Case Report
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Underwater Endoscopic Mucosal Resection without Submucosal Injection Facilitates En bloc Resection of Colon Adenomas Extending into a Diverticulum
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Yoshikazu Hayashi, Masahiro Okada, Takaaki Morikawa, Tatsuma Nomura, Hisashi Fukuda, Takahito Takezawa, Alan Kawarai Lefor, Hironori Yamamoto
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Clin Endosc 2021;54(3):436-440. Published online November 6, 2020
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DOI: https://doi.org/10.5946/ce.2020.168
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Abstract
PDFSupplementary MaterialPubReaderePub
- Superficial colonic neoplasms sometimes extend into a diverticulum. Conventional endoscopic mucosal resection of these lesions is considered challenging because colonic diverticula do not have a muscularis propria and are deeply inverted. Even if the solution is carefully injected below the mucosa at the bottom of the diverticulum, the mucosa is rarely elevated from the diverticular orifice, and it is usually just narrowed. Although endoscopic submucosal dissection or full-thickness resection with an over-the-scope clip device enables the complete resection of these lesions, it is still challenging, time consuming and expensive. Underwater endoscopic mucosal resection without submucosal injection (UEMR) is an innovative technique enabling en bloc resection of superficial colon lesions. We report three patients with colon adenomas extending into a diverticulum treated with successful UEMR. UEMR enabled rapid and safe en bloc resection of colon lesions extending into a diverticulum.
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Citations
Citations to this article as recorded by
- Underwater endoscopic mucosal resection for colorectal lesions: Can it be an “Underwater” revolution?
Yoji Takeuchi, Satoki Shichijo, Noriya Uedo, Ryu Ishihara
DEN Open.2022;[Epub] CrossRef
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Focused Review Series: Current Status of Image-Enhanced Endoscopy (IEE)
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Linked Color Imaging and Blue Laser Imaging for Upper Gastrointestinal Screening
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Hiroyuki Osawa, Yoshimasa Miura, Takahito Takezawa, Yuji Ino, Tsevelnorov Khurelbaatar, Yuichi Sagara, Alan Kawarai Lefor, Hironori Yamamoto
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Clin Endosc 2018;51(6):513-526. Published online November 2, 2018
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DOI: https://doi.org/10.5946/ce.2018.132
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Abstract
PDFPubReaderePub
- White light imaging (WLI) may not reveal early upper gastrointestinal cancers. Linked color imaging (LCI) produces bright images in the distant view and is performed for the same screening indications as WLI. LCI and blue laser imaging (BLI) provide excellent visibility of gastric cancers in high color contrast with respect to the surrounding tissue. The characteristic purple and green color of metaplasias on LCI and BLI, respectively, serve to increase the contrast while visualizing gastric cancers regardless of a history of Helicobacter pylori eradication.
LCI facilitates color-based recognition of early gastric cancers of all morphological types, including flat lesions or those in an H. pylori-negative normal background mucosa as well as the diagnosis of inflamed mucosae including erosions. LCI reveals changes in mucosal color before the appearance of morphological changes in various gastric lesions. BLI is superior to LCI in the detection of early esophageal cancers and abnormal findings of microstructure and microvasculature in close-up views of upper gastrointestinal cancers. Excellent images can also be obtained with transnasal endoscopy. Using a combination of these modalities allows one to obtain images useful for establishing a diagnosis. It is important to observe esophageal cancers (brown) using BLI and gastric cancers (orange) surrounded by intestinal metaplasia (purple) and duodenal cancers (orange) by LCI.
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Citations
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Min Min, Xiaotian Sun, Jianying Bai, Qinsheng Zhang, Xiaocui Yang, Qiang Guo, Rong Wang, Bangmao Wang, Zhiwu Lv, Jie Pan, Chunmeng Jiang, Duanmin Hu, Bing Nong, Enqiang Linghu, Yan Liu
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Journal of Gastroenterology and Hepatology.2021; 36(6): 1642. CrossRef - Linked Color Imaging Demonstrates Characteristic Findings in Semi-Pedunculated Gastric Adenocarcinoma in Helicobacter pylori-Negative Normal Mucosa
Yuji Hiraoka, Yoshimasa Miura, Hiroyuki Osawa, Mio Sakaguchi, Masato Tsunoda, Alan Kawarai Lefor, Hironori Yamamoto
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Maria Pina Dore, Giovanni Mario Pes
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Sang Pyo Lee, Sea Hyub Kae, Hyun Joo Jang, Dong Hee Koh, Eun Suk Jung
Journal of Digestive Diseases.2021; 22(7): 425. CrossRef - Appropriate Color Enhancement Settings for Blue Laser Imaging Facilitates the Diagnosis of Early Gastric Cancer with High Color Contrast
Yuji Hiraoka, Yoshimasa Miura, Hiroyuki Osawa, Yoshie Nomoto, Haruo Takahashi, Masato Tsunoda, Manabu Nagayama, Takashi Ueno, Alan Kawarai Lefor, Hironori Yamamoto
Journal of Gastric Cancer.2021; 21(2): 142. CrossRef - Application of linked color imaging in the diagnosis of early gastrointestinal neoplasms and precancerous lesions: a review
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Therapeutic Advances in Gastroenterology.2021;[Epub] CrossRef - Association between abdominal symptoms and gastric body redness in Linked Color Imaging in patients without Helicobacter pylori infection
Tsutomu Takeda, Daisuke Asaoka, Hisanori Utsunomiya, Shotaro Oki, Nobuyuki Suzuki, Daiki Abe, Atsushi Ikeda, Noboru Yatagai, Yoichi Akazawa, Kohei Matsumoto, Kumiko Ueda, Hiroya Ueyama, Kenshi Matsumoto, Mariko Hojo, Shuko Nojiri, Akihito Nagahara
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Hang Yang, Bing Hu
Diagnostics.2021; 11(8): 1305. CrossRef - Clinical Applications of Linked Color Imaging and Blue Laser/Light Imaging in the Screening, Diagnosis, and Treatment of Superficial Colorectal Tumors
Taku Sakamoto, Hourin Cho, Yutaka Saito
Clinical Endoscopy.2021; 54(4): 488. CrossRef - Application of Current Image-Enhanced Endoscopy in Gastric Diseases
Wansik Lee
Clinical Endoscopy.2021; 54(4): 477. CrossRef - Linked-color Imaging May Help Improve the Visibility of Superficial Barrett's Esophageal Adenocarcinoma by Increasing the Color Difference
Masahiro Saito, Tomoyuki Koike, Yuki Ohara, Kenichiro Nakagawa, Takeshi Kanno, Xiaoyi Jin, Waku Hatta, Kaname Uno, Naoki Asano, Akira Imatani, Atsushi Masamune
Internal Medicine.2021; 60(21): 3351. CrossRef - Potential of automatic diagnosis system with linked color imaging for diagnosis of Helicobacter pylori infection
Takeshi Yasuda, Tomoyuki Hiroyasu, Satoru Hiwa, Yuto Okada, Sadanari Hayashi, Yuki Nakahata, Yuriko Yasuda, Tatsushi Omatsu, Akihiro Obora, Takao Kojima, Hiroshi Ichikawa, Nobuaki Yagi
Digestive Endoscopy.2020; 32(3): 373. CrossRef - Linked Color Imaging of Eosinophilic Esophagitis
Yasuhiko Abe, Yu Sasaki, Takashi Kon, Yoshiyuki Ueno
Internal Medicine.2020; 59(12): 1573. CrossRef - Optical enhancement imaging versus acetic acid for detecting gastric intestinal metaplasia: A randomized, comparative trial
Rui Ji, Jun Liu, Ming-Ming Zhang, Yue-Yue Li, Xiu-Li Zuo, Xiao Wang, Yan-Qing Li
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Mamoru Tokunaga, Tomoaki Matsumura, Kentaro Ishikawa, Tatsuya Kaneko, Hirotaka Oura, Tsubasa Ishikawa, Ariki Nagashima, Wataru Shiratori, Kenichiro Okimoto, Naoki Akizue, Daisuke Maruoka, Yuki Ohta, Keiko Saito, Tomoo Nakagawa, Tetsuhiro Chiba, Makoto Ara
Gastroenterology Research and Practice.2020; 2020: 1. CrossRef - Linked color imaging can improve the visibility of superficial non-ampullary duodenal epithelial tumors
Kenichiro Okimoto, Daisuke Maruoka, Tomoaki Matsumura, Mamoru Tokunaga, Tatsuya Kaneko, Hirotaka Oura, Naoki Akizue, Yuki Ohta, Keiko Saito, Makoto Arai, Jun Kato, Naoya Kato
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Joon Sung Kim, Byung-Wook Kim
The Korean Journal of Internal Medicine.2019; 34(2): 237. CrossRef - Review: Diagnosis of Helicobacter pylori infection
Athanasios Makristathis, Alexander M. Hirschl, Francis Mégraud, Emilie Bessède
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Masato Tsunoda, Yoshimasa Miura, Hiroyuki Osawa, Tsevelnorov Khurelbaatar, Mio Sakaguchi, Hisashi Fukuda, Alan Kawarai Lefor, Hironori Yamamoto
Clinical Endoscopy.2019; 52(5): 497. CrossRef - Linked color imaging for the detection of early gastrointestinal neoplasms
Satoshi Shinozaki, Hiroyuki Osawa, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto
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Kimitoshi Kubo, Noriko Kimura, Soichiro Matsuda, Momoko Tsuda, Mototsugu Kato
Case Reports in Gastroenterology.2019; 13(3): 532. CrossRef
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Case Reports
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Blue Laser Imaging with a Small-Caliber Endoscope Facilitates Detection of Early Gastric Cancer
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Haruo Takahashi, Yoshimasa Miura, Hiroyuki Osawa, Takahito Takezawa, Yuji Ino, Masahiro Okada, Alan Kawarai Lefor, Hironori Yamamoto
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Clin Endosc 2019;52(3):273-277. Published online August 14, 2018
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DOI: https://doi.org/10.5946/ce.2018.100
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Abstract
PDFPubReaderePub
- Conventional endoscopy often misses early gastric cancers with minimal red discoloration because they cannot be distinguished from inflamed mucosa. We treated a patient with a small early gastric cancer that was difficult to diagnose using conventional endoscopy. Conventional endoscopy using a small-caliber endoscope showed only subtle red discoloration of the gastric mucosa. However, blue laser imaging showed a clearly discolored area measuring 10 mm in diameter around the red lesion, which was distinct from the surrounding inflamed mucosa. Irregular vessels on the tumor surface (suspicious for early gastric cancer) were observed even with small-caliber endoscopy. Biopsy revealed a well-moderately differentiated tubular adenocarcinoma, and endoscopic submucosal dissection was performed. Histopathological examination of the specimen confirmed well-moderately differentiated adenocarcinoma localized to the mucosa with slight depression compared to the surrounding mucosa, consistent with the endoscopic findings. This small early gastric cancer became clearly visible with blue laser imaging using small-caliber endoscopy.
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Citations
Citations to this article as recorded by
- Diagnostic performance of blue laser imaging for early detection of gastric cancer: A systematic review and meta-analysis
Mohammed Rifat Shaik, Andrew Canakis, Nishat Anjum Shaik, Shivanand Bomman, Dushyant Singh Dahiya, Emily Gorman, Mohammad Bilal, Saurabh Chandan
Indian Journal of Gastroenterology.2024; 43(5): 976. CrossRef - Improved detection of early gastric cancer with linked color imaging using an ultrathin endoscope: a video-based analysis
Tsevelnorov Khurelbaatar, Yoshimasa Miura, Hiroyuki Osawa, Yuji Ino, Takahito Takezawa, Chihiro Iwashita, Yoshie Nomoto, Masato Tsunoda, Takashi Ueno, Haruo Takahashi, Manabu Nagayama, Hisashi Fukuda, Alan Kawarai Lefor, Hironori Yamamoto
Endoscopy International Open.2022; 10(05): E644. 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 - Current Evidence for a Paradigm Shift in Gastric Cancer Prevention From Endoscopic Screening toHelicobacter pyloriEradication in Korea
Young-Il Kim, Il Ju Choi
Journal of Gastric Cancer.2022; 22(3): 169. CrossRef - Clinical Features of False-Negative Early Gastric Cancers: A Retrospective Study of Endoscopic Submucosal Dissection Cases
Kohei Oka, Naoto Iwai, Takashi Okuda, Tasuku Hara, Yutaka Inada, Toshifumi Tsuji, Toshiyuki Komaki, Junichi Sakagami, Yuji Naito, Keizo Kagawa, Yoshito Itoh, Fabiana Zingone
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef - Appropriate Color Enhancement Settings for Blue Laser Imaging Facilitates the Diagnosis of Early Gastric Cancer with High Color Contrast
Yuji Hiraoka, Yoshimasa Miura, Hiroyuki Osawa, Yoshie Nomoto, Haruo Takahashi, Masato Tsunoda, Manabu Nagayama, Takashi Ueno, Alan Kawarai Lefor, Hironori Yamamoto
Journal of Gastric Cancer.2021; 21(2): 142. CrossRef - Linked Color Imaging and Blue Laser Imaging for Upper Gastrointestinal Screening
Hiroyuki Osawa, Yoshimasa Miura, Takahito Takezawa, Yuji Ino, Tsevelnorov Khurelbaatar, Yuichi Sagara, Alan Kawarai Lefor, Hironori Yamamoto
Clinical Endoscopy.2018; 51(6): 513. CrossRef
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Laser Imaging Facilitates Early Detection of Synchronous Adenocarcinomas in Patients with Barrett’s Esophagus
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Chihiro Iwashita, Yoshimasa Miura, Hiroyuki Osawa, Takahito Takezawa, Yuji Ino, Masahiro Okada, Alan K. Lefor, Hironori Yamamoto
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Clin Endosc 2017;50(1):81-86. Published online May 9, 2016
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DOI: https://doi.org/10.5946/ce.2016.027
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Abstract
PDFPubReaderePub
- Barrett’s adenocarcinoma may occur in multiple sites, and recurrence and metachronous lesions are the major problems with endoscopic resection. Therefore, early detection of such lesions is ideal to achieve complete resection and obtain improved survival rates with minimally invasive treatment. Laser imaging systems allow multiple modalities of endoscopic imaging by using white light laser, flexible spectral imaging color enhancement (FICE), blue laser imaging (BLI), and linked color imaging even at a distant view. However, the usefulness of these modalities has not been sufficiently reported regarding Barrett’s adenocarcinoma. Here, we report on a patient with three synchronous lesions followed by one metachronous lesion in a long segment with changes of Barrett’s esophagus, all diagnosed with this new laser endoscopic imaging system and enhanced by using FICE and/or BLI with high contrast compared with the surrounding mucosa. Laser endoscopic imaging may facilitate the detection of malignancies in patients with early Barrett’s adenocarcinoma.
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Citations
Citations to this article as recorded by
- Validation of simplified classification of magnifying endoscopy for diagnosis of Barrett's dysplasia with blue laser imaging
Tzu‐Haw Chen, Ro‐Ting Lin, Wen‐Lun Wang, Ching‐Tai Lee, Cheng‐Hao Tseng, Wen‐Hung Hsu, Wei‐Chen Tai, Hsiu‐Po Wang, Chi‐Yang Chang
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Félix Junquera, Sonia Fernández-Ananín, Carmen Balagué
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Haruo Takahashi, Yoshimasa Miura, Hiroyuki Osawa, Takahito Takezawa, Yuji Ino, Masahiro Okada, Alan Kawarai Lefor, Hironori Yamamoto
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Félix Junquera, Sonia Fernández-Ananín, Carmen Balagué
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Hiroyuki Osawa, Yoshimasa Miura, Takahito Takezawa, Yuji Ino, Tsevelnorov Khurelbaatar, Yuichi Sagara, Alan Kawarai Lefor, Hironori Yamamoto
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Masayuki Kato, Kenichi Goda, Yuichi Shimizu, Akira Dobashi, Masakazu Takahashi, Masahiro Ikegami, Tadakazu Shimoda, Mototsugu Kato, Prateek Sharma
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Jin-Hua Liu, Dan-Yang Liu, Li Wang, Li-Ping Han, Zhe-Yu Qi, Hai-Jun Ren, Yan Feng, Feng-Ming Luan, Liang-Tian Mi, Shu-Mei Shan
World Journal of Gastroenterology.2017; 23(20): 3684. CrossRef
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9,014
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8
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Brief Report
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Laterally Spreading Tumor of the Rectum Delineated with Linked Color Imaging Technology
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Masahiro Okada, Hirotsugu Sakamoto, Takahito Takezawa, Yoshikazu Hayashi, Keijiro Sunada, Alan K. Lefor, Hironori Yamamoto
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Clin Endosc 2016;49(2):207-208. Published online February 12, 2016
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DOI: https://doi.org/10.5946/ce.2015.077
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PDFPubReaderePub
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Fumiaki Ishibashi, Sho Suzuki
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Kyueng-Whan Min, One-Zoong Kim
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Shoko Ono, Masaki Inoue, Masayuki Higashino, Shuhei Hayasaka, Shugo Tanaka, Hiroki Egami, Naoya Sakamoto
Digestive Endoscopy.2024;[Epub] CrossRef - Linked color imaging improves the diagnostic accuracy of eosinophilic esophagitis
Yasuhiko Abe, Yu Sasaki, Makoto Yagi, Naoko Mizumoto, Yusuke Onozato, Takashi Kon, Masakuni Shoji, Kazuhiro Sakuta, Takayuki Sakai, Matsuki Umehara, Minami Ito, Shuhei Nakamura, Hidemoto Tsuchida, Yoshiyuki Ueno
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Scandinavian Journal of Gastroenterology.2021; 56(1): 103. CrossRef - Optical effect of spraying l-menthol on gastric intestinal metaplasia visualized by linked color imaging
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European Journal of Gastroenterology & Hepatology.2021; 33(3): 358. CrossRef - Linked colour imaging versus white‐light colonoscopy for the detection of flat colorectal lesions: A randomized controlled trial
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Colorectal Disease.2021; 23(6): 1414. CrossRef - Application of linked color imaging in the diagnosis of early gastrointestinal neoplasms and precancerous lesions: a review
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Digestive Endoscopy.2020; 32(6): 874. CrossRef - Significance of Linked Color Imaging for Predicting the Risk of Clinical Relapse in Ulcerative Colitis
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Digestive Endoscopy.2017; 29(2): 230. CrossRef - Flexible Gastro-intestinal Endoscopy — Clinical Challenges and Technical Achievements
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Chinese Medical Journal.2017; 130(9): 1127. CrossRef - Linked color imaging application for improving the endoscopic diagnosis accuracy: a pilot study
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