Clinical Endoscopy

Musculoskeletal Pains and Their Risk Factors in Endoscopists: Gi-young Park; Clin Endosc 2021;54(3):295-296. Published online May 24, 2021; DOI: https://doi.org/10.5946/ce.2021.132

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The Relationship Between Colonoscopy Practice Style, Operator Ergonomics and Procedure Quality
Evren Besler, Mustafa F Celayir, Emre Teke, Cebrail Akyuz, Süleyman Toker
Cureus.2023;[Epub] CrossRef
GIE Editorial Board Top 10: advances in GI endoscopy in 2021
Emad Qayed, Tiffany Y. Chua, Ramzi Mulki, Dennis Yang, Priya A. Jamidar, Ajaypal Singh, Felix W. Leung, Jessica X. Yu, Jenifer R. Lightdale
Gastrointestinal Endoscopy.2022; 96(6): 1062. CrossRef

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Big Issues on Small Polyps: An Ideal Device, But Is It for an Ideal Indication?: Yoji Takeuchi; Clin Endosc 2021;54(3):297-298. Published online May 24, 2021; DOI: https://doi.org/10.5946/ce.2021.112

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Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Focal Liver Lesions: The Expanding Light Over the Shadow: Takuji Iwashita, Masahito Shimizu; Clin Endosc 2021;54(3):299-300. Published online May 20, 2021; DOI: https://doi.org/10.5946/ce.2021.120

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An artificial intelligence algorithm is highly accurate for detecting endoscopic features of eosinophilic esophagitis
Christoph Römmele, Robert Mendel, Caroline Barrett, Hans Kiesl, David Rauber, Tobias Rückert, Lisa Kraus, Jakob Heinkele, Christine Dhillon, Bianca Grosser, Friederike Prinz, Julia Wanzl, Carola Fleischmann, Sandra Nagl, Elisabeth Schnoy, Jakob Schlottman
Scientific Reports.2022;[Epub] CrossRef

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What You Need to Know Before Performing Endoscopic Ultrasound-guided Hepaticogastrostomy: Tanyaporn Chantarojanasiri, Thawee Ratanachu-Ek, Nonthalee Pausawasdi; Clin Endosc 2021;54(3):301-308. Published online May 28, 2021; DOI: https://doi.org/10.5946/ce.2021.103

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Endoscopic retrograde cholangiopancreatography (ERCP) is the primary treatment modality for bile duct obstruction. When ERCP is unsuccessful, percutaneous transhepatic biliary drainage can be an alternative method. Endoscopic ultrasound-guided biliary drainage (EUS-BD) has emerged as a treatment option for biliary obstruction, especially after ERCP failure. EUS-BD offers transluminal intrahepatic and extrahepatic drainage through a transgastric and transduodenal approach. EUS-guided hepaticogastrostomy (EUS-HGS) is an excellent choice for patients with hilar strictures or those with a surgically altered anatomy. The optimal steps in EUS-HGS are case selection, bile duct visualization, puncture-site selection, wire insertion and manipulation, tract dilation, and stent placement. Caution should be taken at each step to prevent complications. Dedicated devices for EUS-HGS have been developed to improve the technical success rate and reduce complications. This technical review focuses on the essential practical points at each step of EUS-HGS.

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Use of a novel screw-type dilator for endoscopic ultrasonography-guided hepaticogastrostomy via 22-gauge needle and 0.018-inch guidewire.
Shin Kato, Mariko Tsukamoto, Taichi Murai, Yuta Koike
Revista Española de Enfermedades Digestivas.2024;[Epub] CrossRef
Transbulbäre und transgastrale Gallengangsdrainage
Philipp Thies, Markus Dollhopf
Gastroenterologie up2date.2024; 20(01): 69. CrossRef
Safety of endoscopic ultrasound-guided hepaticogastrostomy in patients with malignant biliary obstruction and ascites
Tsukasa Yasuda, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Nozomi Okuno, Yasuhiro Kuraishi, Takafumi Yanaidani, Sho Ishikawa, Masanori Yamada, Toshitaka Fukui
Clinical Endoscopy.2024; 57(2): 246. CrossRef
Risk factors for recurrent stenosis after balloon dilation for benign hepaticojejunostomy anastomotic stricture
Takafumi Mie, Takashi Sasaki, Takeshi Okamoto, Tsuyoshi Takeda, Chinatsu Mori, Yuto Yamada, Takaaki Furukawa, Akiyoshi Kasuga, Masato Matsuyama, Masato Ozaka, Naoki Sasahira
Clinical Endoscopy.2024; 57(2): 253. CrossRef
Is Endoscopic Ultrasound-Guided Hepaticogastrostomy Safe and Effective after Failed Endoscopic Retrograde Cholangiopancreatography?—A Systematic Review and Meta-Analysis
Saqr Alsakarneh, Mahmoud Y. Madi, Dushyant Singh Dahiya, Fouad Jaber, Yassine Kilani, Mohamed Ahmed, Azizullah Beran, Mohamed Abdallah, Omar Al Ta’ani, Anika Mittal, Laith Numan, Hemant Goyal, Mohammad Bilal, Wissam Kiwan
Journal of Clinical Medicine.2024; 13(13): 3883. CrossRef
EUS-guided hepaticogastrostomy: practical tips and tricks
Kambiz Kadkhodayan, Shayan Irani
VideoGIE.2024;[Epub] CrossRef
A Possible Contraindication for Endoscopic Ultrasound-Guided Hepaticogastrostomy: A Giant Hiatal Hernia
Koichiro Mandai, Shiho Nakamura
Cureus.2024;[Epub] CrossRef
Endoscopic ultrasound-guided intervention for inaccessible papilla in advanced malignant hilar biliary obstruction
Partha Pal, Sundeep Lakhtakia
Clinical Endoscopy.2023; 56(2): 143. CrossRef
Liver impaction technique improves technical success rate of guidewire insertion during EUS-guided hepaticogastrostomy (with video)
Junichi Nakamura, Takeshi Ogura, Saori Ueno, Atsushi Okuda, Nobu Nishioka, Yuki Uba, Mitsuki Tomita, Kimi Bessho, Nobuhiro Hattori, Hiroki Nishikawa
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Technical Review
Roy L. J. van Wanrooij, Michiel Bronswijk, Rastislav Kunda, Simon M. Everett, Sundeep Lakhtakia, Mihai Rimbas, Tomas Hucl, Abdenor Badaoui, Ryan Law, Paolo Giorgio Arcidiacono, Alberto Larghi, Marc Giovannini, Mouen A. Khashab, Kenneth F. Binmoeller, Marc
Endoscopy.2022; 54(03): 310. CrossRef
Practical Tips for Safe and Successful Endoscopic Ultrasound-Guided Hepaticogastrostomy: A State-of-the-Art Technical Review
Saburo Matsubara, Keito Nakagawa, Kentaro Suda, Takeshi Otsuka, Masashi Oka, Sumiko Nagoshi
Journal of Clinical Medicine.2022; 11(6): 1591. CrossRef
Prevention of Serious Complications during Endoscopic Ultrasound-Guided Biliary Drainage: A Case-Based Technical Review
Surinder Singh Rana, Jimil Shah, Harish Bhujade, Ujjwal Gorsi, Mandeep Kang, Rajesh Gupta
Journal of Digestive Endoscopy.2022; 13(02): 082. CrossRef

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Contrast Harmonic Endoscopic Ultrasound in Pancreatic Diseases: Rafael Mejuto-Fernandez, Julio Iglesias-Garcia; Clin Endosc 2021;54(3):309-313. Published online June 18, 2020; DOI: https://doi.org/10.5946/ce.2020.048

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Endoscopic ultrasound (EUS) was first described in 1986, with the aim of overcoming the problems affecting transabdominal ultrasound imaging, mainly problems related to the interposition of gas, and artifacts produced by bone or fat. Now, EUS can be considered as the best method for the analysis of pancreatic diseases, overtaking the diagnostic accuracy of computed tomography and magnetic resonance imaging. However, fundamental B-mode imaging is limited for the diagnosis of solid pancreatic lesions, because most of them are depicted as heterogeneous and hypo-echoic, and it is difficult to differentiate between benign and malignant lesions. Similar to how perfusion patterns obtained by computed tomography or magnetic resonance imaging after injection of contrast agents allow for the characterization of focal lesions, EUS has also recently been introduced to the use of contrast agents for performing contrast-enhanced harmonic EUS (CEH-EUS), which has the capability to distinguish the type of perfusion between lesions and surrounding tissue. CEH-EUS has shown its usefulness for the diagnosis and characterization of solid pancreatic lesions. Moreover, CEH-EUS is also highly accurate for distinguishing non-neoplastic from neoplastic cysts in pancreatic lesions. Another potential role of CEH-EUS is its ability to direct EUS-guided tissue acquisition.

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Endoscopic ultrasonography: Enhancing diagnostic accuracy
Julio Iglesias-Garcia, Jose Lariño-Noia, Daniel de la Iglesia-García, J. Enrique Dominguez-Muñoz
Best Practice & Research Clinical Gastroenterology.2022; 60-61: 101808. CrossRef

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Endoscopic Ultrasound–Guided Fiducial Placement for Stereotactic Body Radiation Therapy in Pancreatic Malignancy: Seong-Hun Kim, Eun Ji Shin; Clin Endosc 2021;54(3):314-323. Published online May 28, 2021; DOI: https://doi.org/10.5946/ce.2021.102

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Stereotactic body radiation therapy (SBRT) is an important treatment option for pancreatic cancer, which is known to be one of the malignancies with the worst prognosis. However, the high radiation doses delivered during SBRT may cause damage to adjacent radiosensitive organs. To minimize such damage, fiducial markers are used for localization during SBRT for pancreatic cancer. The development of endoscopic ultrasound (EUS) has enabled fiducial markers to be inserted into the pancreas using an EUS fine-needle aspiration (FNA) needle, unlike in the past when percutaneous placement was generally performed. For successful EUS-guided fiducial marker placement, it is necessary for the fiducial markers to be loaded within the EUS-FNA needles to have a low probability of complications and a low migration risk, and to be stably observed in SBRT imaging. A systematic review has shown that the technical success rate of EUS-guided fiducial marker placement is 96.27%, whereas the fiducial marker migration and adverse event rates are 4.33% and 4.85%, respectively. Nonetheless, standardized techniques for fiducial marker placement and the characteristics of optimal fiducial markers have not yet been established. This review will introduce the characteristics (e.g., materials and shapes) of fiducial markers used in fiducial marker placement for pancreatic cancer and will discuss conventional techniques along with their success rates, difficulties, and adverse events.

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EUS-guided interventional therapies for pancreatic diseases
Rongmin Xu, Kai Zhang, Nan Ge, Siyu Sun
Frontiers in Medicine.2024;[Epub] CrossRef
Cardiac migration of an implanted hepatic fiducial marker used for stereotactic body radiation therapy - A case report
Youstina Soliman, Febin Antony, Mark Vivian, Sankar Venkatraman, Maged Nashed
Journal of Cancer Research and Therapeutics.2024;[Epub] CrossRef
Development of devices for interventional endoscopic ultrasound for the management of pancreatobiliary diseases
Masahiro Itonaga, Masayuki Kitano, Reiko Ashida
Digestive Endoscopy.2023; 35(3): 302. CrossRef
Endoscopic Ultrasound-Guided Fiducial Placement for Stereotactic Body Radiation Therapy in Patients with Pancreatic Cancer
Irina M. Cazacu, Ben S. Singh, Rachael M. Martin-Paulpeter, Sam Beddar, Stephen Chun, Emma B. Holliday, Albert C. Koong, Prajnan Das, Eugene J. Koay, Cullen Taniguchi, Joseph M. Herman, Manoop S. Bhutani
Cancers.2023; 15(22): 5355. CrossRef
A Preliminary Controlled Trial of Endoscopic Ultrasound-guided Fiducial Markers to Guide Pancreas Surgery
Patrick W. Chang, Jonathan Sadik, Ara B. Sahakian, Ravi Kankotia, Christopher Ko, Jessica Serna, Alex Rodriguez, Helen Lee, Sujit Kulkarni, Yuri Genyk, Mohd Sheikh, James L. Buxbaum
Journal of Clinical Gastroenterology.2023;[Epub] CrossRef
Endoscopic Management of Pancreatobiliary Malignancies
Dong Wook Lee, Eun Young Kim
Digestive Diseases and Sciences.2022; 67(5): 1635. CrossRef
Hot topics in therapeutic EUS
Daniela Tabacelia, Alexandru Martiniuc, DanielaElena Burtea, Adrian Saftoiu, Cezar Stroescu
Endoscopic Ultrasound.2022; 11(3): 153. CrossRef

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Diagnosing Gastric Mesenchymal Tumors by Digital Endoscopic Ultrasonography Image Analysis: Moon Won Lee, Gwang Ha Kim; Clin Endosc 2021;54(3):324-328. Published online June 18, 2020; DOI: https://doi.org/10.5946/ce.2020.061

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Gastric mesenchymal tumors (GMTs) are incidentally discovered in national gastric screening programs in Korea. Endoscopic ultrasonography (EUS) is the most useful diagnostic modality for evaluating GMTs. The differentiation of gastrointestinal stromal tumors from benign mesenchymal tumors, such as schwannomas or leiomyomas, is important to ensure appropriate clinical management. However, this is difficult and operator dependent because of the subjective interpretation of EUS images. Digital image analysis computes the distribution and spatial variation of pixels using texture analysis to extract useful data, enabling the objective analysis of EUS images and decreasing interobserver and intraobserver agreement in EUS image interpretation. This review aimed to summarize the usefulness and future of digital EUS image analysis for GMTs based on published reports and our experience.

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Schwannoma gástrico. Reporte de un caso
Darío Montes N, Nixon Cevallos R, Rubén Montes N
Oncología (Ecuador).2024; 34(1): 52. CrossRef
Artificial Intelligence-Based Diagnosis of Gastric Mesenchymal Tumors Using Digital Endosonography Image Analysis
Dong Chan Joo, Gwang Ha Kim, Moon Won Lee, Bong Eun Lee, Ji Woo Kim, Kwang Baek Kim
Journal of Clinical Medicine.2024; 13(13): 3725. CrossRef
A combined radiomic model distinguishing GISTs from leiomyomas and schwannomas in the stomach based on endoscopic ultrasonography images
Xian‐Da Zhang, Ling Zhang, Ting‐Ting Gong, Zhuo‐Ran Wang, Kang‐Li Guo, Jun Li, Yuan Chen, Jian‐Tao Zhang, Ben‐Gong Ye, Jin Ding, Jian‐Wei Zhu, Feng Liu, Duan‐Min Hu, JianGang Chen, Chun‐Hua Zhou, Duo‐Wu Zou
Journal of Applied Clinical Medical Physics.2023;[Epub] CrossRef
An Esophageal Leiomyoma with Cystic Degeneration Mimicking a Malignant Neoplasm
Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim
The Ewha Medical Journal.2023;[Epub] CrossRef
Advancements in the Diagnosis of Gastric Subepithelial Tumors
Osamu Goto, Mitsuru Kaise, Katsuhiko Iwakiri
Gut and Liver.2022; 16(3): 321. CrossRef
Schwannoma gástrico. Diagnóstico diferencial de tumores submucosos
M. Reyes Busta Nistal, Noelia Alcaide Suarez, Luis Fernández Salazar, Daniel Corrales Cruz
Gastroenterología y Hepatología.2021;[Epub] CrossRef
Scoring systems for differentiating gastrointestinal stromal tumors and schwannomas from leiomyomas in the stomach
Shotaro Okanoue, Masaya Iwamuro, Takehiro Tanaka, Takuya Satomi, Kenta Hamada, Hiroyuki Sakae, Makoto Abe, Yoshiyasu Kono, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
Medicine.2021; 100(40): e27520. CrossRef

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Artificial Intelligence in Lower Gastrointestinal Endoscopy: The Current Status and Future Perspective: Sebastian Manuel Milluzzo, Paola Cesaro, Leonardo Minelli Grazioli, Nicola Olivari, Cristiano Spada; Clin Endosc 2021;54(3):329-339. Published online January 13, 2021; DOI: https://doi.org/10.5946/ce.2020.082

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The present manuscript aims to review the history, recent advances, evidence, and challenges of artificial intelligence (AI) in colonoscopy. Although it is mainly focused on polyp detection and characterization, it also considers other potential applications (i.e., inflammatory bowel disease) and future perspectives. Some of the most recent algorithms show promising results that are similar to human expert performance. The integration of AI in routine clinical practice will be challenging, with significant issues to overcome (i.e., regulatory, reimbursement). Medico-legal issues will also need to be addressed. With the exception of an AI system that is already available in selected countries (GI Genius; Medtronic, Minneapolis, MN, USA), the majority of the technology is still in its infancy and has not yet been proven to reach a sufficient diagnostic performance to be adopted in the clinical practice. However, larger players will enter the arena of AI in the next few months.

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“AI for the new GI”: What role does artificial intelligence have in early colonoscopy training?
Lawrence Hookey
Gastrointestinal Endoscopy.2024; 99(1): 100. CrossRef
Colonoscopy Quality, Innovation, and the Assessment of New Technology
Sanjay R.V. Gadi, Sriya S. Muralidharan, Jeremy R. Glissen Brown
Techniques and Innovations in Gastrointestinal Endoscopy.2024; 26(2): 177. CrossRef
GI genius endoscopy module: a clinical profile
Alberto Savino, Emanuele Rondonotti, Simone Rocchetto, Alessandra Piagnani, Niccolò Bina, Pasquale Di Domenico, Francesco Segatta, Franco Radaelli
Expert Review of Medical Devices.2024; 21(5): 359. CrossRef
Real-time artificial intelligence (AI)-aided endoscopy improves adenoma detection rates even in experienced endoscopists: a cohort study in Singapore
Frederick H. Koh, Jasmine Ladlad, Fung-Joon Foo, Winson J. Tan, Sharmini S. Sivarajah, Leonard M. L. Ho, Jia-Lin Ng, Frederick H. Koh, Cheryl Chong, Darius Aw, Juinn-Haur Kam, Alvin Y. H. Tan, Choon-Chieh Tan, Baldwin P. M. Yeung, Wai-Keong Wong, Bin-Chet
Surgical Endoscopy.2023; 37(1): 165. CrossRef
Systematic meta-analysis of computer-aided detection to detect early esophageal cancer using hyperspectral imaging
Wei-Chih Liao, Arvind Mukundan, Cleorita Sadiaza, Yu-Ming Tsao, Chien-Wei Huang, Hsiang-Chen Wang
Biomedical Optics Express.2023; 14(8): 4383. CrossRef
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clinical Endoscopy.2023; 56(5): 553. CrossRef
Accuracy of polyp characterization by artificial intelligence and endoscopists: a prospective, non-randomized study in a tertiary endoscopy center
Sebastian Baumer, Kilian Streicher, Saleh A. Alqahtani, Dominic Brookman-Amissah, Monika Brunner, Christoph Federle, Klaus Muehlenberg, Lukas Pfeifer, Andrea Salzberger, Wolfgang Schorr, Jozef Zustin, Oliver Pech
Endoscopy International Open.2023; 11(09): E818. CrossRef
AI-powered medical devices for practical clinicians including the diagnosis of colorectal polyps
Donghwan Kim, Eunsun Kim
Journal of the Korean Medical Association.2023; 66(11): 658. CrossRef
Artificial Intelligence in Colonoscopic Polyp Detection and Characterization: Merging Computer Technology and Endoscopic Skill for Better Patient Care
Uday C. Ghoshal, Saikat Chakrabarti, Mahesh K. Goenka
Journal of Digestive Endoscopy.2023; 14(04): 239. CrossRef
Diagnostic accuracy of a novel artificial intelligence system for adenoma detection in daily practice: a prospective nonrandomized comparative study
Carolin Zippelius, Saleh A. Alqahtani, Jörg Schedel, Dominic Brookman-Amissah, Klaus Muehlenberg, Christoph Federle, Andrea Salzberger, Wolfgang Schorr, Oliver Pech
Endoscopy.2022; 54(05): 465. CrossRef
Development and validation of a deep learning-based algorithm for colonoscopy quality assessment
Yuan-Yen Chang, Pai-Chi Li, Ruey-Feng Chang, Yu-Yao Chang, Siou-Ping Huang, Yang-Yuan Chen, Wen-Yen Chang, Hsu-Heng Yen
Surgical Endoscopy.2022; 36(9): 6446. CrossRef
Innovation in Gastroenterology—Can We Do Better?
Eyal Klang, Shelly Soffer, Abraham Tsur, Eyal Shachar, Adi Lahat
Biomimetics.2022; 7(1): 33. CrossRef
Hybrid and Deep Learning Approach for Early Diagnosis of Lower Gastrointestinal Diseases
Suliman Mohamed Fati, Ebrahim Mohammed Senan, Ahmad Taher Azar
Sensors.2022; 22(11): 4079. CrossRef
No-Code Platform-Based Deep-Learning Models for Prediction of Colorectal Polyp Histology from White-Light Endoscopy Images: Development and Performance Verification
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Seung In Seo, Young Joo Yang, Gwang Ho Baik, Jong Wook Kim
Journal of Personalized Medicine.2022; 12(6): 963. CrossRef
Impact of the Volume and Distribution of Training Datasets in the Development of Deep-Learning Models for the Diagnosis of Colorectal Polyps in Endoscopy Images
Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee, Young Joo Yang, Gwang Ho Baik
Journal of Personalized Medicine.2022; 12(9): 1361. CrossRef
Preparation of image databases for artificial intelligence algorithm development in gastrointestinal endoscopy
Chang Bong Yang, Sang Hoon Kim, Yun Jeong Lim
Clinical Endoscopy.2022; 55(5): 594. CrossRef
Artificial Intelligence-Based Colorectal Polyp Histology Prediction: High Accuracy in Larger Polyps
Naoki Muguruma, Tetsuji Takayama
Clinical Endoscopy.2022; 55(1): 45. CrossRef
Artificial Intelligence and Advanced Melanoma: Treatment Management Implications
Antonino Guerrisi, Italia Falcone, Fabio Valenti, Marco Rao, Enzo Gallo, Sara Ungania, Maria Teresa Maccallini, Maurizio Fanciulli, Pasquale Frascione, Aldo Morrone, Mauro Caterino
Cells.2022; 11(24): 3965. CrossRef
Clinical feasibility of panintestinal (or panenteric) capsule endoscopy: a systematic review
Pablo Cortegoso Valdivia, Alfonso Elosua, Charles Houdeville, Marco Pennazio, Ignacio Fernández-Urién, Xavier Dray, Ervin Toth, Rami Eliakim, Anastasios Koulaouzidis
European Journal of Gastroenterology & Hepatology.2021; 33(7): 949. CrossRef
Predictors of Positive Video Capsule Endoscopy Findings for Chronic Unexplained Abdominal Pain: Single-Center Retrospective Study and Meta-Analysis
Wonshik Kim, Beomjae Lee, Ahyoung Yoo, Seunghan Kim, Moonkyung Joo, Jong-Jae Park
Diagnostics.2021; 11(11): 2123. CrossRef

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Safety and Recipient Satisfaction of Propofol Sedation in Outpatient Endoscopy: A 24-Hour Prospective Investigation Using a Questionnaire Survey: Yoshihide Kanno, Tetsuya Ohira, Yoshihiro Harada, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Yoshiki Koike, Taku Yamagata, Toshitaka Sakai, Kaori Masu, Keisuke Yonamine, Kazuaki Miyamoto, Megumi Tanaka, Tomohiro Shimada, Fumisato Kozakai, Kazuki Endo, Haruka Okano, Daichi Komabayashi, Takeshi Shimizu, Shohei Suzuki, Kei Ito; Clin Endosc 2021;54(3):340-347. Published online December 11, 2020; DOI: https://doi.org/10.5946/ce.2020.138

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Background
/Aims: The aim of this study was to evaluate the safety of sedation with propofol as an alternative to benzodiazepine drugs in outpatient endoscopy.
Methods
In this prospective study, examinees who underwent outpatient endoscopy under propofol sedation and submitted a nextday questionnaire with providing informed consent were evaluated. Periprocedural acute responses, late adverse events within 24 hours, and examinee satisfaction were evaluated.
Results
Among the 4,122 patients who received propofol in the 17,978 outpatient-based endoscopic examinations performed between November 2016 and March 2018, 2,305 eligible examinees (esophagogastroduodenoscopy for 1,340, endoscopic ultrasonography for 945, and total colonoscopy for 20) were enrolled, and their responses to a questionnaire were analyzed. The mean propofol dose was 69.6±24.4 mg (range, 20–200 mg). Diazepam, midazolam, and/or pentazocine in combination with propofol was administered to 146 examinees. Mild oxygen desaturation was observed in 59 examinees (2.6%); and mild bradycardia, in 2 (0.09%). Other severe reactions or late events did not occur. After eliminating 181 invalid responses, 97.7% (2,065/2,124) of the patients desired propofol sedation in future examinations.
Conclusions
Propofol sedation was found to be safe—without severe adverse events or accidents—for outpatient endoscopy on the basis of the patients’ next-day self-evaluation. Given the high satisfaction level, propofol sedation might be an ideal tool for painless endoscopic screening.

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Remimazolam and Its Place in the Current Landscape of Procedural Sedation and General Anesthesia
Matthew Brohan, Janette Brohan, Basavana Goudra
Journal of Clinical Medicine.2024; 13(15): 4362. CrossRef
How to implement adverse events as a quality indicator in gastrointestinal endoscopy
Tom G. Moreels
Digestive Endoscopy.2024; 36(1): 89. CrossRef
Propofol Alone versus Propofol in Combination with Midazolam for Sedative Endoscopy in Patients with Paradoxical Reactions to Midazolam
Ji Hyung Nam, Dong Kee Jang, Jun Kyu Lee, Hyoun Woo Kang, Byung-Wook Kim, Byung Ik Jang
Clinical Endoscopy.2022; 55(2): 234. CrossRef
Drugs used for sedation in gastrointestinal endoscopy
Jun Kyu Lee
Journal of the Korean Medical Association.2022; 65(11): 735. CrossRef

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Clinical Gastroenterology and Gastrointestinal Endoscopy Practices during the Coronavirus Disease 2019 Pandemic in Indonesia: An Online Nationwide Survey: Ahmad Fariz Malvi Zamzam Zein, Rabbinu Rangga Pribadi, Uswatun Khasanah, Muhammad Begawan Bestari, Ari Fahrial Syam; Clin Endosc 2021;54(3):348-355. Published online February 18, 2021; DOI: https://doi.org/10.5946/ce.2020.216

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Background
/Aims: The coronavirus disease 2019 (COVID-19) pandemic has necessitated modifications to allow the safe practice of clinical gastroenterology and gastrointestinal endoscopy. This study aimed to investigate the characteristics of clinical gastroenterology and gastrointestinal endoscopy practices during the COVID-19 pandemic in Indonesia.
Methods
This cross-sectional study enrolled physician members of the Indonesian Society for Digestive Endoscopy. We used an online self-administered questionnaire disseminated via social media. The 32-item survey determined the baseline characteristics of the participants, characteristics of clinical gastroenterology and gastrointestinal endoscopy practices, involvement of the physicians in the management of COVID-19, and overall impact of the pandemic on practice. All collected data were analyzed using descriptive statistics.
Results
The 200 participants in this study had a median age of 50 (34–76) years. Modifications in clinical gastroenterology practice were frequently reported in the outpatient (95.5%) and inpatient (100%) settings. All participants reported changes in the gastrointestinal endoscopy practice patterns. Of the participants, 86.0% were working in high-risk zones, and several of them reported inadequate protective personal equipment (34.0%). The median overall impact score of the pandemic on practice was 9 (2–10).
Conclusions
Physicians practicing clinical gastroenterology and gastrointestinal endoscopy in Indonesia work in high-risk settings. Modifications in clinical gastroenterology and gastrointestinal endoscopy practices are prevalent during the COVID-19 pandemic.

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Impact of the COVID-19 pandemic on digestive endoscopists: an Ibero-American study
Robin German Prieto-Ortiz, Camilo de Jesús Blanco-Avellaneda, Ricardo Cepeda-Vásquez, Diana Yanira Chimbi Rojas, Jhon Edison Prieto-Ortiz, Leticia Moreira-Ruiz, Lázaro Antonio Arango-Molano
Revista Española de Enfermedades Digestivas.2022;[Epub] CrossRef
Clinical Practice of Gastrointestinal Endoscopy in COVID-19 Patients: An Experience from Indonesia
Rabbinu Rangga Pribadi, Amanda Pitarini Utari, Virly Nanda Muzellina, Saskia Aziza Nursyirwan, Hasan Maulahela, Kaka Renaldi, Ari Fahrial Syam
Clinical Endoscopy.2022; 55(1): 156. CrossRef

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Ergonomic Injuries in Endoscopists and Their Risk Factors: Lubna Kamani, Hamid Kalwar; Clin Endosc 2021;54(3):356-362. Published online March 3, 2021; DOI: https://doi.org/10.5946/ce.2020.200

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Background
/Aims: Prolonged repetitive strain caused by the continuous performance of complex endoscopic procedures enhances the risk of ergonomic injuries among health-care providers (HCPs), specifically endoscopists. This study aimed to assess the risk factors of ergonomic injuries among endoscopists and non-endoscopists.
Methods
This cross-sectional study was conducted at the Gastroenterology Department of Liaquat National Hospital, Karachi, Pakistan. A total of 92 HCPs were enrolled, of whom 61 were involved in endoscopic procedures and 31 were non-endoscopists. Data were collected through a self-administered questionnaire during national gastroenterology conferences and analyzed using SPSS version 22 (IBM Corp. Chicago, IL, USA).
Results
Of the total study population, 95.08% of endoscopists were observed to have ergonomic injuries, whereas only 54.83% of non-endoscopists had ergonomic injuries (p<0.00). The most common injury associated with musculoskeletal (MSK) pain sites was back (41%), leg (23%), and hand (19.7%) pain among endoscopists. Of 28 endoscopists performing ≥20 procedures/week, 26 had MSK injury. However, 95.08% of endoscopists had developed MSK injury irrespective of working hours (>5 or <5 hr/wk).
Conclusions
Endoscopists are at high risk of developing ergonomic injuries, representing the negative potential of the endoscopy-associated workload. To overcome these issues, an appropriate strategic framework needs to be designed to avoid occupational compromises.

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Ergonomic wellness for the trainee in gastrointestinal endoscopy
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Reduced Intravenous Fluorescein Dose for Upper and Lower Gastrointestinal Tract Probe-Based Confocal Laser Endomicroscopy: Kazuya Inoki, Seiichiro Abe, Yusaku Tanaka, Koji Yamamoto, Daisuke Hihara, Ryoji Ichijima, Yukihiro Nakatani, HsinYu Chen, Hiroyuki Takamaru, Masau Sekiguchi, Masayoshi Yamada, Taku Sakamoto, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Ichiro Oda, Takahisa Matsuda, Yutaka Saito; Clin Endosc 2021;54(3):363-370. Published online September 8, 2020; DOI: https://doi.org/10.5946/ce.2020.058

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Background
/Aims: Probe-based confocal laser endomicroscopy (pCLE) requires the administration of intravenous (IV) fluorescein. This study aimed to determine the optimal dose of IV fluorescein for both upper and lower gastrointestinal (GI) tract pCLE.
Methods
Patients 20 to 79 years old with gastric high-grade dysplasia (HGD) or colorectal neoplasms (CRNs) were enrolled in the study. The dose de-escalation method was employed with five levels. The primary endpoint of the study was the determination of the optimal dose of IV fluorescein for pCLE of the GI tract. The reduced dose was determined based on off-line reviews by three endoscopists. An insufficient dose of fluorescein was defined as the dose of fluorescein with which the pCLE images were not deemed to be visible. If all three endoscopists determined that the tissue structure was visible, the doses were de-escalated.
Results
A total of 12 patients with gastric HGD and 12 patients with CRNs were enrolled in the study. Doses were de-escalated to 0.5 mg/kg of fluorescein for both non-neoplastic duodenal and colorectal mucosa. All gastric HGD or CRNs were visible with pCLE with IV fluorescein at 0.5 mg/kg.
Conclusions
In the present study, pCLE with IV fluorescein 0.5 mg/kg was adequate to visualize the magnified structure of both the upper and lower GI tract.

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Precision endoscopy in colorectal polyps' characterization and planning of endoscopic therapy
Francesco Vito Mandarino, Silvio Danese, Toshio Uraoka, Adolfo Parra‐Blanco, Yasuharu Maeda, Yutaka Saito, Shin‐Ei Kudo, Michael J. Bourke, Marietta Iacucci
Digestive Endoscopy.2024; 36(7): 761. CrossRef

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Efficacy of Underwater Endoscopic Mucosal Resection for Superficial Non-Ampullary Duodenal Epithelial Tumor: Masanori Furukawa, Akira Mitoro, Takahiro Ozutumi, Yukihisa Fujinaga, Keisuke Nakanishi, Koh Kitagawa, Soichiro Saikawa, Sinya Sato, Yasuhiko Sawada, Hiroaki Takaya, Kosuke Kaji, Hideto Kawaratani, Tadashi Namisaki, Kei Moriya, Takemi Akahane, Junichi Yamao, Hitoshi Yoshiji; Clin Endosc 2021;54(3):371-378. Published online February 18, 2021; DOI: https://doi.org/10.5946/ce.2020.147

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Background
/Aims: Endoscopic resection (ER) for superficial non-ampullary duodenal epithelial tumors (SNADETs) is challenging. Conventional endoscopic mucosal resection (CEMR) is also problematic due to the anatomical features of the duodenum. We compared the safety and efficacy of underwater endoscopic mucosal resection (UEMR) with those of CEMR through a retrospective analysis.
Methods
Altogether, 44 consecutive patients with 46 SNADETs underwent ER (18 CEMR cases and 28 UEMR cases) between January 2016 and October 2019. We investigated the proportions of en bloc resection, R0 resection, complications, resection time, and total procedure time and compared the outcomes of patients from the CEMR group with those of patients from the UEMR group.
Results
The median tumor size was 8.0 mm (range, 2.0–20.0 mm). The UEMR group showed a higher proportion of en bloc resection (96.4% vs. 72.2%, p<0.05) and significantly lower median resection time and total procedure time (4 min vs. 9.5 min, p<0.05 and 13 min vs. 19 min, p<0.05; respectively) than the CEMR group. No complications were observed. However, two patients treated with piecemeal resection in the CEMR group had residual tumors.
Conclusions
UEMR is a feasible therapeutic option for SNADETs. It can be recommended as a standard treatment.

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Conventional versus underwater endoscopic resection for superficial non-ampullary duodenal epithelial tumours
Hajime Miyazaki, Osamu Dohi, Tsugitaka Ishida, Mayuko Seya, Katsuma Yamauchi, Hayato Fukui, Takeshi Yasuda, Takuma Yoshida, Naoto Iwai, Toshifumi Doi, Ryohei Hirose, Ken Inoue, Akihito Harusato, Naohisa Yoshida, Kazuhiko Uchiyama, Tomohisa Takagi, Takeshi
Japanese Journal of Clinical Oncology.2024; 54(2): 137. CrossRef
Can underwater endoscopic mucosal resection be an alternative to conventional endoscopic mucosal resection for superficial non‐ampullary duodenal epithelial tumors?
Hidenori Tanaka, Yuji Urabe, Hiroki Takemoto, Kazuki Ishibashi, Hirona Konishi, Yuka Matsubara, Yudai Takehara, Shin Morimoto, Fumiaki Tanino, Noriko Yamamoto, Hajime Teshima, Junichi Mizuno, Issei Hirata, Hirosato Tamari, Akiyoshi Tsuboi, Ken Yamashita,
DEN Open.2024;[Epub] CrossRef
Underwater Endoscopic Mucosal Resection Vs Conventional Endoscopic Mucosal Resection for Superficial Nonampullary Duodenal Epithelial Tumors in the Western Setting
Rui Morais, José Amorim, Renato Medas, Bernardo Sousa-Pinto, João Santos-Antunes, Romain Legros, Jérémie Albouys, Frédéric Moll, Margarida Marques, Filipe Vilas-Boas, Eduardo Rodrigues-Pinto, Irene Gullo, Fátima Carneiro, Elisa Gravito Soares, Pedro Amaro
Clinical Gastroenterology and Hepatology.2024;[Epub] CrossRef
Underwater versus conventional endoscopic mucosal resection for superficial non-ampullary duodenal epithelial tumors ≤20mm: A systematic review and meta-analysis
Xiu-He Lv, Rong Luo, Qing Lu, Kai Deng, Jin-Lin Yang
Digestive and Liver Disease.2023; 55(6): 714. CrossRef
Underwater Versus Conventional Endoscopic Mucosal Resection for Superficial Non-ampullary Duodenal Epithelial Tumors: A Systematic Review and Meta-Analysis
Jae Gon Lee, Sang Pyo Lee, Hyun Joo Jang, Sea Hyub Kae
Digestive Diseases and Sciences.2023; 68(4): 1482. CrossRef
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Underwater Endoscopic Mucosal Resection Versus Conventional Endoscopic Mucosal Resection for Superficial Non-ampullary Duodenal Epithelial Tumors ≤20 mm
Zhikun Yin, Ji Li, Weilin Yang, Weifeng Huang, Dong Xu, Xiaoyi Lei, Jinyan Zhang
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Jixiang Liu, Shaojie Duan, Yichong Wang, Hongye Peng, Youjia Kong, Shukun Yao
Frontiers in Medicine.2023;[Epub] CrossRef
Underwater versus conventional EMR for nonpedunculated colorectal lesions: a randomized clinical trial
Luciano Lenz, Bruno Martins, Gustavo Andrade de Paulo, Fabio Shiguehissa Kawaguti, Elisa Ryoka Baba, Ricardo Sato Uemura, Carla Cristina Gusmon, Sebastian Naschold Geiger, Renata Nobre Moura, Caterina Pennacchi, Marcelo Simas de Lima, Adriana Vaz Safatle-
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Endoscopic resection of superficial non‐ampullary duodenal epithelial tumor
Motohiko Kato, Takanori Kanai, Naohisa Yahagi
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The Application of Underwater Endoscopic Mucosal Resection for Nonampullary Duodenal Adenomas
Xiu-He Lv, Jin-Lin Yang
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Utility of underwater EMR for nonpolypoid superficial nonampullary duodenal epithelial tumors ≤20 mm
Kenichiro Okimoto, Daisuke Maruoka, Tomoaki Matsumura, Kengo Kanayama, Naoki Akizue, Yuki Ohta, Takashi Taida, Keiko Saito, Yosuke Inaba, Yohei Kawasaki, Makoto Arai, Jun Kato, Naoya Kato
Gastrointestinal Endoscopy.2022; 95(1): 140. CrossRef
Reply
Yasushi Yamasaki, Noriya Uedo
Clinical Gastroenterology and Hepatology.2022; 20(8): 1884. CrossRef
Appropriate selection of endoscopic resection for superficial nonampullary duodenal adenomas in association with recurrence
Kenichiro Okimoto, Daisuke Maruoka, Tomoaki Matsumura, Kengo Kanayama, Naoki Akizue, Yuki Ohta, Takashi Taida, Keiko Saito, Yosuke Inaba, Yohei Kawasaki, Jun Kato, Naoya Kato
Gastrointestinal Endoscopy.2022; 95(5): 939. CrossRef
Reply to Lv and Yang
Motohiko Kato, Yoji Takeuchi, Shu Hoteya, Tsuneo Oyama, Satoru Nonaka, Shoichi Yoshimizu, Naomi Kakushima, Ken Ohata, Hironori Yamamoto, Yuko Hara, Hisashi Doyama, Osamu Dohi, Yasushi Yamasaki, Hiroya Ueyama, Kengo Takimoto, Koichi Kurahara, Tomoaki Tashi
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Xiu-He Lv, Jin-Lin Yang
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Resectability of underwater endoscopic mucosal resection for duodenal tumor: A single‐center, retrospective pilot study
Yosuke Toya, Masaki Endo, Masanao Yamazato, Shun Yamada, Tomo Kumei, Minami Hirai, Makoto Eizuka, Toshifumi Morishita, Risaburo Akasaka, Shunichi Yanai, Noriyuki Uesugi, Tamotsu Sugai, Takayuki Matsumoto
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Underwater Endoscopic Mucosal Resection for 10 mm or Larger Nonpedunculated Colorectal Polyps: A Systematic Review and Meta-Analysis: Rajat Garg, Amandeep Singh, Manik Aggarwal, Jaideep Bhalla, Babu P. Mohan, Carol Burke, Tarun Rustagi, Prabhleen Chahal; Clin Endosc 2021;54(3):379-389. Published online April 29, 2021; DOI: https://doi.org/10.5946/ce.2020.276

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Background
/Aims: Recent studies have reported the favorable outcomes of underwater endoscopic mucosal resection (UEMR) for colorectal polyps. We performed a systematic review and meta-analysis evaluating the efficacy and safety of UEMR for nonpedunculated polyps ≥10 mm.
Methods
We performed a comprehensive search of multiple databases (through May 2020) to identify studies reporting the outcomes of UEMR for ≥10 mm nonpedunculated colorectal polyps. The assessed outcomes were recurrence rate on the first follow-up, en bloc resection, incomplete resection, and adverse events after UEMR.
Results
A total of 1276 polyps from 16 articles were included in our study. The recurrence rate was 7.3% (95% confidence interval [CI], 4.3–12) and 5.9% (95% CI, 3.6–9.4) for nonpedunculated polyps ≥10 and ≥20 mm, respectively. For nonpedunculated polyps ≥10 mm, the en bloc resection, R0 resection, and incomplete resection rates were 57.7% (95% CI, 42.4–71.6), 58.9% (95% CI, 42.4–73.6), and 1.5% (95% CI, 0.8–2.6), respectively. The rates of pooled adverse events, intraprocedural bleeding, and delayed bleeding were 7.0%, 5.4%, and 2.9%, respectively. The rate of perforation and postpolypectomy syndrome was 0.8%.
Conclusions
Our systematic review and meta-analysis demonstrates that UEMR for nonpedunculated colorectal polyps ≥10 mm is safe and effective with a low rate of recurrence.

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Polypectomy Techniques for Pedunculated and Nonpedunculated Polyps
Karl Kwok, Sasan Mosadeghi, Daniel Lew
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 361. CrossRef
Underwater versus conventional endoscopic mucosal resection for colorectal lesions: a systematic review and meta-analysis of randomized clinical trials
Matheus Henrique Gonçalves de Souza, Paula Arruda do Espirito Santo, Fauze Maluf-Filho, Luciano Lenz
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef
EMR and ESD: Indications, techniques and results
Mamoon Ur Rashid, Mohammad Alomari, Sadaf Afraz, Tolga Erim
Surgical Oncology.2022; 43: 101742. CrossRef
Safety and effectiveness of underwater cold snare resection without submucosal injection of large non-pedunculated colorectal lesions
Andrew W. Yen, Joseph W. Leung, Malcom Koo, Felix W. Leung
Endoscopy International Open.2022; 10(06): E791. CrossRef
Underwater or conventional endoscopic mucosal resection for intermediate‐sized colorectal neoplasm?
Li‐Chun Chang
Advances in Digestive Medicine.2021; 8(3): 133. CrossRef

5,077 View
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Dedicated Cold Snare vs. Traditional Snare for Polypectomy of Diminutive and Small Lesions in a Porcine Model: A Research Group for Endoscopic Instruments and Stents (REIS) Study: Han Hee Lee, Bo-In Lee, Jung-Wook Kim, Hyun Lim, Si Hyung Lee, Jun-Hyung Cho, Yunho Jung, Kyoung Oh Kim, Chan Gyoo Kim, Kee Myung Lee, Jong-Jae Park, Myung-Gyu Choi, Hoon Jai Chun, Ho Gak Kim; Clin Endosc 2021;54(3):390-396. Published online September 10, 2020; DOI: https://doi.org/10.5946/ce.2020.096

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Background
/Aims: The aim of this in vivo animal study was to evaluate the effectiveness and safety of dedicated cold snare (DCS) compared with those of traditional snare (TS) for cold snare polypectomy (CSP).
Methods
A total of 36 diminutive (5 mm) and 36 small (9 mm) pseudolesions were made by electrocoagulation in the colons of mini-pigs.
Results
For the diminutive lesions, there were no significant differences in technical success rate, procedure time, or complete resection rate between the DCS and TS groups; the rate of uneven resection margin in the DCS group was significantly lower than that of the TS group. For small lesions, technical success rate and complete resection rate were significantly higher in the DCS group than in the TS group (100% [18/18] vs. 55.6% [10/18], p=0.003; 94.4% [17/18] vs. 40% [4/10], p=0.006). In addition, the procedure duration was significantly shorter, and the rate of uneven resection margin was significantly lower in the DCS group (28.5 sec vs. 66.0 sec, p=0.006; 11.1% [2/18] vs. 100% [10/10], p<0.001). Two cases of perforation occurred in the DCS group. Multivariate analysis revealed that DCS use was independently associated with complete resection.
Conclusions
DCS is superior to TS in terms of technical success, complete resection, and reducing the duration of the procedure for CSP of small polyps.

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Comparison of complete resection rates in cold snare polypectomy using two different wire diameter snares: A randomized controlled study
Toshiki Horii, Sho Suzuki, Akihiro Sugita, Misa Yamauchi, Hisatomo Ikehara, Chika Kusano, Takuji Gotoda
Journal of Gastroenterology and Hepatology.2023; 38(5): 752. CrossRef
Comparison of the clinical efficacy of cold snare polypectomy using a thin-wire snare and thick-wire snare for small colorectal polyps
Hong Jin Yoon, Yunho Jung, Young Sin Cho, Il-Kwun Chung
International Journal of Gastrointestinal Intervention.2023; 12(4): 183. CrossRef
Big Issues on Small Polyps: An Ideal Device, But Is It for an Ideal Indication?
Yoji Takeuchi
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Cold versus hot polypectomy/endoscopic mucosal resection–A review of current evidence
Raquel Ortigão, Jochen Weigt, Ahmed Afifi, Diogo Libânio
United European Gastroenterology Journal.2021; 9(8): 938. CrossRef

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Is Submucosal Injection Helpful in Cold Snare Polypectomy for Small Colorectal Polyps?: Ji Hyun Song, Shai Friedland; Clin Endosc 2021;54(3):397-403. Published online February 9, 2021; DOI: https://doi.org/10.5946/ce.2020.226

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Background
/Aims: Cold snare polypectomy (CSP) is an effective method of polyp removal for small colorectal polyps. However, the effect of submucosal injection in cold snare endoscopic mucosal resection (CS-EMR) for small polyps is unclear. Therefore, this study aimed to evaluate the effect of submucosal injection in CS-EMR for small polyps.
Methods
Between 2018 and 2019, 100 consecutive small colorectal polyps (5–10 mm) were identified in 58 patients. The first 50 consecutive polyps were removed by CS-EMR, and the remaining 50 were removed by CSP. Demographic data, clinical data, endoscopic findings, procedure times, complication rates, and pathology data were collected.
Results
No difference in the complete resection rate was observed between the CS-EMR and CSP groups. A total of 9 polyps showed post-polypectomy bleeding (7 had immediate bleeding, 1 had delayed bleeding, and 1 had both immediate and delayed bleeding). No difference in the bleeding rate was observed between the two groups. In multivariate analysis, warfarin (odds ratio [OR], 42.334; 95% confidence interval [CI], 1.006–1,781.758) and direct-acting oral anticoagulants (OR, 35.244; 95% CI, 3.853–322.397) showed a significantly increased risk of bleeding.
Conclusions
The effect of submucosal injection in CSP was not significant for small colorectal polyps.

Citations

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Cold sub-mucosal injection versus traditional cold snare polypectomy for diminutive and small colorectal polyps: A systematic review and meta-analysis
Yong-Cai Lv, Quan Dong, Yan-Hua Yao, Jing-Jing Lei
Indian Journal of Gastroenterology.2024;[Epub] CrossRef
Colorectal cold snare polypectomy: Current standard technique and future perspectives
Fumiaki Ishibashi, Sho Suzuki, Mizuki Nagai, Kentaro Mochida, Tetsuo Morishita
Digestive Endoscopy.2023; 35(3): 278. CrossRef
The efficacy and safety of cold snare polypectomy with submucosal injection for the removal of polyps less than 20 mm in size: a systematic review and meta‐analysis
Zheng Liang, Yongqiu Wei, Shutian Zhang, Peng Li
Journal of Gastroenterology and Hepatology.2023; 38(11): 1892. CrossRef
Impact of Submucosal Saline Injection During Cold Snare Polypectomy for Colorectal Polyps Sized 3–9 mm: A Multicenter Randomized Controlled Trial
Yi Mou, Liansong Ye, Xiaobo Qin, Rui Feng, Lifan Zhang, Qin Hu, Tingting Cao, Xinyue Zhou, Wu Wen, Chuanming Zhang, Zonghua Chen, Yi Liu, Zhimin Yang, Tao Huo, Fang Pan, Xuelian Li, Bing Hu
American Journal of Gastroenterology.2023; 118(10): 1848. CrossRef
Cold resection for colorectal polyps: where we are and where we are going?
Antonio Capogreco, Ludovico Alfarone, Davide Massimi, Alessandro Repici
Expert Review of Gastroenterology & Hepatology.2023; 17(7): 719. CrossRef
Cold snare endoscopic mucosal resection for colon polyps: a systematic review and meta-analysis
Mohamed Abdallah, Khalid Ahmed, Daniyal Abbas, Mouhand F. H. Mohamed, Gaurav Suryawanshi, Nicholas McDonald, Natalie Wilson, Shifa Umar, Aasma Shaukat, Mohammad Bilal
Endoscopy.2023; 55(12): 1083. CrossRef
Endoscopic treatment of colorectal polyps and early colorectal cancer
Yunho Jung
Journal of the Korean Medical Association.2023; 66(11): 642. CrossRef

4,640 View
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Endoscopic Ultrasound-Guided Fine Needle Aspiration Using a 22-G Needle for Hepatic Lesions: Single-Center Experience: Ebru Akay, Deniz Atasoy, Engin Altınkaya, Ali Koç, Tamer Ertan, Hatice Karaman, Erkan Caglar; Clin Endosc 2021;54(3):404-412. Published online December 9, 2020; DOI: https://doi.org/10.5946/ce.2020.065

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been accepted as a reliable tool in diagnosing and staging intra-abdominal tumors. In this study, we aimed to investigate the performance of EUS-FNA in the evaluation of liver masses and its impact on patient management and procedure-related complications retrospectively.
Methods
Data of patients who underwent EUS-FNA biopsies due to liver masses between November 2017 and July 2018 were retrieved retrospectively. Biopsies were performed using 22-G needles. The demographics, EUS-FNA results, sensitivity and specificity of the procedure, negative predictive value, positive predictive value, and specimen sufficiency rates were assessed.
Results
A total of 25 patients (10 females) were included in the study. The mean age was 62.73±15.2 years. The mean size of the masses was 34.50±16.04 mm. The technical success rate was 88%. During the EUS-FNA procedure, each patient had only one pass with 94.45% of aspirate sufficiency rate and 86.3% of biopsy sufficiency rate. The diagnostic accuracy rate was 86.3%. There were no complications.
Conclusions
For the evaluation of liver masses, EUS-FNA using a 22-G needle with even one pass had high aspiration and biopsy success rates accompanied with high diagnostic accuracy rates.

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Endoscopic ultrasound‐guided tissue acquisition for focal liver lesions in patients with a history of multiple primary malignant neoplasms
Yuichi Takano, Naoki Tamai, Masataka Yamawaki, Jun Noda, Tetsushi Azami, Fumitaka Niiya, Fumiya Nishimoto, Naotaka Maruoka, Tatsuya Yamagami, Masatsugu Nagahama
DEN Open.2025;[Epub] CrossRef
Diagnostic and therapeutic role of endoscopic ultrasound in liver diseases: A systematic review and meta-analysis
Eyad Gadour, Abeer Awad, Zeinab Hassan, Khalid Jebril Shrwani, Bogdan Miutescu, Hussein Hassan Okasha
World Journal of Gastroenterology.2024; 30(7): 742. CrossRef
Endoscopic ultrasound-guided tissue acquisition for the diagnosis of focal liver lesion
Alina Tantău, Cosmina Sutac, Anamaria Pop, Marcel Tantău
World Journal of Radiology.2024; 16(4): 72. CrossRef
Contrast-enhanced guided endoscopic ultrasound procedures
Marcel Ioan Gheorghiu, Andrada Seicean, Cristina Pojoga, Claudia Hagiu, Radu Seicean, Zeno Sparchez
World Journal of Gastroenterology.2024; 30(17): 2311. CrossRef
Endoscopic ultrasound-guided fine-needle aspiration in the diagnostic value of focal liver lesions: A systematic analysis of 88 cases (with video)
Xiaohong Kong, Zijun Fan, Ruiping Li, Duanmin Hu, Guilian Cheng
Clinics and Research in Hepatology and Gastroenterology.2024; 48(7): 102382. CrossRef
Endoscopic Ultrasound-Guided Fine Needle Biopsy of Focal Liver Lesions: An Effective Mini-Invasive Alternative to the Percutaneous Approach
Gabriele Rancatore, Dario Ligresti, Giacomo Emanuele Maria Rizzo, Lucio Carrozza, Mario Traina, Ilaria Tarantino
Diagnostics.2024; 14(13): 1336. CrossRef
A case in which ultrasound-guided fine needle aspiration was useful in the diagnosis of liver metastasis of gallbladder cancer
Ayako Inada, Masao Toki, Takahiro Yamada, Sho Kawamoto, Komei Kambayashi, Takeshi Nosaka, Kazushige Ochiai, Koichi Gondo, Shunsuke Watanabe, Akimasa Hayashi, Hiroaki Shimoyamada, Junji Shibahara, Tadakazu Hisamatsu
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Frances Lee, Tarun Rustagi, R. Todd Frederick
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Chao Sun, Xingliang Zhao, Lei Shi, Xiaofei Fan, Xiaolong Qi
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Keyu Zeng, Zhenpeng Jiang, Jie Yang, Kefei Chen, Qiang Lu
Scandinavian Journal of Gastroenterology.2022; 57(5): 545. CrossRef
Endoscopic Ultrasound-Guided Fine-Needle Biopsy versus Fine-Needle Aspiration in the Diagnosis of Focal Liver Lesions: Prospective Head-to-Head Comparison
Marcel Gheorghiu, Andrada Seicean, Sorana D. Bolboacă, Ioana Rusu, Radu Seicean, Cristina Pojoga, Ofelia Moșteanu, Zeno Sparchez
Diagnostics.2022; 12(9): 2214. CrossRef
Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Focal Liver Lesions: The Expanding Light Over the Shadow
Takuji Iwashita, Masahito Shimizu
Clinical Endoscopy.2021; 54(3): 299. CrossRef
Hepatic Squamous Cell Carcinoma Diagnosed by Endoscopic Ultrasound-Guided Fine-Needle Aspiration
Koki Yamada, Susumu Shinoura, Kaoru Kikuchi, Chia-Tung Shun
Case Reports in Gastrointestinal Medicine.2021; 2021: 1. CrossRef
Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?
Tajana Pavic, Ivana Mikolasevic, Dominik Kralj, Nina Blazevic, Anita Skrtic, Ivan Budimir, Ivan Lerotic, Davor Hrabar
Diagnostics.2021; 11(11): 2021. CrossRef

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Novel Ablation Therapy Using Endoscopic Irreversible Electroporation in the Bile Duct: A Pilot Animal Study: Kang Won Lee, Jae Min Lee, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yeon Seok Seo, Yoon Tae Jeen, Soon Ho Um, Hong Sik Lee, Hoon Jai Chun, Chang Duck Kim, Chi Hyuk Oh, Hong Bae Kim; Clin Endosc 2021;54(3):413-419. Published online October 20, 2020; DOI: https://doi.org/10.5946/ce.2020.126

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Background
/Aims: Irreversible electroporation (IRE) is a relatively new ablation method. However, the application of IRE ablation in the treatment of biliary disease has not been attempted. A minimally invasive approach using endoscopic retrograde cholangiopancreatography (ERCP) can be a novel therapeutic modality for IRE ablation. In this study, we aimed to investigate the feasibility of endoscopic IRE for the biliary tract using an animal model.
Methods
A new catheter-type electrode was developed for endoscopic IRE ablation of the biliary tract. We performed ERCP and endoscopic IRE ablations in the normal common bile duct of Yorkshire pigs. The experimental setting of IRE was 500 V/cm (50 pulses, 100-µs length). The animals were sacrificed after 24 hr, and the ablated bile duct was examined.
Results
Well-demarcated focal color changes were observed on the mucosa of the common bile duct. The depth of change after IRE was confined to the mucosal and submucosal layers. Apoptotic changes in the bile duct were observed only around the IRE ablation area. Immunohistochemistry assay showed cell death in the bile duct along the electrode.
Conclusions
Endoscopic IRE ablation using ERCP was successfully performed in the common bile duct. It can be a potential option for the treatment of biliary tumors.

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Confirming Whether Fine Needle Biopsy Device Shortens the Learning Curve of Endoscopic Ultrasound-Guided Tissue Acquisition Without Rapid Onsite Evaluation: Meng-Ying Lin, Cheng-Lin Wu, Mitsuhiro Kida, Wei-Lun Chang, Bor-Shyang Sheu; Clin Endosc 2021;54(3):420-427. Published online May 28, 2021; DOI: https://doi.org/10.5946/ce.2020.184

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Background
/Aims: Endoscopic ultrasonography (EUS)-guided tissue acquisition requires a long learning curve. We aimed to compare the skill maturation curves between fine needle aspiration (FNA) and biopsy (FNB) for tissue acquisition.
Methods
The initial 60 procedures performed by the trainee endosonographer (30 FNA vs. 30 FNB) were consecutively enrolled. The difference in procedure performance was compared between the two groups. Learning curves were assessed. Twenty additional cases were subsequently enrolled to assess the consistency of performance in the FNB group.
Results
The FNB group acquired larger tissue samples (2.35 vs. 0.70 mm2; p<0.001) with lower blood content (p=0.001) and higher tissue quality (p=0.017) compared with the FNA group. In addition, the FNB group required less needle pass to establish a diagnosis (2.43 vs. 2.97; p=0.006). A threshold diagnostic sensitivity of ≥80% was achieved after performing 10 FNB procedures. The number of needle passes significantly decreased after conducting 20 FNB procedures (1.80 vs. 2.70; p=0.041). The diagnostic sensitivity and number of needle passes remained the same in the subsequent FNB procedures. By contrast, this skill maturation phenomenon was not observed after performing 30 FNA procedures.
Conclusions
In EUS-guided tissue acquisition, the FNB needle was more efficient and thus shortened the learning curve of EUSguided tissue acquisition in trainee endosonographers.

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Over the past year, the novel coronavirus has been a topic of significant research. Multiple gastroenterological symptoms have been associated with this infection, in addition to the well-established pulmonary presentations. Gastrointestinal bleeding can be a complication of infection by severe acute respiratory syndrome coronavirus-2, which can be exacerbated by the anticoagulants used to treat its thrombotic sequelae. We describe the clinical cases of four patients infected with the novel coronavirus, with significant upper gastrointestinal bleeding requiring endoscopic visualization, along with their clinical outcomes.

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Gastric Angiolipoma Resected with Endoscopic Submucosal Dissection: Sang Myung Yeo, Jae Kwang Lee, Hyun Soo Kim, Chang Geun Park, Jae Kwon Jung, Dae Jin Kim, Yun Jin Chung, Han Jun Ryu; Clin Endosc 2021;54(3):432-435. Published online March 15, 2021; DOI: https://doi.org/10.5946/ce.2020.146

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Angiolipoma is a benign fatty neoplasm that has components of proliferating blood vessels. These types of lesions commonly occur in the subcutaneous tissue of the limbs and trunk. Angiolipoma in the gastrointestinal tract is extremely rare, and the final diagnosis generally depends on histological examination of the excised biopsy. In most previously reported cases, the lesions were diagnosed and treated with surgical management. In this study, we report a case of gastric angiolipoma of approximately 4 cm in size that was diagnosed and treated with endoscopic submucosal dissection.

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Underwater Endoscopic Mucosal Resection without Submucosal Injection Facilitates En bloc Resection of Colon Adenomas Extending into a Diverticulum: Yoshikazu Hayashi, Masahiro Okada, Takaaki Morikawa, Tatsuma Nomura, Hisashi Fukuda, Takahito Takezawa, Alan Kawarai Lefor, Hironori Yamamoto; Clin Endosc 2021;54(3):436-440. Published online November 6, 2020; DOI: https://doi.org/10.5946/ce.2020.168

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Superficial colonic neoplasms sometimes extend into a diverticulum. Conventional endoscopic mucosal resection of these lesions is considered challenging because colonic diverticula do not have a muscularis propria and are deeply inverted. Even if the solution is carefully injected below the mucosa at the bottom of the diverticulum, the mucosa is rarely elevated from the diverticular orifice, and it is usually just narrowed. Although endoscopic submucosal dissection or full-thickness resection with an over-the-scope clip device enables the complete resection of these lesions, it is still challenging, time consuming and expensive. Underwater endoscopic mucosal resection without submucosal injection (UEMR) is an innovative technique enabling en bloc resection of superficial colon lesions. We report three patients with colon adenomas extending into a diverticulum treated with successful UEMR. UEMR enabled rapid and safe en bloc resection of colon lesions extending into a diverticulum.

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Diagnosis of Gastric Subepithelial Tumor: Role of Endoscopic Ultrasound-Guided Fine-Needle Biopsy: Ga Hee Kim, Ji Yong Ahn; Clin Endosc 2021;54(3):447-448. Published online May 17, 2021; DOI: https://doi.org/10.5946/ce.2021.134

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