Clinical Endoscopy

Original Articles

The comparative study of Stretta radiofrequency and anti-reflux mucosectomy in the management of intractable gastroesophageal reflux disease: a single-center retrospective study from Korea: Ah Young Lee, Ji Woo Choi, Jeong Haeng Heo, Jun Young Chung, Seong Hwan Kim, Joo Young Cho; Received June 24, 2024 Accepted September 6, 2024 Published online May 7, 2025; DOI: https://doi.org/10.5946/ce.2024.163 [Epub ahead of print]

Abstract PDF PubReader ePub: Background
/Aims: Chronic gastroesophageal reflux disease (GERD) requires symptom relief and treatment of associated conditions. In this study, we aimed to compare anti-reflux mucosectomy (ARMS) and Stretta radiofrequency (SRF) for treating patients with chronic GERD who are unresponsive to proton pump inhibitors (PPIs) and to identify the indications for each procedure.
Methods
Data of patients who underwent ARMS or SRF between March 2021 and April 2023 were analyzed. Changes in GERD questionnaire (GERDQ) scores, endoscopic Los Angeles (LA) grade, flap valve grade (FVG) based on Hill’s type, EndoFLIP distensibility index (DI), endoscopic Barrett’s epithelium (BE) resolution rate, and PPI withdrawal rate were compared between the two groups.
Results
Improvements in the GERDQ scores and PPI withdrawal rates were similar between the groups. The ARMS group showed significantly better changes in endoscopic LA grade, FVG, and EndoFLIP DI than the SRF group. The complications were more prevalent in the ARMS group than in the SRF group.
Conclusions
The change in endoscopic LA grade before and after the procedure was significantly higher in the ARMS group than in the SRF group. Significant improvements in endoscopic FVG, BE resolution, and EndoFLIP DI were observed only with the ARMS group.

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Factors influencing lateral margin diagnosis challenges in Barrett’s esophageal cancer: a bicenter retrospective study in Japan: Ippei Tanaka, Shuhei Unno, Kazuki Yamamoto, Yoshitaka Nawata, Kimihiro Igarashi, Tomoki Matsuda, Dai Hirasawa; Clin Endosc 2025;58(1):85-93. Published online November 11, 2024; DOI: https://doi.org/10.5946/ce.2024.068

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: We aimed to clarify the clinicopathological characteristics and causes of Barrett’s esophageal adenocarcinoma (BEA) with unclear demarcation.
Methods
We reviewed BEA cases between January 2010 and August 2022. The lesions were classified into the following two groups: clear demarcation (CD group) and unclear demarcation (UD group). We compared the clinicopathological findings between the two groups. Furthermore, we measured the length and width of the foveolar structures, as well as the width of marginal crypt epithelium (MCE).
Results
We analyzed data from 68 patients with BEA, including 47 and 21 in the CD and UD groups, respectively. Multivariate analysis revealed long-segment Barrett’s esophagus (LSBE) as the sole significant risk factor for BEA (odds ratio, 12.17; 95% confidence interval, 2.84–47.6; p=0.001). Regarding pathological analysis, significant differences were observed in the length and width of the foveolar structure between cancerous and surrounding mucosa in the CD group (p=0.03 and p=0.00, respectively); however, no significant difference was observed in the UD group (p=0.53 and p=0.72, respectively). Nevertheless, the width of MCE in the cancerous area was significantly shorter than that in the surrounding mucosa in both groups (p<0.05, and p<0.05, respectively).
Conclusions
LSBE is a significant risk factor for BEA in the UD group. The width of MCE may be an important factor in the endoscopic diagnosis of BEA.

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Reviews

Surveillance for metachronous cancers after endoscopic resection of esophageal squamous cell carcinoma: Ryu Ishihara; Clin Endosc 2024;57(5):559-570. Published online May 10, 2024; DOI: https://doi.org/10.5946/ce.2023.263

Abstract PDF PubReader ePub

The literature pertaining to surveillance following treatment for esophageal squamous cell carcinoma (SCC) was reviewed and summarized, encompassing the current status and future perspectives. Analysis of the standardized mortality and incidence ratios for these cancers indicates an elevated risk of cancer in the oral cavity, pharynx, larynx, and lungs among patients with esophageal SCC compared to the general population. To enhance the efficacy of surveillance for these metachronous cancers, risk stratification is needed. Various factors, including multiple Lugol-voiding lesions, multiple foci of dilated vascular areas, young age, and high mean corpuscular volume, have been identified as predictors of metachronous SCCs. Current practice involves stratifying the risk of metachronous esophageal and head/neck SCCs based on the presence of multiple Lugol-voiding lesions. Endoscopic surveillance, scheduled 6–12 months post-endoscopic resection, has demonstrated effectiveness, with over 90% of metachronous esophageal SCCs treatable through minimally invasive modalities. Narrow-band imaging emerges as the preferred surveillance method for esophageal and head/neck SCC based on comparative studies of various imaging techniques. Innovative approaches, such as artificial intelligence-assisted detection systems and radiofrequency ablation of high-risk background mucosa, may improve outcomes in patients following endoscopic resection.

Citations

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Feasibility and safety of endoscopic submucosal dissection for superficial cancer of the remnant esophagus after esophagectomy
Yoshiki Tsujii, Yoshito Hayashi, Ryotaro Uema, Hirotsugu Saiki, Eiji Kimura, Kentaro Nakagawa, Hiromu Fukuda, Ayaka Tajiri, Yujiro Adachi, Takeo Yoshihara, Takanori Inoue, Minoru Kato, Shunsuke Yoshii, Motoyuki Suzuki, Tomoki Makino, Tetsuo Takehara
Esophagus.2025; 22(2): 148. CrossRef
Post-endoscopy esophageal squamous cell carcinoma with invasion of the muscularis mucosa or deeper detected in surveillance endoscopy after esophageal endoscopic resection
Daiki Kitagawa, Ryu Ishihara, Shunsuke Yoshii, Yuya Asada, Tomoya Ueda, Atsuko Kizawa, Takehiro Ninomiya, Yuki Okubo, Yushi Kawakami, Yasuhiro Tani, Minoru Kato, Satoki Shichijo, Takashi Kanesaka, Sachiko Yamamoto, Yoji Takeuchi, Koji Higashino, Noriya Ue
Esophagus.2025;[Epub] CrossRef
Navigating the Treatment Landscape for Widespread Superficial Esophageal Squamous Cell Neoplasia
Moon Won Lee, Gwang Ha Kim
Gut and Liver.2025; 19(3): 305. CrossRef

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Advanced endoscopic imaging for detection of Barrett’s esophagus: Netanel Zilberstein, Michelle Godbee, Neal A. Mehta, Irving Waxman; Clin Endosc 2024;57(1):1-10. Published online January 5, 2024; DOI: https://doi.org/10.5946/ce.2023.031

Abstract PDF PubReader ePub

Barrett’s esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC), and is caused by chronic gastroesophageal reflux. BE can progress over time from metaplasia to dysplasia, and eventually to EAC. EAC is associated with a poor prognosis, often due to advanced disease at the time of diagnosis. However, if BE is diagnosed early, pharmacologic and endoscopic treatments can prevent progression to EAC. The current standard of care for BE surveillance utilizes the Seattle protocol. Unfortunately, a sizable proportion of early EAC and BE-related high-grade dysplasia (HGD) are missed due to poor adherence to the Seattle protocol and sampling errors. New modalities using artificial intelligence (AI) have been proposed to improve the detection of early EAC and BE-related HGD. This review will focus on AI technology and its application to various endoscopic modalities such as high-definition white light endoscopy, narrow-band imaging, and volumetric laser endomicroscopy.

Citations

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Gender disparities and woman-specific trends in Barrett’s esophagus in the United States: An 11-year nationwide population-based study
Karina Fatakhova, Faisal Inayat, Hassam Ali, Pratik Patel, Attiq Ur Rehman, Arslan Afzal, Muhammad Sarfraz, Shiza Sarfraz, Gul Nawaz, Ahtshamullah Chaudhry, Rubaid Dhillon, Arthur Dilibe, Benjamin Glazebnik, Lindsey Jones, Emily Glazer
World Journal of Methodology.2025;[Epub] CrossRef
Image-enhanced endoscopy in upper gastrointestinal disease: focusing on texture and color enhancement imaging and red dichromatic imaging
Jae Yong Park
Clinical Endoscopy.2025; 58(2): 163. CrossRef
Advancements in Barrett's esophagus detection: The role of artificial intelligence and its implications
Sara Massironi
World Journal of Gastroenterology.2024; 30(11): 1494. CrossRef
Advanced Esophageal Endoscopy
Kyoungwon Jung, Rebecca M. Haug, Andrew Y. Wang
Gastroenterology Clinics of North America.2024; 53(4): 603. CrossRef

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Role of endoscopy in gastroesophageal reflux disease: Daniel Martin Simadibrata, Elvira Lesmana, Ronnie Fass; Clin Endosc 2023;56(6):681-692. Published online October 12, 2023; DOI: https://doi.org/10.5946/ce.2023.182

Abstract PDF PubReader ePub

In general, gastroesophageal reflux disease (GERD) is diagnosed clinically based on typical symptoms and/or response to proton pump inhibitor treatment. Upper gastrointestinal endoscopy is reserved for patients presenting with alarm symptoms, such as dysphagia, odynophagia, significant weight loss, gastrointestinal bleeding, or anorexia; those who meet the criteria for Barrett’s esophagus screening; those who report a lack or partial response to proton pump inhibitor treatment; and those with prior endoscopic or surgical anti-reflux interventions. Newer endoscopic techniques are primarily used to increase diagnostic yield and provide an alternative to medical or surgical treatment for GERD. The available endoscopic modalities for the diagnosis of GERD include conventional endoscopy with white-light imaging, high-resolution and high-magnification endoscopy, chromoendoscopy, image-enhanced endoscopy (narrow-band imaging, I- SCAN, flexible spectral imaging color enhancement, blue laser imaging, and linked color imaging), and confocal laser endomicroscopy. Endoscopic techniques for treating GERD include esophageal radiofrequency energy delivery/Stretta procedure, transoral incisionless fundoplication, and endoscopic full-thickness plication. Other novel techniques include anti-reflux mucosectomy, peroral endoscopic cardiac constriction, endoscopic submucosal dissection, and endoscopic band ligation. Currently, many of the new endoscopic techniques are not widely available, and their use is limited to centers of excellence.

Citations

Citations to this article as recorded by

Exploring esophagogastric junction morphology and contractile integral: implications for refractory gastroesophageal reflux disease pathophysiology
Sihui Lin, Zhilong Chen, Wei Jiang, Yucheng Zhu
Scandinavian Journal of Gastroenterology.2025; 60(2): 130. CrossRef
Patients Presenting With Reflux Symptoms - Whom to Test and Whom to Treat?
Noy Lapidot Alon, Tomas Navarro Rodriguez, Ronnie Fass
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2025; 25(1): 7. CrossRef
'Unmasking Endoscopic Patterns in PPI-Refractory GERD: Insights into Findings and Risk Factors'
A Samad
Endoscopy.2025; 57(S 02): S335. CrossRef
Potassium-competitive Acid Blockers for Treatment of Extraesophageal Symptoms and Signs
Gwang Ha Kim, Ronnie Fass
Journal of Neurogastroenterology and Motility.2025; 31(2): 170. CrossRef
ESÔFAGO DE BARRETT: UMA REVISÃO BIBLIOGRÁFICA
Marcelo Vinícius Pereira Silva, Elaine Timm, Allan Martins De Oliveira, Elizeu Augusto De Freitas Junior , Marlison Caldas Gonçalves Pereira
Brazilian Medical Students.2025;[Epub] CrossRef
Better diagnostic accuracy for GERD observed with the new MNBI cutoff: an observational study in Vietnam
Hang Dao Viet, Hue Luu Thi Minh, Long Hoang Bao, Phuong Do Nhat, Long Dao Van
BMC Gastroenterology.2025;[Epub] CrossRef
Long-term efficacy of endoscopic radiofrequency Stretta therapy for patients with refractory gastroesophageal reflux disease
Sung Eun Kim
Clinical Endoscopy.2024; 57(1): 48. CrossRef
Correlation of Endoscopic and Histopathological Diagnoses in Upper Gastrointestinal Tract Lesions: A Cross-Sectional Study
Sudhasmita Rauta, Pratima Baisakh, Aswini K Sahoo, Dhiren K Panda, Manas R Baisakh, Sushree s Dash
Cureus.2024;[Epub] CrossRef
The role of ghrelin and leptin in the formation of morphological changes esophagus of patients with gastro-esophageal reflux disease against type 2 diabetes
Olha Bondar-Keleberda
EUREKA: Health Sciences.2023; (4): 24. CrossRef

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Original Article

Self-expandable metallic stent-induced esophagorespiratory fistulas in patients with advanced esophageal cancer: Iatagan R. Josino, Bruno C. Martins, Andressa A. Machado, Gustavo R. de A. Lima, Martin A. C. Cordero, Amanda A. M. Pombo, Rubens A. A. Sallum, Ulysses Ribeiro Jr, Todd H. Baron, Fauze Maluf-Filho; Clin Endosc 2023;56(6):761-768. Published online July 25, 2023; DOI: https://doi.org/10.5946/ce.2022.297

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: Self-expandable metallic stents (SEMSs) are widely adopted for the palliation of dysphagia in patients with malignant esophageal strictures. An important adverse event is the development of SEMS-induced esophagorespiratory fistulas (SEMS-ERFs). This study aimed to assess the risk factors related to the development of SEMS-ERF after SEMS placement in patients with esophageal cancer.
Methods
This retrospective study was performed at the Instituto do Cancer do Estado de São Paulo. All patients with malignant esophageal strictures who underwent esophageal SEMS placement between 2009 and 2019 were included in the study.
Results
Of the 335 patients, 37 (11.0%) developed SEMS-ERF, with a median time of 129 days after SEMS placement. Stent flare of 28 mm (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.15–5.51; p=0.02) and post-stent chemotherapy (HR, 2.0; 95% CI, 1.01–4.00; p=0.05) were associated with an increased risk of developing SEMS-ERF, while lower-third tumors were a protective factor (HR, 0.5; 95% CI, 0.26–0.85; p=0.01). No difference was observed in overall survival.
Conclusions
The incidence of SEMS-ERFs was 11%, with a median time of 129 days after SEMS placement. Post-stent chemotherapy and a 28 mm stent flare were associated with a higher risk of SEMS-ERF.

Citations

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Clinical Implications of Circulating Tumor Cells in Patients with Esophageal Squamous Cell Carcinoma: Cancer-Draining Blood Versus Peripheral Blood
Dong Chan Joo, Gwang Ha Kim, Hoseok I, Su Jin Park, Moon Won Lee, Bong Eun Lee
Cancers.2024; 16(16): 2921. CrossRef
How to reduce fistula formation after self-expandable metallic stent insertion for treating malignant esophageal stricture?
Kwang Bum Cho
Clinical Endoscopy.2023; 56(6): 735. CrossRef

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Reviews

Complications of endoscopic resection in the upper gastrointestinal tract: Takeshi Uozumi, Seiichiro Abe, Mai Ego Makiguchi, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Yutaka Saito; Clin Endosc 2023;56(4):409-422. Published online June 21, 2023; DOI: https://doi.org/10.5946/ce.2023.024

Abstract PDF PubReader ePub

Endoscopic resection (ER) is widely utilized as a minimally invasive treatment for upper gastrointestinal tumors; however, complications could occur during and after the procedure. Post-ER mucosal defect leads to delayed perforation and bleeding; therefore, endoscopic closure methods (endoscopic hand-suturing, the endoloop and endoclip closure method, and over-the-scope clip method) and tissue shielding methods (polyglycolic acid sheets and fibrin glue) are developed to prevent these complications. During duodenal ER, complete closure of the mucosal defect significantly reduces delayed bleeding and should be performed. An extensive mucosal defect that comprises three-quarters of the circumference in the esophagus, gastric antrum, or cardia is a significant risk factor for post-ER stricture. Steroid therapy is considered the first-line option for the prevention of esophageal stricture, but its efficacy for gastric stricture remains unclear. Methods for the prevention and management of ER-related complications in the esophagus, stomach, and duodenum differ according to the organ; therefore, endoscopists should be familiar with ways of preventing and managing organ-specific complications.

Citations

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The Current Landscape of Endoscopic Submucosal Training in the United States
Mike T. Wei, Shai Friedland, Joo Ha Hwang
Current Gastroenterology Reports.2025;[Epub] CrossRef
Gastric polyps are not created equal: Know your enemy
Fady Daniel
World Journal of Gastroenterology.2025;[Epub] CrossRef
Endoscopic Resection for Superficial Non-Ampullary Duodenal Epithelial Tumors
Hye Kyung Jeon, Gwang Ha Kim
Gut and Liver.2025; 19(1): 19. CrossRef
Diagnosis and treatment of three synchronous early squamous cell carcinomas of the esophagus: case report
A.A. Paratovskaya, M.Yu. Agapov, N.A. Belinskaya, T.F. Savostyanov, E.E. Topuzov
Russian Journal of Evidence-Based Gastroenterology.2025; 14(1): 104. CrossRef
International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Clinical Endoscopy.2024; 57(2): 141. CrossRef
Risk factors for intraoperative and delayed perforation related with gastric endoscopic submucosal dissection
Takuya Mimura, Yoshinobu Yamamoto, Haruhisa Suzuki, Kohei Takizawa, Toshiaki Hirasawa, Yoji Takeuchi, Kenji Ishido, Shu Hoteya, Tomonori Yano, Shinji Tanaka, Norihiko Kudara, Masahiro Nakagawa, Yumi Mashimo, Masahiro Ishigooka, Kazutoshi Fukase, Taichi Sh
Journal of Gastroenterology and Hepatology.2024; 39(7): 1358. CrossRef
IDEN Consensus on Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
The Korean Journal of Gastroenterology.2024; 83(6): 217. CrossRef
International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
Gut and Liver.2024; 18(5): 764. CrossRef
Endoscopic submucosal dissection for early gastric cancer: It is time to consider the quality of its outcomes
Gwang Ha Kim
World Journal of Gastroenterology.2023; 29(43): 5800. CrossRef

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Role of endoscopy in patients with achalasia: So Young Han, Young Hoon Youn; Clin Endosc 2023;56(5):537-545. Published online June 2, 2023; DOI: https://doi.org/10.5946/ce.2023.001

Abstract PDF PubReader ePub

Achalasia is an esophageal motility disorder characterized by impaired lower esophageal sphincter relaxation and peristalsis of the esophageal body. With the increasing prevalence of achalasia, interest in the role of endoscopy in its diagnosis, treatment, and monitoring is also growing. The major diagnostic modalities for achalasia include high-resolution manometry, esophagogastroduodenoscopy, and barium esophagography. Endoscopic assessment is important for early diagnosis to rule out diseases that mimic achalasia symptoms, such as pseudo-achalasia, esophageal cancer, esophageal webs, and eosinophilic esophagitis. The major endoscopic characteristics suggestive of achalasia include a widened esophageal lumen and food residue in the esophagus. Once diagnosed, achalasia can be treated either endoscopically or surgically. The preference for endoscopic treatment is increasing owing to its minimal invasiveness. Botulinum toxins, pneumatic balloon dilation, and peroral endoscopic myotomy (POEM) are important endoscopic treatments. Previous studies have demonstrated excellent treatment outcomes for POEM, with >95% improvement in dysphagia, making POEM the mainstay treatment option for achalasia. Several studies have reported an increased risk of esophageal cancer in patients with achalasia. However, routine endoscopic surveillance remains controversial owing to the lack of sufficient data. Further studies on surveillance methods and duration are warranted to establish concordant guidelines for the endoscopic surveillance of achalasia.

Citations

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O papel da endoscopia no diagnóstico e tratamento de Acalasia
Rebeca Silva Moreira da Fraga, José Joaquim de Almeida Figueiredo, Thaisa de Moraes Ribeiro Espírito Santo, Esteban Sadovsky
Revista Brasileira de Pesquisa em Saúde/Brazilian Journal of Health Research.2025; 26(supl_3): 107. CrossRef
Effect of sex on the outcomes of peroral endoscopic myotomy for the treatment of achalasia
Chen-Yi Zhao, Ning Xu, Hao Dong, Ning-Li Chai, En-Qiang Linghu
World Journal of Gastroenterology.2025;[Epub] CrossRef
The role of cap-assisted endoscopy and its future implications
Sol Kim, Bo-In Lee
Clinical Endoscopy.2024; 57(3): 293. CrossRef
Never judge a book by its cover: the role of timed barium esophagography in patients with complete symptom relief after peroral endoscopic myotomy
Tae Hee Lee
Clinical Endoscopy.2024; 57(5): 604. CrossRef
Advanced Esophageal Endoscopy
Kyoungwon Jung, Rebecca M. Haug, Andrew Y. Wang
Gastroenterology Clinics of North America.2024; 53(4): 603. CrossRef
Case of Concomitant Endoscopic Treatment of Achalasia with Superficial Esophageal Cancer
Myung-Hun Lee, Kyoungwon Jung, Jae Hyun Kim, Sung Eun Kim, Won Moon, Moo In Park, Seun Ja Park
The Korean Journal of Gastroenterology.2023; 82(5): 248. CrossRef

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Original Articles

Management of esophageal neoplasms by endoscopic submucosal dissection: experience over 100 consecutive procedures: Josué Aliaga Ramos, Yoshinori Morita, Takashi Toyonaga, Danilo Carvalho, Moises Salgado Pedrosa, Vitor N. Arantes; Clin Endosc 2023;56(5):613-622. Published online May 17, 2023; DOI: https://doi.org/10.5946/ce.2022.245

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Endoscopic submucosal dissection (ESD) is currently considered the first-line treatment for the eradication of superficial neoplasms of the esophagus in Eastern countries. However, in the West, particularly in Latin America, the experience with esophageal ESD is still limited because of the high technical complexity required for its execution. This study aimed to present the results of the clinical application of ESD to manage superficial esophageal neoplasms in a Latin American center in over 100 consecutive cases.
Methods
This retrospective study included consecutive patients who underwent endoscopic ESD for superficial esophageal neoplasms between 2009 and 2022. The following clinical outcomes were assessed: en bloc, complete, and curative resection rates, local recurrence, adverse events, and procedure-related mortality.
Results
Esophageal ESD was performed mainly for squamous cell carcinoma (66.6%), high-grade intraepithelial neoplasia (17.1%), and adenocarcinoma (11.4%). En bloc and complete resection rates were 96.2% and 81.0%, respectively. The curative resection rate was 64.8%. Adverse events occurred in six cases (5.7%). Endoscopic follow-up was performed for an average period of 29.7 months.
Conclusions
ESD performed by trained operators is feasible, safe, and clinically effective for managing superficial neoplastic lesions of the esophagus in Latin America.

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Endoscopic radiofrequency Stretta therapy reduces proton pump inhibitor dependency and the need for anti-reflux surgery for refractory gastroesophageal reflux disease: Abraham Joel, Alakh Konjengbam, Yirupaiahgari Viswanath, Georgios Kourounis, Emily Hammond, Helen Frank, Shivani Kuttuva, Simon Mbarushimana, Hena Hidayat, Srivishnu Thulasiraman; Clin Endosc 2024;57(1):58-64. Published online May 2, 2023; DOI: https://doi.org/10.5946/ce.2023.026

Graphical Abstract Abstract PDF PubReader ePub

Background
/Aims: Radiofrequency treatment of the gastroesophageal junction using the Stretta procedure for treating gastroesophageal reflux disease (GERD) is observed to improve the symptoms and proton pump inhibitor (PPI) dependence and reduce the need for anti-reflux operations. As one of the largest studies in Europe, we evaluated the clinical outcomes of Stretta in patients with medically refractory GERD.
Methods
A tertiary UK center evaluated all patients with refractory GERD who underwent Stretta between 2014 and 2022. Patients and primary care professionals were contacted to obtain information regarding the initiation of PPI and reintervention after Stretta.
Results
Of the 195 patients (median age, 55 years; 116 women [59.5%]) who underwent Stretta, PPI-free period (PFP) data were available for 144 (73.8%) patients. Overall, 66 patients (45.8%) did not receive PPI after a median follow-up of 55 months. Six patients (3.1%) underwent further interventions. The median PFP after Stretta was 41 months. There was a significant negative correlation between PFP and age (p=0.007), with no differences between sexes (p=0.96). Patients younger than 55 years of age had a longer PFP than their older counterparts (p=0.005). Younger males had a significantly longer PFP than older males (p=0.021). However, this was not observed in the female cohort (p=0.09) or between the younger men and women (p=0.66).
Conclusions
Our findings suggest that Stretta is a safe and feasible option for treating refractory GERD, especially in younger patients. It prevents further anti-reflux interventions in most patients and increases the lead-time to surgery in patients with refractory GERD.

Citations

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Efficacy of endoscopic radiofrequency ablation for proton pump inhibitor‐dependent gastroesophageal reflux disease: Multicenter prospective cohort study
Yuanxi Jiang, Zhiyu Dong, Ying Chen, Huihui Sun, Junwen Wang, Zhenxiang Wang, Qianqian Meng, Han Lin, Qingwei Zhang, Shengliang Chen, Zhizheng Ge, Luowei Wang, Shuchang Xu
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Clinicians should be aware of proton pump inhibitor–related changes in the gastric mucosa
Gwang Ha Kim
Clinical Endoscopy.2024; 57(1): 51. CrossRef
Long-term efficacy of endoscopic radiofrequency Stretta therapy for patients with refractory gastroesophageal reflux disease
Sung Eun Kim
Clinical Endoscopy.2024; 57(1): 48. CrossRef
Efficacy and safety of antireflux mucosectomy versus radiofrequency ablation of the lower esophageal sphincter for the treatment of GERD: a systematic review and meta-analysis
Cristian A. Angeramo, Mateo Lendoire, Fernando A.M. Herbella, Francisco Schlottmann
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
Chronic cough and refractory chronic cough: An important distinction
Peter V. Dicpinigaitis
Journal of Precision Respiratory Medicine.2023; 6(1): 10. CrossRef

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Endoscopic submucosal dissection for superficial esophageal squamous cell carcinoma: long-term follow-up in a Western center: Andreas Probst, Alanna Ebigbo, Stefan Eser, Carola Fleischmann, Tina Schaller, Bruno Märkl, Stefan Schiele, Bernd Geissler, Gernot Müller, Helmut Messmann; Clin Endosc 2023;56(1):55-64. Published online January 13, 2023; DOI: https://doi.org/10.5946/ce.2022.093

Abstract PDF PubReader ePub

Background
/Aims: Endoscopic submucosal dissection (ESD) has been established as a treatment modality for superficial esophageal squamous cell carcinoma (ESCC). Long-term follow-up data are lacking in Western countries. The aim of this study was to analyze long-term survival in a Western center.
Methods
Patients undergoing ESD for ESCC were included. The analysis was performed retrospectively using a prospectively collected database.
Results
R0 resection rate was 96.7% (59/61 lesions in 58 patients). Twenty-seven patients (46.6%) fulfilled the curative resection criteria (M1/M2) (group A), 11 patients (19.0%) had M3 lesions without lymphovascular invasion (LVI) (group B), and 20 patients (34.5%) had lesions with submucosal invasion or LVI (group C). Additional treatment was recommended after non-curative resection. It was not performed in 20/31 patients (64.5%), mainly because of comorbidities (75%). Twenty-nine out of 58 (50.0%) patients died during a mean follow-up of 3.7 years. Death was related to ESCC in 17.2% (5/29) of patients. The disease-specific survival rate after curative resection was 100%. Overall survival rates after 5 years were 61.5%, 63.6% and 28.1% for groups A, B, and C, respectively. The overall survival was significantly worse after non-curative resection (p=0.038).
Conclusions
Non-curative resection is frequent after ESD for ESCC in Western patients. The long-term prognosis is limited and mainly determined by comorbidity. Early diagnosis and pre-interventional assessments need to be improved.

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Endoscopic resection of early esophageal neoplasia in patients with esophageal varices: a systematic review
Charlotte N. Frederiks, Laura S. Boer, Bas Gloudemans, Lorenza Alvarez Herrero, Jacques J.G.H.M. Bergman, Roos E. Pouw, Bas L.A.M. Weusten
Endoscopy.2025;[Epub] CrossRef
Non-Curative Endoscopic Submucosal Dissection: Current Concepts, Pitfalls and Future Perspectives
João Santos-Antunes
Journal of Clinical Medicine.2025; 14(7): 2488. CrossRef
Endoscopic submucosal dissection for early esophageal squamous cell carcinoma: long-term results from a Western cohort
Ilse N. Beaufort, Charlotte N. Frederiks, Anouk Overwater, Lodewijk A.A. Brosens, Arjun D. Koch, Roos E. Pouw, Jacques J.G.H.M. Bergman, Bas L.A.M. Weusten
Endoscopy.2024; 56(05): 325. CrossRef
Long-Term Outcomes of Esophageal Squamous Neoplasia with Muscularis Mucosa Involvement after Endoscopic Submucosal Dissection
Chen-Huan Yu, Yueh-Hung Chou, Tze-Yu Shieh, Chao-Yu Liu, Jiann-Ming Wu, Chen-Hsi Hsieh, Tzong-Hsi Lee, Chen-Shuan Chung
Biomedicines.2024; 12(8): 1660. CrossRef
Endoscopic Submucosal Dissection for Esophageal Cancer: Current and Future
Yuki Okubo, Ryu Ishihara
Life.2023; 13(4): 892. CrossRef

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Safe implementation of transoral incisionless fundoplication as a new technique in a tertiary care center: Shivanand Bomman, Sofya Malashanka, Adil Ghafoor, David J. Sanders, Shayan Irani, Richard A. Kozarek, Andrew Ross, Michal Hubka, Rajesh Krishnamoorthi; Clin Endosc 2022;55(5):630-636. Published online August 17, 2022; DOI: https://doi.org/10.5946/ce.2022.003

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Background
/Aims: Transoral incisionless fundoplication (TIF) is an accepted anatomic treatment for gastroesophageal reflux disease in selected patients. In this report, we analyze our institution’s programmatic allocation of resources during the safe implementation of TIF as a new procedure.
Methods
A retrospective analysis of all patients who underwent TIF from January 2020 to February 2021 at our institution was performed. The process of initially allocating the operating room (OR) with overnight admission and postoperative esophagram for added safety, and subsequently transitioning TIF to the endoscopy suite (ES) as an outpatient procedure was described. Patient safety and outcomes were evaluated during transition.
Results
Thirty patients who underwent TIF were identified. The mean age was 51.2±16.0 years. TIF was performed in an OR in nine patients (30%) and 21 (70%) in the ES. All the OR patients were admitted overnight and had routine EG. In contrast, four (19%) from the ES group required clinically-indicated admission and three (14.2%) required esophagram. The mean procedure duration was significantly lower in the ES group (65.7 min vs. 84 min, p=0.02).
Conclusions
A stepwise, resource-efficient process was described that allowed safe initiation of TIF as a new technique and its effective transition to a fully outpatient procedure.

Citations

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Gastroesophageal reflux disease in children: What’s new right now?
Palittiya Sintusek, Mohamed Mutalib, Nikhil Thapar
World Journal of Gastrointestinal Endoscopy.2023; 15(3): 84. CrossRef
Assessing implementation strategy and learning curve for transoral incisionless fundoplication as a new technique
Muhammad Haseeb, Christopher C. Thompson
Clinical Endoscopy.2022; 55(6): 751. CrossRef

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Intralesional steroid infusion using a spray tube to prevent stenosis after endoscopic submucosal dissection of esophageal cancer: Atsushi Goto, Takeshi Okamoto, Ryo Ogawa, Kouichi Hamabe, Shinichi Hashimoto, Jun Nishikawa, Taro Takami; Clin Endosc 2022;55(4):520-524. Published online July 28, 2022; DOI: https://doi.org/10.5946/ce.2021.262

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Intralesional steroid injections have been administered as prophylaxis for stenosis after esophageal endoscopic submucosal dissection. However, this method carries a risk of potential complications such as perforation because a fine needle is used to directly puncture the postoperative ulcer. We devised a new method of steroid intralesional infusion using a spray tube and evaluated its efficacy and safety.
Methods
Intralesional steroid infusion using a spray tube was performed on 27 patients who underwent endoscopic submucosal dissection for superficial esophageal cancer with three-quarters or more of the lumen circumference resected. The presence or absence of stenosis, complications, and the number of endoscopic balloon dilations (EBDs) performed were evaluated after treatment.
Results
Although stenosis was not observed in 22 of the 27 patients, five patients had stenosis and dysphagia requiring EBD. The stenosis in these five patients was relieved after four EBDs. No complications related to intralesional steroid infusion using the spray tube were observed.
Conclusions
Intralesional steroid infusion using a spray tube is a simple and safe technique that is adequately effective in preventing stenosis Clinical trial number (UMIN000037567).

Citations

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Effectiveness of glucocorticoids in preventing esophageal stricture and predictors of stricture after esophageal ESD: 5 years of experience in a single medical center
Qingxia Wang, Yuan Ding, Qiliu Qian, Yinnan Zhu, Ruihua Shi
Frontiers in Medicine.2025;[Epub] CrossRef
Predictors of stricture after endoscopic submucosal dissection of the esophagus and steroids application
Qing-Xia Wang, Yuan Ding, Qi-Liu Qian, Yin-Nan Zhu, Rui-Hua Shi
World Journal of Gastrointestinal Endoscopy.2024; 16(9): 509. CrossRef
Development of applicator to deliver hydrogel precursor powder for esophageal stricture prevention after endoscopic submucosal dissection
Takeshi Fujiyabu, Pan Qi, Kenichi Yoshie, Ayano Fujisawa, Yosuke Tsuji, Arvind Kumar Singh Chandel, Athira Sreedevi Madhavikutty, Natsuko F. Inagaki, Seiichi Ohta, Mitsuhiro Fujishiro, Taichi Ito
Chemical Engineering Journal.2024; 500: 156742. CrossRef

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Outcomes of endoscopic submucosal dissection for superficial esophageal neoplasms in patients with liver cirrhosis: Young Kwon Choi, Jin Hee Noh, Do Hoon Kim, Hee Kyong Na, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung; Clin Endosc 2022;55(3):381-389. Published online April 20, 2022; DOI: https://doi.org/10.5946/ce.2021.242

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: The treatment of superficial esophageal neoplasms (SENs) in cirrhotic patients is challenging and rarely investigated. We evaluated the outcomes of endoscopic submucosal dissection (ESD) to determine the efficacy and safety of treating SENs in patients with liver cirrhosis.
Methods
The baseline characteristics and treatment outcomes of patients who underwent ESD for SENs between November 2005 and December 2017 were retrospectively reviewed.
Results
ESD was performed in 437 patients with 481 SENs, including 15 cirrhotic patients with 17 SENs. En bloc resection (88.2% vs. 97.0%) and curative resection (64.7% vs. 78.9%) rates were not different between the cirrhosis and non-cirrhosis groups (p=0.105 and p=0.224, respectively). Bleeding was more common in cirrhotic patients (p=0.054), and all cases were successfully controlled endoscopically. The median procedure and hospitalization duration did not differ between the groups. Overall survival was lower in cirrhotic patients (p=0.003), while disease-specific survival did not differ between the groups (p=0.85).
Conclusions
ESD could be a safe and effective treatment option for SENs in patients with cirrhosis. Detailed preprocedural assessments are needed, including determination of liver function, esophageal varix status, and remaining life expectancy, to identify patients who will obtain the greatest benefit.

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Endoscopic resection of early esophageal neoplasia in patients with esophageal varices: a systematic review
Charlotte N. Frederiks, Laura S. Boer, Bas Gloudemans, Lorenza Alvarez Herrero, Jacques J.G.H.M. Bergman, Roos E. Pouw, Bas L.A.M. Weusten
Endoscopy.2025;[Epub] CrossRef
Clinical outcomes of endoscopic submucosal dissection for esophageal squamous cell carcinoma with esophageal varices: Multicenter retrospective study
Yosuke Toya, Waku Hatta, Tomohiro Shimada, Tamotsu Matsuhashi, Takeharu Shiroki, Yu Sasaki, Tetsuya Tatsuta, Jun Nakamura, Norihiro Hanabata, Yohei Horikawa, Ko Nagino, Tomoyuki Koike, Atsushi Masamune, Yoshihiro Harada, Tetsuya Ohira, Katsunori Iijima, Y
Digestive Endoscopy.2024; 36(3): 314. CrossRef
Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasia in close proximity to esophageal varices: a multicenter international experience
Shruti Mony, Bing Hu, Abel Joseph, Hiroyuki Aihara, Lorenzo Ferri, Amit Bhatt, Amit Mehta, Peng-Sheng Ting, Alex Chen, Andrew Kalra, Jad Farha, Manabu Onimaru, Long He, Qi Luo, Andrew Y. Wang, Haruhiro Inoue, Saowanee Ngamruengphong
Endoscopy.2024; 56(02): 119. CrossRef
Risk associated with endoscopic treatment of early upper gastrointestinal cancer in patients with liver cirrhosis and management strategies
Yu-Yong Tan, Yu-Min Qing, Jian Gong, De-Liang Liu
World Chinese Journal of Digestology.2024; 32(2): 102. CrossRef
Radical chemoradiotherapy for superficial esophageal cancer complicated with liver cirrhosis
Hejing Bao, Hehong Bao, Liping Lin, Yuhuan Wang, Longbin Zhang, Li Zhang, Han Zhang, Lingxiang Liu, Xiaolong Cao
PeerJ.2024; 12: e18065. CrossRef
Endoscopic management of early esophageal cancer in patients with concomitant cirrhosis
Linlin Zhu, Zhenming Zhang
Chinese Medical Journal.2024; 137(24): 3142. CrossRef
Endoscopic submucosal dissection for early cancers or precancerous lesions of the upper GI tract in cirrhotic patients with esophagogastric varices: 10-year experience from a large tertiary center in China
Shuai Zhang, Ying-Di Liu, Ning-Li Chai, Yi Yao, Fei Gao, Bo Liu, Zhan-Di He, Lu Bai, Xin Huang, Chao Gao, En-Qiang Linghu, Lian-Yong Li
Gastrointestinal Endoscopy.2023; 97(6): 1031. CrossRef
Endoscopic Submucosal Dissection for Treatment of Early-Stage Cancer or Precancerous Lesion in the Upper Gastrointestinal Tract in Patients with Liver Cirrhosis
Yuyong Tan, Yumin Qing, Deliang Liu, Jian Gong
Journal of Clinical Medicine.2023; 12(20): 6509. CrossRef

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Epidemiology of early esophageal adenocarcinoma: Thuy-Van P. Hang, Zachary Spiritos, Anthony M. Gamboa, Zhengjia Chen, Seth Force, Vaishali Patel, Saurabh Chawla, Steven Keilin, Nabil F. Saba, Bassel El-Rayes, Qiang Cai, Field F. Willingham; Clin Endosc 2022;55(3):372-380. Published online February 11, 2022; DOI: https://doi.org/10.5946/ce.2021.152

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Background
/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma (EAC); however, the epidemiology of early stage disease has not been well defined.
Methods
Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates among major epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according to tumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data were available.
Results
The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annual percent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%–5.56%). The annual percent change appeared to plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of -5.78%.
Conclusions
There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelial malignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients has node negative, potentially resectable early stage disease.

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Focused Review Series: Image-Enhanced Endoscopy: Update on Clinical Practice

Current Status of Image-Enhanced Endoscopy for Early Identification of Esophageal Neoplasms: Shin Hee Kim, Su Jin Hong; Clin Endosc 2021;54(4):464-476. Published online July 26, 2021; DOI: https://doi.org/10.5946/ce.2021.186

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Advanced esophageal cancer is known to have a poor prognosis. The early detection of esophageal neoplasms, including esophageal dysplasia and early esophageal cancer, is highly important for the accurate treatment of the disease. However, esophageal dysplasia and early esophageal cancer are usually subtle and can be easily missed. In addition to the early detection, proper pretreatment evaluation of the depth of invasion of esophageal cancer is very important for curative treatment. The progression of non-invasive diagnosis via image-enhanced endoscopy techniques has been shown to aid the early detection and estimate the depth of invasion of early esophageal cancer and, as a result, may provide additional opportunities for curative treatment. Here, we review the advancement of image-enhanced endoscopy-related technologies and their role in the early identification of esophageal neoplasms.

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Original Articles

Evaluation of Non-invasive Fibrosis Markers in Predicting Esophageal Variceal Bleeding: Sami Cifci, Nergiz Ekmen; Clin Endosc 2021;54(6):857-863. Published online May 26, 2021; DOI: https://doi.org/10.5946/ce.2021.028

Abstract PDF PubReader ePub

Background
/Aims: Esophageal variceal bleeding (EVB) is an important cause of mortality and morbidity in liver cirrhosis. In this study, we aimed to predict the possibility of EVB in patients with cirrhosis using a non-invasive score.
Methods
A total of 359 patients with cirrhosis were divided into two groups based on the presence or absence of EVB. ChildTurcotte-Pugh (CTP) score, a model for end-stage liver disease, aspartate aminotransferase to alanine aminotransferase ratio, aspartate aminotransferase to platelet ratio index (APRI), fibrosis-4-index (FIB-4), aspartate aminotransferase to alanine aminotransferase ratio/platelet ratio index (AARPRI), and S-index were measured for all participants. Receiver operating characteristic curves were obtained for all parameters, and the optimal cut-off value was determined in predicting EVB.
Results
In patients with EVB, the number of platelets (PLT) were low (p<0.001) and APRI, AARPRI, FIB-4, and S-index were significantly higher than those in patients without EBV. APRI, AARPRI, FIB-4, PLT, and S-index were statistically significant predictors of EVB (p<0.05).
Conclusions
FIB-4 and AARPRI, which are non-invasive markers of fibrosis, can be used to predict EVB. In addition, the 66.5 10⁹/L cut-off value for PLT is important for EVB.

Citations

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Prognostic model for esophagogastric variceal rebleeding after endoscopic treatment in liver cirrhosis: A Chinese multicenter study
Jun-Yi Zhan, Jie Chen, Jin-Zhong Yu, Fei-Peng Xu, Fei-Fei Xing, De-Xin Wang, Ming-Yan Yang, Feng Xing, Jian Wang, Yong-Ping Mu
World Journal of Gastroenterology.2025;[Epub] CrossRef
Improving radiomics-based models for esophagogastric variceal bleeding risk prediction in cirrhotic patients
Arunkumar Krishnan
World Journal of Gastroenterology.2025;[Epub] CrossRef
Non-invasive Fibrosis Markers for Predicting Esophageal Varices: A Potential Alternative to Endoscopic Screening
Kunza Ali, Saad Slah-Ud-Din, Mishal Afzal, Mah R Tariq, Tallha Waheed, Haroon Yousuf
Cureus.2024;[Epub] CrossRef
Diagnostic accuracy of shear wave elastography versus laboratory parameters as non-invasive screening tool for esophageal varices
Khaled Mohamed Ali Shehata, Abdul-Allah Ismael Kelany, Salma Mokhtar Osman Hassan, Ramy Mohamed Ahmed, Peter Atef Mounir, Amira Hassan AbdelAziz
The Egyptian Journal of Internal Medicine.2024;[Epub] CrossRef
Assessment of nomogram model for the prediction of esophageal variceal hemorrhage in hepatitis B-induced hepatic cirrhosis
Jing Xu, Lin Tan, Ning Jiang, Fengcheng Li, Jinling Wang, Beibei Wang, Shasha Li
European Journal of Gastroenterology & Hepatology.2024; 36(6): 758. CrossRef
Predicting High-Risk Esophageal Varices in Cirrhosis: A Multi-Parameter Splenic CT Study
Cheng Yan, Chunhua Xia, Qiuting Cao, Jingwen Zhang, Mingzi Gao, Jing Han, Xiaohong Liang, Mingxin Zhang, Lin Wang, Liqin Zhao
Academic Radiology.2024; 31(12): 4866. CrossRef
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Yuki Arita
Academic Radiology.2024; 31(12): 4875. CrossRef
Non-invasive predictors of the first episode of bleeding from esophageal varices in patients with liver cirrhosis awaiting transplantation
V. L. Korobka, Yu. V. Khoronko, V. D. Pasechnikov, R. V. Korobka, M. V. Malevanny, E. S. Pak, D. V. Pasechnikov
Transplantologiya. The Russian Journal of Transplantation.2024; 16(4): 507. CrossRef
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Amine Zoughlami, Jordana Serero, Stephen Congly, Irene Zhao, Julie Zhu, Alnoor Ramji, Curtis Cooper, Philip Wong, Robert Bailey, Carla S Coffin, Giada Sebastiani
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Albumin‑bilirubin grade and INR for the prediction of esophagogastric variceal rebleeding after endoscopic treatment in cirrhosis
Fenghui Li, Tao Wang, Jing Liang, Baoxin Qian, Fei Tang, Yanying Gao, Jiayu Lv
Experimental and Therapeutic Medicine.2023;[Epub] CrossRef
Biochemical markers to predict the development of gastrointestinal bleeding and esophageal varices after portoenterostomy in biliary atresia
Wataru Sumida, Takahisa Tainaka, Chiyoe Shirota, Kazuki Yokota, Satoshi Makita, Masamune Okamoto, Aitaro Takimoto, Akihiro Yasui, Shunya Takada, Yoichi Nakagawa, Daiki Kato, Shinya Yokoyama, Yoji Ishizu, Hizuru Amano, Yaohui Guo, Akinari Hinoki, Hiroo Uch
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Journal of Clinical Medicine.2022; 11(18): 5369. CrossRef

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The Outcome of Endoscopic Radiofrequency Anti-Reflux Therapy (STRETTA) for Gastroesophageal Reflux Disease in Patients with Previous Gastric Surgery: A Prospective Cohort Study: Edward John Nevins, James Edward Dixon, Yirupaiahgari Krishnaiah Setty Viswanath; Clin Endosc 2021;54(4):542-547. Published online March 24, 2021; DOI: https://doi.org/10.5946/ce.2020.243

Abstract PDF PubReader ePub

Background
/Aims: STRETTA improves the quality of life and reduces the need for anti-reflux medication in select patients, especially those with uncomplicated gastroesophageal reflux disease (GERD). We aimed to review the outcomes of STRETTA in patients with medically refractory GERD, who had undergone previous gastric surgery.
Methods
This was a review of a prospective database in a British center. Since 2016, all GERD patients who underwent STRETTA and had a history of previous gastric surgery were studied (n=11). Anti-reflux medication pre- and post-STRETTA was evaluated. The outcomes were assessed objectively by the change in anti-reflux medication and subjectively through a pre- and post-procedure GERD-health-related quality of life (HRQL) questionnaire.
Results
The median length of follow-up was 23 months. Nine patients demonstrated improved GERD-HRQL scores following STRETTA (82%). Of the 7 patients who underwent fundoplication, all reported improved symptoms, with 3 patients discontinuing the medication and 3 patients on a reduced dose of proton pump inhibitor. Four patients underwent surgery other than fundoplication, of which 2 reported improvement and discontinued the proton pump inhibitor. Two patients reported no improvement.
Conclusions
This study demonstrates that STRETTA is successful in reducing refractory GERD in patients with previous gastric surgery. The outcomes were comparable to published outcomes in patients with uncomplicated GERD with no previous history of gastric surgery.

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The Need for Updated Classification of Esophageal Motility Disorders Using High-resolution Impedance Manometry
Sung Eun Kim
Journal of Neurogastroenterology and Motility.2024; 30(1): 1. CrossRef
Endoscopic radiofrequency Stretta therapy reduces proton pump inhibitor dependency and the need for anti-reflux surgery for refractory gastroesophageal reflux disease
Abraham Joel, Alakh Konjengbam, Yirupaiahgari Viswanath, Georgios Kourounis, Emily Hammond, Helen Frank, Shivani Kuttuva, Simon Mbarushimana, Hena Hidayat, Srivishnu Thulasiraman
Clinical Endoscopy.2024; 57(1): 58. CrossRef
Long-term efficacy of endoscopic radiofrequency Stretta therapy for patients with refractory gastroesophageal reflux disease
Sung Eun Kim
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George Triadafilopoulos
Current Gastroenterology Reports.2024; 26(4): 93. CrossRef
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Bhavana Sreepad, Karteek Chennupati, Muhammad Shehroz Zeeshan, Zeeshan Ramzan
Cureus.2024;[Epub] CrossRef
Chinese expert consensus on radiofrequency therapy for gastroesophageal reflux disease 2024
Xinke Sui, Zhiwei Hu, Jimin Wu, Lianyong Li
Gastroenterology & Endoscopy.2024; 2(3): 141. CrossRef
Efficacy and safety of antireflux mucosectomy versus radiofrequency ablation of the lower esophageal sphincter for the treatment of GERD: a systematic review and meta-analysis
Cristian A. Angeramo, Mateo Lendoire, Fernando A.M. Herbella, Francisco Schlottmann
Gastrointestinal Endoscopy.2024;[Epub] CrossRef
In Which Situation is Endoscopic Radiofrequency Anti-Reflux Therapy (Stretta) Effective for Controlling Gastroesophageal Reflux Symptoms?
Hwoon-Yong Jung
Clinical Endoscopy.2021; 54(4): 451. CrossRef
Endoscopic Treatment of GERD in Patients With Obesity
Rabih Ghazi, Babusai Rapaka, Barham K. Abu Dayyeh
Foregut: The Journal of the American Foregut Society.2021; 1(4): 336. CrossRef

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Focused Review Series: Cutting Edge of Advanced Therapeutic Endoscopy

Peroral Endoscopic Myotomy for Esophageal Motility Disorders: Jun Young Kim, Yang Won Min; Clin Endosc 2020;53(6):638-645. Published online November 20, 2020; DOI: https://doi.org/10.5946/ce.2020.223

Abstract PDF PubReader ePub

Peroral endoscopic myotomy (POEM) is one of the most clinically successful tunnel-based minimally invasive endoscopic treatments. The classic indications of POEM include achalasia of all types, including failed prior treatments, and expanded indications include the non-achalasia esophageal motility disorders, such as esophagogastric junction outflow obstruction, diffuse esophageal spasm, and jackhammer esophagus. For achalasia treatment, POEM has achieved a comparable surgical efficacy and a safety outcome and, therefore, has emerged as a first-line treatment. For non-achalasia esophageal motility disorders, POEM has also shown high clinical response rates. The complication rate of POEM for esophageal motility disorders is low and most complications are managed with conservative treatment. Currently, POEM is a representative procedure of natural orifice transluminal endoscopic surgery, which has shown a good clinical efficacy with low complication rates for esophageal motility disorders including achalasia. However, further studies are needed to treat non-achalasia motility disorder via POEM.

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McKenzie K Allen , Wayne Frei
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Kristina T. Flicek, Laura R. Carucci, Mary Ann Turner
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Photodynamic Therapy for Esophageal Cancer: Takahiro Inoue, Ryu Ishihara; Clin Endosc 2021;54(4):494-498. Published online May 19, 2020; DOI: https://doi.org/10.5946/ce.2020.073

Abstract PDF PubReader ePub

Photodynamic therapy, a curative local treatment for esophageal squamous cell carcinoma, involves a photosensitizing drug (photosensitizer) with affinity for tumors and a photodynamic reaction triggered by laser light. Previously, photodynamic therapy was used to treat superficial esophageal squamous cell carcinoma judged to be difficult to undergo endoscopic resection. Recently, photodynamic therapy has mainly been performed for local failure after chemoradiotherapy. Although surgery is the most promising treatment for local failure after chemoradiotherapy, its morbidity and mortality rates are high. Endoscopic resection is feasible for local failure after chemoradiotherapy but requires advanced skills, and its indication is limited to within the submucosal layer by depth. Photodynamic therapy is less invasive than surgery and has a wider indication than endoscopic resection. Porfimer sodium (a first-generation photosensitizer) causes a high frequency of side effects related to photosensitivity and requires the long-term sunshade period. Talaporfin (a second-generation photosensitizer) requires a much shorter sun-shade period than porfimer sodium. Photodynamic therapy will profoundly change treatment strategies for local failure after chemoradiotherapy.

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Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer: Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong Yeul Lee, Jeong-Sik Byeon, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Hoon Jai Chun; Clin Endosc 2020;53(2):142-166. Published online March 30, 2020; DOI: https://doi.org/10.5946/ce.2020.032

Abstract PDF Supplementary Material PubReader ePub

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

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Case Reports

Esophageal Stricture Caused by the Ingestion of Undissolved Picosulfate Powder: Daehyun Kim, Byungha Cho, Jong Wook Choi, Ki Bae Kim, Seon Mee Park; Clin Endosc 2021;54(1):122-126. Published online March 16, 2020; DOI: https://doi.org/10.5946/ce.2019.206

Abstract PDF PubReader ePub

Picosulfate solution is widely used as a small volume bowel cleansing agent and is considered to be effective and relatively safe. A case of a 75-year-old woman ingested picosulfate powder and drank a small volume of water, subsequently experienced severe burning pain in the chest. Endoscopy was performed and showed a submucosal hemorrhage and exudative ulcers at the mid to lower esophagus. At 2 weeks, her symptoms improved with conservative treatment. However, liquid food dysphagia developed 11 weeks after ingestion. A follow-up endoscopy revealed multiple esophageal strictures, which were treated with a fully covered metal stent and esophageal balloon dilation. Consequently, the esophageal strictures improved after one year. As this case demonstrates, detailed information about picosulfate powder ingestion after dissolving it in more than 200 mL of water should be presented to patients to avoid esophageal injury.

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Citric acid/magnesium oxide/sodium picosulfate

Reactions Weekly.2021; 1868(1): 140. CrossRef

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1 Crossref

Successful Closure of a Benign Refractory Tracheoesophageal Fistula Using an Over-the-Scope Clip after Failed Esophageal Stent Placement and Surgical Management: Nonthalee Pausawasdi, Chotirot Angkurawaranon, Tanyaporn Chantarojanasiri, Arunchai Chang, Wanchai Wongkornrat, Somchai Leelakusolvong, Asada Methasate; Clin Endosc 2020;53(3):361-365. Published online October 28, 2019; DOI: https://doi.org/10.5946/ce.2019.106

Abstract PDF Supplementary Material PubReader ePub

Tracheoesophageal fistulas (TEFs) have traditionally been managed surgically, but the endoscopic approach is widely performed as a less invasive alternative. Different closure techniques have been proposed with inconsistent results. An over-the-scope clip (OTSC) appears to be a reasonable option, but long-term results have not been well defined. We report the long-term outcomes of a complex case of successful closure of a benign refractory TEF using an OTSC after failed surgical management and esophageal stent placement.

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Endoscopic closure of tracheoesophageal fistula using a novel over-the-scope clip
Qi Gong, Aihong Yin, Zhi Wei
Asian Journal of Surgery.2025; 48(5): 3450. CrossRef
Successful Closure of a Tracheoesophageal Fistula Using an Over-The-Scope Clip
Osman Ali, Gurbani Singh, Sindhura Kolachana, Mohammed a Khan, Varun Kesar
Cureus.2023;[Epub] CrossRef
Over-the-Scope Clip Closure of Persistent Gastrocutaneous Fistula After Percutaneous Endoscopic Gastrostomy Tube Removal: A Report of Two Cases
Shigenori Masaki, Keishi Yamada
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Over-the-Scope Clip-Associated Endoscopic Muscular Dissection for Seven Cases of Small Gastric Submucosal Tumor: A Video-Based Case Series
Xin Li, Rongfen Wei, Jianfu Qin, Fei Qin, Peng Peng, Mengbin Qin, Shiquan Liu, Jiean Huang, Piero Chirletti
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef

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Focused Review Series: Endoscopic Hemostasis: An Overview of Principles and Recent Applications

Endoscopic Therapy and Radiologic Intervention of Acute Gastroesophageal Variceal Bleeding: Jeong Eun Song, Byung Seok Kim; Clin Endosc 2019;52(5):407-415. Published online September 30, 2019; DOI: https://doi.org/10.5946/ce.2019.178

Abstract PDF PubReader ePub

Acute gastroesophageal variceal hemorrhage is a dreaded complication in patients with liver cirrhosis. Endoscopic therapy and radiologic intervention for gastroesophageal bleeding have rapidly developed in the recent decades. Endoscopic treatment is initially performed to stop variceal hemorrhage. For the treatment of esophageal variceal bleeding, endoscopic variceal ligation (EVL) is considered the endoscopic treatment of choice. In cases of gastric variceal hemorrhage, the type of gastric varices (GVs) is important in deciding the strategy of endoscopic treatment. Endoscopic variceal obturation (EVO) is recommended for fundal variceal bleeding. For the management of gastroesophageal varix type 1 bleeding, both EVO and EVL are available treatment options; however, EVO is preferred over EVL. If endoscopic management fails to control variceal hemorrhage, radiologic interventional modalities could be considered. Transjugular intrahepatic portosystemic shunt is a good option for rescue treatment in refractory variceal bleeding. In cases of refractory hemorrhage of GVs in patients with a gastrorenal shunt, balloon-occluded retrograde transvenous obliteration could be considered as a salvage treatment.

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Research Progress of Endoscopic Treatment of Esophagogastric Varices
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Advances in Clinical Medicine.2025; 15(03): 974. CrossRef
Transjugular intrahepatic portosystemic shunt for esophagojejunal variceal bleeding after total gastrectomy: A case report
Sang Un Kim, Jihoon Hong
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Liver cirrhosis: current status and treatment options using western or traditional Chinese medicine
Shihao Zheng, Chengyuan Xue, Size Li, Xiaobin Zao, Xiaoke Li, Qiyao Liu, Xu Cao, Wei Wang, Wenying Qi, Hongbo Du, Peng Zhang, Yongan Ye
Frontiers in Pharmacology.2024;[Epub] CrossRef
Efficacy of early re-ligation after endoscopic gastric glue injection combined with endoscopic variceal ligation in preventing rebleeding of esophagogastric varices in patients with cirrhosis
Hui-Min Liu, Zhi-Bin Gong
World Chinese Journal of Digestology.2022; 30(17): 748. CrossRef
The Role of Interventional Radiology in Esophageal Varices and Hematemesis: Review Article
Qaed Salem Alhammami, Maisa Hamad Freaj Alanazi, Shahad Khalid A Bedaiwi, Ghazir Aneed N Alruwili, Shouq Fayed Khalaf Alanazi
Archives of Pharmacy Practice.2022; 13(4): 7. CrossRef
Comprehensive treatment of patients with gastric variceal bleeding
S.M. Chooklin, S.S. Chuklin
EMERGENCY MEDICINE.2022; 18(8): 14. CrossRef

10,064 View
354 Download
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Case Reports

Removal of a Trigger Cord Stuck between Bands during Endoscopic Multiple-Band Ligation for Treating Esophageal Variceal Hemorrhage: Nam Seok Ham, Danbi Lee, Sung Hyun Won, Jeongseok Kim, Seokjung Jo, Sangyoung Yi, Seol So; Clin Endosc 2020;53(2):230-231. Published online July 24, 2019; DOI: https://doi.org/10.5946/ce.2019.076

Abstract PDF Supplementary Material PubReader ePub: Endoscopic variceal ligation is the preferred endoscopic treatment method for esophageal variceal bleeding. The incidence of complications such as chest pain, bleeding, stricture formation, and aspiration pneumonia is low. We report a case wherein a malfunctioning multiple-band ligator could have potentially caused damage to the esophageal varices and massive bleeding. The equipment was safely removed using scissors and forceps. To the best of our knowledge, this is the first published report detailing the management of a case of esophageal variceal bleeding.

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Two-Stage Peroral Endoscopic Myotomy for Sigmoid-Type Achalasia: Hak Su Kim, Hee Kyung Kim, Weon Jin Ko; Clin Endosc 2020;53(2):232-235. Published online July 16, 2019; DOI: https://doi.org/10.5946/ce.2019.067

Abstract PDF Supplementary Material PubReader ePub: 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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Original Article

Efficacy of Endoscopic Submucosal Dissection of Esophageal Neoplasms under General Anesthesia: Koichi Hamada, Koichiro Kawano, Atsushi Yamauchi, Ryota Koyanagi, Yoshinori Horikawa, Shinya Nishida, Yoshiki Shiwa, Noriyuki Nishino, Michitaka Honda; Clin Endosc 2019;52(3):252-257. Published online May 23, 2019; DOI: https://doi.org/10.5946/ce.2018.151

Abstract PDF PubReader ePub

Background
/Aims: Evidence that general anesthesia (GA) reduces the operative time of esophageal endoscopic submucosal dissection (ESD) is currently insufficient. This study aims to evaluate the efficacy and safety of esophageal ESD under GA.
Methods
A total of 227 lesions from 198 consecutive patients with superficial esophageal neoplasms treated by ESD at 3 Japanese institutions between April 2011 and September 2017 were included in this retrospective study. For ESD, GA and deep sedation (DS) were used in 102 (51.5%, GA group) and 96 patients (48.5%, DS group), respectively.
Results
There were no statistically significant differences in age, sex, or comorbidities between the groups. In the GA group, the tumor size was larger (21 [3–77] mm vs. 14 [3–63] mm, p<0.001), luminal circumference was larger (≥2/3; 13.9% vs. 5.4%, p=0.042), procedure time was shorter (28 [5–202] min vs. 40 [8–249] min, p<0.001), and submucosal dissection speed was faster (25.2 [7.8–157.2] mm2 /min vs. 16.2 [2.4–41.3] mm2 /min, p<0.001). The rates of intraoperative perforation and aspiration pneumonia were lower in the GA group, but the difference did not achieve statistical significance (p=0.242 and p=0.242).
Conclusions
GA shortens the procedure time of esophageal ESD.

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Case Reports

Endoscopic Submucosal Dissection Followed by Concurrent Chemoradiotherapy in Patients with Early Esophageal Cancer with a High Risk of Lymph Node Metastasis: Hee Kyung Kim, Weon Jin Ko, Chang-Il Kwon, Ga Won Song, In Kyun Yoo, Ji Hyun Song, Hak Su Kim, Joo Young Cho; Clin Endosc 2019;52(5):502-505. Published online May 14, 2019; DOI: https://doi.org/10.5946/ce.2018.176

Abstract PDF PubReader ePub

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.

Citations

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Unveiling Therapeutic Targets for Esophageal Cancer: A Comprehensive Review
Rakesh Acharya, Ananya Mahapatra, Henu Kumar Verma, L. V. K. S. Bhaskar
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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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New Diagnostic Approach for Esophageal Squamous Cell Neoplasms Using Linked Color Imaging and Blue Laser Imaging Combined with Iodine Staining: Masato Tsunoda, Yoshimasa Miura, Hiroyuki Osawa, Tsevelnorov Khurelbaatar, Mio Sakaguchi, Hisashi Fukuda, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2019;52(5):497-501. Published online April 16, 2019; DOI: https://doi.org/10.5946/ce.2018.195

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A 62-year-old man with a flat early esophageal cancer was referred for endoscopic treatment. White light imaging revealed a pale red lesion, whereas linked color imaging (LCI) and blue laser imaging (BLI) yielded purple and brown images, respectively. Iodine staining demonstrated a large unstained area with a homogenous but very weak pink-color sign. This area appeared more clearly as purple and green on LCI and BLI, respectively; however, a different colored portion was observed at the 4 o’clock position inside the iodineunstained area. Histopathology findings of the resected specimen revealed squamous intraepithelial neoplasia at the 4 o’clock position and an esophageal squamous cell carcinoma in the remaining iodine-unstained area. LCI and BLI combined with iodine staining produce characteristic images that overcomes the pink-color sign, reflecting the histological features of a flat esophageal neoplasm. This new method is useful for detailed evaluation of early flat squamous cell neoplasms.

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Position statement of the World Endoscopy Organization: Role of endoscopy in screening, diagnosis, and treatment of esophageal superficial squamous neoplasiaia
Cesare Hassan, Giulio Antonelli, Philip Wai‐yan Chiu, Fabian Emura, Kenichi Goda, Prasad G. Iyer, Sameer Al Awadhi, Abed Al Lehibi, Vitor Arantes, Herbert Burgos, Cecilio L. Cerisoli, Sanford Dawsey, Peter Draganov, David Fleischer, Fernando Fluxá, Nicola
Digestive Endoscopy.2025; 37(5): 470. CrossRef
Linked color imaging vs Lugol chromoendoscopy for esophageal squamous cell cancer and precancerous lesion screening: A noninferiority study
Zi-Xin Wang, Long-Song Li, Song Su, Jin-Ping Li, Bo Zhang, Nan-Jun Wang, Sheng-Zhen Liu, Sha-Sha Wang, Shuai Zhang, Ya-Wei Bi, Fei Gao, Qun Shao, Ning Xu, Bo-Zong Shao, Yi Yao, Fang Liu, En-Qiang Linghu, Ning-Li Chai
World Journal of Gastroenterology.2023; 29(12): 1899. CrossRef
Usefulness of linked color imaging in the early detection of superficial esophageal squamous cell carcinomas
Koki Nakamura, Yuji Urabe, Shiro Oka, Naoko Nagasaki, Naoki Yorita, Kosaku Hata, Kazuhiko Masuda, Mio Kurihara, Takahiro Kotachi, Tomoyuki Boda, Shinji Tanaka, Kazuaki Chayama
Esophagus.2021; 18(1): 118. CrossRef
Inter‐observer variability of experts and trainees for the diagnosis of reflux esophagitis: Comparison of linked color imaging, blue laser imaging, and white light imaging
Sang Pyo Lee, Sea Hyub Kae, Hyun Joo Jang, Dong Hee Koh, Eun Suk Jung
Journal of Digestive Diseases.2021; 22(7): 425. CrossRef

9,511 View
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Buried Barrett’s Esophagus with High-Grade Dysplasia after Radiofrequency Ablation: Joana Castela, Miguel Serrano, Susana Mão de Ferro, Daniela Vinha Pereira, Paula Chaves, António Dias Pereira; Clin Endosc 2019;52(3):269-272. Published online October 5, 2018; DOI: https://doi.org/10.5946/ce.2018.124

Abstract PDF PubReader ePub

Radiofrequency ablation therapy is an effective endoscopic option for the eradication of Barrett’s esophagus that appears to reduce the risk of esophageal cancer. A concern associated with this technique is the development of subsquamous/buried intestinal metaplasia, whose clinical relevance and malignant potential have not yet been fully elucidated. Fewer than 20 cases of subsquamous neoplasia after the successful radiofrequency ablation of Barrett’s esophagus have been reported to date. Here, we describe a new case of subsquamous neoplasia (high-grade dysplasia) following radiofrequency ablation that was managed with endoscopic resection. Our experience suggests that a meticulous endoscopic inspection prior to and after radiofrequency ablation is fundamental to reduce the risk of buried neoplasia development.

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Ryan Demkowicz, Prashanthi N. Thota, Tanmayee Benjamin, Rocio Lopez, Haiyan Lu, Deepa T. Patil, Erinn Downs-Kelly, Jennifer A. Jeung, Keith K. Lai, James Lapinski, Erica C. Savage, John R. Goldblum, Ilyssa O. Gordon
Annals of Diagnostic Pathology.2021; 51: 151672. CrossRef
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Prabhat Kumar, Ilyssa O. Gordon, Prashanthi N. Thota
Scandinavian Journal of Gastroenterology.2021; 56(5): 624. CrossRef
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Nikhil Gupta, Raghav Yelamanchi, Himanshu Agrawal, Nitin Agarwal
Artificial Intelligence in Gastrointestinal Endoscopy.2021; 2(4): 149. CrossRef
Indications, contraindications and limitations of endoscopic therapy for Barrett’s esophagus and early esophageal adenocarcinoma
Carol Rouphael, Mythri Anil Kumar, Madhusudhan R. Sanaka, Prashanthi N. Thota
Therapeutic Advances in Gastroenterology.2020;[Epub] CrossRef
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Connor K. Wilson, Sara R. Frankowski, Susan C. Steelman, Issam Makhoul
SN Comprehensive Clinical Medicine.2020; 2(8): 1163. CrossRef
Multifocal Cryoballoon Ablation for Eradication of Barrett's Esophagus-Related Neoplasia: A Prospective Multicenter Clinical Trial
Marcia Irene Canto, Arvind J. Trindade, Julian Abrams, Michael Rosenblum, John Dumot, Amitabh Chak, Prasad Iyer, David Diehl, Harshit S. Khara, F. Scott Corbett, Matthew McKinley, Eun Ji Shin, Irving Waxman, Anthony Infantolino, Christina Tofani, Jason Sa
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Inflammatory bowel disease- and Barrett’s esophagus-associated neoplasia: the old, the new, and the persistent struggles
Dipti M Karamchandani, Qin Zhang, Xiao-Yan Liao, Jing-Hong Xu, Xiu-Li Liu
Gastroenterology Report.2019; 7(6): 379. CrossRef

7,539 View
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