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Original Article
Predictive Factors for Differentiating Gastrointestinal Stromal Tumors from Leiomyomas Based on Endoscopic Ultrasonography Findings in Patients with Gastric Subepithelial Tumors: A Multicenter Retrospective Study
Sun Moon Kim, Eun Young Kim, Jin Woong Cho, Seong Woo Jeon, Ji Hyun Kim, Tae Hyeon Kim, Jeong Seop Moon, Jin-Oh Kim, the Research Group for Endoscopic Ultrasound of the Korean Society of Gastrointestinal Endoscopy
Clin Endosc 2021;54(6):872-880.   Published online November 18, 2021
DOI: https://doi.org/10.5946/ce.2021.251
AbstractAbstract PDFPubReaderePub
Background
/Aims: The utility of endoscopic ultrasonography (EUS) for differentiating gastrointestinal stromal tumors (GISTs) and leiomyomas of the stomach is not well known. We aimed to evaluate the ability of EUS for differentiating gastric GISTs and leiomyomas.
Methods
We retrospectively reviewed the medical records of patients with histopathologically proven GISTs (n=274) and leiomyomas (n=87). In two consensus meetings, the inter-observer variability in the EUS image analysis was reduced. Using logistic regression analyses, we selected predictive factors and constructed a predictive model and nomogram for differentiating GISTs from leiomyomas. A receiver operating characteristic (ROC) curve analysis was performed to measure the discrimination performance in the development and internal validation sets.
Results
Multivariate analysis identified heterogeneity (odds ratio [OR], 9.48), non-cardia (OR, 19.11), and older age (OR, 1.06) as independent predictors of GISTs. The areas under the ROC curve of the predictive model using age, sex, and four EUS factors (homogeneity, location, anechoic spaces, and dimpling or ulcer) were 0.916 (sensitivity, 0.908; specificity, 0.793) and 0.904 (sensitivity, 0.908; specificity, 0.782) in the development and internal validation sets, respectively.
Conclusions
The predictive model and nomogram using age, sex and homogeneity, tumor location, presence of anechoic spaces, and presence of dimpling or ulcer on EUS may facilitate differentiation between GISTs and leiomyomas.

Citations

Citations to this article as recorded by  
  • Diagnostic Endoscopic Ultrasound (EUS) of the Luminal Gastrointestinal Tract
    Giovanna Impellizzeri, Giulio Donato, Claudio De Angelis, Nico Pagano
    Diagnostics.2024; 14(10): 996.     CrossRef
  • Endoscopic Ultrasound Advanced Techniques for Diagnosis of Gastrointestinal Stromal Tumours
    Socrate Pallio, Stefano Francesco Crinò, Marcello Maida, Emanuele Sinagra, Vincenzo Francesco Tripodi, Antonio Facciorusso, Andrew Ofosu, Maria Cristina Conti Bellocchi, Endrit Shahini, Giuseppinella Melita
    Cancers.2023; 15(4): 1285.     CrossRef
  • Results of the interim analysis of a prospective, multicenter, observational study of small subepithelial lesions in the stomach
    Masaya Iwamuro, Toshiharu Mitsuhashi, Tomoki Inaba, Kazuhiro Matsueda, Teruya Nagahara, Yoji Takeuchi, Hisashi Doyama, Masakatsu Mizuno, Tomoyuki Yada, Yoshinari Kawai, Jun Nakamura, Minoru Matsubara, Hiroko Nebiki, Keiko Niimi, Tatsuya Toyokawa, Ryuta Ta
    Digestive Endoscopy.2023;[Epub]     CrossRef
  • Endoscopic ultrasound artificial intelligence-assisted for prediction of gastrointestinal stromal tumors diagnosis: A systematic review and meta-analysis
    Rômulo Sérgio Araújo Gomes, Guilherme Henrique Peixoto de Oliveira, Diogo Turiani Hourneaux de Moura, Ana Paula Samy Tanaka Kotinda, Carolina Ogawa Matsubayashi, Bruno Salomão Hirsch, Matheus Oliveira Veras, João Guilherme Ribeiro Jordão Sasso, Roberto Pa
    World Journal of Gastrointestinal Endoscopy.2023; 15(8): 528.     CrossRef
  • Prevalence, natural progression, and clinical practices of upper gastrointestinal subepithelial lesions in Korea: a multicenter study
    Younghee Choe, Yu Kyung Cho, Gwang Ha Kim, Jun-Ho Choi, Eun Soo Kim, Ji Hyun Kim, Eun Kwang Choi, Tae Hyeon Kim, Seong-Hun Kim, Do Hoon Kim
    Clinical Endoscopy.2023; 56(6): 744.     CrossRef
  • Significance of Ultrasound Endoscopy in the Differential Diagnosis of Cardiac Leiomyomas and Gastrointestinal Stromal Tumors
    燊 苏
    Advances in Clinical Medicine.2023; 13(11): 17185.     CrossRef
  • The Diagnosis of Small Gastrointestinal Subepithelial Lesions by Endoscopic Ultrasound-Guided Fine Needle Aspiration and Biopsy
    Masanari Sekine, Takeharu Asano, Hirosato Mashima
    Diagnostics.2022; 12(4): 810.     CrossRef
  • Diagnostic accuracy of endoscopic ultrasound with artificial intelligence for gastrointestinal stromal tumors: A meta‐analysis
    Xiao Hua Ye, Lin Lin Zhao, Lei Wang
    Journal of Digestive Diseases.2022; 23(5-6): 253.     CrossRef
  • 3,997 View
  • 164 Download
  • 5 Web of Science
  • 8 Crossref
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Reviews
Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea
Jun Ki Min, Jae Myung Cha, Yu Kyung Cho, Jie-Hyun Kim, Soon Man Yoon, Jong Pil Im, Yunho Jung, Jeong Seop Moon, Jin-Oh Kim, Yoon Tae Jeen
Clin Endosc 2018;51(3):239-252.   Published online May 31, 2018
DOI: https://doi.org/10.5946/ce.2018.075
AbstractAbstract PDFPubReaderePub
Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.

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  • Simulator-based training method in gastrointestinal endoscopy training and currently available simulators
    Yuri Kim, Jeong Hoon Lee, Gin Hyug Lee, Ga Hee Kim, Gunn Huh, Seung Wook Hong, Hwoon-Yong Jung
    Clinical Endoscopy.2023; 56(1): 1.     CrossRef
  • 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
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    Vikneswaran Namasivayam, Noriya Uedo
    DEN Open.2023;[Epub]     CrossRef
  • The Influence of Face Shields on the Quality of Colonoscopy in the Era of the COVID-19 Pandemic
    Jin Wook Lee, Hyo Jeong Lee, Dae Sung Kim, Jiyoung Yoon, Seung Wook Hong, Ha Won Hwang, Jong-Soo Lee, Gwang-Un Kim, Sinwon Lee, Jaewon Choe, Jin Hwa Park, Dong-Hoon Yang, Jeong-Sik Byeon
    Gut and Liver.2022; 16(3): 404.     CrossRef
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    Sang Yoon Kim, Jae Myung Park
    Clinical Endoscopy.2022; 55(3): 319.     CrossRef
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    Lei Xin, Ye Gao, Zhiyuan Cheng, Tianjiao Wang, Han Lin, Yanan Pang, Chang Sun, Zengjun Fu, Zhaoshen Li, Xudong Ma, Luowei Wang
    Chinese Medical Journal.2022; 135(16): 2003.     CrossRef
  • Reduced detection rate of artificial intelligence in images obtained from untrained endoscope models and improvement using domain adaptation algorithm
    Junseok Park, Youngbae Hwang, Hyun Gun Kim, Joon Seong Lee, Jin-Oh Kim, Tae Hee Lee, Seong Ran Jeon, Su Jin Hong, Bong Min Ko, Seokmin Kim
    Frontiers in Medicine.2022;[Epub]     CrossRef
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    Vasuki Rajaguru, Jieun Jang, Jeoung A. Kwon, Jae Hyun Kim, Jaeyong Shin, Mison Chun
    Frontiers in Public Health.2022;[Epub]     CrossRef
  • 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
    The Korean Journal of Gastroenterology.2022; 80(3): 115.     CrossRef
  • Antispasmodic Agent Administration Improves Gastric Neoplasm Detection Rates during Esophagogastroduodenoscopy
    Sang Yoon Kim, Jae Myung Park
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2022; 22(3): 246.     CrossRef
  • 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
    Clinical Endoscopy.2022; 55(6): 703.     CrossRef
  • Current Endoscopy Training in Korea and Future Aspects
    Young-Eun Joo
    The Korean Journal of Gastroenterology.2022; 80(5): 207.     CrossRef
  • Colonoscopy quality in community hospitals and nonhospital facilities in Korea
    Jae Gon Lee, Dong Soo Han, Young-Eun Joo, Dae-Seong Myung, Dong Il Park, Seul Ki Kim, Yunho Jung, Won Hyun Lee, Eun Soo Kim, Joon Seok Yoon, Chang Soo Eun
    The Korean Journal of Internal Medicine.2021; 36(Suppl 1): S35.     CrossRef
  • Association of Regular Endoscopic Screening with Interval Gastric Cancer Incidence in the National Cancer Screening Program
    Choong-Kyun Noh, Eunyoung Lee, Gil Ho Lee, Sun Gyo Lim, Bumhee Park, Sung Jae Shin, Jae Youn Cheong, Kee Myung Lee
    Journal of Clinical Medicine.2021; 11(1): 230.     CrossRef
  • Impacts of age and sedation on cardiocerebrovascular adverse events after diagnostic GI endoscopy: a nationwide population-based study
    Sang Yoon Kim, Chang Mo Moon, Min Ho Kim, Seong-Eun Kim, Hye-Kyung Jung, Ki-Nam Shim, Sung-Ae Jung
    Gastrointestinal Endoscopy.2020; 92(3): 591.     CrossRef
  • Efficacy and Patient Tolerability Profiles of Probiotic Solution with Bisacodyl Versus Conventional Cleansing Solution for Bowel Preparation: A Prospective, Randomized, Controlled Trial
    Youn I Choi, Jong-Joon Lee, Jun-Won Chung, Kyoung Oh Kim, Yoon Jae Kim, Jung Ho Kim, Dong Kyun Park, Kwang An Kwon
    Journal of Clinical Medicine.2020; 9(10): 3286.     CrossRef
  • Endoscopy training in Korea
    Joon Sung Kim, Byung-Wook Kim
    The Korean Journal of Internal Medicine.2019; 34(2): 237.     CrossRef
  • Updates on the Facilities, Procedures, and Performance of the Accredited Endoscopy Unit
    Tae Hee Lee, Jin Young Yoon, Chang Nyol Paik, Hyuk Soon Choi, Jae-Young Jang
    Clinical Endoscopy.2019; 52(5): 431.     CrossRef
  • Quality Indicators and Outcome Measures of Endoscopy in the National Cancer Screening Program
    Jun Ki Min, Jae Myung Cha, Min Seob Kwak, Jin Young Yoon, Yunho Jung, Jeong Eun Shin, Hyo-Joon Yang
    Yonsei Medical Journal.2019; 60(11): 1054.     CrossRef
  • 6,456 View
  • 173 Download
  • 21 Web of Science
  • 21 Crossref
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Education and Training Guidelines for the Board of the Korean Society of Gastrointestinal Endoscopy
Hee Seok Moon, Eun Kwang Choi, Ji Hyun Seo, Jeong Seop Moon, Ho June Song, Kyoung Oh Kim, Jong Jin Hyun, Sung Kwan Shin, Beom Jae Lee, Sang Heon Lee
Clin Endosc 2017;50(4):345-356.   Published online July 31, 2017
DOI: https://doi.org/10.5946/ce.2017.106
AbstractAbstract PDFPubReaderePub
The Korean Society of Gastrointestinal Endoscopy (KSGE) developed a gastrointestinal (GI) endoscopy board in 1995 and related regulations. Although the KSGE has acquired many specialists since then, the education and training aims and guidelines were insufficient. During GI fellowship training, obtaining sufficient exposure to some types of endoscopic procedures is difficult. Fellows should acquire endoscopic skills through supervised endoscopic procedures during GI fellowship training. Thus, the KSGE requires training guidelines for fellowships that allow fellows to perform independent endoscopic procedures without supervision. This document is intended to provide principles that the Committee of Education and Training of the KSGE can use to develop practical guidelines for granting privileges to perform accurate GI endoscopy safely. The KSGE will improve the quality of GI endoscopy by providing guidelines for fellowships and supervisors.

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    Therapeutic Advances in Gastroenterology.2020; 13: 175628482091669.     CrossRef
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  • 21 Web of Science
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Focused Review Series: Advances in the management of upper GI SET
Role of Endoscopic Ultrasonography in Guiding Treatment Plans for Upper Gastrointestinal Subepithelial Tumors
Jeong Seop Moon
Clin Endosc 2016;49(3):220-225.   Published online May 20, 2016
DOI: https://doi.org/10.5946/ce.2016.047
AbstractAbstract PDFPubReaderePub
Gastrointestinal (GI) subepithelial tumors (SETs) are usually observed incidentally by endoscopy and have diverse prognoses, varying from benign to potentially malignant. When a GI SET is suspected, endoscopic ultrasonography (EUS) is the most accurate diagnostic method to differentiate it from extraluminal compression. To determine the nature of GI SETs, EUS is also the most accurate diagnostic method, and reveals the precise sonographic nature of the lesion. There are some SETs with typical EUS findings of GI SETs, but most hypoechoic lesions are difficult to diagnose based on EUS images alone. EUS is also helpful to determine GI wall involvement in SETs and optimal treatment methods. For the diagnosis of GI SETs, obtaining a proper specimen is essential. EUS-guided cytology or biopsy methods such as fine-needle aspiration, Tru-Cut biopsy, and the newly introduced fine-needle biopsy (FNB) provide good results. To increase the diagnostic yield for GI SETs, cytology with immunocytochemical staining is used for cytological interpretation, resulting in good diagnostic yields. Recently, EUS-FNB using cheese slicer technology has been introduced, and has been reported to provide good diagnostic results for GI SETs.

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    Van Huy Tran, Khanh Vinh
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  • 7,393 View
  • 175 Download
  • 12 Web of Science
  • 15 Crossref
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Original Articles
Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea
Yu Kyung Cho, Jeong Seop Moon, Dong Su Han, Yong Chan Lee, Yeol Kim, Bo Young Park, Il-Kwun Chung, Jin-Oh Kim, Jong Pil Im, Jae Myung Cha, Hyun Gun Kim, Sang Kil Lee, Hang Lak Lee, Jae Young Jang, Eun Sun Kim, Yunho Jung, Chang Mo Moon, Ethics and Quality Control Committee of Korean Society of Gastrointestinal Endoscopy
Clin Endosc 2016;49(6):542-547.   Published online March 2, 2016
DOI: https://doi.org/10.5946/ce.2015.113
AbstractAbstract PDFPubReaderePub
Background
/Aims: In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions.
Methods
We surveyed the staff of institutional endoscopic units via e-mail.
Results
Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program.
Conclusions
Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

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Job Stress and Job Satisfaction among Health-Care Workers of Endoscopy Units in Korea
Seung-Joo Nam, Hoon Jai Chun, Jeong Seop Moon, Sung Chul Park, Young-Jae Hwang, In Kyung Yoo, Jae Min Lee, Seung Han Kim, Hyuk Soon Choi, Eun Sun Kim, Bora Keum, Yoon Tae Jeen, Hong Sik Lee, Chang Duck Kim
Clin Endosc 2016;49(3):266-272.   Published online February 22, 2016
DOI: https://doi.org/10.5946/ce.2015.085
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: The management of job-related stress among health-care workers is critical for the improvement of healthcare services; however, there is no existing research on endoscopy unit workers as a team. Korea has a unique health-care system for endoscopy unit workers. In this study, we aimed to estimate job stress and job satisfaction among health-care providers in endoscopy units in Korea.
Methods
We performed a cross-sectional survey of health-care providers in the endoscopy units of three university-affiliated hospitals in Korea. We analyzed the job stress levels by using the Korean occupational stress scale, contributing factors, and job satisfaction.
Results
Fifty-nine workers completed the self-administered questionnaires. The job stress scores for the endoscopy unit workers (46.39±7.81) were relatively lower compared to those of the national sample of Korean workers (51.23±8.83). Job stress differed across job positions, with nurses showing significantly higher levels of stress (48.92±7.97) compared to doctors (42.59±6.37). Job stress and job satisfaction were negatively correlated with each other (R2 =0.340, p<0.001).
Conclusions
An endoscopy unit is composed of a heterogeneous group of health-care professionals (i.e., nurses, fellows, and professors), and job stress and job satisfaction significantly differ according to job positions. Job demand, insufficient job control, and job insecurity are the most important stressors in the endoscopy unit.

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Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry
Yun Jeong Lim, Oh Young Lee, Yoon Tae Jeen, Chi Yeon Lim, Dae Young Cheung, Jae Hee Cheon, Byong Duk Ye, Hyun Joo Song, Jin Su Kim, Jae Hyuk Do, Kwang Jae Lee, Ki-Nam Shim, Dong Kyung Chang, Cheol Hee Park, Byung Ik Jang, Jeong Seop Moon, Hoon Jai Chun, Myung-Gyu Choi, Jin Oh Kim, Korean Gut Image Study Group
Clin Endosc 2015;48(5):399-404.   Published online September 30, 2015
DOI: https://doi.org/10.5946/ce.2015.48.5.399
AbstractAbstract PDFPubReaderePub
Background/Aims

Capsule endoscopy (CE) is widely used. However, CE has limitations including incomplete examination, inadequate bowel preparation, and retention. The aim of this study was to estimate the indications for and detection, completion, and retention rates of small intestine CE based on the 10-year data from the Korean Capsule Endoscopy Registry.

Methods

Twenty-four hospitals participated in this study. Clinical information, such as reasons for CE, method and quality of bowel preparation, and incomplete examination and capsule retention rates, was collected and analyzed.

Results

A total of 2,914 CEs were registered. The most common reason for CE was obscure gastrointestinal bleeding (59%). Significant lesions were detected in 66% of cases. Positive CE diagnosis occurred in 63% of cases. The preparation method did not significantly affect the quality of bowel preparation for CE. The overall incomplete rate was 33%, and was high in the elderly and those with poor bowel preparation. Capsule retention was 3% and high in patients with small bowel tumors and Crohn's disease and in children under 10 years of age.

Conclusions

CE is a valuable technique; while the overall detection rate is high, incompletion and retention rates are also relatively high. CE should be carefully considered in the elderly and children less than 10 years of age, as well as in patients with small bowel tumors and Crohn's disease.

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Learning Curve of Capsule Endoscopy
Korean Gut Image Study Group, Yun Jeong Lim, Young Sung Joo, Dae Young Jung, Byong Duk Ye, Ji Hyun Kim, Jae Hee Cheon, Seong Eun Kim, Jae Hyuk Do, Byung Ik Jang, Jeong Seop Moon, Jin Oh Kim, Hoon Jae Chun, Myung-Gyu Choi
Clin Endosc 2013;46(6):633-636.   Published online November 19, 2013
DOI: https://doi.org/10.5946/ce.2013.46.6.633
AbstractAbstract PDFPubReaderePub
Background/Aims

Capsule endoscopy (CE) has become an important tool for the diagnosis of small bowel disease. Although CE does not require the skill of endoscope insertion, the images should be interpreted by a person with experience in assessing images of the gastrointestinal mucosa. This investigation aimed to document the number of cases needed by trainees to gain the necessary experience for CE competency.

Methods

Fifteen cases were distributed to 12 trainees with no previous experience of CE during their gastroenterology training as clinical fellows. Twelve trainees and an expert were asked to read CE images from one patient each week for 15 weeks. The diagnosis was reported using five categories (no abnormalities detected, small bowel erosion or ulcer, small bowel tumor, Crohn disease, and active small bowel bleeding with no identifiable source). We then examined, using the κ coefficient, how the degree of mean agreements between the trainees and the expert changed as the training progressed each week.

Results

The agreement rate of CE diagnosis increased as the frequencies of interpretation increased. Most of the mean κ coefficients were >0.60 and >0.80 after week 9 and 11, respectively.

Conclusions

Experience with approximately 10 cases of CE is appropriate for trainees to attain CE competency.

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Reviews
Guidelines for Bowel Preparation before Video Capsule Endoscopy
Hyun Joo Song, Jeong Seop Moon, Jae Hyuk Do, In Hye Cha, Chang Hun Yang, Myung-Gyu Choi, Yoon Tae Jeen, Hyun Jung Kim
Clin Endosc 2013;46(2):147-154.   Published online March 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.2.147
AbstractAbstract PDFPubReaderePub

The preparation for video capsule endoscopy (VCE) of the bowel suggested by manufacturers of capsule endoscopy systems consists only of a clear liquid diet and an 8-hour fast. While there is evidence for a benefit from bowel preparation for VCE, so far there is no domestic consensus on the preparation regimen in Korea. Therefore, we performed this study to recommend guidelines for bowel preparation before VCE. The guidelines on VCE were developed by the Korean Gut Image Study Group, part of the Korean Society of Gastrointestinal Endoscopy. Four key questions were selected. According to our guidelines, bowel preparation with polyethylene glycol (PEG) solution enhances small bowel visualization quality (SBVQ) and diagnostic yield (DY), but it has no effect on cecal completion rate (CR). Bowel preparation with 2 L of PEG solution is similar to that with 4 L of PEG in terms of the SBVQ, DY, and CR of VCE. Bowel preparation with fasting or PEG solution combined with simethicone enhances the SBVQ, but it does not affect the CR of VCE. Bowel preparation with prokinetics does not enhance the SBVQ, DY, or CR of VCE.

Citations

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Guideline for Capsule Endoscopy: Obscure Gastrointestinal Bleeding
Ki-Nam Shim, Jeong Seop Moon, Dong Kyung Chang, Jae Hyuk Do, Ji Hyun Kim, Byung Hoon Min, Seong Ran Jeon, Jin-Oh Kim, Myung-Gyu Choi, Korean Gut Image Study Group
Clin Endosc 2013;46(1):45-53.   Published online January 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.1.45
AbstractAbstract PDFPubReaderePub

Capsule endoscopy (CE) is considered as a noninvasive and reliable diagnostic tool of examining the entire small bowel. CE has been performed frequently at many medical centers in South Korea; however, there is no evidence-based CE guideline for adequate diagnostic approaches. To provide accurate information and suggest correct testing approaches for small bowel disease, the guideline on CE was developed by the Korean Gut Image Study Group, a part of the Korean Society of Gastrointestinal Endoscopy. Operation teams for developing the guideline were organized into four areas: obscure gastrointestinal bleeding, small bowel preparation, Crohn's disease, and small bowel tumor. A total of 20 key questions were selected. In preparing this guideline, MEDLINE, Cochrane library, KMbase, KISS, and KoreaMed literature searches were performed. After writing a draft of the guideline, opinions from various experts were reflected before approving the final document. The guideline should be regarded as recommendations only to gastroenterologists in providing care to their patients. These are not absolute rules and should not be construed as establishing a legal standard of care. Although further revision may be necessary as new data appear, this guideline is expected to play a role for adequate diagnostic approaches of various small bowel diseases.

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Focused Review Series: What Should We Know about EUS-FNA?
Endoscopic Ultrasound-Guided Fine Needle Aspiration in Submucosal Lesion
Jeong Seop Moon
Clin Endosc 2012;45(2):117-123.   Published online June 30, 2012
DOI: https://doi.org/10.5946/ce.2012.45.2.117
AbstractAbstract PDFPubReaderePub

A submucosal lesion, more appropriately a subepithelial lesion, is hard to diagnose. Endoscopic ultrasonography is good to differentiate the nature of submucosal lesion. For definite diagnosis, tissue acquisition from submucosal lesion is necessary, and many methods have been introduced for this purpose mainly by endoscopic ultrasonography, such as endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), EUS-guided Trucut Biopsy (TCB), and EUS-guided fine needle biopsy (FNB). For EUS-FNA, adequate processing of specimen is important, and for proper diagnosis of EUS-FNA specimen, both cytologic and histologic examinations, including immunohistochemical stains, are important. All gastrointestinal stromal tumors have some degree of malignant potential, so there have been a lot of efforts and methods to increase diagnostic yields of submucosal lesion. We herein review the current hot topics on EUS-FNA for submucosal tumor, such as needles, on-site cytopathologists, immunohistochemical stains, EUS-TCB, EUS-FNB, Ki-67 labelling index, DOG1, and combining EUS-FNA and EUS-TCB.

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