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Colon stenting as a bridge to surgery in obstructive colorectal cancer management
Dong Hyun Kim, Han Hee Lee
Received May 23, 2023  Accepted July 29, 2023  Published online March 8, 2024  
DOI:    [Epub ahead of print]
AbstractAbstract PDFPubReaderePub
Colonic stent placement is a commonly used bridging strategy for surgery in patients with obstructive colorectal cancer. The procedure involves the placement of a self-expandable metallic stent (SEMS) across the obstructive lesion to restore intestinal patency and alleviate the symptoms of obstruction. By allowing patients to receive surgery in a planned and staged manner with time for preoperative optimization and bowel preparation, stent placement may reduce the need for emergency surgery, which is associated with higher complication rates and poorer outcomes. This review focuses on the role of colon stenting as a bridge to surgery in the management of obstructive colorectal cancer. SEMS as a bridge to surgery for left-sided colon cancer has been demonstrated to be particularly useful; however, further research is needed for its application in cases of right-sided colon cancer. Colon stent placement also has limitations and potential complications including stent migration, re-obstruction, and perforation. However, the timing of curative surgery after SEMS placement remains inconclusive. Considering the literature to date, performing surgery at an interval of approximately 2 weeks is considered appropriate. Therefore, colonic stent placement may be an effective strategy as a bridge to surgery in patients with obstructive colorectal cancer.
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  • 178 Download
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Original Article
Colon Capsule Endoscopy: Indications, Findings, and Complications – Data from a Prospective German Colon Capsule Registry Trial (DEKOR)
Johannes Hausmann, Andrea Tal, Artur Gomer, Michael Philipper, Gero Moog, Horst Hohn, Norbert Hesselbarth, Harald Plass, Jörg Albert, Fabian Finkelmeier
Clin Endosc 2021;54(1):92-99.   Published online June 18, 2020
AbstractAbstract PDFPubReaderePub
/Aims: Reliable and especially widely accepted preventive measures are crucial to further reduce the incidence of colorectal cancer (CRC). Colon capsule endoscopy (CCE) might increase the screening numbers among patients unable or unwilling to undergo conventional colonoscopy. This registry trial aimed to document and determine the CCE indications, findings, complications, and adverse events in outpatient practices and clinics throughout Germany.
Patients undergoing CCE between 2010 and 2015 were enrolled in this prospective multicenter registry trial at six German centers. Patient demographics, outcomes, and complications were evaluated.
A total of 161 patients were included. Of the CCE evaluations, 111 (68.9%) were considered successful. Pathological findings in the colon (n=92, 60.1%) and in the remaining gastrointestinal tract (n=38, 24.8%) were recorded. The main finding was the presence of polyps (n=52, 32.3%). Furthermore, five carcinomas (3.1%) were detected and histologically confirmed later. Adequate bowel cleanliness was more likely to be achieved in the outpatient setting (p<0.0001). Interestingly, 85 patients (55.6%) chose to undergo CCE based on personal motivation.
CCE seems to be a reliable and safe endoscopic tool for screening for CRC and detecting other diseases. Its patient acceptance and feasibility seems to be high, especially in the outpatient setting.


Citations to this article as recorded by  
  • Advances in colon capsule endoscopy: a review of current applications and challenges
    E. Gibbons, O. B. Kelly, B. Hall
    Frontiers in Gastroenterology.2023;[Epub]     CrossRef
  • Computer-Aided Diagnosis of Gastrointestinal Protruded Lesions Using Wireless Capsule Endoscopy: A Systematic Review and Diagnostic Test Accuracy Meta-Analysis
    Hye Jin Kim, Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Ki Tae Suk, Gwang Ho Baik
    Journal of Personalized Medicine.2022; 12(4): 644.     CrossRef
  • Colon Capsule Endoscopy in the Diagnosis of Colon Polyps: Who Needs a Colonoscopy?
    Apostolos Koffas, Apostolis Papaefthymiou, Faidon-Marios Laskaratos, Andreas Kapsoritakis, Owen Epstein
    Diagnostics.2022; 12(9): 2093.     CrossRef
  • The Effectiveness of a Very Low-Volume Compared to High-Volume Laxative in Colon Capsule Endoscopy
    Benedicte Schelde-Olesen, Artur Nemeth, Gabriele Wurm Johansson, Ulrik Deding, Thomas Bjørsum-Meyer, Henrik Thorlacius, Gunnar Baatrup, Anastasios Koulaouzidis, Ervin Toth
    Diagnostics.2022; 13(1): 18.     CrossRef
  • Colon Capsule Endoscopy: An Alternative for Conventional Colonoscopy?
    Britt B.S.L. Houwen, Evelien Dekker
    Clinical Endoscopy.2021; 54(1): 4.     CrossRef
  • Examination of Entire Gastrointestinal Tract: A Perspective of Mouth to Anus (M2A) Capsule Endoscopy
    Ji Hyung Nam, Kwang Hoon Lee, Yun Jeong Lim
    Diagnostics.2021; 11(8): 1367.     CrossRef
  • 6,200 View
  • 176 Download
  • 5 Web of Science
  • 6 Crossref
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Case Report
Ascending Colon Cancer with Pathologically Confirmed Tumor Thrombosis of Superior Mesenteric Vein: A Case Report
Sung Eun Kim, Sang Jin Lee, Jun Young Cha, Sang Won Yi, Tae Sun Kim, Il Leon Cho, Jae Young Kwak, Kwang Hoon Oh
Clin Endosc 2019;52(5):506-509.   Published online April 17, 2019
AbstractAbstract PDFPubReaderePub
Colon cancer is very rarely accompanied by tumor thrombosis of the superior mesenteric vein (SMV). A 46-year-old patient had been diagnosed with SMV tumor thrombosis related to colon cancer without hepatic metastasis and underwent right hemicolectomy with SMV tumor thrombectomy. Tumor thrombosis was pathologically confirmed as metastatic colon cancer. There has been no recurrence for 12 months with 12 cycles of adjuvant-chemotherapy.


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    Janki Trivedi, Heinrich Bouwer, Tom Sutherland
    BJR|case reports.2021; 7(2): 20200147.     CrossRef
  • Isolated Malignant Portal Vein Thrombus in Colon Carcinoma: A Rare Finding on 18F-FDG PET/CECT
    Tarun Kumar Jain, Ajay Yadav, Hemant Malhotra, Nitin Khunteta, Guman Singh
    Journal of Nuclear Medicine Technology.2021; 49(2): 190.     CrossRef
  • Ascending colon cancer accompanied by tumor thrombosis in the superior mesenteric vein: A case report
    Yoshiaki Fujii, Kenji Kobayashi, Sho Kimura, Shuhei Uehara, Shuji Takiguchi
    International Journal of Surgery Case Reports.2020; 73: 239.     CrossRef
  • Treatment of tumor thrombus in the superior mesenteric vein due to advanced colon cancer with complete surgical resection and chemotherapy: a case report
    Yoshitsugu Yanagida, Takahiro Amano, Ryuji Akai, Akira Toyoshima, Jotaro Kobayashi, Takuya Hashimoto, Eiji Sunami, Toshio Kumasaka, Shin Sasaki
    Surgical Case Reports.2020;[Epub]     CrossRef
  • 4,744 View
  • 101 Download
  • 4 Web of Science
  • 4 Crossref
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Quality is the Key for Emerging Issues of Population-Based Colonoscopy Screening
Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen, on behalf of Medical Policy Committee of Korean Association for the Study of Intestinal Diseases (KASID), Quality Improvement Committee of Korean Society of Gastrointestinal Endoscopy (KSGE)
Clin Endosc 2018;51(1):50-55.   Published online January 31, 2018
AbstractAbstract PDFPubReaderePub
Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.


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    Zhen-wen Wu, Sheng-gang Zhan, Mei-feng Yang, Yi-teng Meng, Feng Xiong, Cheng Wei, Ying-xue Li, Ding-guo Zhang, Zheng-lei Xu, Ben-hua Wu, Rui-yue Shi, Jun Yao, Li-sheng Wang, De-feng Li, Cyriac Abby Philips
    Canadian Journal of Gastroenterology and Hepatology.2021; 2021: 1.     CrossRef
  • Efficacy and Patient Tolerability Profiles of Probiotic Solution with Bisacodyl Versus Conventional Cleansing Solution for Bowel Preparation: A Prospective, Randomized, Controlled Trial
    Youn I Choi, Jong-Joon Lee, Jun-Won Chung, Kyoung Oh Kim, Yoon Jae Kim, Jung Ho Kim, Dong Kyun Park, Kwang An Kwon
    Journal of Clinical Medicine.2020; 9(10): 3286.     CrossRef
  • 5,976 View
  • 157 Download
  • 3 Web of Science
  • 3 Crossref
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Original Article
The Impact of Patient Education with a Smartphone Application on the Quality of Bowel Preparation for Screening Colonoscopy
JeongHyeon Cho, SeungHee Lee, Jung A Shin, Jeong Ho Kim, Hong Sub Lee
Clin Endosc 2017;50(5):479-485.   Published online July 3, 2017
AbstractAbstract PDFPubReaderePub
/Aims: Few studies have evaluated the use of a smartphone application (app) for educating people undergoing colonoscopy and optimizing bowel preparation. Therefore, this study was designed to develop a smartphone app for people to use as a preparation guide and to evaluate the efficacy of this app when used prior to colonoscopy.
In total, 142 patients (male:female=84:58, mean age=43.5±9.3 years), who were scheduled to undergo a colonoscopy at Myongji Hospital, were enrolled in this study. Seventy-one patients were asked to use a smartphone app that we had recently developed to prepare for the colonoscopy, while the 71 patients of the sex and age-matched control group were educated via written and verbal instructions.
The quality of bowel cleansing, evaluated using the Boston Bowel Preparation Scale (BBPS), was significantly higher in the smartphone app group than in the control group (7.70±1.1 vs. 7.24±0.8, respectively, p=0.007 by t-test). No significant differences were found between the two groups regarding work-up time and the number of patients with polyps.
In this study, targeting young adults (≤50 years), the bowel preparation achieved by patients using the smartphone app showed significantly better quality than that of the control group.


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  • 8,717 View
  • 285 Download
  • 24 Web of Science
  • 26 Crossref
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Focused Review Series: Endoscopic Screening and Surveillance for Gastrointestinal Cancer
Colon Cancer Screening and Surveillance in Inflammatory Bowel Disease
Song I Bae, You Sun Kim
Clin Endosc 2014;47(6):509-515.   Published online November 30, 2014
AbstractAbstract PDFPubReaderePub

Patients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer (CRC). Accordingly, the duration and anatomic extent of the disease have been known to affect the development of IBD-related CRC. When CRC occurs in patients with IBD, unlike in sporadic CRC, it is difficult to detect the lesions because of mucosal changes caused by inflammation. In addition, the tumor types vary with ill-circumscribed lesions, and the cancer is difficult to diagnose and remedy at an early stage. For the diagnosis of CRC in patients with IBD, screening endoscopy is recommended 8 to 10 years after the IBD diagnosis, and surveillance colonoscopy is recommended every 1 to 2 years thereafter. The recent development of targeted biopsies using chromoendoscopy and relatively newer endoscopic techniques helps in the early diagnosis of CRC in patients with IBD. A total proctocolectomy is advisable when high-grade dysplasia or multifocal low-grade dysplasia is confirmed by screening endoscopy or surveillance colonoscopy or if a nonadenoma-like dysplasia-associated lesion or mass is detected. Currently, pharmacotherapies are being extensively studied as a way to prevent IBD-related CRC.


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  • 130 Download
  • 34 Web of Science
  • 30 Crossref
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Original Article
Angular Positioning of Stent Increases Bowel Perforation after Self-Expandable Metal Stent Placement for Malignant Colorectal Obstruction
Jeong Guil Lee, Kwang Ho Yoo, Chang-Il Kwon, Kwang Hyun Ko, Sung Pyo Hong
Clin Endosc 2013;46(4):384-389.   Published online July 31, 2013
AbstractAbstract PDFPubReaderePub

Some factors like stent wires, balloon dilatation and use of guide wires seems to increase perforation after self-expandable metal stent (SEMS) placement, but few studies mentioned about the relationship between angulation of malignant stricture and perforation. The present study aimed to confirm that more angular positioning of stents increases perforation.


This study was conducted with retrospectively evaluation at Digestive Disease Center, CHA Bundang Medical Center, CHA University. Between January 2002 and August 2011, SEMS was inserted in 130 patients with malignant colorectal obstruction. We studied the difference in the angle of stenosis between perforation and non-perforation groups using fluorography images.


SEMS insertion was performed in 130 cases of obstruction due to colon cancer. Perforation occurred in eight patients (6.2%) of them. Thirteen cases were excluded from the analysis due to poor fluoroscopic images. Among the eight patients with perforation, the mean stenosis angle was 109.9° compared to 153.1° in the nonperforation group, indicating that the angle was more acute in the perforation group (p=0.016).


This study shows that more angular positioning of stent increases bowel perforation after SEMS placement for malignant colorectal obstruction.


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Case Report
Cronkhite-Canada Syndrome Associated with Serrated Adenoma and Malignant Polyp: A Case Report and a Literature Review of 13 Cronkhite-Canada Syndrome Cases in Korea
So Hee Yun, Jin Woong Cho, Ji Woong Kim, Joong Keun Kim, Moon Sik Park, Na Eun Lee, Jae Un Lee, Young Jae Lee
Clin Endosc 2013;46(3):301-305.   Published online May 31, 2013
AbstractAbstract PDFPubReaderePub

Cronkhite-Canada syndrome (CCS) is a rare nonfamilial polyposis syndrome characterized by epithelial disturbances both in the gastrointestinal tract and in the epidermis. The pathologic finding of the polyp is usually a hamartomatous polyp of the juvenile type; however, the possibility of serrated adenoma associated malignant neoplasm was reported in some Japanese cases. Up till now in South Korea, 13 CCS cases have been reported, but there was no case accompanied by the colon cancer. We report the first case of CCS associated with malignant colon polyp and serrated adenoma in Korea. A 72-year-old male patient who complained of diarrhea and weight loss was presented with both hands and feet nail dystrophy, hyperpigmentation, and alopecia. Endoscopic examination showed numerous hamartomatous polyps from the stomach to the colon. The pathologic results confirmed colon cancer and serrated adenoma. Helicobacter pylori eradication and prednisolone was used. Thus, the authors report this case along with a literature review.


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Special Issue Articles of IDEN 2012
Current Status of Colorectal Endoscopic Submucosal Dissection in Korea
Dong Kyung Chang
Clin Endosc 2012;45(3):288-289.   Published online August 22, 2012
AbstractAbstract PDFPubReaderePub

Colorectal endoscopic submucosal dissection (ESD) is not yet fully popularized in Korea, but is increasing steadily. The outcomes of colorectal ESD in Korea are comparable to those in Japan and other countries. ESD-related complication rates are decreasing as experiences accumulate. Particularly for rectal laterally spreading tumors, ESD is becoming more prevalent than transanal endoscopic microsurgery. Standard indication, qualified training system, and full medical insurance coverage should be established for the procedure to become popular in the long run.


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A Case of Chronic Ulcerative Colitis Complicated by Budd-Chiari Syndrome and Colon Cancer
Rok Son Choung, M.D., Yoon Tae Jeen, M.D., Yong Sik Kim, M.D., Young Sun Kim, M.D., Hong Sik Lee, M.D., Hoon Jai Chun, M.D., Soon Ho Um, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D., Ho Sang Ryu, M.D. and Jin Hai Hyun, M.D.
Korean J Gastrointest Endosc 2004;28(6):326-331.   Published online June 30, 2004
AbstractAbstract PDF
Ulcerative colitis is a chronic inflammatory bowel disease and may have many intestinal and extraintestinal complications. Compared with general population, patients with longstanding ulcerative colitis have an increased risk of colorectal cancer. Patients with ulcerative colitis have an increased frequency of thromboembolism too. However, hepatic vein thrombosis is a very rare extraintestinal complication. This is the first reported case of a young patient with ulcerative colitis who developed synchronous colonic neoplasm and chronic Budd-Chiari syndrome manifested as esophageal variceal bleeding. We report a case of ulcerative colitis complicated by Budd-Chiari syndrome and colon cancer in a 28-year-old female. (Korean J Gastrointest Endosc 2004;28:326⁣331)
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