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Original Article
Dedicated Cold Snare vs. Traditional Snare for Polypectomy of Diminutive and Small Lesions in a Porcine Model: A Research Group for Endoscopic Instruments and Stents (REIS) Study
Han Hee Lee, Bo-In Lee, Jung-Wook Kim, Hyun Lim, Si Hyung Lee, Jun-Hyung Cho, Yunho Jung, Kyoung Oh Kim, Chan Gyoo Kim, Kee Myung Lee, Jong-Jae Park, Myung-Gyu Choi, Hoon Jai Chun, Ho Gak Kim
Clin Endosc 2021;54(3):390-396.   Published online September 10, 2020
DOI: https://doi.org/10.5946/ce.2020.096
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: The aim of this in vivo animal study was to evaluate the effectiveness and safety of dedicated cold snare (DCS) compared with those of traditional snare (TS) for cold snare polypectomy (CSP).
Methods
A total of 36 diminutive (5 mm) and 36 small (9 mm) pseudolesions were made by electrocoagulation in the colons of mini-pigs.
Results
For the diminutive lesions, there were no significant differences in technical success rate, procedure time, or complete resection rate between the DCS and TS groups; the rate of uneven resection margin in the DCS group was significantly lower than that of the TS group. For small lesions, technical success rate and complete resection rate were significantly higher in the DCS group than in the TS group (100% [18/18] vs. 55.6% [10/18], p=0.003; 94.4% [17/18] vs. 40% [4/10], p=0.006). In addition, the procedure duration was significantly shorter, and the rate of uneven resection margin was significantly lower in the DCS group (28.5 sec vs. 66.0 sec, p=0.006; 11.1% [2/18] vs. 100% [10/10], p<0.001). Two cases of perforation occurred in the DCS group. Multivariate analysis revealed that DCS use was independently associated with complete resection.
Conclusions
DCS is superior to TS in terms of technical success, complete resection, and reducing the duration of the procedure for CSP of small polyps.

Citations

Citations to this article as recorded by  
  • Comparison of complete resection rates in cold snare polypectomy using two different wire diameter snares: A randomized controlled study
    Toshiki Horii, Sho Suzuki, Akihiro Sugita, Misa Yamauchi, Hisatomo Ikehara, Chika Kusano, Takuji Gotoda
    Journal of Gastroenterology and Hepatology.2023; 38(5): 752.     CrossRef
  • Comparison of the clinical efficacy of cold snare polypectomy using a thin-wire snare and thick-wire snare for small colorectal polyps
    Hong Jin Yoon, Yunho Jung, Young Sin Cho, Il-Kwun Chung
    International Journal of Gastrointestinal Intervention.2023; 12(4): 183.     CrossRef
  • Big Issues on Small Polyps: An Ideal Device, But Is It for an Ideal Indication?
    Yoji Takeuchi
    Clinical Endoscopy.2021; 54(3): 297.     CrossRef
  • Cold versus hot polypectomy/endoscopic mucosal resection–A review of current evidence
    Raquel Ortigão, Jochen Weigt, Ahmed Afifi, Diogo Libânio
    United European Gastroenterology Journal.2021; 9(8): 938.     CrossRef
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Review
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 Yeul Lee, Jeong-Sik Byeon, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Hoon Jai Chun
Clin Endosc 2020;53(2):142-166.   Published online March 30, 2020
DOI: https://doi.org/10.5946/ce.2020.032
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

Citations

Citations to this article as recorded by  
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    Surgical Endoscopy.2023; 37(2): 1231.     CrossRef
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    Surgical Endoscopy.2023; 37(4): 2969.     CrossRef
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    Clinical Endoscopy.2023; 56(1): 55.     CrossRef
  • A Randomized Controlled Trial of Fibrin Glue to Prevent Bleeding After Gastric Endoscopic Submucosal Dissection
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    American Journal of Gastroenterology.2023; 118(5): 892.     CrossRef
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    Journal of Gastric Cancer.2023; 23(1): 146.     CrossRef
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    World Journal of Gastrointestinal Endoscopy.2023; 15(3): 114.     CrossRef
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    Cancer Research and Treatment.2023; 55(2): 603.     CrossRef
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    Bioengineering & Translational Medicine.2023;[Epub]     CrossRef
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    Journal of Gastric Cancer.2023; 23(3): 451.     CrossRef
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    Journal of Gastric Cancer.2022; 22(4): 339.     CrossRef
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    Seung Woo Lee
    Clinical Endoscopy.2022; 55(6): 753.     CrossRef
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    Byung Chul Jin, Ae Ri Ahn, Seong-Hun Kim, Seung Young Seo
    World Journal of Clinical Cases.2022; 10(34): 12793.     CrossRef
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    Adam R. Markowski, Anna J. Markowska, Wiktoria Ustymowicz, Anna Pryczynicz, Katarzyna Guzińska-Ustymowicz
    Scientific Reports.2022;[Epub]     CrossRef
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    Diseases.2022; 11(1): 3.     CrossRef
  • Association between severe hepatic steatosis examined by Fibroscan and the risk of high-risk colorectal neoplasia
    Kwang Woo Kim, Hyoun Woo Kang, Hosun Yoo, Yukyung Jun, Hyun Jung Lee, Jong Pil Im, Ji Won Kim, Joo Sung Kim, Seong-Joon Koh, Yong Jin Jung, Atsushi Hosui
    PLOS ONE.2022; 17(12): e0279242.     CrossRef
  • Long-term outcomes and clinical safety of expanded indication early gastric cancer treated with endoscopic submucosal dissection versus surgical resection: a meta-analysis
    Xing Xu, Guoliang Zheng, Na Gao, Zhichao Zheng
    BMJ Open.2022; 12(12): e055406.     CrossRef
  • Long-Term Safety of Delayed Surgery After Upfront Endoscopic Resection for Early Gastric Cancer: A Propensity Matched Study
    Ji Eun Na, Yeong Gi Kim, Tae Jun Kim, Hyuk Lee, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Seon Yeong Baek, Min Su Park, Poong-Lyul Rhee, Jae J. Kim
    Annals of Surgical Oncology.2021; 28(1): 106.     CrossRef
  • Incidence rates, risk factors, and outcomes of aspiration pneumonia after gastric endoscopic submucosal dissection: A systematic review and meta‐analysis
    Dong Tang, Fuxiang Yuan, Xiaoying Ma, Haixia Qu, Yuan Li, Weiwei Zhang, Huan Ma, Haiping Liu, Yan Yang, Lin Xu, Yuqiang Gao, Shuhui Zhan
    Journal of Gastroenterology and Hepatology.2021; 36(6): 1457.     CrossRef
  • Clinical feasibility and oncologic safety of primary endoscopic submucosal dissection for clinical submucosal invasive early gastric cancer
    Ji Eun Na, Hyuk Lee, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Kyoung-Mee Kim, Jae J. Kim
    Journal of Cancer Research and Clinical Oncology.2021; 147(10): 3051.     CrossRef
  • Endoscopic resections for superficial esophageal squamous cell epithelial neoplasia: focus on histological discrepancies between biopsy and resected specimens
    Lang Yang, Hua Jin, Xiao-li Xie, Yang-tian Cao, Zhen-hua Liu, Na Li, Peng Jin, Yu-qi He, Jian-qiu Sheng
    BMC Gastroenterology.2021;[Epub]     CrossRef
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    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2021; 21(1): 72.     CrossRef
  • Endoscopic Submucosal Dissection versus Surgery for Undifferentiated-Type Early Gastric Cancer: A Systematic Review and Meta-Analysis
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Original Article
Risk Factors and Clinical Outcomes of Non-Curative Resection in Patients with Early Gastric Cancer Treated with Endoscopic Submucosal Dissection: A Retrospective Multicenter Study in Korea
Si Hyung Lee, Min Cheol Kim, Seong Woo Jeon, Kang Nyeong Lee, Jong Jae Park, Su Jin Hong, Korean Society of Gastrointestinal Endoscopy Endoscopic Submucosal Dissection Research Group
Clin Endosc 2020;53(2):196-205.   Published online October 25, 2019
DOI: https://doi.org/10.5946/ce.2019.123
AbstractAbstract PDFPubReaderePub
Background
/Aims: The purpose of this study was to investigate the risk factors and long-term clinical outcomes of non-curative resection (NCR) in a large-scale patient population.
Methods
We retrospectively analyzed the clinical data of 3,094 patients who underwent endoscopic submucosal dissection (ESD) of early gastric cancer from March 2005 to March 2018 at 13 institutions in Korea. We analyzed the risk factors for NCR and the survival between patients with curative resection and those with NCR with no additional treatment.
Results
The NCR rate was 21.4% (661/3,094). In multivariate regression analysis, the risk factors affecting NCR with ESD were old age, undifferentiated tumor, tumor location in the upper body, tumor size ≥2 cm, and presence of an ulcer. In Cox proportional hazard regression analysis, tumor size ≥2 cm, submucosal invasion, positive horizontal margin, and lymphovascular invasion were risk factors for local recurrence. In Kaplan-Meier analysis, there was no statistically significant difference in the overall survival between the two groups (log-rank p=0.788). However, disease-specific survival was significantly lower in the NCR group (log-rank p=0.038).
Conclusions
Clinicians should be aware of the risk factors for NCR and local recurrence after ESD for early gastric cancer, and should consider providing additional treatment after NCR.

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  • Predictive Factors and Long-Term Outcomes of Early Gastric Carcinomas in Patients with Non-Curative Resection by Endoscopic Submucosal Dissection


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Focused Review Series: Endoscopic Submucosal Dissection for Undifferentiated-Type Early Gastric Cancer
Is Radical Surgery Necessary for All Patients Diagnosed as Having Non-Curative Endoscopic Submucosal Dissection?
Si Hyung Lee, Byung Sam Park
Clin Endosc 2019;52(1):21-29.   Published online January 30, 2019
DOI: https://doi.org/10.5946/ce.2019.014
AbstractAbstract PDFPubReaderePub
If a lesion does not meet the expanded indication criteria for treatment with endoscopic therapy for early gastric cancer or does not have a positive resection margin, it is regarded as suitable for non-curative resection. Non-curative resection is closely related to the risk of local recurrence, lymph node metastasis, and poor prognosis. If the result is confirmed as non-curative resection, additional treatment should be considered depending on the risks of residual tumor, local recurrence, and lymph node metastasis. As lymphatic invasion is the most important risk factor of recurrence and poor prognosis, surgical treatment should be considered if lymphatic invasion is present. If patients are not suitable for additional surgery owing to old age or coexisting severe disease, close surveillance can be an alternative treatment option.

Citations

Citations to this article as recorded by  
  • Risk Factors and Clinical Outcomes of Non-Curative Resection in Patients with Early Gastric Cancer Treated with Endoscopic Submucosal Dissection: A Retrospective Multicenter Study in Korea
    Si Hyung Lee, Min Cheol Kim, Seong Woo Jeon, Kang Nyeong Lee, Jong Jae Park, Su Jin Hong
    Clinical Endoscopy.2020; 53(2): 196.     CrossRef
  • 6,356 View
  • 102 Download
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