Clinical Endoscopy

Systematic Review and Meta-Analysis

Contamination Rates in Duodenoscopes Reprocessed Using Enhanced Surveillance and Reprocessing Techniques: A Systematic Review and Meta-Analysis: Shivanand Bomman, Munish Ashat, Navroop Nagra, Mahendran Jayaraj, Shruti Chandra, Richard A Kozarek, Andrew Ross, Rajesh Krishnamoorthi; Clin Endosc 2022;55(1):33-40. Published online January 3, 2022; DOI: https://doi.org/10.5946/ce.2021.212

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Background
/Aims: Multiple outbreaks of multidrug-resistant organisms have been reported worldwide due to contaminated duodenoscopes. In 2015, the United States Food and Drug Administration recommended the following supplemental enhanced surveillance and reprocessing techniques (ESRT) to improve duodenoscope disinfection: (1) microbiological culture, (2) ethylene oxide sterilization, (3) liquid chemical sterilant processing system, and (4) double high-level disinfection. A systematic review and meta-analysis was performed to assess the impact of ESRT on the contamination rates.
Methods
A thorough and systematic search was performed across several databases and conference proceedings from inception until January 2021, and all studies reporting the effectiveness of various ESRTs were identified. The pooled contamination rates of post-ESRT duodenoscopes were estimated using the random effects model.
Results
A total of seven studies using various ESRTs were incorporated in the analysis, which included a total of 9,084 post-ESRT duodenoscope cultures. The pooled contamination rate of the post-ESRT duodenoscope was 5% (95% confidence interval [CI]: 2.3%–10.8%, inconsistency index [I²]=97.97%). Pooled contamination rates for high-risk organisms were 0.8% (95% CI: 0.2%–2.7%, I²=94.96).
Conclusions
While ESRT may improve the disinfection process, a post-ESRT contamination rate of 5% is not negligible. Ongoing efforts to mitigate the rate of contamination by improving disinfection techniques and innovations in duodenoscope design to improve safety are warranted.

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Recommendations and guidelines for endoscope reprocessing: Current position statement of digestive endoscopic society of Taiwan
Wei-Kuo Chang, Chen-Ling Peng, Yen-Wei Chen, Cheuk-Kay Sun, Chieh-Chang Chen, Tao-Chieh Liu, Yin-Yi Chu, I-Fang Tsai, Chen-Shuan Chung, Hsiao-Fen Lin, Fang-Yu Hsu, Wei-Chen Tai, Hsi-Chang Lee, Hsu-Heng Yen, E-Ming Wang, Shu-Hui Chen, Cheng-Hsin Chu, Ming-
Journal of Microbiology, Immunology and Infection.2024; 57(2): 211. CrossRef
Duodenoscopes With Disposable Elevator Caps—An Incremental Reduction in Infection Risk for Patients
Melinda Wang, Graham M. Snyder
JAMA Internal Medicine.2023; 183(3): 200. CrossRef
Transmission of oral microbiota to the biliary tract during endoscopic retrograde cholangiography
Maria Effenberger, Ramona Al-Zoairy, Ronald Gstir, Ivo Graziadei, Hubert Schwaighofer, Herbert Tilg, Heinz Zoller
BMC Gastroenterology.2023;[Epub] CrossRef
Role of peroral cholangioscopy and pancreatoscopy in the diagnosis and treatment of biliary and pancreatic disease: past, present, and future
Harishankar Gopakumar, Neil R. Sharma
Frontiers in Gastroenterology.2023;[Epub] CrossRef
Performance of single-use duodenoscopes for ERCP: a systematic review and meta-analysis
Harishankar Gopakumar, Ishaan Vohra, Neil R. Sharma, Srinivas R. Puli
iGIE.2022; 1(1): 77. CrossRef

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Focused Review Series: Recent Update of Endoscopic Ultrasonography in Gastrointestinal Subepithelial Tumors

Contrast Enhanced Endoscopic Ultrasound Imaging for Gastrointestinal Subepithelial Tumors: Takashi Tamura, Masayuki Kitano; Clin Endosc 2019;52(4):306-313. Published online July 23, 2019; DOI: https://doi.org/10.5946/ce.2019.056

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Subepithelial tumors are divided into benign subepithelial and potentially malignant gastrointestinal stromal tumors. It is difficult to distinguish between these tumor types. Contrast-enhanced harmonic endoscopic ultrasound is reportedly useful for diagnosing subepithelial tumors, can be safely and easily performed by understanding the principle and method, and can be used to distinguish between tumor types with high sensitivity on the basis of differences in contrast effect. The generated image shows a hyperenhancement pattern in gastrointestinal stromal tumors (sensitivity, 78%–100%; specificity, 60%–100%; accuracy, 60%–100%) and hypoenhancement pattern in benign subepithelial tumors. Contrast-enhanced harmonic endoscopic ultrasound can be used to estimate the malignancy potential of gastrointestinal stromal tumors by evaluating the uniformity of the contrast and the blood vessels inside the tumor, with abnormal intra-tumor blood vessels, heterogeneous enhancement, and non-enhancing spots suggesting malignancy. Contrast-enhanced harmonic endoscopic ultrasound has a higher sensitivity than other imaging modalities for the detection of vascularity within gastrointestinal stromal tumors. Additionally, it has been reported that treatment effects can be estimated by evaluating the blood flow in the gastrointestinal stromal tumor before and after treatment with tyrosine kinase inhibitors using contrastenhanced ultrasound. However, there will be subjective-bias and the results depends on the performer’s skill.

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Endoscopic Ultrasound and Gastric Sub-Epithelial Lesions: Ultrasonographic Features, Tissue Acquisition Strategies, and Therapeutic Management
Marzia Varanese, Marco Spadaccini, Antonio Facciorusso, Gianluca Franchellucci, Matteo Colombo, Marta Andreozzi, Daryl Ramai, Davide Massimi, Roberto De Sire, Ludovico Alfarone, Antonio Capogreco, Roberta Maselli, Cesare Hassan, Alessandro Fugazza, Alessa
Medicina.2024; 60(10): 1695. CrossRef
The value of contrast-enhanced harmonic endoscopic ultrasound in differential diagnosis and evaluation of malignant risk of gastrointestinal stromal tumors (<50mm)
Jiali Wu, Mengqi Zhuang, Yubao Zhou, Xiang Zhan, Weiwei Xie
Scandinavian Journal of Gastroenterology.2023; 58(5): 542. CrossRef
Endoscopic Ultrasound Advanced Techniques for Diagnosis of Gastrointestinal Stromal Tumours
Socrate Pallio, Stefano Francesco Crinò, Marcello Maida, Emanuele Sinagra, Vincenzo Francesco Tripodi, Antonio Facciorusso, Andrew Ofosu, Maria Cristina Conti Bellocchi, Endrit Shahini, Giuseppinella Melita
Cancers.2023; 15(4): 1285. CrossRef
EUS-Guided Diagnosis of Gastric Subepithelial Lesions, What Is New?
Thomas Vasilakis, Dimitrios Ziogas, Georgios Tziatzios, Paraskevas Gkolfakis, Eleni Koukoulioti, Christina Kapizioni, Konstantinos Triantafyllou, Antonio Facciorusso, Ioannis S. Papanikolaou
Diagnostics.2023; 13(13): 2176. CrossRef
Rapidly Growing, High-Risk Gastrointestinal Stromal Tumor of the Stomach: A Case Report
Sung Jin Lim, Han Mo Yoo, Seung-Woo Lee, Hae Joung Sul, Dong Soo Lee
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2023; 23(4): 306. CrossRef
The value of color Doppler ultrasonography combined with serum tumor markers in differential diagnosis of gastric stromal tumor and gastric cancer
Xinyu Cheng, Jianguo Xia, Qi Xu, Huawei Gui
Open Medicine.2023;[Epub] CrossRef
Ultrasound imaging of subepithelial rectal tumors (review)
Y. L. Trubacheva, E. M. Bogdanova, A. E. Pershina
Koloproktologia.2022; 21(1): 107. CrossRef
The Asian Federation of Societies for Ultrasound in Medicine and Biology (AFSUMB) Guidelines for Contrast-Enhanced Endoscopic Ultrasound
Masayuki Kitano, Yasunobu Yamashita, Ken Kamata, Tiing Leong Ang, Hiroo Imazu, Eizaburo Ohno, Yoshiki Hirooka, Pietro Fusaroli, Dong-Wan Seo, Bertrand Napoléon, Anthony Yuen Bun Teoh, Tae Hyeon Kim, Christoph F. Dietrich, Hsiu-Po Wang, Masatoshi Kudo
Ultrasound in Medicine & Biology.2021; 47(6): 1433. CrossRef
Efficacy and Safety of Endoscopic Treatment for Gastrointestinal Stromal Tumors in the Upper Gastrointestinal Tract
Cicilia Marcella, Shakeel Sarwar, Hui Ye, Rui Hua Shi
Clinical Endoscopy.2020; 53(4): 458. CrossRef
Contrast Harmonic-Enhanced Endoscopic Ultrasound (EUS) Is the Perfect Companion of EUS-Guided Tumor Ablation
Gianmarco Marocchi, Andrea Lisotti, Pietro Fusaroli
Gut and Liver.2020; 14(5): 669. CrossRef

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Original Article

Endoscopic Ultrasonography Can Prevent Unnecessary Diagnostic Endoscopic Retrograde Cholangiopancreatography Even in Patients with High Likelihood of Choledocholithiasis and Inconclusive Ultrasonography: Results of a Prospective Study: Ruchir Patel, Meghraj Ingle, Dhaval Choksi, Prateik Poddar, Vikas Pandey, Prabha Sawant; Clin Endosc 2017;50(6):592-597. Published online August 9, 2017; DOI: https://doi.org/10.5946/ce.2017.010

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Background
/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is the initial therapy recommended for patients with high likelihood of choledocholithiasis. To determine whether endoscopic ultrasonography (EUS) can prevent diagnostic ERCPs in patients with high probability of choledocholithiasis and inconclusive ultrasonography (US).
Methods
All patients with high likelihood of choledocholithiasis and negative US underwent EUS. ERCP was performed for the patients who showed a definite stone/sludge on EUS. Patients without choledocholithiasis were followed up for 3 months. The primary outcome was avoidance of diagnostic ERCP.
Results
We included 78 patients (51 women; 27 men). Of these, 25 and 7 (total 41%) were diagnosed with choledocholithiasis and sludge, respectively; stone/sludge was removed in 96.9% of the patients. EUS ruled out choledocholithiasis in 38 patients (48.7%). Two of them were found to have choledocholithiasis on follow-up. The sensitivity, specificity, positive and negative predictive value of EUS for detecting choledocholithiasis were 93.9%, 97.3%, 96.9%, and 94.7%, respectively. Unnecessary ERCP was avoided in 57.7% of the patients by using the EUS-first approach.
Conclusions
EUS is a highly accurate and safe procedure. EUS can replace ERCP as the initial investigation in patients with a high probability of choledocholithiasis. It avoids unnecessary ERCP; hence, decreasing related costs and complications.

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Rendimiento diagnóstico de la endosonografía biliopancreática en pacientes con riesgo intermedio de coledocolitiasis
Lázaro Antonio Arango Molano, Andrés Sánchez Gil, Claudia Patricia Diaz Tovar, Andrés Valencia Uribe, Christian Germán Ospina Pérez, Pedro Eduardo Cuervo Pico, Rodrigo Alberto Jiménez Gómez
Revista de Gastroenterología del Perú.2024; 44(1): 8. CrossRef
The additional value of the combined use of EUS and ERCP for the evaluation of unclear biliary strictures
Eszter Bényei, Antonio Molinaro, Per Hedenström, Riadh Sadik
Scandinavian Journal of Gastroenterology.2024; 59(8): 980. CrossRef
Low Detection Rates of Bile Duct Stones During Endoscopic Treatment for Highly Suspected Bile Duct Stones with No Imaging Evidence of Stones
Hirokazu Saito, Hajime Iwasaki, Hisashi Itoshima, Yoshihiro Kadono, Takashi Shono, Kentaro Kamikawa, Atsushi Urata, Jiro Nasu, Masayoshi Uehara, Ikuo Matsushita, Tatsuyuki Kakuma, Shuji Tada
Digestive Diseases and Sciences.2023; 68(5): 2061. CrossRef
Diagnostic accuracy of endoscopic ultrasound in evaluation of patients with obstructive jaundice: single-center experience
Shereen Abou Bakr, Hagar Elessawy, Sameh Ghaly, Muhammed Abo Elezz, Ahmed Farahat, Mariam Salah Zaghloul
Egyptian Liver Journal.2022;[Epub] CrossRef
Endoscopic ultrasound avoids adverse events in high probability choledocholithiasis patients with a negative computed tomography
Meng-Ying Lin, Chun-Te Lee, Ming-Tsung Hsieh, Ming-Ching Ou, Yao-Shen Wang, Meng-Chieh Lee, Wei-Lun Chang, Bor-Shyang Sheu
BMC Gastroenterology.2022;[Epub] CrossRef
Role of endoscopic ultrasound in evaluation of patients with missed common bile duct stones
Mohamed Eissa, Hussein Hassan Okasha, Mohamed Abbasy, Ahmed Kamal Khamis, Abeer Abdellatef, Mohamed Akl Rady
World Journal of Gastrointestinal Endoscopy.2022; 14(9): 564. CrossRef
Az endoszkópos ultrahangvizsgálat diagnosztikus érzékenysége epeúti kövesség gyanúja esetén
Bánk Keczer, Zsolt Dubravcsik, Attila †Szepes, László Madácsy, Attila Szijártó, István Hritz
Orvosi Hetilap.2022; 163(10): 400. CrossRef
Evolution in the Practice of Pediatric Endoscopy and Sedation
Conrad B. Cox, Trevor Laborda, J. Matthew Kynes, Girish Hiremath
Frontiers in Pediatrics.2021;[Epub] CrossRef
The Relationship between Choledocholithiasis and Liver Enzymes in Elderly Patients
Almohamad Almahmud Tamim, Alexey Klimov
Journal Of Biochemical Technology.2021; 12(2): 67. CrossRef
Aspects of diagnosis and treatment of oligosymptomatic choledocholithiasis in patients with acute calculous cholecystitis
V.I. Kolomiytsev, O.M. Terletskiy, O.V. Lukavetskiy
Acta Medica Leopoliensia.2020; 26(2-3): 49. CrossRef
Adenomyoma of the distal common bile duct demonstrated by endoscopic ultrasound: A case report and review of the literature
Li-Ming Xu, Duan-Min Hu, Wen Tang, Shao-Hua Wei, Wei Chen, Guang-Qiang Chen
World Journal of Clinical Cases.2019; 7(21): 3598. CrossRef
Adenomyoma of the distal common bile duct demonstrated by endoscopic ultrasound: A case report and review of the literature
Li-Ming Xu, Duan-Min Hu, Wen Tang, Shao-Hua Wei, Wei Chen, Guang-Qiang Chen
World Journal of Clinical Cases.2019; 7(21): 3615. CrossRef
Can Endoscopic Ultrasonography Prevent Unnecessary Endoscopic Retrograde Cholangiopancreatography in Patients with High and Intermediate Likelihood of Choledocholithiasis?
Eui Joo Kim, Jae Hee Cho
Clinical Endoscopy.2017; 50(6): 518. CrossRef

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Review

Highlights from the 52nd Seminar of the Korean Society of Gastrointestinal Endoscopy: Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Ki Baik Hahm; Clin Endosc 2015;48(4):269-278. Published online July 24, 2015; DOI: https://doi.org/10.5946/ce.2015.48.4.269

Abstract PDF PubReader ePub: In this July issue of Clinical Endoscopy, state-of-the-art articles selected from the lectures delivered during the 52nd Seminar of the Korean Society of Gastrointestinal Endoscopy (KSGE) on March 29, 2015 are covered, focusing on highlighted educational contents relevant to either diagnostic or therapeutic gastrointestinal (GI) endoscopy. Our society, the KSGE, has continued to host this opportunity for annual seminars twice a year over the last 26 years and it has become a large-scale prestigious seminar accommodating over 4,000 participants. Definitely, the KSGE seminar is considered as one of the premier state-of-the-art seminars dealing with GI endoscopy, appealing to both the beginner and advanced experts. Lectures, live demonstrations, hands-on courses, as well as an editor school, which was an important consensus meeting on how to upgrade our society journal, Clinical Endoscopy, to a Science Citation Index (Expanded) designation were included in this seminar. The 52nd KSGE seminar consisted of more than 20 sessions, including special lectures, concurrent sessions for GI endoscopy nurses, and sessions exploring new technologies. This is a very special omnibus article to highlight the core contents divided into four sessions: upper GI tract, lower GI tract, pancreatobiliary system, and other specialized sessions.

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Case Report

A Case of Endoscopic Full-Thickness Resection in a Patient with Gastric High-Grade Dysplasia Unsuitable for Endoscopic Submucosal Dissection: Jung Min Chae, Jae Young Jang, Seonghun Hong, Jung Wook Kim, Young Woon Chang; Clin Endosc 2014;47(4):353-357. Published online July 28, 2014; DOI: https://doi.org/10.5946/ce.2014.47.4.353

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Gastric high-grade dysplasia is an important premalignant lesion in gastric epithelial cells and has a high possibility of transforming to adenocarcinoma. Therefore, biopsy-proven high-grade dysplasia should be treated with en bloc resection methods such as endoscopic mucosal resection or endoscopic submucosal dissection (ESD). We report the case of a 63-year-old male patient, diagnosed with gastric high-grade dysplasia at the angle and lesser curvature side of the lower body. The patient was initially treated with ESD, although histopathology subsequently showed horizontal margin involvement. Since the lesion was diffusely edematous and margins were uncertain because of the previous ESD treatment, we chose to treat the patient with laparoscopy-assisted endoscopic full-thickness resection (EFTR). EFTR is a recently developed procedure, which uses both endoscopic and laparoscopic techniques to resect the full-thickness of the tissue. The final pathologic report revealed high-grade dysplasia and a focal intramucosal carcinoma of 0.8×0.7 cm. We conclude that EFTR can be an effective alternative treatment in gastric high-grade dysplasia unsuitable for ESD.

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Endoscopic diagnosis and treatment of gastric dysplasia and early cancer: Current evidence and what the future may hold
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World Journal of Gastroenterology.2021; 27(31): 5126. CrossRef
Identification and preparation of lesions suitable for endoscopic full-thickness resection
Jeffrey Fiorenza, Pavlos Kaimakliotis
Techniques in Gastrointestinal Endoscopy.2015; 17(3): 108. CrossRef

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Review

Highlights from the 50th Seminar of the Korean Society of Gastrointestinal Endoscopy: Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Seok Ho Dong, Ki Baik Hahm; Clin Endosc 2014;47(4):285-294. Published online July 28, 2014; DOI: https://doi.org/10.5946/ce.2014.47.4.285

Abstract PDF PubReader ePub

The July issue of Clinical Endoscopy deals with selected articles covering the state-of-the-art lectures delivered during the 50th seminar of the Korean Society of Gastrointestinal Endoscopy (KSGE) on March 30, 2014, highlighting educational contents pertaining to either diagnostic or therapeutic gastrointestinal (GI) endoscopy, which contain fundamental and essential points in GI endoscopy. KSGE is very proud of its seminar, which has been presented twice a year for the last 25 years, and hosted more than 3,500 participants at the current meeting. KSGE seminar is positioned as one of premier state-of-the-art seminars for endoscopy, covering topics for novice endoscopists and advanced experts, as well as diagnostic and therapeutic endoscopy. The 50th KSGE seminar consists of more than 20 sessions, including a single special lecture, concurrent sessions for GI endoscopy nurses, and sessions exploring new technologies. Nine articles were selected from these prestigious lectures, and invited for publication in this special issue. This introductory review, prepared by the editors of Clinical Endoscopy, highlights core contents divided into four sessions: upper GI tract, lower GI tract, pancreatobiliary system, and other specialized topic sessions, including live demonstrations and hands-on courses.

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Cost of Endoscopic Submucosal Dissection Versus Endoscopic Piecemeal Mucosal Resection in the Colorectum
Nam Seok Ham, Jeongseok Kim, Eun Hye Oh, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
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Nationwide estimate of emergency department visits in the United States related to caustic ingestion
Yiting Li, James Langworthy, Lan Xu, Haifeng Cai, Yingwei Yang, Yuanyuan Lu, Sara L Wallach, Frank K Friedenberg
Diseases of the Esophagus.2020;[Epub] CrossRef
Upper GIS Endoscopy Indications of Patients Consulted at Internal Medicine Outpatient Clinics and Data Obtained According to These Indications
Muhammed Tunc, Banu Boyuk, Osman Mavis
Open Journal of Gastroenterology.2016; 06(04): 111. CrossRef

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Special Issue Article of IDEN 2013

Highlights of International Digestive Endoscopy Network 2013: Kwang An Kwon, Il Ju Choi, Eun Young Kim, Seok Ho Dong, Ki Baik Hahm; Clin Endosc 2013;46(5):425-435. Published online September 30, 2013; DOI: https://doi.org/10.5946/ce.2013.46.5.425

Abstract PDF PubReader ePub: Rapid advances in the technology of gastrointestinal endoscopy as well as the evolution of science have made it necessary for us to continue update in either various endoscopic techniques or state of art lectures relevant to endoscopy. International Digestive Endoscopy Network (IDEN) 2013 was held in conjunction with Korea-Japan Joint Symposium on Gastrointestinal Endoscopy (KJSGE) during June 8 to 9, 2013 at Seoul, Korea. Two days of impressive scientific program dealt with a wide variety of basic concerns from upper gastrointestine (GI), lower GI, pancreaticobiliary endoscopy to advanced knowledge including endoscopic submucosal dissection forum. IDEN seems to be an excellent opportunity to exchange advanced information of the latest issues on endoscopy with experts from around the world. In this special issue of Clinical Endoscopy, we prepared state of art review articles from contributing authors and the current highlights will skillfully deal with very hot spots of each KJSGE, upper GI, lower GI, and pancreaticobiliary sessions by associated editors of Clinical Endoscopy.

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Review

Highlights of the 48th Seminar of Korean Society of Gastrointestinal Endoscopy: Kwang An Kwon, Il Ju Choi, Eun Young Kim, Seok Ho Dong, Ki Baik Hahm; Clin Endosc 2013;46(3):203-211. Published online May 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.3.203

Abstract PDF PubReader ePub

This special May issue of Clinical Endoscopy discusses the tutorial contents dealing with either the diagnostic or therapeutic gastrointestinal (GI) endoscopy that contain very fundamental and essential points in this filed. The seminar of Korean Society of Gastrointestinal Endoscopy (KSGE) had positioned as one of prime educational seminars covering the very beginner to advanced experts of GI endoscopy. Besides of four rooms allocated for each lecture, two additional rooms were open for either live demonstration or hands-on course, covering totally 20 sessions including one special lecture. Among these prestigious lectures, 12 lectures were selected for the current review articles in this special issue of Clinical Endoscopy journal. Basic course for beginner to advanced tips to expert were all covered in this seminar. This introductory review prepared by four associated editors of Clinical Endoscopy contained core contents divided into four sessions-upper gut, lower gut, pancreaticobiliary, and specialized topic session part-to enhance understandings not covered by enlisted review articles in this issue.

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Upper GIS Endoscopy Indications of Patients Consulted at Internal Medicine Outpatient Clinics and Data Obtained According to These Indications
Muhammed Tunc, Banu Boyuk, Osman Mavis
Open Journal of Gastroenterology.2016; 06(04): 111. CrossRef
Introduction to Starting Upper Gastrointestinal Endoscopy: Proper Insertion, Complete Observation, and Appropriate Photographing
Kyung Sik Park
Clinical Endoscopy.2015; 48(4): 279. CrossRef

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Original Article

Peroral Endoscopic Myotomy for Treatment of Achalasia: Initial Results of a Korean Study: Byung Hoo Lee, Kwang Yeun Shim, Su Jin Hong, Gene Hyun Bok, Jun-Hyung Cho, Tae Hee Lee, Joo Young Cho; Clin Endosc 2013;46(2):161-167. Published online March 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.2.161

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Background/Aims

Achalasia is a rare esophageal motility disorder. Recently, a novel endoscopic technique, peroral endoscopic myotomy (POEM), was introduced as an alternative treatment for achalasia. We report the results and short term outcomes of POEM for patients with achalasia.

Methods

POEM was performed in 13 patients with achalasia. The procedure consisted of creating a submucosal tunnel followed by endoscopic myotomy of circular muscle bundles. The mucosal entry was closed by conventional hemostatic clips. A validated clinical symptom score (Eckardt score) and high resolution manometry were used to evaluate the outcomes.

Results

Both the clinical score of achalasia, as well as the resting lower esophageal sphincter (LES) pressure, were significantly reduced after POEM. Mean posttreatment Eckardt score was 0.4±0.7, compared to 6.4±1.9 prior to the treatment (p=0.001). The mean pretreatment and posttreatment LES pressure was 30.3 and 15.3 mm Hg, respectively (p=0.007). Following POEM, symptomatic relief from dysphagia without reflux symptoms was observed in all patients (13/13). No serious complications related to POEM were encountered.

Conclusions

Based upon our initial experience, the authors believe that POEM is a feasible, safe, and effective treatment and may possibly substitute established treatments of refractory achalasia.

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Achalasia: Current therapeutic options
Sebastien Rolland, William Paterson, Robert Bechara
Neurogastroenterology & Motility.2023;[Epub] CrossRef
Long versus short peroral endoscopic myotomy for the treatment of achalasia: results of a non-inferiority randomised controlled trial
Pietro Familiari, Federica Borrelli de Andreis, Rosario Landi, Francesca Mangiola, Ivo Boskoski, Andrea Tringali, Vincenzo Perri, Guido Costamagna
Gut.2023; 72(8): 1442. CrossRef
Efficacy and Safety of Peroral Endoscopic Myotomy (POEM) in Achalasia: An Updated Meta-analysis
Afshin Khaiser, Muhammad Baig, David Forcione, Matthew Bechtold, Srinivas R. Puli
Middle East Journal of Digestive Diseases.2023; 15(4): 235. CrossRef
Type II achalasia is associated with a comparably favorable outcome following per oral endoscopic myotomy
Yutaka Tomizawa, Nadim Mahmud, Kevin Dasher, Joseph R Triggs, Monica Saumoy, Gary W Falk, Gregory G Ginsberg
Diseases of the Esophagus.2021;[Epub] CrossRef
Miotomía endoscópica peroral para el tratamiento de acalasia y otros trastornos motores del esófago. Resultados a corto y mediano plazo en un centro de referencia en México
O.V. Hernández-Mondragón, O.M. Solórzano-Pineda, M.A. González-Martínez, J.M. Blancas-Valencia, C. Caballero-Luengas
Revista de Gastroenterología de México.2019; 84(1): 1. CrossRef
Peroral endoscopic myotomy for the treatment of achalasia and other esophageal motor disorders: Short-term and medium-term results at a Mexican tertiary care center
O.V. Hernández-Mondragón, O.M. Solórzano-Pineda, M.A. González-Martínez, J.M. Blancas-Valencia, C. Caballero-Luengas
Revista de Gastroenterología de México (English Edition).2019; 84(1): 1. CrossRef
Bridging the Gap between Advancements in the Evolution of Diagnosis and Treatment towards Better Outcomes in Achalasia
Seng-Kee Chuah, Chee-Sang Lim, Chih-Ming Liang, Hung-I Lu, Keng-Liang Wu, Chi-Sin Changchien, Wei-Chen Tai
BioMed Research International.2019; 2019: 1. CrossRef
Preliminary study of 1940 nm thulium laser usage in peroral endoscopic myotomy for achalasia
J Liu, Y Jiao, Y Niu, L Yu, M Ji, S Zhang
Diseases of the Esophagus.2018;[Epub] CrossRef
POEM in the Treatment of Esophageal Disorders
Nasim Parsa, Mouen A. Khashab
Current Treatment Options in Gastroenterology.2018; 16(1): 27. CrossRef
Current Status of Peroral Endoscopic Myotomy
Young Kwan Cho, Seong Hwan Kim
Clinical Endoscopy.2018; 51(1): 13. CrossRef
Safety and efficacy of POEM for treatment of achalasia: a systematic review of the literature
Oscar M. Crespin, Louis W. C. Liu, Ambica Parmar, Timothy D. Jackson, Jemila Hamid, Eran Shlomovitz, Allan Okrainec
Surgical Endoscopy.2017; 31(5): 2187. CrossRef
Early adverse events of per-oral endoscopic myotomy
Yuki B. Werner, Daniel von Renteln, Tania Noder, Guido Schachschal, Ulrike W. Denzer, Stefan Groth, Jan F. Nast, Jan F. Kersten, Martin Petzoldt, Gerhard Adam, Oliver Mann, Alessandro Repici, Cesare Hassan, Thomas Rösch
Gastrointestinal Endoscopy.2017; 85(4): 708. CrossRef
A multicenter international registry of redo per-oral endoscopic myotomy (POEM) after failed POEM
Amy Tyberg, Stefan Seewald, Reem Z. Sharaiha, Guadalupe Martinez, Amit P. Desai, Nikhil A. Kumta, Arnon Lambroza, Amrita Sethi, Kevin M. Reavis, Ketisha DeRoche, Monica Gaidhane, Michael Talbot, Payal Saxena, Felipe Zamarripa, Maximilien Barret, Nicholas
Gastrointestinal Endoscopy.2017; 85(6): 1208. CrossRef
Long-term outcomes of peroral endoscopic myotomy for patients with achalasia: a retrospective single-center study
H. Guo, H. Yang, X. Zhang, L. Wang, Y. Lv, X. Zou, T. Ling
Diseases of the Esophagus.2017; 30(5): 1. CrossRef
Per-Oral Esophageal Myotomy
Eric S. Hungness, Juaquito M. Jorge
Advances in Surgery.2017; 51(1): 193. CrossRef
Comparison of the Outcomes of Peroral Endoscopic Myotomy for Achalasia According to Manometric Subtype
Won Hee Kim, Joo Young Cho, Weon Jin Ko, Sung Pyo Hong, Ki Baik Hahm, Jun-Hyung Cho, Tae Hee Lee, Su Jin Hong
Gut and Liver.2017; 11(5): 642. CrossRef
Peroral endoscopic myotomy for the treatment of esophageal achalasia: systematic review and pooled analysis
K. Patel, N. Abbassi-Ghadi, S. Markar, S. Kumar, P. Jethwa, G. Zaninotto
Diseases of the Esophagus.2016; 29(7): 807. CrossRef
Gastroesophageal reflux disease after peroral endoscopic myotomy: Analysis of clinical, procedural and functional factors, associated with gastroesophageal reflux disease and esophagitis
Pietro Familiari, Santi Greco, Giovanni Gigante, Anna Calì, Ivo Boškoski, Graziano Onder, Vincenzo Perri, Guido Costamagna
Digestive Endoscopy.2016; 28(1): 33. CrossRef
Peroral Endoscopic Myotomy for Esophageal Achalasia
Pietro Familiari, Giovanni Gigante, Michele Marchese, Ivo Boskoski, Andrea Tringali, Vincenzo Perri, Guido Costamagna
Annals of Surgery.2016; 263(1): 82. CrossRef
Surgery or Peroral Esophageal Myotomy for Achalasia
Luigi Marano, Giovanni Pallabazzer, Biagio Solito, Stefano Santi, Alessio Pigazzi, Raffaele De Luca, Francesco Giuseppe Biondo, Alessandro Spaziani, Maurizio Longaroni, Natale Di Martino, Virginia Boccardi, Alberto Patriti
Medicine.2016; 95(10): e3001. CrossRef
Prospective evaluation of CT esophagram findings after peroral endoscopic myotomy
Davinderbir Pannu, Dennis Yang, Patricia L. Abbitt, Peter V. Draganov
Gastrointestinal Endoscopy.2016; 84(3): 408. CrossRef
Clinical response to peroral endoscopic myotomy in patients with idiopathic achalasia at a minimum follow-up of 2 years
Yuki B Werner, Guido Costamagna, Lee L Swanström, Daniel von Renteln, Pietro Familiari, Ahmed M Sharata, Tania Noder, Guido Schachschal, Jan F Kersten, Thomas Rösch
Gut.2016; 65(6): 899. CrossRef
Double-Scope Peroral Endoscopic Myotomy (POEM) for Esophageal Achalasia: The First Trial of a New Double-Scope POEM
Hee Jin Hong, Ga Won Song, Weon Jin Ko, Won Hee Kim, Ki Baik Hahm, Sung Pyo Hong, Joo Young Cho
Clinical Endoscopy.2016; 49(4): 383. CrossRef
Achalasia: from diagnosis to management
Michael F. Vaezi, Valter N. Felix, Roberto Penagini, Aurelio Mauro, Eduardo Guimarães Hourneaux de Moura, Leonardo Zorrón Cheng Tao Pu, Jan Martínek, Erwin Rieder
Annals of the New York Academy of Sciences.2016; 1381(1): 34. CrossRef
Complications of submucosal endoscopy
Jean-Michel Gonzalez, Alban Benezech, Marc Barthet
Best Practice & Research Clinical Gastroenterology.2016; 30(5): 783. CrossRef
Update on the endoscopic treatments for achalasia
Dushant S Uppal, Andrew Y Wang
World Journal of Gastroenterology.2016; 22(39): 8670. CrossRef
Gestion des complications de l’endoscopie interventionnelle œsophagienne
C. Lorenceau-Savale, G. Rahmi
Acta Endoscopica.2015; 45(3): 90. CrossRef
Greater curvature myotomy is a safe and effective modified technique in per-oral endoscopic myotomy (with videos)
Manabu Onimaru, Haruhiro Inoue, Haruo Ikeda, Chiaki Sato, Hiroki Sato, Chainarong Phalanusitthepha, Esperanza Grace Santi, Kevin L. Grimes, Hiroaki Ito, Shin-ei Kudo
Gastrointestinal Endoscopy.2015; 81(6): 1370. CrossRef
Peroral Esophageal Myotomy Versus Laparoscopic Heller's Myotomy for Achalasia: A Meta-analysis
Mingtian Wei, Tinghan Yang, Xuyang Yang, Ziqiang Wang, Zongguang Zhou
Journal of Laparoendoscopic & Advanced Surgical Techniques.2015; 25(2): 123. CrossRef
Efficacy of peroral endoscopic myotomy (POEM) in the treatment of achalasia: a systematic review and meta-analysis
Rupjyoti Talukdar, Haruhiro Inoue, D. Nageshwar Reddy
Surgical Endoscopy.2015; 29(11): 3030. CrossRef
Is Peroral Endoscopic Myotomy Effective for the Treatment of Spastic Esophageal Disorders Refractory to Medical Therapy?
Jae Pil Han
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2015; 15(2): 143. CrossRef
The American Society for Gastrointestinal Endoscopy PIVI (Preservation and Incorporation of Valuable Endoscopic Innovations) on peroral endoscopic myotomy
Vinay Chandrasekhara, David Desilets, Gary W. Falk, Haruhiro Inoue, John R. Romanelli, Thomas J. Savides, Stavros N. Stavropoulos, Lee L. Swanstrom
Gastrointestinal Endoscopy.2015; 81(5): 1087. CrossRef
Peroral Endoscopic Myotomy for Treating Achalasia and Esophageal Motility Disorders
Young Hoon Youn, Hitomi Minami, Philip Wai Yan Chiu, Hyojin Park
Journal of Neurogastroenterology and Motility.2015; 22(1): 14. CrossRef
Effect of Peroral Endoscopic Myotomy on Esoph ageal Motor Function
Su Jin Hong
Journal of Neurogastroenterology and Motility.2015; 22(1): 1. CrossRef
Achalasia: current treatment options
Pietro Familiari, Santi Greco, Ance Volkanovska, Giovanni Gigante, Anna Cali, Ivo Boškoski, Guido Costamagna
Expert Review of Gastroenterology & Hepatology.2015; 9(8): 1101. CrossRef
Systematic review and meta‐analysis: Efficacy and safety of POEM for achalasia
Lavinia A Barbieri, Cesare Hassan, Riccardo Rosati, Uberto Fumagalli Romario, Loredana Correale, Alessandro Repici
United European Gastroenterology Journal.2015; 3(4): 325. CrossRef
Per-oral endoscopic myotomy white paper summary
Stavros N. Stavropoulos, David J. Desilets, Karl-Hermann Fuchs, Christopher J. Gostout, Gregory Haber, Haruhiro Inoue, Michael L. Kochman, Rani Modayil, Thomas Savides, Daniel J. Scott, Lee L. Swanstrom, Melina C. Vassiliou
Surgical Endoscopy.2014; 28(7): 2005. CrossRef
Peroral endoscopic myotomy for achalasia
A. J. Bredenoord, T. Rösch, P. Fockens
Neurogastroenterology & Motility.2014; 26(1): 3. CrossRef
Peroral Endoscopic Myotomy: Establishing a New Program
Nikhil A. Kumta, Shivani Mehta, Prashant Kedia, Kristen Weaver, Reem Z. Sharaiha, Norio Fukami, Hitomi Minami, Fernando Casas, Monica Gaidhane, Arnon Lambroza, Michel Kahaleh
Clinical Endoscopy.2014; 47(5): 389. CrossRef
Introduction of the per-oral endoscopic myotomy technique to pediatric surgical practice
Stephanie Chao, Michael Russo, Robert Wright, Homero Rivas, James Wall
Journal of Pediatric Surgery Case Reports.2014; 2(6): 313. CrossRef
International Digestive Endoscopy Network 2014: Turnpike to the Future
Eun Young Kim, Kwang An Kwon, Il Ju Choi, Ji Kon Ryu, Ki Baik Hahm
Clinical Endoscopy.2014; 47(5): 371. CrossRef
Per-oral endoscopic myotomy white paper summary
Stavros N. Stavropoulos, David J. Desilets, Karl-Hermann Fuchs, Christopher J. Gostout, Gregory Haber, Haruhiro Inoue, Michael L. Kochman, Rani Modayil, Thomas Savides, Daniel J. Scott, Lee L. Swanstrom, Melina C. Vassiliou
Gastrointestinal Endoscopy.2014; 80(1): 1. CrossRef
Effectiveness of peroral endoscopic myotomy in the treatment of achalasia: A pilot trial in Chinese Han population with a minimum of one‐year follow‐up
Ting Sheng Ling, Hui Min Guo, Tian Yang, Chun Yan Peng, Xiao Ping Zou, Rui Hua Shi
Journal of Digestive Diseases.2014; 15(7): 352. CrossRef
Jackhammer Esophagus Treated by a Peroral Endoscopic Myotomy
Weon Jin Ko, Byoung Moo Lee, Won Young Park, Jin Nyoung Kim, Jun-Hyung Cho, Tae Hee Lee, Su Jin Hong, Joo Young Cho
The Korean Journal of Gastroenterology.2014; 64(6): 370. CrossRef
Effect of peroral endoscopic myotomy in achalasia patients with failure of prior pneumatic dilation: A prospective case–control study
Tingsheng Ling, Huimin Guo, Xiaoping Zou
Journal of Gastroenterology and Hepatology.2014; 29(8): 1609. CrossRef
Medical and Endoscopic Management of Achalasia
Jae Pil Han, Su Jin Hong
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2014; 14(2): 82. CrossRef
EndoFLIP system for the intraoperative evaluation of peroral endoscopic myotomy
Pietro Familiari, Giovanni Gigante, Michele Marchese, Ivo Boskoski, Vincenzo Bove, Andrea Tringali, Vincenzo Perri, Graziano Onder, Guido Costamagna
United European Gastroenterology Journal.2014; 2(2): 77. CrossRef
Per Oral Endoscopic Myotomy (POEM): Review of Current Techniques and Outcomes (Including Postoperative Reflux)
David Friedel, Rani Modayil, Stavros N. Stavropoulos
Current Surgery Reports.2013; 1(4): 203. CrossRef
Peroral Endoscopic Myotomy for the Treatment of Achalasia: An Analysis
Dennis Yang, Mihir S. Wagh
Diagnostic and Therapeutic Endoscopy.2013; 2013: 1. CrossRef
Therapeutic flexible endoscopy replacing surgery: Part 3—Peroral esophageal myotomy
Ezra N. Teitelbaum, Eric S. Hungness
Techniques in Gastrointestinal Endoscopy.2013; 15(4): 211. CrossRef
Highlights of International Digestive Endoscopy Network 2013
Kwang An Kwon, Il Ju Choi, Eun Young Kim, Seok Ho Dong, Ki Baik Hahm
Clinical Endoscopy.2013; 46(5): 425. CrossRef
Perorale endoskopische Myotomie zur Therapie der Achalasie
B.H.A. von Rahden, J. Filser, S. Reimer, H. Inoue, C.-T. Germer
Der Chirurg.2013;[Epub] CrossRef

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Focused Review Series: Optical Diagnosis and New Management Strategy of Colorectal Polyps

Introduction: What Are New Roles of Current Colonoscopy?: Hyung Wook Kim; Clin Endosc 2013;46(2):118-119. Published online March 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.2.118

Abstract PDF PubReader ePub

The recent advances in endoscopic imaging technologies make great changes in the management of colorectal polyps. These changes include optical histologic diagnosis with high definition colonscopy, new management strategies such as resect and discard or do not resect, and differentiation of depth of submucosal invasion. In this focused review series, these new paradigms in management of colorectal polyps are discussed by three, world famous authors. First, Amit Rastogi explained optical diagnosis of small colorectal polyp with high definition colonoscopy using narrow band imaging. Second, Cesare Hassan explained new paradigms for colonoscopic management of diminutive colorectal polyps: resect and discard or do not resect. In the last, Shinji Tanaka described, in detail, endoscopic assessment of invasive colorectal cancer: slight vs. deep submucosal invasion. These focused review series introduce the new roles of current colonoscopy to readers and will help the readers to know how to use the new imaging technologies and paradigms in clinical practices.

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Protein-Based Nanoplatform for Detection of Tumorigenic Polyps in the Colon Via Noninvasive Mucosal Routes
Chun-Chieh Chen, Mo A Baikoghli, R Holland Cheng
Pharmaceutical Patent Analyst.2021; 10(1): 13. CrossRef

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1 Crossref

Original Article

Comparison on the Efficacy of Disinfectants Used in Automated Endoscope Reprocessors: PHMB-DBAC versus Orthophthalaldehyde: Sun Young Kim, Hong Sik Lee, Jong Jin Hyun, Min Ho Seo, Sun Young Yim, Ha Young Oh, Hye Sook Kim, Bora Keum, Yeon Seok Seo, Yong Sik Kim, Yoon Tae Jeen, Hoon Jai Chun, Soon Ho Um, Chang Duck Kim, Ho Sang Ryu; Clin Endosc 2011;44(2):109-115. Published online December 31, 2011; DOI: https://doi.org/10.5946/ce.2011.44.2.109

Abstract PDF PubReader ePub

Background/Aims

Since endoscopes are reusable apparatus classified as semicritical item, thorough reprocessing to achieve high-level disinfection is of utmost importance to prevent spread of infection. To improve disinfection efficacy and safety, disinfectants and endoscope reprocessors are continuously evolving. This study aimed to compare the efficacy of the combination of polyhexamethylenebiguanide hydrochloride-alkyldimethylbenzylammonium chloride (PHMB-DBAC) and orthophthalaldehyde (OPA) used respectively in ultrasonographic cleaning incorporated automated endoscope reprocessors: COOLENDO (APEX Korea) or OER-A (Olympus Optical).

Methods

A total of 86 flexible upper endoscopes were randomly reprocessed with either COOLENDO/PHMB-DBAC or OER-A/OPA. Culture samplings were done at two sites (endoscope tip and working channel) which were later incubated on blood agar plate. Bacterial colonies were counted and identified.

Results

The culture-positive rate at the endoscope tip and working channel was 0% and 2.33% for COOLENDO/PHMB-DBAC and 4.65% and 0% for OER-A/OPA. Staphylococcus hominis was cultured from one endoscope reprocessed with COOLENDO/PHMB-DBAC and Pseudomonas putida was isolated from two endoscopes reprocessed with OER-A/OPA.

Conclusions

The reprocessing efficacy of COOLENDO/PHMB-DBAC was non-inferior to that of OER-A/OPA (p=0.032; confidence interval, -0.042 to 0.042). During the study period, significant side effect of PHMB-DBAC was not observed.

Citations

Citations to this article as recorded by

Recommendations and guidelines for endoscope reprocessing: Current position statement of digestive endoscopic society of Taiwan
Wei-Kuo Chang, Chen-Ling Peng, Yen-Wei Chen, Cheuk-Kay Sun, Chieh-Chang Chen, Tao-Chieh Liu, Yin-Yi Chu, I-Fang Tsai, Chen-Shuan Chung, Hsiao-Fen Lin, Fang-Yu Hsu, Wei-Chen Tai, Hsi-Chang Lee, Hsu-Heng Yen, E-Ming Wang, Shu-Hui Chen, Cheng-Hsin Chu, Ming-
Journal of Microbiology, Immunology and Infection.2024; 57(2): 211. CrossRef
Antibacterial Activity of Tannic Acid and Tannic Acid/Amphiphilic Cationic Polymer Mixtures
Fatimah M. Alzahrani, Stephen G. Yeates, Michelle Webb, Hind Ali Alghamdi
Asian Journal of Chemistry.2020; 32(6): 1491. CrossRef
Antibacterial activity of Staphylococcus aureus biofilm under combined exposure of glutaraldehyde, near-infrared light, and 405-nm laser
Van Nam Tran, Chakradhar Dasagrandhi, Van Gia Truong, Young-Mog Kim, Hyun Wook Kang, Michael R. Hamblin
PLOS ONE.2018; 13(8): e0202821. CrossRef
Comparison of the efficacy of disinfectants in automated endoscope reprocessors for colonoscopes: tertiary amine compound (Sencron2®) versus ortho-phthalaldehyde (Cidex®OPA)
Hyun Il Seo, Dae Sung Lee, Eun Mi Yoon, Min-Jung Kwon, Hyosoon Park, Yoon Suk Jung, Jung Ho Park, Chong Il Sohn, Dong Il Park
Intestinal Research.2016; 14(2): 178. CrossRef
Role of Clinical Endoscopy in Emphasizing Endoscope Disinfection
Ji Kon Ryu, Eun Young Kim, Kwang An Kwon, Il Ju Choi, Ki Baik Hahm
Clinical Endoscopy.2015; 48(5): 351. CrossRef
Recent Update of Gastrointestinal Endoscope Reprocessing
Kyong Hee Hong, Yun Jeong Lim
Clinical Endoscopy.2013; 46(3): 267. CrossRef
Steps of Reprocessing and Equipments
Yong Kook Lee, Jeong Bae Park
Clinical Endoscopy.2013; 46(3): 274. CrossRef
The antibiofilm effects of Byotrol™ G32
N. Govindji, P. Wills, M. Upton, N. Tirelli, S. Yeates, M. Webb
Journal of Applied Microbiology.2013; 114(5): 1285. CrossRef

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Colonic Carcinoma and Tubular Adenoma with High Grade Dysplasia Resembling Submucosal Tumor: Eun Ran Kim, M.D., Dong Kyung Chang, M.D., Kyoung-Mee Kim, M.D.*, Jin Yong Kim, M.D., Young-Ho Kim, M.D., Jae Jun Kim, M.D. and Jong Chul Rhee, M.D.; Korean J Gastrointest Endosc 2009;38(4):229-233. Published online April 30, 2009

Abstract PDF: Colorectal carcinoma arises from the epithelium of the colorectal mucosa, and so it displays various macroscopic appearances with abnormal mucosal changes. But submucosal tumor-like colorectal carcinoma is very rare. We report here on two such cases along with a review of the relevant literature. The first case was submucosal tumor-like colorectal carcinoma that was initially diagnosed as rectal submucosal tumor, but the follow-up endoscopic exam revealed ulceroinfiltrative type adenocarcinoma. The second case was an endoscopically determined polypoid lesion combined with submucosal tumor, but it was found to be tubular adenoma with high grade dysplasia combined with a mucin pool collection in the submucosa after surgical resection. (Korean J Gastrointest Endosc 2009;38:229- 233)

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A Case of High Grade Dysplasia in Sporadic Fundic Gland Polyp: Hyung Keun Ha, M.D., Jin Tae Jung, M.D., Young Sup Kim, M.D., Byung Seok Kim, M.D., Kyu Hyun Cho, M.D., Joong Goo Kwon, M.D., Eun Young Kim, M.D., Chang Hyeong Lee, M.D., Ho Gak Kim, M.D. and Chang Ho Cho, M.D.*; Korean J Gastrointest Endosc 2006;32(5):338-341. Published online May 30, 2006

Abstract PDF: Fundic gland polyps (FGP) are the most common type of gastric polyps, with an incidence on endoscopy of 0.8∼1.9%. They have been considered as benign lesions, without the potential for malignant transformation. High grade dysplasia and gastric adenocarcinomas associated with FGP have been described in patients with familial, as well as attenuated adenomatous polyposis (FAP). In contrast, dysplasia associated with FGP in non-FAP patients is extremely rare, and there have been no reports of sporadic FGP with high grade dysplasia in the Korean literature. Herein, we report one case of high grade dysplasia associated with sporadic FGP in a non-FAP patient treated with an endoscopic polypectomy. (Korean J Gastrointest Endosc 2006;32:338⁣341)

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59세 남자, 식후 상복부 불쾌감: Korean J Gastrointest Endosc 2003;26(5):352-352. Published online May 30, 2003

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Comparison of Clinicopathologic Findings between Colorectal Adenoma with High Grade Dysplasia and Colorectal Carcinoma with Mucosal Invasion: Myoung Joo Ki, M.D., Hyun Duk Shin, M.D., Jae Duk Kim, M.D.,Jeong Eun Shin, M.D. and Chang Young Lim, M.D.; Korean J Gastrointest Endosc 2002;25(6):438-442. Published online December 30, 2002

Abstract PDF: Background
/Aims: The precancerous lesion of colorectal cancer is adenoma. Adenoma with high grade dysplasia has been known as the lesion having high malignant potentials. The cancer with invasion to mucosa is limted to the mucosa, and it is difficult to pathologically differentiate the adenoma with high grade dysplasia. Methods: Fifty three adenomas with high grade dysplasia (type I group) and 40 cancers with invasion to mucosa (type II group) for 4 years, were analyzed for the colonoscopic findings and pathological findings before and after EMR. Results: Mean ages were 57.0 years old for type I group and 60.4 for type II group. Chief complaint for colonoscopy was rectal bleeding (21.0%) for type I group, and rectal bleeding (35.0%) for type II group. Mean sizes of the lesions were 1.18 cm for type I group, and 1.71 cm for type II group. Locations of the lesion were rectum 43.4%, sigmoid colon 32.1%, proximal colon 24.5% for type I group, and rectum 45.7%, sigmoid colon 42.9%, proximal colon 11.4% for type II group. Shapes of the lesions were Is 46.9%, Ip 30.6%, Isp 18.4%, LST 4.1% for type I group, and Isp 34.2%, Ip 31.6%, Is 18.4%, LST 5%, IIa⁢depression 5%, Is⁢IIc 5% for type II group. Methods for therapy were EMR 60.4%, operation 1.9%, electrocoagulation 11.3%, observation 26.4% for type I group, and EMR 85.0%, operation 15.0% for type II group. Pathological agreement before and after EMR was 57.1% for type I group and 31.3% for type II group. Conclusions: Type II group had more rectal bleeding, larger, more Isp type, more EMR therapy, more pathological disagreement ratio before and after EMR, than type I group. (Korean J Gastrointest Endosc 2002;25:438⁣442)

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수술 고위험군 급성 담낭염 환자에서의 경피경간적 담낭경검사의 안전성과 유용성 ( Safety and Usefulness of Percutaneous Transhepatic Cholecystoscopy (PTCCS) in High-Risk Surgical Patients Manifesting Acute Cholecystitis ): Korean J Gastrointest Endosc 2001;22(1):27-31. Published online November 30, 2000

Abstract PDF: Background
/Aims: The aim of the present study is to identify the diagnostic and therapeutic usefulness of percutaneous transhepatic cholecystoscopic examination (PTCCS) in high-risk surgical patients manifesting acute cholecystitis. Methods: Between January 1992 and June 1998, 33 consecutive patients who underwent percutaneous transhepatic cholecystostomy (PC) and subsequent PTCCS for the management of acute cholecystitis were included. Results: PC and subsequent PTCCS were successfully accomplished in all of 33 patients. During PTCCS, minor complication (2 of minor bleeding during electrohydraulic lithotripsy, 2 of tube dislodgement and 1 of bile leakage to peritoneum) occurred in five patients. PTCCS revealed 26 cases of gallstones, 3 cases of sludge ball, 3 cases of gallbladder carcinoma and 1 case of clonorchiasis related with acute cholecystitis. Three cases of the gallbladder cancers which were not predicted radiologically were incidentally found during PTCCS. For 26 patients with gallstones, PTCCS and concomitant stone removal were successfully carried out in one to four consecutive sessions (mean 2.2 sessions). Gallstones recurred in three (3/22, 14%) patients during the mean follow-up period of 27 months. All of them remain asymptomatic. Conclusions: PTCCS may be justified in the management of acute cholecystitis in selected patients with high surgical risk. (Korean J Gastrointest Endosc 2001;22:27 - 31)

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원저 : 식도 위장관 ; 출혈위험성이 높은 식도정맥류에 대한 예방적인 내시경적 정맥류 결찰요법 ( Original Articles : Esophagus , Stomach & Intestine ; Prophylactic Endoscopic Variceal Ligation for Esophageal Varices with High - risk of Hemorrhage ): Korean J Gastrointest Endosc 1996;16(4):561-567. Published online November 30, 1995

Abstract PDF: Prophylactic treatment of varices is an appealing concept because 50% of patients who experience variceal bleeding will die within the first 6 weeks of the first bleeding. However, the majority of trials which have evaluated prophylactic therapy gave failed to demonstrate advantage, We tried prophylactic endoscopic variceal ligation(EVL) in 10 patients, to evaluate the safety and effect of prophylactic EVL for esophageal varices with high-risk of hemorrhage. The eradication rate was 100% without bleeding and mortality, the mean session for eradication of varices 1.9, the number of bands per person 16.9 and the number of bands per session 8.9. Although mild chest pain(5.3%) and chest discomfortness(31.6%) were observed, no serious complication related with EVL resulted from 19 EVL sessions. The patients were followed for a mean of 327.0 days(85-708), during which recurrent esophagea1 varices were found in a case at 260 days from last session, but no bleeding nor death was occured. No late complication of EVL was documented. In conclusion, prophylactic EVL is safe and may be effective for esophageal varices with high-risk of hemorrhage. But, the large controlled-trial should be required, (Korean J Gastrointest Endosc 16: 561~567, 1996)

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