Clinical Endoscopy

Original Article

Clinical efficacy of endoscopic resection for subepithelial tumors in the esophagogastric junction and gastric cardia: an observational study: Sang Jin Park, Min A Yang, Jae Sun Song, Won Dong Lee, Myoung Jin Ju, Jin Woong Cho; Received July 8, 2025 Accepted August 25, 2025 Published online January 7, 2026; DOI: https://doi.org/10.5946/ce.2025.219 [Epub ahead of print]

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Gastric subepithelial tumors (SETs) located near the esophagogastric junction (EGJ) are difficult to treat surgically and endoscopically. This study aimed to evaluate the effectiveness and safety of endoscopic resection of SETs growing from the muscularis propria located in the EGJ and gastric cardia.
Methods
This study included 26 consecutive patients who underwent endoscopic resection of 27 gastric SETs between November 2012 and May 2023.
Results
Of the 27 gastric SETs, 3 and 24 were located in the EGJ and gastric cardia, respectively. The mean tumor size, operative time, and duration of hospitalization were 21 (6–52) mm, 35.4 (9–65) minutes, and 4.2 (3–7) days, respectively. Endoscopic resection of the SETs achieved an en bloc resection rate of 100% (27/27) and a complete resection rate of 88.9% (24/27). Pathological examination confirmed four gastrointestinal stromal tumors and 23 leiomyomas. No bleeding, peritonitis, or abdominal infection occurred after the endoscopic resections. Residual lesions were identified in three patients (11.1%). No recurrence was observed during follow-up (range, 3–24 months).
Conclusions
SETs in the EGJ and gastric cardia can be resected effectively, even if they originate from the muscularis propria layer.

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Review

Non-invasive colorectal cancer screening: emerging tools and clinical evidence: Hyoung Il Choi, Jae Myung Cha; Received July 28, 2025 Accepted September 12, 2025 Published online December 3, 2025; DOI: https://doi.org/10.5946/ce.2025.246 [Epub ahead of print]

Abstract PDF PubReader ePub: The fecal immunochemical test (FIT) is a widely used non-invasive screening method for colorectal cancer (CRC) in many countries, valued for its simplicity, affordability, and reasonable sensitivity. Typically recommended on an annual or biennial basis, the FIT is effective in reducing CRC incidence and mortality by facilitating early detection. Stool DNA tests, including multitarget DNA tests and DNA methylation assays, demonstrate higher sensitivity than FIT for CRC and advanced adenomas, although they have slightly lower specificity and higher cost. These tests are generally performed at longer intervals, such as every 3 years, and are useful alternatives for individuals who are unwilling or unable to undergo a colonoscopy. Emerging non-invasive CRC screening tools, such as liquid biopsy, microRNA, microbiome tests, and urine-based tests, are being developed to improve patient compliance and test convenience. In particular, liquid biopsy offers a minimally invasive option that may be more acceptable to populations hesitant to undergo stool-based tests. Furthermore, the integration of machine learning with metagenomic sequencing data has shown promise in distinguishing patients with CRC from healthy individuals. As CRC screening evolves, these novel approaches may enable the development of more personalized, accessible, and effective screening strategies, ultimately improving adherence and reducing CRC-related mortality.

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Original Article

Effect of double-layered suturing for mucosal defect closure after colorectal endoscopic submucosal dissection on postoperative adverse events: a propensity score-matched retrospective study in Japan: Kyohei Nishino, Hiroki Fujita, Takahiro Yuge, Masanori Hongo, Naoko Mori, Kazumi Shimamoto, Yu Kobayashi, Takashi Toyonaga, Hiromitsu Ban; Clin Endosc 2025;58(6):881-889. Published online November 6, 2025; DOI: https://doi.org/10.5946/ce.2025.053

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: Prophylactic closure of mucosal defects after colorectal endoscopic submucosal dissection (ESD) can reduce the incidence of postoperative adverse events. However, data on this notion are limited. This study retrospectively evaluated the effect of closure using a double-layered suturing technique on postoperative adverse events.
Methods
A total of 370 lesions in 317 patients who underwent colorectal ESD were included in this analysis. Patients with 197 lesions that were completely closed were then assigned to the closure group. Patients with 173 lesions, including 55 that were partially closed and 118 that were not closed, were assigned to the non-closure group. Propensity score matching was performed, and 136 lesions were selected for each group.
Results
The closure group had a significantly lower overall incidence rate of postoperative adverse events, including delayed bleeding, delayed perforation, and post-ESD electrocoagulation syndrome, than the non-closure group (2.2% vs. 9.6%, p=0.018). The closure group had a significantly lower incidence of abdominal pain on the day after ESD than the non-closure group (2.9% vs. 11.0%, p=0.015).
Conclusions
Prophylactic closure of mucosal defects after colorectal ESD using a double-layered suturing technique could prevent postoperative adverse events and abdominal pain on the day after ESD.

Citations

Citations to this article as recorded by

Colorectal endoscopic submucosal dissection defect closure: promising but still evolving
Yunho Jung
Clinical Endoscopy.2025; 58(6): 856. CrossRef

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Reviews

Epidemiology of colonic adenoma and cancer: Dong Hyun Kim; Received June 14, 2025 Accepted July 13, 2025 Published online September 29, 2025; DOI: https://doi.org/10.5946/ce.2025.189 [Epub ahead of print]

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