Review
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Clinical practice guidelines for percutaneous endoscopic gastrostomy
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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
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Clin Endosc 2023;56(4):391-408. Published online June 23, 2023
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DOI: https://doi.org/10.5946/ce.2023.062
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Abstract
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.
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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 - When to feed after percutaneous endoscopic gastrostomy: A systematic review and meta‐analysis of randomized controlled trials
Matthew L. Bechtold, Zahid Ijaz Tarar, Muhammad N. Yousaf, Ghady Moafa, Abdul M. Majzoub, Xheni Deda, Michelle L. Matteson‐Kome, Srinivas R. Puli
Nutrition in Clinical Practice.2024; 39(5): 1191. CrossRef - The Effect of Oral Diet Training in Indwelling Nasogastric Tube Patients with Prolonged Dysphagia
Byung-chan Choi, Sook Joung Lee, Eunseok Choi, Sangjee Lee, Jungsoo Lee
Nutrients.2024; 16(15): 2424. CrossRef - The Impact of Palliative Decompressive Gastrostomy Tube Placement on Patients and Their Caregivers: A Mixed Methods Analysis
Jeffrey L. Roberson, Julia A. Gasior, Sara P. Ginzberg, Emna Bakillah, Jesse Passman, Lauren Shreve, Catherine E. Sharoky, Gregory Nadolski, Katherine R. Courtright, Elinore J. Kaufman
Annals of Surgical Oncology.2024; 31(10): 6931. CrossRef - A systematic review and quality appraisal of guidelines and recommendations for home enteral tube feeding in adults
Andriana Korai, Isabella Thomson, Sharon Carey, Margaret Allman-Farinelli
European Journal of Clinical Nutrition.2024;[Epub] CrossRef
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5,805
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Original Article
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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
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Dong Seok Lee, Jeong-Sik Byeon, Sang Gyun Kim, Ji Won Kim, Kook Lae Lee, Ji Bong Jeong, Yong Jin Jung, Hyoun Woo Kang
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Clin Endosc 2024;57(1):82-88. Published online April 18, 2023
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DOI: https://doi.org/10.5946/ce.2022.161
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Graphical Abstract
Abstract
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.
Reviews
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Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition
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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
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Clin Endosc 2022;55(6):703-725. Published online October 13, 2022
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DOI: https://doi.org/10.5946/ce.2022.136
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Abstract
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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Citations
Citations to this article as recorded by
- 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 - Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
Yunho Jung
The Korean Journal of Internal Medicine.2024; 39(4): 563. 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
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6,346
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545
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10
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9
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Clinical Practice Guidelines for the Endoscopic Management of Peripancreatic Fluid Collections
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Chi Hyuk Oh, Jun Kyu Lee, Tae Jun Song, Jin-Seok Park, Jae Min Lee, Jun Hyuk Son, Dong Kee Jang, Miyoung Choi, Jeong-Sik Byeon, In Seok Lee, Soo Teik Lee, Ho Soon Choi, Ho Gak Kim, Hoon Jai Chun, Chan Guk Park, Joo Young Cho
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Clin Endosc 2021;54(4):505-521. Published online July 27, 2021
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DOI: https://doi.org/10.5946/ce.2021.185
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Abstract
PDFPubReaderePub
- Endoscopic ultrasonography-guided intervention has gradually become a standard treatment for peripancreatic fluid collections (PFCs). However, it is difficult to popularize the procedure in Korea because of restrictions on insurance claims regarding the use of endoscopic accessories, as well as the lack of standardized Korean clinical practice guidelines. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to develope medical guidelines by referring to the manual for clinical practice guidelines development prepared by the National Evidence-Based Healthcare Collaborating Agency. Previous studies on PFCs were searched, and certain studies were selected with the help of experts. Then, a set of key questions was selected, and treatment guidelines were systematically reviewed. Answers to these questions and recommendations were selected via peer review. This guideline discusses endoscopic management of PFCs and makes recommendations on Indications for the procedure, pre-procedural preparations, optimal approach for drainage, procedural considerations (e.g., types of stent, advantages and disadvantages of plastic and metal stents, and accessories), adverse events of endoscopic intervention, and procedural quality issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This will be revised as necessary to address advances and changes in technology and evidence obtained in clinical practice and future studies.
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Citations
Citations to this article as recorded by
- Pancreatic Pseudocyst after Fully Covered Self-expandable Metallic Stent Placement
Mitsuhito Koizumi, Sho Ishikawa, Kaori Marui, Masahito Kokubu, Yusuke Okujima, Yuki Numata, Yoshiki Imamura, Teru Kumagi, Yoichi Hiasa
Internal Medicine.2024; 63(21): 2943. CrossRef - Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions
Miruna Patricia Olar, Maria Iacobescu, Sorana D. Bolboacă, Cristina Pojoga, Ofelia Moșteanu, Radu Seicean, Ioana Rusu, Oana Banc, Cristina Adela Iuga, Andrada Seicean
International Journal of Molecular Sciences.2024; 25(6): 3224. CrossRef - Comparative outcome of single versus two double-pigtail stents for endoscopic drainage of pancreatic fluid collections with minimal necrosis: a retrospective analysis
S Giri, S Bhrugumalla, S Gangadhar, S Angadi
Acta Gastro Enterologica Belgica.2024; 87(1): 1. CrossRef - Use of an endoscopic powered debridement device for treatment of post-surgical fatty pancreatic necrosis
Judy Daboul, Shiab Mussad, Anna Cecilia Amaral, Waleed K. Hussain, Peter J. Lee, Samuel Han
Clinical Endoscopy.2024; 57(3): 412. CrossRef - Single double pigtail plastic stent (DPT) is equally effective to two double pigtail plastic stents for endoscopic ultrasonography-guided drainage of "symptomatic peripancreatic fluid collection with 30 % or less necrotic debris"
Hemanta Kumar Nayak, Shubham Gupta, Manas Kumar Panigrahi, Abhijeet Rai, Saswati Kar, Mansi Chaudhary, Ajay Ghosh, Taraprasad Tripathy, Bramhadatta Pattnaik, Subash Chandra Samal
Pancreatology.2024; 24(7): 1211. CrossRef - Advances in self-expandable metal stents for endoscopic ultrasound-guided interventions
Dong Kee Jang, Dong Wook Lee, Seong-Hun Kim, Kwang Bum Cho, Sundeep Lakhtakia
Clinical Endoscopy.2024; 57(5): 588. CrossRef - Endoscopic ultrasound-guided drainage for local complications related to pancreatitis
Hyung Ku Chon, Seong-Hun Kim
International Journal of Gastrointestinal Intervention.2023; 12(1): 7. CrossRef - A preferable modality for the differentiation of peripancreatic fluid collections: Endoscopic ultrasound
Ning Xu, Longsong Li, Danqi Zhao, Zixin Wang, Xueting Wang, Runzi Wang, Yanbo Zeng, Lei Zhang, Ning Zhong, Ying Lv, Enqiang Linghu, Ningli Chai
Endoscopic Ultrasound.2022; 11(4): 291. CrossRef - Disconnected pancreatic duct syndrome in acute pancreatitis
A.V. Fedorov, V.N. Ektov, M.A. Khodorkovsky
Khirurgiya. Zhurnal im. N.I. Pirogova.2022; (8): 83. CrossRef - Single balloon enteroscopy-guided endoscopic retrograde pancreatography for the treatment of a symptomatic pancreatic pseudocyst complicated by pancreaticojejunostomy stricture: A case report
Eunae Cho, Chang-Hwan Park, Seo Yeon Cho
Medicine.2022; 101(43): e31293. CrossRef
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6,537
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Clinical and Technical Guideline for Endoscopic Ultrasound (EUS)-Guided Tissue Acquisition of Pancreatic Solid Tumor: Korean Society of Gastrointestinal Endoscopy (KSGE)
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Moon Jae Chung, Se Woo Park, Seong-Hun Kim, Chang Min Cho, Jun-Ho Choi, Eun Kwang Choi, Tae Hoon Lee, Eunae Cho, Jun Kyu Lee, Tae Jun Song, Jae Min Lee, Jun Hyuk Son, Jin Suk Park, Chi Hyuk Oh, Dong-Ah Park, Jeong-Sik Byeon, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun, Ho Soon Choi, Chan Guk Park, Joo Young Cho
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Clin Endosc 2021;54(2):161-181. Published online March 24, 2021
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DOI: https://doi.org/10.5946/ce.2021.069
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Abstract
PDFPubReaderePub
- Endoscopic ultrasound (EUS)-guided tissue acquisition of pancreatic solid tumor requires a strict recommendation for its proper use in clinical practice because of its technical difficulty and invasiveness. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a Task Force to draft clinical practice guidelines for EUS-guided tissue acquisition of pancreatic solid tumor. The strength of recommendation and the level of evidence for each statement were graded according to the Minds Handbook for Clinical Practice Guideline Development 2014. The committee, comprising a development panel of 16 endosonographers and an expert on guideline development methodology, developed 12 evidence-based recommendations in 8 categories intended to help physicians make evidence-based clinical judgments with regard to the diagnosis of pancreatic solid tumor. This clinical practice guideline discusses EUS-guided sampling in pancreatic solid tumor and makes recommendations on circumstances that warrant its use, technical issues related to maximizing the diagnostic yield (e.g., needle type, needle diameter, adequate number of needle passes, sample obtaining techniques, and methods of specimen processing), adverse events of EUS-guided tissue acquisition, and learning-related issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This guideline may not be applicable for all clinical situations and should be interpreted in light of specific situations and the availability of resources. It will be revised as necessary to cover progress and changes in technology and evidence from clinical practice.
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Citations
Citations to this article as recorded by
- Role of Endoscopic Ultrasound in the Management of Pancreatic Cancer
Balaji Musunuri, Shiran Shetty
Indian Journal of Surgical Oncology.2024; 15(S2): 269. CrossRef - Endoscopic Ultrasound (EUS) guided biopsy of healthy pig pancreas: Towards the histological diagnosis of chronic pancreatitis.
Julio Iglesias-García, Yessica Domínguez-Novoa, Héctor Lazare-Iglesias, Antonio González-Cantalapiedra, Ihab Abdulkader-Nallib, Óscar Varela-López, José Lariño-Noia, Enrique Domínguez-Muñoz
Revista Española de Enfermedades Digestivas.2024;[Epub] CrossRef - Endoscopic ultrasound-guided tissue acquisition for personalized treatment in pancreatic adenocarcinoma
Sang Myung Woo
Clinical Endoscopy.2023; 56(2): 183. CrossRef - Pancreatic duct lavage cytology combined with a cell-block method for patients with possible pancreatic ductal adenocarcinomas, including pancreatic carcinoma in situ
Hiroaki Kusunose, Shinsuke Koshita, Yoshihide Kanno, Takahisa Ogawa, Toshitaka Sakai, Keisuke Yonamine, Kazuaki Miyamoto, Fumisato Kozakai, Hideyuki Anan, Kazuki Endo, Haruka Okano, Masaya Oikawa, Takashi Tsuchiya, Takashi Sawai, Yutaka Noda, Kei Ito
Clinical Endoscopy.2023; 56(3): 353. CrossRef - Anesthesia care provider sedation versus conscious sedation for endoscopic ultrasound–guided tissue acquisition: a retrospective cohort study
Sneha Shaha, Yinglin Gao, Jiahao Peng, Kendrick Che, John J. Kim, Wasseem Skef
Clinical Endoscopy.2023; 56(5): 658. CrossRef - Endoscopic ultrasound-guided tissue acquisition and gene panel testing for pancreatic cancer
Kentaro SUDO, Emiri KITA, Akiko TSUJIMOTO, Kazuyoshi NAKAMURA, Akiko ODAKA, Makiko ITAMI, Sana YOKOI, Hiroshi ISHII
Suizo.2022; 37(1): 8. CrossRef - Impact of rapid on-site evaluation on diagnostic accuracy of EUS-guided fine-needle aspiration of solid pancreatic lesions: experience from a single center
Irem Guvendir, Itir Ebru Zemheri, Kamil Ozdil
BMC Gastroenterology.2022;[Epub] CrossRef - Endoscopic Ultrasound Guided Fine Needle Aspiration and Biopsy for Pancreatic Disease
Kwang Hyuck Lee
The Korean Journal of Pancreas and Biliary Tract.2021; 26(4): 241. CrossRef
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8,696
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304
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Case Report
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Development of colon cancer in a patient with longstanding colonic diffuse ganglioneuromatosis: a case report
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Jin Sun Oh, Seung Wook Hong, Jin Hee Noh, Jiyoung Yoon, Hyo Jeong Kang, Young Soo Park, Dong-Hoon Yang, Jeong-Sik Byeon
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Clin Endosc 2022;55(3):452-457. Published online March 4, 2021
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DOI: https://doi.org/10.5946/ce.2021.013
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Abstract
PDFPubReaderePub
- Colonic diffuse ganglioneuromatosis is an extremely rare disease in which multiple tumors derived from the ganglion cells, nerve fibers, and supporting cells are distributed in the colon. It is generally considered to be a benign neoplastic condition and is occasionally associated with rare hereditary conditions such as neurofibromatosis type I or multiple endocrine neoplasia type 2B. Here, we report a case of a patient in whom colon cancer developed 12 years after the initial diagnosis of colonic diffuse ganglioneuromatosis, which suggests a possible association between colonic diffuse ganglioneuromatosis and colorectal cancer.
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Citations
Citations to this article as recorded by
- A Case Series of Pediatric Intestinal Ganglioneuromatosis With Novel Phenotypic and Genotypic Profile
Yuan Fang, Ye Zhang, Rui Dong, Yi-zhen Wang, Lian Chen, Gong Chen
Frontiers in Medicine.2022;[Epub] CrossRef
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4,483
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Review
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Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
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Hyun Lim, Eun Jeong Gong, Byung-Hoon Min, Seung Joo Kang, Cheol Min Shin, Jeong-Sik Byeon, Miyoung Choi, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun
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Clin Endosc 2020;53(6):663-677. Published online November 26, 2020
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DOI: https://doi.org/10.5946/ce.2020.192
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Abstract
PDFPubReaderePub
- Antithrombotic agents, including antiplatelet agents and anticoagulants, are increasingly used in South Korea. The management of patients using antithrombotic agents and requiring gastrointestinal endoscopy is an important clinical challenge. Although clinical practice guidelines (CPGs) for the management of patients receiving antithrombotic agents and undergoing gastrointestinal endoscopy have been developed in the Unites States, Europe, and Asia Pacific region, it is uncertain whether these guidelines can be adopted in South Korea. After reviewing current CPGs, we identified unmet needs and recognized significant discrepancies in the clinical practice among regions. This is the first CPG in Korea providing information that may assist endoscopists in the management of patients on antithrombotic agents who require diagnostic or elective therapeutic endoscopy. This guideline was developed through the adaptation process as an evidence-based method, with four guidelines retrieved by systematic review. Eligible guidelines were evaluated according to the Appraisal of Guidelines for Research and Evaluation II process, and 13 statements were established using a grading system. This guideline was reviewed by external experts before an official. It will be revised as necessary to cover changes in technology, evidence, or other aspects of clinical practice.
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Citations
Citations to this article as recorded by
- Clinical Practice Guideline 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
Gut and Liver.2024; 18(1): 10. CrossRef - A systematic critical appraisal of clinical practice guidelines of antithrombotic agents in gastrointestinal endoscopy using the AGREE II tool
Denisse Camille Dayto, Wojciech Blonski, Tea Reljic, Farina Klocksieben, Jeffrey Gill, Rene D. Gomez‐Esquivel, Brijesh Patel, Pushpak Taunk, Andrew Sephien, Camille Thelin, Ambuj Kumar
Journal of Gastroenterology and Hepatology.2024; 39(5): 818. CrossRef - The Impact of Sedation on Cardio-Cerebrovascular Adverse Events after Surveillance Esophagogastroduodenoscopy in Patients with Gastric Cancer: A Nationwide Population-Based Cohort Study
Sang Yoon Kim, Jun Kyu Lee, Kwang Hyuck Lee, Jae-Young Jang, Byung-Wook Kim
Gut and Liver.2024; 18(2): 245. CrossRef - 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 - Top tips on the management of antithrombotic agents in the periendoscopic period
Alberto Tringali
Gastrointestinal Endoscopy.2024; 99(6): 1021. CrossRef - IDEN Consensus on 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
The Korean Journal of Gastroenterology.2024; 83(6): 217. CrossRef - Anticoagulants Are a Risk Factor for Delayed Bleeding after Colorectal Endoscopic Submucosal Dissection: A HASID Multicenter Study
Seong-Jung Kim, Jun Lee, Hyo-Yeop Song, Geom Seog Seo, Byung Chul Jin, Sang-Wook Kim, Dong Hyun Kim, Hyun-Soo Kim, Hyung-Hoon Oh, Dae-Seong Myung, Young-Eun Joo
Digestion.2024; 105(5): 389. CrossRef - Local Ablation for Hepatocellular Carcinoma: 2024 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association
Seungchul Han, Pil Soo Sung, Soo Young Park, Jin Woong Kim, Hyun Pyo Hong, Jung-Hee Yoon, Dong Jin Chung, Joon Ho Kwon, Sanghyeok Lim, Jae Hyun Kim, Seung Kak Shin, Tae Hyung Kim, Dong Ho Lee, Jong Young Choi
Korean Journal of Radiology.2024; 25(9): 773. CrossRef - Reproducibility of the AGREE II Tool for Assessing the Methodological Quality of Clinical Practice Guidelines for the Management of Antithrombotic Agents in Patients Undergoing GI Endoscopy
Denisse Camille Dayto, Wojciech Blonski, Tea Reljic, Farina Klocksieben, Jeffrey Gill, Rene D. Gomez-Esquivel, Brijesh Patel, Pushpak Taunk, Andrew Sephien, Camille Thelin, Ambuj Kumar
Journal of Clinical Gastroenterology.2024;[Epub] CrossRef - Local Ablation for Hepatocellular Carcinoma: 2024 Expert Consensus-Based Practical Recommendations of the Korean Liver Cancer Association
Seungchul Han, Pil Soo Sung, Soo Young Park, Jin Woong Kim, Hyun Pyo Hong, Jung-Hee Yoon, Dong Jin Chung, Joon Ho Kwon, Sanghyeok Lim, Jae Hyun Kim, Seung Kak Shin, Tae Hyung Kim, Dong Ho Lee, Jong Young Choi
Gut and Liver.2024; 18(5): 789. CrossRef - 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
Gut and Liver.2024; 18(5): 764. CrossRef - Local ablation for hepatocellular carcinoma: 2024 expert consensus-based practical recommendation of the Korean Liver Cancer Association
Seungchul Han, Pil Soo Sung, Soo Young Park, Jin Woong Kim, Hyun Pyo Hong, Jung-Hee Yoon, Dong Jin Chung, Joon Ho Kwon, Sanghyeok Lim, Jae Hyun Kim, Seung Kak Shin, Tae Hyung Kim, Dong Ho Lee, Jong Young Choi
Journal of Liver Cancer.2024; 24(2): 131. CrossRef - Guideline for Perioperative Cardiovascular Evaluation of the Brazilian Society of Cardiology – 2024
Danielle Menosi Gualandro, Luciana Savoy Fornari, Bruno Caramelli, Alexandre Antonio Cunha Abizaid, Brenno Rizerio Gomes, Caio de Assis Moura Tavares, Caio Julio Cesar dos Santos Fernandes, Carisi Anne Polanczyk, Carlos Jardim, Carolina Leticia Zilli Viei
Arquivos Brasileiros de Cardiologia.2024;[Epub] CrossRef - Diretriz de Avaliação Cardiovascular Perioperatória da Sociedade Brasileira de Cardiologia – 2024
Danielle Menosi Gualandro, Luciana Savoy Fornari, Bruno Caramelli, Alexandre Antonio Cunha Abizaid, Brenno Rizerio Gomes, Caio de Assis Moura Tavares, Caio Julio Cesar dos Santos Fernandes, Carisi Anne Polanczyk, Carlos Jardim, Carolina Leticia Zilli Viei
Arquivos Brasileiros de Cardiologia.2024;[Epub] CrossRef - Assessment of delayed bleeding after endoscopic submucosal dissection of early-stage gastrointestinal tumors in patients receiving direct oral anticoagulants
Mitsushige Sugimoto, Masaki Murata, Takashi Kawai
World Journal of Gastroenterology.2023; 29(19): 2916. CrossRef - 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
Clinical Endoscopy.2023; 56(4): 391. CrossRef - Clinical Practice Guideline 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
The Korean Journal of Gastroenterology.2023; 82(3): 107. CrossRef - Predicting the Bleeding Risk for Patients on Anticoagulant Therapy Prior to Gastric Endoscopic Submucosal Dissection
Jie-Hyun Kim
Journal of Gastric Cancer.2022; 22(1): 1. CrossRef - Utility of a deep learning model and a clinical model for predicting bleeding after endoscopic submucosal dissection in patients with early gastric cancer
Ji Eun Na, Yeong Chan Lee, Tae Jun Kim, Hyuk Lee, Hong-Hee Won, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim
World Journal of Gastroenterology.2022; 28(24): 2721. CrossRef
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17
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Focused Review Series: Application of Artificial Intelligence in GI Endoscopy
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Convolutional Neural Network Technology in Endoscopic Imaging: Artificial Intelligence for Endoscopy
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Joonmyeong Choi, Keewon Shin, Jinhoon Jung, Hyun-Jin Bae, Do Hoon Kim, Jeong-Sik Byeon, Namku Kim
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Clin Endosc 2020;53(2):117-126. Published online March 30, 2020
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DOI: https://doi.org/10.5946/ce.2020.054
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Abstract
PDFPubReaderePub
- Recently, significant improvements have been made in artificial intelligence. The artificial neural network was introduced in the 1950s. However, because of the low computing power and insufficient datasets available at that time, artificial neural networks suffered from overfitting and vanishing gradient problems for training deep networks. This concept has become more promising owing to the enhanced big data processing capability, improvement in computing power with parallel processing units, and new algorithms for deep neural networks, which are becoming increasingly successful and attracting interest in many domains, including computer vision, speech recognition, and natural language processing. Recent studies in this technology augur well for medical and healthcare applications, especially in endoscopic imaging. This paper provides perspectives on the history, development, applications, and challenges of deep-learning technology.
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Review
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Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
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Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong Yeul Lee, Jeong-Sik Byeon, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Hoon Jai Chun
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Clin Endosc 2020;53(2):142-166. Published online March 30, 2020
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DOI: https://doi.org/10.5946/ce.2020.032
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Abstract
PDFSupplementary MaterialPubReaderePub
- Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
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Journal of Digestive Diseases.2022; 23(4): 220. CrossRef - Therapeutic approach to non-curative resection after endoscopic treatment in early gastric cancer
Eun Jeong Gong, Chang Seok Bang
Journal of the Korean Medical Association.2022; 65(5): 284. CrossRef - Endoscopic treatment for early gastric cancer
Ji Yong Ahn
Journal of the Korean Medical Association.2022; 65(5): 276. CrossRef - Endoscopic diagnosis of early gastric cancer
Dong Chan Joo, Gwang Ha Kim
Journal of the Korean Medical Association.2022; 65(5): 267. CrossRef - Current status of the gastric cancer screening program in Korea
Young-Il Kim, Il Ju Choi
Journal of the Korean Medical Association.2022; 65(5): 250. CrossRef - Colorectális polypok ellátása
Szabolcs Ábrahám, Illés Tóth, Dániel Váczi, György Lázár
Magyar Sebészet.2022; 75(2): 155. CrossRef - Utility of a deep learning model and a clinical model for predicting bleeding after endoscopic submucosal dissection in patients with early gastric cancer
Ji Eun Na, Yeong Chan Lee, Tae Jun Kim, Hyuk Lee, Hong-Hee Won, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim
World Journal of Gastroenterology.2022; 28(24): 2721. CrossRef - Rare primary rectal mucosa-associated lymphoid tissue lymphoma with curative resection by endoscopic submucosal dissection: A case report and review of literature
Yan Tao, Qiong Nan, Zi Lei, Ying-Lei Miao, Jun-Kun Niu
World Journal of Clinical Cases.2022; 10(21): 7599. CrossRef - Prevention of stricture after endoscopic submucosal dissection for esophageal cancer: intralesional steroid infusion using a spray tube
Jong Yeul Lee
Clinical Endoscopy.2022; 55(4): 516. CrossRef - Paneth Cell Carcinoma of the Stomach
Jun Wan Kim, Gwang Ha Kim, Kyung Bin Kim
The Korean Journal of Gastroenterology.2022; 80(1): 34. CrossRef - Composite scoring system and optimal tumor budding cut-off number for estimating lymph node metastasis in submucosal colorectal cancer
Jeong-ki Kim, Ye-Young Rhee, Jeong Mo Bae, Jung Ho Kim, Seong-Joon Koh, Hyun Jung Lee, Jong Pil Im, Min Jung Kim, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park, Ji Won Park, Gyeong Hoon Kang
BMC Cancer.2022;[Epub] CrossRef - Multidisciplinary Treatment Strategy for Early Colon Cancer: A Review-An English Version
Gyung Mo Son, Su Bum Park, Tae Un Kim, Byung-Soo Park, In Young Lee, Joo-Young Na, Dong Hoon Shin, Sang Bo Oh, Sung Hwan Cho, Hyun Sung Kim, Hyung Wook Kim
Journal of the Anus, Rectum and Colon.2022; 6(4): 203. CrossRef - Extragastric Metastasis of Early Gastric Cancer After Endoscopic Submucosal Dissection With Lymphovascular Invasion and Negative Resected Margins
Han Myung Lee, Yoonjin Kwak, Hyunsoo Chung, Sang Gyun Kim, Soo-Jeong Cho
Journal of Gastric Cancer.2022; 22(4): 339. CrossRef - 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
Clinical Endoscopy.2022; 55(6): 767. CrossRef - Need for careful endoscopic evaluation of large gastric neoplasms before endoscopic submucosal dissection
Seung Woo Lee
Clinical Endoscopy.2022; 55(6): 753. CrossRef - Regression of gastric endoscopic submucosal dissection induced polypoid nodular scar after Helicobacter pylori eradication: A case report
Byung Chul Jin, Ae Ri Ahn, Seong-Hun Kim, Seung Young Seo
World Journal of Clinical Cases.2022; 10(34): 12793. CrossRef - Simultaneous analysis of tumor-infiltrating immune cells density, tumor budding status, and presence of lymphoid follicles in CRC tissue
Adam R. Markowski, Anna J. Markowska, Wiktoria Ustymowicz, Anna Pryczynicz, Katarzyna Guzińska-Ustymowicz
Scientific Reports.2022;[Epub] CrossRef - Role of Endoscopy in Management of Upper Gastrointestinal Cancers
Jeff Liang, Yi Jiang, Yazan Abboud, Srinivas Gaddam
Diseases.2022; 11(1): 3. CrossRef - Association between severe hepatic steatosis examined by Fibroscan and the risk of high-risk colorectal neoplasia
Kwang Woo Kim, Hyoun Woo Kang, Hosun Yoo, Yukyung Jun, Hyun Jung Lee, Jong Pil Im, Ji Won Kim, Joo Sung Kim, Seong-Joon Koh, Yong Jin Jung, Atsushi Hosui
PLOS ONE.2022; 17(12): e0279242. CrossRef - Long-term outcomes and clinical safety of expanded indication early gastric cancer treated with endoscopic submucosal dissection versus surgical resection: a meta-analysis
Xing Xu, Guoliang Zheng, Na Gao, Zhichao Zheng
BMJ Open.2022; 12(12): e055406. CrossRef - Long-Term Safety of Delayed Surgery After Upfront Endoscopic Resection for Early Gastric Cancer: A Propensity Matched Study
Ji Eun Na, Yeong Gi Kim, Tae Jun Kim, Hyuk Lee, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Seon Yeong Baek, Min Su Park, Poong-Lyul Rhee, Jae J. Kim
Annals of Surgical Oncology.2021; 28(1): 106. CrossRef - Incidence rates, risk factors, and outcomes of aspiration pneumonia after gastric endoscopic submucosal dissection: A systematic review and meta‐analysis
Dong Tang, Fuxiang Yuan, Xiaoying Ma, Haixia Qu, Yuan Li, Weiwei Zhang, Huan Ma, Haiping Liu, Yan Yang, Lin Xu, Yuqiang Gao, Shuhui Zhan
Journal of Gastroenterology and Hepatology.2021; 36(6): 1457. CrossRef - Clinical feasibility and oncologic safety of primary endoscopic submucosal dissection for clinical submucosal invasive early gastric cancer
Ji Eun Na, Hyuk Lee, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Kyoung-Mee Kim, Jae J. Kim
Journal of Cancer Research and Clinical Oncology.2021; 147(10): 3051. CrossRef - Endoscopic resections for superficial esophageal squamous cell epithelial neoplasia: focus on histological discrepancies between biopsy and resected specimens
Lang Yang, Hua Jin, Xiao-li Xie, Yang-tian Cao, Zhen-hua Liu, Na Li, Peng Jin, Yu-qi He, Jian-qiu Sheng
BMC Gastroenterology.2021;[Epub] CrossRef - Atypical Scar Patterns after Gastric Endoscopic Submucosal Dissection
Bomin Kim, Beom Jin Kim, Hong Jip Yoon, Hyunsuk Lee, Jae Yong Park, Chang Hwan Choi, Jae Gyu Kim
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2021; 21(1): 72. CrossRef - Endoscopic Submucosal Dissection versus Surgery for Undifferentiated-Type Early Gastric Cancer: A Systematic Review and Meta-Analysis
Cheal-Wung Huh, Dae Won Ma, Byung-Wook Kim, Joon Sung Kim, Seung Jae Lee
Clinical Endoscopy.2021; 54(2): 202. CrossRef - Role of Endoscopic Ultrasound in Selecting Superficial Esophageal Cancers for Endoscopic Resection
Jinju Choi, Hyunsoo Chung, Ayoung Lee, Jue Lie Kim, Soo-Jeong Cho, Sang Gyun Kim
The Annals of Thoracic Surgery.2021; 111(5): 1689. CrossRef - Recent advances in early esophageal cancer: diagnosis and treatment based on endoscopy
Hang Yang, Bing Hu
Postgraduate Medicine.2021; 133(6): 665. CrossRef - Endoscopic Resection of Gastric Cancer
Ga Hee Kim, Hwoon-Yong Jung
Gastrointestinal Endoscopy Clinics of North America.2021; 31(3): 563. CrossRef - Gastric Mucosa-Associated Lymphoid Tissue Lymphomas Diagnosed by Jumbo Biopsy Using Endoscopic Submucosal Dissection: A Case Report
Jian Han, Jun Wang, Hua-ping Xie
Frontiers in Medicine.2021;[Epub] CrossRef - Considerations for Endoscopic Treatment of Undifferentiated-type Early Gastric Cancer
Kyoungwon Jung
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2021; 21(2): 103. CrossRef - Papillary Adenocarcinoma
Tae-Se Kim, Byung-Hoon Min
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2021; 21(2): 122. CrossRef - Early gastrointestinal cancer: The application of artificial intelligence
Hang Yang, Bing Hu
Artificial Intelligence in Gastrointestinal Endoscopy.2021; 2(4): 185. CrossRef - Successful Endoscopic Resection of Primary Rectal Mucosa-Associated Lymphoid Tissue Lymphoma by Endoscopic Submucosal Dissection: A Case Report
Jian Han, Zhe Zhu, Chao Zhang, Hua-ping Xie
Frontiers in Medicine.2021;[Epub] CrossRef - Assessment of the Diagnostic Performance of Endoscopic Ultrasonography After Conventional Endoscopy for the Evaluation of Esophageal Squamous Cell Carcinoma Invasion Depth
Ryu Ishihara, Junki Mizusawa, Ryoji Kushima, Noriko Matsuura, Tomonori Yano, Tomoko Kataoka, Haruhiko Fukuda, Noboru Hanaoka, Toshiyuki Yoshio, Seiichiro Abe, Yoshinobu Yamamoto, Shinji Nagata, Hiroyuki Ono, Masashi Tamaoki, Naohiro Yoshida, Kohei Takizaw
JAMA Network Open.2021; 4(9): e2125317. CrossRef - Variation in Diagnosis, Treatment, and Outcome of Esophageal Cancer in a Regionalized Care System in Ontario, Canada
Steven Habbous, Olga Yermakhanova, Katharina Forster, Claire M. B. Holloway, Gail Darling
JAMA Network Open.2021; 4(9): e2126090. CrossRef - A Simple Risk Scoring System for Predicting the Occurrence of Aspiration Pneumonia After Gastric Endoscopic Submucosal Dissection
Kyemyung Park, Na Young Kim, Ki Jun Kim, Chaerim Oh, Dongwoo Chae, So Yeon Kim
Anesthesia & Analgesia.2021;[Epub] CrossRef - Risk Stratification of T1 Colorectal Cancer Metastasis to Lymph Nodes: Current Status and Perspective
Katsuro Ichimasa, Shin-ei Kudo, Hideyuki Miyachi, Yuta Kouyama, Masashi Misawa, Yuichi Mori
Gut and Liver.2021; 15(6): 818. CrossRef - Close Observation versus Additional Surgery after Noncurative Endoscopic Resection of Esophageal Squamous Cell Carcinoma
Byeong Geun Song, Ga Hee Kim, Charles J. Cho, Hyeong Ryul Kim, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Ho June Song, Yong-Hee Kim, Jun Haeng Lee, Hwoon-Yong Jung, Jae Ill Zo, Young Mog Shim
Digestive Surgery.2021; 38(3): 247. CrossRef
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17,249
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1,161
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97
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94
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Case Report
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Colonic Intramucosal Cancer in the Interposed Colon Treated with Endoscopic Mucosal Resection: A Case Report and Review of Literature
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Seung-Ho Baek, Jang-Ho Lee, Dong Ryeol Yoo, Hye Yeong Kim, Meihua Jin, Ah-reum Jang, Dong-Hoon Yang, Jeong-Sik Byeon
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Clin Endosc 2019;52(4):377-381. Published online July 30, 2019
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DOI: https://doi.org/10.5946/ce.2018.129
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Abstract
PDFSupplementary MaterialPubReaderePub
- Colon interposition is a surgical procedure used for maintenance of luminal conduit after esophagectomy. Although epithelial neoplasia, such as adenoma and adenocarcinoma, may develop in the interposed colon, there are only few case reports on the condition. Due to the rarity of this condition, there is no definite consensus on recommending screening endoscopy for the early detection of neoplasia in the interposed colons. Here, we report a case of intramucosal adenocarcinoma in an interposed colon. Initial endoscopic resection for this tumor failed to accomplish complete resection. A subsequent endoscopic resection was performed 1 month later and complete resection was achieved. Based on our experience and recommendation on screening endoscopy for gastric cancer in Korea, we suggest that regular screening esophagogastroduodenoscopies should be performed following esophagectomy to detect early neoplasia in the stomach and interposed colon and avoid adverse results induced by delayed detection.
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Citations to this article as recorded by
- The presence of adenocarcinoma of the right colon and polyp in colonic graft in a female patient with colon interposition due to caustic stricture of the esophagus in childhood
Stojan Latincic, Maja Pavlov, Jovica Vasiljevic, Dragan Vasin, Milena Papovic
Srpski arhiv za celokupno lekarstvo.2024; 152(1-2): 71. CrossRef
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Original Articles
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Efficacy of Precut Endoscopic Mucosal Resection for Treatment of Rectal Neuroendocrine Tumors
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Hoonsub So, Su Hyun Yoo, Seungbong Han, Gwang-un Kim, Myeongsook Seo, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon
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Clin Endosc 2017;50(6):585-591. Published online October 12, 2017
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DOI: https://doi.org/10.5946/ce.2017.039
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Abstract
PDFPubReaderePub
- Background
/Aims: Endoscopic resection is the first-line treatment for rectal neuroendocrine tumors (NETs) measuring <1 cm and those between 1 and 2 cm in size. However, conventional endoscopic resection cannot achieve complete resection in all cases. We aimed to analyze clinical outcomes of precut endoscopic mucosal resection (EMR-P) used for the management of rectal NET.
Methods
EMR-P was used to treat rectal NET in 72 patients at a single tertiary center between 2011 and 2015. Both, circumferential precutting and EMR were performed with the same snare device in all patients. Demographics, procedural details, and histopathological features were reviewed for all cases.
Results
Mean size of the tumor measured endoscopically was 6.8±2.8 mm. En bloc and complete resection was achieved in 71 (98.6%) and 67 patients (93.1%), respectively. The mean time required for resection was 9.0±5.6 min. Immediate and delayed bleeding developed in six (8.3%) and 4 patients (5.6%), respectively. Immediate bleeding observed during EMR-P was associated with the risk of delayed bleeding.
Conclusions
Both, the en bloc and complete resection rates of EMR-P in the treatment of rectal NETs using the same snare for precutting and EMR were noted to be high. The procedure was short and safe. EMR-P may be a good treatment choice for the management of rectal NETs.
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Citations
Citations to this article as recorded by
- Endoscopic mucosal resection using anchored snare Tip-in versus precut technique for small rectal neuroendocrine tumors
Seung Wook Hong, Dong-Hoon Yang, Yoo Jin Lee, Dong Hoon Baek, Jaeyoung Chun, Hyun Gun Kim, Sung Joo Kim, Seung-Mo Hong, Dae-Seong Myung
The Korean Journal of Internal Medicine.2024; 39(2): 238. CrossRef - Risk Factors for Lymph Node Metastasis and Oncologic Outcomes in Small Rectal Neuroendocrine Tumors with Lymphovascular Invasion
Seung-Joo Nam, Byung Chang Kim, Hee Jin Chang, Han Ho Jeon, Junho Kim, Su Young Kim
Gut and Liver.2022; 16(2): 228. CrossRef - EMR-P for small rectal neuroendocrine tumors: is it a preferred treatment?
Zhaohui Liu, Chunsi Zheng, Shihua Ding, Chong Chen, Jingbo Yang, Ruinuan Wu, Dayong Sun
Scandinavian Journal of Gastroenterology.2022; 57(12): 1503. CrossRef - Recurrence after endoscopic resection of small rectal neuroendocrine tumors: a retrospective cohort study
Sukit Pattarajierapan, Supakij Khomvilai
Annals of Coloproctology.2022; 38(3): 216. CrossRef - Endoscopic treatment for rectal neuroendocrine tumor: which method is better?
Seung Min Hong, Dong Hoon Baek
Clinical Endoscopy.2022; 55(4): 496. CrossRef - Diagnosis, treatment, and current concepts in the endoscopic management of gastroenteropancreatic neuroendocrine neoplasms
Giuseppe Iabichino, Milena Di Leo, Monica Arena, Giovanni Giuseppe Rubis Passoni, Elisabetta Morandi, Francesca Turpini, Paolo Viaggi, Carmelo Luigiano, Luca De Luca
World Journal of Gastroenterology.2022; 28(34): 4943. CrossRef - Comparison of conventional and modified endoscopic mucosal resection methods for the treatment of rectal neuroendocrine tumors
Hee Sung Lee, Hee Seok Moon, In Sun Kwon, Jae Ho Park, Ju Seok Kim, Sun Hyung Kang, Eaum Seok Lee, Seok Hyun Kim, Jae Kyu Sung, Byung Seok Lee, Hyun Yong Jeong
Surgical Endoscopy.2021; 35(11): 6055. CrossRef - Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs)
Francesco Maione, Alessia Chini, Marco Milone, Nicola Gennarelli, Michele Manigrasso, Rosa Maione, Gianluca Cassese, Gianluca Pagano, Francesca Paola Tropeano, Gaetano Luglio, Giovanni Domenico De Palma
Diagnostics.2021; 11(5): 771. CrossRef - Anchoring the snare tip is a feasible endoscopic mucosal resection method for small rectal neuroendocrine tumors
Jeongseok Kim, Jisup Kim, Eun Hye Oh, Nam Seok Ham, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Seung-Mo Hong, Dong-Hoon Yang
Scientific Reports.2021;[Epub] CrossRef - Safety and efficacy of tip‐in endoscopic mucosal resection for large sessile colorectal polyps: A single‐center experience in Taiwan
Chung‐Ying Lee, Ming‐Yao Chen, Hwai‐Jeng Lin, Hsi‐Yuan Chien
Advances in Digestive Medicine.2020; 7(2): 58. CrossRef - Incidental diagnosis of very small rectal neuroendocrine neoplasms: when should endoscopic submucosal dissection be performed? A single ENETS centre experience
Nico Pagano, Claudio Ricci, Nicole Brighi, Carlo Ingaldi, Francesco Pugliese, Donatella Santini, Davide Campana, Cristina Mosconi, Valentina Ambrosini, Riccardo Casadei
Endocrine.2019; 65(1): 207. CrossRef - Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor
Jihye Kim, Jee Hyun Kim, Joo Young Lee, Jaeyoung Chun, Jong Pil Im, Joo Sung Kim
BMC Gastroenterology.2018;[Epub] CrossRef - Proper Treatment Option for Small Rectal Neuroendocrine Tumors Using Precut Endoscopic Mucosal Resection
Seun Ja Park
Clinical Endoscopy.2017; 50(6): 516. CrossRef
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8,807
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Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences
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Dong-Hoon Yang, Min-Seob Kwak, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Hyun Gun Kim, Shai Friedland
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Clin Endosc 2017;50(4):379-387. Published online March 7, 2017
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DOI: https://doi.org/10.5946/ce.2016.058
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Abstract
PDFPubReaderePub
- Background
/Aims: Endoscopic mucosal resection with circumferential mucosal incision (CMI-EMR) may offer benefits comparable to those of endoscopic submucosal dissection (ESD), while requiring less technical proficiency than ESD.
Methods
We retrospectively compared the outcomes of CMI-EMR (n=34) and size-matched ESD (n=102), which were performed by a Korean endoscopist for colorectal epithelial lesions of 20–35 mm. Procedural parameters of CMI-EMRs performed by an American ESD novice ((n=30) were compared with those performed by the Korean endoscopist.
Results
The lesion size was 22.3±3.9 mm and 22.9±2.4 mm in the CMI-EMR and size-matched ESD groups, respectively (p=0.730). The resection time was 12.7±7.0 minutes in the CMI-EMR group and 45.6±30.1 minutes in the ESD group (p<0.001). The en bloc resection rate was 94.1% in the CMI-EMR group and 100% in the ESD group (p=0.061). There were no differences in the en bloc resection and complication rates of CMI-EMRs between a Korean and an American endoscopist.
Conclusions
For the treatment of moderate-size colorectal lesions, CMI-EMR showed a trend toward lower en bloc resection rate, but required shorter procedure time than ESD. CMI-EMR outcomes were similar when performed by a Korean ESD expert and an American ESD novice.
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Citations
Citations to this article as recorded by
- Endoscopic mucosal resection with a circumferential incision in the removal of colon neoplasms. Results of a randomized trial.
E. U. Abdulzhalieva, A. A. Likutov, V. V. Veselov, D. A. Mtvralashvili, O. M. Yugai, E. A. Khomyakov, S. V. Chernyshov, O. I. Sushkov
Koloproktologia.2024; 23(1): 21. CrossRef - Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
Yunho Jung
The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef - Hybrid Endoscopic Resection With Endo-knife and Snare for Colorectal Lesions: A Systematic Review and Meta-analysis
Shinji Yoshii, Takefumi Kikuchi, Yuki Hayashi, Masahiro Nojima, Hiro-o Yamano, Hiroshi Nakase
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(2): 135. CrossRef - Multicenter evaluation of recurrence in endoscopic submucosal dissection and endoscopic mucosal resection in the colon: A Western perspective
Mike T Wei, Margaret J Zhou, Andrew A Li, Andrew Ofosu, Joo Ha Hwang, Shai Friedland
World Journal of Gastrointestinal Endoscopy.2023; 15(6): 458. CrossRef - Comparison of precutting endoscopic mucosal resection and endoscopic submucosal dissection for large (20–30 mm) flat colorectal lesions
Chang Kyo Oh, Young Wook Cho, In Hyoung Choi, Han Hee Lee, Chul‐Hyun Lim, Jin Su Kim, Bo‐In Lee, Young‐Seok Cho
Journal of Gastroenterology and Hepatology.2022; 37(3): 568. CrossRef - A systematic review and meta-analysis of endoscopic mucosal resection vs endoscopic submucosal dissection for colorectal sessile/non-polypoid lesions
Endrit Shahini, Roberto Passera, Giacomo Lo Secco, Alberto Arezzo
Minimally Invasive Therapy & Allied Technologies.2022; 31(6): 835. CrossRef - Endoscopic mucosal resection with a circumferential incision in the removal of colorectal neoplasms (preliminary results of the prospective randomized study)
A. U. Abdulzhalieva, A. A. Likutov, D. A. Mtvralashvili, V. V. Veselov, Yu. E. Vaganov, S. V. Chernyshov, O. A. Mainovskaya, O. I. Sushkov
Koloproktologia.2022; 21(4): 21. CrossRef - Efficacy and Safety of Complete Endoscopic Resection of Colorectal Neoplasia Using a Stepwise Endoscopic Protocol with SOUTEN, a Novel Multifunctional Snare
Shinji Yoshii, Marina Kubo, Mio Matsumoto, Takefumi Kikuchi, Yasunari Takakuwa
Clinical Endoscopy.2020; 53(2): 206. CrossRef - Tip-in versus conventional endoscopic mucosal resection for flat colorectal neoplasia 10 mm or larger in size
Soo Min Noh, Jin Yong Kim, Jae Cheol Park, Eun Hye Oh, Jeongseok Kim, Nam Seok Ham, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
International Journal of Colorectal Disease.2020; 35(7): 1283. CrossRef - Long‐term clinical outcomes of endoscopic submucosal dissection for colorectal neoplasia with or without the hybrid technique
DU Kang, JC Park, SW Hwang, SH Park, DH Yang, KJ Kim, BD Ye, SJ Myung, SK Yang, JS Byeon
Colorectal Disease.2020; 22(12): 2008. CrossRef - Pyogenic Liver Abscess Caused by Endoscopic Submucosal Dissection for Early Colon Cancer
Joon Seop Lee, Yong Hwan Kwon
Clinical Endoscopy.2019; 52(6): 620. CrossRef - Endoscopic submucosal dissection in the West: Current status and future directions
Michael X. Ma, Michael J. Bourke
Digestive Endoscopy.2018; 30(3): 310. CrossRef - Introduction of endoscopic submucosal dissection in the West
David Friedel, Stavros Nicholas Stavropoulos
World Journal of Gastrointestinal Endoscopy.2018; 10(10): 225. CrossRef - Filling the Technical Gap between Standard Endoscopic Mucosal Resection and Full Endoscopic Submucosal Dissection for 20–35 mm Sized Colorectal Neoplasms
Sung Noh Hong
Clinical Endoscopy.2017; 50(4): 313. CrossRef
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Case Reports
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Unusual Local Recurrence with Distant Metastasis after Successful Endoscopic Submucosal Dissection for Colorectal Mucosal Cancer
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Hyo Jeong Lee, Byong Duk Ye, Jeong-Sik Byeon, Jihun Kim, Young Soo Park, Yong Sang Hong, Yong Sik Yoon, Dong-Hoon Yang
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Clin Endosc 2017;50(1):91-95. Published online August 22, 2016
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DOI: https://doi.org/10.5946/ce.2016.054
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Abstract
PDFPubReaderePub
- Intramucosal colorectal cancer (CRC) is thought not to metastasize because the colonic lamina propria lacks lymphatics. Only a few recent case reports have suggested lymph node metastasis from intramucosal CRC, but there is no clear evidence supporting the metastatic potential of intramucosal CRC. Hence, endoscopic resection is regarded as curative treatment for intramucosal CRC. This report describes two cases of unusual local recurrence with distant metastasis in patients who had previously undergone successful endoscopic submucosal dissection for intramucosal CRC. The recurrent colorectal lesions developed at the site of the previous endoscopic submucosal dissection scars in a relatively short-term period, and the pathologic findings showed an “undermining” invasion pattern without surrounding mucosal change. Based on the clinical course and pathological findings, we concluded that the second colorectal lesions were recurrences rather than de novo cancers.
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Citations
Citations to this article as recorded by
- Local excision after polypectomy for rectal polyp cancer: when is it worthwhile?
Helen J. S. Jones, Issam al‐Najami, Gunnar Baatrup, Chris Cunningham
Colorectal Disease.2021; 23(4): 868. CrossRef - Presacral lymph node recurrence of rectal intramucosal adenocarcinoma after endoscopic mucosal resection: a case report
Taichi Horino, Yukiharu Hiyoshi, Yuji Miyamoto, Naoya Yoshida, Hideo Baba
Surgical Case Reports.2020;[Epub] CrossRef - Recurrence, death risk, and related factors in patients with stage 0 colorectal cancer
Ming-Hao Hsieh, Pei-Tseng Kung, Wen-Yin Kuo, Tao-Wei Ke, Wen-Chen Tsai
Medicine.2020; 99(36): e21688. CrossRef - Recurrence rate of lateral margin-positive cases after en bloc endoscopic submucosal dissection of colorectal neoplasia
Seohyun Lee, Jihun Kim, Jae Seung Soh, Jungho Bae, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
International Journal of Colorectal Disease.2018; 33(6): 735. CrossRef
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7,706
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215
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7
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4
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Unexpected Delayed Colon Perforation after the Endoscopic Submucosal Dissection with Snaring of a Laterally Spreading Tumor
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Young Bo Ko, Jeong-Mi Lee, Wan Soo Kim, Min Seob Kwak, Ji Wan Lee, Dong Yeol Shin, Dong-Hoon Yang, Jeong-Sik Byeon
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Clin Endosc 2015;48(6):570-575. Published online November 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.6.570
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Abstract
PDFPubReaderePub
- Colonic perforation may occur as a complication of diagnostic and therapeutic colonoscopy. The risk factors for perforation after colorectal endoscopic submucosal dissection (ESD) include an inexperienced endoscopist, a large tumor size, and submucosal fibrosis. The mechanisms of perforation include unintended endoscopic resection/dissection and severe thermal injury. Here, we report a case of colon perforation that occurred after ESD with snaring of a laterally spreading tumor. The perforation was completely unexpected because there were no colorectal ESD-associated risk factors for perforation, deep dissection, or severe coagulation injury in our patient.
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Citations
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- Tri-Axial Force Sensor in a Soft Catheter Using Fiber Bragg Gratings for Endoscopic Submucosal Dissection
Ramzi Ben Hassen, Arnaud Lemmers, Alain Delchambre
IEEE Sensors Journal.2023; 23(20): 24626. CrossRef - Factors for conversion risk of colorectal endoscopic submucosal dissection: a multicenter study
Yuki Kamigaichi, Shiro Oka, Shinji Tanaka, Shinji Nagata, Masaki Kunihiro, Toshio Kuwai, Yuko Hiraga, Akira Furudoi, Seiji Onogawa, Hideharu Okanobu, Takeshi Mizumoto, Tomohiro Miwata, Shiro Okamoto, Kenichi Yoshimura, Kazuaki Chayama
Surgical Endoscopy.2022; 36(8): 5698. CrossRef - Life on a knife edge: the optimal approach to the management of perforations during endoscopic submucosal dissection (ESD)
Shria Kumar, Young Hoon Youn, Jeffrey H. Lee
Expert Review of Gastroenterology & Hepatology.2020; 14(10): 965. CrossRef - Delayed perforation after endoscopic resection of a colonic laterally spreading tumor: A case report and literature review
Ge-Yu-Jia Zhou, Jin-Long Hu, Sheng Wang, Nan Ge, Xiang Liu, Guo-Xin Wang, Si-Yu Sun, Jin-Tao Guo
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Hiroyuki Takamaru, Rina Goto, Masayoshi Yamada, Taku Sakamoto, Takahisa Matsuda, Yutaka Saito
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Single Balloon Enteroscopy-Assisted Endoscopic Retrograde Cholangiopancreatography in Patients Who Underwent a Gastrectomy with Roux-en-Y Anastomosis: Six Cases from a Single Center
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Jae Seung Soh, Dong-Hoon Yang, Sang Soo Lee, Seohyun Lee, Jungho Bae, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
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Clin Endosc 2015;48(5):452-457. Published online September 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.5.452
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Abstract
PDFPubReaderePub
Patients with altered anatomy such as a Roux-en-Y anastomosis often present with various pancreaticobiliary problems requiring therapeutic intervention. However, a conventional endoscopic approach to the papilla is very difficult owing to the long afferent limb and acute angle of a Roux-en-Y anastomosis. Balloon-assisted enteroscopy can be used for endoscopic retrograde cholangiopancreatography (ERCP) in patients with altered anatomy. We experienced six cases of Roux-en-Y anastomosis with biliary problems, and attempted ERCP using single balloon enteroscopy (SBE). SBE insertion followed by replacement with a conventional endoscope was attempted in five of six patients. The papilla was successfully approached using SBE in all cases. However, therapeutic intervention was completed in only three cases because of poor maneuverability caused by postoperative adhesion. We conclude that in patients with Roux-en-Y anastomosis, the ampulla can be readily accessed with SBE, but longer dedicated accessories are necessary to improve this therapeutic intervention.
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Chang-Hwan Park
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Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada
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Review
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Diagnostic Coding for Intramucosal Carcinoma and Neuroendocrine Tumor in the Colorectum: Proposal for Avoiding Confusing Coding in Korea
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Dong Soo Han, Jin Hee Sohn, Jeong-Sik Byeon, Hwang Choi, Joon Mee Kim
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Clin Endosc 2015;48(3):216-220. Published online May 29, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.3.216
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Abstract
PDFPubReaderePub
Applying proper coding is important for doctors practicing gastroenterology. The coding systems established by various organizations define tumors differently. As a result of changing concepts of tumor classification, there are coding and reimbursement issues following the confirmation of malignant lesions by nationwide cancer screening in patients with intramucosal carcinoma and neuroendocrine tumors of the colorectum. In addition, there have been discrepancies between the views of endoscopists and pathologists regarding tumor coding. The Korean Society of Gastrointestinal Endoscopy held an expert meeting and established a consensus for the coding of intramucosal carcinoma and neuroendocrine tumor of the colorectum.
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Focused Review Series: Updates on Gastrointestinal and Pancreaticobiliary Stents
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Colorectal Stents: Current Status
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Jeong-Mi Lee, Jeong-Sik Byeon
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Clin Endosc 2015;48(3):194-200. Published online May 29, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.3.194
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Abstract
PDFPubReaderePub
A self-expandable metal stent (SEMS) is an effective and safe method for the decompression of colon obstruction. Based on recent evidence, colorectal SEMS is now recommended for the palliation of patients with colonic obstruction from incurable colorectal cancer or extracolonic malignancy and also as a bridge to surgery in those who are a high surgical risk. Prophylactic SEMS insertion in patients with no obstruction symptoms is not recommended. Most colorectal SEMS are inserted endoscopically under fluoroscopic guidance. The technical and clinical success rates of colorectal SEMS are high, and the complication rate is acceptable. Advances in this technology will make the insertion of colorectal SEMS better and may expand the indications of colorectal SEMS in the future.
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Hideyuki Suzuki, Shingo Tsujinaka, Yoshihiro Sato, Tomoya Miura, Chikashi Shibata
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Original Article
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Postpolypectomy Fever, a Rare Adverse Event of Polypectomy: Nested Case-Control Study
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Seung-Hoon Lee, Kyung-Jo Kim, Dong-Hoon Yang, Kee Wook Jeong, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim
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Clin Endosc 2014;47(3):236-241. Published online May 31, 2014
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DOI: https://doi.org/10.5946/ce.2014.47.3.236
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Abstract
PDFPubReaderePub
- Background/Aims
Although postpolypectomy fever (PPF) without colon perforation or hemorrhage is rare, its incidence and risk factors have not been investigated. The objective of this study was to analyze the incidence and risk factors for PPF among inpatients.
MethodsSeven patients with PPF were matched with 70 patients without PPF from a total of 3,444 patients who underwent colonoscopic polypectomy. The PPF incidence during index hospitalization after colonoscopy was calculated, and univariate and multivariate analyses were performed to calculate the adjusted odds ratios (ORs) for risk factors.
ResultsPPF without bleeding or perforation in the colon occurred in seven patients (0.2%). The median age was 58 years for cases and 61 years for controls. The median interval from polypectomy to occurrence of fever was 7 hours, and the median duration of fever was 9 hours. Polyp size >2 cm (adjusted OR, 1.08; 95% confidence interval [CI], 1.01 to 1.15; p=0.02) and hypertension (adjusted OR, 14.40; 95% CI, 1.23 to 180.87; p=0.03) were associated with a significantly increased risk of PPF. PPF increased the length of hospitalization.
ConclusionsAlthough the crude incidence of PPF is low, PPF may prolong hospitalization. Risk factors for PPF include hypertension and large polyps.
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Special Issue Article of IDEN 2013
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Colonic Perforation: Can We Manage It Endoscopically?
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Jeong-Sik Byeon
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Clin Endosc 2013;46(5):495-499. Published online September 30, 2013
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DOI: https://doi.org/10.5946/ce.2013.46.5.495
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Abstract
PDFPubReaderePub
Colonic perforation occurs in a variety of clinical scenarios and colonoscopy-associated perforation is one of the important reasons for colonic perforation. Colonoscopy-associated perforation may be diagnosed during colonoscopy procedure by the visualization of evident colonic wall defect or, after the completion of colonoscopy, by the visualization of leaked air in the peritoneal or retroperitoneal space. Recently, the incidence of colonoscopy-associated perforation increased because of the introduction of colorectal endoscopic submucosal dissection. Traditionally, colonoscopy-associated perforation was managed surgically. However, medical management has been introduced widely and endoscopic clipping is the most important component for the medical management of colonoscopy-associated perforation. Timely administration of antibiotics is also important. Large perforations, diagnostic colonoscopy-associated perforations, large amount of pneumoperitoneum, and severe abdominal pain have been reported to be predictive of the necessity of surgery after endoscopic clipping. Surgery should be performed if patients show clinical deterioration even after the initiation of medical management.
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Citations
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Original Article
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Clipping for the Prevention of Immediate Bleeding after Polypectomy of Pedunculated Polyps: A Pilot Study
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Sun-Jin Boo, Jeong-Sik Byeon, Seon Young Park, Jong Sun Rew, Da Mi Lee, Sung Jae Shin, Dong Uk Kim, Geum Am Song
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Clin Endosc 2012;45(1):84-88. Published online March 31, 2012
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DOI: https://doi.org/10.5946/ce.2012.45.1.84
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Abstract
PDFPubReaderePub
- Background/Aims
Immediate postpolypectomy bleeding (IPPB) increases the procedure time and it may disturb performing a safe polypectomy. The purpose of this study is to investigate whether clipping before snare polypectomy of large pedunculated polyps is useful for the prevention of IPPB.
MethodsThis is a single arm, pilot study. We enrolled patients with pedunculated colorectal polyps that were 1 cm in size or more from 4 university hospitals between June 2009 and June 2010. Clips were applied at the stalk and snare polypectomy was then performed. The complications, including IPPB, were investigated.
ResultsFifty six pedunculated polyps in 47 patients (Male:Female=36:11; age, 56±11 years) were included. The size of the polyp heads was 17±8 mm. Tubular adenoma was most common (57%). The number of clips used before snare polypectomy was 2±0.5. The procedure was successful in all cases. IPPB occurred in 2 cases (3.6%), and both of these were managed by additional clipping. Delayed bleeding occurred in another one case (1.8%), which improved with conservative treatment. No perforation occurred.
ConclusionsWe suggest that clipping before snare polypectomy of pedunculated polyps may be an easy and effective technique for the prevention of IPPB, and this should be confirmed in large scale, prospective, controlled studies.
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Citations
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