Clinical Endoscopy

Volume 50(1); January 2017

Commentarys

Endoscopic Findings of Gastric Extranodal Marginal Zone B-Cell Mucosa-Associated Lymphoid Tissue Lymphoma: Sang Kil Lee; Clin Endosc 2017;50(1):1-2. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.014

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Uncommon presentation of gastric mucosa-associated lymphoid tissue lymphoma in a 13-year-old girl: acute vomiting of blood as the initial symptom
Xinyu Jin, Xin Jin, Piao Guo, Linjuan Lu, Weisong Sheng, Danrong Zhu
Annals of Medicine & Surgery.2024; 86(5): 3001. CrossRef

9,862 View
178 Download
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Over-the-Scope Clip in the Management of Gastrointestinal Defect and Intractable Non-Variceal Bleeding: Hyungkil Kim; Clin Endosc 2017;50(1):3-5. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.019

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Bleeding malignant gastric ulcer: successful endoscopic hemostasis with an over-the-scope clip
João Carlos Silva, Rolando Pinho, Ana Catarina Gomes, Sónia Leite, João Carvalho
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Jennifer Wellington, Andrew Canakis, Raymond Kim
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6,107 View
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How Can We Obtain Tissue from a Subepithelial Lesion for Pathologic Diagnosis?: Eun Young Kim; Clin Endosc 2017;50(1):6-7. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.016

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What is the Role of Double-Balloon Endoscopy in Patients Presenting with Obscure Gastrointestinal Bleeding?: Jung Ho Kim, Kwang An Kwon; Clin Endosc 2017;50(1):8-10. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.023

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Spontaneous peeled ileal giant lipoma caused by lower gastrointestinal bleeding
Jung Ho Kim, Hyun Hwa Yoon, Seok Hoo Jeong, Hyun Sun Woo, Won-Suk Lee, Seung Joon Choi, Seog Gyun Kim, Seung Yeon Ha, Kwang An Kwon
Medicine.2017; 96(51): e9253. CrossRef

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Focused Review Series: Roleses of Bariatric Endoscopy in Obesity Treatment

Recent Trends in Endoscopic Bariatric Therapies: Hyuk Soon Choi, Hoon Jai Chun; Clin Endosc 2017;50(1):11-16. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.007

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Obesity and its associated metabolic diseases including diabetes mellitus are severe medical problems that are increasing in prevalence worldwide and result in significant healthcare expenses. While behavioral and pharmacological treatment approaches are partly effective in the short term, their effects are not long-lasting. Although previous studies have described bariatric surgery as the most effective treatment for obesity, it is associated with morbidity, mortality, and economic burden. Endoluminal interventions performed entirely using gastrointestinal flexible endoscopy offer alternative approaches to the treatment of obesity that are safer and more cost-effective than current surgical approaches. The use of endoluminal techniques in the field of metabolic obesity disease has diverse promising applications including endoscopic gastroplasty, intragastric balloon, endoluminal malabsorptive bariatric procedures, and gastric electrical stimulation (GES) for the modulation of gastric emptying. This review discusses recent trends and roles in endoscopic bariatric therapies using the currently available endoluminal and transgastric technologies.

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Various Intragastric Balloons Under Clinical Investigation
Seong Ji Choi, Hyuk Soon Choi
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Seung Han Kim, Hyuk Soon Choi, Hoon Jai Chun
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Role of Restrictive Endoscopic Procedures in Obesity Treatment: Hang Lak Lee; Clin Endosc 2017;50(1):17-20. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.022

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It is well recognized that obesity is a big problem and it can induce large economic burden. Obesity affects about 40% people in the America alone and obesity also is the worldwide problem, with about 400 million obese adults. Moreover, another problem of obesity is the increasing prevalence of overweight children. Though bariatric surgery remains the gold treatment modality in the obesity treatment, endoluminal approaches may have the meaningful role for weight control. Endoscopists should have a role in the management of obesity because endoluminal therapies demonstrate their safety and efficacy over the coming years. Endoluminal therapies can be summarized by above methods: space occupying, malabsorption method, and reduction of gastric volume. In this review, we will introduce various restrictive endoscopic procedures in obesity treatment.

Citations

Citations to this article as recorded by

Endoscopic Bariatric Therapy for Obesity and Metabolic Syndrome
Sang Pyo Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(4): 247. CrossRef
Endobariatric procedures for obesity: clinical indications and available options
Hemant Goyal, Jonathan Kopel, Abhilash Perisetti, Rupinder Mann, Aman Ali, Benjamin Tharian, Shreyas Saligram, Sumant Inamdar
Therapeutic Advances in Gastrointestinal Endoscopy.2021; 14: 263177452098462. CrossRef
Novelties in the treatment of obesity
Pavol Holéczy
Medicína pro praxi.2019; 16(4): 259. CrossRef
Currently Available Non-Balloon Devices
Hang Lak Lee
Clinical Endoscopy.2018; 51(5): 416. CrossRef

8,021 View
198 Download
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Role of Endoscopic Gastroplasty Techniques in the Management of Obesity: Yunho Jung; Clin Endosc 2017;50(1):21-25. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2016.147

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Health and wellness represent a major global concern. Trends such as a lack of exercise and excessive consumption of calories are major causes of the rapid increase in obesity worldwide. Obesity should be controlled because it can result in other illnesses, such as diabetes, high blood pressure, high cholesterol, coronary artery disease, stroke, breathing disorders, or cancer. However, many people have difficulty in managing obesity through exercise, dietary control, behavioral modifications, and drug therapy. Bariatric surgery is not commonly used due to a variety of complications, even though it has been demonstrated to produce reliable results with respect to adequate weight loss when performed using an open or a laparoscopic approach. Endoscopic bariatric procedures are emerging techniques that are less invasive and safer compared with current surgical approaches. However, the evaluation of endoluminal procedures is limited by the small number of studies and their short-term follow-up.

Citations

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Left gastric artery embolization for obesity treatment: a systematic review and meta-analysis of human and animal studies
Malkhaz Mizandari, Pedram Keshavarz, Tamta Azrumelashvili, Fereshteh Yazdanpanah, Elnaz Lorzadeh, Hamidreza Hosseinpour, Amir Bazyar, Seyed Faraz Nejati, Faranak Ebrahimian Sadabad
Abdominal Radiology.2021; 46(9): 4440. CrossRef
Bariatric Embolization of the Left Gastric Arteries for the Treatment of Obesity: 9-Month Data in 5 Patients
Zhi-Bin Bai, Yong-Lin Qin, Gang Deng, Guo-Feng Zhao, Bin-Yan Zhong, Gao-Jun Teng
Obesity Surgery.2018; 28(4): 907. CrossRef
Bariatric Arterial Embolization for Obesity: A Review of Early Clinical Evidence
Bin-Yan Zhong, Godwin Abiola, Clifford R. Weiss
CardioVascular and Interventional Radiology.2018; 41(11): 1639. CrossRef
Incidence of nausea and vomiting after intragastric balloon placement in bariatric patients – A systematic review and meta-analysis
Judy Trang, Seung Su Lee, Assia Miller, Christian X. Cruz Pico, Angelina Postoev, Isaac Ibikunle, Christopher Alade Ibikunle
International Journal of Surgery.2018; 57: 22. CrossRef

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218 Download
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Role of Malabsorptive Endoscopic Procedures in Obesity Treatment: Jae Myung Park; Clin Endosc 2017;50(1):26-30. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.004

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The incidence of obesity is increasing, and more definitive treatment modalities are needed. Endoluminal procedures, including restrictive endoscopic procedures, endoscopic gastroplasty, and malabsorptive endoscopic procedures, can reduce weight in obese patients and control obesity-related comorbidities. Malabsorptive endoscopic interventions also offer the potential for an ambulatory procedure that may be safer and more cost-effective compared with laparoscopic surgery. Malabsorptive endoscopic intervention can induce weight reduction and improve obesity-related metabolic parameters, despite complications such as device migration, obstruction, and abdominal pain. Improvement in technique will follow the development of new devices.

Citations

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Overview on the endoscopic treatment for obesity: A review
Maheeba Abdulla, Nafeesa Mohammed, Jehad AlQamish
World Journal of Gastroenterology.2023; 29(40): 5526. CrossRef
Implants with Sensing Capabilities
Mladen Veletić, Ehsanul Hoque Apu, Mitar Simić, Jacob Bergsland, Ilangko Balasingham, Christopher H. Contag, Nureddin Ashammakhi
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Psychological Outcomes and Predictors of Weight Loss in Adolescents With Severe Obesity Following a Reversible Endoscopic Bariatric Procedure
Simona Klemenčič, Ana Bujišić, Neža Štiglic Hribernik, Tadej Battelino, Matjaž Homan, Rok Orel, Primož Kotnik
Frontiers in Pediatrics.2021;[Epub] CrossRef
Novelties in the treatment of obesity
Pavol Holéczy
Medicína pro praxi.2019; 16(4): 259. CrossRef

7,927 View
133 Download
3 Web of Science
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Endoscopic Approach for Major Complications of Bariatric Surgery: Moon Kyung Joo; Clin Endosc 2017;50(1):31-41. Published online December 23, 2016; DOI: https://doi.org/10.5946/ce.2016.140

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As lifestyle and diet patterns have become westernized in East Asia, the prevalence of obesity has rapidly increased. Bariatric surgeries, such as Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB), are considered the first-line treatment option in patients with severe obesity. However, postoperative complications have increased and the proper management of these complications, including the use of endoscopic procedures, has become important. The most serious complications, such as leaks and fistulas, can be treated with endoscopic stent placement and injection of fibrin glue, and a novel full-thickness closure over-the-scope clip (OTSC) has been used for treatment of postoperative leaks. Stricture at the gastrojejunal (GJ) anastomosis site after RYGB or incisura angularis in SG can be managed using stents or endoscopic balloon dilation. Dilation of the GJ anastomosis or gastric pouch may lead to failure of weight loss, and the use of endoscopic sclerotherapy, novel endoscopic suturing devices, and OTSCs have been attempted. Intragastric migration of the gastric band can be successfully treated using various endoscopic tools. Endoscopy plays a pivotal role in the management of post-bariatric complications, and close cooperation between endoscopists and bariatric surgeons may further increase the success rate of endoscopic procedures.

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Recent Clinical Results of Endoscopic Bariatric Therapies as an Obesity Intervention: Fateh Bazerbachi, Eric J. Vargas Valls, Barham K. Abu Dayyeh; Clin Endosc 2017;50(1):42-50. Published online January 30, 2017; DOI: https://doi.org/10.5946/ce.2017.013

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Despite advances in lifestyle interventions, anti-obesity medications, and metabolic surgery, the issue of health burden due to obesity continues to evolve. Interest in endoscopic bariatric techniques has increased over the years, as they have been shown to be efficacious, reversible, relatively safe, and cost effective. Further, these techniques offer a therapeutic window for some patients who may otherwise be unable to undergo bariatric surgery. This article aims to review the literature on the safety and efficacy of currently offered endoscopic bariatric techniques, as well as those that are in the pipeline of end-development and regulatory approval.

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Original Articles

Correlation of Endoscopic Findings of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma with Recurrence after Complete Remission: Chang Min Lee, Dong Ho Lee, Byung Kyu Ahn, Jae Jin Hwang, Hyuk Yoon, Young Soo Park, Cheol Min Shin, Nayoung Kim; Clin Endosc 2017;50(1):51-57. Published online March 24, 2016; DOI: https://doi.org/10.5946/ce.2016.015

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Background
/Aims: In gastric mucosa-associated lymphoid tissue (MALT) lymphoma, the clinical significance of various endoscopic findings has not yet been determined. This study aimed to compare the time to complete remission (CR) and relapse-free survival (RFS) in gastric MALT lymphoma based on endoscopic findings.
Methods
In this single-center retrospective cohort study, the medical records of 122 consecutive adult patients with gastric MALT lymphoma were collected over a period of 12 years. CR was defined by the absence of macroscopic or microscopic features of lymphoma on two subsequent follow-ups. Relapse was clinically defined by a positive endoscopic biopsy after CR.
Results
The median time to CR did not differ significantly between treatment methods. However, it was significantly longer in the group with polypoid endoscopic appearance than in the groups with diffuse infiltration or ulceration (7.83, 3.43, and 3.10 months, respectively; p=0.003). Six patients relapsed after CR. Kaplan-Meier analysis showed that RFS differed significantly between groups based on Ann Arbor staging, treatment methods, and initial endoscopic findings.
Conclusions
In gastric MALT lymphoma, the endoscopically defined polypoid type was characterized by a longer duration to CR, with a higher likelihood of recurrence, compared to the endoscopically defined diffuse infiltration or ulceration types.

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A Case of Gastric Mucosa-Associated Lymphoid Tissue Lymphoma with Special Endoscopic Morphology
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T Kanno, T Katano, T Shimura, R Nishigaki, Y Kojima, M Sasaki, Y Okuda, N Sugimura, S Fukusada, Y Mizuno, H Iwasaki, H Nishie, M Tanaka, K Ozeki, E Kubota, S Tanida, H Kataoka
Acta Gastro Enterologica Belgica.2022; 85(3): 477. CrossRef
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Endoscopic Management of Gastrointestinal Leaks and Bleeding with the Over-the-Scope Clip: A Prospective Study: Mahesh Kumar Goenka, Vijay Kumar Rai, Usha Goenka, Indrajit Kumar Tiwary; Clin Endosc 2017;50(1):58-63. Published online October 31, 2016; DOI: https://doi.org/10.5946/ce.2016.028

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Background
/Aims: The over-the-scope clip (OTSC) is a device used for endoscopic closure of perforations, leaks and fistulas, and for endoscopic hemostasis. To evaluate the clinical effectiveness and safety of OTSC.
Methods
Between October 2013 and November 2015, 12 patients underwent OTSC placement by an experienced endoscopist. OTSC was used for the closure of gastrointestinal (GI) leaks and fistula in six patients, three of which were iatrogenic (esophageal, gastric, and duodenal) and three of which were inflammatory. In six patients, OTSC was used for hemostasis of non-variceal upper GI bleeding. Endoscopic tattooing using India ink was used to assist the accurate placement of the clip.
Results
All subjects except one with a colonic defect experienced immediate technical success as well as long-term clinical success, during a mean follow-up of 6 weeks. Only one clip was required to close each of the GI defects and to achieve hemostasis in all patients. There were no misfirings or complications of clips. The procedure was well tolerated, and patients were hospitalized for an average of 8 days (range, 3 to 10). Antiplatelet therapy was continued in patients with GI bleeding.
Conclusions
In our experience, OTSC was safe and effective for the closure of GI defect and to achieve hemostasis of non-variceal GI bleeding.

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Shannon Chan, Rapat Pittayanon, Hsiu-Po Wang, Jiann-Hwa Chen, Anthony YB Teoh, Yu Ting Kuo, Raymond SY Tang, Hon Chi Yip, Stephen Ka Kei Ng, Sunny Wong, Joyce Wing Yan Mak, Heyson Chan, Louis Lau, Rashid N Lui, Marc Wong, Rungsun Rerknimitr, Enders K Ng,
Gut.2023; 72(4): 638. CrossRef
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Mucosal Incision and Forceps Biopsy for Reliable Tissue Sampling of Gastric Subepithelial Tumors: Sa Young Shin, Sang Jin Lee, Jae Hyuck Jun, Jong Kyu Park, Hyun Il Seo, Koon Hee Han, Young Don Kim, Woo Jin Jeong, Gab Jin Cheon; Clin Endosc 2017;50(1):64-68. Published online March 4, 2016; DOI: https://doi.org/10.5946/ce.2015.094

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Background
/Aims: The diagnostic efficacy of current tissue sampling techniques for gastric subepithelial tumors (SETs) is limited. Better tissue sampling techniques are needed to improve pathological diagnosis. The aim of this study was to evaluate the safety and efficacy of a new technique, mucosal incision and forceps biopsy, for reliable tissue sampling of gastric SETs.
Methods
This study enrolled 12 consecutive patients who underwent mucosal incision and forceps biopsy of gastric SETs between November 2011 and September 2014 at Gangneung Asan Hospital. The medical records of patients were reviewed retrospectively. The safety and diagnostic yield of this method were evaluated.
Results
By performing mucosal incision and forceps biopsy, we were able to provide a definitive histological diagnosis for 11 out of 12 cases. The pathological diagnoses were leiomyoma (3/11), gastrointestinal stromal tumor (GIST; 2/11), lipoma (2/11), schwannoma (1/11), and ectopic pancreas (3/11). In cases of leiomyoma (n=3) and GIST (n=2), tissue samples were of sufficient size to allow immunohistochemical staining. In addition, the mitotic index was evaluated in two cases of GIST. There were no procedure-related complications.
Conclusions
Mucosal incision and forceps biopsy can be used as one of several methods to obtain adequate tissue samples from gastric SETs.

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Eun Young Kim
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Double-Balloon Endoscopy in Overt and Occult Small Bowel Bleeding: Results, Complications, and Correlation with Prior Videocapsule Endoscopy in a Tertiary Referral Center: Carlijn Hermans, Arnold Stronkhorst, Annemarie Tjhie-Wensing, Jan Kamphuis, Bas van Balkom, Rob Dahlmans, Lennard Gilissen; Clin Endosc 2017;50(1):69-75. Published online January 12, 2017; DOI: https://doi.org/10.5946/ce.2016.079

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Background
/Aims: Videocapsule endoscopy (VCE) and double-balloon endoscopy (DBE) allow deep exploration in patients with suspected small bowel pathology. VCE is often performed as an initial small bowel examination to explore whether an intervention by DBE is indicated and to determine insertion route. The study aim was to evaluate the correlation between DBE and VCE in patients with obscure or overt bleeding or anemia, as well as intervention frequency, and complications.
Methods
Retrospective observational study.
Results
DBE procedures (n=205) showed small bowel lesions in 64% cases. Antegrade DBE showed positive results in 79% cases, mostly angiodysplasias (63%). Retrograde DBE showed positive results in 22% cases. An intervention was performed in 64% of DBE procedures. The major complication rate was 0.5%, which was one case of perforation. Pancreatitis did not occur. The overall diagnostic agreement was 66% among the 134 DBEs with preceded VCE.
Conclusions
In cases of overt or occult bleeding or anemia, DBE was positive in 64%, with only a few complications. Positive correlation was 66% among initially performed VCEs and DBEs. Owing to the time-consuming and invasive character of DBE, performing VCE before DBE might still be clinically relevant.

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Abstract PDF PubReader ePub

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Abstract PDF PubReader ePub

Barrett’s adenocarcinoma may occur in multiple sites, and recurrence and metachronous lesions are the major problems with endoscopic resection. Therefore, early detection of such lesions is ideal to achieve complete resection and obtain improved survival rates with minimally invasive treatment. Laser imaging systems allow multiple modalities of endoscopic imaging by using white light laser, flexible spectral imaging color enhancement (FICE), blue laser imaging (BLI), and linked color imaging even at a distant view. However, the usefulness of these modalities has not been sufficiently reported regarding Barrett’s adenocarcinoma. Here, we report on a patient with three synchronous lesions followed by one metachronous lesion in a long segment with changes of Barrett’s esophagus, all diagnosed with this new laser endoscopic imaging system and enhanced by using FICE and/or BLI with high contrast compared with the surrounding mucosa. Laser endoscopic imaging may facilitate the detection of malignancies in patients with early Barrett’s adenocarcinoma.

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Acute Gastric Injury Caused by Undissolved Sodium Picosulfate/Magnesium Citrate Powder: Eun Young Ze, Chang Hwan Choi, Jeong Wook Kim; Clin Endosc 2017;50(1):87-90. Published online October 12, 2016; DOI: https://doi.org/10.5946/ce.2016.081

Abstract PDF PubReader ePub

Sodium picosulfate/magnesium citrate (SPMC) is a widely used oral bowel cleansing agent considered to be relatively safe. However, partially dissolved or undissolved SPMC powder may cause severe injuries of the esophagus and stomach. We report a very rare case of acute gastric injury without esophageal damage caused by the ingestion of undissolved SPMC powder. A 69-year-old man experienced epigastric pain after swallowing SPMC powder without dissolving it in water in preparation for a screening colonoscopy. He realized his mistake immediately and subsequently drank 2 L of water. The esophagogastroduodenoscopy conducted after 12 hours indicated an acute gastric ulceration without injury of the esophagus or duodenum. The endoscopy conducted after 6 weeks of oral proton pump inhibitor treatment showed healing of the gastric injury. This suggested that drinking large amounts of water after ingesting partially dissolved or undissolved SPMC powder can prevent serious esophageal injury, but offers no preventive benefit for acute gastric injury.

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Abstract PDF PubReader ePub

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