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- Recent advancement in endoscopic diagnosis for risk stratification of gastric cancer
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Takuma Hiramatsu
, Naomi Kakushima, Hikaru Kuribara, Ryohei Miyata, Hideki Nakagawa, Hiroyuki Hisada, Dai Kubota, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Chihiro Takeuchi, Seiichi Yakabi, Yosuke Tsuji, Nobutake Yamamichi, Mitsuhiro Fujishiro - Clin Endosc 2025;58(6):787-796. Published online July 10, 2025
- DOI: https://doi.org/10.5946/ce.2024.355
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Abstract
PDF - Approximately 90% of cases of gastric cancer (GC) are caused by Helicobacter pylori infection, and screening esophagogastroduodenoscopy is effective for secondary prevention of GC. Endoscopic findings of the stomach due to H. pylori infection vary widely, and the risk of GC varies according to each finding. GC risk is evaluated by combining endoscopic and histopathological findings. In the operative link on gastritis assessment and operative link on gastric intestinal metaplasia assessment staging, GC risk is determined by histopathological evaluation. In the endoscopic grading of gastric intestinal metaplasia, Kyoto classification, and modified Kyoto classification, the risk is considered based on endoscopic findings. However, evaluating endoscopic findings is challenging because the evaluation varies depending on the skill of the endoscopist. Similarly, histopathological findings can be assessed differently by different pathologists. Histopathological evaluation by biopsy carries a risk of bleeding; thus, simpler and less-invasive risk stratification methods are desirable. Artificial intelligence for risk stratification, which has the potential for improved accuracy and consistency, has been developed for endoscopic and histopathological evaluations. Appropriate GC risk stratification would benefit the economy and patients, and further evaluation of surveillance intervals tailored to individual risks is warranted.
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Citations
Citations to this article as recorded by
- Autoimmune gastritis: a comprehensive review of pathophysiology, risk stratification, and management
Minxiao Feng, Wenting Xu, Haiyan Zhu
Frontiers in Immunology.2026;[Epub] CrossRef - Real-World Evidence for Expanding the Criteria for Endoscopic Resection in Submucosal Gastric Cancer: The Role of Invasion Width
Min-Jae Kim, Su-Jin Shin, In Gyu Kwon, Il Ju Choi, Keun Won Ryu, Yuna Kim, Jaeyoung Chun, Young Hoon Youn, Hyojin Park, Myeong-Cherl Kook, Jie-Hyun Kim
Journal of Gastric Cancer.2026; 26(3): 462. CrossRef
- Autoimmune gastritis: a comprehensive review of pathophysiology, risk stratification, and management
- 16,804 View
- 734 Download
- 2 Web of Science
- 2 Crossref
- Clinical meaning of sarcopenia in patients undergoing endoscopic treatment
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Hiroyuki Hisada, Yosuke Tsuji, Hikaru Kuribara, Ryohei Miyata, Kaori Oshio, Satoru Mizutani, Hideki Nakagawa, Rina Cho, Nobuyuki Sakuma, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Seiichi Yakabi, Yu Takahashi, Yoshiki Sakaguchi, Naomi Kakushima, Nobutake Yamamichi, Mitsuhiro Fujishiro
- Clin Endosc 2024;57(4):446-453. Published online March 22, 2024
- DOI: https://doi.org/10.5946/ce.2023.193
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Abstract
PDF
- With increasing global life expectancy, the significance of geriatric assessment parameters has increased. Sarcopenia is a crucial assessment parameter and is defined as the age-related loss of muscle mass and strength. Sarcopenia is widely acknowledged as a risk factor for postoperative complications in diverse advanced malignancies and has a detrimental effect on the long-term prognosis. While most studies have primarily concentrated on the correlation between sarcopenia and advanced cancer, more recent investigations have focused on the relationship between sarcopenia and early-stage cancer. Endoscopic submucosal dissection (ESD), which is less invasive than surgical intervention, is extensively employed in the management of early-stage cancer, although it is associated with complications such as bleeding and perforation. In recent years, several reports have revealed the adverse consequences of sarcopenia in patients with early-stage cancer undergoing ESD. This literature review briefly summarizes the recent studies on the association between sarcopenia and ESD.
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Citations
Citations to this article as recorded by- Correlation between sarcopenia and esophageal stenosis following endoscopic submucosal dissection and construction of a postoperative stenosis risk model
Kai-Zhe Yang, Lu Chen, Li Xu, Bin-Xiang Xu, Ming-Yue Li, Zhi Wang, Qin Lu
World Journal of Gastroenterology.2026;[Epub] CrossRef - Impact of Sarcopenia on Elderly Patients Undergoing Endoscopic Resection: Scoping Review
Hiroyuki Hisada, Hiroki Asano, Yosuke Tsuji, Dai Kubota, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Chihiro Takeuchi, Seiichi Yakabi, Keiko Niimi, Naomi Kakushima, Nobutake Yamamichi, Mitsuhiro Fujishiro
Digestive Endoscopy.2026;[Epub] CrossRef - Long-term Outcomes of Endoscopic Submucosal Dissection Versus Surgery in Late Older Adult Patients Aged ≥75 Years With Early Gastric Cancer Meeting the Curative Resection Criteria
Seung Han Kim, Seon-Young Park, Young-Il Kim, Chung Hyun Tae, Hyeong Ho Jo, Jeong Hoon Lee, Ayoung Lee, Jae Myung Park, Hwoon-Yong Jung, Dae Hwan Kim, Hong Man Yoon, Hyunsoo Chung
Journal of Gastric Cancer.2026; 26(3): 448. CrossRef - Beyond local injury: Sarcopenia as a systemic host-related determinant of esophageal stenosis after endoscopic submucosal dissection
Wen-Mao Li, Bo Liu, Qing Liu
World Journal of Gastroenterology.2026;[Epub] CrossRef - Sarcopenia in the era of aging populations: its clinical implications for peptic ulcer bleeding
Hiroyuki Hisada, Yosuke Tsuji, Mitsuhiro Fujishiro
Clinical Endoscopy.2025; 58(3): 401. CrossRef - Clinical Significance of Sarcopenia in Elderly Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-analysis
Yuanhao Su, Yongke Wu, Cheng Li, Yiyuan Zhao, Yunhao Li, Xing Jin, Zhidong Wang
Digestive Diseases and Sciences.2024; 69(8): 2970. CrossRef
- Correlation between sarcopenia and esophageal stenosis following endoscopic submucosal dissection and construction of a postoperative stenosis risk model
- 8,583 View
- 265 Download
- 6 Web of Science
- 6 Crossref
- Recent Development of Techniques and Devices in Colorectal Endoscopic Submucosal Dissection
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Hiroya Mizutani, Satoshi Ono, Daisuke Ohki, Chihiro Takeuchi, Seiichi Yakabi, Yosuke Kataoka, Itaru Saito, Yoshiki Sakaguchi, Chihiro Minatsuki, Yosuke Tsuji, Keiko Niimi, Shinya Kodashima, Nobutake Yamamichi, Mitsuhiro Fujishiro, Kazuhiko Koike
- Clin Endosc 2017;50(6):562-568. Published online November 30, 2017
- DOI: https://doi.org/10.5946/ce.2017.108
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Abstract
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- Colorectal endoscopic submucosal dissection (ESD) is now a well-established endoscopic treatment for early-stage colorectal neoplasms, especially in Asian countries, including Japan. Despite the spread of colorectal ESD, there are still situations in which achieving successful submucosal dissection is difficult. Various novel techniques and devices have been developed to overcome these difficulties, and past reports have shown that some of these strategies can be applied to colorectal ESD. We review several recent developments in the field. The techniques reviewed include the pocket creation method and traction methods and the devices reviewed include the overtube with balloon and electrosurgical knives with water-jet function. These improved techniques and devices can facilitate safer, more reliable ESDs and expand its applicability and acceptability all over the world.
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Citations
Citations to this article as recorded by- A novel robotic traction system for endoscopic submucosal dissection – achieving en bloc resection of an extensive laterally spreading tumor in the lower rectum
Zhiyong Zhai, Chongju Bao, Wanjun Li, Chao Yang, Wei Gong
Endoscopy.2026; 58(S 01): E53. CrossRef - American Society for Gastrointestinal Endoscopy Technology Status Evaluation Report: endoscopic submucosal dissection (with videos)
Galen Leung, Daniela Guerrero Vinsard, Maaza Abdi, Paul A. Akerman, Venkata S. Akshintala, Petros C. Benias, Koushik K. Das, David J. Desilets, Mark Hanscom, Nabil M. Mansour, Neil B. Marya, Girish Mishra, V. Raman Muthusamy, Swati Pawa, Tarun Rustagi, Ni
Gastrointestinal Endoscopy.2026; 104(2): 152. CrossRef - Submucosal Pressure Ejection Endoscopic Dissection (SPEED): A New Technique in Increasing the Safety and Efficacy of ESD (With Video)
Tao Chen, Zhu Yun Leng, Ai Ping Xu, Jing Jing Lian, Hai Bin Zhang, Li Shen, Li Zhang, Mei Dong Xu
Journal of Digestive Diseases.2026;[Epub] CrossRef - The Current Landscape of Endoscopic Submucosal Training in the United States
Mike T. Wei, Shai Friedland, Joo Ha Hwang
Current Gastroenterology Reports.2025;[Epub] CrossRef - A new technique for ureteral reconstruction using a colonic mucosa graft in a beagle model
Xincheng Gao, Yuancheng Zhou, Shuaishuai Chai, Ming Yang, Jiawei Chen, Zehao Yu, Xingyuan Xiao, Bing Li
Asian Journal of Urology.2025; 12(4): 554. CrossRef - Endoscopic mucosal resection with an over‐the‐scope clip for colorectal tumors (with video)
Takahiro Muramatsu, Tomoaki Tashima, Tomonori Kawasaki, Tsubasa Ishikawa, Kodai Esaki, Kei Sugimoto, Masami Sano, Shotaro Ishizaka, Yumi Mashimo, Takao Itoi, Shomei Ryozawa
DEN Open.2025;[Epub] CrossRef - Facilitating Colorectal Endoscopic Submucosal Dissection: Devices and Techniques
Teppei Akimoto, Naohisa Yahagi, Motohiko Kato
Techniques and Innovations in Gastrointestinal Endoscopy.2025; 27(4): 250932. CrossRef - Conventional Versus Traction Endoscopic Submucosal Dissection for Colorectal Tumors
Sahib Singh, Babu P. Mohan, Saurabh Chandan, Neil Sharma, Rakesh Vinayek, Sudhir Dutta, Sergey V. Kantsevoy, Michelle Le, Douglas G. Adler
Journal of Clinical Gastroenterology.2024; 58(10): 1016. CrossRef - Conventional Versus Traction-Assisted Endoscopic Submucosal Dissection for Esophageal, Gastric, and Colorectal Neoplasms: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Felipe Giacobo Nunes, Igor Logetto Caetité Gomes, Diogo Turiani Hourneaux De Moura, Juan Eduardo G Dominguez, Fernando Fornari, Igor Braga Ribeiro, Guilherme Henrique Peixoto de Oliveira, Sérgio Mazzola P de Figueiredo, Wanderley Marques Bernardo, Eduardo
Cureus.2024;[Epub] CrossRef - Endoscopic techniques for management of large colorectal polyps, strictures and leaks
Stuart R. Gordon, Lauren S. Eichenwald, Hannah K. Systrom
Surgery Open Science.2024; 20: 156. CrossRef - Endoscopic Submucosal Dissection of Superficial Colorectal Neoplasms at “Challenging Sites” Using a Double-Balloon Endoluminal Interventional Platform: A Single-Center Study
Gianluca Andrisani, Francesco Maria Di Matteo
Diagnostics.2023; 13(19): 3154. CrossRef - Traction-assisted endoscopic submucosal dissection reduces procedure time and risk of serious adverse events: a systematic review and meta-analysis
Chawin Lopimpisuth, Malorie Simons, Venkata S. Akshintala, Klaorat Prasongdee, Julie Nanavati, Saowanee Ngamruengphong
Surgical Endoscopy.2022; 36(3): 1775. CrossRef - Snare devices with thinner loop wire may provide higher performance for cold snare polypectomy in an experimental model
Satoshi Ono, Kyohei Maejima, Shun Ito, Shosuke Hosaka, Kiyotaka Umeki, Shin-ichiro Sato, Kota Akamine, Daichi Asai, Mitsuhiro Fujishiro
Endoscopy International Open.2022; 10(05): E664. CrossRef - The usefulness of a double-balloon endolumenal interventional platform for colorectal endoscopic submucosal dissection by non-expert endoscopists in a porcine model (with video)
Hiroki Yamashita, Hiroaki Ikematsu, Tatsuro Murano, Naoki Aoyama, Yuki Kano, Tomohiro Mitsui, Hironori Sunakawa, Kensuke Shinmura, Kenji Takashima, Keiichiro Nakajo, Tomohiro Kadota, Yusuke Yoda, Tomonori Yano
Surgical Endoscopy.2022; 36(10): 7818. CrossRef - Long-Term Outcomes of Endoscopic Submucosal Dissection for Colorectal Epithelial Neoplasms: A Systematic Review
Toshihiro Nishizawa, Takashi Ueda, Hirotoshi Ebinuma, Osamu Toyoshima, Hidekazu Suzuki
Cancers.2022; 15(1): 239. CrossRef - A Clip-with-Line Traction Suture Method for Closing Mucosal Defects after Endoscopic Submucosal Dissection
Chong Wang, Yiting Wang, Yuanyuan Li, Sheng Zeng, Youxiang Chen, Guohua Li, Konstantinos Triantafyllou
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef - Effectiveness of S-O Clip-Assisted Colorectal Endoscopic Submucosal Dissection
Haruka Fujinami, Akira Teramoto, Saeko Takahashi, Takayuki Ando, Shinya Kajiura, Ichiro Yasuda
Journal of Clinical Medicine.2021; 11(1): 141. CrossRef - Efficacy and suitable indication of colorectal endoscopic submucosal dissection using a balloon‐assisted endoscope
Yuichiro Kuroki, Kunio Asonuma, Natsumi Uehara, Toshiyuki Endo, Reika Suzuki, Yorimasa Yamamoto, Masatsugu Nagahama
JGH Open.2020; 4(2): 185. CrossRef - Task Deconstruction of Colonic Endoscopic Submucosal Dissection (cESD): An Expert Consensus
Karen J. Dickinson, Brian J. Dunkin, John J. Nguyen‐Lee, Aman B. Ali, Stephanie Zajac
World Journal of Surgery.2020; 44(7): 2401. CrossRef - Review on colorectal endoscopic submucosal dissection focusing on the technical aspect
Tak Lit Derek Fung, Chi Woo Samuel Chow, Pak Tat Chan, Kam Hung Kwok
Surgical Endoscopy.2020; 34(9): 3766. CrossRef - A Novel Technique of Endoscopic Papillectomy with Hybrid Endoscopic Submucosal Dissection for Ampullary Tumors: A Proof-of-Concept Study (with Video)
Naminatsu Takahara, Yosuke Tsuji, Yousuke Nakai, Yukari Suzuki, Akiyuki Inokuma, Sachiko Kanai, Kensaku Noguchi, Tatsuya Sato, Ryunosuke Hakuta, Kazunaga Ishigaki, Kei Saito, Yoshiki Sakaguchi, Tomotaka Saito, Tsuyoshi Hamada, Suguru Mizuno, Hirofumi Kogu
Journal of Clinical Medicine.2020; 9(8): 2671. CrossRef - Cost Analysis of Endoscopic Submucosal Dissection for the Treatment of Colorectal Lesions in China
Ning Cui, Yu Zhao, Honggang Yu
BioMed Research International.2019; 2019: 1. CrossRef - Colorectal endoscopic submucosal dissection: a robotic system is coming
Dong-Hoon Yang, Dong-Wan Seo
Gastrointestinal Endoscopy.2019; 90(2): 299. CrossRef
- A novel robotic traction system for endoscopic submucosal dissection – achieving en bloc resection of an extensive laterally spreading tumor in the lower rectum
- 12,083 View
- 329 Download
- 26 Web of Science
- 23 Crossref
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