Original Article
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Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection?
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Yunho Jung, Gwang Ho Baik, Weon Jin Ko, Bong Min Ko, Seong Hwan Kim, Jin Seok Jang, Jae-Young Jang, Wan-Sik Lee, Young Kwan Cho, Sun Gyo Lim, Hee Seok Moon, In Kyung Yoo, Joo Young Cho
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Clin Endosc 2021;54(4):555-562. Published online January 13, 2021
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DOI: https://doi.org/10.5946/ce.2020.229
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Abstract
PDFSupplementary MaterialPubReaderePub
- Background
/Aims: A new medical fiber-guided diode laser system (FDLS) is expected to offer high-precision cutting with simultaneous hemostasis. Thus, this study aimed to evaluate the feasibility of using the 1,940-nm FDLS to perform endoscopic submucosal dissection (ESD) in the gastrointestinal tract of an animal model.
Methods
In this prospective animal pilot study, gastric and colorectal ESD using the FDLS was performed in ex vivo and in vivo porcine models. The completeness of en bloc resection, the procedure time, intraprocedural bleeding, histological injuries to the muscularis propria (MP) layer, and perforation were assessed.
Results
The en bloc resection and perforation rates in the ex vivo study were 100% (10/10) and 10% (1/10), respectively; those in the in vivo study were 100% (4/4) and 0% for gastric ESD and 100% (4/4) and 25% (1/4) for rectal ESD, respectively. Deep MP layer injuries tended to occur more frequently in the rectal than in the gastric ESD cases, and no intraprocedural bleeding occurred in either group.
Conclusions
The 1,940-nm FDLS was capable of yielding high en bloc resection rates without intraprocedural bleeding during gastric and colorectal ESD in animal models.
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Citations
Citations to this article as recorded by
- Use of Diode Laser in Hysteroscopy for the Management of Intrauterine Pathology: A Systematic Review
Andrea Etrusco, Giovanni Buzzaccarini, Antonio Simone Laganà, Vito Chiantera, Salvatore Giovanni Vitale, Stefano Angioni, Maurizio Nicola D’Alterio, Luigi Nappi, Felice Sorrentino, Amerigo Vitagliano, Tommaso Difonzo, Gaetano Riemma, Liliana Mereu, Alessa
Diagnostics.2024; 14(3): 327. CrossRef - Recent advances in endoscopic management of gastric neoplasms
Hira Imad Cheema, Benjamin Tharian, Sumant Inamdar, Mauricio Garcia-Saenz-de-Sicilia, Cem Cengiz
World Journal of Gastrointestinal Endoscopy.2023; 15(5): 319. CrossRef - Safety and efficacy of dual emission endoscopic laser treatment in patients with upper or lower gastrointestinal vascular lesions causing chronic anemia: results from the first multicenter cohort study
Gian Eugenio Tontini, Lorenzo Dioscoridi, Alessandro Rimondi, Paolo Cantù, Flaminia Cavallaro, Aurora Giannetti, Luca Elli, Luca Pastorelli, Francesco Pugliese, Massimiliano Mutignani, Maurizio Vecchi
Endoscopy International Open.2022; 10(04): E386. CrossRef
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Case Reports
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Two-Stage Peroral Endoscopic Myotomy for Sigmoid-Type Achalasia
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Hak Su Kim, Hee Kyung Kim, Weon Jin Ko
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Clin Endosc 2020;53(2):232-235. Published online July 16, 2019
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DOI: https://doi.org/10.5946/ce.2019.067
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Abstract
PDFSupplementary MaterialPubReaderePub
- Peroral endoscopic myotomy (POEM) has been recently considered as the first treatment option for achalasia. The standard POEM procedures are often successful in most patients, but sometimes technical challenges are encountered. We report a new technique that is divided between two tunneling sites in the esophagus for sigmoid-type achalasia. A 40-year-old male patient with dysphagia for 10 years was diagnosed with a sigmoid-shaped esophagus at our hospital. We devised a two-stage myotomy technique to treat sigmoidtype achalasia. The myotomy was first performed in the upper part of the greater flexion area and then in the lower part of the flexion. We termed this method “two-stage POEM”, which was successfully performed without any complications. This new POEM method can also be used to improve symptoms in patients with achalasia who have a structural deformity that may result in a high change of treatment failure.
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Endoscopic Submucosal Dissection Followed by Concurrent Chemoradiotherapy in Patients with Early Esophageal Cancer with a High Risk of Lymph Node Metastasis
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Hee Kyung Kim, Weon Jin Ko, Chang-Il Kwon, Ga Won Song, In Kyun Yoo, Ji Hyun Song, Hak Su Kim, Joo Young Cho
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Clin Endosc 2019;52(5):502-505. Published online May 14, 2019
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DOI: https://doi.org/10.5946/ce.2018.176
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Abstract
PDFPubReaderePub
- Endoscopic submucosal dissection is recommended as an alternative therapy for early esophageal cancer. However, achieving curative resection in this procedure remains controversial since precise prediction of lymph node metastasis can be difficult. Here, we present the preliminary results of endoscopic submucosal dissection followed by concurrent chemoradiotherapy for early esophageal cancer with a high risk of lymph node metastasis. From May 2006 to January 2014, six patients underwent concurrent chemoradiotherapy after endoscopic submucosal dissection with a median follow-up period of 63 months. No complications were encountered during concurrent chemoradiotherapy. Although local recurrence did not occur in all patients, two patients were diagnosed with metachronous cancer. Overall, the survival rate was 100%. Thus, endoscopic submucosal dissection followed by concurrent chemoradiotherapy may be a feasible treatment for early esophageal cancer in patients with a high risk of lymph node metastasis. Future prospective large-scale studies are warranted to confirm our results.
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Citations
Citations to this article as recorded by
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Rakesh Acharya, Ananya Mahapatra, Henu Kumar Verma, L. V. K. S. Bhaskar
Current Oncology.2023; 30(11): 9542. CrossRef - Editorial “Discrepancy Between the Clinical and Final Pathological Findings of Lymph Node Metastasis in Superficial Esophageal Cancer”
Rian M. Hasson, Joseph D. Phillips
Annals of Surgical Oncology.2019; 26(9): 2662. CrossRef
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4,717
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Focused Review Series: The New Era of Therapeutic Endoscopy - Endoscopic Submucosal Surgery
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Introduction to Endoscopic Submucosal Surgery
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Weon Jin Ko, Joo Young Cho
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Clin Endosc 2018;51(1):8-12. Published online January 23, 2018
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DOI: https://doi.org/10.5946/ce.2017.154
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Abstract
PDFPubReaderePub
- The concept of using natural orifices to reduce the complications of surgery, Natural Orifices Transluminal Endoscopic Surgery, has also been applied to therapeutic endoscopy. Endoscopic submucosal surgery (ESS) provides more treatment options for various gastrointestinal diseases than traditional therapeutic endoscopy by using the submucosal layer as a working space. ESS has been performed in various fields ranging from transluminal peritoneoscopy to peroral endoscopic myotomy. With further advances in technology, ESS will be increasingly useful for diagnosis and treatment of gastrointestinal diseases.
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Citations
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- Design and validation of performance-oriented injectable chitosan thermosensitive hydrogels for endoscopic submucosal dissection
Jia Liu, Panxianzhi Ni, Yi Wang, Zhengkui Zhou, Junlin Li, Tianxu Chen, Tun Yuan, Jie Liang, Yujiang Fan, Jing Shan, Xiaobin Sun, Xingdong Zhang
Biomaterials Advances.2023; 146: 213286. CrossRef - Comparison of peroral endoscopic myotomy between de-novo achalasia and achalasia with prior treatment
Abdullah Ozgur Yeniova, In kyung Yoo, Eunju Jeong, Joo Young Cho
Surgical Endoscopy.2021; 35(1): 200. CrossRef - Tunnel endoscopic interventions in esophageal diseases
E. A. Drobyazgin, Yu. V. Chikinev, D. A. Arkhipov, N. I. Mit’ko, M. N. Chekanov, E. I. Vereshchagin, I. V. Peshkova, A. S. Polyakevich
Experimental and Clinical Gastroenterology.2021; 1(6): 75. CrossRef
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Review
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Evaluation and Endoscopic Management of Esophageal Submucosal Tumor
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Weon Jin Ko, Ga Won Song, Joo Young Cho
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Clin Endosc 2017;50(3):250-253. Published online November 7, 2016
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DOI: https://doi.org/10.5946/ce.2016.109
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Abstract
PDFPubReaderePub
- Submucosal tumors (SMTs) originate from tissues that constitute the submucosal layer and muscularis propria, and are covered by normal mucosa. Esophageal SMTs are rare, accounting for <1% of all esophageal tumors. However, the recent widespread use of endoscopy has led to a rapid increase in incidental detection of SMTs in Korea. Esophageal SMTs are benign in ≥90% of cases, but the possibility of malignancies such as gastrointestinal stromal tumor and malignant leiomyosarcoma still exists. Therefore, patients undergo resection in the presence of symptoms or the possibility of a malignant tumor. For resection of esophageal SMTs, surgical resection was the only option available in case of possible malignancy, but minimally invasive surgery by endoscopic resection is becoming more preferable to surgical resection with the development of endoscopic ultrasonography, endoscopic techniques, and other devices.
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Chien-Ming Chiang, Hsueh-Chien Chiang, Jui-Wen Kang
Frontline Gastroenterology.2024; 15(5): 434. CrossRef - Clinical course of asymptomatic duodenal subepithelial lesions
Seokin Kang, Kwangbeom Park, Do Hoon Kim, Yuri Kim, Hee Kyong Na, Jeong Hoon Lee, Ji Yong Ahn, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
The Korean Journal of Internal Medicine.2024; 39(4): 603. CrossRef - Management of subepithelial esophageal tumors
Marcel A. Schneider, Diana Vetter, Christian A. Gutschow
Innovative Surgical Sciences.2024;[Epub] CrossRef - Ligation-assisted endoscopic submucosal resection following unroofing technique for small esophageal subepithelial lesions originating from the muscularis propria
Quan Lu, Quan-Zhou Peng, Jun Yao, Li-Sheng Wang, De-Feng Li
World Journal of Gastroenterology.2024; 30(32): 3748. CrossRef - Advanced Esophageal Endoscopy
Kyoungwon Jung, Rebecca M. Haug, Andrew Y. Wang
Gastroenterology Clinics of North America.2024; 53(4): 603. CrossRef - Cholangiocarcinoma With Rare Esophageal Metastasis
Mana Matsuoka, Katsumasa Kobayashi, Yukito Okura, Takahito Nozaka, Ayako Sato, Masato Yauchi, Taichi Matsumoto, Yohei Furumoto, Takao Horiuchi, Toru Asano
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Medicine.2022; 101(51): e32380. CrossRef - Role of endoscopic ultrasound in anticancer therapy: Current evidence and future perspectives
Andre Bratanic, Dorotea Bozic, Antonio Mestrovic, Dinko Martinovic, Marko Kumric, Tina Ticinovic Kurir, Josko Bozic
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Tomoaki Aoki, Tetsu Nakamura, Taro Oshikiri, Hiroshi Hasegawa, Masashi Yamamoto, Yoshiko Matsuda, Shingo Kanaji, Kimihiro Yamashita, Takeru Matsuda, Yasuo Sumi, Satoshi Suzuki, Yoshihiro Kakeji
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Soon Young Kim, Sang Kil Lee, Hyang Joo Ryu
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2017; 17(3): 144. CrossRef
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Focused Review Series: Advances in the management of upper GI SET
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Current Techniques for Treating Gastrointestinal Stromal Tumors in the Upper Gastrointestinal Tract
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Weon Jin Ko, Joo Young Cho
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Clin Endosc 2016;49(3):226-228. Published online May 23, 2016
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DOI: https://doi.org/10.5946/ce.2016.061
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Abstract
PDFPubReaderePub
- Most gastrointestinal stromal tumors (GISTs) arise from the proper muscle layer of the upper gastrointestinal (GI) tract and have a low malignant potential. They are sometimes accompanied by symptoms, but in most cases are detected by chance. Endoscopic surgery of subepithelial tumors in the upper GI tract has been actively performed, and its merits include the need for fewer medical devices compared with other surgical procedures and post-resection organ preservation. However, because endoscopic procedures are still limited to small or pilot studies, a multidisciplinary approach combining laparoscopy and endoscopy is needed for more effective and pathologically acceptable management of GISTs. Many new endoscopic surgeries have been developed, and this review describes the current status of and the new approaches for endoscopic surgery of GISTs in the upper GI tract.
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Clinical Endoscopy.2024; 57(3): 350. CrossRef - New data on the types of sulfide copper-nickel ores of the Kharaelakh trough and the main patterns of their distribution
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Journal of Gastroenterology and Hepatology.2021; 36(9): 2558. CrossRef - Endoskopische Vollwandresektion im oberen Gastrointestinaltrakt – erste Erfahrungen
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Endoscopy International Open.2018; 06(08): E950. CrossRef
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Case Report
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Double-Scope Peroral Endoscopic Myotomy (POEM) for Esophageal Achalasia: The First Trial of a New Double-Scope POEM
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Hee Jin Hong, Ga Won Song, Weon Jin Ko, Won Hee Kim, Ki Baik Hahm, Sung Pyo Hong, Joo Young Cho
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Clin Endosc 2016;49(4):383-386. Published online March 15, 2016
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DOI: https://doi.org/10.5946/ce.2015.108
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Abstract
PDFPubReaderePub
- With the accumulation of clinical trials demonstrating its efficacy and safety, peroral endoscopic myotomy (POEM) has emerged as a less invasive treatment option for esophageal achalasia compared with laparoscopic Heller myotomy. However, the difficulty in determining the exact extent of myotomy, a critical factor associated with the success and safety of the procedure, remains a limitation. Although the various endoscopic landmarks and ancillary techniques have been applied, none of these has been proven sufficient. As a solution for this limitation, the double-scope POEM technique with a second endoscope to assure the exact length of the submucosal tunnel has been applied since 2014. Before double-scope POEM was introduced, the second endoscope was applied only to confirm the accuracy of the procedure. In the present study, we performed double-scope POEM in the treatment of esophageal achalasia through a novel procedure of simultaneous application of the second endoscope to assist in the conventional POEM procedure.
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Citations
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Ahmed Tawheed, Ibrahim Halil Bahcecioglu, Mehmet Yalniz, Mohamed El-Kassas
World Journal of Gastroenterology.2024; 30(23): 2947. CrossRef - Peroral Endoscopic Myotomy (POEM) in Children: A State of the Art Review
Ali A. Mencin, Amrita Sethi, Monique T. Barakat, Diana G. Lerner
Journal of Pediatric Gastroenterology & Nutrition.2022; 75(3): 231. CrossRef - Per-oral endoscopic myotomy (POEM) for a sigmoid type of achalasia: short-term outcomes and changes in the esophageal angle
Shota Maruyama, Yusuke Taniyama, Tadashi Sakurai, Makoto Hikage, Chiaki Sato, Kai Takaya, Takuro Konno, Takeshi Naitoh, Michiaki Unno, Takashi Kamei
Surgical Endoscopy.2020; 34(9): 4124. CrossRef - Characteristics of a Subset of Achalasia With Normal Integrated Relaxation Pressure
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Review
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Image Quality Analysis of Various Gastrointestinal Endoscopes: Why Image Quality Is a Prerequisite for Proper Diagnostic and Therapeutic Endoscopy
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Weon Jin Ko, Pyeong An, Kwang Hyun Ko, Ki Baik Hahm, Sung Pyo Hong, Joo Young Cho
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Clin Endosc 2015;48(5):374-379. Published online September 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.5.374
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Abstract
PDFPubReaderePub
Arising from human curiosity in terms of the desire to look within the human body, endoscopy has undergone significant advances in modern medicine. Direct visualization of the gastrointestinal (GI) tract by traditional endoscopy was first introduced over 50 years ago, after which fairly rapid advancement from rigid esophagogastric scopes to flexible scopes and high definition videoscopes has occurred. In an effort towards early detection of precancerous lesions in the GI tract, several high-technology imaging scopes have been developed, including narrow band imaging, autofocus imaging, magnified endoscopy, and confocal microendoscopy. However, these modern developments have resulted in fundamental imaging technology being skewed towards red-green-blue and this technology has obscured the advantages of other endoscope techniques. In this review article, we have described the importance of image quality analysis using a survey to consider the diversity of endoscope system selection in order to better achieve diagnostic and therapeutic goals. The ultimate aims can be achieved through the adoption of modern endoscopy systems that obtain high image quality.
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Frontiers in Medicine.2022;[Epub] CrossRef - Diagnosis of Early Gastric Cancer Using Image-enhanced Endoscopy
Weon Jin Ko
The Korean Journal of Medicine.2017; 92(3): 264. CrossRef
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Case Report
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Endoscopic Treatment of Various Gastrointestinal Tract Defects with an Over-the-Scope Clip: Case Series from a Tertiary Referral Hospital
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Woong Cheul Lee, Weon Jin Ko, Jun-Hyung Cho, Tae Hee Lee, Seong Ran Jeon, Hyun Gun Kim, Joo Young Cho
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Clin Endosc 2014;47(2):178-182. Published online March 31, 2014
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DOI: https://doi.org/10.5946/ce.2014.47.2.178
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Abstract
PDFPubReaderePub
Recently, increasingly invasive therapeutic endoscopic procedures and more complex gastrointestinal surgeries such as endoscopic mucosal resection, endoscopic submucosal dissection, and novel laparoscopic approaches have resulted in endoscopists being confronted more frequently with perforations, fistulas, and anastomotic leakages, for which nonsurgical closure is desired. In this article, we present our experiences with the use of over-the-scope clip (OTSC) for natural orifice transluminal endoscopic surgery (NOTES) closure, prevention of perforation, anastomotic leakages, and fistula closures. The OTSC is a valuable device for closing intestinal perforations and fistulas, for NOTES closure, and for the prevention of perforation after the excision of a tumor from the proper muscle layer. Furthermore, it seems to be quite safe to perform, even by endoscopists with little experience of the technique.
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