompromised patients, such as those receiving immunosuppressive therapy, high-dose steroids, or chemotherapy, can develop fatal hyperinfections. An 84-year-old man without any symptoms was diagnosed with strongyloidiasis during a regular screening colonoscopy. His medical history only involved a gastric endoscopic submucosal dissection for early gastric cancer 6 months previously. Few cases have been published about asymptomatic strongyloidiasis diagnosed in an immunocompetent host via endoscopic mucosal resection with characteristic colonoscopic findings. We report a case of colon-involved asymptomatic strongyloidiasis with specific colonic findings of yellowish-white nodules. This finding may be an important marker of S. stercoralis infection, which could prevent hyperinfections.

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Severe strongyloidiasis: a systematic review and meta-analysis of 339 cases
Olga C Rojas, Alexandra M Montoya, Hiram Villanueva-Lozano, Diego Carrion-Alvarez
Transactions of The Royal Society of Tropical Medicine and Hygiene.2023; 117(10): 682. CrossRef
Seropositivity Rates of Strongyloides stercoralis Antibody in the Southeastern Region of Republic of Korea: A Single-Center Retrospective Study
Taehwa Kim, Seungjin Lim
The Korean Journal of Parasitology.2022; 60(3): 181. CrossRef
Phylogenetic Positioning of a Strongyloides stercoralis Isolate Recovered from a Korean Patient and Comparison with Other Asian Isolates
Jaeho Bae, Mi Jin Jeong, Dong hoon Shin, Hyun Woo Kim, Sung Ho Ahn, Jun Ho Choi, Hak Sun Yu
The Korean Journal of Parasitology.2020; 58(6): 689. CrossRef

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Synchronous Peripancreatic Lymph Node Gastrinoma and Gastric Neuroendocrine Tumor Type 2: Hee Woo Lee, Jun-Won Chung, Yoon Jae Kim, Kwang Ahn Kwon, Eui Joo Kim, Keon Kuk Kim, Woon Ki Lee, Sun Jin Sym; Clin Endosc 2016;49(5):483-487. Published online May 20, 2016; DOI: https://doi.org/10.5946/ce.2016.008

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A 34-year-old man was referred to our hospital with gastric polypoid lesions and biopsy-confirmed neuroendocrine tumor (NET). Computed tomography (CT) revealed a 3×3.5×8-cm retroperitoneal mass behind the pancreas, with multiple hepatic metastases. His serum gastrin level was elevated to 1,396 pg/mL. We performed a wedge resection of the stomach, a right hemi-hepatectomy, and a retroperitoneal mass excision. After careful review of the clinical, radiological, histopathological, and immunohistochemical findings, peripancreatic gastrinoma, and synchronous gastric NET were ultimately diagnosed. We reviewed a CT scan that had been performed 6 years previously after surgery for a duodenal perforation. There was no evidence of gastric or hepatic lesions, but the retroperitoneal mass was present at the same site. Had gastrinoma been detected earlier, our patient could have been cured using less invasive treatment. This case demonstrates how important it is to consider Zollinger-Ellison syndrome in patients with a recurrent or aggressive ulcer.

Citations

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Insights into Effects/Risks of Chronic Hypergastrinemia and Lifelong PPI Treatment in Man Based on Studies of Patients with Zollinger–Ellison Syndrome
Lingaku Lee, Irene Ramos-Alvarez, Tetsuhide Ito, Robert T. Jensen
International Journal of Molecular Sciences.2019; 20(20): 5128. CrossRef
Diagnosis of Zollinger–Ellison Syndrome in the Era of Ppis, Faulty Gastrin Assays, Sensitive Imaging and Limited Access to Acid Secretory Testing
David C Metz, Guillaume Cadiot, Pierre Poitras, Tetsuhide Ito, Robert T Jensen
International Journal of Endocrine Oncology.2017; 4(4): 167. CrossRef

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Huge Liposarcoma of Esophagus Resected by Endoscopic Submucosal Dissection: Case Report with Video: Inku Yo, Jun-Won Chung, Myung Ho Jeong, Jong Joon Lee, Jungsuk An, Kwang An Kwon, Min Young Rim, Ki Baik Hahm; Clin Endosc 2013;46(3):297-300. Published online May 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.3.297

Abstract PDF Supplementary Material PubReader ePub

Liposarcoma is one of the most common soft tissue sarcomas occurring in adults, but it rarely occurs in the gastrointestinal tract and more uncommonly in the esophagus. To the best of our knowledge, there are only 19 reported cases of esophageal liposarcoma in the literature published in English language up to the year 2008, and they were all treated by surgical methods. Here, we report a case of primary liposarcoma of the esophagus which was treated with endoscopic submucosal dissection (ESD). ESD was well tolerated in this patient, suggesting that it may be a therapeutic option for primary esophageal sarcomas.

Citations

Citations to this article as recorded by

Thoracoscopic resection of a huge esophageal dedifferentiated liposarcoma: A case report
Yi-Wang Ye, Meng-Ying Liao, Zhi-Min Mou, Xiao-Xin Shi, Yuan-Cai Xie
World Journal of Clinical Cases.2020; 8(9): 1698. CrossRef
Giant pedunculated oesophageal liposarcomas: A review of literature and resection techniques
Y. Annalisa Ng, June Lee, X.J. Zheng, J.C. Nagaputra, S.H. Tan, S.A. Wong
International Journal of Surgery Case Reports.2019; 64: 113. CrossRef
Ungewöhnlicher Ösophagustumor
A. Tobisch, C. Taylessani, G. Puhl
Der Chirurg.2018; 89(10): 822. CrossRef
Successful resection of giant esophageal liposarcoma by endoscopic submucosal dissection combined with surgical retrieval: a case report and literature review
Gosuke Takiguchi, Tetsu Nakamura, Yasunori Otowa, Ayako Tomono, Shingo Kanaji, Taro Oshikiri, Satoshi Suzuki, Tsukasa Ishida, Yoshihiro Kakeji
Surgical Case Reports.2016;[Epub] CrossRef
Giant liposarcoma of the esophagus: A case report
Zhi-Chao Lin
World Journal of Gastroenterology.2015; 21(33): 9827. CrossRef
A Pedunculated Giant Esophageal Liposarcoma: a Case Report and Literature Review
A. Dowli, A. Mattar, H. Mashimo, Q. Huang, D. Cohen, P.M. Fisichella, A. Lebenthal
Journal of Gastrointestinal Surgery.2014; 18(12): 2208. CrossRef
Malignant Dysphagia Treated by Esophageal Sparing Surgery with Good Prognosis
F. J. R. Teixeira, A. V. Reis, R. S. S. Medeiros, E. H. Akaishi, V. C. Moutinho, S. D. Couto Netto, T. M. Andrade Lima, A. L. F. Perina, F. O. Ferreira, G. O. Mendes, M. P. Lallé, E. M. Utiyama
Journal of Gastrointestinal Cancer.2014; 45(S1): 241. CrossRef

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