Clinical Endoscopy

Original Articles

Factors influencing lateral margin diagnosis challenges in Barrett’s esophageal cancer: a bicenter retrospective study in Japan: Ippei Tanaka, Shuhei Unno, Kazuki Yamamoto, Yoshitaka Nawata, Kimihiro Igarashi, Tomoki Matsuda, Dai Hirasawa; Clin Endosc 2025;58(1):85-93. Published online November 11, 2024; DOI: https://doi.org/10.5946/ce.2024.068

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: We aimed to clarify the clinicopathological characteristics and causes of Barrett’s esophageal adenocarcinoma (BEA) with unclear demarcation.
Methods
We reviewed BEA cases between January 2010 and August 2022. The lesions were classified into the following two groups: clear demarcation (CD group) and unclear demarcation (UD group). We compared the clinicopathological findings between the two groups. Furthermore, we measured the length and width of the foveolar structures, as well as the width of marginal crypt epithelium (MCE).
Results
We analyzed data from 68 patients with BEA, including 47 and 21 in the CD and UD groups, respectively. Multivariate analysis revealed long-segment Barrett’s esophagus (LSBE) as the sole significant risk factor for BEA (odds ratio, 12.17; 95% confidence interval, 2.84–47.6; p=0.001). Regarding pathological analysis, significant differences were observed in the length and width of the foveolar structure between cancerous and surrounding mucosa in the CD group (p=0.03 and p=0.00, respectively); however, no significant difference was observed in the UD group (p=0.53 and p=0.72, respectively). Nevertheless, the width of MCE in the cancerous area was significantly shorter than that in the surrounding mucosa in both groups (p<0.05, and p<0.05, respectively).
Conclusions
LSBE is a significant risk factor for BEA in the UD group. The width of MCE may be an important factor in the endoscopic diagnosis of BEA.

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Utility of the Gel Immersion Method for Treating Massive Colonic Diverticular Bleeding: Kazuki Yamamoto, Yasutoshi Shiratori, Takashi Ikeya; Clin Endosc 2021;54(2):256-260. Published online August 11, 2020; DOI: https://doi.org/10.5946/ce.2020.081

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: In Asia, right-sided diverticular bleeding is more common than that of the left side. It often causes massive bleeding and difficulties in identifying the stigmata of recent hemorrhage (SRH) of colonic diverticular bleeding (CDB). This case series demonstrates the efficacy of the gel immersion method using OS-1 Jelly (Otsuka Pharmaceuticals Factory, Tokushima, Japan) in patients with CDB.
Methods
This retrospective case series analyzed data of patients with CDB who underwent the gel immersion method from April 2016 to February 2020 at St. Luke’s International Hospital, Japan. All patients diagnosed with CDB who underwent the gel immersion method were included. We collected data on the site of bleeding, identification of SRH, and efficacy of the method from the electronic medical records.
Results
A total of 9 patients (including 7 with right-sided CDB) underwent gel immersion method and were included in this study. SRH were successfully found in 66.7% (6/9) of patients. Moreover, effective hemostasis was achieved in 85.7% (6/7) of patients with right-sided CDB. There were no adverse events.
Conclusions
The gel immersion method was found to be effective, especially for massive right-sided CDB.

Citations

Citations to this article as recorded by

Gel immersion in endoscopy: Exploring potential applications
Hiroki Sato, Hidemasa Kawabata, Mikihiro Fujiya
World Journal of Gastroenterology.2025;[Epub] CrossRef
Advances in endoscopic management of colonic diverticular bleeding
Yasutoshi Shiratori, Syed Matthew Kodilinye, Ahmed E. Salem
Current Opinion in Gastroenterology.2024; 40(5): 363. CrossRef
Successful direct clipping of the bleeding source of a colonic diverticular hemorrhage using the “long-hood gel-filling” method
Satoshi Abiko, Koji Hirata, Kazuharu Suzuki, Kenji Kinoshita, Kazuteru Hatanaka, Yoshiya Yamamoto, Hirohito Naruse
Endoscopy.2023; 55(S 01): E606. CrossRef
Utility of under-gel endoscopic mucosal resection with partial submucosal injection for a laterally spreading tumor
Kazuki Yamamoto, Naoki Kanomata, Takashi Ikeya
Endoscopy.2022; 54(03): E88. CrossRef
Localizing spontaneously hemostatic colonic diverticular bleeding using VISCOCLEAR gel: A case report
Daisuke Suto, Masashi Yoshida, Takaaki Otake, Eiichiro Ichiishi, Kiichi Sato, Yosuke Osawa, Hirotoshi Ebinuma, Hironori Odaira, Yutaka Suzuki, Yutaka Kohgo
Annals of Medicine & Surgery.2022;[Epub] CrossRef
Gel Immersion Endoscopic Mucosal Resection (EMR) for Superficial Nonampullary Duodenal Epithelial Tumors May Reduce Procedure Time Compared with Underwater EMR (with Video)
Takeshi Yamashina, Masaaki Shimatani, Yu Takahashi, Masahiro Takeo, Natsuko Saito, Hironao Matsumoto, Takeshi Kasai, Masataka Kano, Kimi Sumimoto, Toshiyuki Mitsuyama, Hiroyuki Marusawa, Akiyoshi Nishio, Takafumi Yuba, Toshihito Seki, Makoto Naganuma, Tat
Gastroenterology Research and Practice.2022; 2022: 1. CrossRef
Digital compression for hemostasis in acute hemorrhagic rectal ulcer: a report of 4 cases and review of the literature
Takeshi Okamoto, Ayaka Takasu, Takaaki Yoshimoto, Kazuki Yamamoto, Yasutoshi Shiratori, Takashi Ikeya, Katsuyuki Fukuda
Clinical Journal of Gastroenterology.2021; 14(3): 796. CrossRef
Efficiency of a novel gel product for duodenal ulcer bleeding
Shuichi Miyamoto, Kazuharu Suzuki, Kenji Kinoshita
Digestive Endoscopy.2021;[Epub] CrossRef
Development of a gel dedicated to gel immersion endoscopy
Tomonori Yano, Atsushi Ohata, Yuji Hiraki, Makoto Tanaka, Satoshi Shinozaki, Alan Kawarai Lefor, Hironori Yamamoto
Endoscopy International Open.2021; 09(06): E918. CrossRef
Gel immersion endoscopy: Innovation in securing the visual field – Clinical experience with 265 consecutive procedures
Tomonori Yano, Takahito Takezawa, Kousei Hashimoto, Ayako Ohmori, Satoshi Shinozaki, Manabu Nagayama, Hirotsugu Sakamoto, Yoshimasa Miura, Yoshikazu Hayashi, Keijiro Sunada, Alan Kawarai Lefor, Hironori Yamamoto
Endoscopy International Open.2021; 09(07): E1123. CrossRef

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