Clinical Endoscopy

Reviews

Recent advancement in endoscopic diagnosis for risk stratification of gastric cancer: Takuma Hiramatsu, Naomi Kakushima, Hikaru Kuribara, Ryohei Miyata, Hideki Nakagawa, Hiroyuki Hisada, Dai Kubota, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Chihiro Takeuchi, Seiichi Yakabi, Yosuke Tsuji, Nobutake Yamamichi, Mitsuhiro Fujishiro; Received December 26, 2024 Accepted April 3, 2025 Published online July 10, 2025; DOI: https://doi.org/10.5946/ce.2024.355 [Epub ahead of print]

Abstract PDF PubReader ePub: Approximately 90% of cases of gastric cancer (GC) are caused by Helicobacter pylori infection, and screening esophagogastroduodenoscopy is effective for secondary prevention of GC. Endoscopic findings of the stomach due to H. pylori infection vary widely, and the risk of GC varies according to each finding. GC risk is evaluated by combining endoscopic and histopathological findings. In the operative link on gastritis assessment and operative link on gastric intestinal metaplasia assessment staging, GC risk is determined by histopathological evaluation. In the endoscopic grading of gastric intestinal metaplasia, Kyoto classification, and modified Kyoto classification, the risk is considered based on endoscopic findings. However, evaluating endoscopic findings is challenging because the evaluation varies depending on the skill of the endoscopist. Similarly, histopathological findings can be assessed differently by different pathologists. Histopathological evaluation by biopsy carries a risk of bleeding; thus, simpler and less-invasive risk stratification methods are desirable. Artificial intelligence for risk stratification, which has the potential for improved accuracy and consistency, has been developed for endoscopic and histopathological evaluations. Appropriate GC risk stratification would benefit the economy and patients, and further evaluation of surveillance intervals tailored to individual risks is warranted.

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Clinical meaning of sarcopenia in patients undergoing endoscopic treatment: Hiroyuki Hisada, Yosuke Tsuji, Hikaru Kuribara, Ryohei Miyata, Kaori Oshio, Satoru Mizutani, Hideki Nakagawa, Rina Cho, Nobuyuki Sakuma, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Seiichi Yakabi, Yu Takahashi, Yoshiki Sakaguchi, Naomi Kakushima, Nobutake Yamamichi, Mitsuhiro Fujishiro; Clin Endosc 2024;57(4):446-453. Published online March 22, 2024; DOI: https://doi.org/10.5946/ce.2023.193

Abstract PDF PubReader ePub

With increasing global life expectancy, the significance of geriatric assessment parameters has increased. Sarcopenia is a crucial assessment parameter and is defined as the age-related loss of muscle mass and strength. Sarcopenia is widely acknowledged as a risk factor for postoperative complications in diverse advanced malignancies and has a detrimental effect on the long-term prognosis. While most studies have primarily concentrated on the correlation between sarcopenia and advanced cancer, more recent investigations have focused on the relationship between sarcopenia and early-stage cancer. Endoscopic submucosal dissection (ESD), which is less invasive than surgical intervention, is extensively employed in the management of early-stage cancer, although it is associated with complications such as bleeding and perforation. In recent years, several reports have revealed the adverse consequences of sarcopenia in patients with early-stage cancer undergoing ESD. This literature review briefly summarizes the recent studies on the association between sarcopenia and ESD.

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Sarcopenia in the era of aging populations: its clinical implications for peptic ulcer bleeding
Hiroyuki Hisada, Yosuke Tsuji, Mitsuhiro Fujishiro
Clinical Endoscopy.2025; 58(3): 401. CrossRef
Clinical Significance of Sarcopenia in Elderly Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-analysis
Yuanhao Su, Yongke Wu, Cheng Li, Yiyuan Zhao, Yunhao Li, Xing Jin, Zhidong Wang
Digestive Diseases and Sciences.2024; 69(8): 2970. CrossRef

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Focused Review Series: Cutting Edge of Advanced Therapeutic Endoscopy

Present Status of Endoscopic Submucosal Dissection for Non-Ampullary Duodenal Epithelial Tumors: Naomi Kakushima, Masao Yoshida, Yohei Yabuuchi, Noboru Kawata, Kohei Takizawa, Yoshihiro Kishida, Sayo Ito, Kenichiro Imai, Kinichi Hotta, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Hiroyuki Ono; Clin Endosc 2020;53(6):652-658. Published online January 15, 2020; DOI: https://doi.org/10.5946/ce.2019.184

Abstract PDF PubReader ePub

Prediction of histology by endoscopic examination is important in the clinical management of non-ampullary duodenal epithelial tumors (NADETs), including adenoma and adenocarcinoma. The use of a simple scoring system based on the findings of white-light endoscopy or magnified endoscopy with narrow-band imaging is useful to differentiate between Vienna category 3 (C3) and C4/5 lesions. Less invasive endoscopic resection procedures, such as cold snare polypectomy, are quick to perform and convenient for small (<10 mm) C3 lesions. Neoplasms with higher grade histology, such as C4/5 lesions, should be treated by endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or surgery. Although EMR often requires piecemeal resection, the complication rate is acceptable. Excellent complete resection rates could be achieved by ESD; however, it remains a challenging method considering the high risk of complications. Shielding or closure of the ulcer after ESD is effective at decreasing the risk of delayed bleeding and perforation. Laparoscopic endoscopic cooperative surgery is an ideal treatment with a high rate of en bloc resection and a low rate of complications, although it is limited to high-volume centers. Patients with NADETs could benefit from a multidisciplinary approach to stratify the optimal treatment based on endoscopic diagnoses.

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Risk factors for delayed bleeding after endoscopic resection of non-ampullary duodenal epithelial tumors and the effectiveness of complete mucosal closure in high-risk patients
Kohei Shigeta, Masao Yoshida, Yoichi Yamamoto, Yuki Maeda, Noboru Kawata, Kazunori Takada, Kenichiro Imai, Kinichi Hotta, Junya Sato, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Hiroyuki Ono
Surgical Endoscopy.2025; 39(2): 1025. CrossRef
Endoscopic Resection for Superficial Non-Ampullary Duodenal Epithelial Tumors
Hye Kyung Jeon, Gwang Ha Kim
Gut and Liver.2025; 19(1): 19. CrossRef
The Characteristics and Treatment Outcomes of 71 Duodenal Brunner’s Gland Adenomas with Endoscopic Submucosal Dissection
Ying Xiang, Jinyan Liu, Nan ya Wang, Dehua Tang, Lei Wang, Ping xiao Zou, Guifang Xu, Qin Huang
Digestive Diseases.2023; 41(6): 852. CrossRef
Endoscopic diagnosis and treatment of superficial non-ampullary duodenal epithelial tumors: A review
Zheng Zhao, Yue Jiao, Shuyue Yang, Anni Zhou, Guiping Zhao, Shuilong Guo, Peng Li, Shutian Zhang
Journal of Translational Internal Medicine.2023; 11(3): 206. CrossRef
Current Treatment Strategy for Superficial Nonampullary Duodenal Epithelial Tumors
Tetsuya Suwa, Kohei Takizawa, Noboru Kawata, Masao Yoshida, Yohei Yabuuchi, Yoichi Yamamoto, Hiroyuki Ono
Clinical Endoscopy.2022; 55(1): 15. CrossRef
Rapid and chronological expression of angiogenetic genes is a major mechanism involved in cell sheet transplantation in a rat gastric ulcer model
Shun Yamaguchi, Miki Higashi, Kengo Kanetaka, Yasuhiro Maruya, Shinichiro Kobayashi, Keiichi Hashiguchi, Masaaki Hidaka, Kazuhiko Nakao, Susumu Eguchi
Regenerative Therapy.2022; 21: 372. CrossRef
Survival comparison between endoscopic and surgical resection for non-ampullary duodenal neuroendocrine tumor (1–2 cm)
Jiebin Xie, Yuan Zhang, Ming He, Xu Liu, Pin Xie, Yueshan Pang
Scientific Reports.2022;[Epub] CrossRef
Efficacy, feasibility, and safety of endoscopic double closure in the GI tract
Ahmad M. Al-Taee, Kohtaro Ooka, Gregory B. Haber, Jonathan Cohen
iGIE.2022; 1(1): 19. CrossRef
Current endoscopic diagnosis treatment strategy for superficial nonampullary duodenal tumours
Aichun Li, Jianwei Shen
European Journal of Medical Research.2022;[Epub] CrossRef
The incidence of non‐ampullary duodenal cancer in Japan: The first analysis of a national cancer registry
Masao Yoshida, Yohei Yabuuchi, Naomi Kakushima, Motohiko Kato, Mikitaka Iguchi, Yorimasa Yamamoto, Kengo Kanetaka, Toshio Uraoka, Mitsuhiro Fujishiro, Masayuki Sho
Journal of Gastroenterology and Hepatology.2021; 36(5): 1216. CrossRef
White light and/or magnifying endoscopy with narrow band imaging for superficial nonampullary duodenal epithelial tumors
Naomi Kakushima, Masao Yoshida, Kohei Takizawa, Yohei Yabuuchi, Noboru Kawata, Yoshihiro Kishida, Sayo Ito, Kenichiro Imai, Kinichi Hotta, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Hiroyuki Ono
Scandinavian Journal of Gastroenterology.2021; 56(2): 211. CrossRef
Endoscopic management of superficial nonampullary duodenal tumors: European Society of Gastrointestinal Endoscopy (ESGE) Guideline
Geoffroy Vanbiervliet, Alan Moss, Marianna Arvanitakis, Urban Arnelo, Torsten Beyna, Olivier Busch, Pierre H. Deprez, Lumir Kunovsky, Alberto Larghi, Gianpiero Manes, Bertrand Napoleon, Kumanan Nalankilli, Manu Nayar, Enrique Pérez-Cuadrado-Robles, Stefan
Endoscopy.2021; 53(05): 522. CrossRef
Endoscopic Treatment for Superficial Nonampullary Duodenal Tumors
Hyo-Joon Yang
The Korean Journal of Gastroenterology.2021; 77(4): 164. CrossRef
Duodenal endoscopic submucosal dissection: Is it ready for primetime? (with video)
Sergey V. Kantsevoy
Gastrointestinal Endoscopy.2020; 91(5): 1138. 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
Tapering body stiffness shortens upper gastrointestinal examination via transoral insertion with ultrathin endoscope
Satoshi Ono, Shun Ito, Kyohei Maejima, Shosuke Hosaka, Kiyotaka Umeki, Shin-ichiro Sato
Endoscopy International Open.2020; 08(12): E1748. CrossRef

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