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Clinical Endoscopy

Myeong-Cherl Kook
Undifferentiated-type carcinoma has a high incidence of lymph node metastasis. The independent risk factors for lymph node metastasis in undifferentiated-type carcinoma are invasion depth, tumor size, lymphovascular invasion, and presence of ulcer. In the cases that meet the curative resection criteria, no lymph node metastasis was observed in the Japanese studies, but some metastases were observed in Korean studies. After performing curative endoscopic submucosal dissection, the survival rate is similar to that of gastrectomy...
January 25, 2019: Clinical Endoscopy
Jongha Park, Tae Oh Kim
No abstract text is available yet for this article.
January 25, 2019: Clinical Endoscopy
Jie-Hyun Kim
Endoscopic resection (ER) of undifferentiated-type early gastric cancer (UD-EGC) has a lower curative resection (CR) rate than differentiated-type EGC. However, if UD-EGC is curatively resected using ER, long-term outcomes can be favorable. Thus, the strategy for CR by ER is important in UD-EGC. To achieve CR in UD-EGC, biological behaviors including tumor growth patterns must be considered. This review aims to describe what is important for curative ER of UD-EGC.
January 24, 2019: Clinical Endoscopy
Zaheer Nabi, D Nageshwar Reddy
Malignancies of the pancreatobiliary system are usually unresectable at the time of diagnosis. As a consequence, a majority of these cases are candidates for palliative care. With advances in chemotherapeutic agents and multidisciplinary care, the survival rate in pancreatobiliary malignancies has improved. Therefore, there is a need to provide an effective and long-lasting palliative care for these patients. Endoscopic palliation is preferred to surgery as the former is associated with equal efficacy and reduced morbidity...
January 22, 2019: Clinical Endoscopy
Pujan Kandel, Michael B Wallace
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...
January 21, 2019: Clinical Endoscopy
Jimin Han
No abstract text is available yet for this article.
January 17, 2019: Clinical Endoscopy
Kyoungwon Jung, Moo In Park
No abstract text is available yet for this article.
January 17, 2019: Clinical Endoscopy
Chang Seok Bang, Gwang Ho Baik
Endoscopic submucosal dissection (ESD) is a standard treatment for patients with gastrointestinal neoplasms with a negligible risk of lymph node metastasis. ESD enables en bloc resection of gastrointestinal neoplasms and organ preservation, thereby, avoiding surgical treatment. Although small (<2 cm) intramucosal early gastric cancer with undifferentiated-type histology (EGC-UH) without ulceration is included in the expanded criteria for ESD, controversies remain due to different biology and characteristics compared to EGC with differentiated-type histology...
January 17, 2019: Clinical Endoscopy
Lalitha M Sitaraman, Amit H Sachdev, Tamas A Gonda, Amrita Sethi, John M Poneros, Frank G Gress
Background/Aims: The aim of this study was to describe the diagnostic yield of endoscopic ultrasound (EUS) in patients with isolated elevated levels of amylase and/or lipase. Methods: A retrospective chart review was conducted at a large academic medical center from 2000 to 2016. Patients were selected based on having elevated amylase, lipase, or both, but without a diagnosis of pancreatitis or known pancreatobiliary disease. Patients were excluded if they had abnormal liver function tests or abnormal imaging of the pancreas...
January 16, 2019: Clinical Endoscopy
Hironori Yamamoto, Satoshi Shinozaki, Yoshikazu Hayashi, Yoshimasa Miura, Tsevelnorov Khurelbaatar, Hiroyuki Osawa, Alan Kawarai Lefor
Early detection and resection of neoplastic lesions are key objectives to diminish colorectal cancer mortality. Resection of superficial colorectal neoplasms, cold snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection have all been developed and used worldwide. The pocket-creation method facilitates the resection of tumors in difficult and routine locations. Early detection is the most important first step to maximize the benefits of recent advancements in endoscopic techniques...
January 10, 2019: Clinical Endoscopy
Zaheer Nabi, D Nageshwar Reddy
Combined obstruction of the bile duct and duodenum is a common occurrence in periampullary malignancies. The obstruction of gastric outlet or duodenum can follow, occur simultaneously, or precede biliary obstruction. The prognosis in patients with combined obstruction is particularly poor. Therefore, minimally invasive palliation is preferred in these patients to avoid morbidity associated with surgery. Endoscopic palliation is preferred to surgical bypass due to similar efficacy, less morbidity, and shorter hospital stay...
January 10, 2019: Clinical Endoscopy
Ji Young Park, Tae Joo Jeon
Background/Aims: Pathological diagnosis of biliary strictures with atypical or suspicious cells on endoscopic retrograde brush cytology and indeterminate strictures on imaging is challenging. The aim of this study was to identify markers for malignant strictures in such cases. Methods: We retrospectively analyzed data collected from 146 consecutive patients with indeterminate biliary strictures on imaging who underwent endoscopic retrograde brush cytology from 2007 to 2013...
January 9, 2019: Clinical Endoscopy
Ahmed Youssef Altonbary, Hazem Hakim, Ahmed Mohamed El-Shamy
Background/Aims: Endoscopic ultrasound (EUS) has a limited ability to determine the nature of solid pancreatic lesions (SPLs). Most recent ultrasound processors are provided with elastography software, which allows quantification of the tissue hardness. The aim of this study is to evaluate the effectiveness of the elasticity score (ES) and strain ratio (SR) in the differentiation of benign pancreatic lesions from malignant pancreatic lesions. Methods: The study had a retrospective design; it included 97 patients with SPLs and 19 patients with inflammatory lesions...
January 8, 2019: Clinical Endoscopy
Charles J Kahi
Conventional adenomas have historically been considered to be the only screening-relevant colorectal cancer (CRC) precursor lesion. The prevailing paradigm was that most CRCs arise along the chromosomal instability pathway, where adenomas accumulate incremental genetic alterations over time, leading eventually to malignancy. However, it is now recognized that this "conventional" pathway accounts for only about two-thirds of CRCs. The serrated pathway is responsible for most of the remainder, and is a disproportionate contributor to postcolonoscopy CRC...
January 8, 2019: Clinical Endoscopy
Yuki Fujii, Yoshihide Kanno, Shinsuke Koshita, Takahisa Ogawa, Hiroaki Kusunose, Kaori Masu, Toshitaka Sakai, Keisuke Yonamine, Yujiro Kawakami, Toji Murabayashi, Fumisato Kozakai, Yutaka Noda, Hiroyuki Okada, Kei Ito
Background/Aims: This study aimed to identify the predictive factors for inaccurate endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnosis of swollen lymph nodes without rapid on-site cytopathological evaluation. Methods: Eighty-three consecutive patients who underwent EUS-FNA for abdominal or mediastinal lymph nodes from January 2008 to June 2017 were included from a prospectively maintained EUS-FNA database and retrospectively reviewed. The sensitivity, specificity, and accuracy of EUS-FNA for the detection of neoplastic diseases were calculated...
January 7, 2019: Clinical Endoscopy
Yousuke Nakai, Hirofumi Kogure, Hiroyuki Isayama, Kazuhiko Koike
Endoscopic transpapillary biliary drainage is the current standard of care for unresectable hilar malignant biliary obstruction (MBO) and bilateral metal stent placement is shown to have longer patency. However, technical and clinical failure is possible and percutaneous transhepatic biliary drainage (PTBD) is sometimes necessary. Endoscopic ultrasound-guided biliary drainage (EUS-BD) is increasingly being reported as an alternative rescue procedure to PTBD. EUS-BD has a potential advantage of not traversing the biliary stricture and internal drainage can be completed in a single session...
November 29, 2018: Clinical Endoscopy
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
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...
November 21, 2018: Clinical Endoscopy
Jung-Wook Kim
There have been many advances in endoscopic imaging technologies. Magnifying endoscopy with narrow-band imaging is an innovative optical technology that enables the precise discrimination of structural changes on the mucosal surface. Several studies have demonstrated its usefulness and superiority for tumor detection and differential diagnosis in the stomach as compared with conventional endoscopy. Furthermore, magnifying endoscopy with narrow-band imaging has the potential to predict the invasion depth and tumor margins during gastric endoscopic submucosal dissection...
November 19, 2018: Clinical Endoscopy
Si Hyung Lee, Byung Sam Park
If a lesion does not meet the expanded indication criteria for treatment with endoscopic therapy for early gastric cancer or does not have a positive resection margin, it is regarded as suitable for non-curative resection. Non-curative resection is closely related to the risk of local recurrence, lymph node metastasis, and poor prognosis. If the result is confirmed as non-curative resection, additional treatment should be considered depending on the risks of residual tumor, local recurrence, and lymph node metastasis...
January 2019: Clinical Endoscopy
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