Clinical Endoscopy

Endoscopic resection of gastric gastrointestinal stromal tumor using clip-and-cut endoscopic full-thickness resection: a single-center, retrospective cohort in Korea: Yuri Kim, Ji Yong Ahn, Hwoon-Yong Jung, Seokin Kang, Ho June Song, Kee Don Choi, Do Hoon Kim, Jeong Hoon Lee, Hee Kyong Na, Young Soo Park; Clin Endosc 2024;57(3):350-363. Published online February 15, 2024; DOI: https://doi.org/10.5946/ce.2023.144

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Background
/Aims: To overcome the technical limitations of classic endoscopic resection for gastric gastrointestinal stromal tumors (GISTs), various methods have been developed. In this study, we examined the role and feasibility of clip-and-cut procedures (clip-and-cut endoscopic full-thickness resection [cc-EFTR]) for gastric GISTs.
Methods
Medical records of 83 patients diagnosed with GISTs after endoscopic resection between 2005 and 2021 were retrospectively reviewed. Moreover, clinical characteristics and outcomes were analyzed.
Results
Endoscopic submucosal dissection (ESD) and cc-EFTR were performed in 51 and 32 patients, respectively. The GISTs were detected in the upper third of the stomach for ESD (52.9%) and cc-EFTR (90.6%). Within the cc-EFTR group, a majority of GISTs were located in the deep muscularis propria or serosal layer, accounting for 96.9%, as opposed to those in the ESD group (45.1%). The R0 resection rates were 51.0% and 84.4% in the ESD and cc-EFTR groups, respectively. Seven (8.4%) patients required surgical treatment (six patients underwent ESD and one underwent cc-EFTR,) due to residual tumor (n=5) and post-procedure adverse events (n=2). Patients undergoing R0 or R1 resection did not experience recurrence during a median 14-month follow-up period, except for one patient in the ESD group.
Conclusions
cc-EFTR displayed a high R0 resection rate; therefore, it is a safe and effective therapeutic option for small gastric GISTs.

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Endoscopic resection penetrating the muscularis propria for gastric gastrointestinal stromal tumors: advances and challenges
Jin Woong Cho
Clinical Endoscopy.2024; 57(3): 329. CrossRef

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Unusual cause of persistent chest pain: Yuri Kim, Ji Yong Ahn; Clin Endosc 2023;56(5):677-679. Published online July 26, 2023; DOI: https://doi.org/10.5946/ce.2023.078

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Simulator-based training method in gastrointestinal endoscopy training and currently available simulators: Yuri Kim, Jeong Hoon Lee, Gin Hyug Lee, Ga Hee Kim, Gunn Huh, Seung Wook Hong, Hwoon-Yong Jung; Clin Endosc 2023;56(1):1-13. Published online January 6, 2023; DOI: https://doi.org/10.5946/ce.2022.191

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The apprenticeship-based training method (ABTM) is highly effective for gastrointestinal (GI) endoscopic training. However, the conventional ABTM has significant issues. Although many supplementary training methods (TMs) have been developed and utilized, they cannot entirely replace the ABTM, which remains the major TM strategy. Currently, new TM construction is crucial and necessary due to financial constraints, difficulty of obtaining sufficient training time due to patient safety-related regulations, and catastrophic damage caused by disasters such as the coronavirus disease 2019 pandemic. The simulator-based TM (SBTM) is widely accepted as an alternative to the ABTM, owing to the SBTM’s advantages. Since the 1960s, many GI endoscopy training simulators have been developed and numerous studies have been published on their effectiveness. While previous studies have focused on the simulator’s validity, this review focused on the accessibility of simulators that were introduced by the end of 2021. Although the current SBTM is effective in GI endoscopic education, extensive improvements are needed to replace the ABTM. Incorporating simulator-incorporated TMs into an improved ABTM is an attempt to overcome the incompleteness of the current SBTM. Until a new simulator is developed to replace the ABTM, it is desirable to operate a simulator-integrated and well-coordinated TM that is suitable for each country and institution.

Citations

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Impact and assessment of training models in interventional endoscopic ultrasound
Bogdan Miutescu, Vinay Dhir
Digestive Endoscopy.2024; 36(1): 59. CrossRef
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Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
Gut and Liver.2024; 18(1): 77. CrossRef
Exploring Endoscopic Competence in Gastroenterology Training: A Simulation-Based Comparative Analysis of GAGES, DOPS, and ACE Assessment Tools
Faisal Wasim Ismail, Azam Afzal, Rafia Durrani, Rayyan Qureshi, Safia Awan, Michelle R Brown
Advances in Medical Education and Practice.2024; Volume 15: 75. CrossRef
Assemblage of a functional and versatile endoscopy trainer reusing medical waste: Step‐by‐step video tutorial
Riccardo Vasapolli, Jörg Schirra, Christian Schulz
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D. Roser, S. Nagl, A. Ebigbo
Best Practice & Research Clinical Gastroenterology.2024; 71: 101918. CrossRef
Systematic review of subjective validation methods for computerized colonoscopy simulators
Adrián Lugilde-López, Manuel Caeiro-Rodríguez, Fernando A. Mikic-Fonte, Martín Llamas-Nistal
Health Informatics Journal.2024;[Epub] CrossRef
EUS and ERCP training in Europe: Time for simulation, optimization, and standardization
Selma J. Lekkerkerker, Rogier P. Voermans
United European Gastroenterology Journal.2023; 11(5): 407. CrossRef
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Seong Woo Jeon
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Gastroenterology Insights.2023; 15(1): 1. CrossRef

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