Clinical Endoscopy

FOCUSED REVIEW SERIES: Endoscopic Managements for Patients with Obesity and Its Related Comorbidities

The Efficacy and Safety of Endoscopic Sleeve Gastroplasty as an Alternative to Laparoscopic Sleeve Gastrectomy: Jin Young Yoon, Román Turró Arau, The study group for endoscopic bariatric and metabolic therapies in the Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2021;54(1):17-24. Published online January 22, 2021; DOI: https://doi.org/10.5946/ce.2021.019

Endoscopic sleeve gastroplasty (ESG) is a therapeutic endoscopic technique for reducing the size of the gastric reservoir in obese patients, using a full-thickness endoscopic suturing device. The effectiveness of ESG in weight loss is significantly greater than that of high-intensity diet and lifestyle therapy and lower than that of laparoscopic sleeve gastrectomy (LSG). The efficacy at 12 months after ESG in terms of percentage of total body weight loss and excess body weight loss was approximately 16% and 60%, respectively. The well-known predictive factors for increased weight loss by ESG are good compliance with regular monitoring and post-procedure care involving a multidisciplinary team approach. Although the underlying mechanism of weight loss induced by ESG is debatable, delayed gastric emptying and early satiation are some of the proposed mechanisms. The pooled rate of adverse events after ESG reported in several meta-analysis studies ranged from 1.5% to 2.3% and the incidence of new-onset gastroesophageal reflux disease after ESG was negligible, indicating that ESG has a superior safety profile to LSG. Moreover, ESG reduced the risk of obesity-related metabolic comorbidities, evidenced by the reduction in HbA1c level, systolic blood pressure, triglyceride level, and risk of hepatic steatosis and fibrosis; it even improved the quality of life. ESG could be considered safe and qualify as an alternative treatment to LSG.

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Endoscopic Sleeve Gastroplasty: A Practice Pattern Survey
James D. Haddad, Jaime P. Almandoz, Victoria Gomez, Allison R. Schulman, Jay D. Horton, Jeffrey Schellinger, Sarah E. Messiah, M. Sunil Mathew, Elisa Morales Marroquin, Anna Tavakkoli
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Case Report

Fatal Necrotizing Fasciitis Following Uncomplicated Colonoscopic Polypectomy: A Case Report: Min Kyu Chae, Sang Youn Shin, Min Seob Kwak, Jin Young Yoon, Ha Il Kim, Jae Myung Cha; Clin Endosc 2021;54(2):280-284. Published online December 11, 2020; DOI: https://doi.org/10.5946/ce.2020.117

Abstract PDF PubReader ePub: Necrotizing fasciitis (NF) is a life-threatening infection that can be caused by various procedures or surgery and may develop in healthy elderly patients. Here, we report a case of a 66-year-old man with diabetes mellitus who underwent colonoscopic polypectomy, without complications. However, he visited the emergency department 24 hours after the procedure complaining of abdominal pain. Abdominopelvic computed tomography revealed multiple air bubbles in the right lateral abdominal muscles. After a diagnosis of NF was made, immediate surgical debridement was performed. However, despite three sessions of extensive surgical debridement and best supportive care at the intensive care unit, the patient died because of sepsis and NF-associated multiple-organ failure. In conclusion, physicians should pay special attention to the possibility of NF if a patient with risk factors for NF develops sepsis after colonoscopic polypectomy.

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Special Review: Korean Society of Gastrointestinal Endoscopy “Accreditation of Qualified Endoscopy Unit” Guideline: Update 2019

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, The Quality Management Committee of The Korean Society of Gastrointestinal Endoscopy; Clin Endosc 2019;52(5):431-442. Published online September 30, 2019; DOI: https://doi.org/10.5946/ce.2019.164

Abstract PDF PubReader ePub

Endoscopic quality indicators can be classified into three categories, namely facilities and equipment, endoscopic procedures, and outcome measures. In 2019, the Korean Society of Gastrointestinal Endoscopy updated the accreditation of qualified endoscopy unit assessment items for these quality indicators to establish competence and define areas of continuous quality improvement. Here, we presented the updated program guidelines on the facilities, procedures, and performance of the accredited endoscopy unit. Many of these items have not yet been validated. However, the updated program will help in establishing competence and defining areas of continuous quality improvement in Korean endoscopic practice.

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BMC Gastroenterology.2022;[Epub] CrossRef
Endoscopist-Driven Sedation Practices in South Korea: Re-evaluation Considering the Nationwide Survey in 2019
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Rumi Shin, Seongdae Lee, Kyung-Su Han, Dae Kyung Sohn, Sang Hui Moon, Dong Hyun Choi, Bong-Hyeon Kye, Hae-Jung Son, Sun Il Lee, Sumin Si, Won-Kyung Kang
Annals of Surgical Treatment and Research.2021; 100(3): 154. CrossRef
A Nationwide Survey on the Facilities and Personnel for Endoscopic Sedation: Results from 50 Qualified Endoscopy Units of Teaching Hospitals Accredited by the Korean Society of Gastrointestinal Endoscopy (KSGE)
Seon-Young Park, Jun Kyu Lee, Jung-Wook Kim, Tae Hee Lee, Chang-Hwan Park, Jae-Yong Jang, Byung-Wook Kim, Byung Ik Jang
Clinical Endoscopy.2021; 54(6): 843. CrossRef
SAFETY IN THE GASTROENTEROLOGY SETTING

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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

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Review

Quality is the Key for Emerging Issues of Population-Based Colonoscopy Screening: Jin Young Yoon, Jae Myung Cha, Yoon Tae Jeen, on behalf of Medical Policy Committee of Korean Association for the Study of Intestinal Diseases (KASID), Quality Improvement Committee of Korean Society of Gastrointestinal Endoscopy (KSGE); Clin Endosc 2018;51(1):50-55. Published online January 31, 2018; DOI: https://doi.org/10.5946/ce.2018.010

Abstract PDF PubReader ePub

Colonoscopy is currently regarded as the gold standard and preferred method of screening for colorectal cancer (CRC). However, the benefit of colonoscopy screening may be blunted by low participation rates in population-based screening programs. Harmful effects of population-based colonoscopy screening may include complications induced by colonoscopy itself and by sedation, psychosocial distress, potential over-diagnosis, and socioeconomic burden. In addition, harmful effects of colonoscopy may increase with age and comorbidities. As the risk of adverse events in population-based colonoscopy screening may offset the benefit, the adverse events should be managed and monitored. To adopt population-based colonoscopy screening, consensus on the risks and benefits should be developed, focusing on potential harm, patient preference, socioeconomic considerations, and quality improvement of colonoscopy, as well as efficacy for CRC prevention. As suboptimal colonoscopy quality is a major pitfall of population-based screening, adequate training and regulation of screening colonoscopists should be the first step in minimizing variations in quality. Gastroenterologists should promote quality improvement, auditing, and training for colonoscopy in a population-based screening program.

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Gut and Liver.2022; 16(3): 404. CrossRef
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Zhen-wen Wu, Sheng-gang Zhan, Mei-feng Yang, Yi-teng Meng, Feng Xiong, Cheng Wei, Ying-xue Li, Ding-guo Zhang, Zheng-lei Xu, Ben-hua Wu, Rui-yue Shi, Jun Yao, Li-sheng Wang, De-feng Li, Cyriac Abby Philips
Canadian Journal of Gastroenterology and Hepatology.2021; 2021: 1. 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

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Commentary

Can We Measure the Learning Curve of Colonoscopy Using Polyp Detection Rate?: Jin Young Yoon, Jae Myung Cha; Clin Endosc 2016;49(1):6-7. Published online January 28, 2016; DOI: https://doi.org/10.5946/ce.2016.49.1.6

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