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Systematic Review and Meta-analysis
To what extent can bowel preparation quality be considered “adequate”?: a systematic review and meta-analysis
Chen-Ya Kuo, David Karsenti, Salvador Machlab, Fu-Jen Lee, Yu-Tsung Chen, Te-Ling Ma, Chi-Yang Chang, Yu-Tse Chiu
Clin Endosc 2026;59(4):569-580.   Published online July 30, 2026
DOI: https://doi.org/10.5946/ce.2026.022
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
/Aims: While low-quality bowel preparation is known to reduce the adenoma detection rate (ADR), the distinction between intermediate- and high-quality preparations remains unclear.
Methods
Electronic searches were conducted in PubMed and Embase through July 2024. Randomized controlled trials reporting ADR and the Boston bowel preparation scale (BBPS) were included, and outcomes were pooled according to bowel preparation quality using a random-effects model. The primary outcome was ADR in intermediate-quality (BBPS ≥6, and ≥2 in each segment) versus high-quality (BBPS≥8) bowel preparation. Secondary outcomes included advanced ADR.
Results
Fourteen trials were included (5,246 in the high-quality group and 1,728 in the other group). There was no significant difference in ADR (risk difference [RD], –0.02; p=0.13; I2=21%). Subgroup analyses showed no significant difference with computer-aided detection (CADe; RD, –0.03; p=0.70; I2=81%) or linked color imaging (RD, 0.04; p=0.31; I2=0%). The heterogeneity observed with CADe may reflect differences in colonoscopist experience or CADe systems. The results were similar for advanced ADR. Funnel plot and Egger’s test indicated minimal publication bias.
Conclusions
Intermediate-quality preparation allows adequate adenoma detection. When each BBPS subscore is ≥2, surveillance recommendations can generally be followed.
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Original Articles
Effect of external evaluation and training on the incomplete resection rate in cold snare polypectomies for colonic lesions <10 mm: a prospective Spanish study (POLIPEVA)
Marina de Benito Sanz, Jorge Feito, Luis Hernández, Javier Tejedor-Tejada, Pilar Diez-Redondo, María Henar Núñez Rodríguez, Raúl Honrubia-López, Cristina Fernández, Victoria Busto, Sofia Parejo, Marta Aicart-Ramos, Marina Solano, Silvia Patricia Ortega, Natalia Marcos, Francisco Javier García-Alonso, on behalf of the POLIPEVA study group
Clin Endosc 2026;59(4):653-662.   Published online July 30, 2026
DOI: https://doi.org/10.5946/ce.2025.474
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
/Aims: Cold snare polypectomy (CSP) technique for polyps <10 mm varies widely among endoscopists. This study aimed to evaluate an online educational intervention for incomplete resections.
Methods
This multicenter trial was performed between 2021 and 2024. After a baseline assessment of incomplete resection rates for CSP of lesions <10 mm was completed, participants undertook a 1-hour online course led by an expert senior endoscopist. A second assessment was performed following course completion. Resections were evaluated using two marginal biopsies obtained after CSP, assessed by a single pathologist blinded to polyp histology. Follow-up was conducted by telephone 4 weeks after colonoscopy.
Results
A total of 29 endoscopists participated in the baseline assessment, yielding a baseline 4.8% incomplete resection rate, with a median individual rate of 4.3% (interquartile range [IQR], 2.9%–5.7%; range, 0%–15.6%). Thirteen endoscopists completed the course and participated in the second study phase, which included 1,271 polyps in phase 1 and 826 in phase 2. No significant improvement in incomplete resection rate was observed (4.8% in phase 1 vs. 4.0% in phase 2; difference, 0.8%; 95% confidence interval [CI], –1.1% to 2.6%; p=0.4). Among 3,087 polypectomies, intraprocedural bleeding occurred in 288 (9.3%) cases; most were self-limited, with only 45 (1.5%) requiring clipping. Delayed bleeding was observed in five (0.5%) patients, four of whom had mild bleeding and one severe. No perforations were observed.
Conclusions
The utility of online endoscopic technique courses appears limited. CSP demonstrates an excellent safety profile (ClinicalTrials.gov number: NCT04636619).
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  • 63 Download
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Linked color imaging versus artificial intelligence-assisted linked color imaging for neoplasia detection in the colorectum: a randomized trial in Brazil
Carlos Eduardo Oliveira dos Santos, Naohisa Yoshida, Asadur Jorge Tchekmedyian, Gabriel Malaman dos Santos, Luma Alves Costa, Ivan David Arciniegas Sanmartin, Júlio Pereira-Lima
Clin Endosc 2026;59(2):264-272.   Published online March 27, 2026
DOI: https://doi.org/10.5946/ce.2025.276
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Background
/Aims: Adenomas and sessile serrated lesions (SSLs) are neoplasms that play a role in colorectal cancer development. Improving adenoma detection rate (ADR) and SSL detection rates (SDR) allows for more effective prevention of colorectal cancer. Linked color imaging (LCI) and artificial intelligence (AI) have contributed to increased ADR and SDR. This study aimed to compare the neoplasia detection rates (NDR, adenomas, or SSLs) between LCI and AI-assisted LCI colonoscopy.
Methods
We conducted a prospective randomized trial to compare LCI with LCI+AI. We evaluated ADR, SDR, and NDR as the primary outcomes.
Results
A total of 779 polyps were detected in 622 patients (304 in the LCI group and 318 in the LCI+AI group); 555 were adenomas and 62 were SSLs for a total of 617 neoplastic lesions (79.2%) in 363 patients. Comparing the LCI and LCI+AI groups, the ADR, SDR, and NDR were 46.7% vs. 53.1% (p=0.13), 8.2% vs. 8.5% (p=0.90), and 52.3% vs. 56.6% (p=0.30), respectively. The mean number of adenomas per patient, advanced ADR, and withdrawal time did not significantly differ between the two groups.
Conclusions
Similar results were observed in both groups, and even with the good performance of AI-assisted LCI, LCI alone yielded high ADR, SDR, and NDR.
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Systematic Review and Meta-analysis
Enhanced adenoma detection with Endocuff Vision: a GRADE assessed systematic review and meta-analysis
Ahmed Ali Khan, Fariha Hasan, Mohammed Dheyaa Marsool Marsool, Muhammad Uzair, Kanz Ul Eman Maryam, Muhammad Usman Babar, Mutahhar Talha, Haider Imran, Rayyan Mohammad Makki Bakhsh, Kalsoom Zulfiqar, Fatima Wahid, Amal Shahzad Khan, Daniel Ashraf Guirguis, Christina Tofani, Anthony Infantolino
Clin Endosc 2026;59(3):371-385.   Published online February 2, 2026
DOI: https://doi.org/10.5946/ce.2025.163
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
/Aims: Colorectal cancer (CRC) is the second leading cause of cancer-related deaths and the third most common cancer worldwide. Detecting adenomas during colonoscopy reduces the CRC risk, with higher adenoma detection rates (ADRs) correlating with lower CRC incidence and mortality. Endocuff Vision (EV) enhances mucosal visualization and may improve ADRs.
Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, PubMed, Embase, and Cochrane databases were searched through April 2025 for studies comparing EV-assisted and standard colonoscopy. The primary outcomes of interest were the ADRs, polyp detection rates (PDRs), and adverse events (AEs). Outcomes were pooled using a random-effects meta-analysis model and are presented as risk ratios (RRs) and mean differences. Heterogeneity in the pooled outcomes was assessed using the Higgins I².
Results
Thirty-four studies (43,702 participants) were included. EV significantly improved ADRs (RR, 1.15; 95% confidence interval [CI],1.07–1.25) and PDRs (RR, 1.16; 95% CI, 1.10–1.23). EV also improved lesion detection in the left colon (RR, 1.23; 95% CI, 1.11–1.35) and right colon (RR, 1.19; 95% CI, 1.09–1.29). No significant improvement was observed in advanced ADRs or cecal intubation. EV use was associated with more AEs.
Conclusions
EV-assisted colonoscopy improved ADRs and PDRs in both colonic regions and enhanced CRC screening despite increased AEs.
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Original Articles
Prognosis of Korean patients with familial adenomatous polyposis who did not undergo colectomy: a retrospective study
Min Kwan Kwon, Jin Hee Noh, Ji Yong Ahn, Woochang Lee, Seok-Byung Lim, Yong Sang Hong, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
Clin Endosc 2026;59(2):254-263.   Published online December 31, 2025
DOI: https://doi.org/10.5946/ce.2025.191
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
/Aims: The International Society for Gastrointestinal Hereditary Tumors polyposis scoring system (IPSS) categorizes familial adenomatous polyposis (FAP) according to the burden of colorectal polyps and histology. However, the prognosis of patients with uncolectomized FAP has not been established.
Methods
Medical records of patients diagnosed with FAP between 1991 and 2021 were reviewed, and the IPSS stage was determined. The cumulative upstaging rate and risk factors for IPSS upstaging during surveillance were analyzed in patients without colectomies.
Results
Among 237 patients, 35 (28.9%) with IPSS stages 0–2 did not undergo colectomy. The cumulative risk of upstaging was 0%, 31%, 54%, and 73% at 1, 3, 7, and 10 years after FAP diagnosis, respectively. In univariate analysis, age (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.01–1.08; p=0.014) and having an ampulla of Vater adenoma (HR, 3.95; 95% CI, 1.17–13.30; p=0.027) were associated with upstaging. Multivariate analysis revealed that each 1-year increase in age was an independent risk factor of upstaging (adjusted HR, 1.04; 95% CI, 1.01–1.09; p=0.027).
Conclusions
In our analysis, patients with uncolectomized FAP and IPSS stages 0–2 at diagnosis showed a time-dependent progression in the IPSS stage.

Citations

Citations to this article as recorded by  
  • Colonoscopic surveillance without prophylactic colectomy in familial adenomatous polyposis: who are the appropriate candidates?
    Hyun Jung Lee
    Clinical Endoscopy.2026; 59(2): 237.     CrossRef
  • 3,341 View
  • 147 Download
  • 1 Crossref
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Comparison of colon adenoma detection rate using cap-assisted and artificial intelligence-assisted colonoscopy at a tertiary hospital in the Philippines: a propensity score-matched analysis
Justin Ryan Lay Tan, Keith Brian Tan Enriquez, Kenneth Vergel Tecson Aballe, Mary Anne Gonzales Go, Michael Louie Ong Lim, Jonard Tan Co
Clin Endosc 2026;59(1):106-114.   Published online December 31, 2025
DOI: https://doi.org/10.5946/ce.2024.337
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Background
/Aims: The integration of artificial intelligence (AI)-powered image analysis and mucosal exposure devices, such as distal attachment caps, has been demonstrated to significantly improve the adenoma detection rate (ADR) during colonoscopy. This study aimed to compare AI-assisted colonoscopy (AIC) with cap-assisted colonoscopy (CAC).
Methods
This retrospective propensity score-matched cohort study was performed at a tertiary care hospital between January 2022 and May 2022. Data were extracted from the electronic health record system and colonoscopy video recordings. Adult patients aged 40 years who underwent screening or surveillance colonoscopies were included. The primary outcome was the ADR, whereas the secondary outcome was the polyp detection rate (PDR).
Results
A 1:1 propensity score-matched analysis was performed, resulting in 49 well-matched patient pairs. One patient from each pair was assigned to the CAC group, whereas the other was assigned to the AIC group. No significant difference in ADR was observed between the CAC and AIC groups (47% vs. 51%, p=0.69). Similarly, PDR did not significantly differ between the two groups (80% vs. 71%, p=0.35).
Conclusions
Both CAC and AIC have the potential to increase ADR and PDR. However, neither modality offers a significant advantage.

Citations

Citations to this article as recorded by  
  • Is cap still useful for colon adenoma detection rate improvement in the artificial intelligence era?
    Tae-Woo Kim, Soo-Young Na
    Clinical Endoscopy.2026; 59(1): 73.     CrossRef
  • 3,178 View
  • 80 Download
  • 1 Web of Science
  • 1 Crossref
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Depth of noninjecting resection using bipolar soft coagulation mode for 6 to 9 mm colorectal polyps: a retrospective study in Japan
Yoshifumi Watanabe, Mitsuo Tokuhara, Hidetoshi Nakata, Hiroko Nakahira, Ikuko Torii, Yasumasa Sumitomo
Clin Endosc 2026;59(1):115-123.   Published online December 18, 2025
DOI: https://doi.org/10.5946/ce.2025.100
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Background
/Aims: Endoscopic resection of colorectal polyps reduces mortality from colorectal cancer. We report here a novel resection method, known as noninjecting resection using bipolar soft coagulation mode (NIRBS), and assess its feasibility. This study aimed to compare the resection depth achieved with NIRBS to those achieved with cold snare polypectomy (CSP) and conventional endoscopic mucosal resection (CEMR).
Methods
Patients with 6 to 9 mm colorectal polyps underwent endoscopic resection at Hoshigaoka Medical Center between October 2023 and January 2024. We analyzed the thickness of resected submucosal tissue following the use of NIRBS, CSP, and CEMR.
Results
We identified 95 polyps, including adenomas and serrated lesions. The proportions of specimens containing submucosal tissue were 21.4%, 100.0%, and 97.9% in CSP, CEMR, and NIRBS, respectively. The median submucosal tissue thickness for CEMR and NIRBS was 1,167 and 1,125 µm, respectively, which was significantly greater than 0 µm for CSP. For NIRBS, the median thickness was 1,140 and 1,017 µm for the expert and non-expert endoscopists, respectively.
Conclusions
The depth of submucosal resection with NIRBS exceeded 1,000 μm regardless of endoscopist experience. NIRBS can be a useful resection method for patients with colorectal polyps, including those with non-submucosally invasive carcinomas.
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Endoscopic predictors of iron deficiency in Helicobacter pylori gastritis: a Kyoto classification-based study
Hyun Tak Lee, Ah Young Lee, Hyesun Hong, Jun-young Seo
Clin Endosc 2026;59(1):79-88.   Published online November 6, 2025
DOI: https://doi.org/10.5946/ce.2025.175
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Background
/Aims: Helicobacter pylori infection is reportedly associated with iron-deficiency anemia. However, little is known about the association between the endoscopic features of H. pylori in the Kyoto classification of gastritis and iron deficiency. Therefore, we analyzed the endoscopic features of H. pylori gastritis and studied the association between these endoscopic features and iron deficiency.
Methods
We retrospectively analyzed patients diagnosed with H. pylori gastritis between May 2022 and June 2023 who also underwent laboratory tests, including anemia profiling. Iron deficiency was defined as a ferritin level below 55 ng/mL. Multivariate analysis was used to assess the association between endoscopic features and iron deficiency.
Results
Of the included patients, 47 had iron deficiency. Female patients were significantly more common in the iron-deficient group (87.2% vs. 33.4%, p<0.001). Endoscopically, nodularity (46.8% vs. 23.4%, p=0.001) and hyperplastic polyps (17.0% vs. 3.7%, p=0.001) were more common in patients with iron deficiency. Multivariate analysis identified younger age, female sex, and larger hyperplastic polyps (≥5 mm) as independent risk factors for iron deficiency.
Conclusions
Younger age, female sex, and larger hyperplastic polyps (≥5 mm) are associated with iron deficiency in patients with H. pylori gastritis. These features may help identify patients at higher risk of iron deficiency.

Citations

Citations to this article as recorded by  
  • Endoscopic predictors of iron deficiency in Helicobacter pylori gastritis: a Kyoto classification-based study
    Na Rae Lim, Woo Chul Chung
    Clinical Endoscopy.2026; 59(1): 67.     CrossRef
  • The Role of Helicobacter pylori Infection in Iron Deficiency and B12 Deficiency Anemia
    A. A. Sheptulin, S. S. Kardasheva, A. A. Kurbatova, N. A. Benuni
    Russian Journal of Gastroenterology, Hepatology, Coloproctology.2026; 36(2): 104.     CrossRef
  • 4,380 View
  • 210 Download
  • 1 Web of Science
  • 2 Crossref
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Assessment of colorectal polyp detection along the short-axis direction of the intestinal lumen during colonoscopic observation: a retrospective study in Japan
Daichi Mori, Atsushi Katagiri, Yoshinao Onishi, Yuta Yamazaki, Kensuke Higuchi, Norihiro Suzuki, Kazuo Kikuchi, Shinya Nakatani, Takahisa Fujiwara, Kazuya Inoki, Kenichi Konda, Masayuki Tojo, Fuyuhiko Yamamura, Hitoshi Yoshida
Clin Endosc 2026;59(1):96-105.   Published online October 23, 2025
DOI: https://doi.org/10.5946/ce.2025.112
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
/Aims: Colorectal polyp detection during colonoscopy is influenced by the lesion location, size, morphology, and histology. However, no studies have systematically assessed the difficulty of detection along the short axis of the intestinal lumen. This study aimed to evaluate the colorectal polyp detection rates on this axis during colonoscopy.
Methods
This retrospective study analyzed 1,169 polyps in 513 patients who underwent colonoscopy at Showa University Hospital between November 2022 and February 2023. The short-axis lumen was divided into: upper right, lower right, lower left, and upper left. Each polyp detected was assigned to a quadrant. Detection rates were compared across quadrants and analyzed for associations with clinicopathological factors including lesion size, location, macroscopic type, and examiner experience.
Results
The lesion detection rates varied significantly by quadrant. The upper left quadrant had the lowest detection rate (17.5%) compared with the expected 25.0% per quadrant. Subgroup analyses consistently confirmed the lower detection rates in this quadrant across most lesion types and patient groups, except for lesions in the cecum and rectum.
Conclusions
The lower detection rate in the upper left quadrant suggests that this orientation poses a challenge and may increase the number of missed lesions. Enhanced examination of this area may improve detection; however, further prospective studies are required.

Citations

Citations to this article as recorded by  
  • Directional Bias in Polyp Detection during Colonoscopy: A Prospective Observational Study
    Atsushi Katagiri, Sayaka Mizuno, Daichi Mori, Yoshinao Onishi, Yuta Yamazaki, Kensuke Higuchi, Norihiro Suzuki, Kazuo Kikuchi, Shinya Nakatani, Takahisa Fujiwara, Kazuya Inoki, Kenichi Konda, Masayuki Tojo, Kunihiko Wakamura, Hitoshi Yoshida
    Digestion.2026; : 1.     CrossRef
  • 3,810 View
  • 170 Download
  • 1 Web of Science
  • 1 Crossref
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Reviews
Clinical significance of computer-aided quality assessment systems in colonoscopy: a comprehensive review
Wai Phyo Lwin, Katsuro Ichimasa, Shin-Ei Kudo, Yuta Kouyama, Taishi Okumura, Yasuharu Maeda, Yutaro Ide, Khay Guan Yeoh, Masashi Misawa
Clin Endosc 2025;58(5):638-645.   Published online May 27, 2025
DOI: https://doi.org/10.5946/ce.2025.022
AbstractAbstract PDF
Colonoscopy is the primary tool for colorectal cancer screening. High-quality colonoscopy is crucial for the detection of precancerous adenomas; however, the adenoma detection rate varies depending on the skill and experience of the endoscopist. Computer-aided quality assessment (CAQ) uses artificial intelligence (AI) technology to evaluate the quality of colonoscopy examinations. It plays an important role in reducing variations in examination quality and obtaining high-quality colonoscopic images. In this review, we focus specifically on the speedometer, effective withdrawal time, fold examination quality, bowel preparation quality assessment, and cecal intubation with CAQ systems and discuss the role and effectiveness of these systems. CAQ systems are expected to contribute to increase in adenoma detection rates, improvement in endoscopist skills, and standardization of examination quality. However, challenges such as variability in AI performance across different clinical settings and potential overreliance on automated prompts remain key limitations.

Citations

Citations to this article as recorded by  
  • Prospective Validation of the First US FDA-Approved Computer-Aided Quality Assessment Tool for Colonoscopy: An Initial Clinical Experience
    Todd A. Brenner, Chris Labaki, Joseph D. Feuerstein, Tyler M. Berzin
    American Journal of Gastroenterology.2026; 121(4): 1036.     CrossRef
  • Artificial Intelligence and Its Role in Endoscopic Adenoma and Cancer Detection
    Hannah R. Phillips, Wilfor J. Diaz Fernandez, Cadman L. Leggett
    Clinics in Colon and Rectal Surgery.2026; 39(03): 209.     CrossRef
  • Prospective evaluation of artificial intelligence-assisted monitoring of the effective withdrawal time on adenoma detection
    Thomas Ka Luen Lui, Carla Pui-Mei Lam, Vivien Wai-Man Tsui, Rex Wan-Hin Hui, Elvis Wai-Pan To, Loey Lung-Yi Mak, Michael Kwan-Lung Ko, Kevin Sze-Hang Liu, Cynthia Ka-Yin Hui, Jing Jia Liu, Xiao Xiao, Wai K. Leung
    Intestinal Research.2026;[Epub]     CrossRef
  • Management of Appendiceal Inflammatory Mass: Nonoperative Treatment, Malignancy Risk, and Surveillance
    İlyas Kudaş, Olgun Erdem, Fatih Başak, Zeynep Şevval Aliş, Hüsna Tosun, Yahya Kemal Calışkan, Aylin Acar, Tolga Canbak, Huseyin Kerem Tolan, Kemal Tekeşin
    The American Surgeon™.2026; 92(9): 2378.     CrossRef
  • Ethical and Legal Implications of Implementing AI in Gastrointestinal Endoscopy
    Ahmed El‐Sayed, Syed Geelani, Sherif El‐Sayed, Hassan Ali Choudry, Laurence B. Lovat, Omer F. Ahmad
    Digestive Endoscopy.2026;[Epub]     CrossRef
  • Human-machine collaboration in colorectal cancer screening: a narrative review of artificial intelligence-assisted colonoscopy
    Chi Zhang, Jinguo Liu, Zhou Zhang, Liangliang Yu
    Frontiers in Medicine.2026;[Epub]     CrossRef
  • Cognitive Workload and Mental Burden in Health Care Professionals Interacting With AI: Systematic Review and Meta-Analysis
    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
    Journal of Medical Internet Research.2026; 28: e93618.     CrossRef
  • Advances in artificial intelligence-based colonoscopic tools and modalities: Transforming colorectal cancer detection and management
    Philippe Attieh, Antonio Al Hazzouri, Rim Moubayed, Tya Youssef, Karam Karam, Said G Farhat
    Artificial Intelligence in Gastroenterology.2026;[Epub]     CrossRef
  • Artificial Intelligence-Assisted Colonoscopy for Colorectal Lesion Detection: Current Evidence, Challenges, and Future Directions
    Andreas Antzoulas, Francesk Mulita, Vasileios Leivaditis, Elias Liolis, Platon Dimopoulos, Vasiliki Tzelepi, Ioannis Maroulis, Christos-Nikolaos Anagnostopoulos
    Journal of Clinical Medicine.2026; 15(17): 6558.     CrossRef
  • 6,936 View
  • 238 Download
  • 9 Web of Science
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Recent advancement in size measurement during endoscopy
Hye Kyung Jeon, Gwang Ha Kim
Clin Endosc 2026;59(1):1-8.   Published online May 23, 2025
DOI: https://doi.org/10.5946/ce.2025.070
AbstractAbstract PDF
Accurate lesion size measurement is essential in endoscopic practice as it influences treatment strategies, surveillance decisions, and clinical outcomes, especially in colorectal polyps. Traditional measurement techniques, including visual estimation and biopsy forceps, have significant interobserver variability and procedural inefficiencies. Recent advancements in digital measurement technologies, including virtual scale endoscopy (VSE) and artificial intelligence (AI)-assisted virtual rulers, have addressed these limitations. VSE projects a virtual scale onto endoscopic images, enhancing measurement precision and reducing variability. Several studies have demonstrated its superior accuracy compared with conventional methods; however, limitations such as increased procedure time and operator training requirements persist. AI-assisted virtual rulers utilize deep learning algorithms to automate lesion size estimation, significantly improving reproducibility and diagnostic reliability. Although these technologies offer promising improvements, challenges remain, including real-time integration, standardization, and regulatory approval. Future research should focus on refining AI models, expanding validation studies, and optimizing their usability in routine practice. A hybrid approach that combines AI automation with real-time digital tools may enhance the precision and efficiency of endoscopic lesion assessment, ultimately improving patient outcomes.

Citations

Citations to this article as recorded by  
  • Accuracy of Virtual Scale Endoscopy in colorectal polyp size measurement: a Grading of Recommendations Assessment, Development and Evaluation–assessed pairwise and network meta-analysis
    Mohamed S. Elgendy, Mohamed Rifai, Amira M. Taha, Islam Rajab, Abdulrahman Maged, Mohamed A. Elgamasy, Hosam I. Taha, Mohamed Abuelazm, Babu P. Mohan, Douglas G. Adler
    Gastrointestinal Endoscopy.2026; 103(5): 904.     CrossRef
  • Lyon endoscopic submucosal dissection score: a preprocedure prediction model for operating time in colorectal endoscopic submucosal dissection
    Elena De Cristofaro, Jean Grimaldi, Diana Giannarelli, Roupen Djinbachian, Jérémie Jacques, Timothée Wallenhorst, Clara Yzet, Louis-Jean Masgnaux, Florian Rostain, Alexandru Lupu, Jérôme Rivory, Mathieu Pioche
    Gastrointestinal Endoscopy.2026; 104(3): 436.     CrossRef
  • Expert Endoscopist Agreement for Size Measurement of Large (> 2 cm) Colorectal Laterally Spreading Tumors: A Prospective Video-Based Study
    Roupen Djinbachian, Jérémie Jacques, Victoire Michal, Ludovico Alfarone, Robert Bechara, Nicholas G. Burgess, Mariana Figueiredo, Yusuke Fujiyoshi, Lucile Heroin, Michal F. Kaminski, Eric Lam, Philippe Leclercq, Isabelle Lienhart-Chambon, Alexandru Lupu,
    Digestive Diseases and Sciences.2026; 71(9): 4202.     CrossRef
  • Endoscopic depth estimation based on deep learning: A survey
    Ke Niu, Zeyun Liu, Xue Feng, Heng Li, Naian Xiao, Binghua Su, Qika Lin, Kaize Shi
    Neurocomputing.2026; 696: 133958.     CrossRef
  • Response
    Elena De Cristofaro, Jean Grimaldi, Mathieu Pioche
    Gastrointestinal Endoscopy.2026; 104(1): 139.     CrossRef
  • Efficacy of deeper tissue sections for colorectal serrated polyps histologically diagnosed as normal mucosa
    Masaya Sano, Toshihiro Nishizawa, Osamu Toyoshima, Hidenobu Watanabe, Takuma Hiramatsu, Hiroki Asano, Tomonori Aoki, Keisuke Hata, Hirotoshi Ebinuma, Hidekazu Suzuki
    Arab Journal of Gastroenterology.2026;[Epub]     CrossRef
  • 8,517 View
  • 587 Download
  • 6 Web of Science
  • 6 Crossref
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Classification of image-enhanced endoscopy in colon tumors
One-Zoong Kim
Clin Endosc 2025;58(3):337-351.   Published online May 8, 2025
DOI: https://doi.org/10.5946/ce.2024.263
AbstractAbstract PDF
Colorectal cancer accounts for 10% of global cancer cases in each year, making accurate evaluation and resection crucial. Imaging-enhanced endoscopy helps differentiate between hyperplastic polyps and adenomas, guiding treatment decisions. Colon tumors are classified into benign (e.g., serrated and adenomatous polyps) and malignant (e.g., adenocarcinomas). The Paris classification categorizes superficial neoplastic lesions by morphology, while laterally spreading tumors are classified by size and growth pattern. Effective classification aids in determining resectability and appropriate interventions for colon tumors, ultimately improving patient outcomes. Image-enhanced endoscopy improves colon tumor diagnosis using various techniques like dye, optical, and electronic methods. Kudo’s pit pattern categorizes lesions based on surface morphology using dye, while Sano, Jikei, and Hiroshima classifications focus on vascular patterns using narrow-band imaging (NBI). The NBI International Colorectal Endoscopic (NICE) classification integrates these methods to identify lesions, especially deep submucosal invasive cancers. The Workgroup Serrated Polyps and Polyposis (WASP) classification targets sessile serrated lesions, and the Japan NBI Expert Team (JNET) classification further refines adenoma categorization with low- and high-grade adenoma. The Colorectal Neoplasia Endoscopic Classification to Choose the Treatment (CONECCT) classification consolidates multiple systems for comprehensive assessment, aiding in treatment decisions and potentially applicable to artificial intelligence for diagnostic validation across imaging modalities like linked color imaging, blue light imaging, or i-scan.

Citations

Citations to this article as recorded by  
  • Endoscopic Submucosal Dissection for Early Colorectal Carcinoma with High-risk Criteria: Long-term Follow-up from the German Multicenter Registry
    Sara Moser, Andreas Probst, Alanna Ebigbo, Ingo Steinbrück, Hans-Peter Allgaier, Jürgen Pohl, Roland Reinehr, Viktor Rempel, Michael Anzinger, Franz Ludwig Dumoulin, Jörg Schirra, Dani Dakkak, Ulrike Denzer, Andreas Wannhoff, Stefan Sulk, Siegbert Faiss,
    Endoscopy International Open.2026;[Epub]     CrossRef
  • 27,400 View
  • 896 Download
  • 2 Web of Science
  • 1 Crossref
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Original Article
Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial
Ramona Schiumerini, Paola Baccarini, Adele Fornelli, Davide Allegri, Francesca Lodato, Alessia Gazzola, Pasquale Apolito, Nunzio P. Longo, Anna M. Polifemo, Franca Patrizi, Federica Buonfiglioli, Stefania Ghersi, Marco Bassi, Liza Ceroni, Antonella Ghetti, Giulio Fonti, Vincenzo Cennamo
Clin Endosc 2025;58(2):291-302.   Published online February 24, 2025
DOI: https://doi.org/10.5946/ce.2024.113
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Background
/Aims: Small polyps are the most frequently detected lesions during colonoscopy, with an incomplete resection rate of 6.8% to 15.9%. This study aimed to improve small polyp cold snare resection radicality using submucosal contrast dye pre-lifting (PL+CSP).
Methods
This single-center, prospective, randomized controlled trial compared the standard cold snare polypectomy technique (PL-CSP) with PL+CSP to evaluate endoscopic and histological complete resection rates, adverse events, procedural times, and polyp retrieval failure rates.
Results
In 143 patients consecutively enrolled, 186 small polyps were detected and randomly assigned following a 1:1 ratio to the PL-CSP (n=97, 51.6%) and PL+CSP (n=90, 48.4%) techniques. Endoscopic (p=0.97) and histologic (p=0.23) complete resection rates did not differ significantly even in univariate analysis. The intraprocedural bleeding rate was significantly higher in the PL+CSP group as confirmed by the univariate analysis (35.8% vs. 8.3%, p<0.001). The polyps retrieval failure rates were similar (p=0.83). Procedural time was significantly longer for PL+CSP (median time, 75 vs. 45 seconds; p<0.001), without impacting colonoscopy withdrawal time (p=0.215).
Conclusions
PL+CSP of small polyps did not improve endoscopic and histological complete resection rates and polyp sample retrieval. PL+CSP had higher rates of intraprocedural bleeding and was “time-consuming”.
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Review
Post-polypectomy colorectal bleeding: current strategies and the way forward
Nilanga Nishad, Mo Hameed Thoufeeq
Clin Endosc 2025;58(2):191-200.   Published online November 27, 2024
DOI: https://doi.org/10.5946/ce.2024.241
AbstractAbstract PDF
Post-endoscopic mucosal resection (EMR) bleeding, or clinically significant post-EMR bleeding, is influenced by factors such as polyp size, right-sided colonic lesions, laterally spreading tumors, anticoagulant use, and comorbidities like cardiovascular or chronic renal disease. The optimal prophylactic therapy for post-EMR bleeding remains unknown, with no consensus on specific criteria for its application. Moreover, prophylactic measures, including clipping, suturing, and coagulation, have produced mixed results. Selective clipping in high-risk patients is cost-effective, whereas universal clipping is not. Studies and meta-analyses indicate that routine prophylactic clipping does not generally reduce post-polypectomy bleeding but may be beneficial in cases of large proximal lesions. Some studies have revealed that the post-polypectomy bleeding risk after EMR of transverse colonic lesions is lower than that of the ascending colon and caecum, suggesting limited efficacy of clipping in the transverse colon. Cost-effectiveness studies support selective clipping in high-risk groups, and newer static agents such as PuraStat are alternatives; however, their cost-effectiveness is undetermined. Further research is required to establish clear guidelines and refine prophylactic strategies to prevent post-EMR bleeding.

Citations

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  • Prophylactic clipping versus no clipping after endoscopic mucosal resection of large nonpedunculated colon polyps: a cost-effectiveness analysis
    Sneh Sonaiya, Raj Patel, Charmy Parikh, Magnus Chun, Amrit Narwan, Karan Yagnik, Pranav Patel, Bradley Confer, Harshit Khara, Babu P. Mohan
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    Gastrointestinal Endoscopy.2026; 103(4): 771.     CrossRef
  • Cold Versus Hot Endoscopic Mucosal Resection for ≥15 mm Large Nonpedunculated Colorectal Polyps
    Sneh Sonaiya, Dushyant S. Dahiya, Raj Patel, Shahryar Khan, Charmy Parikh, Karan Yagnik, Chun-Han Lo, Kyaw Min Tun, Pranav D. Patel, Bradley Confer, Harshit S. Khara, Sumant Inamdar, Babu P. Mohan
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    Seung Bum Lee
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    Jin Ho Hwang, Hye Kyung Hyun, So Hyeon Gwon, Nak-Hoon Son, Cheal Wung Huh
    World Journal of Gastroenterology.2026;[Epub]     CrossRef
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    Yaping Wei, Shi Zhang, Hawa Suleiman Mabenga, Brenda John Ngowi, Zheng Jin
    BMJ Open.2026; 16(6): e118581.     CrossRef
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    Sneh Sonaiya, Sahib Singh, Tooba Laeeq, Vaishnavi Modi, Magnus Chun, Pranav Patel, Vignan Manne, Babu P. Mohan
    Techniques and Innovations in Gastrointestinal Endoscopy.2025; 27(4): 250935.     CrossRef
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Systematic Review and Meta-analysis
Cold snare polypectomy versus cold endoscopic mucosal resection for small colorectal polyps: a meta-analysis of randomized controlled trials
Vishali Moond, Priyadarshini Loganathan, Sheza Malik, Dushyant Singh Dahiya, Babu P. Mohan, Daryl Ramai, Michele McGinnis, Deepak Madhu, Mohammad Bilal, Aasma Shaukat, Saurabh Chandan
Clin Endosc 2024;57(6):747-758.   Published online August 23, 2024
DOI: https://doi.org/10.5946/ce.2024.081
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
/Aims: Cold snare polypectomy (CSP) is routinely performed for small colorectal polyps (≤10 mm). However, challenges include insufficient resection depth and immediate bleeding, hindering precise pathological evaluation. We aimed to compare the outcomes of cold endoscopic mucosal resection (CEMR) with that of CSP for colorectal polyps ≤10 mm, using data from randomized controlled trials (RCTs).
Methods
Multiple databases were searched in December 2023 for RCTs reporting outcomes of CSP versus CEMR for colorectal polyps ≤10 mm in size. Our primary outcomes were rates of complete and en-bloc resections, while our secondary outcomes were total resection time (seconds) and adverse events, including immediate bleeding, delayed bleeding, and perforation.
Results
The complete resection rates did not significantly differ (CSP, 91.8% vs. CEMR 94.6%), nor did the rates of en-bloc resection (CSP, 98.9% vs. CEMR, 98.3%) or incomplete resection (CSP, 6.7% vs. CEMR, 4.8%). Adverse event rates were similarly insignificant in variance. However, CEMR had a notably longer mean resection time (133.51 vs. 91.30 seconds).
Conclusions
Our meta-analysis of seven RCTs showed that while both CSP and CEMR are equally safe and effective for resecting small (≤10 mm) colorectal polyps, the latter is associated with a longer resection time.

Citations

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  • Recent advancement in size measurement during endoscopy
    Hye Kyung Jeon, Gwang Ha Kim
    Clinical Endoscopy.2026; 59(1): 1.     CrossRef
  • Does the size of the cold snare affect the outcome of cold snare polypectomy in the colon? A KASID prospective multicenter study
    Seongwoo Choi, Jaeyoung Chun, Geunhyuk Choi, Yoojin Lee, Taegeun Gweon, Yunho Jung
    Intestinal Research.2026; 24(1): 76.     CrossRef
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    Seung Bum Lee
    Clinical Endoscopy.2026; 59(1): 33.     CrossRef
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    Shirui Li, Yue Lei, Yunfan Deng, Sheng Dai, Dehai Xiong, Qi Fan, Xiuyang Li
    Therapeutic Advances in Gastroenterology.2026;[Epub]     CrossRef
  • Histopathologic outcomes comparison between cold snare polypectomy and cold snare EMR for colorectal polyps: a full-thickness serial sectioning analysis
    Ran Chen, Shiya Hong, Jie Gao, Zhi Ni, Peichun Peng, Shuling Lai, Xiaoqing Huang, Yueping Zheng, Qingyong Zhang, Tingting Lin, Bo Hu, Rongchun Zhang
    Gastroenterology Report.2026;[Epub]     CrossRef
  • Effective Polypectomy Practice
    Malique Delbrune, Thomas Enke, Mohammad Bilal
    Gastrointestinal Endoscopy Clinics of North America.2026; 36(4): 719.     CrossRef
  • Cost-Minimization and Procedural Outcomes of Cold Snare Versus Cold Forceps Polypectomy for Small Colorectal Polyps: A Prospective Cohort Study Using Real Institutional Pricing
    Güney Özkaya, İsmail Ege Subaşı, Sangar Abdullah, Sertaç Doğan, Şiva Nafez
    Healthcare.2026; 14(16): 2656.     CrossRef
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Original Articles
Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea
Jung-Bin Park, Jung Ho Bae
Clin Endosc 2025;58(1):112-120.   Published online August 5, 2024
DOI: https://doi.org/10.5946/ce.2024.168
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Background
/Aims: The real-world effectiveness of computer-aided detection (CADe) systems during colonoscopies remains uncertain. We assessed the effectiveness of the novel CADe system, ENdoscopy as AI-powered Device (ENAD), in enhancing the adenoma detection rate (ADR) and other quality indicators in real-world clinical practice.
Methods
We enrolled patients who underwent elective colonoscopies between May 2022 and October 2022 at a tertiary healthcare center. Standard colonoscopy (SC) was compared to ENAD-assisted colonoscopy. Eight experienced endoscopists performed the procedures in randomly assigned CADe- and non-CADe-assisted rooms. The primary outcome was a comparison of ADR between the ENAD and SC groups.
Results
A total of 1,758 sex- and age-matched patients were included and evenly distributed into two groups. The ENAD group had a significantly higher ADR (45.1% vs. 38.8%, p=0.010), higher sessile serrated lesion detection rate (SSLDR) (5.7% vs. 2.5%, p=0.001), higher mean number of adenomas per colonoscopy (APC) (0.78±1.17 vs. 0.61±0.99; incidence risk ratio, 1.27; 95% confidence interval, 1.13–1.42), and longer withdrawal time (9.0±3.4 vs. 8.3±3.1, p<0.001) than the SC group. However, the mean withdrawal times were not significantly different between the two groups in cases where no polyps were detected (6.9±1.7 vs. 6.7±1.7, p=0.058).
Conclusions
ENAD-assisted colonoscopy significantly improved the ADR, APC, and SSLDR in real-world clinical practice, particularly for smaller and nonpolypoid adenomas.

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  • Clinical Efficacy of Real-Time Artificial Intelligence-Assisted Colonoscopy in Colorectal Polyp Detection: A Prospective Multicenter Randomized Controlled Trial
    Han Jo Jeon, Bora Keum, Eui Sun Jeong, Seong-Eun Kim, Chang Mo Moon, Bomee Lee, Sanghyun Kim, Hyuk Soon Choi, Jae Min Lee, Eun Sun Kim, Yoon Tae Jeen
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    Justin Ryan Lay Tan, Keith Brian Tan Enriquez, Kenneth Vergel Tecson Aballe, Mary Anne Gonzales Go, Michael Louie Ong Lim, Jonard Tan Co
    Clinical Endoscopy.2026; 59(1): 106.     CrossRef
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    Peter Kokol, Bojan Žlahtič, Helena Blažun Vošner, Jernej Završnik, Tadej Završnik
    Applied Sciences.2026; 16(3): 1524.     CrossRef
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    Miguel Suarez, Raquel Martínez, Félix González-Martínez, Ana María Torres, Jorge Mateo
    World Journal of Hepatology.2026;[Epub]     CrossRef
  • Computer-aided polyp detection multicenter international randomized controlled study with a focus on community clinics: Gastroenterology Artificial INtelligence system for detecting colorectal polyps
    Cadman L. Leggett, R. Scooter Plowman, Lindsey Surace, Emmanuel Gorospe, Jesse Lachter, Dana Ben-Ami Shor, Keith Friedenberg, David A. Leiman, Simon Schlachter, Anil Patwardhan, Roman Goldenberg, Ehud Rivlin, Leera Choi, Nayantara Coelho-Prabhu, Tonya Kal
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    Alan Barkun, Daniel Von Renteln, Shadi Shuraida, Dragos Vieru
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    Yunho Jung
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    Ji Hyun Kim, Sung Chul Park, Hyun-Soo Kim
    The Korean Journal of Gastroenterology.2025; 85(2): 137.     CrossRef
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    Eun Jeong Gong, Chang Seok Bang
    Diagnostics.2025; 15(12): 1478.     CrossRef
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    Negin Letafatkar, Amr Ali Mohamed Abdelgawwad El-Sehrawy, KDV Prasad, Ahmad Alkhayyat, Ehsan Amini-Salehi, Maryam Hasanpour, Masoomeh Namdar Taleshani, Mohammad Hashemi, Hadi Alotaibi, Pegah Rashidian, Mohammad-Hossein Keivanlou, Soheil Hassanipour
    Frontiers in Medicine.2025;[Epub]     CrossRef
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    Jeong Hoon Kim, Jade Wang, Colton Pence, Patrick Magahis, Enad Dawod, Felice Schnoll-Sussman, Reem Z. Sharaiha, David Wan
    Clinical Endoscopy.2025; 58(3): 438.     CrossRef
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    Wai Phyo Lwin, Katsuro Ichimasa, Shin-Ei Kudo, Yuta Kouyama, Taishi Okumura, Yasuharu Maeda, Yutaro Ide, Khay Guan Yeoh, Masashi Misawa
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    Muhammad N Yousaf, Neal Sharma, Michelle L Matteson-Kome, Srinivas Puli, Douglas Nguyen, Matthew L Bechtold
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    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
    Biomimetics.2024; 9(12): 783.     CrossRef
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Endoscopic management of giant colonic polyps: a retrospective Italian study
Paolo Quitadamo, Sara Isoldi, Germana De Nucci, Giulia Muzi, Flora Caruso
Clin Endosc 2024;57(4):501-507.   Published online June 5, 2024
DOI: https://doi.org/10.5946/ce.2023.229
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Background
/Aims: Polyps greater than 30 mm are classified as “giants”. Their endoscopic removal represents a technical challenge. The choice of the endoscopic removal technique is important because it provides a resection sample for precise histopathological staging. This is pivotal for diagnostic, prognostic, and management purposes.
Methods
From a retrospective analysis, we obtained a sample of 38 giant polyps. Eighteen polypectomies were performed using the epinephrine volume reduction (EVR) method, nine polypectomies utilized endo-looping or clipping methods, and 11 patients underwent surgery.
Results
We obtained en bloc resection with the EVR method in all cases; histology confirmed the correct indication for endoscopic resection in all cases. Moreover, no early or delayed complications were observed, and no patient required hospitalization. Using endo-looping or clipping methods, we observed advanced histology in 1/9 (11.1%) cases, while another patient (1/9, 11.1%) had delayed bleeding. Among patients who underwent surgery, 5/11 (45.5%) were deemed overtreated and three had post-surgical complications.
Conclusions
We propose EVR as an alternative technique for giant polyp resection due to its safety, effectiveness, cost-efficiency, and the advantage of avoiding the need to postpone polypectomy to a later time. Further prospective studies might help improve this experience and enhance the technique.

Citations

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  • Development and validation of a predictive model for pathological upgrading in colorectal polyps based on endoscopic forceps biopsy
    Ziyao Cheng, Chang Zhang, Feng Yu
    Frontiers in Medicine.2026;[Epub]     CrossRef
  • Safe endoscopic resection of a giant pedunculated colonic polyp after epinephrine volume reduction with clip placement
    Tsukasa Ishida, Hiroyuki Hashimoto, Akiko Shioya, Masaru Takimoto, Yusuke Nakata, Taro Tanaka, Yukako Masuko, Takashi Nakashima
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    Amit Bagrodia, Venkatesh Vaithiyam, Supraja Laguduva Mohan
    World Journal of Gastrointestinal Endoscopy.2025;[Epub]     CrossRef
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    Yunho Jung
    Clinical Endoscopy.2024; 57(4): 468.     CrossRef
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  • 4 Crossref
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Performance comparison between two computer-aided detection colonoscopy models by trainees using different false positive thresholds: a cross-sectional study in Thailand
Kasenee Tiankanon, Julalak Karuehardsuwan, Satimai Aniwan, Parit Mekaroonkamol, Panukorn Sunthornwechapong, Huttakan Navadurong, Kittithat​ Tantitanawat, Krittaya Mekritthikrai, Salin Samutrangsi, Peerapon Vateekul, Rungsun Rerknimitr
Clin Endosc 2024;57(2):217-225.   Published online February 7, 2024
DOI: https://doi.org/10.5946/ce.2023.145
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
/Aims: This study aims to compare polyp detection performance of “Deep-GI,” a newly developed artificial intelligence (AI) model, to a previously validated AI model computer-aided polyp detection (CADe) using various false positive (FP) thresholds and determining the best threshold for each model.
Methods
Colonoscopy videos were collected prospectively and reviewed by three expert endoscopists (gold standard), trainees, CADe (CAD EYE; Fujifilm Corp.), and Deep-GI. Polyp detection sensitivity (PDS), polyp miss rates (PMR), and false-positive alarm rates (FPR) were compared among the three groups using different FP thresholds for the duration of bounding boxes appearing on the screen.
Results
In total, 170 colonoscopy videos were used in this study. Deep-GI showed the highest PDS (99.4% vs. 85.4% vs. 66.7%, p<0.01) and the lowest PMR (0.6% vs. 14.6% vs. 33.3%, p<0.01) when compared to CADe and trainees, respectively. Compared to CADe, Deep-GI demonstrated lower FPR at FP thresholds of ≥0.5 (12.1 vs. 22.4) and ≥1 second (4.4 vs. 6.8) (both p<0.05). However, when the threshold was raised to ≥1.5 seconds, the FPR became comparable (2 vs. 2.4, p=0.3), while the PMR increased from 2% to 10%.
Conclusions
Compared to CADe, Deep-GI demonstrated a higher PDS with significantly lower FPR at ≥0.5- and ≥1-second thresholds. At the ≥1.5-second threshold, both systems showed comparable FPR with increased PMR.

Citations

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  • Comparison of colon adenoma detection rate using cap-assisted and artificial intelligence-assisted colonoscopy at a tertiary hospital in the Philippines: a propensity score-matched analysis
    Justin Ryan Lay Tan, Keith Brian Tan Enriquez, Kenneth Vergel Tecson Aballe, Mary Anne Gonzales Go, Michael Louie Ong Lim, Jonard Tan Co
    Clinical Endoscopy.2026; 59(1): 106.     CrossRef
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    Rungsun Rerknimitr
    Best Practice & Research Clinical Gastroenterology.2026; 80: 102091.     CrossRef
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    Martin Putera, Frederick Hong Xiang Koh, James Weiquan Li
    Digestion.2026; : 1.     CrossRef
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    Nikko Gimpaya, Joshua Landy, William T. Tran, Samir C. Grover
    Gastrointestinal Endoscopy Clinics of North America.2026; 36(3): 581.     CrossRef
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    Vipul Yagnik, Prema Choudhary, Pankaj Garg
    Clinical and Experimental Gastroenterology.2026; Volume 19: 1.     CrossRef
  • Effectiveness of a novel artificial intelligence-assisted colonoscopy system for adenoma detection: a prospective, propensity score-matched, non-randomized controlled study in Korea
    Jung-Bin Park, Jung Ho Bae
    Clinical Endoscopy.2025; 58(1): 112.     CrossRef
  • GI Genius increases small and right-sided adenoma and sessile serrated lesion detection rate when used with EndoCuff in a real-world setting: a retrospective United States study
    Jeong Hoon Kim, Jade Wang, Colton Pence, Patrick Magahis, Enad Dawod, Felice Schnoll-Sussman, Reem Z. Sharaiha, David Wan
    Clinical Endoscopy.2025; 58(3): 438.     CrossRef
  • Understanding the discrepancy in the effectiveness of artificial intelligence-assisted colonoscopy: from randomized controlled trials to clinical reality
    Jung Ho Bae
    Clinical Endoscopy.2024; 57(6): 765.     CrossRef
  • Edge Artificial Intelligence Device in Real-Time Endoscopy for Classification of Gastric Neoplasms: Development and Validation Study
    Eun Jeong Gong, Chang Seok Bang, Jae Jun Lee
    Biomimetics.2024; 9(12): 783.     CrossRef
  • 8,935 View
  • 214 Download
  • 8 Web of Science
  • 9 Crossref
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Review
Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials
Mizuki Nagai, Sho Suzuki, Yohei Minato, Fumiaki Ishibashi, Kentaro Mochida, Ken Ohata, Tetsuo Morishita
Clin Endosc 2023;56(5):553-562.   Published online July 26, 2023
DOI: https://doi.org/10.5946/ce.2023.055
AbstractAbstract PDF
Colonoscopy plays an important role in reducing the incidence and mortality of colorectal cancer by detecting adenomas and other precancerous lesions. Image-enhanced endoscopy (IEE) increases lesion visibility by enhancing the microstructure, blood vessels, and mucosal surface color, resulting in the detection of colorectal lesions. In recent years, various IEE techniques have been used in clinical practice, each with its unique characteristics. Numerous studies have reported the effectiveness of IEE in the detection of colorectal lesions. IEEs can be divided into two broad categories according to the nature of the image: images constructed using narrowband wavelength light, such as narrowband imaging and blue laser imaging/blue light imaging, or color images based on white light, such as linked color imaging, texture and color enhancement imaging, and i-scan. Conversely, artificial intelligence (AI) systems, such as computer-aided diagnosis systems, have recently been developed to assist endoscopists in detecting colorectal lesions during colonoscopy. To better understand the features of each IEE, this review presents the effectiveness of each type of IEE and their combination with AI for colorectal lesion detection by referencing the latest research data.

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    World Journal of Gastrointestinal Endoscopy.2025;[Epub]     CrossRef
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    Tsuyoshi Ishii, Toshihiro Nishizawa, Hidenobu Watanabe, Masaya Sano, Ai Fujimoto, Yoshiyuki Takahashi, Ryo Shimizu, Hirotoshi Ebinuma, Takahisa Matsuda, Osamu Toyoshima
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    Eyad Gadour
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    Byung Wook Jung
    The Korean Journal of Gastroenterology.2025; 85(4): 579.     CrossRef
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    Phuoc Huu Tran, Thi Huyen Thuong Nguyen, Van Huy Tran
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    Kyueng-Whan Min, One-Zoong Kim
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    Stefan Mitev, Humza Saeed, Ch Faizan Rasheed, Abdullah, Stefan Murvakov, Vassil Sirakov, Stefan Tchernodrinski, Zoya Spassova
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    Yong Soo Kwon, Su Young Kim
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    Donghwan Kim, Eunsun Kim
    Journal of the Korean Medical Association.2023; 66(11): 658.     CrossRef
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Original Article
Utility of narrow-band imaging with or without dual focus magnification in neoplastic prediction of small colorectal polyps: a Vietnamese experience
Tien Manh Huynh, Quang Dinh Le, Nhan Quang Le, Huy Minh Le, Duc Trong Quach
Clin Endosc 2023;56(4):479-489.   Published online May 24, 2023
DOI: https://doi.org/10.5946/ce.2022.212
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
/Aims: Accurate neoplastic prediction can significantly decrease costs associated with pathology and unnecessary colorectal polypectomies. Narrow band imaging (NBI) and dual-focus (DF) mode are promising emerging optical technologies for recognizing neoplastic features of colorectal polyps digitally. This study aimed to clarify the clinical usefulness of NBI with and without DF assistance in the neoplastic prediction of small colorectal polyps (<10 mm).
Methods
This cross-sectional study included 530 small colorectal polyps from 343 consecutive patients who underwent colonoscopy at the University Medical Center from September 2020 to May 2021. Each polyp was endoscopically diagnosed in three successive steps using white-light endoscopy (WLE), NBI, and NBI-DF and retrieved for histopathological assessment. The diagnostic accuracy of each modality was evaluated with reference to histopathology.
Results
There were 295 neoplastic polyps and 235 non-neoplastic polyps. The overall accuracies of WLE, WLE+NBI, and WLE+NBI+NBI-DF in the neoplastic prediction of colorectal polyps were 70.8%, 87.4%, and 90.8%, respectively (p<0.001). The accuracy of WLE+NBI+NBI-DF was significantly higher than that of WLE+NBI in the polyp size ≤5 mm subgroup (87.3% vs. 90.1%, p<0.001).
Conclusions
NBI improved the real-time neoplastic prediction of small colorectal polyps. The DF mode was especially useful in polyps ≤5 mm in size.

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    绩徽 李
    Asian Case Reports in Emergency Medicine.2025; 13(02): 146.     CrossRef
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    Jin Hwa Park
    Clinical Endoscopy.2023; 56(4): 455.     CrossRef
  • Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
    Yong Soo Kwon, Su Young Kim
    Journal of the Korean Medical Association.2023; 66(11): 652.     CrossRef
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  • 120 Download
  • 5 Web of Science
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Systematic Review and Meta-Analysis
Outcomes of thin versus thick-wire snares for cold snare polypectomy: a systematic review and meta-analysis
Suprabhat Giri, Vaneet Jearth, Harish Darak, Sridhar Sundaram
Clin Endosc 2022;55(6):742-750.   Published online November 9, 2022
DOI: https://doi.org/10.5946/ce.2022.141
AbstractAbstract PDFSupplementary Material
Background
/Aims: Cold snare polypectomy (CSP) is commonly used for the resection of colorectal polyps ≤10 mm. Data regarding the influence of snare type on CSP effectiveness are conflicting. Hence, this meta-analysis aimed to compare the outcomes and safety of thin- and thick-wire snares for CSP.
Methods
A comprehensive search of the literature published between 2000 and 2021 was performed of various databases for comparative studies evaluating the outcomes of thin- versus thick-wire snares for CSP.
Results
Five studies with data on 1,425 polyps were included in the analysis. The thick-wire snare was comparable to the thin-wire snare with respect to complete histological resection (risk ratio [RR], 1.03; 95% confidence interval [CI], 0.97–1.09), overall bleeding (RR, 0.98; 95% CI, 0.40–2.40), polyp retrieval (RR, 1.01; 95% CI, 0.97–1.04), and involvement of submucosa in the resection specimen (RR, 1.28; 95% CI, 0.72–2.28). There was no publication bias and a small study effect, and the relative effects remained the same in the sensitivity analysis.
Conclusions
CSP using a thin-wire snare has no additional benefit over thick-wire snares in small colorectal polyps. Factors other than snare design may play a role in improving CSP outcomes.

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  • High‐Performance Dedicated Snares with Tip Attachments can Overcome Current Disadvantages in Cold Snare Polypectomy
    Ryohei Hirose, Naohisa Yoshida, Takuma Yoshida, Hiroki Mukai, Katsuma Yamauchi, Hajime Miyazaki, Naoto Watanabe, Risa Bandou, Ken Inoue, Osamu Dohi, Yoshikazu Inagaki, Yutaka Inada, Takaaki Murakami, Akio Yanagisawa, Hiroshi Ikegaya, Takaaki Nakaya, Yoshi
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    Hye Kyung Jeon, Gwang Ha Kim
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    Giulia Gibiino, Cecilia Binda, Matteo Secco, Lorenzo Cosentino, Francesco Poggioli, Stefania Cappetta, Davide Trama, Andrea Fabbri, Chiara Coluccio, Carlo Fabbri
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    Ryohei Hirose, Takuma Yoshida, Naohisa Yoshida, Katsuma Yamauchi, Hajime Miyazaki, Naoto Watanabe, Risa Bandou, Ken Inoue, Hiroshi Ikegaya, Takaaki Nakaya, Yoshito Itoh
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    Rishad Khan, Sunil Samnani, Marcus Vaska, Samir C Grover, Catharine M Walsh, Jeffrey Mosko, Michael J Bourke, Steven J Heitman, Nauzer Forbes
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    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
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    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
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    Seung Joo Kang, Chung Hyun Tae, Chang Seok Bang, Cheol Min Shin, Young-Hoon Jeong, Miyoung Choi, Joo Ha Hwang, Yutaka Saito, Philip Wai Yan Chiu, Rungsun Rerknimitr, Christopher Khor, Vu Van Khien, Kee Don Choi, Ki-Nam Shim, Geun Am Song, Oh Young Lee
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Original Article
Endoscopic and histological characteristics of small bowel tumors diagnosed by double-balloon enteroscopy
Suleyman Dolu, Soner Onem, Zarni Htway, Farid Hajıyev, Ali Bilgen, Hatice Cilem Binicier, Ecem Kalemoglu, Ozgul Sagol, Mesut Akarsu
Clin Endosc 2023;56(1):83-91.   Published online October 27, 2022
DOI: https://doi.org/10.5946/ce.2022.131
AbstractAbstract PDF
Background
/Aims: Double-balloon enteroscopy (DBE) allows for the diagnoses and treatment of small bowel tumors (SBTs). This study aimed to evaluate the utility of DBE for the diagnosis and treatment of SBTs.
Methods
Patients diagnosed with SBTs who underwent DBE were included in this study. According to their endoscopic appearances, they were categorized as polyps or masses, and according to their histological characteristics, they were categorized as benign or malignant SBTs.
Results
A total of 704 patients were retrospectively analyzed, and 90 (12.8%) were diagnosed with SBTs. According to their endoscopic appearance, 48 (53.3%) had polyps and 42 (46.7%) had masses. Additionally, 53 (58.9%) and 37 (41.1%) patients had malignant and benign SBTs, respectively, depending on their histological characteristics. Patients diagnosed with polyps were younger than those diagnosed with masses (p<0.001). Patients diagnosed with benign SBTs were younger than those diagnosed with malignant SBT (p<0.001). Overall, histological diagnosis was determined using DBE in 73 (81.1%) patients.
Conclusions
DBE is a useful method for diagnosing SBTs. Additionally, the histological type of the lesion can be determined using DBE.

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    Cosmin Vasile Obleaga, Sergiu Marian Cazacu, Cecil Sorin Mirea, Radu Mesina, Alexandru Marin Pascu, Georgica Costinel Târtea, Mirela-Marinela Florescu, Dragos-Florin Vasile, Lucian Mihai Florescu, Ion Vasile, Cristin Constantin Vere
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    Suleyman Dolu, Mehmet Emin Arayici, Soner Onem, Ilker Buyuktorun, Huseyin Dongelli, Goksel Bengi, Mesut Akarsu
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    Suleyman Dolu, Mehmet Emin Arayici, Soner Onem, Huseyin Dongelli, Mesut Akarsu
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Review
Korean guidelines for postpolypectomy colonoscopic surveillance: 2022 revised edition
Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases
Clin Endosc 2022;55(6):703-725.   Published online October 13, 2022
DOI: https://doi.org/10.5946/ce.2022.136
AbstractAbstract PDFSupplementary Material
Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for the management of advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: (1) adenoma ≥10 mm in size; (2) 3 to 5 (or more) adenomas; (3) tubulovillous or villous adenoma; (4) adenoma containing high-grade dysplasia; (5) traditional serrated adenoma; (6) sessile serrated lesion (SSL) containing any grade of dysplasia; (7) serrated polyp of at least 10 mm in size; and (8) 3 to 5 (or more) SSLs. More studies are needed to fully comprehend the patients most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

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Original Articles
Optical diagnosis by near-focus versus normal-focus narrow band imaging colonoscopy in colorectal polyps based on combined NICE and WASP classification: a randomized controlled trial
Nisa Netinatsunton, Natcha Cheewasereechon, Tanawat Pattarapuntakul, Jaksin Sottisuporn, Kanet Kanjanapradit, Bancha Ovartlarnporn
Clin Endosc 2022;55(5):645-654.   Published online September 8, 2022
DOI: https://doi.org/10.5946/ce.2022.048
AbstractAbstract PDFSupplementary Material
Background
/Aims: Narrow Band Imaging (NBI) International Colorectal Endoscopic (NICE) and Workgroup Serrated Polyps and Polyposis (WASP) classifications were developed for optical diagnosis of neoplastic and sessile serrated polyps, respectively. Near-focus NBI with NICE combined with WASP criteria for optical diagnosis of colonic polyps has not yet been evaluated. We aimed to compare the accuracy of near-focus NBI (group A) with normal-focus NBI (group B) in real-time optical diagnosis of colorectal polyps using combined NICE and WASP criteria.
Methods
Among 362 patients, 118 with 227 polyps were recruited. Groups A and B included 62 patients with 130 polyps (three lost polyps) and 56 patients with 106 polyps (six lost polyps), respectively. Optical diagnoses were compared with pathological reports.
Results
The accuracy of optical diagnosis of neoplastic polyps in groups A and B was not significantly different (76% vs. 71%, p=0.52). WASP criteria provided all false positive diagnoses of sessile polyps as serrated polyps in 31 (16.2%) patients.
Conclusions
Near-focus NBI was not superior to normal-focus NBI in optical diagnostics of neoplastic polyps using NICE criteria. In our study, WASP classification yielded all false positives in the diagnosis of sessile serrated adenomas/polyps. Routine real-life optical diagnosis of polyps is still unadvisable.

Citations

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Factors influencing endoscopic estimation of colon polyp size in a colon model
Koen Robert Beukema, Jaimy A. Simmering, Marjolein Brusse-Keizer, Sneha John, Rutger Quispel, Peter B. Mensink
Clin Endosc 2022;55(4):540-548.   Published online July 28, 2022
DOI: https://doi.org/10.5946/ce.2022.017
AbstractAbstract PDF
Background
/Aims: Colorectal polyps are removed to prevent progression to colorectal cancer. Polyp size is an important factor for risk stratification of malignant transformation. Endoscopic size estimation correlates poorly with pathological reports and several factors have been suggested to influence size estimation. We aimed to gain insight into the factors influencing endoscopic polyp size estimation.
Methods
Images of polyps in an artificial model were obtained at 1, 3, and 5 cm from the colonoscope’s tip. Participants were asked to estimate the diameter and volume of each polyp.
Results
Fifteen endoscopists from three large-volume centers participated in this study. With an intraclass correlation coefficient of 0.66 (95% confidence interval [CI], 0.62–0.71) for diameter and 0.56 (95% CI, 0.50–0.62) for volume. Polyp size estimated at 3 cm from the colonoscope’s tip yielded the best results. A lower distance between the tip and the polyp was associated with a larger estimated polyp size.
Conclusions
Correct endoscopic estimation of polyp size remains challenging. This finding can affect size estimation skills and future training programs for endoscopists.

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Reviews
Post-polypectomy surveillance: the present and the future
Masau Sekiguchi, Takahisa Matsuda, Kinichi Hotta, Yutaka Saito
Clin Endosc 2022;55(4):489-495.   Published online July 11, 2022
DOI: https://doi.org/10.5946/ce.2022.097
AbstractAbstract PDF
An appropriate post-polypectomy surveillance program requires the effectiveness of reducing colorectal cancer and safety. In addition, the post-polypectomy surveillance program should consider the burden of limited medical resource capacity, cost-effectiveness, and patient adherence. In this sense, a risk-stratified surveillance program based on baseline colonoscopy results is ideal. Major international guidelines for post-polypectomy surveillance, such as those from the European Union and the United States, have recommended risk-stratified surveillance programs. Both guidelines have recently been updated to better differentiate between high- and low-risk individuals. In both updated guidelines, more individuals have been downgraded to lower-risk groups that require less frequent or no surveillance. Furthermore, increased attention has been paid to the surveillance of patients who undergo serrated polyp removal. Previous guidelines in Japan did not clearly outline the risk stratification in post-polypectomy surveillance. However, the new colonoscopy screening and surveillance guidelines presented by the Japan Gastroenterological Endoscopy Society include a risk-stratified post-polypectomy surveillance program. Further discussion and analysis of unresolved issues in this field, such as the optimal follow-up after the first surveillance, the upper age limit for surveillance, and the ideal method for improving adherence to surveillance guidelines, are warranted.

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Can Computed Tomography Colonography Replace Optical Colonoscopy in Detecting Colorectal Lesions?: State of the Art
Alessia Chini, Michele Manigrasso, Grazia Cantore, Rosa Maione, Marco Milone, Francesco Maione, Giovanni Domenico De Palma
Clin Endosc 2022;55(2):183-190.   Published online February 24, 2022
DOI: https://doi.org/10.5946/ce.2021.254
AbstractAbstract PDF
Colorectal cancer is an important cause of morbidity and mortality worldwide. Optical colonoscopy (OC) is widely accepted as the reference standard for the screening of colorectal polyps and cancers, and computed tomography colonography (CTC) is a valid alternative to OC. The purpose of this review was to assess the diagnostic accuracy of OC and CTC for colorectal lesions. A literature search was performed in PubMed, Embase, and Cochrane Library, and 18 articles were included. CTC has emerged in recent years as a potential screening examination with high accuracy for the detection of colorectal lesions. However, the clinical application of CTC as a screening technique is limited because it is highly dependent on the size of the lesions and has poor performance in detecting individual lesions <5 mm or flat lesions, which, although rarely, can have a malignant potential.

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Case Report
Less invasive transoral resection of esophageal fibrovascular polyps: case reports
Janusz Włodarczyk, Tomasz Smęder
Clin Endosc 2022;55(5):683-687.   Published online December 6, 2021
DOI: https://doi.org/10.5946/ce.2021.144
AbstractAbstract PDF
We report five patients treated for esophageal fibrovascular polyps using a minimally invasive technique. Esophageal fibrovascular polyps are benign pedunculated submucosal tumors of considerable size. The treated polyps size ranged from 1.5 to 13 cm. The polyps were removed by relocation to the oral cavity under endoscopic control. No perioperative complications occurred after the treatment. The follow-up of patients after surgery was 9–89 months, with no evidence of polyp recurrence. Thus, the described treatment is safe but requires experience with endoscopy as well as esophageal surgery.

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Review
Current Treatment Strategy for Superficial Nonampullary Duodenal Epithelial Tumors
Tetsuya Suwa, Kohei Takizawa, Noboru Kawata, Masao Yoshida, Yohei Yabuuchi, Yoichi Yamamoto, Hiroyuki Ono
Clin Endosc 2022;55(1):15-21.   Published online September 29, 2021
DOI: https://doi.org/10.5946/ce.2021.141
AbstractAbstract PDF
Endoscopic submucosal dissection (ESD) is the standard treatment method for esophageal, gastric, and colorectal cancers. However, it has not been standardized for duodenal lesions because of its high complication rates. Recently, minimally invasive and simple methods such as cold snare polypectomy and underwater endoscopic mucosal resection have been utilized more for superficial nonampullary duodenal epithelial tumors (SNADETs). Although the rate of complications associated with duodenal ESD has been gradually decreasing because of technical advancements, performing ESD for all SNADETs is unnecessary. As such, the appropriate treatment plan for SNADETs should be chosen according to the lesion type, patient condition, and endoscopist’s skill.

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    Michael Ghadimi, Jochen Gaedcke
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Original Article
Artificial Intelligence-Based Colorectal Polyp Histology Prediction by Using Narrow-Band Image-Magnifying Colonoscopy
Istvan Racz, Andras Horvath, Noemi Kranitz, Gyongyi Kiss, Henriett Regoczi, Zoltan Horvath
Clin Endosc 2022;55(1):113-121.   Published online September 23, 2021
DOI: https://doi.org/10.5946/ce.2021.149
AbstractAbstract PDF
Background
/Aims: We have been developing artificial intelligence based polyp histology prediction (AIPHP) method to classify Narrow Band Imaging (NBI) magnifying colonoscopy images to predict the hyperplastic or neoplastic histology of polyps. Our aim was to analyze the accuracy of AIPHP and narrow-band imaging international colorectal endoscopic (NICE) classification based histology predictions and also to compare the results of the two methods.
Methods
We studied 373 colorectal polyp samples taken by polypectomy from 279 patients. The documented NBI still images were analyzed by the AIPHP method and by the NICE classification parallel. The AIPHP software was created by machine learning method. The software measures five geometrical and color features on the endoscopic image.
Results
The accuracy of AIPHP was 86.6% (323/373) in total of polyps. We compared the AIPHP accuracy results for diminutive and non-diminutive polyps (82.1% vs. 92.2%; p=0.0032). The accuracy of the hyperplastic histology prediction was significantly better by NICE compared to AIPHP method both in the diminutive polyps (n=207) (95.2% vs. 82.1%) (p<0.001) and also in all evaluated polyps (n=373) (97.1% vs. 86.6%) (p<0.001)
Conclusions
Our artificial intelligence based polyp histology prediction software could predict histology with high accuracy only in the large size polyp subgroup.

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    Clinical Endoscopy.2023; 56(5): 553.     CrossRef
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    Donghwan Kim, Eunsun Kim
    Journal of the Korean Medical Association.2023; 66(11): 658.     CrossRef
  • Artificial Intelligence-Based Colorectal Polyp Histology Prediction: High Accuracy in Larger Polyps
    Naoki Muguruma, Tetsuji Takayama
    Clinical Endoscopy.2022; 55(1): 45.     CrossRef
  • Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
    Ji Young Chang
    Clinical Endoscopy.2022; 55(5): 699.     CrossRef
  • Response to Artificial intelligence-based colorectal polyp histology prediction using narrow-band image-magnifying colonoscopy: a stepping stone for clinical practice
    Istvan Racz, Andras Horvath, Zoltán Horvath
    Clinical Endoscopy.2022; 55(5): 701.     CrossRef
  • 10,208 View
  • 238 Download
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Case Reports
A large and pedunculated inflammatory pseudotumor with pseudosarcomatous change of the cecum mimicking a malignant polyp: a case report and literature review
Jong Suk Oh, Hyung Wook Kim, Su Bum Park, Dae Hwan Kang, Cheol Woong Choi, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu
Clin Endosc 2023;56(1):119-124.   Published online July 19, 2021
DOI: https://doi.org/10.5946/ce.2021.081
AbstractAbstract PDF
Inflammatory pseudotumor (IPT) is a rare benign tumor of unknown etiology that can occur in almost any organ system. It has neoplastic features such as local recurrence, invasive growth, and vascular invasion, leading to the possibility of malignant sarcomatous changes. The clinical presentations of colonic IPT may include abdominal pain, anemia, a palpable mass, and intestinal obstruction. A few cases of colonic IPT have been reported, but colonic IPT with pedunculated morphology is very rare. Furthermore, since it can mimic malignant polyps, understanding the endoscopic findings of colonic IPT is important for proper treatment. Herein, we present a case of colonic IPT with pseudosarcomatous changes, presenting as a large polyp, mimicking a malignant polyp in the cecum, along with a literature review.
  • 7,855 View
  • 232 Download
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Extracutaneous mastocytoma of colon: a case report and literature review
Min Su Chu, Eui Joong Kim
Clin Endosc 2022;55(6):810-814.   Published online July 7, 2021
DOI: https://doi.org/10.5946/ce.2021.003
AbstractAbstract PDF
Extracutaneous mastocytoma is a rare benign tumor composed of mature mast cells and is located in tissues other than the skin. We report the case of a 61-year-old male who was diagnosed with extracutaneous mastocytoma via colonoscopic polypectomy and biopsy. To our knowledge, this was the first case of a solitary extracutaneous mastocytoma of the colon. We reported this case and reviewed the literature.

Citations

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  • Incidental discovery of KIT‐mutated mastocytoma in a colon polyp
    Naseema Gangat, Ellen McPhail, Kaaren Reichard, Attilio Orazi, Animesh Pardanani, Ayalew Tefferi
    American Journal of Hematology.2024; 99(5): 973.     CrossRef
  • 7,320 View
  • 179 Download
  • 1 Web of Science
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Original Articles
Underwater Endoscopic Mucosal Resection for 10 mm or Larger Nonpedunculated Colorectal Polyps: A Systematic Review and Meta-Analysis
Rajat Garg, Amandeep Singh, Manik Aggarwal, Jaideep Bhalla, Babu P. Mohan, Carol Burke, Tarun Rustagi, Prabhleen Chahal
Clin Endosc 2021;54(3):379-389.   Published online April 29, 2021
DOI: https://doi.org/10.5946/ce.2020.276
AbstractAbstract PDFSupplementary Material
Background
/Aims: Recent studies have reported the favorable outcomes of underwater endoscopic mucosal resection (UEMR) for colorectal polyps. We performed a systematic review and meta-analysis evaluating the efficacy and safety of UEMR for nonpedunculated polyps ≥10 mm.
Methods
We performed a comprehensive search of multiple databases (through May 2020) to identify studies reporting the outcomes of UEMR for ≥10 mm nonpedunculated colorectal polyps. The assessed outcomes were recurrence rate on the first follow-up, en bloc resection, incomplete resection, and adverse events after UEMR.
Results
A total of 1276 polyps from 16 articles were included in our study. The recurrence rate was 7.3% (95% confidence interval [CI], 4.3–12) and 5.9% (95% CI, 3.6–9.4) for nonpedunculated polyps ≥10 and ≥20 mm, respectively. For nonpedunculated polyps ≥10 mm, the en bloc resection, R0 resection, and incomplete resection rates were 57.7% (95% CI, 42.4–71.6), 58.9% (95% CI, 42.4–73.6), and 1.5% (95% CI, 0.8–2.6), respectively. The rates of pooled adverse events, intraprocedural bleeding, and delayed bleeding were 7.0%, 5.4%, and 2.9%, respectively. The rate of perforation and postpolypectomy syndrome was 0.8%.
Conclusions
Our systematic review and meta-analysis demonstrates that UEMR for nonpedunculated colorectal polyps ≥10 mm is safe and effective with a low rate of recurrence.

Citations

Citations to this article as recorded by  
  • Underwater endoscopy in the diagnosis and therapy of gastrointestinal neoplasia: focus on the lower gastrointestinal tract
    Georgios Kalopitas, Zaheer Nabi, Elisabet Maristany Bosch, Jahnvi Dhar, Jayanta Samanta, Edward J Despott
    Frontline Gastroenterology.2026; 17(e1): e112.     CrossRef
  • Management of non-ampullary duodenal adenomas
    Gaurav B Nigam, Yash Kanani, Amol Bapaye, Pradeep Mundre
    Frontline Gastroenterology.2026; 17(e1): e48.     CrossRef
  • Endoscopic Resection for Superficial Non-Ampullary Duodenal Epithelial Tumors
    Hye Kyung Jeon, Gwang Ha Kim
    Gut and Liver.2025; 19(1): 19.     CrossRef
  • Underwater vs conventional endoscopic mucosal resection for nonpedunculated colorectal neoplasms: A randomized controlled trial
    Quang D Le, Nhan Q Le, Duc T Quach
    World Journal of Gastrointestinal Surgery.2025;[Epub]     CrossRef
  • New chapter in precision medicine: strategies for endoscopic resection of 10–20 mm non-pedunculated colorectal polyps
    Changwei Duan, Zhen Liu, Xin Wang, Mingjie Zhang, Jianqiu Sheng, Yuqi He, Xianzong Ma
    Therapeutic Advances in Gastroenterology.2025;[Epub]     CrossRef
  • Current Management of Duodenal Neoplasia: Endoscopic Treatment for Large Superficial Non-Ampullary Duodenal Epithelial Tumor
    Kurato Miyazaki, Naohisa Yahagi, Motohiko Kato
    Digestion.2025; 107(3): 282.     CrossRef
  • Management of recurrent colorectal polyps post initial polypectomy: a review of the current evidence
    Giovanna McGinty, Zeino Zeino
    Frontline Gastroenterology.2025; : flgastro-2024-103016.     CrossRef
  • Water-assisted colonoscopy in inflammatory bowel diseases: From technical implications to diagnostic and therapeutic potentials
    Raffaele Pellegrino, Giovanna Palladino, Michele Izzo, Ilaria De Costanzo, Fabio Landa, Alessandro Federico, Antonietta Gerarda Gravina
    World Journal of Gastrointestinal Endoscopy.2024; 16(12): 647.     CrossRef
  • Underwater Versus Conventional Endoscopic Mucosal Resection for Colorectal Laterally Spreading Tumors: A Post Hoc Analysis of Efficacy
    Quang Dinh Le, Nhan Quang Le, Duc Trong Quach
    JGH Open.2024;[Epub]     CrossRef
  • Polypectomy Techniques for Pedunculated and Nonpedunculated Polyps
    Karl Kwok, Sasan Mosadeghi, Daniel Lew
    Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 361.     CrossRef
  • Underwater versus conventional endoscopic mucosal resection for colorectal lesions: a systematic review and meta-analysis of randomized clinical trials
    Matheus Henrique Gonçalves de Souza, Paula Arruda do Espirito Santo, Fauze Maluf-Filho, Luciano Lenz
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • Endoscopic treatment of colorectal polyps and early colorectal cancer
    Yunho Jung
    Journal of the Korean Medical Association.2023; 66(11): 642.     CrossRef
  • EMR and ESD: Indications, techniques and results
    Mamoon Ur Rashid, Mohammad Alomari, Sadaf Afraz, Tolga Erim
    Surgical Oncology.2022; 43: 101742.     CrossRef
  • Safety and effectiveness of underwater cold snare resection without submucosal injection of large non-pedunculated colorectal lesions
    Andrew W. Yen, Joseph W. Leung, Malcom Koo, Felix W. Leung
    Endoscopy International Open.2022; 10(06): E791.     CrossRef
  • Underwater or conventional endoscopic mucosal resection for intermediate‐sized colorectal neoplasm?
    Li‐Chun Chang
    Advances in Digestive Medicine.2021; 8(3): 133.     CrossRef
  • 12,440 View
  • 208 Download
  • 16 Web of Science
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Is Submucosal Injection Helpful in Cold Snare Polypectomy for Small Colorectal Polyps?
Ji Hyun Song, Shai Friedland
Clin Endosc 2021;54(3):397-403.   Published online February 9, 2021
DOI: https://doi.org/10.5946/ce.2020.226
AbstractAbstract PDF
Background
/Aims: Cold snare polypectomy (CSP) is an effective method of polyp removal for small colorectal polyps. However, the effect of submucosal injection in cold snare endoscopic mucosal resection (CS-EMR) for small polyps is unclear. Therefore, this study aimed to evaluate the effect of submucosal injection in CS-EMR for small polyps.
Methods
Between 2018 and 2019, 100 consecutive small colorectal polyps (5–10 mm) were identified in 58 patients. The first 50 consecutive polyps were removed by CS-EMR, and the remaining 50 were removed by CSP. Demographic data, clinical data, endoscopic findings, procedure times, complication rates, and pathology data were collected.
Results
No difference in the complete resection rate was observed between the CS-EMR and CSP groups. A total of 9 polyps showed post-polypectomy bleeding (7 had immediate bleeding, 1 had delayed bleeding, and 1 had both immediate and delayed bleeding). No difference in the bleeding rate was observed between the two groups. In multivariate analysis, warfarin (odds ratio [OR], 42.334; 95% confidence interval [CI], 1.006–1,781.758) and direct-acting oral anticoagulants (OR, 35.244; 95% CI, 3.853–322.397) showed a significantly increased risk of bleeding.
Conclusions
The effect of submucosal injection in CSP was not significant for small colorectal polyps.

Citations

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  • Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines
    Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong-Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, Eun R
    Gut and Liver.2025; 19(1): 77.     CrossRef
  • Impact of contrast dye submucosal pre-lifting on cold snare resection of small polyps: an Italian randomized observational trial
    Ramona Schiumerini, Paola Baccarini, Adele Fornelli, Davide Allegri, Francesca Lodato, Alessia Gazzola, Pasquale Apolito, Nunzio P. Longo, Anna M. Polifemo, Franca Patrizi, Federica Buonfiglioli, Stefania Ghersi, Marco Bassi, Liza Ceroni, Antonella Ghetti
    Clinical Endoscopy.2025; 58(2): 291.     CrossRef
  • Cold sub-mucosal injection versus traditional cold snare polypectomy for diminutive and small colorectal polyps: A systematic review and meta-analysis
    Yong-Cai Lv, Quan Dong, Yan-Hua Yao, Jing-Jing Lei
    Indian Journal of Gastroenterology.2024; 43(6): 1111.     CrossRef
  • Colorectal cold snare polypectomy: Current standard technique and future perspectives
    Fumiaki Ishibashi, Sho Suzuki, Mizuki Nagai, Kentaro Mochida, Tetsuo Morishita
    Digestive Endoscopy.2023; 35(3): 278.     CrossRef
  • The efficacy and safety of cold snare polypectomy with submucosal injection for the removal of polyps less than 20 mm in size: a systematic review and meta‐analysis
    Zheng Liang, Yongqiu Wei, Shutian Zhang, Peng Li
    Journal of Gastroenterology and Hepatology.2023; 38(11): 1892.     CrossRef
  • Impact of Submucosal Saline Injection During Cold Snare Polypectomy for Colorectal Polyps Sized 3–9 mm: A Multicenter Randomized Controlled Trial
    Yi Mou, Liansong Ye, Xiaobo Qin, Rui Feng, Lifan Zhang, Qin Hu, Tingting Cao, Xinyue Zhou, Wu Wen, Chuanming Zhang, Zonghua Chen, Yi Liu, Zhimin Yang, Tao Huo, Fang Pan, Xuelian Li, Bing Hu
    American Journal of Gastroenterology.2023; 118(10): 1848.     CrossRef
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    Antonio Capogreco, Ludovico Alfarone, Davide Massimi, Alessandro Repici
    Expert Review of Gastroenterology & Hepatology.2023; 17(7): 719.     CrossRef
  • Cold snare endoscopic mucosal resection for colon polyps: a systematic review and meta-analysis
    Mohamed Abdallah, Khalid Ahmed, Daniyal Abbas, Mouhand F. H. Mohamed, Gaurav Suryawanshi, Nicholas McDonald, Natalie Wilson, Shifa Umar, Aasma Shaukat, Mohammad Bilal
    Endoscopy.2023; 55(12): 1083.     CrossRef
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    Yunho Jung
    Journal of the Korean Medical Association.2023; 66(11): 642.     CrossRef
  • 9,617 View
  • 191 Download
  • 10 Web of Science
  • 9 Crossref
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Impact of Moderate versus Deep Sedation and Trainee Participation on Adenoma Detection Rate-Analysis of a Veteran Population
Hemnishil K. Marella, Nasir Saleem, Claudio Tombazzi
Clin Endosc 2021;54(2):250-255.   Published online December 15, 2020
DOI: https://doi.org/10.5946/ce.2020.091
AbstractAbstract PDF
Background
/Aims: The adenoma detection rate (ADR) is used as a quality indicator for screening and surveillance colonoscopy. The study aimed to determine if moderate versus deep sedation affects the outcomes of the ADR and other quality metrics in the veteran population.
Methods
A retrospective review of colonoscopies performed at Memphis Veterans Affairs Medical Center over a one-year period was conducted. A total of 900 colonoscopy reports were reviewed. After exclusion criteria, a total of 229 index, average-risk screening colonoscopies were identified. Data were collected to determine the impact of moderate (benzodiazepine plus opioids) versus deep (propofol) sedation on the ADR, polyp detection rate (PDR), and withdrawal time.
Results
Among 229 screening colonoscopies, 103 (44.9%) used moderate sedation while 126 (55%) were done under deep sedation. The ADR and PDR were not significantly different between moderate versus deep sedation at 35.9% vs. 37.3% (p=0.82) and 58.2% vs. 48.4% (p=0.13), respectively. Similarly, there was no significant difference in withdrawal time between moderate and deep sedation (13.4 min vs. 14 min, p=0.56) during screening colonoscopies.
Conclusions
In veterans undergoing index, average-risk screening colonoscopies, the quality metrics of the ADR, PDR, and withdrawal time are not influenced by deep sedation compared with moderate sedation.

Citations

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  • Is painless colonoscopy associated with trainee learning? A single-center study of insertion speed and adenoma detection curves in 1,769 procedures
    Yiming Ding, Hongjuan Wang, Xiangchun Lin
    Frontiers in Medicine.2026;[Epub]     CrossRef
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    Donghwan Kim, Eunsun Kim
    Journal of the Korean Medical Association.2023; 66(11): 658.     CrossRef
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    Byron P. Vaughn
    Clinical Gastroenterology and Hepatology.2022; 20(4): e912.     CrossRef
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    Hawraa Tarhini, Ayman Alrazim, Wissam Ghusn, Mohammad Hosni, Anthony Kerbage, Assaad Soweid, Ala-I Sharara, Fadi Mourad, Fadi Francis, Yasser Shaib, Kassem Barada, Fady Daniel
    Clinics and Research in Hepatology and Gastroenterology.2022; 46(7): 101981.     CrossRef
  • Safety, Efficacy and High-Quality Standards of Gastrointestinal Endoscopy Procedures in Personalized Sedoanalgesia Managed by the Gastroenterologist: A Retrospective Study
    Marina Rizzi, Francesco Panzera, Demetrio Panzera, Berardino D’Ascoli
    Journal of Personalized Medicine.2022; 12(7): 1171.     CrossRef
  • 6,720 View
  • 128 Download
  • 7 Web of Science
  • 5 Crossref
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Dedicated Cold Snare vs. Traditional Snare for Polypectomy of Diminutive and Small Lesions in a Porcine Model: A Research Group for Endoscopic Instruments and Stents (REIS) Study
Han Hee Lee, Bo-In Lee, Jung-Wook Kim, Hyun Lim, Si Hyung Lee, Jun-Hyung Cho, Yunho Jung, Kyoung Oh Kim, Chan Gyoo Kim, Kee Myung Lee, Jong-Jae Park, Myung-Gyu Choi, Hoon Jai Chun, Ho Gak Kim
Clin Endosc 2021;54(3):390-396.   Published online September 10, 2020
DOI: https://doi.org/10.5946/ce.2020.096
AbstractAbstract PDFSupplementary Material
Background
/Aims: The aim of this in vivo animal study was to evaluate the effectiveness and safety of dedicated cold snare (DCS) compared with those of traditional snare (TS) for cold snare polypectomy (CSP).
Methods
A total of 36 diminutive (5 mm) and 36 small (9 mm) pseudolesions were made by electrocoagulation in the colons of mini-pigs.
Results
For the diminutive lesions, there were no significant differences in technical success rate, procedure time, or complete resection rate between the DCS and TS groups; the rate of uneven resection margin in the DCS group was significantly lower than that of the TS group. For small lesions, technical success rate and complete resection rate were significantly higher in the DCS group than in the TS group (100% [18/18] vs. 55.6% [10/18], p=0.003; 94.4% [17/18] vs. 40% [4/10], p=0.006). In addition, the procedure duration was significantly shorter, and the rate of uneven resection margin was significantly lower in the DCS group (28.5 sec vs. 66.0 sec, p=0.006; 11.1% [2/18] vs. 100% [10/10], p<0.001). Two cases of perforation occurred in the DCS group. Multivariate analysis revealed that DCS use was independently associated with complete resection.
Conclusions
DCS is superior to TS in terms of technical success, complete resection, and reducing the duration of the procedure for CSP of small polyps.

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  • Comparison of complete resection rates in cold snare polypectomy using two different wire diameter snares: A randomized controlled study
    Toshiki Horii, Sho Suzuki, Akihiro Sugita, Misa Yamauchi, Hisatomo Ikehara, Chika Kusano, Takuji Gotoda
    Journal of Gastroenterology and Hepatology.2023; 38(5): 752.     CrossRef
  • Comparison of the clinical efficacy of cold snare polypectomy using a thin-wire snare and thick-wire snare for small colorectal polyps
    Hong Jin Yoon, Yunho Jung, Young Sin Cho, Il-Kwun Chung
    International Journal of Gastrointestinal Intervention.2023; 12(4): 183.     CrossRef
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    Yoji Takeuchi
    Clinical Endoscopy.2021; 54(3): 297.     CrossRef
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    Raquel Ortigão, Jochen Weigt, Ahmed Afifi, Diogo Libânio
    United European Gastroenterology Journal.2021; 9(8): 938.     CrossRef
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  • 272 Download
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  • 4 Crossref
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Focused Review Series: Present and Future of Diagnosis and Management of Small Bowel Diseases Exploiting Artificial Intelligence and Advanced Endoscopy
Roles of Capsule Endoscopy and Device-Assisted Enteroscopy in the Diagnosis and Treatment of Small-Bowel Tumors
Eun Ran Kim
Clin Endosc 2020;53(4):410-416.   Published online July 30, 2020
DOI: https://doi.org/10.5946/ce.2020.161
AbstractAbstract PDF
With the development of capsule endoscopy (CE) and device-assisted enteroscopy (DAE), the incidence of small-bowel tumors has increased and the characteristics of these tumors have changed. In addition, the diagnostic and therapeutic approaches for small-bowel tumors have diversified. CE is a simple, noninvasive method that aid in the visualization the entire small bowel. CE is considered the initial approach for small-bowel tumors. DAE can be used to perform endoscopic procedures such as bleeding control, polypectomy, stent insertion, and tattooing, as well as for diagnosis through visualization or tissue sampling. Therapeutic intervention with DAE is particularly useful in polyposis syndromes such as familial adenomatous polyposis and Peutz-Jeghers syndrome. This review will discuss the roles of CE and DAE in the diagnosis and treatment of small-bowel tumors.

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    Brendan Halloran, Jimmy Yimeng Guo, Getanshu Malik, Shawn Wasilenko, Aldo J Montano-Loza, Sergio Zepeda-Gomez
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Review
Endoscopic Management of Post-Polypectomy Bleeding
Aditya Gutta, Mark A. Gromski
Clin Endosc 2020;53(3):302-310.   Published online September 17, 2019
DOI: https://doi.org/10.5946/ce.2019.062
AbstractAbstract PDF
Post-polypectomy bleeding (PPB) is one of the most common complications of endoscopic polypectomy. There are multiple risk factors related to patient and polyp characteristics that should be considered. In most cases, immediate PPB can be effectively managed endoscopically when recognized and managed promptly. Delayed PPB can manifest in a myriad of ways. In severe delayed PPB, resuscitation for hemodynamic stabilization should be prioritized, followed by endoscopic evaluation and therapy once the patient is stabilized. Future areas of research in PPB include the risks of direct oral anticoagulants and of specific electrosurgical settings for hot-snare polypectomy vs. cold-snare polypectomy, benefits of closure of post-polypectomy mucosal defects using through-the-scope clips, and prospective comparative evaluation of newer hemostasis agents such as hemostatic spray powder and over-the-scope clips.

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  • Gastrointestinal Tract Polyp Detection, Tracking, and Surveillance and the Role of Artificial Intelligence
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Original Article
Endoscopic Findings in Children with Isolated Lower Gastrointestinal Bleeding
Ari Silbermintz, Manar Matar, Amit Assa, Noam Zevit, Yael Mozer Glassberg, Raanan Shamir
Clin Endosc 2019;52(3):258-261.   Published online May 14, 2019
DOI: https://doi.org/10.5946/ce.2018.046
AbstractAbstract PDF
Background
/Aims: Colorectal polyps are a common cause of lower gastrointestinal bleeding in children. Our aim was to study the causes of isolated lower gastrointestinal bleeding and to analyze the characteristics of the colorectal polyps found in our cohort.
Methods
We retrospectively reviewed colonoscopic procedures performed between 2007 and 2015. Children with isolated lower gastrointestinal bleeding were included in the study.
Results
A total of 185 colonoscopies were performed for isolated lower gastrointestinal bleeding. The median patient age was 8 years, and 77 patients (41.6%) were found to have colonic polyps. Normal colonoscopy findings were observed and acute colitis was detected in 77 (41.6%) and 14 (7.4%) patients, respectively. Single colonic polyps and 2–3 polyps were detected in 73 (94.8%) and 4 (5.2%) patients with polyps, respectively. Of the single polyps, 69 (94.5%) were juvenile polyps, among which 65 (94.2%) were located in the left colon.
Conclusions
Single left-sided juvenile polyps were the most common cause of isolated lower gastrointestinal bleeding in our study. It was rare to find multiple polyps and polyps proximal to the splenic flexure in our cohort. A full colonoscopy is still recommended in all patients in order to properly diagnose the small but significant group of patients with pathologies found proximal to the splenic flexure.

Citations

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Review
Should We Resect and Discard Low Risk Diminutive Colon Polyps
Pujan Kandel, Michael B. Wallace
Clin Endosc 2019;52(3):239-246.   Published online January 21, 2019
DOI: https://doi.org/10.5946/ce.2018.136
AbstractAbstract PDF
Diminutive colorectal polyps <5 mm are very common and almost universally benign. The current strategy of resection with histological confirmation of all colorectal polyps is costly and may increase the risk of colonoscopy. Accurate, optical diagnosis without histology can be achieved with currently available endoscopic technologies. The American Society of Gastrointestinal Endoscopy Preservation and Incorporation of Valuable endoscopic Innovations supports strategies for optical diagnosis of small non neoplastic polyps as long as two criteria are met. For hyperplastic appearing polyps <5 mm in recto-sigmoid colon, the negative predictive value should be at least 90%. For diminutive low grade adenomatous appearing polyps, a resect and discard strategy should be sufficiently accurate such that post-polypectomy surveillance recommendations based on the optical diagnosis, agree with a histologically diagnosis at least 90% of the time. Although the resect and discard as well as diagnose and leave behind approach has major benefits with regard to both safety and cost, it has yet to be used widely in practice. To fully implement such as strategy, there is a need for better-quality training, quality assurance, and patient acceptance. In the article, we will review the current state of the science on optical diagnose of colorectal polyps and its implications for colonoscopy practice.

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    Roger Fonollà, Quirine E.W. van der Zander, Ramon M. Schreuder, Sharmila Subramaniam, Pradeep Bhandari, Ad A.M. Masclee, Erik J. Schoon, Fons van der Sommen, Peter H.N. de With
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    Gwang Ha Kim, Kwang An Kwon, Do Hyun Park, Jimin Han
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    Iness Soltani, Daniel von Renteln
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    Lasse Kaalby, Ulrik Deding, Morten Kobaek-Larsen, Anne-Line Volden Havshoi, Erik Zimmermann-Nielsen, Marianne Kirstine Thygesen, Rasmus Kroijer, Thomas Bjørsum-Meyer, Gunnar Baatrup
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  • A CNN CADx System for Multimodal Classification of Colorectal Polyps Combining WL, BLI, and LCI Modalities
    Roger Fonollà, Quirine E. W. van der Zander, Ramon M. Schreuder, Ad A. M. Masclee, Erik J. Schoon, Fons van der Sommen, Peter H. N. de With
    Applied Sciences.2020; 10(15): 5040.     CrossRef
  • UEG Week 2019 Poster Presentations

    United European Gastroenterology Journal.2019; 7(S8): 189.     CrossRef
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  • 334 Download
  • 28 Web of Science
  • 30 Crossref
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Focused Review Series: Current Status of Image-Enhanced Endoscopy (IEE)
Image-Enhanced Endoscopy in Lower Gastrointestinal Diseases: Present and Future
Han Hee Lee, Bo-In Lee
Clin Endosc 2018;51(6):534-540.   Published online November 30, 2018
DOI: https://doi.org/10.5946/ce.2018.187
AbstractAbstract PDF
From dye-assisted conventional chromoendoscopy to novel virtual chromoendoscopy, image-enhanced endoscopy (IEE) is continuously evolving to meet clinical needs and improve the quality of colonoscopy. Dye-assisted chromoendoscopy using indigo carmine or crystal violet, although slightly old-fashioned, is still useful to emphasize the pit patterns of the colonic mucosa and predict the histological structures of relevant lesions. Equipment-based virtual chromoendoscopy has the advantage of being relatively easy to use. There are several types of virtual chromoendoscopy that vary depending on the manufacturer and operating principle. IEE plays distinctive roles with respect to histologic characterization of colorectal polyps and prediction of the invasion depth of colorectal cancers. In addition, the newest models of IEE have the potential to increase adenoma and polyp detection rates in screening colonoscopy.

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    Conceição de Maria Aquino Vieira Clairet, José Luis Braga De Aquino, Laurent Martial Clairet
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Original Articles
Magnified Endoscopic Findings of Multiple White Flat Lesions: A New Subtype of Gastric Hyperplastic Polyps in the Stomach
Rino Hasegawa, Kenshi Yao, Shoutomi Ihara, Masaki Miyaoka, Takao Kanemitsu, Kenta Chuman, Go Ikezono, Akikazu Hirano, Toshiharu Ueki, Hiroshi Tanabe, Atsuko Ota, Seiji Haraoka, Akinori Iwashita
Clin Endosc 2018;51(6):558-562.   Published online November 21, 2018
DOI: https://doi.org/10.5946/ce.2018.104
AbstractAbstract PDF
Background
/Aims: While the occurrence of multiple whitish flat elevated lesions (MWFL) was first reported in 2007, no studies on MWFL have been published to date. The present retrospective observational study aimed to clarify the endoscopic findings and clinicopathological features of MWFL.
Methods
Subjects were consecutive patients who underwent upper gastrointestinal endoscopy as part of routine screening between April 2014 and March 2015. The conventional white-light, non-magnifying and magnifying narrow-band images were reviewed. Clinical features were compared between patients with and without MWFL.
Results
The conventional endoscopic findings of MWFL include multiple whitish, flat, and slightly elevated lesions of various sizes, mainly located in the gastric body and fundus. Narrow-band imaging enhanced the contrast of MWFL and background mucosa, and magnifying narrow-band imaging depicted a uniformly long, narrow, and elliptical marginal crypt epithelium with an unclear microvascular pattern. Histopathological findings revealed hyperplastic changes of the foveolar epithelium, and parietal cell protrusions and oxyntic gland dilatations were observed in the fundic glands, without any intestinal metaplasia. The rate of acid-reducing drug use was significantly higher in patients with MWFL than in those without (100% [13/13] vs. 53.7% [88/164], p<0.001).
Conclusions
The present study indicated a relationship between the presence and endoscopic features of MWFL and history of acidreducing drug use.

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    Hiroko Suda, Koichi Sakurai, Ken Haruma
    Expert Review of Gastroenterology & Hepatology.2026; 20(5): 395.     CrossRef
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    Liang Zhang, Jian Liu, Yali Wang
    BMC Gastroenterology.2026;[Epub]     CrossRef
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    Satoshi Shinozaki, Hiroyuki Osawa, Yoshimasa Miura, Hiroaki Nomoto, Hirotsugu Sakamoto, Yoshikazu Hayashi, Tomonori Yano, Edward J. Despott, Hironori Yamamoto
    DEN Open.2025;[Epub]     CrossRef
  • Association between occurrence of multiple white and flat elevated gastric lesions and oral proton pump inhibitor intake
    Rino Hasegawa, Kenshi Yao, Takao Kanemitsu, Hisatomi Arima, Takayuki Hirase, Yuuya Hiratsuka, Kazuhiro Takeda, Kentaro Imamura, Kensei Ohtsu, Yoichiro Ono, Masaki Miyaoka, Takashi Hisabe, Toshiharu Ueki, Hiroshi Tanabe, Atsuko Ohta, Satoshi Nimura
    Clinical Endoscopy.2024; 57(1): 65.     CrossRef
  • Randomised clinical trial: 3-year interim analysis results of the VISION trial to evaluate the long-term safety of vonoprazan as maintenance treatment in patients with erosive oesophagitis
    Ken Haruma, Yoshikazu Kinoshita, Takashi Yao, Ryoji Kushima, Junichi Akiyama, Nobuo Aoyama, Tatsuhiro Kanoo, Kouji Miyata, Naomi Kusumoto, Naomi Uemura
    BMC Gastroenterology.2023;[Epub]     CrossRef
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    Akira Hokama, Mayumi Shiroma, Mami Tomiyama, Yuko Tasato, Maki Setake
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    Jong Hyeon Jeong, Sun-Young Lee, Hye Seung Han
    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2022; 22(1): 63.     CrossRef
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    Satoshi Shinozaki, Hiroyuki Osawa, Yoshimasa Miura, Yoshikazu Hayashi, Hirotsugu Sakamoto, Tomonori Yano, Alan Lefor, Hironori Yamamoto
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    Amit Kumar Dutta, Noriya Uedo, Deepu David, Jagan Chandramohan, Abhishek Jain, Itish Patnayak, Piyush Gupta, Bharath K. Ayapati, Kaushik Chatterjee, Rajeeb Jaleel, Reuben T. Kurien, Sudipta D. Chowdhury, Ebby G. Simon, Anjilivelil J. Joseph, Anna B. Pulim
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    Gwang Ha Kim
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    Matthew Banks, David Graham, Marnix Jansen, Takuji Gotoda, Sergio Coda, Massimiliano di Pietro, Noriya Uedo, Pradeep Bhandari, D Mark Pritchard, Ernst J Kuipers, Manuel Rodriguez-Justo, Marco R Novelli, Krish Ragunath, Neil Shepherd, Mario Dinis-Ribeiro
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Technical Feasibility of a Guidetube for Various Endoscopic Procedures in Human Gastrointestinal Simulators
Dong Seok Lee, Byeong Gwan Kim, Kook Lae Lee, Yong Jin Jung, Ji Won Kim
Clin Endosc 2019;52(3):247-251.   Published online November 9, 2018
DOI: https://doi.org/10.5946/ce.2018.147
AbstractAbstract PDF
Background
/Aims: Many gastrointestinal (GI) endoscopic procedures are difficult and cumbersome owing to the limitation of currently available endoscopic devices. This study aimed to develop an endoscopic guidetube for multipurpose endoscopic procedures and assess its use in a realistic GI endoscopic simulator.
Methods
The guidetube used is a soft overtube composed of neoprene and is designed to assist various endoscopic procedures on demand. In total, 15 types of procedures were performed in GI simulators. Four procedures were performed in the stomach model and 11 in the colon model. The procedures include repeated endoscopic insertion and foreign body removal in various positions. The mean insertion and procedure time were assessed in each session. All procedures were performed by 5 expert endoscopists.
Results
Endoscopic procedures with the new guidetube were faster and more effective than the conventional endoscopic techniques. The mean insertion time of the endoscope with the guidetube was significantly shorter than that without the guidetube. The guidetube was safely inserted without scratch using low pushing force. Objects of various sizes larger than the endoscopic channel were easily removed by the guidetube-assisted endoscopic procedures.
Conclusions
This preliminary study shows that guidetube-assisted endoscopic procedures are faster, easier, safer and cheaper than conventional endoscopic procedures.

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  • Efficacy of an assistive guide tube for improved endoscopic access to gastrointestinal lesions: an in vivo study in a porcine model
    Dong Seok Lee, Jeong-Sik Byeon, Sang Gyun Kim, Ji Won Kim, Kook Lae Lee, Ji Bong Jeong, Yong Jin Jung, Hyoun Woo Kang
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    Dong Seok Lee, Ji Won Kim, Kook Lae Lee, Byeong Gwan Kim, Su Hwan Kim, Jeong-Sik Byeon
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  • Usefulness of an Overtube Device in Gastrointestinal Endoscopy
    Seung Han Kim
    Clinical Endoscopy.2019; 52(3): 203.     CrossRef
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  • 106 Download
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  • 3 Crossref
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Case Reports
A Rare Case of Lymph Node Metastasis from Early Gastric Cancer
Takaaki Yoshikawa, Yoshio Kadokawa, Masaya Ohana, Akihisa Fukuda, Hiroshi Seno
Clin Endosc 2019;52(4):369-372.   Published online October 5, 2018
DOI: https://doi.org/10.5946/ce.2018.130
AbstractAbstract PDF
Gastric cancers that fulfill the Japanese criteria for curative endoscopic resection show a low risk of lymph node (LN) metastasis. Here, we report a case of LN metastasis from early gastric cancer that fulfilled the curative criteria. A 74-year-old Japanese woman was referred to our hospital for treatment of early gastric cancer identified at the site of a hyperplastic polyp that had been diagnosed 10 years prior to presentation. Contrast-enhanced computed tomography did not show any lymphadenopathy and laparoscopy-assisted distal gastrectomy was performed. Histopathological examination revealed a predominantly moderately differentiated adenocarcinoma that measured 15 mm in size and was confined to the mucosa. However, a single metastatic regional LN was observed. A few cancer cells showed positive staining for alpha-fetoprotein. It should be noted that early gastric cancer can be accompanied by LN metastasis even if it fulfills the criteria for curative endoscopic resection.

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  • Alpha-fetoprotein-producing intramucosal gastric cancer found during examination of metastatic lymph nodes
    Tomoya Sano, Takahiro Toyokawa, Mami Yoshii, Yuichiro Miki, Tatsuro Tamura, Shigeru Lee, Kiyoshi Maeda
    Clinical Journal of Gastroenterology.2025; 18(1): 57.     CrossRef
  • Tumor Budding as an Additional Factor in Determining the Need for Surgery after Endoscopic Resection in Mucosal Invasive Gastric Cancer: A Retrospective Study from a Korean Tertiary Hospital
    Yeonjin Je, Yuna Kim, Su-Jin Shin, Jie-Hyun Kim, Goeun Park, Jaeyoung Chun, Young Hoon Youn, Hyojin Park, Sung Hoon Noh, In Gyu Kwon
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    Hayemin Lee, Mi Ryeong Park, Junhyun Lee
    Annals of Surgical Treatment and Research.2025; 109(2): 81.     CrossRef
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  • 139 Download
  • 3 Web of Science
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First Characterization with Ultrasound Contrast Agent of a Fibrovascular Polyp Before Its Endoscopic Resection: A Case Report (with Videos)
Nicolas Williet, Radwan Kassir, Francois Casteillo, Violaine Yvorel, Cyril Habougit, Xavier Roblin, Jean-Marc Phelip
Clin Endosc 2019;52(2):186-190.   Published online October 5, 2018
DOI: https://doi.org/10.5946/ce.2018.083
AbstractAbstract PDFSupplementary Material
We described for the first time the contrast enhancement of a giant fibrovascular esophageal polyp using ultrasound contrast agent, Sonovue® (Bracco, Milan, Italy) during echoendoscopy. Fine Doppler was unsuccessful in showing vascularization due to the mobile characteristic of the tumor. In contrast, via Sonovue® , tissue microcirculation was highlighted inside the entire head of the polyp, leading to better appreciate the risk of bleeding related to its resection. In a second part, we showed the feasibility of classic polypectomy for this giant polyp (5×5 cm) without complication and results of control endoscopy at 3 months. The present case is summarized in a video.

Citations

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  • Hybrid laparo-endoscopic access: New approach to surgical treatment for giant fibrovascular polyp of esophagus: A case report and review of literature
    Seda Dzhantukhanova, Lyudmila Grigori Avetisyan, Amina Badakhova, Yury Starkov, Andrey Glotov
    World Journal of Gastrointestinal Endoscopy.2023; 15(11): 666.     CrossRef
  • Hybrid laparo-endoscopic access for giant fibrovascular esophageal polyp: a case report
    Yu.G. Starkov, S.V. Dzhantukhanova, R.D. Zamolodchikov, A.B. Badakhova
    Pirogov Russian Journal of Surgery.2023; (11): 123.     CrossRef
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  • 83 Download
  • 1 Web of Science
  • 2 Crossref
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Original Articles
Mis-sizing of Adenomatous Polyps is Common among Endoscopists and Impacts Colorectal Cancer Screening Recommendations
Thu Pham, Aung Bajaj, Lorela Berberi, Chengcheng Hu, Sasha Taleban
Clin Endosc 2018;51(5):485-490.   Published online June 21, 2018
DOI: https://doi.org/10.5946/ce.2017.183
AbstractAbstract PDF
Background
/Aims: To determine the accuracy of identifying ≥6-mm adenomatous polyps during colonoscopy and define its impact on subsequent interval screening.
Methods
We conducted a retrospective study of patients who underwent colonoscopies at Banner University Medical Center, Tucson from 2011 to 2015. All patients with ≥6-mm adenomatous polyps based on their colonoscopy report were included. Adenomatous polyps were excluded if they did not meet the criteria. Discrepancies in the polyp size were determined by calculating the percentage of size variation (SV). Clinical mis-sizing was defined as SV >33%.
Results
The polyps analyzed were predominantly <10 mm in size. Approximately 13% of the examined polyps met the inclusion criteria, and 40.7% of the adenomas were ≥10 mm. A total of 189 ≥6-mm adenomatous polyps were collected from 10 different gastroenterologists and a colorectal surgeon. Adenomatous polyps were clinically mis-sized in 56.6% of cases and overestimated in 71.4%. Among the adenomas reviewed, 22% of mis-sized polyps and 11% of non-mis-sized polyps resulted in an inappropriate surveillance interval.
Conclusions
We found that more than half of ≥6-mm adenomatous polyps are mis-sized and that there is a tendency to overestimate adenoma size among endoscopists. This frequently leads to inappropriate intervals of surveillance colonoscopy.

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    Mohamed S. Elgendy, Mohamed Rifai, Amira M. Taha, Islam Rajab, Abdulrahman Maged, Mohamed A. Elgamasy, Hosam I. Taha, Mohamed Abuelazm, Babu P. Mohan, Douglas G. Adler
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    Bianca Thakkar, Rachael Hagen, Joseph C. Anderson
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    Sijia Du, Yang Ding, Yaqi Wang, Chen Liu, Jun Wang, Ruilan Wang, Huiyu Zhou, Qingwei Zhang, Xiaobo Li, Dahong Qian
    Pattern Recognition.2026; 179: 113646.     CrossRef
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    Mohamed S. Elgendy, Mohamed Abuelazm, Babu P. Mohan, Douglas G. Adler
    Gastrointestinal Endoscopy.2026; 104(2): 346.     CrossRef
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    N.A. Belinskaya, I.S. Verkhovodova, A.V. Dudnikov, L.V. Kim, S.I. Kim, A.A. Paratovskaya, M.S. Tsvetkov, K.D. Khalin, M.Yu. Agapov
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    Mahsa Taghiakbari, Roupen Djinbachian, Juliette Labelle, Daniel von Renteln
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    Roupen Djinbachian, Mahsa Taghiakbari, Abla Alj, Edgard Medawar, Sacha Sidani, Jeremy Liu Chen Kiow, Benoit Panzini, Mickael Bouin, Daniel von Renteln
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    Luan Minh Dang, Nhan Quang Le, Huy Minh Le, Diem Thi-Ngoc Vo, Nguyen Lam Vuong, Minh Cuong Duong, Duc Trong Quach
    Digestive Diseases and Sciences.2025; 70(6): 2105.     CrossRef
  • Measuring Size of Colorectal Polyps Using a Virtual Scale Endoscope or Visual Assessment: A Randomized Controlled Trial
    Mahsa Taghiakbari, Roupen Djinbachian, Claire Haumesser, Sacha Sidani, Jeremy Liu Chen Kiow, Benoit Panzini, Daniel von Renteln
    American Journal of Gastroenterology.2024; 119(7): 1309.     CrossRef
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    Geoffrey A. Bader, Carl L. Kay, Zachary Eagle, Brandon W. Kuiper, Charles B. Miller, John G. Gancayco
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    Daisuke Tsurumaru, Yusuke Nishimuta, Katsuya Nanjo, Satohiro Kai, Mitsutoshi Miyasaka, Toshio Muraki, Kousei Ishigami
    Japanese Journal of Radiology.2024; 42(11): 1255.     CrossRef
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    Daniel von Renteln, Roupen Djinbachian, Melissa Zarandi-Nowroozi, Mahsa Taghiakbari
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    Ryo Shimoda, Takashi Akutagawa, Michito Tomonaga, Tatsuro Murano, Kensuke Shinmura, Masato Yoshioka, Yuichi Teramura, Fumiaki Kiyomi, Hiroaki Ikematsu
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    Linda Tang, Angelina Di Re, Toufic El‐Khoury
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    Nadia Ibrahimi, Seth S. Septer, Brian R. Lee, Robert Garola, Raj Shah, Thomas M. Attard
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    Hoon Sup Koo, Kyu Chan Huh
    Clinical Endoscopy.2018; 51(5): 404.     CrossRef
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Endoscopic Features of Mucous Cap Polyps: A Way to Predict Serrated Polyps
Brian T. Moy, Faripour Forouhar, Chia-Ling Kuo, Thomas J. Devers
Clin Endosc 2018;51(4):368-374.   Published online April 27, 2018
DOI: https://doi.org/10.5946/ce.2017.155
AbstractAbstract PDF
Background
/Aims: The aims of the study were to identify whether a mucous-cap predicts the presence of serrated polyps, and to determine whether additional endoscopic findings predict the presence of a sessile serrated adenomas/polyp (SSA/P).
Methods
We analyzed 147 mucous-capped polyps with corresponding histology, during 2011–2014. Eight endoscopic features (presence of borders, elevation, rim of debris, location in the colon, size ≥10 mm, varicose vessels, nodularity, and alteration in mucosal folds) of mucous-capped polyps were examined to see if they can predict SSA/Ps.
Results
A total of 86% (n=126) of mucous-capped polyps were from the right sided serrated pathway (right-sided hyperplastic [n=83], SSA/Ps [n=43], traditional serrated adenoma [n=1]), 10% (n=15) were left-sided hyperplastic polyps, and 3% (n=5) were from the adenoma-carcinoma sequence. The presence of a mucous cap combined with varicose vessels was the only significant predictor for SSA/Ps. The other seven characteristics were not found to be statistically significant for SSA/Ps, although location in the colon and the presence of nodularity trended towards significance.
Conclusions
Our study suggests that mucous-capped polyps have high predictability for being a part of the serrated pathway. Gastroenterologists should be alert for a mucous-capped polyp with varicose veins, as these lesions have a higher risk of SSA/P.

Citations

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  • Impaired Bicarbonate Transport via SLC26A3 and CFTR Downregulation Promotes Mucous Cap Formation in Sessile Serrated Lesions
    Hiroyoshi Ota, Miharu Suzuki, Heiwa Tanabe, Yukiko Kusama, Ayako Seki, Etsuo Hara, Takeshi Uehara
    Digestive Diseases and Sciences.2026; 71(3): 941.     CrossRef
  • Deep Learning–Based Detection of Sessile Serrated Lesions in Colonoscopy Images: Optimization of a YOLOv3 Framework With Mucus Cap Feature Enhancement for Sessile Serrated Lesion Detection
    Hongna Lu, Pan Jiang, Tianyin Chen, QinQin Hu, Jiahua Wu, Xi Deng, Mengyao Ge, Ting Weng, Liangshun Zhang, Wenying Guo, Xiaolin Chen, Feng Xu
    Journal of Gastroenterology and Hepatology.2026;[Epub]     CrossRef
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    Dan Qiao, Xiao-Yan Liu, Lie Zheng, Ya-Li Zhang, Ren-Ye Que, Bing-Jing Ge, Hong-Yan Cao, Yan-Cheng Dai
    World Journal of Clinical Cases.2023; 11(9): 1963.     CrossRef
  • Coagulase-negative staphylococci (CoNS) as a significant etiological factor of laryngological infections: a review
    Michał Michalik, Alfred Samet, Adrianna Podbielska-Kubera, Vincenzo Savini, Jacek Międzobrodzki, Maja Kosecka-Strojek
    Annals of Clinical Microbiology and Antimicrobials.2020;[Epub]     CrossRef
  • Endoscopic features of sessile serrated adenoma/polyps under narrowband imaging: A retrospective study
    Xin Tian Zhang, Qing Wei Zhang, Fei Liu, Xiao Lu Lin, Jin Nan Chen, Xiao Bo Li
    Journal of Digestive Diseases.2019; 20(3): 135.     CrossRef
  • How to Detect Sessile Serrated Adenoma/Polyps
    Eun Ran Kim, Dong Kyung Chang
    Clinical Endoscopy.2018; 51(4): 313.     CrossRef
  • 12,491 View
  • 173 Download
  • 5 Web of Science
  • 6 Crossref
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Case Reports
Primary Colonic Follicular Lymphoma Presenting as Four Diminutive Sessile Polyps Found Incidentally During Colonoscopy
Sun Jin, Hyun Seok Lee, Ji Yun Jeong, Young Wook Jo
Clin Endosc 2018;51(4):388-392.   Published online April 18, 2018
DOI: https://doi.org/10.5946/ce.2017.114
AbstractAbstract PDF
Follicular lymphomas, which typically arise in the lymph nodes with spleen, liver, and bone marrow involvement, have generally low occurrence rates in Asian countries as compared with Western countries. Follicular lymphomas of the gastrointestinal tract are rare, and primary colonic follicular lymphomas are particularly rare compared with others found in the small intestine and duodenum. Colonoscopic imaging of colonic lymphomas, including follicular lymphoma, may reveal mucosal ulcerations, erosions, indurations, polypoid mass-like lesions, and diffuse mucosal nodularity. Herein, we report a unique case of a follicular lymphoma of the transverse colon characterized by four sessile diminutive polyps located intermittently with multiple lymph node involvement in a 62-year-old man.

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  • Linfoma primario folicular rectal
    E. López Rodríguez, R. Fernández López, I. Borrego Dorado
    Revista Clínica Española.2021; 221(7): 426.     CrossRef
  • Primary rectal follicular lymphoma
    E. López Rodríguez, R. Fernández López, I. Borrego Dorado
    Revista Clínica Española (English Edition).2021; 221(7): 426.     CrossRef
  • A rare case of duodenal-type follicular lymphoma in rectum appearing as hyperplastic polyp with metachronous appearance in duodenum and stomach
    Ioannis Giotis, George Tribonias, Eirini Zacharopoulou, Maria Palatianou, Nikolaos Leontidis, Panagiota Pantoula, Georgia Vogiatzi, Athanasios Dimitrios Bakasis, Asimina Papanikolaou, Maria Tzouvala
    Clinical Journal of Gastroenterology.2021; 14(6): 1632.     CrossRef
  • Primary Colorectal Follicular Lymphoma Observed by Magnifying Endoscopy, with a Five-year Follow-up
    Masaki Katsurahara, Yuhei Umeda, Takashi Sakuno, Jyunya Tsuboi, Reiko Yamada, Misaki Nakamura, Yasuhiko Hamada, Hiroyuki Inoue, Kyosuke Tanaka, Noriyuki Horiki, Yoshiyuki Takei
    Internal Medicine.2020; 59(11): 1395.     CrossRef
  • Follicular non-Hodgkin lymphoma with primary colonic involvement
    Raquel Muñoz González, Pablo Miranda García, Cecilio Santander Vaquero
    Revista Española de Enfermedades Digestivas.2020;[Epub]     CrossRef
  • 10,763 View
  • 149 Download
  • 4 Web of Science
  • 5 Crossref
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Laparoscopic Resection of a Jejunal Inflammatory Fibroid Polyp that Caused Occult Gastrointestinal Bleeding, Diagnosed via Capsule Endoscopy and Double-Balloon Enteroscopy: A Case Report
Chizu Kameda, Hideaki Miwa, Ryohei Kawabata, Daiki Marukawa, Masahiro Murakami, Shingo Noura, Junzo Shimizu, Junichi Hasegawa
Clin Endosc 2018;51(4):384-387.   Published online March 20, 2018
DOI: https://doi.org/10.5946/ce.2017.162
AbstractAbstract PDF
An inflammatory fibroid polyp (IFP) is a mesenchymal tumor of the gastrointestinal tract. IFPs in the small intestine are the most frequently detected with symptoms, such as abdominal pain and tarry stool due to intussusception. Accordingly, few studies have reported jejunal IFP as a cause of occult gastrointestinal bleeding (OGIB) diagnosed via both of capsule endoscopy (CE) and double-balloon enteroscopy (DBE). A 68-year-old woman presented with a progression of anemia and a positive fecal occult blood test result. Esophagogastroduodenoscopy and total colonoscopy findings were unremarkable. CE revealed a tumor with bleeding in the jejunum. DBE also revealed a jejunal polypoid tumor. Bleeding from the tumor seemed to have caused anemia. The patient underwent partial laparoscopic resection of the jejunum, including resection of the tumor. The tumor was histopathologically diagnosed as IFP. To our knowledge, this is the first reported case of laparoscopic resection of jejunal IFP with OGIB diagnosed via CE and DBE preoperatively.

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  • Minimally invasive colonoscopy treatment of inflammatory fibroid polyps in the terminal ileum
    Yin-Si Tang, Lu Liu, Ying Gao, Qiao-Chu He, Hai-Mei Guo, Zhi-Feng Zhao
    Scientific Reports.2023;[Epub]     CrossRef
  • Where does capsule endoscopy fit in the diagnostic algorithm of small bowel intussusception?
    Stefania Chetcuti Zammit, Aman Yadav, Deirdre McNamara, Alejandro Bojorquez, Cristina Carretero-Ribón, Martin Keuchel, Peter Baltes, Reuma Margalit-Yehuda, Uri Kopylov, Reena Sidhu, Clelia Marmo, Maria Elena Riccioni, Xavier Dray, Romain Leenhardt, Emanue
    Digestive and Liver Disease.2023; 55(12): 1719.     CrossRef
  • Cystic lymphangioma in the peripheral jejunal mesentery in an adult and excision with laparoscopic-assisted surgery: a case report
    Hideki Nagano, Toshihisa Kimura, Atsushi Iida, Tamotsu Togawa, Takanori Goi, Yasunori Sato
    World Journal of Surgical Oncology.2019;[Epub]     CrossRef
  • 9,507 View
  • 99 Download
  • 4 Web of Science
  • 3 Crossref
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Endoscopic Treatment of Jejunal Heterotopic Gastric Mucosa that Caused Recurrent Intussusception
Ke Ryun Ahn, Ja Seol Koo, Hwan Il Kim, Ji Hye Kim, Jee Hyun Lee, Seung Young Kim, Sung Woo Jung, Sang Woo Lee
Clin Endosc 2017;50(6):605-608.   Published online October 18, 2017
DOI: https://doi.org/10.5946/ce.2017.026
AbstractAbstract PDF
Heterotopic gastric mucosa (HGM) is a rare anomaly in the small bowel and may be the cause of intussusception when it gets a lead point in the jejunum. All cases of intussusception due to intestinal HGM have been treated with surgical resection. A 5-year-old girl presented with chief complaints of vomiting and abdominal pain for 2 weeks. A computed tomography scan of the abdomen showed intussusception at the proximal jejunal loops. Three air reductions and one saline reduction were attempted without success. She continued to be symptomatic, and endoscopic evaluation was performed. Enteroscopy revealed some variable-sized polypoid mucosal lesions with erosions on the proximal jejunum. Endoscopic mucosal resection was performed using a snare. The resected tissues histologically showed a hyperplastic polyp arising from the HGM. Her symptoms did not recur within 1 year after the treatment. Our case showed that enteroscopy could be useful for the diagnosis and management of jejunal intussusception caused by HGM.

Citations

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    David S. Vitale, Kelly Wang, Laith H. Jamil, Kenneth H. Park, Quin Y. Liu
    Journal of Pediatric Gastroenterology and Nutrition.2022; 74(1): 20.     CrossRef
  • Life-threatening gastrointestinal bleeding caused by jejunal heterotopic gastric mucosa in an adult dog: a rare case report
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    BMC Veterinary Research.2022;[Epub]     CrossRef
  • Rare polypoid gastric mucosa induced small bowel intussusception in a toddler
    Brianna M. Bowman, Suy sen Hung Fong, Joel M. Prince, Subhasis Misra, Thomas Abbruzzese, Drew Rideout
    Journal of Pediatric Surgery Case Reports.2022; 87: 102476.     CrossRef
  • Intraoperative Endoscopy in Transient Adult Jejunojejunal Intussusception
    Takeshi Okamoto, Hidekazu Suzuki, Katsuyuki Fukuda, Yoshihiro Moriwaki
    Case Reports in Gastrointestinal Medicine.2021; 2021: 1.     CrossRef
  • Heterotopic Gastric Mucosa in Adolescent Girl
    Esra Polat, Rahşan Özcan, Nuray Kepil, Mine Güllüoğlu, Sevinç Kalin
    Journal of Pediatric Gastroenterology and Nutrition.2020;[Epub]     CrossRef
  • Jejunal Polyps out of Place: A Case of Gastric Heterotopia of the Jejunum
    Siri A. Urquhart, Nayantara Coelho-Prabhu
    Case Reports in Gastrointestinal Medicine.2020; 2020: 1.     CrossRef
  • Heterotopic Gastric Mucosa Presenting as Lower Gastrointestinal Bleeding: An Unusual Case Report
    Syed Muhammad Ali, Ayman Abdelhafiz Ahmed, Leena Amin Hussain Saaid, Gihan Mustafa Kamal Mohamed, Amjad Ali Shah, Mohannad Al-Tarakji, Zia Aftab, Inamulla, Sameera Rashid, Paola De Nardi
    Case Reports in Surgery.2019;[Epub]     CrossRef
  • 10,358 View
  • 149 Download
  • 7 Web of Science
  • 7 Crossref
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