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Yung-Kuan Tsou, Chia-Yuan Liu, Kuang-I Fu, Cheng-Hui Lin, Mu-Shien Lee, Ming-Yao Su, Ken Ohata, Cheng-Tang Chiu
BACKGROUND: Esophageal endoscopic submucosal dissection (ESD) has rarely been reported for the treatment of cirrhotic patients. AIM: To report the results of ESD treatment of superficial esophageal neoplasms (SENs) for cirrhotic patients. METHODS: Forty patients with 50 consecutive SENs undergoing 46 sessions of ESD were retrospectively reviewed. The cirrhotic group included eight patients (11 SENs) with liver cirrhosis consisting of six patients classified as Child-Pugh class A liver cirrhosis and two patients classified as class B liver cirrhosis...
October 21, 2016: Digestive Diseases and Sciences
Eun Hye Kim, Jun Chul Park, In Ji Song, Yeong Jin Kim, Dong Hoo Joh, Kyu Yeon Hahn, Yong Kang Lee, Ha Yan Kim, Hyunsoo Chung, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee
BACKGROUND: and study aim: Endoscopic submucosal dissection (ESD) is a useful method for complete resection of early gastric cancer (EGC). However, there are still some cases that underwent additional gastrectomy after ESD because of non-curative resection. There is no model that can accurately predict non-curative resection of ESD. We aimed to create a model for predicting non-curative resection of ESD in patients with EGC. PATIENTS AND METHODS: We reviewed the medical records, including all gross findings of EGC, of patients who underwent ESD for EGCs...
October 15, 2016: Gastrointestinal Endoscopy
Daisuke Kikuchi, Toshiro Iizuka, Akihiro Yamada, Kosuke Nomura, Yasutaka Kuribayashi, Ryusuke Kimura, Shu Hoteya, Mitsuru Kaise
BACKGROUND/AIM: We developed a new device for the simultaneous manipulation of an endoscope and treatment devices, which we named the Smart Shooter®. The aim of this study was to validate the feasibility of using the Smart Shooter® in endoscopic submucosal dissection (ESD). METHODS: This pilot feasibility study conducted between March and June 2014 involved 20 consecutive patients who underwent ESD for superficial gastrointestinal neoplasia. The primary endpoint was a serious adverse event during the ESD procedure...
October 19, 2016: Digestion
Hiroki Sugita, Hideyuki Kuroki, Takahiko Akiyama, Nobuya Daitoku, Rumi Tashima, Hiroshi Tanaka, Shinobu Honda, Masahiko Hirota
INTRODUCTION: In a distal pancreatectomy combined with a distal gastrectomy, the splenic artery and vein must be conserved. However, it is not easy in pure laparoscopic surgery. We performed a hand-assisted laparoscopic spleen-preserving distal pancreatectomy (HALS-SPDP) combined with a laparoscopic distal gastrectomy (LDG) for the treatment of a pancreatic neuroendocrine tumor (NET) with early gastric cancer. PRESENTATION OF CASE: A 67-year-old male was hospitalized with no complaint...
October 8, 2016: International Journal of Surgery Case Reports
Shigehisa Aoki, Yasuhisa Sakata, Ryo Shimoda, Toshiaki Takezawa, Ayumi Oshikata-Miyazaki, Hiromi Kimura, Mihoko Yamamoto, Ryuichi Iwakiri, Kazuma Fujimoto, Shuji Toda
BACKGROUND AND AIMS: Extensive excision of the esophageal mucosa by endoscopic submucosal dissection (ESD) frequently evokes a luminal stricture. This study aimed to determine the efficacy of a high-density collagen patch for the prevention of esophageal stricture in extensive ESD. METHODS: Six pigs underwent circumferential esophageal ESD under general anesthesia. In 3 pigs, artificial ulcers were covered by 2 collagen patches. The other 3 pigs underwent circumferential ESD only...
October 14, 2016: Gastrointestinal Endoscopy
Masau Sekiguchi, Ichiro Oda, Haruhisa Suzuki, Seiichiro Abe, Satoru Nonaka, Shigetaka Yoshinaga, Hirokazu Taniguchi, Shigeki Sekine, Yutaka Saito
BACKGROUND AND AIMS: Although the number of gastric cancer patients aged ≥85 years indicated for endoscopic submucosal dissection (ESD) has increased, little is known about their outcomes and prognostic factors. This study aimed to investigate the clinical outcomes and factors prognostic of overall survival (OS) of patients aged ≥85 years who underwent ESD for gastric cancer. METHODS: We retrospectively reviewed 108 patients aged ≥85 years with 149 gastric cancers treated by ESD between 1999 and 2014 at our institution...
October 14, 2016: Gastrointestinal Endoscopy
Ling Xin, Li Qian Jun, Xu Li Hua, Zhu Hong, Chen Tian Bao, Tang Jin Hai
BACKGROUND/AIMS: Complications are important determining factors for safety of endoscopic submucosal dissection (ESD) for gastric heterotopic pancreas (HP). This study investigated whether endoscopic color Doppler ultrasonography (ECDUS) could be used to predict the feasibility, efficacy, and safety of ESD. PATIENTS AND METHODS: The study included 52 patients with heterotopic pancreas of the gastric antrum who underwent ECDUS before ESD. ECDUS was used to evaluate the submucosal vascular structure and the location of HP in gastric wall...
September 2016: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Nicholas G Burgess, Michael J Bourke
No abstract text is available yet for this article.
October 2016: Endoscopy International Open
Teppei Akimoto, Osamu Goto, Motoki Sasaki, Yasutoshi Ochiai, Tadateru Maehata, Ai Fujimoto, Toshihiro Nishizawa, Naohisa Yahagi
Background and study Aims: To prevent complications after colonic endoscopic submucosal dissection (ESD), we developed a new closure technique using repositionable clips. Patients and methods: The closure of post-ESD mucosal defects was attempted in 19 cases. Mucosal defects were linearly closed by holding and dragging the anal mucosal edge towards the oral mucosal edge using repositionable clips. Standard hemoclips were additionally placed to complete the closure. We retrospectively assessed the feasibility of this technique...
October 2016: Endoscopy International Open
Emmanuel Akintoye, Nitin Kumar, Hiroyuki Aihara, Hala Nas, Christopher C Thompson
Background and study aims: Endoscopic submucosal dissection (ESD) is an advanced endoscopic technique that allows en-bloc resection of gastrointestinal tumor. We systematically review the medical literature in order to evaluate the safety and efficacy of colorectal ESD. Patients and methods: We performed a comprehensive literature search of MEDLINE, EMBASE, Ovid, CINAHL, and Cochrane for studies reporting on the clinical efficacy and safety profile of colorectal ESD. Results: Included in this study were 13833 tumors in 13603 patients (42 % female) who underwent colorectal ESD between 1998 and 2014...
October 2016: Endoscopy International Open
Gwang Ha Kim
Endoscopic submucosal dissection (ESD) enables en bloc curative resection of early gastric cancers (EGCs) with a negligible risk of lymph node metastasis (LNM). Although ESD for EGCs with absolute and expanded indications is safe, the results differ between EGCs with specialized and common histologies. EGC with papillary adenocarcinoma is a differentiated-type adenocarcinoma. At present, it is treated with ESD according to the same criteria as other differentiated-type adenocarcinomas. The LNM rate under the current indication criteria is high, and over half of the patients who undergo ESD as a primary treatment for EGC with papillary adenocarcinoma achieve an out-of-ESD result...
September 2016: Clinical Endoscopy
Seokyung Shin, Chan Hyuk Park, Hyun Ju Kim, Sang Hun Park, Sang Kil Lee, Young Chul Yoo
BACKGROUND: Ideal sedation for endoscopic submucosal dissection (ESD) aims to satisfy both the endoscopist and patient. However, previous studies show that a satisfactory procedure for the endoscopist does not equal higher patient satisfaction. This study attempted to find a sedation protocol that is able to increase patient satisfaction during propofol-based sedation by adding low-dose midazolam as premedication. METHODS: Seventy-two adult patients were randomly allocated to receive either 0...
October 14, 2016: Surgical Endoscopy
Takahiko Ito, Shuko Morita, Naoto Shimeno, Keiichiro Uehara, Yukihiro Imai, Tetsuro Inokuma
Squamous cell carcinoma (SCC) of the anal canal is seldom diagnosed at an early stage. Chemoradiation therapy is a standard in Europe and the United States, though in squamous cell carcinoma there is no evidence-based therapy. In Japan, endoscopic submucosal dissection (ESD) is the standard minimally invasive treatment for early stage cancer of the digestive tract, including the colorectum. Therefore, if the lesion is diagnosed at an early stage, ESD may be selected for anal canal lesions. We experienced two cases of early stage anal canal cancer in which the diagnosis and the extent of the lesions were confirmed using magnifying endoscopy with narrow-band imaging (NBI), as well as performing ESD...
October 13, 2016: Clinical Journal of Gastroenterology
Haruhisa Suzuki, Ichiro Oda, Seiichiro Abe, Masau Sekiguchi, Satoru Nonaka, Shigetaka Yoshinaga, Yutaka Saito, Takeo Fukagawa, Hitoshi Katai
BACKGROUND: Clinical outcomes of early gastric cancer (EGC) patients after noncurative endoscopic submucosal dissection (ESD) have not been fully elucidated; we therefore aimed to clarify these outcomes. METHODS: A total of 3058 consecutive patients with 3474 clinically diagnosed EGCs at initial onset underwent ESD with curative intent at our hospital between 1999 and 2010. We retrospectively assessed the following clinical outcomes of noncurative gastric ESD patients with a possible risk of lymph node (LN) metastasis by dividing patients into two groups with different treatment strategies (additional gastrectomy and simple follow-up): presence of LN metastasis at the time of gastrectomy, incidence of LN and distant metastases during the follow-up period, clinicopathological factors associated with metastasis, and 5-year disease-specific survival (DSS)...
October 8, 2016: Gastric Cancer
Xiaohuan Li, Yongxian Gui, Wenliang Han, Hongjian Jiang, Daihua Qi, Yi Yang
OBJECTIVE: The objective of this study is to explore the clinical effect and safety of endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for treatment of rectal carcinoids. METHODS: A retrospective analysis was conducted on 42 patients with rectal carcinoids who were hospitalized and subjected to surgical treatment in our hospital from January 2010 to November 2015. The patients were categorized into two groups based on treatment received: ESD (n = 22) and EMR (n = 20)...
October 2016: Journal of Cancer Research and Therapeutics
Glenn T Crossin, Tony D Williams
When successive stages in the life history of an animal directly overlap, physiological conflicts can arise resulting in carryover effects from one stage to another. The extreme egg-size dimorphism (ESD) of Eudyptes penguins, where the first-laid A-egg is approximately 18-57% smaller than the second-laid B-egg, has interested researchers for decades. Recent studies have linked variation in this trait to a carryover effect of migration that limits the physiology of yolk production and egg sizes. We assembled data on ESD and estimates of migration-reproduction overlap in penguin species and use phylogenetic methods to test the idea that migration-reproduction overlap explains variation in ESD...
October 12, 2016: Proceedings. Biological Sciences
Mathieu Pioche, Jérôme Rivory, Toshihiro Nishizawa, Toshio Uraoka, Sandrine Touzet, Marc O'Brien, Jean-Christophe Saurin, Thierry Ponchon, Angélique Denis, Naohisa Yahagi
Background and study aim: Endoscopic submucosal dissection (ESD) is currently the reference method to achieve an en bloc resection for large lesions; however, the technique is difficult and risky, with a long learning curve. In order to reduce the morbidity, training courses that use animal models are recommended. Recently, self-learning software has been developed to assist students in their training. The aim of this study was to evaluate the impact of this tool on the ESD learning curve. Methods: A prospective, randomized, comparative study enrolled 39 students who were experienced in interventional endoscopy...
October 5, 2016: Endoscopy
Mitsuhiro Fujishiro, Shuntaro Yoshida, Rie Matsuda, Akiko Narita, Hiroharu Yamashita, Yasuyuki Seto
BACKGROUND: Endoscopic resection for early gastric cancer (EGC) plays a central role in the treatment of EGC in Japan. However, there is still room for improvement, and it is necessary to summarize the recently obtained knowledge from Japan for further improvement. METHODS: We conducted a PubMed search to select relevant articles in the 5 years until September 18, 2016, using the keywords "gastric cancer" and "endoscopic treatment," "endoscopic submucosal dissection," "endoscopic mucosal resection," or "polypectomy" and filtering article types as "clinical study" or "clinical trial...
October 4, 2016: Gastric Cancer
Dennis Yang, Roxana M Coman, Michel Kahaleh, Irving Waxman, Andrew Y Wang, Amrita Sethi, Ashish R Shah, Peter V Draganov
BACKGROUND: and Study Aim: The role of endoscopic submucosal dissection (ESD) in Barrett's early neoplasia is not well-defined, with most studies originating from Asia and Europe. We aimed to assess the efficacy, safety, and results of ESD in Barrett's esophagus (BE) with high-grade dysplasia (HGD) and early adenocarcinoma (EAC) across centers in the United States. METHODS: Multicenter retrospective analysis on 46 patients with BE who underwent ESD for BE-HGD and/or EAC between January 2010 and April 2015...
September 26, 2016: Gastrointestinal Endoscopy
Takahisa Yamasaki, Toshihiko Tomita, Mayu Takimoto, Yoshio Ohda, Tadayuki Oshima, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
The growing use of endoscopic submucosal dissection (ESD) has enabled the highly curative treatment of early esophageal cancer. The circumferential extent of the tumor is reportedly related to the frequency of post-treatment stricture, with postoperative esophageal stricture reported to occur frequently when the post-resection mucosal defect exceeds 75 % of the esophageal luminal circumference. In some clinical cases, locally injected or orally administered steroids aimed at preventing post-treatment stricture fail to prevent re-stricture...
September 29, 2016: Clinical Journal of Gastroenterology
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