Clinical Endoscopy

Original Article

Effectiveness of a novel ex vivo training model for gastric endoscopic submucosal dissection training: a prospective observational study conducted at a single center in Japan: Takahito Toba, Tsuyoshi Ishii, Nobuyuki Sato, Akira Nogami, Aya Hojo, Ryo Shimizu, Ai Fujimoto, Takahisa Matsuda; Clin Endosc 2025;58(1):94-101. Published online November 4, 2024; DOI: https://doi.org/10.5946/ce.2024.108

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: The efficacy of endoscopic submucosal dissection (ESD) for early-stage gastric cancer is well established. However, its acquisition is challenging owing to its complexity. In Japan, G-Master is a novel ex vivo gastric ESD training model. The effectiveness of training using G-Master is unknown. This study evaluated the efficacy of gastric ESD training using the G-Master to evaluate trainees’ learning curves and performance.
Methods
Four trainees completed 30 ESD training sessions using the G-Master, and procedure time, resection area, resection completion, en-bloc resection requirement, and perforation occurrence were measured. Resection speed was the primary endpoint, and learning curves were evaluated using the Cumulative Sum (CUSUM) method.
Results
All trainees completed the resection and en-bloc resection of the lesion without any intraoperative perforations. The learning curves covered three phases: initial growth, plateau, and late growth. The transition from phase 1 to phase 2 required a median of 10 sessions. Each trainee completed 30 training sessions in approximately 4 months.
Conclusions
Gastric ESD training using the G-Master is a simple, fast, and effective method for pre-ESD training in clinical practice. It is recommended that at least 10 training sessions be conducted.

539 View
104 Download

Review

Post-polypectomy surveillance: the present and the future: Masau Sekiguchi, Takahisa Matsuda, Kinichi Hotta, Yutaka Saito; Clin Endosc 2022;55(4):489-495. Published online July 11, 2022; DOI: https://doi.org/10.5946/ce.2022.097

Abstract PDF PubReader ePub

An appropriate post-polypectomy surveillance program requires the effectiveness of reducing colorectal cancer and safety. In addition, the post-polypectomy surveillance program should consider the burden of limited medical resource capacity, cost-effectiveness, and patient adherence. In this sense, a risk-stratified surveillance program based on baseline colonoscopy results is ideal. Major international guidelines for post-polypectomy surveillance, such as those from the European Union and the United States, have recommended risk-stratified surveillance programs. Both guidelines have recently been updated to better differentiate between high- and low-risk individuals. In both updated guidelines, more individuals have been downgraded to lower-risk groups that require less frequent or no surveillance. Furthermore, increased attention has been paid to the surveillance of patients who undergo serrated polyp removal. Previous guidelines in Japan did not clearly outline the risk stratification in post-polypectomy surveillance. However, the new colonoscopy screening and surveillance guidelines presented by the Japan Gastroenterological Endoscopy Society include a risk-stratified post-polypectomy surveillance program. Further discussion and analysis of unresolved issues in this field, such as the optimal follow-up after the first surveillance, the upper age limit for surveillance, and the ideal method for improving adherence to surveillance guidelines, are warranted.

Citations

Citations to this article as recorded by

Protocolo diagnóstico del seguimiento de pólipos colónicos
S. Redondo Evangelista, M. Sierra Morales, I. Bartolomé Oterino, P. García Centeno, A. Santos Rodríguez
Medicine - Programa de Formación Médica Continuada Acreditado.2024; 14(4): 219. CrossRef
Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
Yunho Jung
The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef
Efficacy of Oral Sulfate Tablet and 2 L-Polyethylene Glycol With Ascorbic Acid for Bowel Preparation: A Prospective Randomized KASID Multicenter Trial
Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
Metabolic‐associated fatty liver disease is associated with colorectal adenomas in young and older Korean adults
Jiwon Chang, Yoosoo Chang, Yoosun Cho, Hyun‐Suk Jung, Dong‐Il Park, Soo‐Kyung Park, Soo‐Youn Ham, Sarah H. Wild, Christopher D. Byrne, Seungho Ryu
Liver International.2023; 43(11): 2548. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
Journal of the Korean Medical Association.2023; 66(11): 652. CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef
Understanding colorectal polyps to prevent colorectal cancer
Dong-Hoon Yang
Journal of the Korean Medical Association.2023; 66(11): 626. CrossRef

4,525 View
278 Download
6 Web of Science
8 Crossref

Original Article

Reduced Intravenous Fluorescein Dose for Upper and Lower Gastrointestinal Tract Probe-Based Confocal Laser Endomicroscopy: Kazuya Inoki, Seiichiro Abe, Yusaku Tanaka, Koji Yamamoto, Daisuke Hihara, Ryoji Ichijima, Yukihiro Nakatani, HsinYu Chen, Hiroyuki Takamaru, Masau Sekiguchi, Masayoshi Yamada, Taku Sakamoto, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Ichiro Oda, Takahisa Matsuda, Yutaka Saito; Clin Endosc 2021;54(3):363-370. Published online September 8, 2020; DOI: https://doi.org/10.5946/ce.2020.058

Abstract PDF PubReader ePub

Background
/Aims: Probe-based confocal laser endomicroscopy (pCLE) requires the administration of intravenous (IV) fluorescein. This study aimed to determine the optimal dose of IV fluorescein for both upper and lower gastrointestinal (GI) tract pCLE.
Methods
Patients 20 to 79 years old with gastric high-grade dysplasia (HGD) or colorectal neoplasms (CRNs) were enrolled in the study. The dose de-escalation method was employed with five levels. The primary endpoint of the study was the determination of the optimal dose of IV fluorescein for pCLE of the GI tract. The reduced dose was determined based on off-line reviews by three endoscopists. An insufficient dose of fluorescein was defined as the dose of fluorescein with which the pCLE images were not deemed to be visible. If all three endoscopists determined that the tissue structure was visible, the doses were de-escalated.
Results
A total of 12 patients with gastric HGD and 12 patients with CRNs were enrolled in the study. Doses were de-escalated to 0.5 mg/kg of fluorescein for both non-neoplastic duodenal and colorectal mucosa. All gastric HGD or CRNs were visible with pCLE with IV fluorescein at 0.5 mg/kg.
Conclusions
In the present study, pCLE with IV fluorescein 0.5 mg/kg was adequate to visualize the magnified structure of both the upper and lower GI tract.

Citations

Citations to this article as recorded by

Prospective assessment of probe‐based confocal laser endomicroscopy under direct cholangioscopic visualization for biliary strictures that could not be definitively diagnosed using endoscopic retrograde cholangiopancreatography (with video)
Yuki Tanisaka, Shomei Ryozawa, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Ryuichi Watanabe, Ryo Sato, Tomoaki Tashima, Yumi Mashimo
DEN Open.2025;[Epub] CrossRef
Precision endoscopy in colorectal polyps' characterization and planning of endoscopic therapy
Francesco Vito Mandarino, Silvio Danese, Toshio Uraoka, Adolfo Parra‐Blanco, Yasuharu Maeda, Yutaka Saito, Shin‐Ei Kudo, Michael J. Bourke, Marietta Iacucci
Digestive Endoscopy.2024; 36(7): 761. CrossRef

5,466 View
118 Download
2 Web of Science
2 Crossref

Focused Review Series: Endoscopic Submucosal Dissection for Colorectal Tumors

Estimation of Invasion Depth: The First Key to Successful Colorectal ESD: Bo-In Lee, Takahisa Matsuda; Clin Endosc 2019;52(2):100-106. Published online March 27, 2019; DOI: https://doi.org/10.5946/ce.2019.012

Abstract PDF PubReader ePub

Colorectal tumors with superficial submucosal invasion, which cannot be removed by snaring, are one of the most optimal indications for colorectal endoscopic submucosal dissection (ESD). Therefore, estimation of the invasion depth is the first key to successful colorectal ESD. Although estimation of the invasion depth based on the gross morphology may be useful in selected cases, its diagnostic accuracy could not reach the clinical requirement. The Japan Narrow-band Imaging (NBI) Expert Team (JNET) classification of NBI magnifying endoscopy findings is a useful method for histologic prediction and invasion depth estimation. However, magnifying chromoendoscopy is still necessary for JNET type 2B lesions to reach a satisfactory diagnostic accuracy. Endocytoscopy with artificial intelligence is a promising technology in invasion depth estimation; however, more data are needed for its clinical application.

Citations

Citations to this article as recorded by

Deep Learning in Endoscopic Ultrasound: A Breakthrough in Detecting Distal Cholangiocarcinoma
Rares Ilie Orzan, Delia Santa, Noemi Lorenzovici, Thomas Andrei Zareczky, Cristina Pojoga, Renata Agoston, Eva-Henrietta Dulf, Andrada Seicean
Cancers.2024; 16(22): 3792. CrossRef
Comparison of two pathological processing methods for large endoscopic submucosal dissection (ESD) specimens
Zixiang Yu, Dongxian Jiang, Wen Huang, Rongkui Luo, Haixing Wang, Jieakesu Su, Jia Liu, Chen Xu, Yingyong Hou
Journal of Clinical Pathology.2023; 76(11): 757. CrossRef
Endoscopic submucosal dissection for colorectal polyps: outcome determining factors
Chi Woo Samuel Chow, Tak Lit Derek Fung, Pak Tat Chan, Kam Hung Kwok
Surgical Endoscopy.2023; 37(2): 1293. CrossRef
Endoscopic management of patients with high-risk colorectal colitis–associated neoplasia: a Delphi study
Michiel T.J. Bak, Eduardo Albéniz, James E. East, Nayantara Coelho-Prabhu, Noriko Suzuki, Yutaka Saito, Takayuki Matsumoto, Rupa Banerjee, Michal F. Kaminski, Ralf Kiesslich, Emmanuel Coron, Annemarie C. de Vries, C. Janneke van der Woude, Raf Bisschops,
Gastrointestinal Endoscopy.2023; 97(4): 767. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
Development of artificial intelligence technology in diagnosis, treatment, and prognosis of colorectal cancer
Feng Liang, Shu Wang, Kai Zhang, Tong-Jun Liu, Jian-Nan Li
World Journal of Gastrointestinal Oncology.2022; 14(1): 124. CrossRef
Linear-array EUS improves the accuracy of predicting deep submucosal invasion in non-pedunculated rectal polyps compared with radial EUS: a prospective observational study
Zhixian Lan, Kangyue Sun, Yuchen Luo, Haiyan Hu, Wei Zhu, Wen Guo, Jing Wen, Wenting Mi, Junsheng Chen, Xiang Chen, Venkata Akshintala, Ying Huang, Side Liu, Yue Li
Surgical Endoscopy.2021; 35(4): 1734. CrossRef
Deep learning analysis for the detection of pancreatic cancer on endosonographic images: a pilot study
Ryosuke Tonozuka, Takao Itoi, Naoyoshi Nagata, Hiroyuki Kojima, Atsushi Sofuni, Takayoshi Tsuchiya, Kentaro Ishii, Reina Tanaka, Yuichi Nagakawa, Shuntaro Mukai
Journal of Hepato-Biliary-Pancreatic Sciences.2021; 28(1): 95. CrossRef
Comparison of long-term recurrence-free survival between primary surgery and endoscopic resection followed by secondary surgery in T1 colorectal cancer
Eun Hye Oh, Nayoung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Chang Sik Yu, Jin Cheon Kim, Jeong-Sik Byeon
Gastrointestinal Endoscopy.2021; 94(2): 394. CrossRef
The impact of transanal local excision of early rectal cancer on completion rectal resection without neoadjuvant chemoradiotherapy: a systematic review
R. Zinicola, R. Nascimbeni, R. Cirocchi, G. Gagliardi, N. Cracco, M. Giuffrida, G. Pedrazzi, G. A. Binda
Techniques in Coloproctology.2021; 25(9): 997. CrossRef
Role of Artificial Intelligence in Video Capsule Endoscopy
Ioannis Tziortziotis, Faidon-Marios Laskaratos, Sergio Coda
Diagnostics.2021; 11(7): 1192. CrossRef
Controversies in EUS: Do we need miniprobes?
Hans Seifert, Pietro Fusaroli, PaoloGiorgio Arcidiacono, Barbara Braden, Felix Herth, Michael Hocke, Alberto Larghi, Bertrand Napoleon, Mihai Rimbas, BogdanSilvio Ungureanu, Adrian Sãftoiu, AnandV Sahai, ChristophF Dietrich
Endoscopic Ultrasound.2021; 10(4): 246. CrossRef
RNA-sequencing identification and validation of genes differentially expressed in high-risk adenoma, advanced colorectal cancer, and normal controls
Namjoo Kim, Jeong-An Gim, Beom Jae Lee, Byung il Choi, Seung Bin Park, Hee Sook Yoon, Sang Hee Kang, Seung Han Kim, Moon Kyung Joo, Jong-Jae Park, Chungyeul Kim, Han-Kyeom Kim
Functional & Integrative Genomics.2021; 21(3-4): 513. CrossRef
Editors' Choice of Noteworthy Clinical Endoscopy Publications in the First Decade
Gwang Ha Kim, Kwang An Kwon, Do Hyun Park, Jimin Han
Clinical Endoscopy.2021; 54(5): 633. CrossRef
Artificial intelligence in gastrointestinal endoscopy: general overview
Ahmad El Hajjar, Jean-François Rey
Chinese Medical Journal.2020; 133(3): 326. CrossRef
Curriculum for optical diagnosis training in Europe: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement
Evelien Dekker, Britt B. S. L. Houwen, Ignasi Puig, Marco Bustamante-Balén, Emmanuel Coron, Daniela E. Dobru, Roman Kuvaev, Helmut Neumann, Gavin Johnson, Pedro Pimentel-Nunes, David S. Sanders, Mario Dinis-Ribeiro, Marianna Arvanitakis, Thierry Ponchon,
Endoscopy.2020;[Epub] CrossRef
Use of artificial intelligence in improving adenoma detection rate during colonoscopy: Might both endoscopists and pathologists be further helped
Emanuele Sinagra, Matteo Badalamenti, Marcello Maida, Marco Spadaccini, Roberta Maselli, Francesca Rossi, Giuseppe Conoscenti, Dario Raimondo, Socrate Pallio, Alessandro Repici, Andrea Anderloni
World Journal of Gastroenterology.2020; 26(39): 5911. CrossRef
The Role of Artificial Intelligence in Endoscopic Ultrasound for Pancreatic Disorders
Ryosuke Tonozuka, Shuntaro Mukai, Takao Itoi
Diagnostics.2020; 11(1): 18. CrossRef
Endoscopic imaging techniques for detecting early colorectal cancer
Ignasi Puig, Carlos Mármol, Marco Bustamante
Current Opinion in Gastroenterology.2019; 35(5): 432. CrossRef

8,436 View
358 Download
20 Web of Science
19 Crossref

First
Prev
Page of 1
Next
Last

Search