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Original Articles
A novel fully covered metal stent for unresectable malignant distal biliary obstruction: results of a multicenter prospective study
Arata Sakai, Atsuhiro Masuda, Takaaki Eguchi, Keisuke Furumatsu, Takao Iemoto, Shiei Yoshida, Yoshihiro Okabe, Kodai Yamanaka, Ikuya Miki, Saori Kakuyama, Yosuke Yagi, Daisuke Shirasaka, Shinya Kohashi, Takashi Kobayashi, Hideyuki Shiomi, Yuzo Kodama
Clin Endosc 2024;57(3):375-383.   Published online July 10, 2023
DOI: https://doi.org/10.5946/ce.2023.035
Funded: JSPS KAKENHI
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic self-expandable metal stent (SEMS) placement is currently the standard technique for treating unresectable malignant distal biliary obstructions (MDBO). Therefore, covered SEMS with longer stent patency and fewer migrations are required. This study aimed to assess the clinical performance of a novel, fully covered SEMS for unresectable MDBO.
Methods
This was a multicenter single-arm prospective study. The primary outcome was a non-obstruction rate at 6 months. The secondary outcomes were overall survival (OS), recurrent biliary obstruction (RBO), time to RBO (TRBO), technical and clinical success, and adverse events.
Results
A total of 73 patients were enrolled in this study. The non-obstruction rate at 6 months was 61%. The median OS and TRBO were 233 and 216 days, respectively. The technical and clinical success rates were 100% and 97%, respectively. Furthermore, the rate of occurrence of RBO and adverse events was 49% and 21%, respectively. The length of bile duct stenosis (<2.2 cm) was the only significant risk factor for stent migration.
Conclusions
The non-obstruction rate of a novel fully covered SEMS for MDBO is comparable to that reported earlier but shorter than expected. Short bile duct stenosis is a significant risk factor for stent migration.

Citations

Citations to this article as recorded by  
  • Endeavors to prevent stent malfunction: new insights into the risk factors for recurrent biliary obstruction
    Sung-Jo Bang
    Clinical Endoscopy.2024; 57(1): 56.     CrossRef
  • Understanding mechanical properties of biliary metal stents for wise stent selection
    Seok Jeong
    Clinical Endoscopy.2023; 56(5): 592.     CrossRef
  • 2,661 View
  • 72 Download
  • 1 Web of Science
  • 2 Crossref
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Novel upper gastrointestinal bleeding sensor capsule: a first human feasibility and safety trial
Lukas Bajer, Marvin Ryou, Christopher C. Thompson, Pavel Drastich
Clin Endosc 2024;57(2):203-208.   Published online January 17, 2024
DOI: https://doi.org/10.5946/ce.2023.111
Funded: European Union’s Horizon 2020 research and innovation programme
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Upper gastrointestinal bleeding (UGIB) is the most common GI condition requiring hospitalization, and can be diagnosed by direct visualization. The present study aimed to evaluate the safety and feasibility of using the PillSense system (EnteraSense Ltd.), a novel diagnostic tool designed for the rapid in vivo detection of UGIB, in human volunteers.
Methods
In the present study, 10 volunteers swallowed a PillSense capsule, followed by 2 servings of an autologous blood preparation. Participants were monitored for capsule passage, overall tolerability of the procedure, and adverse events.
Results
The procedure was completed per the protocol established in the present study in 9/10 cases. In 9 of the subjects, after capsule ingestion, the device indicated the absence of blood with sensor output values of 1. After the ingestion of the first blood mixture, the sensor outputs of all devices increased from 2.8 to 4, indicating that each camera detected blood. The sensor output remained within that range after the ingestion of the second mixture; however, in one case, the baseline capsule signal was positive, because of a preexisting condition. The passage of the capsule was verified in all patients, and no adverse events were reported.
Conclusions
The first trial of the PillSense system in human subjects demonstrated the feasibility, safety, and tolerability of utilizing this product as a novel, noninvasive, and easy-to-use triage tool for the diagnosis of patients suspected of having UGIB.

Citations

Citations to this article as recorded by  
  • Could a bleeding-sensor device be established as a new paradigm for detecting upper gastrointestinal bleeding before performing endoscopy?
    Sun Gyo Lim
    Clinical Endoscopy.2024; 57(2): 191.     CrossRef
  • 2,201 View
  • 155 Download
  • 1 Crossref
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Performance comparison between two computer-aided detection colonoscopy models by trainees using different false positive thresholds: a cross-sectional study in Thailand
Kasenee Tiankanon, Julalak Karuehardsuwan, Satimai Aniwan, Parit Mekaroonkamol, Panukorn Sunthornwechapong, Huttakan Navadurong, Kittithat​ Tantitanawat, Krittaya Mekritthikrai, Salin Samutrangsi, Peerapon Vateekul, Rungsun Rerknimitr
Clin Endosc 2024;57(2):217-225.   Published online February 7, 2024
DOI: https://doi.org/10.5946/ce.2023.145
Funded: National Research Council of Thailand, Center of Excellence for Gastrointestinal and Oncology Endoscopy Unit, King Chulalongkorn Memorial Hospital
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: This study aims to compare polyp detection performance of “Deep-GI,” a newly developed artificial intelligence (AI) model, to a previously validated AI model computer-aided polyp detection (CADe) using various false positive (FP) thresholds and determining the best threshold for each model.
Methods
Colonoscopy videos were collected prospectively and reviewed by three expert endoscopists (gold standard), trainees, CADe (CAD EYE; Fujifilm Corp.), and Deep-GI. Polyp detection sensitivity (PDS), polyp miss rates (PMR), and false-positive alarm rates (FPR) were compared among the three groups using different FP thresholds for the duration of bounding boxes appearing on the screen.
Results
In total, 170 colonoscopy videos were used in this study. Deep-GI showed the highest PDS (99.4% vs. 85.4% vs. 66.7%, p<0.01) and the lowest PMR (0.6% vs. 14.6% vs. 33.3%, p<0.01) when compared to CADe and trainees, respectively. Compared to CADe, Deep-GI demonstrated lower FPR at FP thresholds of ≥0.5 (12.1 vs. 22.4) and ≥1 second (4.4 vs. 6.8) (both p<0.05). However, when the threshold was raised to ≥1.5 seconds, the FPR became comparable (2 vs. 2.4, p=0.3), while the PMR increased from 2% to 10%.
Conclusions
Compared to CADe, Deep-GI demonstrated a higher PDS with significantly lower FPR at ≥0.5- and ≥1-second thresholds. At the ≥1.5-second threshold, both systems showed comparable FPR with increased PMR.
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Efficacy of an assistive guide tube for improved endoscopic access to gastrointestinal lesions: an in vivo study in a porcine model
Dong Seok Lee, Jeong-Sik Byeon, Sang Gyun Kim, Ji Won Kim, Kook Lae Lee, Ji Bong Jeong, Yong Jin Jung, Hyoun Woo Kang
Clin Endosc 2024;57(1):82-88.   Published online April 18, 2023
DOI: https://doi.org/10.5946/ce.2022.161
Funded: Seoul National University Boramae Medical Center, National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Guide tube-assisted endoscopy for procedures that require repeated endoscopic access is safer and more effective than conventional endoscopy. However, its effectiveness has not been confirmed in animal studies. We assessed the usefulness of guide tube-assisted endoscopic procedures in an in vivo porcine model.
Methods
Five different guide tube-assisted endoscopic procedures were performed by experienced endoscopists on a pig weighing 32 kg. To evaluate the efficacy of these procedures, we compared the endoscopic approach time when a guide tube was used to that when it was not. Additional endoscopic procedures using a guide tube were performed, including multiple foreign body extractions, multiple polypectomies, and multiple submucosal dissections. To evaluate safety, we compared the insertion force into the proximal esophagus between the guide tube and conventional overtube methods.
Results
Using the endoscopic approach with a guide tube required a shorter average approach time to reach the three target lesions than when using the endoscopic approach without a guide tube (p<0.001). Compared to the conventional overtube method, the guide tube method produced a lower average resistance during insertion into the upper esophagus (p<0.001).
Conclusions
Guide tube-assisted endoscopic procedures are effective and safe for repeated endoscopic access in an in vivo porcine model.
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Preclinical study of a novel ingestible bleeding sensor for upper gastrointestinal bleeding
Kimberly F. Schuster, Christopher C. Thompson, Marvin Ryou
Clin Endosc 2024;57(1):73-81.   Published online May 31, 2023
DOI: https://doi.org/10.5946/ce.2022.293
Funded: EnteraSense Inc
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Upper gastrointestinal bleeding (UGIB) is a life-threatening condition that necessitates early identification and intervention and is associated with substantial morbidity, mortality, and socioeconomic burden. However, several diagnostic challenges remain regarding risk stratification and the optimal timing of endoscopy. The PillSense System is a noninvasive device developed to detect blood in patients with UGIB in real time. This study aimed to assess the safety and performance characteristics of PillSense using a simulated bleeding model.
Methods
A preclinical study was performed using an in vivo porcine model (14 animals). Fourteen PillSense capsules were endoscopically placed in the stomach and blood was injected into the stomach to simulate bleeding. The safety and sensitivity of blood detection and pill excretion were also investigated.
Results
All the sensors successfully detected the presence or absence of blood. The minimum threshold was 9% blood concentration, with additional detection of increasing concentrations of up to 22.5% blood. All the sensors passed naturally through the gastrointestinal tract.
Conclusions
This study demonstrated the ability of the PillSense System sensor to detect UGIB across a wide range of blood concentrations. This ingestible device detects UGIB in real time and has the potential to be an effective tool to supplement the current standard of care. These favorable results will be further investigated in future clinical studies.

Citations

Citations to this article as recorded by  
  • Miniaturized Capsule System Toward Real‐Time Electrochemical Detection of H2S in the Gastrointestinal Tract
    Justin M. Stine, Katie L. Ruland, Luke A. Beardslee, Joshua A. Levy, Hossein Abianeh, Santiago Botasini, Pankaj J. Pasricha, Reza Ghodssi
    Advanced Healthcare Materials.2024;[Epub]     CrossRef
  • 2,200 View
  • 142 Download
  • 1 Web of Science
  • 1 Crossref
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Brief Report
Side-opening cutting forceps and esophageal lamina propria yield in pediatric patients with eosinophilic esophagitis
Adam T. Cardullo, Jacob O. Robson
Clin Endosc 2024;57(1):128-130.   Published online June 28, 2023
DOI: https://doi.org/10.5946/ce.2023.008
Funded: North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
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  • 1,551 View
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Review
Advanced endoscopic imaging for detection of Barrett’s esophagus
Netanel Zilberstein, Michelle Godbee, Neal A. Mehta, Irving Waxman
Clin Endosc 2024;57(1):1-10.   Published online January 5, 2024
DOI: https://doi.org/10.5946/ce.2023.031
Funded: National Research Service Award
AbstractAbstract PDFPubReaderePub
Barrett’s esophagus (BE) is the precursor to esophageal adenocarcinoma (EAC), and is caused by chronic gastroesophageal reflux. BE can progress over time from metaplasia to dysplasia, and eventually to EAC. EAC is associated with a poor prognosis, often due to advanced disease at the time of diagnosis. However, if BE is diagnosed early, pharmacologic and endoscopic treatments can prevent progression to EAC. The current standard of care for BE surveillance utilizes the Seattle protocol. Unfortunately, a sizable proportion of early EAC and BE-related high-grade dysplasia (HGD) are missed due to poor adherence to the Seattle protocol and sampling errors. New modalities using artificial intelligence (AI) have been proposed to improve the detection of early EAC and BE-related HGD. This review will focus on AI technology and its application to various endoscopic modalities such as high-definition white light endoscopy, narrow-band imaging, and volumetric laser endomicroscopy.

Citations

Citations to this article as recorded by  
  • Advancements in Barrett's esophagus detection: The role of artificial intelligence and its implications
    Sara Massironi
    World Journal of Gastroenterology.2024; 30(11): 1494.     CrossRef
  • 2,845 View
  • 209 Download
  • 1 Web of Science
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Case Report
Ischemic colitis complicated by Clostridioides difficile infection treated with fecal microbiota transplantation
Seok Hyung Kang, Tae-Geun Gweon, Hyunjung Hwang, Myong Ki Baeg
Clin Endosc 2023;56(5):666-670.   Published online January 20, 2022
DOI: https://doi.org/10.5946/ce.2021.199
Funded: National Research Foundation of Korea, Ministry of Science and ICT
AbstractAbstract PDFPubReaderePub
Ischemic colitis is an inflammatory condition of the colon that results from insufficient blood supply commonly caused by enterocolitis, vessel occlusion, or shock. In contrast, pseudomembranous colitis is a clinical manifestation of Clostridioides difficile infection (CDI). Ischemic colitis caused by CDI has rarely been reported. Fecal microbiota transplantation (FMT) is an efficient treatment for refractory or fulminant CDI, and the indications for its use have recently expanded. However, performing FMT in patients with ischemic colitis is challenging because of the risk of perforation. Here, we have presented a case of ischemic colitis caused by CDI that was successfully treated with FMT via sigmoidoscopy.

Citations

Citations to this article as recorded by  
  • Case of Pseudomembranous Colitis Caused by a Clostridioides difficile Infection Concomitant with Cytomegalovirus colitis Mimicking Ischemic Colitis
    Hyo Suk Kim, Hye Min Kim, Tae-Geun Gweon
    The Korean Journal of Gastroenterology.2023; 81(3): 133.     CrossRef
  • Fecal microbiota transplantation in non-communicable diseases: Recent advances and protocols
    Sevag Hamamah, Roxana Gheorghita, Andrei Lobiuc, Ioan-Ovidiu Sirbu, Mihai Covasa
    Frontiers in Medicine.2022;[Epub]     CrossRef
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Original Article
Medical disputes related to advanced endoscopic procedures with endoscopic retrograde cholangiopancreatography or endoscopic ultrasonography for the management of pancreas and biliary tract diseases
Yoon Suk Lee, Jae-Young Jang, Jun Yong Bae, Eun Hye Oh, Yehyun Park, Yong Hwan Kwon, Jeong Eun Shin, Jun Kyu Lee, Tae Hee Lee, Chang Nyol Paik
Clin Endosc 2023;56(4):499-509.   Published online March 28, 2023
DOI: https://doi.org/10.5946/ce.2022.208
Funded: Korean Gastrointestinal Endoscopy Research Foundation
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: This study aimed to evaluate the characteristics of endoscopic retrograde cholangiopancreatography (ERCP) or endoscopic ultrasonography (EUS)-related adverse events (AEs) that eventually lead to medical disputes or claims on medical professional liability.
Methods
Medical disputes for ERCP/EUS-related AEs filed in the Korea Medical Dispute Mediation and Arbitration Agency between April 2012 and August 2020 were evaluated using corresponding medical records. AEs were categorized into three sections: procedure-related, sedation-related, and safety-related AEs.
Results
Among a total of 34 cases, procedure-related AEs were 26 (76.5%; 12 duodenal perforations, 7 post-ERCP pancreatitis, 5 bleedings, 2 perforations combined with post-ERCP pancreatitis); sedation-related AEs were 5 (14.7%; 4 cardiac arrests, 1 desaturation), and safety-related AEs were 5 (8.8%; 1 follow-up loss for stent removal, 1 asphyxia, 1 fall). Regarding clinical outcomes, 20 (58.8%) were fatal and eventually succumbed to AEs. For the types of medical institutions, 21 cases (61.8%) occurred at tertiary or academic hospitals, and 13 (38.2%) occurred at community hospitals.
Conclusions
The ERCP/EUS-related AEs filed in Korea Medical Dispute Mediation and Arbitration Agency showed distinct features: duodenal perforation was the most frequent AE, and clinical outcomes were fatal, resulting in at least more than permanent physical impairment.
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Boost Your Learning with Quiz
Rare cause of granulomatous enteritis
Seung Min Hong, Byeong Kyu Park, Dong Hoon Baek
Clin Endosc 2023;56(4):534-536.   Published online May 9, 2023
DOI: https://doi.org/10.5946/ce.2023.014
Funded: Pusan National University Hospital
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  • 1,599 View
  • 69 Download
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Reviews
Clinical practice guidelines for percutaneous endoscopic gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy Task Force on Clinical Practice Guidelines
Clin Endosc 2023;56(4):391-408.   Published online June 23, 2023
DOI: https://doi.org/10.5946/ce.2023.062
Funded: Korean Society of Gastrointestinal Endoscopy
AbstractAbstract PDFSupplementary MaterialPubReaderePub
With an aging population, the number of patients with difficulty in swallowing due to medical conditions is gradually increasing. In such cases, enteral nutrition is administered through a temporary nasogastric tube. However, the long-term use of a nasogastric tube leads to various complications and a decreased quality of life. Percutaneous endoscopic gastrostomy (PEG) is the percutaneous placement of a tube into the stomach that is aided endoscopically and may be an alternative to a nasogastric tube when enteral nutritional is required for four weeks or more. This paper is the first Korean clinical guideline for PEG developed jointly by the Korean College of Helicobacter and Upper Gastrointestinal Research and led by the Korean Society of Gastrointestinal Endoscopy. These guidelines aimed to provide physicians, including endoscopists, with the indications, use of prophylactic antibiotics, timing of enteric nutrition, tube placement methods, complications, replacement, and tube removal for PEG based on the currently available clinical evidence.

Citations

Citations to this article as recorded by  
  • A Multicenter Survey of Percutaneous Endoscopic Gastrostomy in 2019 at Korean Medical Institutions
    Jun Woo Park, Tae Gyun Kim, Kwang Bum Cho, Jeong Seok Kim, Jin Woong Cho, Jung Won Jeon, Sun Gyo Lim, Chan Gyoo Kim, Hong Jun Park, Tae Jun Kim, Eun Sun Kim, Su Jin Jeong, Yong Hwan Kwon
    Gut and Liver.2024; 18(1): 77.     CrossRef
  • Fast-track discharge following percutaneous endoscopic gastrostomy removal in head and neck cancer patients after remission: a feasibility and safety study
    Daniel Conceição, Luís Correia Gomes, Fátima Francisco, Ivone Frade, Joana Gramacho, Sandra Faias, Isabel Claro
    Journal of Gastrointestinal Surgery.2024; 28(6): 943.     CrossRef
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  • 420 Download
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Management of complications related to colorectal endoscopic submucosal dissection
Tae-Geun Gweon, Dong-Hoon Yang
Clin Endosc 2023;56(4):423-432.   Published online July 27, 2023
DOI: https://doi.org/10.5946/ce.2023.104
Funded: National Research Foundation of Korea, Ministry of Science and ICT
AbstractAbstract PDFPubReaderePub
Compared to endoscopic mucosal resection (EMR), colonoscopic endoscopic submucosal dissection (C-ESD) has the advantages of higher en bloc resection rates and lower recurrence rates of colorectal neoplasms. Therefore, C-ESD is considered an effective treatment method for laterally spread tumors and early colorectal cancer. However, C-ESD is technically more difficult and requires a longer procedure time than EMR. In addition to therapeutic efficacy and procedural difficulty, safety concerns should always be considered when performing C-ESD in clinical practice. Bleeding and perforation are the main adverse events associated with C-ESD and can occur during C-ESD or after the completion of the procedure. Most bleeding associated with C-ESD can be managed endoscopically, even if it occurs during or after the procedure. More recently, most perforations identified during C-ESD can also be managed endoscopically, unless the mural defect is too large to be sutured with endoscopic devices or the patient is hemodynamically unstable. Delayed perforations are quite rare, but they require surgical treatment more frequently than endoscopically identified intraprocedural perforations or radiologically identified immediate postprocedural perforations. Post-ESD coagulation syndrome is a relatively underestimated adverse event, which can mimic localized peritonitis from perforation. Here, we classify and characterize the complications associated with C-ESD and recommend management options for them.

Citations

Citations to this article as recorded by  
  • International Digestive Endoscopy Network consensus on the management of antithrombotic agents in patients undergoing gastrointestinal endoscopy
    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
    Clinical Endoscopy.2024; 57(2): 141.     CrossRef
  • Is there a best choice of equipment for colorectal endoscopic submucosal dissection?
    Francesco Cocomazzi, Sonia Carparelli, Nunzia Labarile, Antonio Capogreco, Marco Gentile, Roberta Maselli, Jahnvi Dhar, Jayanta Samanta, Alessandro Repici, Cesare Hassan, Francesco Perri, Antonio Facciorusso
    Expert Review of Medical Devices.2024; : 1.     CrossRef
  • 1,739 View
  • 131 Download
  • 4 Web of Science
  • 2 Crossref
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Original Articles
Efficacy and safety of intragastric balloon for obesity in Korea
Kwang Gyun Lee, Seung-Joo Nam, Hyuk Soon Choi, Hang Lak Lee, Jai Hoon Yoon, Chan Hyuk Park, Kyoung Oh Kim, Do Hoon Kim, Jung-Wook Kim, Won Sohn, Sung Hoon Jung, Korean Research Group for Endoscopic Management of Metabolic Disorder and Obesity
Clin Endosc 2023;56(3):333-339.   Published online December 13, 2022
DOI: https://doi.org/10.5946/ce.2022.143
Funded: Korean Gastrointestinal Endoscopy Research Foundation
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Intragastric balloon (IGB) is the only available endoscopic bariatric and metabolic therapy in Korea. End-ball (Endalis) has the longest history of clinical use among the IGBs available in Korea. However, little clinical data on this system have been reported. In this study, we aimed to evaluate the efficacy and safety of End-ball in Korea.
Methods
We performed a retrospective cohort study of patients who underwent IGB insertion (End-ball) from 2013 to 2019. Demographic and anthropometric data were collected. The efficacy and safety of IGB treatment were analyzed.
Results
In total, 80 patients were included. Mean age was 33.7 years and 83.8% were female. Initial body mass index was 34.48±4.69 kg/m2. Body mass index reduction was 3.72±2.63 kg/m2 at the time of IGB removal. Percent of total body weight loss (%TBWL) was 10.76%±6.76%. Percentage excess body weight loss was 43.67%±27.59%. Most adverse events were minor, and 71.4% of participants showed nausea, vomiting, or abdominal pain.
Conclusions
IGB treatment showed good efficacy and safety profile in Korean patients with obesity. In terms of %TBWL and percentage excess body weight loss, the efficacy was similar to that in the Western population.

Citations

Citations to this article as recorded by  
  • Intragastric Balloons
    D.T.H. de Moura, Sergio A. Sánchez-Luna, Adriana Fernandes Silva, Alexandre Moraes Bestetti
    Gastrointestinal Endoscopy Clinics of North America.2024;[Epub]     CrossRef
  • How effective is intragastric balloon insertion as an obesity treatment in Korea?
    Youngdae Kim
    Clinical Endoscopy.2023; 56(3): 310.     CrossRef
  • Laparoscopy-assisted trans-hiatal endoscopic removal of an intragastric balloon after placement-related esophageal perforation
    Pablo Cortegoso Valdivia, Giorgio Dalmonte, Marina Valente, Lucia Ballabeni, Federica Gaiani, Gian Luigi de' Angelis, Federico Marchesi
    Endoscopy.2023; 55(S 01): E1137.     CrossRef
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  • 224 Download
  • 2 Web of Science
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Accuracy of administrative claim data for gastric adenoma after endoscopic resection
Ga-Yeong Shin, Hyun Ho Choi, Jae Myung Park, Sang Yoon Kim, Jun Young Park, Donghoon Kang, Yu Kyung Cho, Sung Soo Kim, Myung-Gyu Choi
Clin Endosc 2023;56(3):325-332.   Published online March 21, 2023
DOI: https://doi.org/10.5946/ce.2022.147
Funded: National Research Foundation of Korea, Ministry of Education, Science and Technology
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Administrative databases provide valuable information for large-cohort studies. This study aimed to evaluate the diagnostic accuracy of an administrative database for resected gastric adenomas.
Methods
Data of patients who underwent endoscopic resection for benign gastric lesions were collected from three hospitals. Gastric adenoma cases were identified in the hospital database using International Classification of Diseases (ICD) 10-codes. The non-adenoma group included patients without gastric adenoma codes. The diagnostic accuracy for gastric adenoma was analyzed based on the pathological reports of the resected specimen.
Results
Among 5,095 endoscopic resections with codes for benign gastric lesions, 3,909 patients were included in the analysis. Among them, 2,831 and 1,078 patients were allocated to the adenoma and non-adenoma groups, respectively. Regarding the overall diagnosis of gastric adenoma with ICD-10 codes, the sensitivity, specificity, positive predictive value, and negative predictive value were 98.7%, 88.5%, 95.2%, and 96.8%, respectively. There were no significant differences in these parameters between the tertiary and secondary centers.
Conclusions
Administrative codes of gastric adenoma, according to ICD-10 codes, showed good accuracy and can serve as a useful tool to study prognosis of these patients in real-world data studies in the future.

Citations

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  • Gastric Cancer Incidence and Mortality After Endoscopic Resection of Gastric Adenoma: A Nationwide Cohort Study
    Jae Myung Park, Songhee Cho, Ga-Yeong Shin, Jayoun Lee, Minjee Kim, Hyeon Woo Yim
    American Journal of Gastroenterology.2023; 118(12): 2166.     CrossRef
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  • 119 Download
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Review
Sex/gender differences in gastrointestinal endoscopy from the perspective of patients and gastroenterologists
Nayoung Kim
Clin Endosc 2023;56(3):268-282.   Published online May 3, 2023
DOI: https://doi.org/10.5946/ce.2022.270
Funded: National Research Foundation of Korea, Ministry of Science and ICT
AbstractAbstract PDFPubReaderePub
The sex/gender of gastroenterologists impact patients’ satisfaction, compliance, and clinical outcomes. For instance, female gastrointestinal (GI) endoscopist–patient gender concordance improves health-related outcomes. This finding suggests that it is important to increase the number of female GI endoscopists. While the number of women in the field of gastroenterology is increasing in the United States and Korea by over 28.3%, it is not enough to account for the gender preferences of female patients. GI endoscopists are at a high risk of endoscopy-related injuries. However, there is a different distribution of muscle and fat; male endoscopists are more affected in their back, while females are more affected in the upper extremities. Women are more susceptible to endoscopy-related injuries than men. There is a correlation between the number of colonoscopies performed and musculoskeletal pain. Job satisfaction is lower in young female gastroenterologists (30’ and 40’) than in the opposite gender and other ages. Thus, it is important to address these issues in the development of GI endoscopy.

Citations

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  • Protecting Gastroenterologists through Rehabilitation Training: An Overlooked Area of Concern
    Sun-Hye Ko, Myong Ki Baeg
    Gut and Liver.2023; 17(6): 829.     CrossRef
  • 2,135 View
  • 144 Download
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Original Articles
Methylene blue chromoendoscopy is more useful in detection of intestinal metaplasia in the stomach than mucosal pit pattern or vessel evaluation and predicts advanced Operative Link on Gastric Intestinal Metaplasia stages
Justyna Wasielica-Berger, Pawel Rogalski, Anna Pryczynicz, Agnieszka Swidnicka-Siergiejko, Andrzej Dabrowski
Clin Endosc 2023;56(2):203-213.   Published online March 9, 2023
DOI: https://doi.org/10.5946/ce.2022.087
Funded: Medical University of Bialystok
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Intestinal metaplasia (IM) of the stomach is a precancerous condition that is often not visible during conventional endoscopy. Hence, we evaluated the utility of magnification endoscopy and methylene blue (MB) chromoendoscopy to detect IM.
Methods
We estimated the percentage of gastric mucosa surface staining with MB, mucosal pit pattern, and vessel visibility and correlated it with the presence of IM and the percentage of metaplastic cells in histology, similar to the Operative Link on Gastric Intestinal Metaplasia (OLGIM) stage.
Results
IM was found in 25 of 33 (75.8%) patients and in 61 of 135 biopsies (45.2%). IM correlated with positive MB staining (p<0.001) and other than dot pit patterns (p=0.015). MB staining indicated IM with better accuracy than the pit pattern or vessel evaluation (71.7% vs. 60.5% and 49.6%, respectively). At a cut-off point of 16.5% for the MB-stained gastric surface, the sensitivity, specificity, and accuracy of chromoendoscopy in the detection of advanced OLGIM stages were 88.9%, 91.7%, and 90.9%, respectively. The percentage of metaplastic cells detected on histology was the strongest predictor of positive MB staining.
Conclusions
MB chromoendoscopy can serve as a screening method for detecting advanced OLGIM stages. MB mainly stains IM areas with a high concentration of metaplastic cells.

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  • The prediction model of operative link on gastric intestinal metaplasia stage III-IV: A multicenter study
    Song Wang, Meng Qian, Min Wu, Shuo Feng, Kaiguang Zhang
    Heliyon.2023; 9(11): e21905.     CrossRef
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Defining the optimal technique for endoscopic ultrasound shear wave elastography: a combined benchtop and animal model study with comparison to transabdominal shear wave elastography
Thomas J. Wang, Marvin Ryou
Clin Endosc 2023;56(2):229-238.   Published online February 28, 2023
DOI: https://doi.org/10.5946/ce.2022.135
Funded: Olympus America Inc
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Shear wave elastography (SWE) is used for liver fibrosis staging based on stiffness measurements. It can be performed using endoscopic ultrasound (EUS) or a transabdominal approach. Transabdominal accuracy can be limited in patients with obesity because of the thick abdomen. Theoretically, EUS-SWE overcomes this limitation by internally assessing the liver. We aimed to define the optimal technique for EUS-SWE for future research and clinical use and compare its accuracy with that of transabdominal SWE.
Methods
Benchtop study: A standardized phantom model was used. The compared variables included the region of interest (ROI) size, depth, and orientation and transducer pressure. Porcine study: Phantom models with varying stiffness values were surgically implanted between the hepatic lobes.
Results
For EUS-SWE, a larger ROI size of 1.5 cm and a smaller ROI depth of 1 cm demonstrated a significantly higher accuracy. For transabdominal SWE, the ROI size was nonadjustable, and the optimal ROI depth ranged from 2 to 4 cm. The transducer pressure and ROI orientation did not significantly affect the accuracy. There were no significant differences in the accuracy between transabdominal SWE and EUS-SWE in the animal model. The variability among the operators was more pronounced for the higher stiffness values. Small lesion measurements were accurate only when the ROI was entirely situated within the lesion.
Conclusions
We defined the optimal viewing windows for EUS-SWE and transabdominal SWE. The accuracy was comparable in the non-obese porcine model. EUS-SWE may have a higher utility for evaluating small lesions than transabdominal SWE.

Citations

Citations to this article as recorded by  
  • Endoscopic Ultrasound-based Shear Wave Elastography for Detection of Advanced Liver Disease
    Jad AbiMansour, Jerry Yung-Lun Chin, Jyotroop Kaur, Eric J. Vargas, Barham K. Abu Dayyeh, Ryan Law, Vishal Garimella, Michael J. Levy, Andrew C. Storm, Ross Dierkhising, Alina Allen, Sudhakar Venkatesh, Vinay Chandrasekhara
    Journal of Clinical Gastroenterology.2024;[Epub]     CrossRef
  • Response
    Divyanshoo R. Kohli, Mohammad Shadab Siddiqui
    Gastrointestinal Endoscopy.2024; 100(1): 161.     CrossRef
  • Standardization of endoscopic ultrasound shear wave elastography
    Julio Iglesias-García, J. Enrique Domínguez-Muñoz
    Clinical Endoscopy.2023; 56(2): 185.     CrossRef
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  • 161 Download
  • 1 Web of Science
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Review
Role of radiofrequency ablation in advanced malignant hilar biliary obstruction
Mamoru Takenaka, Tae Hoon Lee
Clin Endosc 2023;56(2):155-163.   Published online January 16, 2023
DOI: https://doi.org/10.5946/ce.2022.218
Funded: Soonchunhyang University Research Fund
AbstractAbstract PDFPubReaderePub
Malignant hilar biliary obstruction (MHO), an aggressive perihilar biliary obstruction caused by cholangiocarcinoma, gallbladder cancer, or other metastatic malignancies, has a poor prognosis. Surgical resection is the only curative treatment for biliary malignancies. However, the majority of patients with MHO cannot undergo surgery on presentation because of an advanced inoperable state or a poor performance state due to old age or comorbid diseases. Therefore, palliative biliary drainage is mandatory to improve symptomatic jaundice and the quality of life. Among the drainage methods, endoscopic biliary drainage is the current standard for palliation of unresectable advanced MHO. In addition, combined with endoscopic drainage, additional local ablation therapies, such as photodynamic therapy or radiofrequency ablation (RFA), have been introduced to prolong stent patency and survival. Currently, RFA is commonly used as palliative therapy, even for advanced MHO. This literature review summarizes recent studies on RFA for advanced MHO.

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  • Percutaneous endobiliary radiofrequency ablation with stent placement in type IV hilar cholangiocarcinoma: A prospective comparison with stent placement alone
    Kun Yung Kim, Chang Jin Yoon, Jae Hwan Lee, Chong-Ho Lee, Jin-Hyeok Hwang, Jaihwan Kim
    European Journal of Radiology.2024; 176: 111516.     CrossRef
  • Metastatic Cholangiocarcinoma Presenting as Colonic Obstruction
    Yianni Protopapadakis, Kevin Lamm, Joseph Baber
    ACG Case Reports Journal.2023; 10(12): e01238.     CrossRef
  • Is endoscopic radiofrequency ablation plus stent placement superior to stent placement alone for the treatment of malignant biliary obstruction? A systematic review and meta-analysis
    Chenming Liu, Jiaming Dong, Yuxing Liu, Siyuan Zhang, Ruanchang Chen, Haijun Tang
    Journal of International Medical Research.2023;[Epub]     CrossRef
  • 2,886 View
  • 246 Download
  • 2 Web of Science
  • 3 Crossref
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Brief Report
Trans-cavity lumen-apposing metal stent removal: an alternative safe modality
Giacomo Emanuele Maria Rizzo, Ilaria Tarantino
Clin Endosc 2023;56(1):129-131.   Published online January 18, 2023
DOI: https://doi.org/10.5946/ce.2022.105
Funded: Italian Ministry of Health
PDFSupplementary MaterialPubReaderePub
  • 1,659 View
  • 95 Download
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Editorials
Role of endoscopic ultrasound in the secondary prevention of gastric varices
Joung-Ho Han
Clin Endosc 2023;56(1):50-52.   Published online January 16, 2023
DOI: https://doi.org/10.5946/ce.2022.301
Funded: Chungbuk National University
PDFPubReaderePub
  • 1,694 View
  • 134 Download
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Application of double-balloon enteroscopy for small bowel tumors
Su Bum Park
Clin Endosc 2023;56(1):53-54.   Published online January 13, 2023
DOI: https://doi.org/10.5946/ce.2022.307
Funded: Pusan National University Yangsan Hospital
PDFPubReaderePub

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  • Transumbilical single-site laparoscopic treatment of small intestinal cavernous hemangioma in child: a case report
    Meng Kong, Weiqiang Liu, Yuexia Bai, Jinhua Jia, Chuanyang Liu, Shisong Zhang
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • Detection of Neuroendocrine Tumours by Enteroscopy: A Case Report
    Adriana Ortega Larrode, Sergio Farrais Villalba, Claudia Guerrero Muñoz, Leonardo Blas Jhon, Maria Jesus Martin Relloso, Paloma Sanchez-Fayos Calabuig, Daniel Calero Baron, Andres Varela Silva, Juan Carlos Porres Cubero
    Medicina.2023; 59(8): 1469.     CrossRef
  • 1,448 View
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Original Article
Comparison between a novel core knife and the conventional IT knife 2 for endoscopic submucosal dissection of gastric mucosal lesions
Myeongsoon Park, Jin Wook Lee, Dong Woo Shin, Jungseok Kim, Yoo Jin Lee, Ju Yup Lee, Kwang Bum Cho
Clin Endosc 2022;55(6):767-774.   Published online May 25, 2022
DOI: https://doi.org/10.5946/ce.2022.002
Funded: Korea Health Industry Development Institute, INCORE Co. Ltd
AbstractAbstract PDFPubReaderePub
Background
/Aims: Few studies have compared the performances of endoscopic knives. This study aimed to compare the therapeutic outcomes of a novel core knife and the conventional IT knife 2 for endoscopic submucosal dissection (ESD) of gastric mucosal lesions.
Methods
This prospective, non-inferiority trial included patients diagnosed with gastric adenoma or early-stage adenocarcinoma at Keimyung University Dongsan Hospital between June and November 2020. The patients were randomly assigned to either the core knife or the IT knife 2 group. The operators and assistants scored the knives’ grip convenience and cutting abilities.
Results
A total of 39 patients were enrolled (core knife group, 20 patients; IT knife 2 group, 19 patients). There were no significant between-group differences in operator-assessed grip convenience (9.600 vs. 9.526, p=0.753), cutting ability (9.600 vs. 9.105, p=0.158), or assistant-assessed grip convenience (9.500 vs. 9.368, p=0.574).
Conclusions
The core knife achieved therapeutic outcomes that were comparable to those of the IT knife 2 for ESD of gastric mucosal lesions.
  • 2,215 View
  • 114 Download
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Reviews
Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition
Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases
Clin Endosc 2022;55(6):703-725.   Published online October 13, 2022
DOI: https://doi.org/10.5946/ce.2022.136
Funded: Korean Society of Gastrointestinal Endoscopy
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

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  • Association between Atherosclerosis and High-Risk Colorectal Adenomas based on Cardio-Ankle Vascular Index and Ankle-Brachial Index
    Jung Ho Lee, Hyunseok Cho, Sang Hoon Lee, Sung Joon Lee, Chang Don Kang, Dae Hee Choi, Jin Myung Park, Seung-Joo Nam, Tae Suk Kim, Ji Hyun Kim, Sung Chul Park
    The Korean Journal of Gastroenterology.2024; 83(4): 143.     CrossRef
  • A survey of current practices in post-polypectomy surveillance in Korea
    Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoo
    Intestinal Research.2024; 22(2): 186.     CrossRef
  • Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revision
    Su Young Kim
    The Korean Journal of Medicine.2023; 98(3): 102.     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
  • Understanding colorectal polyps to prevent colorectal cancer
    Dong-Hoon Yang
    Journal of the Korean Medical Association.2023; 66(11): 626.     CrossRef
  • Classification and endoscopic diagnosis of colorectal polyps
    Ji Hyun Kim, Sung Chul Park
    Journal of the Korean Medical Association.2023; 66(11): 633.     CrossRef
  • Endoscopic treatment of colorectal polyps and early colorectal cancer
    Yunho Jung
    Journal of the Korean Medical Association.2023; 66(11): 642.     CrossRef
  • Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
    Yong Soo Kwon, Su Young Kim
    Journal of the Korean Medical Association.2023; 66(11): 652.     CrossRef
  • 5,251 View
  • 515 Download
  • 8 Web of Science
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Preparation of image databases for artificial intelligence algorithm development in gastrointestinal endoscopy
Chang Bong Yang, Sang Hoon Kim, Yun Jeong Lim
Clin Endosc 2022;55(5):594-604.   Published online May 31, 2022
DOI: https://doi.org/10.5946/ce.2021.229
Funded: Korean Health Industry Development Institute, Ministry of Health and Welfare
AbstractAbstract PDFPubReaderePub
Over the past decade, technological advances in deep learning have led to the introduction of artificial intelligence (AI) in medical imaging. The most commonly used structure in image recognition is the convolutional neural network, which mimics the action of the human visual cortex. The applications of AI in gastrointestinal endoscopy are diverse. Computer-aided diagnosis has achieved remarkable outcomes with recent improvements in machine-learning techniques and advances in computer performance. Despite some hurdles, the implementation of AI-assisted clinical practice is expected to aid endoscopists in real-time decision-making. In this summary, we reviewed state-of-the-art AI in the field of gastrointestinal endoscopy and offered a practical guide for building a learning image dataset for algorithm development.

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  • Use of artificial intelligence in the management of T1 colorectal cancer: a new tool in the arsenal or is deep learning out of its depth?
    James Weiquan Li, Lai Mun Wang, Katsuro Ichimasa, Kenneth Weicong Lin, James Chi-Yong Ngu, Tiing Leong Ang
    Clinical Endoscopy.2024; 57(1): 24.     CrossRef
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    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
    United European Gastroenterology Journal.2024; 12(4): 487.     CrossRef
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    Hannah Williams, Hannah M. Thompson, Christina Lee, Aneesh Rangnekar, Jorge T. Gomez, Maria Widmar, Iris H. Wei, Emmanouil P. Pappou, Garrett M. Nash, Martin R. Weiser, Philip B. Paty, J. Joshua Smith, Harini Veeraraghavan, Julio Garcia-Aguilar
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    Jean-Francois Rey
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    Irene Zammarchi, Giovanni Santacroce, Marietta Iacucci
    Diagnostics.2023; 13(15): 2547.     CrossRef
  • Public Imaging Datasets of Gastrointestinal Endoscopy for Artificial Intelligence: a Review
    Shiqi Zhu, Jingwen Gao, Lu Liu, Minyue Yin, Jiaxi Lin, Chang Xu, Chunfang Xu, Jinzhou Zhu
    Journal of Digital Imaging.2023; 36(6): 2578.     CrossRef
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    Donghwan Kim, Eunsun Kim
    Journal of the Korean Medical Association.2023; 66(11): 658.     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
  • 3,407 View
  • 249 Download
  • 8 Web of Science
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Original Article
Efficacy of a novel channel-cleaning ball brush for endoscope reprocessing: a randomized controlled trial
Kwang Hyun Chung, Jeong Don Chae, Wonho Choe, Hyo Young Lee, Il Hwan Oh, Byoung Kwan Son
Clin Endosc 2022;55(5):674-682.   Published online August 2, 2022
DOI: https://doi.org/10.5946/ce.2021.210
Funded: Silverex
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic channels are difficult to clean and can cause infection transmission. We examined the effectiveness of a newly developed channel-cleaning ball brush (BB), which is sucked into the endoscopic channel and scrapes and cleans the lumen as it passes through.
Methods
The upper and lower gastrointestinal endoscopes used for patient examinations were randomly selected as the conventional brush (CB) or BB group. After manual cleaning, the presence or absence of carbohydrates, proteins, adenosine triphosphate, and hemoglobin was assessed.
Results
Fifty-six and 58 endoscopes were cleaned with the CB and BB, respectively. Carbohydrate and protein were detected in one (1.8%) and two endoscopes (3.4%) in the CB and BB groups, respectively (p=1.000). Hemoglobin was observed in one (1.8%) and three endoscopes (5.2%) in the CB and BB groups, respectively (p=0.636). The adenosine triphosphate levels were 10.6±15.9 and 12.5±14.3 relative light units in the CB and BB groups, respectively (p=0.496). Twenty-seven (48.2%) and 19 (32.8%) endoscopes were positive for microbial cultures in the CB and BB groups, respectively (p=0.136).
Conclusions
The efficacy of BB was not significantly different from that of CB in the endoscopic channel-cleaning process.
  • 3,289 View
  • 164 Download
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Brief Report
General guideline in the endoscopy room to avoid air-borne infection during the COVID-19 pandemic
Kwang Hyun Chung, Soo-Jeong Cho
Clin Endosc 2022;55(5):688-690.   Published online September 14, 2022
DOI: https://doi.org/10.5946/ce.2022.146
Funded: National Research Foundation of Korea
PDFPubReaderePub
  • 2,181 View
  • 116 Download
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Original Article
Bispectral index-guided propofol sedation during endoscopic ultrasonography
Ayana Okamoto, Ken Kamata, Takeshi Miyata, Tomoe Yoshikawa, Rei Ishikawa, Tomohiro Yamazaki, Atsushi Nakai, Shunsuke Omoto, Kosuke Minaga, Kentaro Yamao, Mamoru Takenaka, Yasutaka Chiba, Toshiharu Sakurai, Naoshi Nishida, Masayuki Kitano, Masatoshi Kudo
Clin Endosc 2022;55(4):558-563.   Published online July 12, 2022
DOI: https://doi.org/10.5946/ce.2022.001
Funded: Japan Research Foundation for Clinical Pharmacology
AbstractAbstract PDFPubReaderePub
Background
/Aims: Bispectral index (BIS) monitors process and display electroencephalographic data are used to assess the depth of anesthesia. This study retrospectively evaluated the usefulness of BIS monitoring during endoscopic ultrasonography (EUS).
Methods
This study included 725 consecutive patients who underwent EUS under sedation with propofol. BIS monitoring was used in 364 patients and was not used in 361. The following parameters were evaluated: (1) median dose of propofol; (2) respiratory and circulatory depression; (3) occurrence of body movements; (4) awakening score >8 at the time; and (5) awakening score 2 hours after leaving the endoscopy room.
Results
The BIS group received a significantly lower median dose of propofol than the non-BIS group (159.2 mg vs. 167.5 mg; p=0.015) in all age groups. For patients aged ≥75 years, the reduction in heart rate was significantly lower in the BIS group than in the non-BIS group (1.2% vs. 9.1%; p=0.023). Moreover, the occurrence of body movements was markedly lower in the BIS group than in the non-BIS group (8.5% vs. 39.4%; p<0.001).
Conclusions
During EUS examination, BIS monitoring is useful for maintaining a constant depth of anesthesia, especially in patients 75 years of age or older.

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  • Advances in Analgosedation and Periprocedural Care for Gastrointestinal Endoscopy
    Sonja Skiljic, Dino Budrovac, Ana Cicvaric, Nenad Neskovic, Slavica Kvolik
    Life.2023; 13(2): 473.     CrossRef
  • Clinical and economic value of bispectral index monitoring for adequate endoscopic sedation
    Se Woo Park
    Clinical Endoscopy.2022; 55(4): 518.     CrossRef
  • Respiratory Failure during BIS-Guided Sedation in a Patient with Relapsing Polychondritis: A Case Report
    Jaesang Lee, Hosik Moon, Sungjin Hong, Jinyoung Chon, Hyejin Kwon, Hunwoo Park, Jiyung Lee
    Medicina.2022; 59(1): 65.     CrossRef
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  • 140 Download
  • 3 Web of Science
  • 3 Crossref
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Review
Post-polypectomy surveillance: the present and the future
Masau Sekiguchi, Takahisa Matsuda, Kinichi Hotta, Yutaka Saito
Clin Endosc 2022;55(4):489-495.   Published online July 11, 2022
DOI: https://doi.org/10.5946/ce.2022.097
Funded: National Cancer Center Research and Development Fund
AbstractAbstract PDFPubReaderePub
An appropriate post-polypectomy surveillance program requires the effectiveness of reducing colorectal cancer and safety. In addition, the post-polypectomy surveillance program should consider the burden of limited medical resource capacity, cost-effectiveness, and patient adherence. In this sense, a risk-stratified surveillance program based on baseline colonoscopy results is ideal. Major international guidelines for post-polypectomy surveillance, such as those from the European Union and the United States, have recommended risk-stratified surveillance programs. Both guidelines have recently been updated to better differentiate between high- and low-risk individuals. In both updated guidelines, more individuals have been downgraded to lower-risk groups that require less frequent or no surveillance. Furthermore, increased attention has been paid to the surveillance of patients who undergo serrated polyp removal. Previous guidelines in Japan did not clearly outline the risk stratification in post-polypectomy surveillance. However, the new colonoscopy screening and surveillance guidelines presented by the Japan Gastroenterological Endoscopy Society include a risk-stratified post-polypectomy surveillance program. Further discussion and analysis of unresolved issues in this field, such as the optimal follow-up after the first surveillance, the upper age limit for surveillance, and the ideal method for improving adherence to surveillance guidelines, are warranted.

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  • Protocolo diagnóstico del seguimiento de pólipos colónicos
    S. Redondo Evangelista, M. Sierra Morales, I. Bartolomé Oterino, P. García Centeno, A. Santos Rodríguez
    Medicine - Programa de Formación Médica Continuada Acreditado.2024; 14(4): 219.     CrossRef
  • Metabolic‐associated fatty liver disease is associated with colorectal adenomas in young and older Korean adults
    Jiwon Chang, Yoosoo Chang, Yoosun Cho, Hyun‐Suk Jung, Dong‐Il Park, Soo‐Kyung Park, Soo‐Youn Ham, Sarah H. Wild, Christopher D. Byrne, Seungho Ryu
    Liver International.2023; 43(11): 2548.     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
  • Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
    Yong Soo Kwon, Su Young Kim
    Journal of the Korean Medical Association.2023; 66(11): 652.     CrossRef
  • Endoscopic treatment of colorectal polyps and early colorectal cancer
    Yunho Jung
    Journal of the Korean Medical Association.2023; 66(11): 642.     CrossRef
  • Understanding colorectal polyps to prevent colorectal cancer
    Dong-Hoon Yang
    Journal of the Korean Medical Association.2023; 66(11): 626.     CrossRef
  • 3,569 View
  • 250 Download
  • 5 Web of Science
  • 6 Crossref
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Original Articles
Epidemiology of early esophageal adenocarcinoma
Thuy-Van P. Hang, Zachary Spiritos, Anthony M. Gamboa, Zhengjia Chen, Seth Force, Vaishali Patel, Saurabh Chawla, Steven Keilin, Nabil F. Saba, Bassel El-Rayes, Qiang Cai, Field F. Willingham
Clin Endosc 2022;55(3):372-380.   Published online February 11, 2022
DOI: https://doi.org/10.5946/ce.2021.152
Funded: Winship Cancer Institute, National Cancer Institute
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic resection has become the preferred treatment approach for select early esophageal adenocarcinoma (EAC); however, the epidemiology of early stage disease has not been well defined.
Methods
Surveillance Epidemiology and End Results (SEER) data were analyzed to determine age-adjusted incidence rates among major epithelial carcinomas, including EAC, from 1973 to 2017. The percent change in incidence over time was compared according to tumor subtype. Early T-stage, node-negative EAC without metastasis was examined from 2004 to 2017 when precise T-stage data were available.
Results
The percent change in annual incidence from 1973 to 2017 was 767% for EAC. Joinpoint analysis showed that the average annual percent change in EAC from 1973 to 2017 was 5.11% (95% confidence interval, 4.66%–5.56%). The annual percent change appeared to plateau between 2004 and 2017; however, early EAC decreased from 2010 to 2017, with an annual percent change of -5.78%.
Conclusions
There has been a 7-fold increase in the incidence of EAC, which was significantly greater than that of the other major epithelial malignancies examined. More recently, the incidence of early EAC has been decreasing. Approximately one in five patients has node negative, potentially resectable early stage disease.

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    Mohammad Sadra Gholami Chahkand, Fatemeh Esmaeilpour Moallem, Fatemeh Ghasemi-Kebria, Reza Malekzadeh, Gholamreza Roshandel, Mohammad Taher
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    Sabine Luttmann, Andrea Eberle, Joachim Hübner
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    Khanh Hoang Nicholas Le, Eric E. Low, Rena Yadlapati
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    Tieying Hou, Zhaohai Yang, Qingzhao Zhang, Xuchen Zhang, Xiaoyan Liao, Jingmei Lin
    International Journal of Surgical Pathology.2023;[Epub]     CrossRef
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    Shulin Li, Sanne Johanna Maria Hoefnagel, Kausilia Krishnawatie Krishnadath
    Cancers.2023; 15(22): 5410.     CrossRef
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    天伟 赖
    Advances in Clinical Medicine.2023; 13(11): 17210.     CrossRef
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    Yun Zhang, Katherine M. Weh, Bridget A. Tripp, Jennifer L. Clarke, Connor L. Howard, Shruthi Sunilkumar, Amy B. Howell, Laura A. Kresty
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    Hye Kyung Jung
    Clinical Endoscopy.2022; 55(3): 365.     CrossRef
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Real-time semantic segmentation of gastric intestinal metaplasia using a deep learning approach
Vitchaya Siripoppohn, Rapat Pittayanon, Kasenee Tiankanon, Natee Faknak, Anapat Sanpavat, Naruemon Klaikaew, Peerapon Vateekul, Rungsun Rerknimitr
Clin Endosc 2022;55(3):390-400.   Published online May 9, 2022
DOI: https://doi.org/10.5946/ce.2022.005
Funded: National Research Council of Thailand, Chulalongkorn University, Chulalongkorn University
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Previous artificial intelligence (AI) models attempting to segment gastric intestinal metaplasia (GIM) areas have failed to be deployed in real-time endoscopy due to their slow inference speeds. Here, we propose a new GIM segmentation AI model with inference speeds faster than 25 frames per second that maintains a high level of accuracy.
Methods
Investigators from Chulalongkorn University obtained 802 histological-proven GIM images for AI model training. Four strategies were proposed to improve the model accuracy. First, transfer learning was employed to the public colon datasets. Second, an image preprocessing technique contrast-limited adaptive histogram equalization was employed to produce clearer GIM areas. Third, data augmentation was applied for a more robust model. Lastly, the bilateral segmentation network model was applied to segment GIM areas in real time. The results were analyzed using different validity values.
Results
From the internal test, our AI model achieved an inference speed of 31.53 frames per second. GIM detection showed sensitivity, specificity, positive predictive, negative predictive, accuracy, and mean intersection over union in GIM segmentation values of 93%, 80%, 82%, 92%, 87%, and 57%, respectively.
Conclusions
The bilateral segmentation network combined with transfer learning, contrast-limited adaptive histogram equalization, and data augmentation can provide high sensitivity and good accuracy for GIM detection and segmentation.

Citations

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