Clinical Endoscopy

Original Article

Effectiveness of Autologous Platelet-Rich Plasma for the Healing of Ulcers after Endoscopic Submucosal Dissection: Eunju Jeong, In kyung Yoo, Ozlem Ozer Cakir, Hee Kyung Kim, Won Hee Kim, Sung Pyo Hong, Joo Young Cho; Clin Endosc 2019;52(5):472-478. Published online May 17, 2019; DOI: https://doi.org/10.5946/ce.2018.152

Background
/Aims: Platelet-rich plasma (PRP) has been used for wound healing in various medical fields. The aim of this study was to evaluate the clinical efficacy and safety of local PRP injections after endoscopic submucosal dissection (ESD).
Methods
Patients were non-randomly divided into the following two groups: (1) control group in which patients were administered only an intravenous proton pump inhibitor (PPI), and (2) a study group in which patients were administered an intravenous PPI and a topical PRP injection. We assessed the reduction in the ulcer area and stage of the ulcer after the procedure (24 hours, 48 hours, and 28 days after endoscopic surgery).
Results
We enrolled 7 study and 7 control patients. In the study group, the rate of ulcer reduction was 59% compared to 52% in the control group (p=0.372), 28 days after ESD. There were 5 patients in the S stage and 2 patients in the H stage in the study group compared to no patient in the S stage and 7 patients in the H stage in the control group (p=0.05), 28 days after ESD. There were no serious complications in either group.
Conclusions
The local injection of PRP is a safe and effective procedure for ulcer healing after ESD.

Citations

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Clinical efficacy of blood derivatives on wound healing: A systematic review and network meta‐analysis
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International Wound Journal.2024;[Epub] CrossRef
Endoscopic Shielding With Platelet-rich Plasma After Resection Of Large Colorectal Lesions
Vicente Lorenzo-Zúñiga, Vicente Moreno de Vega, Ramón Bartolí
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(3): 376. CrossRef
The Additive Effect of Platelet-Rich Plasma in the Treatment of Actively Bleeding Peptic Ulcer
Waseem M. Seleem, Amr Shaaban Hanafy
Clinical Endoscopy.2021; 54(6): 864. CrossRef
Endless Challenges in Overcoming Complications Associated with Endoscopic Submucosal Dissection
Satoshi Ono, Shun Ito, Kenji Ogata
Clinical Endoscopy.2019; 52(5): 395. CrossRef

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Review

Korean Society of Gastrointestinal Endoscopy Guidelines for Endoscope Reprocessing: Byoung Kwan Son, Byung-Wook Kim, Won Hee Kim, Dae-Sung Myung, Young-Seok Cho, Byung Ik Jang, The Disinfection Management and Conscious Sedation Committee of Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2017;50(2):143-147. Published online March 17, 2017; DOI: https://doi.org/10.5946/ce.2017.029

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The Korean Society of Gastrointestinal Endoscopy (KSGE) issued guidelines for endoscope reprocessing for the first time in 1995, and the version of the guidelines was updated in August 2009, August 2012, and March 2015. Guidelines for endoscope reprocessing should be revised continuously, because new disinfectants and devices are developed and introduced. The current official version of the KSGE guidelines for endoscope reprocessing is explained herein to assist the reader in understanding the KSGE requirements for cleaning and disinfecting endoscopes.

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Jiang Du, Miao Zhang, Si-Yuan Tao, Lian-Song Ye, Hui Gong, Bing Hu, Qiong-Ying Zhang, Fu Qiao
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Current management status of cleaning and disinfection for gastrointestinal endoscopy: a meta-analysis
Ruixue Hu, Liangying Yi, Tianle Zou, Juan Hu, Yanhua Chen, Wei Pan
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Yoo-Bin Seo, Seung Hee Kim, Eon Sook Lee, Seung Jin Jung, Sang Keun Hahm
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Young Chan Lee, Hae Sang Park, Heejin Kim, Nayeon Choi, Sang Hyuk Lee, Sei Young Lee, Kwang Jae Cho
Journal of The Korean Society of Laryngology, Phoniatrics and Logopedics.2024; 35(3): 89. CrossRef
Comparison of channel sampling methods and brush heads in surveillance culture of endoscope reprocessing
Xue-Yue Ji, Pei-Yong Ning, Chun-Nan Fei, Jia Song, Xue-Mei Dou, Nan-Nan Zhang, Jun Liu, He Liu
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Hefeng Tian, Jiao Sun, Shaoning Guo, Xuanrui Zhu, Han Feng, Yijin Zhuang, Xiu Wang, Konstantinos Triantafyllou
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Vanessa M Eichel, Jonas M Jabs, Samy Unser, Nico T Mutters, Martin Scherrer
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Jeong Eun Shin, Yunho Jung, Jeong Hoon Lee, Byoung Kwan Son, Jae-Young Jang, Hyung-Keun Kim, Byung Ik Jang
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Case Report

Double-Scope Peroral Endoscopic Myotomy (POEM) for Esophageal Achalasia: The First Trial of a New Double-Scope POEM: Hee Jin Hong, Ga Won Song, Weon Jin Ko, Won Hee Kim, Ki Baik Hahm, Sung Pyo Hong, Joo Young Cho; Clin Endosc 2016;49(4):383-386. Published online March 15, 2016; DOI: https://doi.org/10.5946/ce.2015.108

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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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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
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Characteristics of a Subset of Achalasia With Normal Integrated Relaxation Pressure
Eunju Kim, In Kyung Yoo, Dong Keon Yon, Joo Young Cho, Sung Pyo Hong
Journal of Neurogastroenterology and Motility.2020; 26(2): 274. CrossRef
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Oscar Víctor Hernández Mondragón, Raúl Zamarripa Mottú, Omar Solórzano Pineda, Raúl Alberto Gutierrez Aguilar, Luís Fernando García Contreras
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Treatment of Achalasia with Per-Oral Endoscopic Myotomy: Analysis of 50 Consecutive Patients
Erica D. Kane, David J. Desilets, Donna Wilson, Marc Leduc, Vikram Budhraja, John R. Romanelli
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Original Article

Optimal Methods for the Management of Iatrogenic Colonoscopic Perforation: Dae Kyu Shin, Sun Young Shin, Chi Young Park, Sun Mi Jin, Yang Hyun Cho, Won Hee Kim, Chang-Il Kwon, Kwang Hyun Ko, Ki Baik Hahm, Pil Won Park, Jong Woo Kim, Sung Pyo Hong; Clin Endosc 2016;49(3):282-288. Published online February 18, 2016; DOI: https://doi.org/10.5946/ce.2015.046

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Background
/Aims: Colonoscopic perforations have been managed with exploratory laparotomy, and have resulted in some morbidity and mortality. Recently, laparoscopic surgery is commonly performed for this purpose. The aim of this study was to compare the outcomes of several management strategies for iatrogenic colonoscopic perforations.
Methods
We retrospectively reviewed the medical records of patients who had been treated for colonoscopic perforation between January 2004 and April 2013 at CHA Bundang Medical Center in Korea.
Results
A total of 41 patients with colonoscopic perforation were enrolled. Twenty patients underwent conservative management with a success rate of 90%. Surgical management was performed in 23 patients including two patients who were converted to surgical management after the failure of the initial conservative management. Among 14 patients who underwent surgery at 8 hours after the perforation, there was no considerable difference in adverse outcomes between the laparotomy group and the laparoscopic surgery group. The medical costs and claim rate were 1.45 and 1.87 times greater in the exploratory laparotomy group, respectively.
Conclusions
Conservative management of colonoscopic perforation could be an option for patients without overt symptoms of peritonitis or with a small defect size. If surgical management is required, laparoscopic surgery may be considered as the initial procedure even with a delayed diagnosis.

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Vanessa L. Woolhead, Jacqueline C. Whittemore, Sarah A. Stewart
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Focused Review Series: Endoscopic Disinfection in the Era of MERS

Recent Update on Microbiological Monitoring of Gastrointestinal Endoscopes after High-Level Disinfection: Suk Pyo Shin, Won Hee Kim; Clin Endosc 2015;48(5):369-373. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.369

Abstract PDF PubReader ePub

Endoscopy-related infections are important contributors to nosocomial infections. Endoscope reprocessing according to standard guidelines ensures high-level disinfection and prevents endoscopy-related infections. Microbiological surveillance may help in monitoring the effectiveness of gastrointestinal endoscope disinfection. The process involves microbial cultures and non-culture methods such as bioburden assays, adenosine triphosphate (ATP) bioluminescence, and quantitative polymerase chain reactions (PCRs). Surveillance culturing to monitor endoscopes after reprocessing has been recommended by a majority of organizations. Bioburden assays, ATP bioluminescence, and quantitative PCRs provide rapid and reliable measures. Each institution will have to try to establish its own surveillance guidelines.

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Case Report

Extragastroesophageal Malignancy-Associated Secondary Achalasia: A Rare Association of Pancreatic Cancer Rendering Alarm Manifestation: Hong Min Kim, Ji Min Chu, Won Hee Kim, Sung Pyo Hong, Ki Baik Hahm, Kwang Hyun Ko; Clin Endosc 2015;48(4):328-331. Published online July 24, 2015; DOI: https://doi.org/10.5946/ce.2015.48.4.328

Abstract PDF PubReader ePub

Secondary achalasia or pseudoachalasia is a rare esophageal motor abnormality, which mimics primary achalasia; it is not easily distinguishable from idiopathic achalasia by manometry, radiological examination, or endoscopy. Although the majority of reported pseudoachalasia cases are associated with neoplasms at or near the esophagogastric (EG) junction, other neoplastic processes or even chronic illnesses such as rheumatoid arthritis can lead to the development of pseudoachalasia, for example, mediastinal masses, gastrointestinal (GI) tumors of the liver and biliary tract, and non-GI malignancies. Therefore, even if a patient presents with the typical findings of achalasia, we should be alert to the possibility of other GI malignancies besides EG tumors. For instance, pancreatic cancer was found in the case reported here; only four such cases have been reported in the literature. A 47-year-old man was admitted to our center with a 3-month history of dysphagia. His endoscopic and esophageal manometric findings were compatible with primary achalasia. However, unresponsiveness to diverse conventional achalasia treatments led us to suspect secondary achalasia. An active search led to a diagnosis of pancreatic mucinous cystadenocarcinoma invading the gastric fundus and EG junction. This rare case of pseudoachalasia caused by pancreatic carcinoma emphasizes the need for suspecting GI malignancies other than EG tumors in patients refractory to conventional achalasia treatment.

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Original Article

Endoscopic Submucosal Dissection Using a Novel Versatile Knife: An Animal Feasibility Study (with Video): Chang-Il Kwon, Gwangil Kim, Il-Kwun Chung, Won Hee Kim, Kwang Hyun Ko, Sung Pyo Hong, Seok Jeong, Don Haeng Lee; Clin Endosc 2014;47(6):544-554. Published online November 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.6.544

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives.

Methods

This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed.

Results

A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm²/sec vs. 1.57 mm²/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities.

Conclusions

ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.

Citations

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Case Report

Gastrointestinal Cancers in a Peutz-Jeghers Syndrome Family: A Case Report: Sang Hee Song, Kun Woo Kim, Won Hee Kim, Chang Il Kwon, Kwang Hyun Ko, Ki Baik Hahm, Pil Won Park, Sung Pyo Hong; Clin Endosc 2013;46(5):572-575. Published online September 30, 2013; DOI: https://doi.org/10.5946/ce.2013.46.5.572

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A 17-year-old man was diagnosed as Peutz-Jeghers syndrome (PJS) because of pigmented lip and multiple gastrointestinal polyps. He had anemia and underwent polypectomy on the duodenum and colon. His maternal family members were patients with PJS. His mother used to be screened with endoscopy to remove large polyps. One and half years later, he underwent jejunal segmental resection due to intussusceptions. He underwent endoscopic polypectomy every 2 to 3 years. When he was 23 years old, high-grade dysplasia was found in colonic polyp and his mother underwent partial pancreatectomy due to intraductal papillary mucinous carcinoma. When he was 27 years old, diffuse gastric polyps on the greater curvature of corpus expanded and grew. Therefore, wide endoscopic polypectomy was done. Histological examination revealed focal intramucosal carcinoma and low-grade dysplasia in hamartomatous polyps. We report cases of cancers occurred in first-degree relatives with PJS.

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Familial and hereditary gastric cancer, an overview
Fátima Carneiro
Best Practice & Research Clinical Gastroenterology.2022; 58-59: 101800. CrossRef
Small bowel intussusception and concurrent sigmoid polyp with malignant transformation in Peutz–Jeghers syndrome
Maidah Algarni, Enas Raml, Nora Trabulsi, Mohammed Nassif
Journal of Surgical Case Reports.2019;[Epub] CrossRef
The first European family with gastric adenocarcinoma and proximal polyposis of the stomach: case report and review of the literature
Rudolf Repak, Darina Kohoutova, Miroslav Podhola, Stanislav Rejchrt, Marek Minarik, Lucie Benesova, Michal Lesko, Jan Bures
Gastrointestinal Endoscopy.2016; 84(4): 718. CrossRef
Gastric Hamartomatous Polyps—Review and Update
Monika Vyas, Xiu Yang, Xuchen Zhang
Clinical Medicine Insights: Gastroenterology.2016; 9: CGast.S38452. CrossRef
Giant rectal polyp prolapse in an adult patient with the Peutz-Jeghers syndrome
Ana Delfina Cano-Contreras, Arturo Meixueiro-Daza, Peter Grube-Pagola, Jose Maria Remes-Troche
BMJ Case Reports.2016; : bcr2016215629. CrossRef
Prevention Strategies for Gastric Cancer: A Global Perspective
Jin Young Park, Lawrence von Karsa, Rolando Herrero
Clinical Endoscopy.2014; 47(6): 478. CrossRef

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Review

Endoscopic Treatment of Refractory Gastroesohageal Reflux Disease: Won Hee Kim, Pil Won Park, Ki Baik Hahm, Sung Pyo Hong; Clin Endosc 2013;46(3):230-234. Published online May 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.3.230

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Though efficient acid suppression with proton pump inhibitors (PPIs) remains the mainstay of treatment of gastroesophageal reflux disease (GERD), some of the patients showed refractory response to PPIs, necessitating further intervention. After increasing dose of PPIs and other kinds of pharmacological intervention adopting prokinetics or others, variable endoscopic treatments are introduced for the treatment of these refractory cases. The detailed introduction regarding endoscopic treatment for GERD is forwarded in this review article. Implantation of reabsorbable or synthetic materials in the distal esophagus was tried in vain and is expelled from the market due to limited efficacy and serious complication. Radiofrequency energy delivery (Stretta) and transoral incisionless fundoplication (EsophyX) are actively tried currently.

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Endoskopische und operative Therapie der gastroösophagealen Refluxkrankheit
Sebastian F. Schoppmann, Gerd Jomrich
Die Gastroenterologie.2024; 19(6): 524. CrossRef
Refractory gastroesophageal reflux disease
C. R. Subramanian, G. Triadafilopoulos
Gastroenterology Report.2015; 3(1): 41. CrossRef
Long-term outcomes of patients with refractory gastroesophageal reflux disease following a minimally invasive endoscopic procedure: a prospective observational study
Wei-Tao Liang, Zhong-Gao Wang, Feng Wang, Yue Yang, Zhi-Wei Hu, Jian-Jun Liu, Guang-Chang Zhu, Chao Zhang, Ji-Min Wu
BMC Gastroenterology.2014;[Epub] CrossRef

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Commentary

Endoscopically Diagnosed Gastric Cancers: Looking Alike, but Behave Differently: Won Hee Kim, Ki Baik Hahm; Clin Endosc 2013;46(2):111-112. Published online March 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.2.111

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Case Report

An Impacted Pancreatic Stone in the Papilla Induced Acute Obstructive Cholangitis in a Patient with Chronic Pancreatitis: Kwang-Ho Yoo, Chang-Il Kwon, Sang-Wook Yoon, Won Hee Kim, Jung Min Lee, Kwang Hyun Ko, Sung Pyo Hong, Pil Won Park; Clin Endosc 2012;45(1):99-102. Published online March 31, 2012; DOI: https://doi.org/10.5946/ce.2012.45.1.99

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Obstructive jaundice is very rarely caused by impaction of a pancreatic stone in the papilla. We report here on a case of obstructive jaundice with acute cholangitis that was caused by an impacted pancreatic stone in the papilla in a patient with chronic pancreatitis. A 48-year-old man presented with acute obstructive cholangitis. Abdominal computed tomography with the reconstructed image revealed distal biliary obstruction that was caused by a pancreatic stone in the pancreatic head, and there was also pancreatic ductal dilatation and parenchymal atrophy of the pancreatic body and tail with multiple calcifications. Emergency duodenoscopy revealed an impacted pancreatic stone in the papilla. Precut papillotomy using a needle knife was performed, followed by removal of the pancreatic stone using grasping forceps. After additional sphincterotomy, a large amount of dark-greenish bile juice gushed out. The patient rapidly improved and he has remained well.

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Anurag J. Shetty, C. Ganesh Pai, Shiran Shetty, Girisha Balaraju
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