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6 "Takashi Toyonaga"
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Original Articles
Management of esophageal neoplasms by endoscopic submucosal dissection: experience over 100 consecutive procedures
Josué Aliaga Ramos, Yoshinori Morita, Takashi Toyonaga, Danilo Carvalho, Moises Salgado Pedrosa, Vitor N. Arantes
Clin Endosc 2023;56(5):613-622.   Published online May 17, 2023
DOI: https://doi.org/10.5946/ce.2022.245
Graphical AbstractGraphical Abstract AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic submucosal dissection (ESD) is currently considered the first-line treatment for the eradication of superficial neoplasms of the esophagus in Eastern countries. However, in the West, particularly in Latin America, the experience with esophageal ESD is still limited because of the high technical complexity required for its execution. This study aimed to present the results of the clinical application of ESD to manage superficial esophageal neoplasms in a Latin American center in over 100 consecutive cases.
Methods
This retrospective study included consecutive patients who underwent endoscopic ESD for superficial esophageal neoplasms between 2009 and 2022. The following clinical outcomes were assessed: en bloc, complete, and curative resection rates, local recurrence, adverse events, and procedure-related mortality.
Results
Esophageal ESD was performed mainly for squamous cell carcinoma (66.6%), high-grade intraepithelial neoplasia (17.1%), and adenocarcinoma (11.4%). En bloc and complete resection rates were 96.2% and 81.0%, respectively. The curative resection rate was 64.8%. Adverse events occurred in six cases (5.7%). Endoscopic follow-up was performed for an average period of 29.7 months.
Conclusions
ESD performed by trained operators is feasible, safe, and clinically effective for managing superficial neoplastic lesions of the esophagus in Latin America.
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Feasibility and safety of endoscopic submucosal dissection for lesions in proximity to a colonic diverticulum
Nobuaki Ikezawa, Takashi Toyonaga, Shinwa Tanaka, Tetsuya Yoshizaki, Toshitatsu Takao, Hirofumi Abe, Hiroya Sakaguchi, Kazunori Tsuda, Satoshi Urakami, Tatsuya Nakai, Taku Harada, Kou Miura, Takahisa Yamasaki, Stuart Kostalas, Yoshinori Morita, Yuzo Kodama
Clin Endosc 2022;55(3):417-425.   Published online May 12, 2022
DOI: https://doi.org/10.5946/ce.2021.245
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Endoscopic submucosal dissection (ESD) for diverticulum-associated colorectal lesions is generally contraindicated because of the high risk of perforation. Several studies on patients with such lesions treated with ESD have been reported recently. However, the feasibility and safety of ESD for lesions in proximity to a colonic diverticulum (D-ESD) have not been fully clarified. The aim of this study was to evaluate the feasibility and safety of D-ESD.
Methods
D-ESD was defined as ESD for lesions within approximately 3 mm of a diverticulum. Twenty-six consecutive patients who underwent D-ESD were included. Two strategic approaches were used depending on whether submucosal dissection of the diverticulum-related part was required (strategy B) or not (strategy A). Treatment outcomes and adverse events associated with each strategy were analyzed.
Results
The en bloc resection rate was 96.2%. The rates of R0 and curative resection in strategies A and B were 80.8%, 73.1%, 84.6%, and 70.6%, respectively. Two cases of intraoperative perforation and one case of delayed perforation occurred. The delayed perforation case required emergency surgery, but the other cases were managed conservatively.
Conclusions
D-ESD may be a feasible treatment option. However, it should be performed in a high-volume center by expert hands because it requires highly skilled endoscopic techniques.

Citations

Citations to this article as recorded by  
  • Endoscopic submucosal dissection for diverticulum using combination of countertraction and circumferential-inversion method
    Hiroshi Takayama, Yoshinori Morita, Toshitatsu Takao, Douglas Motomura, Madoka Takao, Takashi Toyonaga, Yuzo Kodama
    Endoscopy.2024; 56(S 01): E91.     CrossRef
  • Traction-assisted endoscopic submucosal dissection for resection of ileocecal valve neoplasia: a French retrospective multicenter case series
    Clara Yzet, Timothée Wallenhorst, Jérémie Jacques, Mariana Figueiredo Ferreira, Jérôme Rivory, Florian Rostain, Louis-Jean Masgnaux, Jean Grimaldi, Romain Legros, Pierre Lafeuille, Jérémie Albouys, Fabien Subtil, Marion Schaefer, Mathieu Pioche
    Endoscopy.2024;[Epub]     CrossRef
  • The role of cap-assisted endoscopy and its future implications
    Sol Kim, Bo-In Lee
    Clinical Endoscopy.2024; 57(3): 293.     CrossRef
  • Successful planned piecemeal endoscopic resection using gel immersion and an over-the-scope clip for a lesion extensively extended into the colonic diverticulum
    Tomoaki Tashima, Takahiro Muramatsu, Tomonori Kawasaki, Tsubasa Ishikawa, Shomei Ryozawa
    VideoGIE.2023; 8(4): 167.     CrossRef
  • Future therapeutic implications of new molecular mechanism of colorectal cancer
    Sen Lu, Cheng-You Jia, Jian-She Yang
    World Journal of Gastroenterology.2023; 29(16): 2359.     CrossRef
  • Iatrogenic colorectal perforation caused by a clip
    Hirotaka Oura, Yasuki Hatayama, Erika Nomura, Harutoshi Sugiyama, Daisuke Murakami, Makoto Arai, Takayoshi Nishino
    Endoscopy.2023; 55(S 01): E1091.     CrossRef
  • 3,841 View
  • 175 Download
  • 5 Web of Science
  • 6 Crossref
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Clinical Impact of Different Reconstruction Methods on Remnant Gastric Cancer at the Anastomotic Site after Distal Gastrectomy
Kei Matsumoto, Shinwa Tanaka, Takashi Toyonaga, Nobuaki Ikezawa, Mari Nishio, Masanao Uraoka, Tomoatsu Yoshihara, Hiroya Sakaguchi, Hirofumi Abe, Tetsuya Yoshizaki, Madoka Takao, Toshitatsu Takao, Yoshinori Morita, Hiroshi Yokozaki, Yuzo Kodama
Clin Endosc 2022;55(1):86-94.   Published online August 13, 2021
DOI: https://doi.org/10.5946/ce.2021.084
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: The anastomotic site after distal gastrectomy is the area most affected by duodenogastric reflux. Different reconstruction methods may affect the lesion characteristics and treatment outcomes of remnant gastric cancers at the anastomotic site. We retrospectively investigated the clinicopathologic and endoscopic submucosal dissection outcomes of remnant gastric cancers at the anastomotic site.
Methods
We recruited 34 consecutive patients who underwent endoscopic submucosal dissection for remnant gastric cancer at the anastomotic site after distal gastrectomy. Clinicopathology and treatment outcomes were compared between the Billroth II and non-Billroth II groups.
Results
The tumor size in the Billroth II group was significantly larger than that in the non-Billroth II group (22 vs. 19 mm; p=0.048). More severe gastritis was detected endoscopically in the Billroth II group (2 vs. 1.33; p=0.0075). Moreover, operation time was longer (238 vs. 121 min; p=0.004) and the frequency of bleeding episodes was higher (7.5 vs. 3.1; p=0.014) in the Billroth II group.
Conclusions
Compared to remnant gastric cancers in non-Billroth II patients, those in the Billroth II group had larger lesions with a background of severe remnant gastritis. Endoscopic submucosal dissection for remnant gastric cancers in Billroth II patients involved longer operative times and more frequent bleeding episodes than that in patients without Billroth II.
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Efficacy of the Envelope Method in Applying Polyglycolic Acid Sheets to Post-Endoscopic Submucosal Dissection Ulcers in Living Pigs
Hiroya Sakaguchi, Toshitatsu Takao, Yoshitaka Takegawa, Yuki Koga, Kazunori Yamanaka, Masataka Sagata, Shinwa Tanaka, Yoshinori Morita, Takashi Toyonaga, Yuzo Kodama
Clin Endosc 2021;54(1):64-72.   Published online July 16, 2020
DOI: https://doi.org/10.5946/ce.2020.014
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Application of polyglycolic acid (PGA) sheets using fibrin glue in post-endoscopic submucosal dissection (ESD) ulcers to prevent bleeding has been reported to be difficult with the conventional delivery method because of gravity. This study assessed the usefulness of the envelope-based delivery system with and against gravity in living pigs.
Methods
PGA sheets were applied on post-ESD ulcers with and against gravity six times each using the conventional and envelope methods, respectively. The PGA sheet delivery time and the endoscopic and histological findings of the treated ulcer floors were compared.
Results
With gravity, the median PGA sheet application time was 1.00 (0.68–1.30) min/cm2 and 0.32 (0.18–0.52) min/cm2 with the conventional and envelope techniques (p=0.002), respectively, and against gravity, it was 1.20 (1.13–1.63) min/cm2 and 0.50 (0.39–0.58) min/cm2 (p=0.002), respectively. Against gravity, the endoscopic and histological findings revealed that the conventional group had insufficient fixation of the PGA sheets, but the envelope groups had sufficient fixation. The results with gravity were similar between the groups.
Conclusions
The envelope method makes it possible to deliver PGA sheets to the stomach quickly and cover ulcers appropriately both with and against gravity in living pigs.

Citations

Citations to this article as recorded by  
  • Endoscopic sealing hemostasis with polyglycolic acid sheet and fibrin glue as a novel endoscopic hemostatic technique: a report of three cases
    Kai Korekawa, Atsushi Kunimitsu
    Clinical Journal of Gastroenterology.2024;[Epub]     CrossRef
  • Clinical Impact of Different Reconstruction Methods on Remnant Gastric Cancer at the Anastomotic Site after Distal Gastrectomy
    Kei Matsumoto, Shinwa Tanaka, Takashi Toyonaga, Nobuaki Ikezawa, Mari Nishio, Masanao Uraoka, Tomoatsu Yoshihara, Hiroya Sakaguchi, Hirofumi Abe, Tetsuya Yoshizaki, Madoka Takao, Toshitatsu Takao, Yoshinori Morita, Hiroshi Yokozaki, Yuzo Kodama
    Clinical Endoscopy.2022; 55(1): 86.     CrossRef
  • The importance of pH adjustment for preventing fibrin glue dissolution in the stomach: an in vitro study
    Yoshitaka Takegawa, Toshitatsu Takao, Hiroya Sakaguchi, Tatsuya Nakai, Kazuhiro Takeo, Yoshinori Morita, Takashi Toyonaga, Yuzo Kodama
    Scientific Reports.2022;[Epub]     CrossRef
  • A Novel Self-Assembled Gel for Gastric Endoscopic Submucosal Dissection-Induced Ulcer: A Preclinical Study in a Porcine Model
    Meng Li, Haifeng Jin, Changpei Shi, Bin Lyu, Xiao Ying, Yuan Shi
    Frontiers in Pharmacology.2021;[Epub]     CrossRef
  • 4,997 View
  • 119 Download
  • 5 Web of Science
  • 4 Crossref
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Reasons for Diagnostic Failure in Forty-Five Consecutive Mucosal Cutting Biopsy Examinations of Gastric Subepithelial Tumors
Yoshiko Nakano, Toshitatsu Takao, Yoshinori Morita, Shinwa Tanaka, Takashi Toyonaga, Eiji Umegaki, Yuzo Kodama
Clin Endosc 2020;53(5):575-582.   Published online February 14, 2020
DOI: https://doi.org/10.5946/ce.2019.150
AbstractAbstract PDFPubReaderePub
Background
/Aims: Mucosal cutting biopsy (MCB) is useful for the histopathological diagnosis of gastric subepithelial tumors (SETs). However, there is little information on cases in which MCB did not establish a diagnosis. In the current study, we aimed to investigate the characteristics of cases in which MCB was unsuccessful.
Methods
Cases in which MCB was used to histopathologically diagnose gastric SETs at Kobe University Hospital between August 2012 and October 2018 were retrospectively reviewed.
Results
Forty-five cases in which MCB was used to diagnose 43 gastric SETs in 43 patients were analyzed. The median tumor size was 20 mm (range, 8–50 mm). Pathological examinations resulted in definitive and suspected diagnoses and no diagnosis in 29 (gastrointestinal stromal tumor: n=17, leiomyoma: n=7, aberrant pancreas: n=3, others: n=2), 6, and 10 cases, respectively. Failure to expose the tumor according to retrospective examinations of endoscopic images was significantly associated with no diagnosis. Other possible explanations included a less elevated tumor, biopsy of the surrounding field instead of the tumor due to the mobility, and poor endoscope maneuverability due to the tumor being close to the cardia.
Conclusions
Clear exposure of gastric SETs during MCB may improve the diagnostic rate of such examinations.

Citations

Citations to this article as recorded by  
  • Technical outcomes and postprocedural courses of mucosal incision‐assisted biopsy for possible gastric gastrointestinal stromal tumors: A series of 48 cases (with video)
    Eriko Koizumi, Osamu Goto, Shun Nakagome, Tsugumi Habu, Yumiko Ishikawa, Kumiko Kirita, Hiroto Noda, Kazutoshi Higuchi, Takeshi Onda, Teppei Akimoto, Jun Omori, Naohiko Akimoto, Katsuhiko Iwakiri
    DEN Open.2024;[Epub]     CrossRef
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    Masashi Yamamoto, Tsutomu Nishida, Ryotaro Uema, Takashi Kanesaka, Hiroyuki Ogawa, Shinji Kitamura, Hideki Iijima, Kengo Nagai, Shusaku Tsutsui, Masato Komori, Katsumi Yamamoto, Yoshiki Tsujii, Yoshito Hayashi, Tetsuo Takehara
    DEN Open.2024;[Epub]     CrossRef
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    Gwang Ha Kim
    Gut and Liver.2022; 16(1): 19.     CrossRef
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    Masanari Sekine, Takeharu Asano, Hirosato Mashima
    Diagnostics.2022; 12(4): 810.     CrossRef
  • Advancements in the Diagnosis of Gastric Subepithelial Tumors
    Osamu Goto, Mitsuru Kaise, Katsuhiko Iwakiri
    Gut and Liver.2022; 16(3): 321.     CrossRef
  • Mucosal Incision-Assisted Endoscopic Biopsy as an Alternative to Endoscopic Ultrasound-Guided Fine-Needle Aspiration/Biopsy for Gastric Subepithelial Tumor
    Cheol Woong Choi, Joo Ha Hwang
    Clinical Endoscopy.2020; 53(5): 505.     CrossRef
  • 3,627 View
  • 109 Download
  • 6 Web of Science
  • 6 Crossref
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Focused Review Series: Globalization and Universalization of ESD
Principles of Quality Controlled Endoscopic Submucosal Dissection with Appropriate Dissection Level and High Quality Resected Specimen
Takashi Toyonaga, Eisei Nishino, Mariko Man-i, James E. East, Takeshi Azuma
Clin Endosc 2012;45(4):362-374.   Published online November 30, 2012
DOI: https://doi.org/10.5946/ce.2012.45.4.362
AbstractAbstract PDFPubReaderePub

Endoscopic submucosal dissection (ESD) has enabled en bloc resection of early stage gastrointestinal tumors with negligible risk of lymph node metastasis, regardless of tumor size, location, and shape. However, ESD is a relatively difficult technique compared with conventional endoscopic mucosal resection, requiring a longer procedure time and potentially causing more complications. For safe and reproducible procedure of ESD, the appropriate dissection of the ramified vascular network in the level of middle submucosal layer is required to reach the avascular stratum just above the muscle layer. The horizontal approach to maintain the appropriate depth for dissection beneath the vascular network enables treatment of difficult cases with large vessels and severe fibrosis. The most important aspect of ESD is the precise evaluation of curability. This approach can also secure the quality of the resected specimen with enough depth of the submucosal layer.

Citations

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    Surgical Endoscopy.2024; 38(4): 2267.     CrossRef
  • Is there a best choice of equipment for colorectal endoscopic submucosal dissection?
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    Clinics in Colon and Rectal Surgery.2023;[Epub]     CrossRef
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    Digestive Endoscopy.2023;[Epub]     CrossRef
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  • A Steep Early Learning Curve for Endoscopic Submucosal Dissection in the Live Porcine Model
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    Digestive Diseases.2022; 40(6): 816.     CrossRef
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    Endoscopy International Open.2022; 10(06): E727.     CrossRef
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    Gianluca Andrisani, Takehide Fukuchi, Giulio Antonelli, Jun Hamanaka, Cesare Hassan, Guido Costamagna, Shin Maeda, Francesco Maria Di Matteo, Kingo Hirasawa
    Digestive and Liver Disease.2021; 53(7): 889.     CrossRef
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    Gastrointestinal Endoscopy.2021; 94(1): 155.     CrossRef
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    Surgical Endoscopy.2020; 34(9): 3766.     CrossRef
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    Nobuaki Ikezawa, Shinwa Tanaka, Takashi Toyonaga
    Digestive Endoscopy.2020;[Epub]     CrossRef
  • Feasibility of gastric endoscopic submucosal dissection without using proton pump inhibitor injection: a propensity score analysis
    Saki Fushimi, Yohei Horikawa, Hiroya Mizutamari, Nobuya Mimori, Yuhei Kato, Sayaka Sato
    Journal of Rural Medicine.2020; 15(3): 85.     CrossRef
  • Efficacy of a new image-enhancement technique for achieving hemostasis in endoscopic submucosal dissection
    Tadateru Maehata, Ai Fujimoto, Toshio Uraoka, Motohiko Kato, Joichiro Horii, Motoki Sasaki, Yoshiyuki Kiguchi, Teppei Akimoto, Atsushi Nakayama, Yasutoshi Ochiai, Osamu Goto, Toshihiro Nishizawa, Naohisa Yahagi
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    Eun Ran Kim, Dong Kyung Chang
    Clinical Endoscopy.2019; 52(2): 114.     CrossRef
  • Use of electrosurgical units in the endoscopic resection of gastrointestinal tumors
    José C. Marín-Gabriel, Raffaella Romito, Carlos Guarner-Argente, José Santiago-García, Joaquín Rodríguez-Sánchez, Takashi Toyonaga
    Gastroenterología y Hepatología.2019; 42(8): 512.     CrossRef
  • Use of electrosurgical units in the endoscopic resection of gastrointestinal tumors
    José C. Marín-Gabriel, Raffaella Romito, Carlos Guarner-Argente, José Santiago-García, Joaquín Rodríguez-Sánchez, Takashi Toyonaga
    Gastroenterología y Hepatología (English Edition).2019; 42(8): 512.     CrossRef
  • Two penetrating vessels as a novel indicator of the appropriate distal end of peroral endoscopic myotomy
    Shinwa Tanaka, Fumiaki Kawara, Takashi Toyonaga, Haruhiro Inoue, Robert Bechara, Namiko Hoshi, Hirohumi Abe, Yoshiko Ohara, Tsukasa Ishida, Yoshinori Morita, Eiji Umegaki
    Digestive Endoscopy.2018; 30(2): 206.     CrossRef
  • Short-term efficacy of potassium-competitive acid blocker following gastric endoscopic submucosal dissection: a propensity score analysis
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    Scandinavian Journal of Gastroenterology.2018; 53(2): 243.     CrossRef
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    Min Min, Yan Liu, Xin Chen, Yiliang Bi, Wei Shen, Yang Xu
    Scientific Reports.2018;[Epub]     CrossRef
  • Endoscopic non-ablative fractional laser therapy in an orthotopic colon tumour model
    Su Woong Yoo, Gyungseok Oh, Abdul Mohaimen Safi, Soonjoo Hwang, Young-Seok Seo, Kyung-Hwa Lee, Young L. Kim, Euiheon Chung
    Scientific Reports.2018;[Epub]     CrossRef
  • Single‐center implementation of endoscopic submucosal dissection (ESD) in the colorectum: Low recurrence rate after intention‐to‐treat ESD
    Andrej Wagner, Daniel Neureiter, Tobias Kiesslich, Gernot W. Wolkersdörfer, Thomas Pleininger, Christian Mayr, Christiane Dienhart, Naohisa Yahagi, Tsuneo Oyama, Frieder Berr
    Digestive Endoscopy.2018; 30(3): 354.     CrossRef
  • Splash M-knife versus Flush Knife BT in the technical outcomes of endoscopic submucosal dissection for early gastric cancer: a propensity score matching analysis
    Mitsuru Esaki, Sho Suzuki, Yasuyo Hayashi, Azusa Yokoyama, Shuichi Abe, Taizo Hosokawa, Haruei Ogino, Hirotada Akiho, Eikichi Ihara, Yoshihiro Ogawa
    BMC Gastroenterology.2018;[Epub]     CrossRef
  • Histological Comparison of Cold versus Hot Snare Resections of the Colorectal Mucosa
    Daisuke Takayanagi, Daiki Nemoto, Noriyuki Isohata, Shungo Endo, Masato Aizawa, Kenichi Utano, Kensuke Kumamoto, Hiroshi Hojo, Alan Kawarai Lefor, Kazutomo Togashi
    Diseases of the Colon & Rectum.2018; 61(8): 964.     CrossRef
  • Usefulness of the clip-flap method of endoscopic submucosal dissection: A randomized controlled trial
    Hiromitsu Ban, Mitsushige Sugimoto, Taketo Otsuka, Masaki Murata, Toshiro Nakata, Hiroshi Hasegawa, Osamu Inatomi, Shigeki Bamba, Akira Andoh
    World Journal of Gastroenterology.2018; 24(35): 4077.     CrossRef
  • Efficacy of a new hemostatic forceps during gastric endoscopic submucosal dissection: A prospective randomized controlled trial
    Shinwa Tanaka, Takashi Toyonaga, Yoshinori Morita, Tsukasa Ishida, Namiko Hoshi, Kevin L Grimes, Yoshiko Ohara, Tetsuya Yoshizaki, Fumiaki Kawara, Eiji Umegaki, Takeshi Azuma
    Journal of Gastroenterology and Hepatology.2017; 32(4): 846.     CrossRef
  • History and Development of Accessories for Endoscopic Submucosal Dissection
    Bong Min Ko
    Clinical Endoscopy.2017; 50(3): 219.     CrossRef
  • The Psychosocial Influences of Waiting Periods on Patients Undergoing Endoscopic Submucosal Dissection
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