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How to establish endoscopic submucosal dissection in Western countries

World Journal of Gastroenterology 2015年第40期21卷 11209-11220页

作者： Tsuneo Oyama naohisa yahagi Thierry Ponchon Tobias Kiesslich Frieder Berr Department of Endoscopy Saku Central Hospital Advanced Care Center Cancer Center Keio University School of Medicine35 ShinanomachiShinjuku-kuTokyo 160-8582Japan H?pital Edouard Herriot Specialités DigestivesPavillon HPlaced’Arsonval69437 LyonFrance Department of Medicine I University Hospital Salzburg and Institute of Physiology and PathophysiologyParacelsus Medical University

Endoscopic submucosal dissection(ESD) has been invented in Japan to provide resection for cure of early cancer in the gastrointestinal tract. Professional level of ESD requires excellent staging of early neoplasias with image enhanced endoscopy(IEE) to make correct indications for ESD,and high skills in endoscopic electrosurgical dissection. In Japan,endodiagnostic and endosurgical excellence spread through personal tutoring of skilled endoscopists by the inventors and experts in IEE and ESD. To translocate this expertise to other continents must overcome two fundamental obstacles:(1) inadequate expectations as to the complexity of IEE and ESD; and(2) lack of suitable lesions and master-mentors for ESD trainees. Leading endoscopic mucosal resection-proficient endoscopists must pioneer themselves through the long learning curve to proficient ESD experts. Major referral centers for ESD must arise in Western countries on comparable professional level as in Japan. In the second stage,the upcoming Western experts must commit themselves to teach skilled endoscopists from other referral centers,in order to spread ESD in Western countries. Respect for patients with early gastrointestinal cancer asks for best efforts to learn endoscopic categorization of early neoplasias and skills for ESD based on sustained cooperation with the masters in Japan. The strategy is discussed here.

关键词： Endoscopic submucosal dissection Early cancer Endo

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What are the latest developments in colorectal endoscopic submucosal dissection?

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World Journal of Gastrointestinal Endoscopy 2012年第7期4卷 296-300页

作者： Toshio Uraoka Yutaka Saito naohisa yahagi Division of Research and Development for Minimally Invasive Treatment Cancer Center School of Medicine Keio UniversityTokyo 160-8582 Japan Division of Endoscopy National Cancer Center HospitalTokyo 160-8582 Japan

Endoscopic submucosal dissection (ESD) enables direct submucosal dissection so that even large early-stage gastrointestinal tumors can be resected en bloc . ESD has recently been applied to the colorectum since it was originally developed for use in the stomach. However, colorectal ESD is technically more difficult with an increased risk of perforation compared with gastric ESD. In addition, this procedure is seldom performed in Western countries. Consequently, further technical advances and the availability of a suitable clinical training system are required for the extensive use of colorectal ESD. In this topic highlight, we review the most recent developments in colorectal ESD.

关键词： Endoscopic submucosal dissection Colonoscopy Colorectum Complication Perforation Training

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Surveillance using trimodal imaging endoscopy after endoscopic submucosal dissection for superficial gastric neoplasia

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World Journal of Gastroenterology 2014年第43期20卷 16311-16317页

作者： Hiroyuki Imaeda Naoki Hosoe Kazuhiro Kashiwagi Yosuke Ida Rieko Nakamura Hidekazu Suzuki Yoshimasa Saito naohisa yahagi Yasushi Iwao Yuko Kitagawa Toshifumi Hibi Haruhiko Ogata Takanori Kanai Department of General Internal Medicine Saitama Medical UniversitySaitama 350-0495Japan Center for Diagnostic and Therapeutic Endoscopy School of MedicineKeio UniversityTokyo 108-8345Japan Division of Gastroenterology Department of Internal MedicineSchool of MedicineKeio UniversityTokyo 108-8345Japan Cancer Center School of MedicineKeio UniversityTokyo 108-8345Japan Center for Preventive Medicine School of MedicineKeio UniversityTokyo 108-8345Japan Department of Surgery School of MedicineKeio UniversityTokyo 108-8345Japan

AIM: To evaluate the effectiveness of trimodal imaging endoscopy (TME) to detect another lesion after endoscopic submucosal dissection (ESD) for superficial gastric neoplasia (SGN).

关键词： Autofluorescence imaging Endoscopic submucosal dissection Superficial gastric neoplasia

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Cutting edge of endoscopic full-thickness resection for gastric tumor

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World Journal of Gastrointestinal Endoscopy 2015年第16期7卷 1208-1215页

作者： Tadateru Maehata Osamu Goto Hiroya Takeuchi Yuko Kitagawa naohisa yahagi Division of Research and Development for Minimally Invasive Treatment Cancer CenterKeio UniversitySchool of Medicine Department of Surgery Keio UniversitySchool of Medicine

Recently,several studies have reported local full-thickness resection techniques using flexible endoscopy for gastric tumors,such as gastrointestinal stromal tumors,gastric carcinoid tumors,and early gastric cancer(EGC). These techniques have the advantage of allowing precise resection lines to be determined using intraluminal endoscopy. Thus,it is possible to minimize the resection area and subsequent deformity. Some of these methods include:(1) classical laparoscopic and endoscopic cooperative surgery(LECS);(2) inverted LECS;(3) combination of laparoscopic and endoscopic approaches to neoplasia with non-exposure technique; and(4) non-exposed endoscopic wall-inversion surgery. Furthermore,a recent prospective multicenter trial of the sentinel node navigation surgery(SNNS) for EGC has shown acceptable results in terms of sentinel node detection rate and the accuracy of nodal metastasis. Endoscopic full-thickness resection with SNNS is expected to become a treatment option that bridges the gap between endoscopic submucosal dissection and standard surgery for EGC. In the future,the indications for these procedures for gastric tumors could be expanded.

关键词： Gastrointestinal stromal tumor Early gastric cance

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Management of bleeding and artificial gastric ulcers associated with endoscopic submucosal dissection

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World Journal of Gastrointestinal Endoscopy 2012年第1期4卷 1-8页

作者： Yosuke Muraki Shotaro Enomoto Mikitaka Iguchi Mitsuhiro Fujishiro naohisa yahagi Masao Ichinose Second Department of Internal Medicine Wakayama Medical University Department of Endoscopy and Endoscopic Surgery Faculty of Medicine University of Tokyo Division of Research and Development for Minimally Invasive Treatment Cancer Center Keio University School of Medicine

Endoscopic submucosal dissection (ESD), an endoscopic procedure for the treatment of gastric epithelial neoplasia without lymph node metastases, spread rapidly, primarily in Japan, starting in the late 1990s. ESD enables en bloc resection of lesions that are difficult to resect using conventional endoscopic mucosal resection (EMR). However, in comparison to EMR, ESD requires a high level of endoscopic competence and a longer resection time. Thus, ESD is associated with a higher risk of adverse events, including intraoperative and postoperative bleeding and gastrointestinal perforation. In particular, because of a higher incidence of intraoperative bleeding with mucosal incision and submucosal dissection, which are distinctive endoscopic procedures in ESD, a strategy for endoscopic hemostasis, mainly by thermo-coagulation hemostasis using hemostatic forceps, is important. In addition, because of iatrogenic artificial ulcers that always form after ESD, endoscopic hemostasis and appropriate pharma-cotherapy during the healing process are essential.

关键词： Artificial ulcer Endoscopic hemostasis Endoscopic submucosal dissection Gastric epithelial neoplasia Hemostatic forceps

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Endoscopic mucosal resection and endoscopic submucosal dissection in the treatment of sporadic nonampullary duodenal adenomatous polyps

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World Journal of Gastrointestinal Endoscopy 2015年第7期7卷 720-727页

作者： Joana Marques Francisco Baldaque-Silva Pedro Pereira Urban Arnelo naohisa yahagi Guilherme Macedo Faculty of Medicine University of Porto Gastrocentrum Karolinska University Hospital Karolinska Institutet Gastroenterology Department Hospital Sao Joao Department of Clinical Science Intervention and Technology (CLINTEC) Karolinska Institutet and Centre for Digestive Diseases Karolinska University Hospital Division of Research and Development for Minimally Invasive Treatment Cancer Center School of Medicine Keio University

Although uncommon, sporadic nonampullary duodenal adenomas have a growing detection due to the widespread of endoscopy. Endoscopic therapy is being increasingly used for these lesions, since surgery, considered the standard treatment, carries significant morbidity and mortality. However, the knowledge about its risks and benefits is limited, which contributes to the current absence of standardized recommendations. This review aims to discuss the efficacy and safety of endoscopic mucosal resection(EMR) and endoscopic submucosal dissection(ESD) in the treatment of these lesions. A literature review was performed, using the Pubmed database with the query: "(duodenum or duodenal)(endoscopy or endoscopic) adenoma resection", in the human species and in English. Of the 189 retrieved articles, and after reading their abstracts, 19 were selected due to their scientific interest. The analysis of their references, led to the inclusion of 23 more articles for their relevance in this subject. The increased use of EMR in the duodenum has shown good results with complete resection rates exceeding 80% and low complication risk(delayed bleeding in less than 12% of the procedures). Although rarely used in the duodenum, ESD achieves close to 100% complete resection rates, but is associated with perforation and bleeding risk in up to one third of the cases. Even though literature is insufficient to draw definitive conclusions, studies suggest that EMR and ESD are valid options for the treatment of nonampullary adenomas. Thus, strategies to improve these techniques, and consequently increase the effectiveness and safety of the resection of these lesions, should be developed.

关键词： Polyps Duodenum Adenoma Resection Endoscopy

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Advanced endoscopic submucosal dissection with traction

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World Journal of Gastrointestinal Endoscopy 2014年第7期6卷 286-295页

作者： Hiroyuki Imaeda Naoki Hosoe Kazuhiro Kashiwagi Tai Ohmori naohisa yahagi Takanori Kanai Haruhiko Ogata Department of General Internal Medicine Saitama Medical UniversitySaitama 350-0495Japan Center for Diagnostic and Therapeutic Endoscopy School of MedicineKeio University108-8345 TokyoJapan Division of Research and Development for Minimally Invasive Treatment Cancer CenterSchool of MedicineKeio University108-8345 TokyoJapan Division of Gastroenterology and Hepatology Department of Internal MedicineSchool of MedicineKeio University108-8345 TokyoJapan

Endoscopic submucosal dissection(ESD)has been established as a standard treatment for early stage gastric cancer(EGC)in Japan and has spread *** has been used not only for EGC but also for early esophageal and colonic ***,ESD is as-sociated with several adverse events,such as bleeding and perforation,which requires more *** tissue tension and clear visibility of the tissue to be dissected are important for effective and safe *** ESD methods using traction have been devel-oped,such as clip-with-line method,percutaneous trac-tion method,sinker-assisted method,magnetic anchor method,external forceps method,internal-traction method,double-channel-scope method,outerroute method,double-scope method,endoscopic-surgical-platform,and robot-assisted *** method has both advantages and *** endos-copy,enabling ESD with a traction method,will become more common due to advances in *** thenear future,simple,noninvasive,and effective ESD us-ing traction is expected to be developed and become established as a worldwide standard treatment for superficial gastrointestinal neoplasias.

关键词： Endoscopic submucosal dissection Traction Early gastric cancer Early esophageal cancer Early colonic cancer

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Percutaneous endoscopic gastrostomy under steadypressure automatically controlled endoscopy:First clinicalseries

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World Journal of Gastrointestinal Endoscopy 2016年第3期8卷 186-191页

作者： Hiroyuki Imaeda Kiyokazu Nakajima Naoki Hosoe Masanori Nakahara Shinichiro Zushi Motohiko Kato Kazuhiro Kashiwagi Yasushi Matsumoto Kayoko Kimura Rieko Nakamura Norihito Wada Masahiko Tsujii naohisa yahagi Toshifumi Hibi Takanori Kanai Tetsuo Takehara Haruhiko Ogata Department of General Internal Medicine Saitama Medical UniversitySaitama 350-0495Japan Division of Next Generation Endoscopic Intervention Osaka UniversityOsaka 565-0871Japan Center for Diagnostic and Therapeutic Endoscopy School of MedicineKeio UniversityTokyo 160-8582Japan Department of Gastroenterology Ikeda City HospitalOsaka 563-8510Japan Department of Gastroenterology and Hepatology Graduate School of MedicineOsaka UniversityOsaka 565-0871Japan Department of Surgery School of MedicineKeio UniversityTokyo 160-8582Japan Division of Research and Development for Minimally Invasive Treatment Cancer CenterSchool of MedicineKeio UniversityTokyo 160-8582Japan Division of Gastroenterology and Hepatology Department of Internal MedicineSchool of MedicineKeio UniversityTokyo 160-8582Japan

AIM: To elucidate the safety of percutaneous endoscopic gastrostomy(PEG) under steady pressure automatically controlled endoscopy(SPACE) using carbon dioxide(CO_2).METHODS: Nine patients underwent PEG with a modified introducer method under conscious sedation. A T-tube was attached to the channel of an endoscope connected to an automatic surgical insufflator. The stomach was inflated under the SPACE system. The intragastric pressure was kept between 4-8 mmH g with a flow of CO_2 at 35 L/min. Median procedure time, intragastric pressure, median systolic blood pressure, partial pressure of CO_2, abdominal girth before and immediately after PEG, and free gas and small intestinal gas on abdominal X-ray before and after PEG were recorded. RESULTS: PEG was completed under stable pneumostomach in all patients, with a median procedural time of 22 min. Median intragastric pressure was 6.9 mmH g and median arterial CO_2 pressure before and after PEG was 42.1 and 45.5 Torr(NS). The median abdominal girth before and after PEG was 68.1 and 69.6 cm(NS). A mild free gas image after PEG was observed in two patients, and faint abdominal gas in the downstream bowel was documented in two ***: SPACE might enable standardized pneumostomach and modified introducer procedure of PEG.

关键词： Percutaneous endoscopic gastrostomy Steadypressure automatically controlled endoscopy Carbondioxide

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Endoscopic removal of foreign bodies:A retrospective study in Japan

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World Journal of Gastrointestinal Endoscopy 2020年第1期12卷 33-41页

作者： Kenji JL Limpias Kamiya Naoki Hosoe Kaoru Takabayashi Yukie Hayashi Xi Sun Ryoichi Miyanaga Kayoko Fukuhara Seiichiro Fukuhara Makoto Naganuma Atsushi Nakayama Motohiko Kato Tadateru Maehata Rieko Nakamura Koichi Ueno Junichi Sasaki Yuko Kitagawa naohisa yahagi Haruhiko Ogata Takanori Kanai Division of Gastroenterology and Hepatology Department of Internal MedicineKeio University School of MedicineTokyo 160-8582Japan Center for Diagnostic and Therapeutic Endoscopy Keio University School of MedicineTokyo 160-8582Japan Department of Gastroenterology and Hepatology Chinese PLA General HospitalBeijing 100853China Division of Research and Development for Minimally Invasive Treatment Cancer CenterKeio University School of MedicineTokyo 160-8582Japan Department of Surgery Keio University School of MedicineTokyo 160-8582Japan Department of Emergency and Critical Care Medicine Keio University School of MedicineTokyo 160-8582Japan

BACKGROUND The ingestion of foreign bodies(FBs)and food bolus impaction(FBI)in the digestive tract are commonly encountered clinical *** to handle such problems continue to evolve offering advantages,such as the avoidance of surgery,reduced cost,improved visualization,reduced morbidity,and high removal success ***,to date,no studies have evaluated the endoscopic management of FBs in *** To elucidate level of safety and efficacy in the endoscopic management of FBs and *** A total of 215 procedures were performed at Keio University Hospital between November 2007 and August *** were collected from medical charts,and endoscopic details were collected from an endoscopic reporting *** performed with a flexible gastrointestinal endoscope were only taken into *** who underwent a technique involving FB or FBI from the digestive tract were only *** on patient sex,patient age,outpatient,inpatient,FB type,FB location,procedure time,procedure type,removal device type,success,and technical complications were reviewed and analyzed *** Among the 215 procedures,136(63.3%)were performed in old adults(≥60 years),180(83.7%)procedures were performed in *** most common type of FBs were press-through-pack(PTP)medications[72(33.5%)cases],FBI[47(21.9%)],Anisakis parasite(AP)[41(19.1%)cases].Most FBs were located in the esophagus[130(60.5%)cases]followed by the stomach[68(31.6%)cases].AP was commonly found in the stomach[39(57.4%)cases],and it was removed using biopsy forceps in 97.5%of the *** most common FBs according to anatomical location were PTP medications(40%)and dental prostheses(DP)(40%)in the laryngopharynx,PTP(48.5%)in the esophagus,AP(57.4%)in the stomach,DP(37.5%)in the small intestine and video capsule endoscopy device(75%)in the colon.A transparent cap with grasping forceps was the most commonly used device[82(38.1%)cases].The success rate of the procedure was

关键词： Anisakis parasite Endoscopic removal Food bolus impaction Foreign body Grasping forceps

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High-throughput study of the anomalous Hall effect

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npj Computational Materials 2023年第1期9卷 767-774页

作者： JakubŽelezný Yuta yahagi Carles Gomez-Olivella Yang Zhang Yan Sun Institute of Physics Czech Academy of SciencesCukrovarnická1016200 Praha 6Czech Republic Department of Applied Physics Tohoku UniversitySendaiMiyagiJapan Department of Physics and Astronomy University of Tennessee KnoxvilleKnoxvilleTN 37996USA Min H.Kao Department of Electrical Engineering and Computer Science University of TennesseeKnoxvilleTN 37996USA Shenyang National Laboratory for Materials Science Institute of Metal ResearchChinese Academy of SciencesShenyang 110016China

Despite its long history,the anomalous Hall continues to attract attention due to its complex origins,its connection to topology,and its use as a probe of magnetic *** this work we investigate the anomalous Hall effect in 2871 ferromagnetic materials using an automatic high-throughput calculation *** analyze general properties of the effect,such as its reliance on spin-orbit coupling strength and *** materials with the largest anomalous Hall effect,we find that symmetry-protected band degeneracies in the non-relativistic electronic structure,such as mirror symmetry-protected nodal lines,are typically responsible for the large ***,we examine the dependence of the anomalous Hall effect on magnetization direction and demonstrate deviations from the commonly assumed expression j^(AHE)~M×E.

关键词： effect symmetry protected

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