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Yonazu S, Ozawa T, Nakanishi T, Ochiai K, Shibata J, Osawa H, Hirasawa T, Kato Y, Tajiri H, Tada T. Cost-effectiveness analysis of the artificial intelligence diagnosis support system for early gastric cancers. DEN Open 2024; 4:e289. [PMID: 37644958 PMCID: PMC10461711 DOI: 10.1002/deo2.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/24/2023] [Accepted: 08/11/2023] [Indexed: 08/31/2023]
Abstract
Objectives The introduction of artificial intelligence into the medical field has improved the diagnostic capabilities of physicians. However, few studies have analyzed the economic impact of employing artificial intelligence technologies in the clinical environment. This study evaluated the cost-effectiveness of a computer-assisted diagnosis (CADx) system designed to support clinicians in differentiating early gastric cancers from non-cancerous lesions in Japan, where the universal health insurance system was introduced. Methods The target population to be used for the CADx was estimated as those with moderate to severe gastritis caused by Helicobacter pylori infection. Decision trees with Markov models were built to analyze the cumulative cost-effectiveness of using CADx relative to the pre-artificial intelligence status quo, a condition reconstructed from data in published reports. After conducting a base-case analysis, we performed sensitivity analyses by modifying several parameters. The primary outcome was the incremental cost-effectiveness ratio. Results Compared with the status quo as represented in the base-case analysis, the incremental cost-effectiveness ratio of CADx in the Japanese market was forecasted to be 11,093 USD per quality-adjusted life year. The sensitivity analyses demonstrated that the expected incremental cost-effectiveness ratios were within the willingness-to-pay threshold of 50,000 USD per quality-adjusted life year when the cost of the CAD was less than 104 USD. Conclusions Using CADx for EGCs may decrease their misdiagnosis, contributing to improved cost-effectiveness in Japan.
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Affiliation(s)
- Shion Yonazu
- Faculty of MedicineThe University of TokyoTokyoJapan
- AI Medical Service Inc.TokyoJapan
| | - Tsuyoshi Ozawa
- AI Medical Service Inc.TokyoJapan
- Tada Tomohiro Institute of Gastroenterology and ProctologySaitamaJapan
| | | | - Kentaro Ochiai
- AI Medical Service Inc.TokyoJapan
- Department of Surgical Oncology, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Junichi Shibata
- AI Medical Service Inc.TokyoJapan
- Tada Tomohiro Institute of Gastroenterology and ProctologySaitamaJapan
| | - Hiroyuki Osawa
- Departments of Medicine and GastroenterologyDivision of Gastroenterology, Jichi Medical UniversityTochigiJapan
| | - Toshiaki Hirasawa
- Department of GastroenterologyCancer Institute Hospital of the Japanese Foundation for Cancer ResearchTokyoJapan
| | | | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy ResearchThe Jikei University School of MedicineTokyoJapan
| | - Tomohiro Tada
- AI Medical Service Inc.TokyoJapan
- Tada Tomohiro Institute of Gastroenterology and ProctologySaitamaJapan
- Department of Surgical Oncology, Graduate School of MedicineThe University of TokyoTokyoJapan
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2
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Sakurai T, Omori T, Tanaka H, Ito T, Ando K, Yamamura T, Nanjjo S, Osawa S, Takeda T, Watanabe K, Hiraga H, Yamamoto S, Ozeki K, Tanaka S, Tajiri H, Saruta M. Multicenter prospective registration study of efficacy and safety of capsule endoscopy in Crohn's disease in Japan (SPREAD-J study). J Gastroenterol 2023; 58:1003-1014. [PMID: 37479808 PMCID: PMC10522504 DOI: 10.1007/s00535-023-02017-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/27/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Evidence of small-bowel capsule endoscopy (SBCE) for evaluating lesions in Crohn's disease (CD) is lacking. We aimed to clarify the effectiveness and safety of SBCE in a large sample of patients with CD. METHODS This multicenter prospective registration study recorded the clinical information and SBCE results of patients with definitive CD (d-CD) or suspected CD (s-CD). The primary outcomes were the rates of successful assessment of disease activity using SBCE, definitive diagnosis of CD, and adverse events. Secondary outcomes were the assessment of SBCE findings in patients with d-CD and s-CD and factors affecting SBCE incompletion and retention; and tertiary outcomes included the association between clinical disease activity or blood examination, endoscopic disease activity, ileal CD, and the questionnaire assessment of patient acceptance of SBCE. RESULTS Of 544 patients analyzed, 541 underwent SBCE with 7 (1.3%) retention cases. Of 468 patients with d-CD, 97.6% could be evaluated for endoscopic activity. Of 76 patients with s-CD, 15.8% were diagnosed with 'confirmed CD'. CD lesions were more frequently observed in the ileum and were only seen in the jejunum in 3.4% of the patients. Male sex and stenosis were risk factors for incomplete SBCE, and high C-reactive protein levels and stenosis were risk factors for capsule retention. In L1 (Montreal classification) patients, clinical remission was associated with endoscopic remission but showed low specificity and accuracy. The answers to the acceptability questionnaire showed the minimal invasiveness and tolerability of SBCE. CONCLUSION SBCE is practical and safe in patients with CD.
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Affiliation(s)
- Toshiyuki Sakurai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Teppei Omori
- Institute of Gastroenterology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Hiroki Tanaka
- Sapporo IBD Clinic, Yamahana Doctor Town F2, 1-18, Minami-19, Nishi-8, Chuo-ku, Sapporo, Hokkaido, 064-0919, Japan
| | - Takahiro Ito
- Inflammatory Bowel Disease Center, Sapporo Higashi Tokushukai Hospital, N33-E14, Higashi-ku, Sapporo, Hokkaido, 065-0033, Japan
| | - Katsuyoshi Ando
- Gastroenterology and Endoscopy, Division of Metabolism and Biosystemic Science, Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 1-1-1, Higashi-nizyo, Midorigaoka, Asahikawa, Hokkaido, 078-8510, Japan
| | - Takeshi Yamamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Sohachi Nanjjo
- Third Department of Internal Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan
| | - Satoshi Osawa
- Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu, 431-3192, Japan
| | - Teruyuki Takeda
- Inflammatory Bowel Disease Center, Fukuoka University Chikushi Hospital, 1-1-1, Zokumyoin, Chikushino, Fukuoka, 818-8502, Japan
| | - Kenji Watanabe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo Medical University, 1-1, Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Hiroto Hiraga
- Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, 53-Hon-cho, Hirosaki, Aomori, 036-8563, Japan
| | - Shuji Yamamoto
- Department of Gastroenterology and Hepatology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Keiji Ozeki
- Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1, Kawasumi, Mizuho-machi, Mizuho-ku, Nagoya, 467-0001, Japan
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masayuki Saruta
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
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3
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Saito Y, Sakamoto T, Dekker E, Pioche M, Probst A, Ponchon T, Messmann H, Dinis-Ribeiro M, Matsuda T, Ikematsu H, Saito S, Wada Y, Oka S, Sano Y, Fujishiro M, Murakami Y, Ishikawa H, Inoue H, Tanaka S, Tajiri H. First report from the International Evaluation of Endoscopic classification Japan NBI Expert Team: International multicenter web trial. Dig Endosc 2023. [PMID: 37702082 DOI: 10.1111/den.14682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/10/2023] [Indexed: 09/14/2023]
Abstract
OBJECTIVES Narrow-band imaging (NBI) contributes to real-time optical diagnosis and classification of colorectal lesions. The Japan NBI Expert Team (JNET) was introduced in 2011. The aim of this study was to explore the diagnostic accuracy of JNET when applied by European and Japanese endoscopists not familiar with this classification. METHODS This study was conducted by 36 European Society of Gastrointestinal Endoscopy (ESGE) and 49 Japan Gastroenterological Endoscopy Society (JGES) non-JNET endoscopists using still images of 150 lesions. For each lesion, nonmagnified white-light, nonmagnified NBI, and magnified NBI images were presented. In the magnified NBI, the evaluation area was designated by region of interest (ROI). The endoscopists scored histological prediction for each lesion. RESULTS In ESGE members, the sensitivity, specificity, and accuracy were respectively 73.3%, 94.7%, and 93.0% for JNET Type 1; 53.0%, 64.9%, and 62.1% for Type 2A; 43.9%, 67.7%, and 55.1% for Type 2B; and 38.1%, 93.7%, and 85.1% for Type 3. When Type 2B and 3 were considered as one category of cancer, the sensitivity, specificity, and accuracy for differentiating high-grade dysplasia and cancer from the others were 59.9%, 72.5%, and 63.8%, respectively. These trends were the same for JGES endoscopists. CONCLUSION The diagnostic accuracy of the JNET classification was similar between ESGE and JGES and considered to be sufficient for JNET Type 1. On the other hand, the accuracy for Types 2 and 3 is not sufficient; however, JNET 2B lesions should be resected en bloc due to the risk of cancers and JNET 3 can be treated by surgery due to its high specificity.
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Affiliation(s)
- Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Taku Sakamoto
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
- University of Tsukuba, Ibaraki, Japan
| | - Evelien Dekker
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Andreas Probst
- RISE@CI-IPO, Portuguese Oncology Institute of Porto/Porto Comprehensive Cancer Center, Porto, Portugal
| | | | - Helmut Messmann
- RISE@CI-IPO, Portuguese Oncology Institute of Porto/Porto Comprehensive Cancer Center, Porto, Portugal
| | | | - Takahisa Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
- Toho University, Tokyo, Japan
| | | | | | | | - Shiro Oka
- Hiroshima University, Hiroshima, Japan
| | | | | | | | | | | | - Shinji Tanaka
- Hiroshima University, Hiroshima, Japan
- JA Onomichi General Hospital, Hiroshima, Japan
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4
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Perisetti A, Desai M, Bourke MJ, Penman I, Repici A, Reddy DN, Tajiri H, Rex DK, Hassan C, Sharma P. Production and possible reduction of greenhouse gases produced during GI endoscopy activity: a systematic review of available literature. Gut 2023; 72:493-500. [PMID: 36522150 DOI: 10.1136/gutjnl-2022-328369] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 10/29/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND AIMS Greenhouse gases (GHGs) that trap heat in the atmosphere are composed of carbon dioxide (CO2), methane, nitrous oxide and fluorinated gases (synthetic hydrofluorocarbons, perfluorocarbons and nitrogen trifluoride). In the USA, the health sector accounts for 8.5% of total GHG emissions. The primary objective of this systematic review was to critically analyse the carbon emissions data from GI endoscopic activity. DESIGN The GI endoscopy carbon cycle was evaluated at preprocedural, intraprocedural and postprocedural levels. We performed a systematic literature search of articles published on these issues until 30 June 2022 and discussed these available data on endoscopy unit GHG carbon cycle, barriers to reduce GHG emissions and potential solutions. The inclusion criteria were any full-text articles (observational, clinical trials, brief communications, case series and editorials) reporting waste generation from GI endoscopy. Abstracts, news articles and conference proceedings were excluded. RESULTS Our search yielded 393 records in PubMed, 1708 in Embase and 24 in Google Scholar. After application of inclusion and exclusion factors, we focused on 9 fulllength articles in detail, only 3 of them were cross-sectional studies (all from the USA), the others reviews or position statements. Therefore, the quality of the studies could not be assessed due to heterogeneity in definitions and amount of emissions. CONCLUSIONS Recognition of carbon emissions generated by GI endoscopy activity is critical. Although multiple limitations exists for quantification of these emission, there is an urgent need for collecting proper data as well as examining novel methods for reduction of these emissions for a sustainable endoscopic practices in the future.
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Affiliation(s)
- Abhilash Perisetti
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Madhav Desai
- Gastroenterology, Kansas City VA Medical Center, Kansas City, Missouri, USA
| | - Michael J Bourke
- Gastroenterology and Hepatology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Ian Penman
- Gastroenterology and Hepatology, Centre for Liver & Digestive Disorders, Royal Infirmary Edinburgh, Edinburgh, UK
| | - Alessandro Repici
- Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Rozzano, Milano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Duvvur Nageshwar Reddy
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India
| | - Hisao Tajiri
- Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Douglas K Rex
- Gastroenterology and Hepatology, Indiana University School of Medicine, Indiana University Hospital, Indianapolis, Indiana, USA
| | - Cesare Hassan
- Department of Gastroenterology, IRCCS Istituto Clinico Humanitas, Rozzano, Milano, Italy.,Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milano, Italy
| | - Prateek Sharma
- Gastroenterology and Hepatology, Kansas City VA Medical Center, Kansas City, Missouri, USA .,Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, Missouri, USA
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5
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Mori Y, East JE, Hassan C, Halvorsen N, Berzin TM, Byrne M, von Renteln D, Hewett DG, Repici A, Ramchandani M, Al Khatry M, Kudo SE, Wang P, Yu H, Saito Y, Misawa M, Parasa S, Matsubayashi CO, Ogata H, Tajiri H, Pausawasdi N, Dekker E, Ahmad OF, Sharma P, Rex DK. Benefits and challenges in implementation of artificial intelligence in colonoscopy: World Endoscopy Organization position statement. Dig Endosc 2023; 35:422-429. [PMID: 36749036 DOI: 10.1111/den.14531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/06/2023] [Indexed: 02/08/2023]
Abstract
The number of artificial intelligence (AI) tools for colonoscopy on the market is increasing with supporting clinical evidence. Nevertheless, their implementation is not going smoothly for a variety of reasons, including lack of data on clinical benefits and cost-effectiveness, lack of trustworthy guidelines, uncertain indications, and cost for implementation. To address this issue and better guide practitioners, the World Endoscopy Organization (WEO) has provided its perspective about the status of AI in colonoscopy as the position statement. WEO Position Statement: Statement 1.1: Computer-aided detection (CADe) for colorectal polyps is likely to improve colonoscopy effectiveness by reducing adenoma miss rates and thus increase adenoma detection; Statement 1.2: In the short term, use of CADe is likely to increase health-care costs by detecting more adenomas; Statement 1.3: In the long term, the increased cost by CADe could be balanced by savings in costs related to cancer treatment (surgery, chemotherapy, palliative care) due to CADe-related cancer prevention; Statement 1.4: Health-care delivery systems and authorities should evaluate the cost-effectiveness of CADe to support its use in clinical practice; Statement 2.1: Computer-aided diagnosis (CADx) for diminutive polyps (≤5 mm), when it has sufficient accuracy, is expected to reduce health-care costs by reducing polypectomies, pathological examinations, or both; Statement 2.2: Health-care delivery systems and authorities should evaluate the cost-effectiveness of CADx to support its use in clinical practice; Statement 3: We recommend that a broad range of high-quality cost-effectiveness research should be undertaken to understand whether AI implementation benefits populations and societies in different health-care systems.
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Affiliation(s)
- Yuichi Mori
- Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway.,Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway.,Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - James E East
- Translational Gastroenterology Unit, John Radcliffe Hospital, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford, UK.,Division of Gastroenterology and Hepatology, Mayo Clinic Healthcare, London, UK
| | - Cesare Hassan
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.,Endoscopy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | - Natalie Halvorsen
- Clinical Effectiveness Research Group, University of Oslo, Oslo, Norway
| | - Tyler M Berzin
- Division of Gastroenterology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, USA
| | - Michael Byrne
- Department of Medicine, The University of British Columbia, Vancouver, Canada
| | - Daniel von Renteln
- Division of Gastroenterology, University of Montreal Medical Center (CHUM) and Research Center (CRCHUM), Montreal, Canada
| | - David G Hewett
- School of Medicine, The University of Queensland, Brisbane, Australia
| | - Alessandro Repici
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy.,Endoscopy Unit, Humanitas Clinical and Research Center - IRCCS, Rozzano, Italy
| | | | - Maryam Al Khatry
- Department of Gastroenterology, Obaidulla Hospital, Ras Al Khaimah, United Arab Emirates
| | - Shin-Ei Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | - Pu Wang
- Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Honggang Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Masashi Misawa
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa, Japan
| | | | - Carolina Ogawa Matsubayashi
- Gastrointestinal Endoscopy Unit, Gastroenterology Department, University of São Paulo Medical School, São Paulo, Brazil
| | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan
| | - Hisao Tajiri
- Jikei University School of Medicine, Tokyo, Japan
| | - Nonthalee Pausawasdi
- Vikit Viranuvatti Siriraj GI Endoscopy Center,, Mahidol University, Bangkok, Thailand.,Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Evelien Dekker
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | | | - Prateek Sharma
- Division of Gastroenterology and Hepatology, University of Kansas School of Medicine and VA Medical Center, Kansas City, USA
| | - Douglas K Rex
- Division of Gastroenterology, Indiana University School of Medicine, Indianapolis, USA
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6
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Ishioka M, Osawa H, Hirasawa T, Kawachi H, Nakano K, Fukushima N, Sakaguchi M, Tada T, Kato Y, Shibata J, Ozawa T, Tajiri H, Fujisaki J. Performance of an artificial intelligence-based diagnostic support tool for early gastric cancers: Retrospective study. Dig Endosc 2022; 35:483-491. [PMID: 36239483 DOI: 10.1111/den.14455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/12/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Endoscopists' abilities to diagnose early gastric cancers (EGCs) vary, especially between specialists and nonspecialists. We developed an artificial intelligence (AI)-based diagnostic support tool "Tango" to differentiate EGCs and compared its performance with that of endoscopists. METHODS The diagnostic performances of Tango and endoscopists (34 specialists, 42 nonspecialists) were compared using still images of 150 neoplastic and 165 non-neoplastic lesions. Neoplastic lesions included EGCs and adenomas. The primary outcome was to show the noninferiority of Tango (based on sensitivity) over specialists. The secondary outcomes were the noninferiority of Tango (based on accuracy) over specialists and the superiority of Tango (based on sensitivity and accuracy) over nonspecialists. The lower limit of the 95% confidence interval (CI) of the difference between Tango and the specialists for sensitivity was calculated, with >-10% defined as noninferiority and >0% defined as superiority in the primary outcome. The comparable differences between Tango and the endoscopists for each performance were calculated, with >10% defined as superiority and >0% defined as noninferiority in the secondary outcomes. RESULTS Tango achieved superiority over the specialists based on sensitivity (84.7% vs. 65.8%, difference 18.9%, 95% CI 12.3-25.3%) and demonstrated noninferiority based on accuracy (70.8% vs. 67.4%). Tango achieved superiority over the nonspecialists based on sensitivity (84.7% vs. 51.0%) and accuracy (70.8% vs. 58.4%). CONCLUSIONS The AI-based diagnostic support tool for EGCs demonstrated a robust performance and may be useful to reduce misdiagnosis.
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Affiliation(s)
- Mitsuaki Ishioka
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroyuki Osawa
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Toshiaki Hirasawa
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroshi Kawachi
- Department of Pathology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Kaoru Nakano
- Department of Pathology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | | | - Mio Sakaguchi
- Department of Pathology, Jichi Medical University, Tochigi, Japan
| | - Tomohiro Tada
- AI Medical Service Inc., Tokyo, Japan.,Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Tada Tomohiro Institute of Gastroenterology and Proctology, Saitama, Japan
| | | | - Junichi Shibata
- AI Medical Service Inc., Tokyo, Japan.,Tada Tomohiro Institute of Gastroenterology and Proctology, Saitama, Japan
| | - Tsuyoshi Ozawa
- AI Medical Service Inc., Tokyo, Japan.,Department of Surgical Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisao Tajiri
- The Jikei University School of Medicine, Tokyo, Japan
| | - Junko Fujisaki
- Department of Gastroenterology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
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7
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Sugano K, Spechler SJ, El-Omar EM, McColl KEL, Takubo K, Gotoda T, Fujishiro M, Iijima K, Inoue H, Kawai T, Kinoshita Y, Miwa H, Mukaisho KI, Murakami K, Seto Y, Tajiri H, Bhatia S, Choi MG, Fitzgerald RC, Fock KM, Goh KL, Ho KY, Mahachai V, O'Donovan M, Odze R, Peek R, Rugge M, Sharma P, Sollano JD, Vieth M, Wu J, Wu MS, Zou D, Kaminishi M, Malfertheiner P. Kyoto international consensus report on anatomy, pathophysiology and clinical significance of the gastro-oesophageal junction. Gut 2022; 71:1488-1514. [PMID: 35725291 PMCID: PMC9279854 DOI: 10.1136/gutjnl-2022-327281] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/03/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE An international meeting was organised to develop consensus on (1) the landmarks to define the gastro-oesophageal junction (GOJ), (2) the occurrence and pathophysiological significance of the cardiac gland, (3) the definition of the gastro-oesophageal junctional zone (GOJZ) and (4) the causes of inflammation, metaplasia and neoplasia occurring in the GOJZ. DESIGN Clinical questions relevant to the afore-mentioned major issues were drafted for which expert panels formulated relevant statements and textural explanations.A Delphi method using an anonymous system was employed to develop the consensus, the level of which was predefined as ≥80% of agreement. Two rounds of voting and amendments were completed before the meeting at which clinical questions and consensus were finalised. RESULTS Twenty eight clinical questions and statements were finalised after extensive amendments. Critical consensus was achieved: (1) definition for the GOJ, (2) definition of the GOJZ spanning 1 cm proximal and distal to the GOJ as defined by the end of palisade vessels was accepted based on the anatomical distribution of cardiac type gland, (3) chemical and bacterial (Helicobacter pylori) factors as the primary causes of inflammation, metaplasia and neoplasia occurring in the GOJZ, (4) a new definition of Barrett's oesophagus (BO). CONCLUSIONS This international consensus on the new definitions of BO, GOJ and the GOJZ will be instrumental in future studies aiming to resolve many issues on this important anatomic area and hopefully will lead to better classification and management of the diseases surrounding the GOJ.
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Affiliation(s)
- Kentaro Sugano
- Division of Gastroenterology, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Stuart Jon Spechler
- Division of Gastroenterology, Center for Esophageal Diseases, Baylor University Medical Center, Dallas, Texas, USA
| | - Emad M El-Omar
- Microbiome Research Centre, St George & Sutherland Clinical Campuses, School of Clinical Medicine, Faculty of Medicine & Health, Sydney, New South Wales, Australia
| | - Kenneth E L McColl
- Division of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Kaiyo Takubo
- Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Takuji Gotoda
- Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Katsunori Iijima
- Department of Gastroenterology, Akita University Graduate School of Medicine, Akita, Japan
| | - Haruhiro Inoue
- Digestive Disease Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Takashi Kawai
- Department of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan
| | | | - Hiroto Miwa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Hyogo College of Medicine, Kobe, Japan
| | - Ken-ichi Mukaisho
- Education Center for Medicine and Nursing, Shiga University of Medical Science, Otsu, Japan
| | - Kazunari Murakami
- Department of Gastroenterology, Oita University Faculty of Medicine, Yuhu, Japan
| | - Yasuyuki Seto
- Department of Gastrointestinal Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisao Tajiri
- Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | | | - Myung-Gyu Choi
- Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, The Republic of Korea
| | - Rebecca C Fitzgerald
- Medical Research Council Cancer Unit, Hutchison/Medical Research Council Research Centre, University of Cambridge, Cambridge, UK
| | - Kwong Ming Fock
- Department of Gastroenterology and Hepatology, Duke NUS School of Medicine, National University of Singapore, Singapore
| | | | - Khek Yu Ho
- Department of Medicine, National University of Singapore, Singapore
| | - Varocha Mahachai
- Center of Excellence in Digestive Diseases, Thammasat University and Science Resarch and Innovation, Bangkok, Thailand
| | - Maria O'Donovan
- Department of Histopathology, Cambridge University Hospital NHS Trust UK, Cambridge, UK
| | - Robert Odze
- Department of Pathology, Tuft University School of Medicine, Boston, Massachusetts, USA
| | - Richard Peek
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Massimo Rugge
- Department of Medicine DIMED, Surgical Pathology and Cytopathology Unit, University of Padova, Padova, Italy
| | - Prateek Sharma
- Department of Gastroenterology and Hepatology, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Jose D Sollano
- Department of Medicine, University of Santo Tomas, Manila, Philippines
| | - Michael Vieth
- Institute of Pathology, Klinikum Bayreuth, Friedrich-Alexander University Erlangen, Nurenberg, Germany
| | - Justin Wu
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - Ming-Shiang Wu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Duowu Zou
- Department of Gastroenterology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Peter Malfertheiner
- Medizinixhe Klinik und Poliklinik II, Ludwig Maximillian University Klinikum, Munich, Germany,Klinik und Poliklinik für Radiologie, Ludwig Maximillian University Klinikum, Munich, Germany
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8
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Tajiri H. History of the Japan Gastroenterological Endoscopy Society. Dig Endosc 2022; 34 Suppl 2:8-12. [PMID: 34423515 DOI: 10.1111/den.14084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
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9
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Ohmiya N, Oka S, Nakayama Y, Iwama I, Nakamura M, Shimizu H, Sumioka A, Abe N, Kudo T, Osawa S, Honma H, Okuhira T, Mtsufuji S, Imaeda H, Ota K, Matsuoka R, Hotta N, Inoue M, Nakaji K, Takamaru H, Ozeki K, Kobayashi T, Hosoe N, Tajiri H, Tanaka S. Safety and efficacy of the endoscopic delivery of capsule endoscopes in adult and pediatric patients: Multicenter Japanese study (AdvanCE-J study). Dig Endosc 2022; 34:543-552. [PMID: 34379849 DOI: 10.1111/den.14104] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND AIM We retrospectively determined the safety and efficacy of the endoscopic delivery (ED) of capsule endoscopes. METHODS We enrolled 10,156 patients who underwent small bowel capsule endoscopy (SBCE), 3182 who underwent patency capsule (PC), and 1367 who underwent colon capsule endoscopy (CCE), at 11 gastroenterological and nine pediatric centers. RESULTS Small bowel capsule endoscopies, PCs, and CCEs were endoscopically delivered to 546 (5.4%), 214 (6.7%), and 14 (1.0%) patients, respectively. Only mild complications occurred for 21.6% (167/774), including uneventful mucosal damage, bleeding, and abdominal pain. Successful ED of SBCE to the duodenum or jejunum occurred in 91.8% and 90.7% of patients aged <16 years and ≥16 years, respectively (P = 0.6661), but the total enteroscopy rate was higher in the first group (91.7%) than in the second (76.2%, P < 0.0001), for whom impossible ingestion (87.3%) was significantly more common than prolonged lodging in the stomach (64.2%, P = 0.0010). Successful PC and CCE delivery to the duodenum occurred in 84.1% and 28.6%, thereafter the patency confirmation rate and total colonoscopy rate was 100% and 61.5%, respectively. The height, weight, and age cutoff points in predicting spontaneous ingestion were 132 cm, 24.8 kg, and 9 years 2 months, respectively, in patients aged <16 years. Patients aged ≥16 years could not swallow the SBCEs mainly due to dysphagia (75.0%); those who retained it in the esophagus due to cardiac disease (28.6%), etc. and in the stomach due to diabetes mellitus (15.7%), etc. CONCLUSIONS: This large-scale study supports the safety and efficacy of ED in adult and pediatric patients. UMIN000042020.
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Affiliation(s)
- Naoki Ohmiya
- Departments of Gastroenterology and Advanced Endoscopy, Fujita Health University School of Medicine, Aichi, Japan
| | - Shiro Oka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Yoshiko Nakayama
- Department of Pediatrics, Shinshu University School of Medicine, Nagano, Japan
| | - Itaru Iwama
- Division of Gastroenterology and Hepatology, Saitama Children's Medical Center, Saitama, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hirotaka Shimizu
- Division of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan
| | - Akihiko Sumioka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Naoki Abe
- Division of Infectious Diseases and Immunology, Aichi Children's Health and Medical Center, Aichi, Japan
| | - Takahiro Kudo
- Department of Pediatrics, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Satoshi Osawa
- Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Hitoshi Honma
- Department of Gastroenterology and Endocrinology, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Takeru Okuhira
- Department of Pediatrics, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Shoji Mtsufuji
- Department of Gastroenterology, Kyoto Kujo Hospital, Kyoto, Japan
| | - Hiroyuki Imaeda
- Department of Gastroenterology, Saitama Medical University, Saitama, Japan
| | - Kazuhiro Ota
- Second Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Ryo Matsuoka
- Department of Pediatrics, Fuji City General Hospital, Shizuoka, Japan
| | - Naoki Hotta
- Department of Internal Medicine, Masuko Memorial Hospital, Aichi, Japan
| | - Mikihiro Inoue
- Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | | | | | - Keiji Ozeki
- Departments of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Taku Kobayashi
- Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Naoki Hosoe
- Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
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10
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Saito Y, Kodashima S, Matsuda T, Matsuda K, Fujishiro M, Tanaka K, Kobayashi K, Katada C, Horimatsu T, Muto M, Ohtsuka K, Oda I, Kato M, Kida M, Hoteya S, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Kato M, Haruma K, Fujimoto K, Iishi H, Ogata H, Uemura N, Kaminishi M, Tajiri H, Inoue H. Current status of diagnostic and therapeutic colonoscopy in Japan: The Japan Endoscopic Database Project. Dig Endosc 2022; 34:144-152. [PMID: 33774877 DOI: 10.1111/den.13980] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/23/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The Japan Endoscopy Database Project was initiated to develop the world's largest endoscopy data repository. This study describes the first phase of the colonoscopy project in Japan. METHODS Data were aggregated offline by integrating information from the endoscopy database software from January 2015 through March 2017. The study population included all patients who underwent colonoscopy at eight centers. RESULTS A total of 31,395 patients who underwent 38,497 colonoscopy procedures were registered. The majority of procedures were performed for screening (n = 14,156), followed by fecal immunochemical test positivity (n = 3960), abdominal symptoms (n = 3864), post-colorectal surgery surveillance (n = 3431), post-endoscopic treatment surveillance (n = 3757), thorough pre-treatment examination (n = 2822), and therapeutic purposes (n = 6507). In the screening group, advanced cancers, early cancers, and adenomas were diagnosed endoscopically in 2.1%, 1.3%, and 28.7% of cases, respectively, while in the fecal immunochemical test-positive group, they were diagnosed in 2.5%, 1.9%, and 41.6% of cases, respectively. The incidence of complications was 0.177% and 0.152% in the screening and fecal immunochemical test-positive groups, respectively. The therapeutic procedures included 1446 cold forceps polypectomy procedures, 4770 cold snare polypectomy procedures, 368 hot biopsies, 2998 hot snare polypectomy procedures, 9775 endoscopic or piecemeal endoscopic mucosal resections, and 1660 endoscopic submucosal dissections. A total of 173 procedure-related complications (0.82%) occurred in 21,017 therapeutic procedures performed in 15,744 patients. CONCLUSIONS The first phase of the Japan Endoscopy Database Project established the proportions of the diagnostic and therapeutic colonoscopy procedures, and complication rates in real-world settings.
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Affiliation(s)
- Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroyasu Iishi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Haruhiko Ogata
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Haruhiro Inoue
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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11
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Saito Y, Oka S, Tamai N, Kudo T, Kuniyoshi N, Shirakura T, Omae Y, Hamahata Y, Arai T, Tanaka S, Uedo N, Shimizu S, Fukuzawa M, Uraoka T, Ichinose S, Ogata H, Kobayashi K, Saito S, Tajiri H. Efficacy and safety of oral sulfate solution for bowel preparation in Japanese patients undergoing colonoscopy: Noninferiority-based, randomized, controlled study. Dig Endosc 2021; 33:1131-1138. [PMID: 33476415 PMCID: PMC8596579 DOI: 10.1111/den.13930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/18/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To compare the efficacy and safety of oral sulfate solution administered using the same-day dose and the split-dose regimens with those of polyethylene glycol plus ascorbate solution, used for bowel preparation in Japanese patients undergoing colonoscopy. METHODS This multicenter (n = 13), randomized, active-controlled, colonoscopist- and image evaluator-blinded, noninferiority study with parallel-group comparison recruited 632 patients from December 2018 to June 2019. Of these, 602 patients were divided into the oral sulfate solution same-day dose group (n = 200); oral sulfate solution split-dose group (n = 202); and polyethylene glycol plus ascorbate same-day dose group (n = 200). Differences in the efficacy rates between the polyethylene glycol plus ascorbate group and each oral sulfate solution group were calculated using the asymptotic method. The safety of the oral sulfate solution was evaluated, based on the occurrence of adverse events and reactions. RESULTS Both oral sulfate solution protocols were confirmed as noninferior to the polyethylene glycol plus ascorbate protocol for bowel-cleansing. The occurrence of adverse reactions was significantly lower in the oral sulfate solution same-day dose group than in the polyethylene glycol plus ascorbate group (P = 0.010). The occurrence of adverse reactions was not significantly different between the oral sulfate solution split-dose and the polyethylene glycol plus ascorbate group. CONCLUSIONS Oral sulfate solution is not only safe and efficacious but also not inferior to polyethylene glycol plus ascorbate solution (active control). It could be used for bowel preparation in Japanese patients scheduled for colonoscopy (Clinical trial registration number: NCT03794310).
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Affiliation(s)
- Yutaka Saito
- Endoscopy DivisionNational Cancer Center HospitalTokyoJapan
| | - Shiro Oka
- Department ofGastroenterology and MetabolismHiroshima University HospitalHiroshimaJapan
| | | | - Toyoki Kudo
- Digestive Disease CenterShowa University Northern Yokohama HospitalKanagawaJapan
| | | | | | - Yoshio Omae
- Department of GastroenterologyKawasaki Saiwai HospitalKanagawaJapan
| | - Yukihiro Hamahata
- Department of ColoproctologyTsujinaka Hospital KashiwanohaChibaJapan
| | - Takehiro Arai
- Gastroenterology DivisionTokatsu‐Tsujinaka HospitalChibaJapan
| | - Shinji Tanaka
- Department ofEndoscopyHiroshima University HospitalHiroshimaJapan
| | - Noriya Uedo
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Seiji Shimizu
- Departments of Gastroenterology and HepatologyOsaka General Hospital of West Japan Railway CompanyOsakaJapan
| | - Masakatsu Fukuzawa
- Department of Gastroenterology and HepatologyTokyo Medical UniversityTokyoJapan
| | - Toshio Uraoka
- Department of Gastroenterology and HepatologyGunma University Graduate School of MedicineGunmaJapan
| | | | - Haruhiko Ogata
- Center for Diagnostic and Therapeutic EndoscopyKeio University School of MedicineTokyoJapan
| | - Kiyonori Kobayashi
- Research and Development Center for New Medical FrontiersKitasato University School of MedicineKanagawaJapan
| | - Shoichi Saito
- Department of GastroenterologyThe Cancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan
| | - Hisao Tajiri
- Department ofInnovative Interventional Endoscopy ResearchThe Jikei University School of MedicineTokyoJapan
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12
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Affiliation(s)
- Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
| | - Seiichiro Abe
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Haruhiro Inoue
- Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
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13
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Sekiya M, Uraoka T, Tajiri H. Novel hemostatic method for non-spouting bleeding from unidentified point in endoscopic submucosal dissection using a self-assembling peptide solution. Dig Endosc 2021; 33:e70-e71. [PMID: 33713496 DOI: 10.1111/den.13948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/03/2021] [Accepted: 02/04/2021] [Indexed: 01/01/2023]
Affiliation(s)
- Masashi Sekiya
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Toshio Uraoka
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Gunma, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
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14
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Uraoka T, Tanaka S, Saito Y, Matsumoto T, Kuribayashi S, Hori K, Tajiri H. Computer-assisted detection of diminutive and small colon polyps by colonoscopy using an extra-wide-area-view colonoscope. Endoscopy 2021; 53:E102-E103. [PMID: 32659811 DOI: 10.1055/a-1202-1277] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Toshio Uraoka
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Medicine, Iwate Medical University, Morioka, Japan
| | - Shiko Kuribayashi
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Keisuke Hori
- Department of Internal Medicine, Tsuyama Central Hospital, Okayama, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
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15
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Nakamura M, Watanabe K, Ohmiya N, Hirai F, Omori T, Tokuhara D, Nakaji K, Nouda S, Esaki M, Sameshima Y, Goto H, Terano A, Tajiri H, Matsui T. Tag-less patency capsule for suspected small bowel stenosis: Nationwide multicenter prospective study in Japan. Dig Endosc 2021; 33:151-161. [PMID: 32215959 DOI: 10.1111/den.13673] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/13/2020] [Accepted: 03/19/2020] [Indexed: 12/20/2022]
Abstract
STUDY AIMS The PillCam patency capsule (PPC) is an Agile tag-less patency capsule used to evaluate gastrointestinal (GI) patency. We determined the appropriate use of PPC to preclude subsequent small bowel capsule endoscopy (SBCE) retention. METHODS This prospective multicenter study consecutively enrolled patients indicated for SBCE with suspected or established small bowel stenosis. Excretion of an intact PPC or its radiologic visualization in the large bowel was considered GI patency. Primary and secondary study endpoints were SBCE retention rates in patients with confirmed patency and identification of factors associated with patency and SBCE retention, respectively. RESULTS Of 1096 patients enrolled in the study, patency was confirmed in 976 (89.1%). PPC excretion occurred in 579 patients. Of the remaining 517 patients, patency was confirmed using imaging modalities in 401 (77.5%). SBCE retention occurred in five (0.51%) of 963 patients who underwent SBCE: 1.0% in established Crohn's disease (CD) patients, 0% in suspected CD, 0% in tumors, and 1.6% in patients with obscure GI bleeding, for which PPC localization had been radiographically misinterpreted. The non-confirmation of patency was associated with established CD, stenosis identified using imaging modalities, abdominal fullness, serum albumin levels <4.0 g/dL, and previous small bowel obstruction (adjusted odds ratios: 4.21, 2.60, 2.47, 2.12, and 2.00; 95% confidence intervals: 2.62-6.78, 1.62-4.17, 1.43-4.27, 1.32-3.40, and 1.15-3.47, respectively). CONCLUSIONS The PillCam™ patency capsule helped preclude SBCE retention in most patients, but its accurate localization was essential for cases without excretion (Study registered the University Hospital Medical Information Network, #UMIN000010513).
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Affiliation(s)
- Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Kenji Watanabe
- Department of Gastroenterology, Graduate School of Medicine, Osaka City University, Osaka, Japan.,Department of Intestinal Inflammation Research, Hyogo College of Medicine, Hyogo, Japan
| | - Naoki Ohmiya
- Department of Gastroenterology, Fujita Health University School of Medicine, Aichi, Japan
| | - Fumihito Hirai
- Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Teppei Omori
- Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
| | - Daisuke Tokuhara
- Department of Pediatrics, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | | | - Sadaharu Nouda
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Motohiro Esaki
- Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Hidemi Goto
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Aichi, Japan.,Department of Gastroenterology, Meijo Hospital, Aichi, Japan
| | - Akira Terano
- Dokkyo Group of Academic Institutions, Tochigi, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Toshiyuki Matsui
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan
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16
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Guda NM, Emura F, Reddy DN, Rey J, Seo D, Gyokeres T, Tajiri H, Faigel D. Recommendations for the Operation of Endoscopy Centers in the setting of the COVID-19 pandemic - World Endoscopy Organization guidance document. Dig Endosc 2020; 32:844-850. [PMID: 32569438 PMCID: PMC7361408 DOI: 10.1111/den.13777] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/14/2020] [Accepted: 06/16/2020] [Indexed: 01/25/2023]
Abstract
Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) is the etiologic agent causing the disease Corona Virus Disease 19 (COVID-19), resulting in a worldwide pandemic. Non-emergent endoscopy services have been disrupted as incidence and hospitalizations were rising. It is anticipated that the peak incidence may be leveling off in many parts of the world, but there is a concern for resurgence of the virus activity. Thus, it is important for endoscopy units to have plans in place during peak times of the epidemic and when resuming endoscopic services as the pandemic wanes. The global endoscopy community is faced with the challenge of providing care during this time. The WEO-COVID guidance task force has provided this resource document based on the current evidence and consensus opinion. These World Endoscopy Organization (WEO) recommendations are meant to guide endoscopists worldwide, should be interpreted in light of specific clinical conditions and resource availability and may not apply in all situations. This guidance document does not supersede the need to check for all local regulations and legislations.
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Affiliation(s)
- Nalini M. Guda
- Aurora St.Luke's Medical CenterMilwaukee and GI AssociatesMilwaukeeUSA
| | - Fabian Emura
- Advanced EndoscopyEmuraCenter LatinoaméricaBogotáColombia
- Gastroenterology DivisionUniversidad de La SabanaChiaColombia
| | | | - Jean‐Fracois Rey
- Department of Hepato‐GastroenterologyInstitut Arnault TzanckSaint‐Laurent‐du‐VarFrance
| | - Dong‐Wan Seo
- Department of GastroenterologyAsan Medical Center University of Ulsan Medical CollegeSeoulKorea
| | - Tibor Gyokeres
- Department of GastroenterologyMedical CentreHungarian Defence ForcesBudapestHungary
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy ResearchThe Jikei University School of MedicineTokyoJapan
| | - Douglas Faigel
- Department of Gastroenterology and HepatologyMayo ClinicScottsdaleUSA
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17
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Furuta T, Irisawa A, Matsumoto T, Kawai T, Inaba T, Kanno A, Katanuma A, Kawahara Y, Matsuda K, Mizukami K, Otsuka T, Yasuda I, Fujishiro M, Tanaka S, Fujimoto K, Fukuda S, Iishi H, Igarashi Y, Inui K, Ueki T, Ogata H, Kato M, Shiotani A, Higuchi K, Fujita N, Murakami K, Yamamoto H, Ito T, Okazaki K, Kitagawa Y, Mine T, Tajiri H, Inoue H. Clinical Questions and Answers on Gastrointestinal Endoscopy during the Novel Coronavirus Disease 2019 pandemic. Dig Endosc 2020; 32:651-657. [PMID: 32470171 PMCID: PMC7301013 DOI: 10.1111/den.13757] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/19/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022]
Abstract
Some situations may require endoscopy during the COVID-19 (Coronavirus Disease 2019) pandemic. Here, we describe the necessary precautions in the form of clinical questions and answers (Q&A) regarding the safe deployment of gastrointestinal endoscopy in such situations while protecting endoscopy staff and patients from infection. Non-urgent endoscopy should be postponed. The risk of infection in patients should be evaluated in advance by questionnaire and body temperature. The health of staff must be checked every day. Decisions to employ endoscopy should be based on the institutional conditions and aims of endoscopy. All endoscopic staff need to wear appropriate personal protective equipment (PPE). The endoscope and other devices should be cleaned and disinfected after procedures in accordance with the relevant guidelines. Optimal management of the endoscopy unit is required. Endoscopy for infected patients or those with suspected infection demands exceptional caution. When a patient who undergoes endoscopy is later found to have COVID-19, the members of staff involved are considered exposed to the virus and must not work for at least 14 days if their PPE is considered insufficient. When PPE resources are limited, some equipment may be used continuously throughout a shift as long as it is not contaminated. Details of the aforementioned protective measures are described.
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Affiliation(s)
| | | | | | - Takashi Kawai
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Tomoki Inaba
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Atsushi Kanno
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Akio Katanuma
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | - Koji Matsuda
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | - Takao Otsuka
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Ichiro Yasuda
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | - Shinji Tanaka
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | | | | | | | - Kazuo Inui
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | | | | | | | | | | | | | | | - Tohru Ito
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | - Yuko Kitagawa
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Tetsuya Mine
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Hisao Tajiri
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
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18
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Irisawa A, Furuta T, Matsumoto T, Kawai T, Inaba T, Kanno A, Katanuma A, Kawahara Y, Matsuda K, Mizukami K, Otsuka T, Yasuda I, Tanaka S, Fujimoto K, Fukuda S, Iishi H, Igarashi Y, Inui K, Ueki T, Ogata H, Kato M, Shiotani A, Higuchi K, Fujita N, Murakami K, Yamamoto H, Ito T, Okazaki K, Kitagawa Y, Mine T, Tajiri H, Inoue H. Gastrointestinal endoscopy in the era of the acute pandemic of coronavirus disease 2019: Recommendations by Japan Gastroenterological Endoscopy Society (Issued on April 9th, 2020). Dig Endosc 2020; 32:648-650. [PMID: 32335946 PMCID: PMC7267159 DOI: 10.1111/den.13703] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 04/15/2020] [Accepted: 04/20/2020] [Indexed: 01/08/2023]
Abstract
All gastrointestinal endoscopic procedures have a high risk of aerosol contamination of the coronavirus disease 2019 (COVID-19) to endoscopists, nurses, and healthcare assistants. Given the current pandemic situation of COVID-19, the Japan Gastroenterological Endoscopy Society issued the recommendation for gastrointestinal (GI) endoscopy based on the status of COVID-19 as of April 9, 2020, in Japan: (i) indications for GI endoscopy in the pandemic of COVID-19; (ii) practical protective equipment for medical personnel depending on the risk for COVID-19; (iii) preprocedural management, such as pharyngeal local anesthesia using lidocaine spray which has a potential to generate the aerosols; (iv) ideal settings of the endoscopy room including the numbers of the staff and the patients; (v) postprocedural management, such as undressing and follow-up of the patients, as well as the involved staff, were documented to fit the practical scenarios in GI endoscopy, with the available data in Japan and the world. We believe that certain measures will prevent further spread of COVID-19.
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Affiliation(s)
| | | | | | - Takashi Kawai
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Tomoki Inaba
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Atsushi Kanno
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Akio Katanuma
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | - Koji Matsuda
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | - Takao Otsuka
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Ichiro Yasuda
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Shinji Tanaka
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | | | | | | | - Kazuo Inui
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | | | | | | | | | | | | | | | - Tohru Ito
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | | | - Yuko Kitagawa
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Tetsuya Mine
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
| | - Hisao Tajiri
- Japan Gastroenterological Endoscopy SocietyTokyoJapan
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19
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Neumann H, Emura F, Bokemeyer B, Guda N, Tajiri H, Matsumoto T, Rubin DT. Practical advice for management of inflammatory bowel diseases patients during the COVID-19 pandemic: World Endoscopy Organization Statement. Dig Endosc 2020; 32:658-662. [PMID: 32369646 DOI: 10.1111/den.13712] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/29/2020] [Accepted: 04/29/2020] [Indexed: 01/07/2023]
Abstract
COVID-19 is rapidly spreading worldwide and specific literature how to deal with inflammatory bowel diseases (IBD) patients is limited so far. Here, the World Endoscopy Organisation is providing practical advice for the management of IBD patients during the pandemic covering the diagnostic and therapeutic spectrum.
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Affiliation(s)
- Helmut Neumann
- Interdisciplinary Endoscopy, First Medical Department, University Medical Center Mainz, Mainz, Germany
| | - Fabian Emura
- Advanced Gastrointestinal Endoscopy, EmuraCenter LatinoAmerica, Bogotá DC, Colombia.,Division of Gastroenterology, Universidad de La Sabana, Chía, Colombia
| | | | - Nalini Guda
- Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin, Milwaukee, USA
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Takayuki Matsumoto
- Division of Gastroenterology, Department of Medicine, Iwate Medical University, Iwate, Japan
| | - David T Rubin
- Inflammatory Bowel Disease Center, The University of Chicago Medicine, Chicago, USA
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20
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Yao K, Uedo N, Kamada T, Hirasawa T, Nagahama T, Yoshinaga S, Oka M, Inoue K, Mabe K, Yao T, Yoshida M, Miyashiro I, Fujimoto K, Tajiri H. Guidelines for endoscopic diagnosis of early gastric cancer. Dig Endosc 2020; 32:663-698. [PMID: 32275342 DOI: 10.1111/den.13684] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/01/2020] [Indexed: 02/06/2023]
Abstract
The Japan Gastroenterological Endoscopy Society developed the Guideline for Endoscopic Diagnosis of Early Gastric Cancer based on scientific methods. Endoscopy for the diagnosis of early gastric cancer has been acknowledged as a useful and highly precise examination, and its use has become increasingly more common in recent years. However, the level of evidence in this field is low, and it is often necessary to determine recommendations based on expert consensus only. This clinical practice guideline consists of the following sections to provide the current guideline: [I] Risk stratification of gastric cancer before endoscopic examination, [II] Detection of early gastric cancer, [III] Qualitative diagnosis of early gastric cancer, [IV] Diagnosis to choose the therapeutic strategy for gastric cancer, [V] Risk stratification after endoscopic examination, and [VI] Surveillance of early gastric cancer.
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Affiliation(s)
- Kenshi Yao
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Noriya Uedo
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Tomoari Kamada
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | | | | | - Masashi Oka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuhiko Inoue
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Katsuhiro Mabe
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takashi Yao
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Isao Miyashiro
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Hisao Tajiri
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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21
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Chiu PWY, Ng SC, Inoue H, Reddy DN, Ling Hu E, Cho JY, Ho LK, Hewett DG, Chiu HM, Rerknimitr R, Wang HP, Ho SH, Seo DW, Goh KL, Tajiri H, Kitano S, Chan FKL. Practice of endoscopy during COVID-19 pandemic: position statements of the Asian Pacific Society for Digestive Endoscopy (APSDE-COVID statements). Gut 2020; 69:991-996. [PMID: 32241897 PMCID: PMC7211066 DOI: 10.1136/gutjnl-2020-321185] [Citation(s) in RCA: 241] [Impact Index Per Article: 60.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/15/2022]
Abstract
Coronavirus-19 (COVID-19) caused by SARS-CoV-2 has become a global pandemic. Risk of transmission may occur during endoscopy and the goal is to prevent infection among healthcare professionals while providing essential services to patients. Asia was the first continent to have a COVID-19 outbreak, and this position statement of the Asian Pacific Society for Digestive Endoscopy shares our successful experience in maintaining safe and high-quality endoscopy practice at a time when resources are limited. Sixteen experts from key societies of digestive endoscopy in Asia were invited to develop position statements, including patient triage and risk assessment before endoscopy, resource prioritisation and allocation, regular monitoring of personal protective equipment, infection control measures, protective device training and implementation of a strategy for stepwise resumption of endoscopy services after control of the COVID-19 outbreak.
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Affiliation(s)
- Philip Wai Yan Chiu
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Siew C Ng
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Haruhiro Inoue
- Digestive Disease Center, Showa University, Northern Yokohama Hospital, Yokohama, Japan
| | - D Nageshwar Reddy
- Asian Healthcare Foundation, Asian Institute of Gastroenterology, Hyderabad, Andhra Pradesh, India
| | - Enqiang Ling Hu
- Department of Gastroenterology and Hepatology, General Hospital of Chinese PLA, Beijing, China
| | - Joo Young Cho
- Digestive Endoscopy Center, CHA Bundang Medical Center, CHA University, Seoul, Republic of Korea
| | - Lawrence Ky Ho
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - David G Hewett
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Division of Gastroenterology, Queen Elizabeth II Jubilee Hospital, Brisbane, Queensland, Australia
| | - Han-Mo Chiu
- Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Hsiu-Po Wang
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shiaw Hooi Ho
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Dong Wan Seo
- Asan Medical Center, Songpa-gu, Seoul, Republic of Korea
| | - Khean-Lee Goh
- Department of Gastroenterology and Hepatology, University of Malaya, Kuala Lumpur, Malaysia
| | - Hisao Tajiri
- Division of Gastroenterology and Hepatology, The Jikei University School of Medicine, Tokyo, Japan
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Francis K L Chan
- Department of Medicine and Therapeutics, Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
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22
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Kato M, Tanaka K, Kida M, Ryozawa S, Matsuda K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Katada C, Kobayashi K, Hoteya S, Horimatsu T, Kodashima S, Matsuda T, Muto M, Yamamoto H, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. Multicenter database registry for endoscopic retrograde cholangiopancreatography: Japan Endoscopic Database Project. Dig Endosc 2020; 32:494-502. [PMID: 31361923 DOI: 10.1111/den.13495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 07/26/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM Few studies have reported on a national, population-based endoscopic retrograde cholangiopancreatography (ERCP) database. Hence, in 2015, we established a multicenter ERCP database registry, the Japan Endoscopic Database (JED) Project in preparation for a nationwide endoscopic database. The objective the present study was to evaluate this registry before the establishment of a nationwide endoscopic database. METHODS From 1 January 2015 to 31 March 2017, we collected and analyzed the ERCP data of all patients who underwent ERCP in four participating centers in the JED Project based on the JED protocol. RESULTS Four centers carried out 4104 ERCP on 2173 patients. Data entry of ERCP information (age, 100%; gender, 100%; American Society of Anesthesiologists Physical Status Classification System, 74.5%; scope, 92.7%; time to ERCP, 100%; antithrombotic drug information, 55.0%; primary selective common bile duct [CBD] cannulation methods, 73.0%; number of attempts at primary selective CBD cannulation, 67.6%; overall selective CBD cannulation methods, 68.9%; ERCP procedure time, 66.3%; fluoroscopy time, 65.1%; adverse events, 74.9%; serum amylase levels 1 day post-ERCP, 36.5%) was accurately extracted from the four centers. Success rate of CBD cannulation by level of ERCP difficulty was 98.5%, 99.0%, and 96.4% in grades 1, 2, and 3, respectively. Complication rate by overall selective CBD cannulation method was 5.6%, 7.6%, and 10.5% in the contrast-assisted technique, guidewire-assisted technique, and cross-over method, respectively. CONCLUSION Data from this evaluation of the JED Project, a multicenter ERCP database registry, suggest the feasibility of establishing a nationwide ERCP database and its challenges.
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Affiliation(s)
- Masayuki Kato
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyohito Tanaka
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Kida
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shomei Ryozawa
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Yutaka Saito
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ichiro Oda
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Chikatoshi Katada
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyonori Kobayashi
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shu Hoteya
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahiro Horimatsu
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shinya Kodashima
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahisa Matsuda
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Manabu Muto
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hironori Yamamoto
- Minimal Standard Endoscopic Database (MSED-J) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ryuichi Iwakiri
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroaki Miyata
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hisao Tajiri
- Japan Endoscopy Database (JED) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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23
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Ishihara R, Arima M, Iizuka T, Oyama T, Katada C, Kato M, Goda K, Goto O, Tanaka K, Yano T, Yoshinaga S, Muto M, Kawakubo H, Fujishiro M, Yoshida M, Fujimoto K, Tajiri H, Inoue H. Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer. Dig Endosc 2020; 32:452-493. [PMID: 32072683 DOI: 10.1111/den.13654] [Citation(s) in RCA: 152] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/23/2020] [Indexed: 01/17/2023]
Abstract
The Japan Gastroenterological Endoscopy Society has developed endoscopic submucosal dissection/endoscopic mucosal resection guidelines. These guidelines present recommendations in response to 18 clinical questions concerning the preoperative diagnosis, indications, resection methods, curability assessment, and surveillance of patients undergoing endoscopic resection for esophageal cancers based on a systematic review of the scientific literature.
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Affiliation(s)
- Ryu Ishihara
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Miwako Arima
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Toshiro Iizuka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Tsuneo Oyama
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Motohiko Kato
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kenichi Goda
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Osamu Goto
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kyosuke Tanaka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Tomonori Yano
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Manabu Muto
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | | | | | | | - Hisao Tajiri
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Haruhiro Inoue
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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24
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Niikura R, Yamada A, Fujishiro M, Tanaka K, Matsuda K, Saito Y, Ohtsuka K, Oda I, Katada C, Kato M, Kida M, Kobayashi K, Hoteya S, Horimatsu T, Kodashima S, Matsuda T, Muto M, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Shinozaki T, Tajiri H, Koike K. The Effects of Direct Oral Anticoagulants, Warfarin, Aspirin and Thienopyridine on the Performance of Immunochemical, Faecal, Occult Blood Tests. Digestion 2020; 100:117-126. [PMID: 30408803 DOI: 10.1159/000494251] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/01/2018] [Indexed: 02/04/2023]
Abstract
AIM To clarify whether antithrombotic drugs affect diagnosis using the immunochemical faecal occult blood test -(iFOBT) of colorectal neoplasia. METHODS Using the Japan Endoscopy Database from 8 centres between 2015 and 2017, we analyzed data about patients who were iFOBT positive and had received direct oral anticoagulants (DOAC), warfarin, aspirin or thienopyridine. One-to-one matching-analogue propensity score weighted analyses were performed to compare the positive predictive value (PPV) of all neoplasms, invasive and non-invasive colorectal cancers and adenomas between drug users and non-users. All neoplasms included invasive and non-invasive colorectal cancer, and adenomas. RESULTS We analyzed 197 DOAC users and 196 non-users, 153 warfarin users and 153 non-users, 408 aspirin users and 415 non-users, and 97 thienopyridine users and 97 non-users. No significant differences were observed in the PPV for all neoplasms (56.67 vs. 50.43%), invasive cancer (4.32 vs. 3.53%), non-invasive cancer (15.58 vs. 15.56%) or adenoma (53.13 vs. 48.09%) between the DOAC user and non-user groups. No significant differences were observed in the PPV for all neoplasia, invasive and non-invasive cancer, or adenoma between warfarin, aspirin and thienopyridine use and non-users. CONCLUSIONS DOAC, warfarin, aspirin and thienopyridine use did not decrease the PPVs of the iFOBT used to evaluate all colorectal neoplasia.
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Affiliation(s)
- Ryota Niikura
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Atsuo Yamada
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan,
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Tokyo, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroaki Miyata
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Tomohiro Shinozaki
- Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, The Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuhiko Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Emura F, Sharma P, Arantes V, Cerisoli C, Parra-Blanco A, Sumiyama K, Araya R, Sobrino S, Chiu P, Matsuda K, Gonzalez R, Fujishiro M, Tajiri H. Principles and practice to facilitate complete photodocumentation of the upper gastrointestinal tract: World Endoscopy Organization position statement. Dig Endosc 2020; 32:168-179. [PMID: 31529547 DOI: 10.1111/den.13530] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 09/11/2019] [Indexed: 12/21/2022]
Abstract
Although esophagogastroduodenoscopy (EGD) is the most commonly used procedure in the gastrointestinal (GI) tract, the method of esophageal, gastric and duodenal mucosa photodocumentation varies considerably worldwide. One probable explanation is that for generations, EGD has primarily been taught by GI faculty and instructors based on their perceptions and experience, which has resulted in EGD being a non-standardized procedure. Currently, the procedure is facing a challenging scenario as endoscopy societies are implementing procedure-associated quality indicators aiming for best practice among practitioners and evidence-based care for patients. Contrary to colonoscopy where cecum landmarks photodocumentation is considered proof of completeness, there are currently no reliable performance measures to gauge the completeness of an upper endoscopy nor guidance for complete photodocumentation. This World Endoscopy Organization (WEO) position statement aims to provide practical guidance to practitioners to carry out complete EGD photodocumentation. Hence, an international group of experts from the WEO Upper GI Cancer Committee formulated the following document using the body of evidence established through literature reviews, expert opinions, and other scientific sources. The group acknowledged that although the procedure should be feasible in any facility, what is needed to achieve a global shift on the concept of completeness is a common written statement of agreement on its potential impact and added value. This best practice statement offers endoscopists principles and practical guidance in order to carry out complete photodocumentation from the hypopharynx to the second duodenal portion.
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Affiliation(s)
- Fabian Emura
- Advanced Gastrointestinal Endoscopy, Emura Center LatinoAmerica.,Division of Gastroenterology, La Sabana University.,Emura Foundation for the Promotion of Cancer Research, Bogotá D.C, Colombia
| | - Prateek Sharma
- Veterans Affairs Medical Center.,University of Kansas School of Medicine, Kansas City, USA
| | - Vitor Arantes
- Endoscopy Division, Hospital das Clínicas e Mater Dei Contorno.,Alfa Institute of Gastroenterology, Medical School, Federal Univetsity of MInas Gerais, Belo Horizonte, Brazil
| | - Cecilio Cerisoli
- Gedyt, Gastroenterology and Diagnostic and Therapeutic Endoscopy, Buenos Aires, Argentina
| | - Adolfo Parra-Blanco
- NIHR Nottingham Biomedical Research Centre, Department of Gastroenterology, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | | | - Raul Araya
- Clinic Los Andes University, Division of Gastroenterology and Endoscopy, Army Hospital of Santiago
| | | | - Philip Chiu
- Division of Upper GI & Metabolic Surgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Koji Matsuda
- Division of Gastroenterology, St. Marianna University, Kanagawa, Tokyo
| | | | - Mitsuhiro Fujishiro
- Department of Gastroenterology & Hepatology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo
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26
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Inoue H, Shiwaku H, Kobayashi Y, Chiu PWY, Hawes RH, Neuhaus H, Costamagna G, Stavropoulos SN, Fukami N, Seewald S, Onimaru M, Minami H, Tanaka S, Shimamura Y, Santi EG, Grimes K, Tajiri H. Statement for gastroesophageal reflux disease after peroral endoscopic myotomy from an international multicenter experience. Esophagus 2020; 17:3-10. [PMID: 31559513 PMCID: PMC6976544 DOI: 10.1007/s10388-019-00689-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/28/2019] [Indexed: 02/07/2023]
Abstract
It has been 10 years since peroral endoscopic myotomy (POEM) was reported for the first time, and POEM has currently become the standard treatment for achalasia and related disorders globally because it is less invasive and has a higher curative effect than conventional therapeutic methods. However, there are limited studies comparing the long-term outcomes of POEM with those of conventional therapeutic methods, particularly in the occurrence of gastroesophageal reflux disease (GERD) after therapy. With this background, we held a consensus meeting to discuss the pathophysiology and management of GERD after POEM based on published papers and experiences of each expert and to discuss the prevention of GERD and dealing with anti-acid drug refractory GERD. This meeting was held on April 27, 2018 in Tokyo to establish statements and finalize the recommendations using the modified Delphi method. This manuscript presents eight statements regarding GERD after POEM.
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Affiliation(s)
- Haruhiro Inoue
- Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Toyosu 5-1-38, Koto-Ku, Tokyo, 135-8577 Japan
| | - Hironari Shiwaku
- Department of Gastroenterological Surgery, Fukuoka University Faculty of Medicine, 7-45-1, Nanakuma, Jyonan-ku, Fukuoka, 814-0180 Japan
| | - Yasutoshi Kobayashi
- Department of Gastroenterology and Hepatology, Jichi Medical University, Shimotsuke, Tochigi Japan
| | - Philip W. Y. Chiu
- The Institute of Digestive Disease, Faculty of Medicine of the Chinese University of Hong Kong, Hong Kong, China
| | - Robert H. Hawes
- Center for Interventional Endoscopy, Florida Hospital Orlando, Orlando, Florida USA
| | - Horst Neuhaus
- Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany
| | - Guido Costamagna
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University, Rome, Italy
| | - Stavros N. Stavropoulos
- Division of Gastroenterology, Hepatology, and Nutrition, NYU-Winthrop Hospital, New York, USA
| | - Norio Fukami
- Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Scottsdale, AZ USA
| | - Stefan Seewald
- Centre of Gastroenterology, Klinik Hirslanden, Zurich, Switzerland
| | - Manabu Onimaru
- Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Toyosu 5-1-38, Koto-Ku, Tokyo, 135-8577 Japan
| | - Hitomi Minami
- Department of Gastroenterology and Hepatology, Nagasaki University, Nagasaki, Japan
| | - Shinwa Tanaka
- Division of Gastroenterology, Department of Internal Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Yuto Shimamura
- Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Toyosu 5-1-38, Koto-Ku, Tokyo, 135-8577 Japan
| | - Esperanza Grace Santi
- Section of Gastroenterology and Digestive Endoscopy, De La Salle University Medical Center, Dasmarinas City, Philippines
| | - Kevin Grimes
- Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
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Tanaka S, Kashida H, Saito Y, Yahagi N, Yamano H, Saito S, Hisabe T, Yao T, Watanabe M, Yoshida M, Saitoh Y, Tsuruta O, Sugihara KI, Igarashi M, Toyonaga T, Ajioka Y, Kusunoki M, Koike K, Fujimoto K, Tajiri H. Japan Gastroenterological Endoscopy Society guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc 2020; 32:219-239. [PMID: 31566804 DOI: 10.1111/den.13545] [Citation(s) in RCA: 172] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 09/13/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022]
Abstract
Suitable lesions for endoscopic treatment include not only early colorectal carcinomas but also several types of precarcinomatous adenomas. It is important to establish practical guidelines wherein preoperative diagnosis of colorectal neoplasia and selection of endoscopic treatment procedures are appropriately outlined and to ensure that actual endoscopic treatment is useful and safe in general hospitals when carried out in accordance with guidelines. In cooperation with the Japanese Society for Cancer of the Colon and Rectum, the Japanese Society of Coloproctology, and the Japanese Society of Gastroenterology, the Japan Gastroenterological Endoscopy Society compiled colorectal endoscopic submucosal dissection/endoscopic mucosal resection guidelines by using evidence-based methods in 2014. The first edition of these guidelines was published 5 years ago. Accordingly, we have published the second edition of these guidelines based on recent new knowledge and evidence.
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Affiliation(s)
- Shinji Tanaka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.,Japanese Society of Coloproctology, Tokyo, Japan.,Japanese Society of Gastroenterology, Tokyo, Japan
| | | | - Yutaka Saito
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
| | - Naohisa Yahagi
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroo Yamano
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shoichi Saito
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takashi Hisabe
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takashi Yao
- Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
| | - Masahiko Watanabe
- Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan.,Japanese Society of Coloproctology, Tokyo, Japan
| | - Masahiro Yoshida
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,Japanese Society of Gastroenterology, Tokyo, Japan
| | - Yusuke Saitoh
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Osamu Tsuruta
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | | | | | - Yoichi Ajioka
- Japanese Society for Cancer of the Colon and Rectum, Tokyo, Japan
| | | | | | | | - Hisao Tajiri
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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28
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Iwakiri R, Tanaka K, Gotoda T, Oka S, Ohtsuka T, Sakata Y, Chiba T, Higuchi K, Masuyama H, Nozaki R, Matsuda K, Shimono N, Fujimoto K, Tajiri H. Guidelines for standardizing cleansing and disinfection of gastrointestinal endoscopes. Dig Endosc 2019; 31:477-497. [PMID: 31241788 DOI: 10.1111/den.13474] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/23/2019] [Indexed: 02/05/2023]
Abstract
As part of the activities toward standardizing endoscopy procedures, the Japan Gastroenterological Endoscopy Society has prepared guidelines for cleansing and disinfection of gastrointestinal endoscopes. The environment of gastrointestinal endoscopy differs between Japan and advanced Western countries. In advanced Western countries, gastrointestinal endoscopy is performed almost exclusively at specialized facilities, where strict provisions are observed for cleansing and disinfecting endoscopes. In Japan, however, gastrointestinal endoscopy is performed even in small clinics, and the annual number of gastrointestinal endoscopy cases is enormous. In addition, the method for cleansing and disinfecting endoscopes differs among hospitals. Although there is a distinct lack of evidence for how gastrointestinal endoscopes are cleaned and disinfected, it is necessary to standardize the method for doing so to advance the field of endoscopic medicine.
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Affiliation(s)
| | | | - Takuji Gotoda
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shiro Oka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takao Ohtsuka
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Toshimi Chiba
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | | | - Ryoichi Nozaki
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | | | - Hisao Tajiri
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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29
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Uemura N, Oda I, Saito Y, Ono H, Fujisaki J, Matsuhashi N, Ohata K, Yahagi N, Yada T, Satoh M, Tajiri H, Inomata M, Kitano S. Efficacy and safety of 0.6% sodium alginate solution in endoscopic submucosal dissection for esophageal and gastric neoplastic lesion: A randomized controlled study. Dig Endosc 2019; 31:396-404. [PMID: 30667557 PMCID: PMC6850280 DOI: 10.1111/den.13352] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 01/17/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Sodium alginate (SA) solution has characteristic viscoelasticity. We aimed to determine efficacy and safety of 0.6% SA for submucosal injection during endoscopic submucosal dissection (ESD) in patients with localized neoplastic lesion in the esophageal and gastric mucosa. METHODS We conducted a randomized controlled study at six major hospitals in Japan including 130 patients with endoscopically localized neoplastic lesion in the esophageal and gastric mucosa and eligible for ESD. Patients were randomly assigned to SA or 0.4% sodium hyaluronate (SH) group (control); ESD was performed using a submucosal injection of SA/SH. As a primary outcome measure, non-inferiority of SA against SH was investigated using en bloc complete resection in ESD and formation and maintenance of mucosal elevation upon injection as an efficacy index. Adverse events during the study were evaluated as safety outcome measures. This study was registered with Pharmaceuticals and Medical Devices Agency (clinical trial no. 28-277/2016-18; clinical trial identification no. KP2013-009_C001). RESULTS Efficacy rate of submucosal injection during ESD was 91.7% (55/60) and 88.7% (55/62) in the SA and SH groups, respectively, demonstrating non-inferiority of SA against SH. Adverse events for which a causal relationship with submucosal injection solution could not be eliminated were noted in 8.2% (5/61) and 4.7% (3/64) in the SA and SH groups, respectively, but symptoms disappeared without treatment/after drug administration in both groups. CONCLUSIONS In Japan, 0.4% SH is the only commercially approved formulation for submucosal injection during ESD. The study results may expand submucosal injection solution options in clinical practice.
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Affiliation(s)
- Naomi Uemura
- Kohnodai HospitalNational Center for Global Health and MedicineChibaJapan
| | - Ichiro Oda
- Endoscopy DivisionNational Cancer Center HospitalTokyoJapan
| | - Yutaka Saito
- Endoscopy DivisionNational Cancer Center HospitalTokyoJapan
| | - Hiroyuki Ono
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | - Junko Fujisaki
- Department of GastroenterologyCancer Institute Hospital AriakeTokyoJapan
| | | | - Ken Ohata
- Department of GastroenterologyNTT Medical Center TokyoTokyoJapan
| | - Naohisa Yahagi
- Division of Research and Development for Minimally Invasive TreatmentCancer CenterKeio University School of MedicineTokyoJapan
| | - Tomoyuki Yada
- Department of Gastroenterology and HepatologyKohnodai HospitalNational Center for Global Health and MedicineChibaJapan
| | - Masahiro Satoh
- Department of Research and DevelopmentKaigen Pharma Co. LtdHokkaidoJapan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy ResearchThe Jikei University School of MedicineTokyoJapan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric SurgeryOita UniversityFaculty of MedicineOitaJapan
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30
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Arihiro S, Nakashima A, Matsuoka M, Suto S, Uchiyama K, Kato T, Mitobe J, Komoike N, Itagaki M, Miyakawa Y, Koido S, Hokari A, Saruta M, Tajiri H, Matsuura T, Urashima M. Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis 2019; 25:1088-1095. [PMID: 30601999 PMCID: PMC6499936 DOI: 10.1093/ibd/izy346] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND We evaluated whether oral vitamin D supplementation during the winter and early spring reduces the incidence of influenza and upper respiratory infections in patients with inflammatory bowel disease (IBD). METHODS A randomized, double-blind, controlled trial was conducted to compare the effects of vitamin D supplementation (500 IU/day) and a placebo. The primary outcome was the incidence of influenza; the secondary outcome was the incidence of upper respiratory infection. Prespecified subgroup analyses were performed according to 25-hydroxyvitamin D (25-OHD) levels (low <20 ng/mL or high ≥20 ng/mL) and whether ulcerative colitis (UC) or Crohn's disease (CD) was present. We also used the Lichtiger clinical activity index for patients with UC and the Crohn's Disease Activity Index (CDAI) for patients with CD before and after interventions. RESULTS We included 223 patients with IBD and randomized them into 2 groups: vitamin D supplementation (n = 108) and placebo (n = 115). The incidence of influenza did not differ between the groups. However, the incidence of upper respiratory infection was significantly lower in the vitamin D group (relative risk [RR], 0.59; 95% confidence interval (CI), 0.35-0.98; P = 0.042). This effect was enhanced in the low 25-OHD level subgroup (RR, 0.36; 95% CI, 0.14-0.90; P = 0.02). With respect to adverse events, the Lichtiger clinical activity index score was significantly worse in the vitamin D group (P = 0.002) and remained significant only in the high 25-OHD level subgroup. CONCLUSIONS Vitamin D supplementation may have a preventative effect against upper respiratory infection in patients with IBD but may worsen the symptoms of UC.
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Affiliation(s)
- Seiji Arihiro
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center,Tokyo, Japan
| | - Akio Nakashima
- Division of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan,Division of Molecular Epidemiology, The Jikei University School of Medicine, Tokyo, Japan
| | - Mika Matsuoka
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Suto
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center,Tokyo, Japan
| | - Kan Uchiyama
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Kashiwa Hospital, Chiba, Japan
| | - Tomohiro Kato
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Jimi Mitobe
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Nobuhiko Komoike
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Munenori Itagaki
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center,Tokyo, Japan
| | - Yoshinari Miyakawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Daisan Hospital, Tokyo, Japan
| | - Shigeo Koido
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Kashiwa Hospital, Chiba, Japan
| | - Atsushi Hokari
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University Katsushika Medical Center,Tokyo, Japan
| | - Masayuki Saruta
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Tomokazu Matsuura
- Department of Internal Medicine, Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Mitsuyoshi Urashima
- Division of Molecular Epidemiology, The Jikei University School of Medicine, Tokyo, Japan,Address correspondence to: Mitsuyoshi Urashima MD, MPH, PhD, Division of Molecular Epidemiology, Jikei University School of Medicine, Nishi-shimbashi 3-25-8, Minato-ku, Tokyo 105–8461, Japan. E-mail:
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31
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Affiliation(s)
- Hisao Tajiri
- Jikei University School of Medicine, Tokyo, Japan
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32
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Dobashi A, Goda K, Furuhashi H, Matsui H, Hara Y, Kamba S, Kobayashi M, Sumiyama K, Hirooka S, Hamatani S, Rajan E, Ikegami M, Tajiri H. Diagnostic efficacy of dual-focus endoscopy with narrow-band imaging using simplified dyad criteria for superficial esophageal squamous cell carcinoma. J Gastroenterol 2019; 54:501-510. [PMID: 30406847 DOI: 10.1007/s00535-018-1527-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 10/26/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND Our previous studies have shown the diagnostic utility of a newly developed dual-focus endoscope with narrow-band imaging (DF-NBI) and simplified dyad criteria for detection of superficial esophageal squamous cell carcinoma (SESCC). This clinical trial aimed to study the diagnostic efficacy of DF-NBI with dyad criteria for detecting SESCC compared to white light imaging (WLI). METHODS This was a single-arm prospective comparative trial. We enrolled 170 consecutive high-risk patients for esophageal squamous cell carcinoma. Patients were initially examined with WLI by one independent endoscopist and then the other performed DF-NBI blinded to the WLI diagnosis to avoid a carry-over effect. Lesions showing proliferation and/or various shapes of intrapapillary capillary loops (IPCL) under DF-NBI (i.e., dyad criteria) were endoscopically diagnosed as SESCC including high-grade intraepithelial neoplasia. The primary endpoint was sensitivity of WLI and DF-NBI for detecting SESCC. The secondary endpoints were the diagnostic performance (i.e., specificity and accuracy) and inter/intra-observer concordance of DF-NBI with dyad criteria. RESULTS A total 77 SESCCs were detected. The sensitivity of DF-NBI for SESCC was significantly higher than that of WLI (91% vs. 51%, P < 0.001). The specificity and accuracy of WLI and DF-NBI using dyad criteria were 100% vs. 84%, and 86% vs. 86%, respectively. Various shapes and proliferation of IPCL showed the highest value in inter-observer and intra-observer agreements (κ = 0.77 and 0.82, respectively). CONCLUSION DF-NBI combined with dyad criteria may be a promising technique with a high sensitivity for diagnosis of SESCC and high inter/intra-observer agreement.
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Affiliation(s)
- Akira Dobashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan. .,Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
| | - Kenichi Goda
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.,Department of Gastroenterology, Dokkyo Medical University, Mibu, Japan
| | - Hiroto Furuhashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Matsui
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Yuko Hara
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Shunsuke Kamba
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Masakuni Kobayashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuki Sumiyama
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinichi Hirooka
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shigeharu Hamatani
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Elizabeth Rajan
- Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Masahiro Ikegami
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
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33
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Tajiri H, Dinis-Ribeiro M. How I inspect the stomach. Endoscopy 2019; 51:571-573. [PMID: 30943552 DOI: 10.1055/a-0876-1873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Hisao Tajiri
- Jikei University School of Medicine, Tokyo, Japan
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34
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Goda K, Dobashi A, Yoshimura N, Hara Y, Tamai N, Sumiyama K, Ikegami M, Tajiri H. Dye solution optimizing staining conditions for in vivo endocytoscopy for normal villi and superficial epithelial tumors in the duodenum. Ann Gastroenterol 2019; 32:378-386. [PMID: 31263360 PMCID: PMC6595928 DOI: 10.20524/aog.2019.0382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 03/26/2019] [Indexed: 12/26/2022] Open
Abstract
Background Vital staining is mandatory for endocytoscopy, which enables visualization of gastrointestinal mucosa at the cellular level. This study aimed to identify a dye solution that would optimize staining conditions for in vivo endocytoscopy in the duodenum, including normal villi and superficial non-ampullary duodenal epithelial tumors (SNADETs). Methods We performed endocytoscopy in 9 patients who had normal villi (27 sites) and 20 patients with SNADETs (20 sites). The normal sites were allocated to methylene blue (MB; 5/2.5/1%), toluidine blue (TB; 1/0.5/0.25%), and crystal violet (1/0.5/0.25%) staining. Based on the results of normal sites, we used 1% MB or 0.5% TB for staining SNADETs. Three reviewers, including endoscopists and pathologists, evaluated and scored the endocytoscopy images (1, poor; 2, moderate; 3, good) for general image quality and visibility of structure and nuclei. We calculated frequencies and compared the proportions of the highest score of 3 (good). Results The majority of scores of 3 for normal villi was given to 0.5% TB (81%), followed by 1% MB. For SNADETs, 1% MB showed significantly higher scores compared with 0.5% TB (P=0.035). Conclusion Among the dye solutions evaluated, 0.5% TB and 1% MB achieved the optimizing staining conditions for in vivo endocytoscopy for normal villi and SNADETs, respectively.
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Affiliation(s)
- Kenichi Goda
- Department of Gastroenterology, Dokkyo Medical University, Tochigi (Kenichi Goda).,Department of Endoscopy (Kenichi Goda, Akira Dobashi, Noboru Yoshimura, Yuko Hara, Naoto Tamai, Kazuki Sumiyama)
| | - Akira Dobashi
- Department of Endoscopy (Kenichi Goda, Akira Dobashi, Noboru Yoshimura, Yuko Hara, Naoto Tamai, Kazuki Sumiyama)
| | - Noboru Yoshimura
- Department of Endoscopy (Kenichi Goda, Akira Dobashi, Noboru Yoshimura, Yuko Hara, Naoto Tamai, Kazuki Sumiyama)
| | - Yuko Hara
- Department of Endoscopy (Kenichi Goda, Akira Dobashi, Noboru Yoshimura, Yuko Hara, Naoto Tamai, Kazuki Sumiyama)
| | - Naoto Tamai
- Department of Endoscopy (Kenichi Goda, Akira Dobashi, Noboru Yoshimura, Yuko Hara, Naoto Tamai, Kazuki Sumiyama)
| | - Kazuki Sumiyama
- Department of Endoscopy (Kenichi Goda, Akira Dobashi, Noboru Yoshimura, Yuko Hara, Naoto Tamai, Kazuki Sumiyama)
| | | | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research (Hisao Tajiri), The Jikei University School of Medicine, Tokyo, Japan
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Sano Y, Chiu H, Li X, Khomvilai S, Pisespongsa P, Co JT, Kawamura T, Kobayashi N, Tanaka S, Hewett DG, Takeuchi Y, Imai K, Utsumi T, Teramoto A, Hirata D, Iwatate M, Singh R, Ng SC, Ho S, Chiu P, Tajiri H. Standards of diagnostic colonoscopy for early-stage neoplasia: Recommendations by an Asian private group. Dig Endosc 2019; 31:227-244. [PMID: 30589103 PMCID: PMC6850515 DOI: 10.1111/den.13330] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/24/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIM In recent years, the incidence of colorectal cancer has been increasing, and it is now becoming the major cause of cancer death in Asian countries. The aim of the present study was to develop Asian expert-based consensus to standardize the preparation, detection and characterization for the diagnosis of early-stage colorectal neoplasia. METHODS A professional group was formed by 36 experts of the Asian Novel Bio-Imaging and Intervention Group (ANBI2 G) members. Representatives from 12 Asia-Pacific countries participated in the meeting. The group organized three consensus meetings focusing on diagnostic endoscopy for gastrointestinal neoplasia. The Delphi method was used to develop the consensus statements. RESULTS Through the three consensus meetings with debating, reviewing the literature and regional data, a consensus was reached at third meeting in 2016. The consensus was reached on a total of 10 statements. Summary of statements is as follows: (i) Adequate bowel preparation for high-quality colonoscopy; (ii) Antispasmodic agents for lesion detection; (iii) Image-enhanced endoscopy (IEE) for polyp detection; (iv) Adenoma detection rate for quality indicators; (v) Good documentation of colonoscopy findings; (vi) Complication rates; (vii) Cecal intubation rate; (viii) Cap-assisted colonoscopy (CAC) for polyp detection; (ix) Macroscopic classification using indigocarmine spray for characterization of colorectal lesions; and (x) IEE and/or magnifying endoscopy for prediction of histology. CONCLUSION This consensus provides guidance for carrying out endoscopic diagnosis and characterization for early-stage colorectal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early-stage colorectal neoplasia.
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Affiliation(s)
- Yasushi Sano
- Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC)Sano HospitalHyogo
| | - Han‐Mo Chiu
- Department of Internal MedicineCollege of MedicineNational Taiwan UniversityTaipeiTaiwan
| | - Xiao‐bo Li
- Division of Gastroenterology and HepatologyKey Laboratory of Gastroenterology and HepatologyMinistry of HealthRenji HospitalSchool of MedicineShanghai Institute of Digestive DiseaseShanghai Jiao Tong UniversityShanghaiChina
| | - Supakij Khomvilai
- Surgical EndoscopyColorectal SurgeryDepartment of SurgeryChulalongkorn UniversityBangkokThailand
| | - Pises Pisespongsa
- Digestive Disease CenterBumrungrad International HospitalBangkokThailand
| | - Jonard Tan Co
- St. Luke's Medical Centre ‐ Global CityTaguig City, Metro ManilaPhilippines
| | - Takuji Kawamura
- Department of GastroenterologyKyoto Second Red Cross HospitalKyotoJapan
| | | | - Shinji Tanaka
- Department of EndoscopyHiroshima University HospitalHiroshimaJapan
| | - David G. Hewett
- Faculty of MedicineUniversity of QueenslandBrisbaneAustralia
| | - Yoji Takeuchi
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Kenichiro Imai
- Division of EndoscopyShizuoka Cancer CenterShizuokaJapan
| | - Takahiro Utsumi
- Department of Gastroenterology and HepatologyKyoto University Graduate School of MedicineKyotoJapan
| | - Akira Teramoto
- Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC)Sano HospitalHyogo
| | - Daizen Hirata
- Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC)Sano HospitalHyogo
| | - Mineo Iwatate
- Gastrointestinal Center and Institute of Minimally invasive Endoscopic Care (iMEC)Sano HospitalHyogo
| | - Rajvinder Singh
- Gastroenterology UnitDivision of MedicineLyell McEwin HospitalSchool of MedicineThe University of AdelaideAdelaideAustralia
| | - Siew C. Ng
- Departments of Medicine and TherapeuticsInstitute of Digestive DiseaseState Key Laboratory of Digestive DiseasesLKS Institute of Health ScienceThe Chinese University of Hong KongHong KongChina
| | - Shiaw‐Hooi Ho
- Department of MedicineFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Philip Chiu
- SurgeryInstitute of Digestive DiseaseState Key Laboratory of Digestive DiseasesLKS Institute of Health ScienceThe Chinese University of Hong KongHong KongChina
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy ResearchThe Jikei University School of MedicineTokyoJapan
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36
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Katada C, Horimatsu T, Muto M, Tanaka K, Matsuda K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Kato M, Kida M, Kobayashi K, Hoteya S, Kodashima S, Matsuda T, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. Current status of esophageal endoscopy including the evaluation of smoking and alcohol consumption in Japan: an analysis based on the Japan endoscopy database. Esophagus 2019; 16:174-179. [PMID: 30519821 DOI: 10.1007/s10388-018-0650-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 11/20/2018] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim was to investigate the current status of esophageal endoscopy, including the evaluation of smoking and alcohol consumption, in Japan. METHODS A total of 47,441 patients who underwent 69,748 sessions of esophageal endoscopy were registered in the Japan Endoscopy Database between January 2015 and March 2017. The study variables were as follows: (1) methods for monitoring the esophagus and the time required for monitoring and (2) the status of smoking and alcohol consumption in patients with esophageal cancer and head and neck cancer. RESULTS Image-enhanced endoscopy was performed in 10.6%, Lugol chromoendoscopy in 4.1%, and magnifying endoscopy in 3.2%. The mean time required for gastrointestinal endoscopy was 10 min 58 s. The mean examination times in patients with or without monitoring of the head and neck were 10 min 51 s and 11 min 13 s, respectively. In 57.0% of the patients with esophageal cancer, the head and neck were monitored at the time of gastrointestinal endoscopy. The proportion of current smokers (esophageal cancer: 16.8-4.7%; head and neck cancer: 24.3-9.3%) and addicted drinkers (esophageal cancer: 52.3-40.8%; head and neck cancer: 50.2-47.3%) were lower at the second or subsequent endoscopy than at the initial endoscopy. CONCLUSIONS The new strategy for esophageal endoscopy has led to an evolutionary change in Japan. The patients with esophageal cancer and head and neck cancer who underwent a second or subsequent endoscopy had lower incidences of smoking and alcohol consumption, although the incidences remained high.
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Affiliation(s)
- Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan. .,Department of Gastroenterology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara, 252-0374, Japan.
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroaki Miyata
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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Ohmiya N, Hotta N, Mitsufuji S, Nakamura M, Omori T, Maeda K, Okuda K, Yatsuya H, Tajiri H. Multicenter feasibility study of bowel preparation with castor oil for colon capsule endoscopy. Dig Endosc 2019; 31:164-172. [PMID: 30102791 DOI: 10.1111/den.13259] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/09/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Extensive use of laxatives and incomplete excretion rates are problematic for colon capsule endoscopy (CCE). The aim of the present study was to determine the effectiveness of castor oil as a booster. METHODS At four Japanese hospitals, 319 examinees undergoing CCE were enrolled retrospectively. Before and after the introduction of castor oil, other preparation reagents were unchanged. RESULTS Of 319 examinees who underwent CCE, 152 and 167 examinees took regimens with castor oil (between November 2013 and June 2016) and without castor oil (between October 2015 and September 2017), respectively. Capsule excretion rates within its battery life in the groups with and without castor oil were 97% and 81%, respectively (P < 0.0001). Multivariate analysis showed that ages younger than 65 years (adjusted odds ratio [OR], 3.00; P = 0.0048), male gender (adjusted OR, 3.20; P = 0.0051), and use of castor oil (adjusted OR, 6.29; P = 0.0003) were predictors of capsule excretion within its battery life. Small bowel transit time was shorter and total volume of lavage and fluid intake was lower with castor oil than without (P = 0.0154 and 0.0013, respectively). Overall adequate cleansing level ratios with and without castor oil were 74% and 83%, respectively (P = 0.0713). Per-examinee sensitivity for polyps ≥6 mm with and without castor oil was 83% and 85%, respectively, with specificities of 80% and 78%, respectively. CONCLUSION Bowel preparation with castor oil was effective for improving capsule excretion rate and reducing liquid loading.
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Affiliation(s)
- Naoki Ohmiya
- Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Naoki Hotta
- Department of Internal Medicine, Masuko Memorial Hospital, Nagoya, Japan
| | - Shoji Mitsufuji
- Department of Gastroenterology, Kyoto Kujo Hospital, Kyoto, Japan
| | - Masanao Nakamura
- Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takafumi Omori
- Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kohei Maeda
- Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake, Japan
| | - Kotaro Okuda
- Department of Gastroenterology, Kyoto Kujo Hospital, Kyoto, Japan
| | - Hiroshi Yatsuya
- Public Health, Fujita Health University School of Medicine, Toyoake, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
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Hara Y, Goda K, Dobashi A, Ohya TR, Kato M, Sumiyama K, Mitsuishi T, Hirooka S, Ikegami M, Tajiri H. Short- and long-term outcomes of endoscopically treated superficial non-ampullary duodenal epithelial tumors. World J Gastroenterol 2019; 25:707-718. [PMID: 30783374 PMCID: PMC6378536 DOI: 10.3748/wjg.v25.i6.707] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/31/2018] [Accepted: 01/09/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It is widely recognized that endoscopic resection (ER) of superficial non-ampullary duodenal epithelial tumors (SNADETs) is technically challenging and may carry high risks of intraoperative and delayed bleeding and perforation. These adverse events could be more critical than those occurring in other levels of the gastrointestinal tract. Because of the low prevalence of the disease and the high risks of severe adverse events, the curability including short- and long-term outcomes have not been standardized yet.
AIM To investigate the curability including short- and long-term outcomes of ER for SNADETs in a large case series.
METHODS This retrospective study included cases that underwent ER for SNADETs at our university hospital between March 2004 and July 2017. Short-term outcomes of ER were measured based on en bloc and R0 resection rates as well as adverse events. Long-term outcomes included local recurrence detected on endoscopic surveillance and disease-specific mortality in patients followed up for ≥ 12 mo after ER.
RESULTS In the study, 131 patients with 147 SNADETs were analyzed. The 147 ERs consisted of 136 endoscopic mucosal resections (EMRs) (93%) and 11 endoscopic submucosal dissections (ESDs) (7%). The median tumor diameter was 10 mm. The pathology diagnosis was adenocarcinoma (56/147, 38%), high-grade intraepithelial neoplasia (44/147, 30%), or low-grade intraepithelial neoplasia (47/147, 32%). The R0 resection rate was 68% (93/136) in the EMR group and 73% (8/11) in the ESD group, respectively. Cap-assisted EMR (known as EMR-C) showed a higher rate of R0 resection compared to the conventional method of EMR using a snare (78% vs 62%, P = 0.06). No adverse event was observed in the EMR group, whereas delayed bleeding, intraoperative perforation, and delayed perforation in 3, 3, and 5 patients occurred in the ESD group, respectively. One patient with perforation required emergency surgery. In the 43 mo median follow-up period, local recurrence was found in four EMR cases and all cases were treated endoscopically. No patient died due to tumor recurrence.
CONCLUSION Our findings suggest that ER provides good long-term outcomes in the patients with SNADETs. EMR is likely to become the safe and reliable treatment for small SNADETs.
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Affiliation(s)
- Yuko Hara
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Kenichi Goda
- Department of Gastroenterology, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Akira Dobashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Tomohiko Richard Ohya
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Masayuki Kato
- Department of Endoscopy, The Jikei University Katsushika Medical Center, Tokyo 125-8506, Japan
| | - Kazuki Sumiyama
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Takehiro Mitsuishi
- Department of Pathology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Shinichi Hirooka
- Department of Pathology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Masahiro Ikegami
- Department of Pathology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo 105-8461, Japan
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Chiu PWY, Uedo N, Singh R, Gotoda T, Ng EKW, Yao K, Ang TL, Ho SH, Kikuchi D, Yao F, Pittayanon R, Goda K, Lau JYW, Tajiri H, Inoue H. An Asian consensus on standards of diagnostic upper endoscopy for neoplasia. Gut 2019; 68:186-197. [PMID: 30420400 DOI: 10.1136/gutjnl-2018-317111] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/25/2018] [Accepted: 10/15/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND This is a consensus developed by a group of expert endoscopists aiming to standardise the preparation, process and endoscopic procedural steps for diagnosis of early upper gastrointestinal (GI) cancers. METHOD The Delphi method was used to develop consensus statements through identification of clinical questions on diagnostic endoscopy. Three consensus meetings were conducted to consolidate the statements and voting. We conducted a systematic literature search on evidence for each statement. The statements were presented in the second consensus meeting and revised according to comments. The final voting was conducted at the third consensus meeting on the level of evidence and agreement. RESULTS Risk stratification should be conducted before endoscopy and high risk endoscopic findings should raise an index of suspicion. The presence of premalignant mucosal changes should be documented and use of sedation is recommended to enhance detection of superficial upper GI neoplasms. The use of antispasmodics and mucolytics enhanced visualisation of the upper GI tract, and systematic endoscopic mapping should be conducted to improve detection. Sufficient examination time and structured training on diagnosis improves detection. Image enhanced endoscopy in addition to white light imaging improves detection of superficial upper GI cancer. Magnifying endoscopy with narrow-band imaging is recommended for characterisation of upper GI superficial neoplasms. Endoscopic characterisation can avoid unnecessary biopsy. CONCLUSION This consensus provides guidance for the performance of endoscopic diagnosis and characterisation for early gastric and oesophageal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early upper GI cancers.
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Affiliation(s)
| | - Noriya Uedo
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Rajvinder Singh
- Department of Gastroenterology, Lyell McEwin and Modbury Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Takuji Gotoda
- Department of Gastroenterology and Hepatology, Nihon University School of Medicine, Tokyo, Japan
| | | | - Kenshi Yao
- Department of Endoscopy, University Chikushi Hospital, Fukuoka, Japan
| | - Tiing Leong Ang
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
| | - Shiaw Hooi Ho
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Daisuke Kikuchi
- Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
| | - Fang Yao
- Institute and Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Rapat Pittayanon
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital The Thai Red Cross, Bangkok, Thailand
| | - Kenichi Goda
- Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan
| | - James Y W Lau
- Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, Jikei University School of Medicine, Tokyo, Japan
| | - Haruhiro Inoue
- Digestive Diseases Center, Showa University Koto-Toyosu Hospital, Tokyo, Japan
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40
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Kudo T, Saito Y, Ikematsu H, Hotta K, Takeuchi Y, Shimatani M, Kawakami K, Tamai N, Mori Y, Maeda Y, Yamada M, Sakamoto T, Matsuda T, Imai K, Ito S, Hamada K, Fukata N, Inoue T, Tajiri H, Yoshimura K, Ishikawa H, Kudo SE. New-generation full-spectrum endoscopy versus standard forward-viewing colonoscopy: a multicenter, randomized, tandem colonoscopy trial (J-FUSE Study). Gastrointest Endosc 2018; 88:854-864. [PMID: 29908178 DOI: 10.1016/j.gie.2018.06.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Accepted: 06/05/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Although colonoscopy is the criterion standard for detection of colorectal adenomas, some adenomas are missed. Full-spectrum endoscopy (FUSE) allows for observation with a 330-degree angle of view, which is expected to decrease the miss rate. However, no consensus has been reached regarding the superiority of FUSE over standard forward-viewing colonoscopy (SFVC) for detection of adenomas; we therefore compared new-generation FUSE and SFVC regarding colorectal adenoma miss rate (AMR) in this, the first reported randomized control trial using new-generation FUSE. METHODS We enrolled individuals aged 40 to 75 years who had been referred for screening, surveillance, fecal occult blood test positivity, or symptoms in a prospective randomized trial of tandem colonoscopy in 8 institutions. Patients were randomly assigned (1:1) via computer-generated stratified randomization. Neither the endoscopists nor patients were blinded to the allocation. The primary endpoint was AMR per patient (AMR-PP). RESULTS We enrolled 345 patients and included 319 in the per-protocol analyses. AMR-PP was significantly lower with FUSE (11.7%; 95% confidence interval [CI], 8.0%-15.4%) than with SFVC (22.9%; 95% CI, 17.5%-28.3%; P < .001). AMR-PP for lesions ≤5 mm in size was significantly lower with FUSE (10.4%; 95% CI, 6.5%-14.3%) than with SFVC (20.0%; 95% CI, 14.4%-25.6%; P = .0057). Furthermore, AMR-PP in the ascending colon was significantly lower with FUSE (4.3%; 95% CI, 1.4%-7.2%) than with SFVC (10.6%; 95% CI, 6.1%-15.1%; P = .0212). CONCLUSIONS FUSE is superior to SFVC regarding both AMR-PP and AMR; additionally, AMR-PP is both significantly lower with FUSE than SFVC for lesions ≤5 mm in size and in the ascending colon. (Clinical trial registration number: UMIN000020448.).
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Affiliation(s)
- Toyoki Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroaki Ikematsu
- Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East, Chiba, Japan
| | - Kinichi Hotta
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoji Takeuchi
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Masaaki Shimatani
- Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | - Ken Kawakami
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Naoto Tamai
- Department of Endoscopy, Jikei University School of Medicine, Tokyo, Japan
| | - Yuichi Mori
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yasuharu Maeda
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Masayoshi Yamada
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Taku Sakamoto
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takahisa Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Kenichiro Imai
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Sayo Ito
- Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Kenta Hamada
- Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Norimasa Fukata
- Third Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kansai Medical University, Osaka, Japan
| | - Takuya Inoue
- Second Department of Internal Medicine, Osaka Medical College, Osaka, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, Jikei University School of Medicine, Tokyo, Japan
| | - Kenichi Yoshimura
- Innovative Clinical Research Center, Kanazawa University Hospital, Kanazawa, Japan
| | - Hideki Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shin-Ei Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
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Inoue H, Shiwaku H, Iwakiri K, Onimaru M, Kobayashi Y, Minami H, Sato H, Kitano S, Iwakiri R, Omura N, Murakami K, Fukami N, Fujimoto K, Tajiri H. Clinical practice guidelines for peroral endoscopic myotomy. Dig Endosc 2018; 30:563-579. [PMID: 30022514 DOI: 10.1111/den.13239] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 07/17/2018] [Indexed: 12/11/2022]
Abstract
Peroral endoscopic myotomy (POEM) is a novel clinical technique developed in Japan used to treat esophageal achalasia and esophageal motility disorders. This technique has been rapidly accepted and widely disseminated throughout our clinical practice because of its low invasiveness, technical novelty, and high efficacy. Since the advent of POEM, there have been no clinical guidelines that clearly indicated its standard of care, and these guidelines have been anticipated both nationally and internationally by clinicians who engage in POEM practice. In 2017, to meet these needs, the Japan Gastroenterological Endoscopy Society (JGES) launched the guideline committee for POEM. Based on the guideline development process proposed by the Medical Information Network Distribution Service (MINDS), the guideline committee initially created research questions on POEM and conducted a systematic review and meta-analysis on each topic. The clinical research extracted from databases for these clinical questions and the systematic review mainly comprised a few retrospective studies with a small number of participants and short trial periods; hence, the strength of the evidence and recommendations derived from these results was low. Throughout this process, the guideline committee met thrice: once on May 13, 2017, and again on September 17, 2017, to formulate the draft. A consensus meeting was then held on January 14, 2018, in Tokyo to establish the guideline statements and finalize the recommendations using the modified Delphi method. This manuscript presents clinical guidelines regarding current standards of practice and recommendations in terms of the nine chief topics in POEM.
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Affiliation(s)
- Haruhiro Inoue
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | | | - Manabu Onimaru
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Hitomi Minami
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroki Sato
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Seigo Kitano
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Nobuo Omura
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Norio Fukami
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | | | - Hisao Tajiri
- Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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42
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Oka S, Tanaka S, Sano Y, Saitoh Y, Shimoda R, Tajiri H. Advanced diagnostic endoscopy in the lower gastrointestinal tract: A review of JGES core sessions. Dig Endosc 2018; 30:192-197. [PMID: 29055071 DOI: 10.1111/den.12977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 10/16/2017] [Indexed: 12/20/2022]
Abstract
At each of the 89th to the 92nd congresses of the Japan Gastroenterological Endoscopy Society, a series of featured discussion sessions concerning advanced diagnostic endoscopy in the lower gastrointestinal tract were presented. In total, 45 lectures were presented in this subject area. It was shown that, in recent years, several convenient and less invasive colonoscopic modalities have been developed. This review article summarizes these core sessions and the efficacy of the techniques discussed.
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Affiliation(s)
- Shiro Oka
- Department of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Yasushi Sano
- Gastrointestinal Center & Institute of Minimally-invasive Endoscopic Care (iMEC), Sano Hospital, Hyogo, Japan
| | - Yusuke Saitoh
- Digestive Disease Center, Asahikawa City Hospital, Asahikawa, Japan
| | - Ryo Shimoda
- Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
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43
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Kodashima S, Tanaka K, Matsuda K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Katada C, Kato M, Kida M, Kobayashi K, Hoteya S, Horimatsu T, Matsuda T, Muto M, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. First progress report on the Japan Endoscopy Database project. Dig Endosc 2018; 30:20-28. [PMID: 28885724 DOI: 10.1111/den.12963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 08/31/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIM The Japan Endoscopy Database (JED) Project was started to develop the world's largest endoscopic database, capture the actual performance of endoscopic practice, and standardize the terminology and fundamental items needed for a clinical and research registry. This paper presents a progress report on the first phase of this project undertaken at eight endoscopic centers in Japan. METHODS The list of data items to be collected was drafted by the MSED-J (Minimal Standard Endoscopic Database) subcommittee. These items were aggregated offline by integrating data from two endoscopic filing systems between July 2015 and December 2015. The study population included all patients who underwent esophagogastroduodenoscopy or colonoscopy at all eight centers, patients who underwent enteroscopy at five of the eight centers, and patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) at four of the eight centers. RESULTS Data collected in this phase included 61 070 endoscopic procedures, of which 40 475 were esophagogastroduodenoscopies, 215 were enteroscopies, 19 204 were colonoscopies, and 1176 were ERCPs. Frequencies of complications were 0.68% for esophagogastroduodenoscopy, 0% for enteroscopy, 0.43% for colonoscopy, and 13.34% for ERCP. In addition, we obtained various data including Helicobacter pylori infection status, past history of endoscopy in patients who underwent enteroscopy or colonoscopy, and degree of difficulty of ERCP, although the frequencies of reporting were sometimes low, with some items <20%. CONCLUSION Results of the first phase suggest that the JED project can provide vast quantities of useful data about endoscopic procedures.
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Affiliation(s)
- Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan.,JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) subcommittee, Tokyo, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hiroaki Miyata
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Michio Kaminishi
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
| | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, Japan Gastroenterological Endoscopy Society, Tokyo, Japan
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44
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Matsuda K, Tanaka K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Katada C, Kato M, Kida M, Kobayashi K, Hoteya S, Horimatsu T, Kodashima S, Matsuda T, Muto M, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. Design paper: Japan Endoscopy Database (JED): A prospective, large database project related to gastroenterological endoscopy in Japan. Dig Endosc 2018; 30:5-19. [PMID: 28905472 DOI: 10.1111/den.12964] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/05/2017] [Indexed: 02/08/2023]
Abstract
The advent of electronic medical records brought image filing systems to many hospitals, as well as electronic endoscopic medical records. However, data integration among multiple different vendors has not yet been accomplished. We start the Japan Endoscopic Database (JED) Project endorsed by Japan Gastroenterological Endoscopy Society (JGES) from January 2015. The purposes of this project are as follows: (i) developing the world's largest endoscopic database generated from daily use of the reporting system; (ii) capturing the actual performance of endoscopic practice in Japan; and (iii) standardizing the terminology and fundamental items for registry of clinical studies. Moreover, the JED project has the potential to automatically collect data about adverse events, competency and evaluation of residents, and actual numbers of procedures on a nationwide scale, certification for the specialty board system, and so on. We believe that this design paper will be helpful not only for future nationwide research but also for international research (UMIN000016093).
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Affiliation(s)
- Koji Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan.,JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Kiyohito Tanaka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan.,JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Mitsuhiro Fujishiro
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan.,JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Yutaka Saito
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan.,JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Kazuo Ohtsuka
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Ichiro Oda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Chikatoshi Katada
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Masayuki Kato
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Mitsuhiro Kida
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Kiyonori Kobayashi
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Shu Hoteya
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Takahiro Horimatsu
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Shinya Kodashima
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Takahisa Matsuda
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Manabu Muto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Hironori Yamamoto
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Shomei Ryozawa
- MSED-J (Minimal Standard Endoscopic Database) Creation Subcommittee, JGES, Japan
| | - Ryuichi Iwakiri
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Hiromu Kutsumi
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Hiroaki Miyata
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Mototsugu Kato
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Ken Haruma
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Kazuma Fujimoto
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | - Naomi Uemura
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
| | | | - Hisao Tajiri
- JED (Japan Endoscopy Database) Project Committee, JGES, Japan
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Ito K, Mitsunaga M, Nishimura T, Kobayashi H, Tajiri H. Combination photoimmunotherapy with monoclonal antibodies recognizing different epitopes of human epidermal growth factor receptor 2: an assessment of phototherapeutic effect based on fluorescence molecular imaging. Oncotarget 2017; 7:14143-52. [PMID: 26909859 PMCID: PMC4924703 DOI: 10.18632/oncotarget.7490] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 01/31/2016] [Indexed: 01/22/2023] Open
Abstract
Photoimmunotherapy is a new class of molecular targeted cancer therapy based on a monoclonal antibody (mAb) conjugated to a photosensitizer and irradiation with near-infrared (NIR) light for both imaging and therapy. Here, we sought to determine the feasibility of combining photoimmunotherapy using conjugates of human epidermal growth factor receptor 2 (HER2)-specific mAb-photosensitizer IR700, trastuzumab-IR700 and pertuzumab-IR700. HER2-expressing and non-expressing cells were treated with mAb-IR700 conjugates and irradiated with NIR light. Fluorescence imaging and cytotoxic effects were examined in cultured HER2-expressng cancer cell lines and in a mouse tumor xenograft model. Trastuzumab-IR700 and pertuzumab-IR700 could specifically bind to HER2 without competing, and the combination treatment of both agents yielded stronger HER2-specific IR700 fluorescence signals than with the treatment with either agent singly. A cytotoxicity assay showed that the combination treatment of both trastuzumab-IR700 and pertuzumab-IR700 followed by NIR light irradiation induced stronger cytotoxic effect than with treatment of either agent plus NIR light irradiation. Furthermore, the phototoxic and cytotoxic effects of mAb depended on HER2-specific IR700 signal intensities. Consistent with in vitro studies, in xenograft tumor models also, IR700 fluorescence imaging-guided NIR light irradiation after the combination treatment of trastuzumab-IR700 and pertuzumab-IR700 led to stronger antitumor effects than by treatment with either agent followed by NIR light irradiation. In conclusion, fluorescence molecular imaging can facilitate the assessment of treatment outcomes of molecular targeted photoimmunotherapy, which holds great potential in facilitating better outcomes in cancer patients.
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Affiliation(s)
- Kimihiro Ito
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato, Tokyo 105-8461, Japan
| | - Makoto Mitsunaga
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato, Tokyo 105-8461, Japan
| | - Takashi Nishimura
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato, Tokyo 105-8461, Japan
| | - Hisataka Kobayashi
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute, Bethesda, MD 20892, USA
| | - Hisao Tajiri
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, The Jikei University School of Medicine, Minato, Tokyo 105-8461, Japan
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46
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Hachiya M, Satoh K, Takami S, Uetake S, Arihiro S, Hokari A, Ishikawa T, Takagi I, Tajiri H, Saruta M. [A case of metastatic uveal melanoma of the liver and digestive tract]. Nihon Shokakibyo Gakkai Zasshi 2017; 114:1978-1986. [PMID: 29109346 DOI: 10.11405/nisshoshi.114.1978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Metastasis of uveal melanoma of the digestive tract is rare. We report a case of a patient with metastatic uveal melanoma of the liver and digestive tract. A 68-year-old man was admitted with primary complaint of appetite loss and fatigue. Abdominal computed tomography revealed a 13-cm diameter tumor in the right lobe of the liver. We diagnosed him with metastatic uveal melanoma. We performed a liver tumor biopsy and diagnosed metastatic melanoma;we found distant metastases in the stomach, duodenum, and rectum on endoscopic biopsy. We administered systemic chemotherapy [DACa-Tam therapy (Dacarbazine, 220mg/m2×3 days;Nimustine, 60mg/m2×1 day;Carboplatin area under the curve (AUC) =4×1 day;Tamoxifen, 40mg/day×3 days)]. Prognosis is unfavorable in approximately half of the patients with liver metastases that occur through blood circulation. The patient died of liver failure two months after the diagnosis.
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Affiliation(s)
- Mami Hachiya
- Department of Gastroenterology and Hepatology, The Jikei University School of Medicine
| | - Kenichi Satoh
- Department of Gastroenterology and Hepatology, The Jikei University School of Medicine
| | - Shinichiro Takami
- Department of Gastroenterology and Hepatology, The Jikei University School of Medicine
| | - Shinichiro Uetake
- Department of Gastroenterology and Hepatology, The Jikei University School of Medicine
| | - Seiji Arihiro
- Department of Gastroenterology and Hepatology, The Jikei University School of Medicine
| | - Atsushi Hokari
- Department of Gastroenterology and Hepatology, The Jikei University School of Medicine
| | - Tomohisa Ishikawa
- Department of Gastroenterology and Hepatology, The Jikei University School of Medicine
| | - Ichiro Takagi
- Department of Gastroenterology and Hepatology, The Jikei University School of Medicine
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine
| | - Masayuki Saruta
- Department of Gastroenterology and Hepatology, The Jikei University School of Medicine
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47
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Stellhorn JR, Hosokawa S, Happo N, Tajiri H, Matsushita T, Kaminaga K, Fukumura T, Hasegawa T, Hayashi K. A valence-selective X-ray fluorescence holography study of an yttrium oxide thin film. J Appl Crystallogr 2017. [DOI: 10.1107/s1600576717012821] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The first direct valence-selective structure determination by X-ray fluorescence holography is reported. The method is applied to investigate an epitaxial thin film of the rare earth monoxide YO, which has recently been synthesized by pulsed laser deposition. The surface of the sample is easily oxidized to Y2O3. In order to separate the structural information connected with the two different valence states of Y, the X-ray fluorescence holography measurements were performed close to the YKabsorption edge. Using the shift of the absorption edge for the different valence states, very different relative contributions of YO and Y2O3are obtained. Thus, it is possible to distinguish the crystal structures of YO and Y2O3in the thin-film sample.
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48
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Tamai N, Saito Y, Sakamoto T, Nakajima T, Matsuda T, Sumiyama K, Tajiri H, Koyama R, Kido S. Effectiveness of computer-aided diagnosis of colorectal lesions using novel software for magnifying narrow-band imaging: a pilot study. Endosc Int Open 2017; 5:E690-E694. [PMID: 28782001 PMCID: PMC5542817 DOI: 10.1055/s-0043-105490] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 02/06/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND AND STUDY AIMS Magnifying narrow-band imaging (M-NBI) enables detailed observation of microvascular architecture and can be used in endoscopic diagnosis of colorectal lesion. However, in clinical practice, differential diagnosis and estimation of invasion depth of colorectal lesions based on M-NBI findings require experience. Therefore, developing computer-aided diagnosis (CAD) for M-NBI would be beneficial for clinical practice. The aim of this study was to evaluate the effectiveness of software for CAD of colorectal lesions. MATERIALS AND METHODS In collaboration with Yamaguchi University, we developed novel software that enables CAD of colorectal lesions using M-NBI images. This software for CAD further specifically divides original Sano's colorectal M-NBI classification into 3 groups (group A, capillary pattern [CP] type I; group B, CP type II + CP type IIIA; group C, CP type IIIB), which describe hyperplastic polyps (HPs), adenoma/adenocarcinoma (intramucosal [IM] to submucosal [SM]-superficial) lesions, and SM-deep lesions, respectively. We retrospectively reviewed 121 lesions evaluated using M-NBI. RESULTS The 121 reviewed lesions included 21 HP, 80 adenoma/adenocarcinoma (IM to SM-superficial), and 20 SM-deep lesions. The concordance rate between the CAD and the diagnosis of the experienced endoscopists was 90.9 %. The sensitivity, specificity, positive and negative predictive values, and accuracy of the CAD for neoplastic lesions were 83.9 %, 82.6 %, 53.1 %, 95.6 %, and 82.8 %, respectively. The values for SM-deep lesions were 83.9 %, 82.6 %, 53.1 %, 95.6 %, and 82.8 %, respectively. CONCLUSION Relatively high diagnostic values were obtained using CAD. This software for CAD could possibly lead to a wider use of M-NBI in the endoscopic diagnosis of colorectal lesions.
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Affiliation(s)
- Naoto Tamai
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan,Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan,Corresponding author Naoto Tamai, MD, PhD Department of EndoscopyThe Jikei University School of Medicine3-25-8 Nishi Shinbashi, Minato-ku, Tokyo 105-8461Japan+81-3-3433-1111 (Ext. 3181)+81-3-3459-4524
| | - Yutaka Saito
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Taku Sakamoto
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takeshi Nakajima
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Takahisa Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Sumiyama
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan
| | - Hisao Tajiri
- Department of Innovative Interventional Endoscopy Research, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryosuke Koyama
- Applied Medical Engineering Science, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
| | - Shoji Kido
- Applied Medical Engineering Science, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan
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49
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Ito K, Mitsunaga M, Nishimura T, Saruta M, Iwamoto T, Kobayashi H, Tajiri H. Near-Infrared Photochemoimmunotherapy by Photoactivatable Bifunctional Antibody-Drug Conjugates Targeting Human Epidermal Growth Factor Receptor 2 Positive Cancer. Bioconjug Chem 2017; 28:1458-1469. [PMID: 28402624 DOI: 10.1021/acs.bioconjchem.7b00144] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Near-infrared photoimmunotherapy (NIR-PIT) is a new class of molecular targeted cancer therapy based on antibody-photoabsorber conjugates and NIR light irradiation. Recent studies have shown effective tumor control, including that of human epidermal growth factor receptor 2 (HER2)-positive cancer, by selective molecular targeting with NIR-PIT. However, the depth of NIR light penetration limits its use. Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate consisting of the monoclonal antibody trastuzumab linked to the cytotoxic agent maytansinoid DM1. Here, we developed bifunctional antibody-drug-photoabsorber conjugates, T-DM1-IR700, that can work as both NIR-PIT and chemoimmunotherapy agents. We evaluated the feasibility of T-DM1-IR700-mediated NIR light irradiation by comparing the in vitro and in vivo cytotoxic efficacy of trastuzumab-IR700 (T-IR700)-mediated NIR light irradiation in HER2-expressing cells. T-IR700 and T-DM1-IR700 showed almost identical binding to HER2 in vitro and in vivo. Owing to the presence of internalized DM1 in the target cells, NIR-PIT using T-DM1-IR700 tended to induce greater cytotoxicity than that of NIR-PIT using T-IR700 in vitro. In vivo NIR-PIT using T-DM1-IR700 did not show a superior antitumor effect to NIR-PIT using T-IR700 in subcutaneous small-tumor models, which could receive sufficient NIR light. In contrast, NIR-PIT using T-DM1-IR700 tended to reduce the tumor volume and showed significant prolonged survival compared to NIR-PIT using T-IR700 in large-tumor models that could not receive sufficient NIR light. We successfully developed a T-DM1-IR700 conjugate that has a similar immunoreactivity to the parental antibody with increased cytotoxicity due to DM1 and potential as a new NIR-PIT agent for targeting tumors that are large and inaccessible to sufficient NIR light irradiation to activate the photoabsorber IR700.
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Affiliation(s)
| | | | | | | | | | - Hisataka Kobayashi
- Molecular Imaging Program, Center for Cancer Research, National Cancer Institute , NIH, Building 10, Room B3B69, MSC1088, Bethesda, Maryland 20892, United States
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Murdani A, Kumar A, Chiu HM, Goh KL, Jang BI, Khor CJL, Lau J, Mostafa I, Ramchandani M, Ratanalert S, Tajiri H, Yuen M, Zhang ST, Duforest-Rey D, Rey JF. WEO position statement on hygiene in digestive endoscopy: Focus on endoscopy units in Asia and the Middle East. Dig Endosc 2017; 29:3-15. [PMID: 27696514 DOI: 10.1111/den.12745] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 09/21/2016] [Indexed: 12/14/2022]
Abstract
The aim of this position statement is to reinforce the key points of hygiene in digestive endoscopy. The present article details the minimum hygiene requirements for reprocessing of endoscopes and endoscopic devices, regardless of the reprocessing method (automated washer-disinfector or manual cleaning) and the endoscopy setting (endoscopy suite, operating room, elective or emergency procedures). These minimum requirements are mandatory for patient safety. Both advanced diagnostic and therapeutic endoscopies should be carried out in an environment that is safe for patients and staff. Particular attention is given to contaminants. Procedural errors in decontamination, defective equipment, and failure to follow disinfection guidelines are major factors contributing to transmission of infection during endoscopy. Other important risk factors include inadequate cleaning, use of older endoscopes with surface and working channel irregularities, and contamination of water bottles or irrigating solutions. Infections by multidrug-resistant organisms have become an increasing problem in health-care systems worldwide. Since 2010, outbreaks of multidrug-resistant bacteria associated with endoscopic retrograde cholangiopancreatography have been reported from the USA, France, Germany, and The Netherlands. In many endoscopy units in Asia and the Middle East, reprocessing procedures have lagged behind those of Western countries for cultural reasons or lack of financial resources. This inconsistency in standards is now being addressed, and the World Endoscopy Organization has prepared this position statement to highlight key points for quality assurance in any endoscopy unit in any country.
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Affiliation(s)
- Abdullah Murdani
- Department of Internal Medicine, Universitas Indonesia, Jakarta Timur, Indonesia
| | - Ajay Kumar
- Fortis Escorts Liver and Digestive Diseases Institute, New Delhi, India
| | - Han-Mo Chiu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Khean-Lee Goh
- Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Byung Ik Jang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Christopher J L Khor
- Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore
| | - James Lau
- Endoscopy Center, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Ibrahim Mostafa
- Endoscopy Unit, Department of Gastroenterology and Hepatology, Theodor Bilharz Research Institute, Cairo, Egypt
| | | | - Siriporn Ratanalert
- NKC Institute of Gastroenterology, Songklanagarind Hospital, Songkhla, Thailand
| | - Hisao Tajiri
- Department of Internal Medicine, Jikei University School of Medicine, Tokyo, Japan
| | - Minghwa Yuen
- Cantel Medical Asia/Pacific Pte. Ltd, Singapore, Singapore
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