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Original Articles
Feasibility and safety of endoscopic submucosal dissection for lesions in proximity to a colonic diverticulum
Nobuaki Ikezawa, Takashi Toyonaga, Shinwa Tanaka, Tetsuya Yoshizaki, Toshitatsu Takao, Hirofumi Abe, Hiroya Sakaguchi, Kazunori Tsuda, Satoshi Urakami, Tatsuya Nakai, Taku Harada, Kou Miura, Takahisa Yamasaki, Stuart Kostalas, Yoshinori Morita, Yuzo Kodama
Clin Endosc 2022;55(3):417-425.   Published online May 12, 2022
DOI: https://doi.org/10.5946/ce.2021.245
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic submucosal dissection (ESD) for diverticulum-associated colorectal lesions is generally contraindicated because of the high risk of perforation. Several studies on patients with such lesions treated with ESD have been reported recently. However, the feasibility and safety of ESD for lesions in proximity to a colonic diverticulum (D-ESD) have not been fully clarified. The aim of this study was to evaluate the feasibility and safety of D-ESD.
Methods
D-ESD was defined as ESD for lesions within approximately 3 mm of a diverticulum. Twenty-six consecutive patients who underwent D-ESD were included. Two strategic approaches were used depending on whether submucosal dissection of the diverticulum-related part was required (strategy B) or not (strategy A). Treatment outcomes and adverse events associated with each strategy were analyzed.
Results
The en bloc resection rate was 96.2%. The rates of R0 and curative resection in strategies A and B were 80.8%, 73.1%, 84.6%, and 70.6%, respectively. Two cases of intraoperative perforation and one case of delayed perforation occurred. The delayed perforation case required emergency surgery, but the other cases were managed conservatively.
Conclusions
D-ESD may be a feasible treatment option. However, it should be performed in a high-volume center by expert hands because it requires highly skilled endoscopic techniques.

Citations

Citations to this article as recorded by  
  • Endoscopic submucosal dissection for diverticulum using combination of countertraction and circumferential-inversion method
    Hiroshi Takayama, Yoshinori Morita, Toshitatsu Takao, Douglas Motomura, Madoka Takao, Takashi Toyonaga, Yuzo Kodama
    Endoscopy.2024; 56(S 01): E91.     CrossRef
  • Traction-assisted endoscopic submucosal dissection for resection of ileocecal valve neoplasia: a French retrospective multicenter case series
    Clara Yzet, Timothée Wallenhorst, Jérémie Jacques, Mariana Figueiredo Ferreira, Jérôme Rivory, Florian Rostain, Louis-Jean Masgnaux, Jean Grimaldi, Romain Legros, Pierre Lafeuille, Jérémie Albouys, Fabien Subtil, Marion Schaefer, Mathieu Pioche
    Endoscopy.2024; 56(10): 790.     CrossRef
  • The role of cap-assisted endoscopy and its future implications
    Sol Kim, Bo-In Lee
    Clinical Endoscopy.2024; 57(3): 293.     CrossRef
  • Strategies to successfully complete complex ESD in the colon
    David Barquero Declara, Alex Blasco Pelicano, Claudia Berbel Comas, Alfredo Mata Bilbao
    Endoscopy International Open.2024; 12(07): E914.     CrossRef
  • Novel technique “short myotomy” during endoscopic submucosal dissection for a diverticulum‐associated colonic lesion
    Ryosuke Kobayashi, Kingo Hirasawa, Shin Maeda
    Digestive Endoscopy.2024;[Epub]     CrossRef
  • Successful planned piecemeal endoscopic resection using gel immersion and an over-the-scope clip for a lesion extensively extended into the colonic diverticulum
    Tomoaki Tashima, Takahiro Muramatsu, Tomonori Kawasaki, Tsubasa Ishikawa, Shomei Ryozawa
    VideoGIE.2023; 8(4): 167.     CrossRef
  • Future therapeutic implications of new molecular mechanism of colorectal cancer
    Sen Lu, Cheng-You Jia, Jian-She Yang
    World Journal of Gastroenterology.2023; 29(16): 2359.     CrossRef
  • Iatrogenic colorectal perforation caused by a clip
    Hirotaka Oura, Yasuki Hatayama, Erika Nomura, Harutoshi Sugiyama, Daisuke Murakami, Makoto Arai, Takayoshi Nishino
    Endoscopy.2023; 55(S 01): E1091.     CrossRef
  • 4,438 View
  • 185 Download
  • 7 Web of Science
  • 8 Crossref
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A prospective study of fully covered self-expandable metal stents for refractory benign pancreatic duct strictures
Bhavik Bharat Shah, Gajanan Ashokrao Rodge, Usha Goenka, Shivaraj Afzalpurkar, Mahesh Kumar Goenka
Clin Endosc 2022;55(6):793-800.   Published online April 4, 2022
DOI: https://doi.org/10.5946/ce.2021.211
AbstractAbstract PDFPubReaderePub
Background
/Aims: Fully covered self-expanding metal stents (FCSEMSs) are a relatively novel option for treating painful main pancreatic duct refractory strictures in patients with chronic pancreatitis. Herein, we aimed to assess the efficacy, feasibility, and safety of FCSEMSs in this patient group.
Methods
This prospective single-center study included patients who underwent endoscopic retrograde pancreatography with FCSEMS placement. The primary endpoints were the technical and clinical success rates. A reduction in visual analog scale pain score of >50% compared with that before stent placement was defined as clinical success. Secondary endpoints were resolution of pancreatic strictures on fluoroscopy during endoscopic retrograde pancreatography and the development of stent-related adverse events.
Results
Thirty-six patients were included in the analysis. The technical success rate was 100% (n=36) and the clinical success rate was 86.1% (n=31). There was a significant increase in stricture diameter from 1.7 mm to 3.5 mm (p<0.001) after stent removal. The mean visual analog scale pain score showed statistically significant improvement. At 19 months of follow-up, 55.6% of the patients were asymptomatic. Stent migration (16.7%), intolerable abdominal pain (8.3%), development of de novo strictures (8.3%), and mild pancreatitis (2.8%) were the most common adverse events.
Conclusions
FCSEMS placement showed good technical and clinical success rates for achieving pain relief in patients with refractory main pancreatic duct strictures.

Citations

Citations to this article as recorded by  
  • Citric Acid Loaded Hydrogel-Coated Stent for Dissolving Pancreatic Duct Calculi
    Jing Li, Yanwei Lv, Zheng Chen, Jiulong Zhao, Shige Wang
    Gels.2024; 10(2): 125.     CrossRef
  • Fully Covered Self-expandable Metallic Stents for Refractory Benign Pancreatic Duct Strictures: A Systematic Review and Meta-analysis
    Gajanan Rodge, Suprabhat Giri, Kailash Kolhe, Shivaraj Afzalpurkar, Sidharth Harindranath, Sridhar Sundaram, Aditya Kale
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2024; 34(5): 529.     CrossRef
  • Self-expanding metallic stent for refractory pancreatic duct stricture in chronic pancreatitis: A prospective follow-up study
    Praveer Rai, Pankaj Kumar, Ashok Kumar, Sana Asari, Kartik Agarwal, Mayank, Ravi V. Krishna Kishore, Prabhaker Mishra
    Indian Journal of Gastroenterology.2023;[Epub]     CrossRef
  • Quality of life after endoscopic procedures for chronic pancreatitis: A multicentre study
    Mikael Parhiala, Camilla Nøjgaard, Andreas Bartholdy, Anne Waage, Povilas Ignatavičius, Trond Engjom, Georg Dimcevski, Ingrid Kvåle Nordaas, Evangelos Kalaitzakis, Asbjørn M. Drewes, Amer Hadi, Søren S. Olesen, Jakob L. Poulsen, Johanna Laukkarinen
    United European Gastroenterology Journal.2023; 11(9): 884.     CrossRef
  • Pancreatic duct stents
    Jin Hui Yi, Zhao Shen Li, Liang Hao Hu
    Journal of Digestive Diseases.2022; 23(12): 675.     CrossRef
  • 3,247 View
  • 288 Download
  • 5 Web of Science
  • 5 Crossref
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Feasibility and Accuracy of Transduodenal Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Solid Lesions Using a 19-Gauge Flexible Needle: A Multicenter Study
Germana de Nucci, Maria Chiara Petrone, Nicola Imperatore, Edoardo Forti, Roberto Grassia, Silvia Giovanelli, Laura Ottaviani, Vincenzo Mirante, Giuseppe Sabatino, Carlo Fabbri, Mauro Manno, Paolo Giorgio Arcidiacono, Gianpiero Manes
Clin Endosc 2021;54(2):229-235.   Published online May 25, 2020
DOI: https://doi.org/10.5946/ce.2020.056
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the go-to method for obtaining samples from gastrointestinal tract and pancreatic lesions. When the transduodenal approach is utilized, the use of a more flexible needle, such as a nitinol 19-gauge (G) needle, has been recommended. The aim of this study was to evaluate the feasibility and accuracy of 19-G flexible aspiration needles in obtaining samples from solid lesions through a transduodenal approach.
Methods
This was a retrospective analysis of prospectively collected data from eight Italian endoscopy centers. Consecutive patients with solid lesions who underwent transduodenal EUS-FNA with a 19-G flexible needle were included.
Results
A total of 201 patients were enrolled. According to histology, EUS, radiology and 12 months of follow-up, 151 patients had malignant lesions and 50 patients had benign lesions. EUS-FNA was feasible in all cases. An adequate histologic sample was obtained in all except eight cases (96.1%). The sensitivity of EUS-FNA was 92.1% (95% confidence interval [CI], 86.8%–95.7%), and the specificity was 100% (95% CI, 90.5%–100%). The positive predictive value was 100% (95% CI, 93.4%–100%), and the negative predictive value was 74% (95% CI, 62.8%–82.7%). The diagnostic accuracy was 93.5% (95% CI, 89.2%–96.5%).
Conclusions
The transduodenal approach for obtaining samples from solid lesions using a 19-G flexible needle seems feasible and accurate.

Citations

Citations to this article as recorded by  
  • Comparation of 5 ml and 10 ml Negative Pressures with Wet-suction Techniques for EUS-FNA of Solid Lesions
    Yuchun Zhu, Yang Su, Peng Yang, Jiaojun Li, Tai Yu, Yi Wang, Xi Zhou, Ming Zhao, Xiaobin Sun, Jing Shan
    Journal of Clinical Gastroenterology.2024;[Epub]     CrossRef
  • Diagnostic Ability of Endoscopic Ultrasound-Guided Tissue Acquisition Using 19-Gauge Fine-Needle Biopsy Needle for Abdominal Lesions
    Kotaro Takeshita, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Yuki Kawasaki, Kosuke Maehara, Yumi Murashima, Mao Okada, Go Ikeda, Natsumi Yamada, Tetsuro Takasaki, Daiki Agarie, Hidenobu Hara, Yuya Hagiwara, Kohei Okamoto, Daiki Yamashige, Akihiro Oh
    Diagnostics.2023; 13(3): 450.     CrossRef
  • Effect of wet-heparinized suction on the quality of mediastinal solid tumor specimens obtained by endoscopic ultrasound-guided fine-needle aspiration: a retrospective study from a single center
    Bo Xu, Qian Lu, Rong Fang, Xiaojuan Dai, Haiyan Xu, Xiangwu Ding, Huawei Gui
    BMC Gastroenterology.2023;[Epub]     CrossRef
  • Comparison of Endoscopic Ultrasound-Guided Fine Needle Aspiration with 19-Gauge and 22-Gauge Needles for Solid Pancreatic Lesions
    Changjuan Li, Jianwei Mi, Fulai Gao, Xinying Zhu, Miao Su, Xiaoli Xie, Dongqiang Zhao
    International Journal of General Medicine.2021; Volume 14: 10439.     CrossRef
  • 4,836 View
  • 114 Download
  • 6 Web of Science
  • 4 Crossref
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Peroral Endoscopic Myotomy for Treating Achalasia in an Animal Model: A Feasibility Study
Byoung Wook Bang, Young Chul Choi, Hyung Gil Kim, Kye Sook Kwon, Yong Woon Shin, Don Haeng Lee, Joon Mee Kim
Clin Endosc 2013;46(1):54-58.   Published online January 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.1.54
AbstractAbstract PDFPubReaderePub
Background/Aims

Laparoscopic Heller myotomy with antireflux procedure is considered to be a standard treatment for achalasia. Recently, peroral endoscopic myotomy (POEM) was developed and performed on patients with achalasia. However, there is no report on POEM use in South Korea. The aim of this study was to evaluate the technical feasibility of POEM in a porcine model.

Methods

POEM was performed on two mini pigs. We performed upper endoscopy under general anesthesia. A submucosal tunnel was created and the circular muscle layer was incised using several knives. The mucosal entry was closed using resolution clips. We performed a follow-up endoscopy and sacrificed the pigs 2 weeks after the POEM. The myotomy site was evaluated grossly and histologically.

Results

POEM was successfully performed on the two mini pigs. No injuries to any abdominal or mediastinal structures occurred. Two weeks after the POEM, the esophageal mucosa healed without any endoscopic evidence of complications. Necropsy revealed that the circular muscle layer was completely lost and replaced with fibrotic tissue.

Conclusions

We found that POEM is a technically feasible method which can be performed on an animal model. However, to ensure safe use on patients with achalasia, further studies on technical methods and long-term follow-up examinations are required.

Citations

Citations to this article as recorded by  
  • Pilot prospective study on formal training in per-oral endoscopic myotomy (POEM) during advanced endoscopy fellowship
    Salmaan Jawaid, Peter V. Draganov, Hiroyuki Aihara, Mouen A. Khashab, Dennis Yang
    Endoscopy International Open.2021; 09(12): E1890.     CrossRef
  • Miotomía endoscópica peroral, experiencia in vivo : imprescindible para desarrollo de la técnica en humanos
    A. Peñaloza-Ramírez, J. Suárez-Correa, J. Báez-Blanco, C. Sabogal-Gómez, H. Kuan-Casas, C. Sánchez-Pignalosa, P. Aponte-Ordóñez
    Revista de Gastroenterología de México.2018; 83(2): 86.     CrossRef
  • In vivo experience with peroral endoscopic myotomy: An essential activity for developing the technique in humans
    A. Peñaloza-Ramírez, J. Suárez-Correa, J. Báez-Blanco, C. Sabogal-Gómez, H. Kuan-Casas, C. Sánchez-Pignalosa, P. Aponte-Ordóñez
    Revista de Gastroenterología de México (English Edition).2018; 83(2): 86.     CrossRef
  • Factors predicting the technical difficulty of peroral endoscopic myotomy for achalasia
    Xiaowei Tang, Yutang Ren, Zhengjie Wei, Jieqiong Zhou, Zhiliang Deng, Zhenyu Chen, Bo Jiang, Wei Gong
    Surgical Endoscopy.2016; 30(9): 3774.     CrossRef
  • Peroral endoscopic myotomy for treatment of achalasia in children and adolescents
    Chenjie Li, Yuyong Tan, Xuehong Wang, Deliang Liu
    Journal of Pediatric Surgery.2015; 50(1): 201.     CrossRef
  • The Ideal Experimental Training Session for Minimally Invasive Endoluminal Techniques
    Sakai P
    Gastroenterology & Hepatology: Open Access.2015;[Epub]     CrossRef
  • International Digestive Endoscopy Network 2014: Turnpike to the Future
    Eun Young Kim, Kwang An Kwon, Il Ju Choi, Ji Kon Ryu, Ki Baik Hahm
    Clinical Endoscopy.2014; 47(5): 371.     CrossRef
  • Training for peroral endoscopic myotomy
    Daniel von Renteln, Melina C. Vassiliou, Thomas Rösch
    Techniques in Gastrointestinal Endoscopy.2013; 15(3): 153.     CrossRef
  • Peroral Endoscopic Myotomy for the Treatment of Achalasia: An Analysis
    Dennis Yang, Mihir S. Wagh
    Diagnostic and Therapeutic Endoscopy.2013; 2013: 1.     CrossRef
  • Peroral Endoscopic Myotomy in a Porcine Model: A Step to Achalasia Patients
    Su Jin Hong
    Clinical Endoscopy.2013; 46(1): 1.     CrossRef
  • 6,677 View
  • 67 Download
  • 10 Crossref
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