Kyushu University Academic Staff Educational and Research Activities Database
List of Papers
Yosuke Minoda Last modified date:2024.06.03

Assistant Professor / Department of Medicine and Bioregulatory Science / Department of Hepatology and Pancreatology / Kyushu University Hospital

1. Kei Nishioka, Mitsuru Esaki, Tsutomu Iwasa, Yosuke Minoda, Noriko Shiga, Haruei Ogino, Eikichi Ihara, Two-step traction-assisted endoscopic submucosal dissection for a gastric neoplasm using a clip with a traction band and thread., Endoscopy, 10.1055/a-2155-7172, 55, S 01, E1041-E1042, 2023.12.
2. Tsubasa Takeuchi, Mitsuru Esaki, Yosuke Minoda, Yoshitaka Hata, Haruei Ogino, Eikichi Ihara, Yoshihiro Ogawa, Two-point fixed pulley-traction method in endoscopic submucosal dissection for early gastric neoplasm., Endoscopy, 10.1055/a-2173-8010, 55, S 01, E1087-E1088, 2023.12.
3. Leonardo Yoshio Sato, Yoshitaka Hata, Mitsuru Esaki, Eikichi Ihara, Shiho Tajiri, Tomohiko Moriyama, Yosuke Minoda, Double-scope technique to recover from hand-suturing trouble in the duodenum., Endoscopy, 10.1055/a-2199-3398, 55, S 01, E1193-E1194, 2023.12.
4. Masafumi Wada, Yosuke Minoda, Eikichi Ihara, Hirotaka Tsuru, Yoshitaka Hata, Shuzaburo Nagatomo, Mitsuru Esaki, Xiaopeng Bai, Yoshimasa Tanaka, Takatoshi Chinen, Haruei Ogino, Yoshihiro Ogawa, Development of a new endoscopy system to visualize bilirubin for the diagnosis of duodenogastroesophageal reflux., Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.14749, 2023.12, OBJECTIVES: Reflux hypersensitivity (RH) is a form of refractory gastroesophageal reflux disease in which duodenogastroesophageal reflux (DGER) plays a role. This study aimed to determine the usefulness of an endoscopy system equipped with image-enhanced technology for evaluating DGER and RH. METHODS: The image enhancement mode for detecting bilirubin and calculated values were defined as the Bil mode and Bil value, respectively. First, the visibility of the Bil mode was validated for a bilirubin solution and bile concentrations ranging from 0.01% to 100% (0.002-20 mg/dL). Second, visibility scores of the Bil mode, when applied to the porcine esophagus sprayed with a bilirubin solution, were compared to those of the blue laser imaging (BLI) and white light imaging (WLI) modes. Third, a clinical study was conducted to determine the correlations between esophageal Bil values and the number of nonacid reflux events (NNRE) during multichannel intraluminal impedance-pH monitoring as well as the utility of esophageal Bil values for the differential diagnosis of RH. RESULTS: Bilirubin solution and bile concentrations higher than 1% were visualized in red using the Bil mode. The visibility score was significantly higher with the Bil mode than with the BLI and WLI modes for 1% to 6% bilirubin solutions (P 
5. Ryohei Maruoka, Mitsuru Esaki, Yosuke Minoda, Noriko Tokunaga, Kazuhiro Haraguchi, Eikichi Ihara, Yoshihiro Ogawa, Three-point traction method for endoscopic submucosal dissection using clip-with-thread and clip-with-silicon bands for large early gastric neoplasms., Endoscopy international open, 10.1055/a-2219-8130, 12, 1, E57-E58, 2024.01.
6. Kosuke Maehara, Mitsuru Esaki, Yorinobu Sumida, Daisuke Yamaguchi, Kei Nishioka, Hitoshi Homma, Taisuke Inada, Kazuo Shiotsuki, Shin-Ichiro Fukuda, Hirotada Akiho, Tadahiro Nomura, Yumi Mizuta, Satoshi Ishida, Shun Fujimoto, Shunichiro Kimura, Yuichiro Tanaka, Kaori Hata, Noriko Shiga, Tsutomu Iwasa, Yusuke Kimura, Norimoto Nakamura, Yusuke Suzuki, Yosuke Minoda, Yoshitaka Hata, Haruei Ogino, Koshiro Tagawa, Eikichi Ihara, Yoshihiro Ogawa, Comparison of hemostatic ability between spray coagulation and forced coagulation modes in endoscopic submucosal dissection in patients with early gastric neoplasms: a study protocol for multicenter randomized controlled trial (Spray-G trial)., Trials, 10.1186/s13063-023-07852-6, 25, 1, 53-53, 2024.01, BACKGROUND: Endoscopic submucosal dissection (ESD) is the standard treatment for early gastric neoplasms (EGN). Controlling intraoperative bleeding is crucial for ensuring safe and reliable procedures. ESD using the spray coagulation mode (SCM-ESD) has been developed to control bleeding more effectively than ESD using the conventional forced coagulation mode (FCM-ESD). This study aims to compare the hemostatic efficacies of SCM-ESD and FCM-ESD. METHODS: This multicenter, prospective, parallel, randomized, open-label superiority trial will be conducted in five Japanese institutions. Patients with a preoperative diagnosis of intramucosal EGC will be randomized to undergo either SCM-ESD or FCM-ESD. The primary outcome measure is the completion of ESD with an electrosurgical knife alone, without the use of hemostatic forceps. Secondary outcomes include the number and duration of hemostasis using hemostatic forceps, procedure time, curability, and safety. A total of 130 patients will be enrolled in this study. DISCUSSION: This trial will provide evidence on the hemostatic efficacy of SCM-ESD compared with FCM-ESD in patients with intramucosal EGN, potentially improving the safety and reliability of ESD procedures. TRIAL REGISTRATION: The trial has been registered at the University Hospital Medical Information Network Clinical Trials Registration (UMIN-CTR) as UMIN000040518. The reception number is R000054009..
7. Kazuya Inoki, Hiroyuki Takamaru, Hiroto Furuhashi, Yoshihiro Kishida, Yuichi Shimodate, Yorinobu Sumida, Kazuya Hosotani, Hiroya Ueyama, Yohei Furumoto, Shinichi Hashimoto, Yoji Takeuchi, Ryoji Ichijima, Yashiro Yoshizawa, Takuto Suzuki, Yosuke Minoda, Kazuhiro Mizukami, Tomoaki Matsumura, Toyotaka Kasai, Takeshi Yamamura, Ken Ohnita, Ken Hara, Mitsuru Esaki, Atsushi Katagiri, Hideki Ishikawa, Takuji Gotoda, Management of colorectal high-grade dysplasia or cancer resected by cold snare polypectomy: a multicenter exploratory study., Journal of gastroenterology, 10.1007/s00535-023-01980-1, 2023.03, BACKGROUND: The clinical course and surveillance strategy for patients who undergo cold snare polypectomy (CSP) for high-grade dysplasia (HGD) or cancer is unclear. We investigated the management of colorectal HGDs and cancers following CSP. METHODS: This Japanese nationwide multicenter exploratory study was retrospectively conducted on patients who had undergone CSP for colorectal HGDs or cancers and follow-up colonoscopy at least once from 2014 to 2020. We investigated the detection rate of CSP scars, local recurrence rate (LRR), risk factors for local recurrence, and follow-up strategy. This study was registered with the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000043670). RESULTS: We included 155 patients with 156 lesions. CSP scars were identified in 22 (31.4%), 41 (54.7%), and 10 (90.9%) patients with curative, borderline, and non-curative resection, respectively. Among them, residual tumors were observed in one (4.5%), six (14.6%), and three (30.0%) cases, respectively. The total LRR was 13.7% (95% confidence interval: 6.8-23.8). R1 resection cases (either horizontal or vertical margins positive for tumors) were associated with local recurrence (p = 0.031). Salvage endoscopic and surgical resections were performed on 21 and 10 patients, respectively. Among them, the proportion of endoscopically suspected residual tumors was significantly higher (p 
8. Mitsuru Esaki, Eikichi Ihara, Yorinobu Sumida, Hiroyuki Fujii, Shunsuke Takahashi, Kazuhiro Haraguchi, Tsutomu Iwasa, Shinichi Somada, Yosuke Minoda, Haruei Ogino, Koshiro Tagawa, Yoshihiro Ogawa, Hybrid- and conventional endoscopic submucosal dissection for early gastric neoplasms: a multi-center randomized controlled trial., Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 10.1016/j.cgh.2022.10.030, 21, 7, 1810-1818, 2022.11, BACKGROUND & AIMS: Hybrid endoscopic submucosal dissection (H-ESD), which incorporates ESD with endoscopic mucosal resection, has been developed to make ESD technically easier. This study aimed to determine if H-ESD is superior to conventional ESD (C-ESD) for small early gastric neoplasms (EGN). METHODS: We conducted a multi-center, prospective, open-label, randomized controlled trial to compare the treatment outcomes of H-ESD and C-ESD (Hybrid-G Trial). The patients with differentiated-type intramucosal EGN ≤ 20 mm in diameter and without ulceration were randomly assigned (1:1) to groups that underwent H-ESD or C-ESD. A single multi-functional snare, SOUTEN (ST1850-20, Kaneka, Medix, Tokyo, Japan), was used for H-ESD. The primary outcome was procedure time. Secondary outcomes included mucosal incision time, time and speed of submucosal dissection, curability, and endoscopic procedural adverse events. RESULTS: A total of 39 and 40 patients underwent H-ESD and C-ESD, respectively. The procedure time of H-ESD was significantly shorter than that of C-ESD (33.16 min vs. 62.46 min, H-ESD/C-ESD ratio: 0.53, 95% confidence interval 0.41-0.69, P
9. Yusuke Suzuki, Mitsuru Esaki, Taisuke Inada, Yosuke Minoda, Haruei Ogino, Eikichi Ihara, Yoshihiro Ogawa, Gastric endoscopic submucosal dissection assisted by intralesional cross-traction using silicone bands., Endoscopy, 10.1055/a-1982-3875, 55, S 01, E324-E325, 2022.12.
10. Yosuke Minoda, Eikichi Ihara, Nao Fujimori, Shuzaburo Nagatomo, Mitsuru Esaki, Yoshitaka Hata, Xiaopeng Bai, Yoshimasa Tanaka, Haruei Ogino, Takatoshi Chinen, Qingjiang Hu, Eiji Oki, Hidetaka Yamamoto, Yoshihiro Ogawa, Efficacy of ultrasound endoscopy with artificial intelligence for the differential diagnosis of non-gastric gastrointestinal stromal tumors., Scientific reports, 10.1038/s41598-022-20863-8, 12, 1, 16640-16640, 2022.10, Gastrointestinal stromal tumors (GISTs) are common subepithelial lesions (SELs) and require treatment considering their malignant potential. We recently developed an endoscopic ultrasound-based artificial intelligence (EUS-AI) system to differentiate GISTs from non-GISTs in gastric SELs, which were used to train the system. We assessed whether the EUS-AI system designed for diagnosing gastric GISTs could be applied to non-gastric GISTs. Between January 2015 and January 2021, 52 patients with non-gastric SELs (esophagus, n = 15; duodenum, n = 26; colon, n = 11) were enrolled. The ability of EUS-AI to differentiate GISTs from non-GISTs in non-gastric SELs was examined. The accuracy, sensitivity, and specificity of EUS-AI for discriminating GISTs from non-GISTs in non-gastric SELs were 94.4%, 100%, and 86.1%, respectively, with an area under the curve of 0.98 based on the cutoff value set using the Youden index. In the subanalysis, the accuracy, sensitivity, and specificity of EUS-AI were highest in the esophagus (100%, 100%, 100%; duodenum, 96.2%, 100%, 0%; colon, 90.9%, 100%, 0%); the cutoff values were determined using the Youden index or the value determined using stomach cases. The diagnostic accuracy of EUS-AI increased as lesion size increased, regardless of lesion location. EUS-AI based on gastric SELs had good diagnostic ability for non-gastric GISTs..
11. Yosuke Minoda, Mitsuru Esaki, Eikichi Ihara, Shuzaburo Nagatomo, Kei Nishioka, Nao Fujimori, Haruei Ogino, Xiaopeng Bai, Yoshimasa Tanaka, Takatoshi Chinen, Qingjiang Hu, Mitsuhiko Ota, Shinya Umekita, Hidetaka Yamamoto, Yoshihiro Ogawa, Auxiliary diagnosis of subepithelial lesions by impedance measurement during endoscopic ultrasound guided fine-needle biopsy., Gastrointestinal endoscopy, 10.1016/j.gie.2022.11.022, 97, 5, 977-984, 2022.11, INTRODUCTION: Endoscopic ultrasound guided fine-needle aspiration/biopsy (EUS-FNA/B) is the gold standard for diagnosing subepithelial lesions (SELs); however, its diagnostic ability for SELs
12. Kazuo Shiotsuki, Yorinobu Sumida, Mitsuru Esaki, Yosuke Minoda, Shin-Ichiro Fukuda, Eikichi Ihara, Hirotada Akiho, Underwater precutting endoscopic mucosal resection using a multifunctional snare for a large colonic laterally spreading tumor., Endoscopy, 10.1055/a-2072-3383, 55, S 01, E702-E703, 2023.12.
13. Yosuke Minoda, Nao Fujimori, Mitsuru Esaki, Shuzaburo Nagatomo, Yasuhiro Komori, Keijiro Ueda, Eikichi Ihara, Rare complications related to lumen-apposing metal stent placement, successfully treated by endoscopic hand-suturing device., Endoscopy, 10.1055/a-2072-5740, 55, S 01, E692-E693, 2023.12.
14. Azusa Kawasaki, Kunihiro Tsuji, Noriya Uedo, Takashi Kanesaka, Hideaki Miyamoto, Ryosuke Gushima, Yosuke Minoda, Eikichi Ihara, Ryosuke Amano, Kenshi Yao, Yoshihide Naito, Hiroyuki Aoyagi, Takehiro Iwasaki, Kunihisa Uchita, Hisatomi Arima, Hisashi Doyama, Non-atrophic gastric mucosa is an independent associated factor for superficial non-ampullary duodenal epithelial tumors: a multicenter, matched, case-control study., Clinical endoscopy, 10.5946/ce.2022.059, 56, 1, 75-82, 2023.01, BACKGROUND/AIMS: The etiology of superficial non-ampullary duodenal epithelial tumors (SNADETs) remains unclear. Recent studies have reported conflicting associations between duodenal tumor development and Helicobacter pylori (H. pylori) infection or endoscopic gastric mucosal atrophy. As such, the present study aimed to clarify the relationship between SNADETs and H. pylori infection and/or endoscopic gastric mucosal atrophy. METHODS: This retrospective case-control study reviewed data from 177 consecutive patients with SNADETs who underwent endoscopic or surgical resection at seven institutions in Japan over a three-year period. The prevalence of endoscopic gastric mucosal atrophy and the status of H. pylori infection were compared in 531 sex- and age-matched controls selected from screening endoscopies at two of the seven participating institutions. RESULTS: For H. pylori infection, 85 of 177 (48.0%) patients exhibited SNADETs and 112 of 531 (21.1%) control patients were non-infected (p
15. Yosuke Minoda, Haruei Ogino, Yorinobu Sumida, Takashi Osoegawa, Soichi Itaba, Norikazu Hashimoto, Mitsuru Esaki, Yusuke Kitagawa, Kentaro Yodoe, Yoichiro Iboshi, Takahiro Matsuguchi, Mei Tadokoro, Tomohito Chaen, Hiroaki Kubo, Masaru Kubokawa, Naohiko Harada, Kenichi Nishizima, Hiroyuki Fujii, Yoshitaka Hata, Yoshimasa Tanaka, Eikichi Ihara, Yoshihiro Ogawa, Is a small-caliber or large-caliber endoscope more suitable for colonic self-expandable metallic stent placement? A randomized controlled study., Therapeutic advances in gastroenterology, 10.1177/17562848211065331, 15, 17562848211065331-17562848211065331, 2022.01, Objectives: The colonic self-expandable metallic stent (C-SEMS) with a 9-French (Fr) delivery system allows for a small-caliber endoscope (SCE) to be used to treat malignant colonic obstruction. Despite the lack of evidence, the SCE has become popular because it is considered easier to insert than the large-caliber endoscope (LCE). We aimed to determine whether the SCE is more suitable than the LCE for C-SEMS placement. Methods: Between July 2018 and November 2019, 50 consecutive patients who were scheduled to undergo C-SEMS for colon obstruction were recruited in this study. Patients were randomized to the SCE or LCE group. The SCE and LCE were used with 9-Fr and 10-Fr delivery systems, respectively. The primary outcome was the total procedure time. Secondary outcomes were the technical success rate, complication rate, clinical success rate, insertion time, guidewire-passage time, stent-deployment time, and colonic obstruction-scoring-system score. Results: Forty-five patients (SCE group, n = 22; LCE group, n = 23) were analyzed. The procedure time in the LCE group (median, 20.5 min) was significantly (p = 0.024) shorter than that in the SCE group (median, 25.1 min). The insertion time in the LCE group (median, 2.0 min) was significantly (p = 0.0049) shorter than that in the SCE group (median, 6.0 min). A sub-analysis of the procedure difficulties showed that the insertion time in the LCE group (median, 5.0 min) was significantly shorter than that in the SCE group (median, 8.5 min). Conclusion: Both LCE and SCE can be used for C-SEMS; however, LCE is more suitable than SCE as it achieved a faster and equally efficacious C-SEMS placement as that of SCE. Clinical trial registration number: University Hospital Medical Information Network Clinical Trials Registry (UMIN 32748)..
16. 江崎 充, 市島 諒二, 鈴木 翔, 草野 央, 池原 久朝, 和田 将史, 蓑田 洋介, 後藤田 卓志, Clutch Cutterを用いた食道ESDにおける助手の能力の影響(The influence of assistant skill in esophageal ESD using Clutch Cutter), 日本食道学会学術集会プログラム・抄録集, 74回, 108-108, 2020.12.
17. Takayuki Nasu, Mitsuru Esaki, Yoshihisa Shoguchi, Xiaopeng Bai, Yosuke Minoda, Haruei Ogino, Eikichi Ihara, Traction-assisted hybrid endoscopic submucosal dissection for small rectal neuroendocrine tumors., Endoscopy, 10.1055/a-1662-4965, 2021.11.
18. Misato Esaki, Mitsuru Esaki, Kosuke Maehara, Yosuke Minoda, Haruei Ogino, Eikichi Ihara, Yoshihiro Ogawa, Rubber band-assisted, one-person-operated cold snare polypectomy for colorectal polyps., Endoscopy international open, 10.1055/a-1576-7673, 9, 11, E1845-E1846, 2021.11.
19. Nao Fujimori, Yosuke Minoda, Yoshihiro Ogawa, What is the best modality for diagnosing pancreatic cancer?, Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.14283, 34, 4, 744-746, 2022.03.
20. Mitsuru Esaki, Shun Yamakawa, Ryoji Ichijima, Sho Suzuki, Chika Kusano, Hisatomo Ikehara, Yosuke Minoda, Eikichi Ihara, Takuji Gotoda, Self-completion method of endoscopic submucosal dissection using the Endosaber for treating colorectal neoplasms (with video)., Scientific reports, 10.1038/s41598-022-09792-8, 12, 1, 5821-5821, 2022.04, Endoscopic submucosal dissection (ESD) is effective for the treatment of colorectal neoplasms. We have developed a self-completion ESD (S-ESD) using Endosaber without requiring additional instruments or assistance. This prospective cohort study was conducted to investigate the feasibility of S-ESD for colorectal neoplasms. Patients with colorectal neoplasms measuring 20-40 mm in size were enrolled. A single operator, without assistance, performed ESD using only the Endosaber. The primary outcome was the success rate of S-ESD. Secondary outcomes included procedure time, the rates of en bloc, complete, and curative resection, and complication rates, including the incidence of perforation and delayed bleeding. In total, 15 patients with 15 lesions were enrolled. The median size of the resected lesions was 28 mm (interquartile range 25-29 mm). S-ESD success rate of 100% was achieved. The median procedure time was 44 min (29.5-53.5 min). We observed en bloc, complete, and curative resection rates of 100%, 93.3%, and 86.7%, respectively, and a complication rate of 6.7% (perforation: 0%, delayed bleeding: 6.7%). S-ESD for colorectal neoplasms was successfully performed with favorable treatment outcomes and low complication rates. S-ESD reduces the number of devices and extent of assistance, making S-ESD a simple and cost-effective procedure..
21. Yosuke Minoda, Eikichi Ihara, Soichi Itaba, Yorinobu Sumida, Kazuhiro Haraguchi, Akira Aso, Takahiro Mizutani, Takashi Osoegawa, Mitsuru Esaki, Shuzaburo Nagatomo, Kei Nishioka, Kazumasa Muta, Xiaopeng Bai, Haruei Ogino, Nao Fujimori, Daisuke Tsurumaru, Kenoki Ohuchida, Hu Qingjiang, Eiji Oki, Hidetaka Yamamoto, Yoshihiro Ogawa, Negligible procedure-related dissemination risk of mucosal incision-assisted biopsy for gastrointestinal stromal tumors versus endoscopic ultrasound-guided fine-needle aspiration/biopsy., Surgical endoscopy, 10.1007/s00464-022-09419-z, 37, 1, 101-108, 2022.07, BACKGROUND: Mucosal incision-assisted biopsy (MIAB) is a valuable alternative to endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNAB) for sampling gastric subepithelial lesions (SELs). This study aimed to evaluate the potential risk of dissemination and impact on postoperative prognosis associated with MIAB, which has not yet been investigated. METHODS: Study 1: A prospective observational study was conducted to examine the presence or absence and growth rate of tumor cells in gastric juice before and after the procedure in patients with SELs who underwent MIAB (n = 25) or EUS-FNAB (n = 22) between September 2018 and August 2021. Study 2: A retrospective study was conducted to examine the impact of MIAB on postoperative prognosis in 107 patients with gastrointestinal stromal tumors diagnosed using MIAB (n = 39) or EUS-FNAB (n = 68) who underwent surgery between January 2001 and July 2020. RESULTS: In study 1, although no tumor cells were observed in gastric juice in MIAB before the procedure, they were observed in 64% of patients after obtaining samples (P 
22. Yoshihisa Shoguchi, Mitsuru Esaki, Yosuke Minoda, Xiaopeng Bai, Haruei Ogino, Eikichi Ihara, Yoshihiro Ogawa, Innovative endoscopic submucosal dissection for early gastric neoplasm using intralesional traction and snaring techniques., Endoscopy, 10.1055/a-1841-5907, 54, S 02, E865-E866, 2022.06.
23. Yoshitaka Hata, Eikichi Ihara, Masafumi Wada, Hirotaka Tsuru, Kazumasa Muta, Yosuke Minoda, Xiaopeng Bai, Mitsuru Esaki, Yoshimasa Tanaka, Takatoshi Chinen, Haruei Ogino, Ryuichi Sakamoto, Yoshihiro Ogawa, Improved esophagography screening for esophageal motility disorders using wave appearance and supra-junctional ballooning., Journal of gastroenterology, 10.1007/s00535-022-01913-4, 57, 11, 838-847, 2022.08, BACKGROUND: High-resolution manometry (HRM) is the gold standard for diagnosing esophageal motility disorders (EMDs); however, it requires specialized equipment. The development of more accessible screening examinations is expected. We evaluated the utility of barium esophagography (BE) screening using two novel findings to diagnose EMDs. METHODS: Between January 2013 and October 2020, 244 patients with suspected EMDs who underwent both HRM and BE were analyzed. The EMD diagnosis was based on HRM findings using Chicago Classification version 3.0. BE was performed using sequential esophagography with barium sulfate. Three conventional BE findings (air-fluid level, rosary-bead/corkscrew appearance, and absent/weak peristalsis) and two novel BE findings (wave appearance and supra-junctional ballooning) were used for diagnosis. RESULTS: The sensitivity and specificity of BE screening using the two novel findings and conventional findings to diagnose EMDs were 79.4% and 88%, respectively [area under the receiver-operating characteristic curve (AUC) = 0.837]. Without these novel findings, they were 63.9% and 96%, respectively (AUC = 0.800), respectively. Achalasia was highly correlated with the air-fluid level (88.7%). Absent contractility was highly correlated with absent/weak peristalsis (85.7%). Relatively high correlations were observed between distal esophageal spasm and rosary-bead/corkscrew appearance (60%), and between achalasia and wave appearance (59.7%). The intra-observer reproducibility and inter-observer agreement for individual BE findings were 84.4% and 75%, respectively. Wave appearance was associated with higher integrated relaxation pressure (IRP) and shorter distal latency. Supra-junctional ballooning was associated with higher IRP. CONCLUSIONS: BE screening using two additional novel findings to diagnose EMDs could be useful in general practice..
24. Mitsuru Esaki, Yu Tamura, Ryoji Ichijima, Sho Suzuki, Maho Iwamoto, Yosuke Minoda, Mitsuhiko Moriyama, Takuji Gotoda, Efficacy and timing of gastrografin administration after ileus tube insertion in patients with adhesive small bowel obstruction., Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology, 10.1016/j.ajg.2021.12.004, 23, 1, 45-51, 2022.02, BACKGROUND AND STUDY AIMS: Gastrografin administration (GA) is performed for adhesive small bowel obstruction (ASBO) in cases when decompression therapy using an ileus tube fails to relieve the obstruction. This study evaluated the efficacy of GA and optimized its timing after ileus tube insertion. PATIENTS AND METHODS: In this retrospective study, we evaluated data from patients with ASBO admitted between January 2014 and August 2018 and included patients who underwent ileus tube intubation and GA. The patients were classified as those treated with GA within 48 h after admission (early GA [EGA]) and those treated later with GA (delayed GA [DGA]). Propensity score matching was performed to compensate for differences between the groups. Short-term outcomes were compared between the two groups. RESULTS: We included 67 and 80 patients in the EGA and DGA groups, respectively, and 55 pairs with similar background characteristics were matched. The rates of successful conservative management were 87.3% (48/55) in the EGA group, 96.4% (53/55) in the DGA group, and 91.8% (101/110) in the entire sample. The median period of ileus tube insertion in the DGA group was significantly lower than that in the EGA group, whereas other outcomes did not significantly differ between the groups. Aspiration pneumonia occurred in one patient in the EGA group. CONCLUSIONS: GA with an ileus tube achieved a high rate of successful conservative management. Follow-up using decompression with an ileus tube for at least 48 h after admission is recommended in patients with ASBO..
25. Kosuke Maehara, Mitsuru Esaki, Yorinobu Sumida, Shin-Ichro Fukuda, Yosuke Minoda, Eikichi Ihara, Hirotada Akiho, Complete closure of mucosal defect after colonic endoscopic submucosal dissection using clip with a silicone traction band., Endoscopy, 10.1055/a-1889-4838, 2022.08.
26. Mitsuru Esaki, Eikichi Ihara, Misato Esaki, Kei Nishioka, Yusuke Kimura, Yoshitaka Hata, Hirotaka Tsuru, Masafumi Wada, Yosuke Minoda, Xiaopeng Bai, Yoshihisa Shoguchi, Takayuki Nasu, Shuzaburo Nagatomo, Kazumasa Muta, Haruei Ogino, Yoshihiro Ogawa, Comparisons of outcomes between ProKnife injection endoscopic submucosal dissection and conventional endoscopic submucosal dissection for large gastric lesions in ex vivo porcine model study: A randomized controlled trial., DEN open, 10.1002/deo2.91, 2, 1, e91, 2022.04, Objective: To compare treatment outcomes between injection endoscopic submucosal dissection using ProKnife (P-ESD) and conventional ESD (C-ESD) for gastric lesions. Methods: In this randomized controlled trial, we compared treatment outcomes of P-ESD and C-ESD for simulated gastric lesions ≥3 cm in resected porcine stomachs. Predictive factors associated with ESD difficulties were investigated using logistic regression analysis. Results: Seventy lesions were screened; however, two lesions were excluded. A total of 12 endoscopists performed 68 ESDs: 34 P-ESDs and 34 C-ESDs. The ESD procedure time of P-ESD (36.3 [28.4-46.8] min) was significantly shorter than that of C-ESD (46 [36.4-64.6] min; p = 0.0014). The technical success rates did not differ between the P-ESD and C-ESD groups (en bloc resection rate, 100% in both groups; complete resection rate, 94.1% and 85.3%, respectively; p = 0.23). The number of injections during P-ESD (7.5 [6-10] times) was significantly higher than during C-ESD (4 [3-5] times; p
27. Mitsuru Esaki, Eikichi Ihara, Hiroyuki Fujii, Yorinobu Sumida, Kazuhiro Haraguchi, Shunsuke Takahashi, Tsutomu Iwasa, Kayoko Nakano, Masafumi Wada, Shinichi Somada, Yosuke Minoda, Haruei Ogino, Koshiro Tagawa, Yoshihiro Ogawa, Comparison of the procedure time differences between hybrid endoscopic submucosal dissection and conventional endoscopic submucosal dissection in patients with early gastric neoplasms: a study protocol for a multi-center randomized controlled trial (Hybrid-G trial)., Trials, 10.1186/s13063-022-06099-x, 23, 1, 166-166, 2022.02, BACKGROUND: Endoscopic submucosal dissection (ESD) is widely accepted as a local treatment for gastrointestinal tract tumors. As a simplified endoscopic procedure, hybrid ESD (H-ESD) has been performed for colorectal neoplasms in recent times. However, whether H-ESD is superior to conventional ESD (C-ESD) for patients with early gastric neoplasms (EGN) remains unclear. In this trial, we will compare the treatment outcomes of H-ESD and C-ESD. We hypothesize that the procedure time for H-ESD is shorter than that for C-ESD. METHODS: This is an investigator-initiated, multi-center, prospective, randomized, open-label, parallel-group trial to be conducted beginning in August 2020 at nine institutions in Japan. We will determine if H-ESD is superior to C-ESD in terms of procedure time in patients with EGN diagnosed as macroscopically intramucosal (T1a) differentiated carcinoma ≤ 20 mm in diameter without ulcerative findings according to current Japanese gastric cancer treatment guidelines. A total of 82 patients will be recruited and randomly assigned to either the C-ESD or the H-ESD group. The primary outcome is ESD procedure time. Secondary outcomes include mucosal incision, time and speed of submucosal dissection, en bloc resection, complete resection, curability, adverse events related to the ESD procedure, extent of dissection before snaring, volume of injection solution, number and time of hemostasis, thickness of the submucosal layer in the resected specimen, and handover to another operator. The stated sample size was determined based on the primary outcome. According to a previous report comparing the procedure times of C-ESD and H-ESD, we hypothesized that H-ESD would provide a 0.2 reduction in logarithmically concerted procedure time (-37%). We estimated that a total of 82 participants were needed to reach a power of 80% for a t-test with a significance level of 0.05 and considering a 10% dropout. DISCUSSION: This trial will provide high-quality data on the benefits and risks of H-ESD for EGN patients. The results of this study could lead to improved outcomes in patients with EGN undergoing ESD. The results will be presented at national and international meetings and published in peer-reviewed journals. TRIAL REGISTRATION: UMIN-CTR UMIN000041244 . Registered on July 29, 2020..
28. Yusuke Suzuki, Takashi Osoegawa, Masaru Kubokawa, Mitsuru Esaki, Yosuke Minoda, Haruei Ogino, Eikichi Ihara, Circumferential suture delivery method of polyglycolic acid sheets for gastric postendoscopic submucosal dissection ulcers., Endoscopy, 10.1055/a-1934-9752, 55, S 01, E68-E69, 2022.09.
29. Takayuki Nasu, Mitsuru Esaki, Yoshihisa Shoguchi, Xiaopeng Bai, Yosuke Minoda, Haruei Ogino, Eikichi Ihara, Application of intralesional traction assistance with traction wire to endoscopic submucosal dissection for colorectal neoplasms., Endoscopy, 10.1055/a-1809-4967, 2022.04.
30. Kazuhide Matsumoto, Nao Fujimori, Yoshitaka Hata, Yosuke Minoda, Masatoshi Murakami, Katsuhito Teramatsu, Yu Takamatsu, Ayumu Takeno, Takamasa Oono, Eikichi Ihara, Kohei Nakata, Masafumi Nakamura, Takeo Yamamoto, Yutaka Koga, Yoshinao Oda, Tetsuhide Ito, Yoshihiro Ogawa, Ampullary Neuroendocrine Neoplasm: Clinicopathological Characteristics and Novel Endoscopic Entity., Digestive diseases (Basel, Switzerland), 10.1159/000525013, 41, 2, 316-324, 2022.05, BACKGROUND: Neuroendocrine neoplasms of the ampulla of Vater (ampullary NEN) have features of both gastrointestinal and pancreato-biliary (PB) NEN. However, the limited number of studies examining ampullary NEN makes it difficult to clarify their unique characteristics. This study aimed to elucidate the clinical characteristics of ampullary NEN. METHODS: We enrolled 162 patients with PB-NEN diagnosed at Kyushu University Hospital between 2011 and 2020. Clinical features, pathological diagnoses, treatments, and prognoses were retrospectively analyzed. We also compared ampullary NEN with pancreatic NEN (PanNEN). RESULTS: We analyzed 10 ampullary NEN cases and 149 PanNEN cases. The ampullary NEN cases consisted of four cases of NET G1 (neuroendocrine tumor Grade 1), one NET G2 (Grade 2), and five NECs (neuroendocrine carcinoma). The incidences of NEC and cholangitis were significantly higher in ampullary NEN than in PanNEN. All ampullary NETs had a submucosal tumor-like appearance, as identified by endoscopic ultrasound-guided fine needle aspiration. We treated small NET G1 (
31. Ryoji Ichijima, Hisatomo Ikehara, Yorinobu Sumida, Taisuke Inada, Daiki Nemoto, Yuki Nakajima, Takeyoshi Minagawa, Tetsuya Sumiyoshi, Kazuya Inoki, Naohisa Yoshida, Ken Inoue, Masakatsu Fukuzawa, Yosuke Minoda, Koshiro Tsutsumi, Mitsuru Esaki, Takuji Gotoda, A randomized controlled trial comparing conventional and traction endoscopic submucosal dissection for early colon tumor (CONNECT-C trial)., Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.14426, 2022.08, OBJECTIVES: Endoscopic submucosal dissection (ESD) is a widely used treatment for early gastrointestinal cancer. However, colon ESD remains challenging. Previous studies on colon ESD using the traction method used a small-sample, single-center design, providing insufficient evidence of this procedure's efficacy. We thus aimed to investigate the efficacy and safety of the traction method in colon ESD in this multicenter randomized trial. METHODS: We conducted a prospective, multicenter, randomized, two-arm controlled trial at 10 facilities in Japan. A 1:1 allocation was conducted for the conventional ESD (C-ESD) and traction ESD (T-ESD) groups. The primary endpoint was ESD procedure time. RESULTS: We included 128 C-ESD and 123 T-ESD cases from April 2020 to August 2021. The median procedure times for C-ESD and T-ESD were 61 (40-100) and 53 (40-76) min (p=0.18), respectively, and no significant differences were observed between the groups. Subgroup analysis showed that the median procedure times for patients with a lesion diameter of ≥30 mm in the C-ESD and T-ESD groups were 89 (57-80) and 69 (50-104) min (p=0.05), respectively, and for non-expert operators were 81 (62-120) and 64 (52-109) min (p=0.07), respectively. CONCLUSIONS: The traction method did not contribute to a significantly shortened ESD procedure time. However, this method may be useful when the tumor diameter is large or if the procedure is conducted by non-expert endoscopists..
32. Eikichi Ihara, Haruei Ogino, Kazumasa Muta, Shohei Hamada, Masafumi Wada, Yoshitaka Hata, Hiroko Ikeda, Xiaopeng Bai, Yosuke Minoda, Mitsuru Esaki, Yoshimasa Tanaka, Takatoshi Chinen, Yoshihiro Ogawa, The treatment effects of acotiamide in esophagogastric outflow obstruction: a prospective longitudinal observational study., Esophagus : official journal of the Japan Esophageal Society, 10.1007/s10388-021-00887-1, 19, 2, 332-342, 2021.10, OBJECTIVES: We have found that an altered lower esophageal sphincter (LES) accommodation response is an underlying cause of esophagogastric junction outflow obstruction (EGJOO). The objective of this study was to examine the treatment effect of acotiamide, a prokinetic agent which improves impaired gastric accommodation in functional dyspepsia, in patients with EGJOO. METHODS: A prospective observational longitudinal study was conducted between October 2014 and March 2020. Acotiamide (100 mg, 3 times a day) was administered to 25 patients with EGJOO for 4 weeks. High-resolution manometry (HRM) was performed just before and after 4 weeks of treatment. RESULTS: As the primary outcome, the extent of integrated relaxation pressure (IRP) after treatment (14.6, 12.1-22.0 mmHg) was significantly lower than that before treatment (19.4, 17.1-27.4 mmHg). The extent of LES accommodation index after treatment (32.7, 21.0-40.0 mmHg) was also significantly lower than that before treatment (39.3, 31.2-50.2 mmHg). Acotiamide normalized the IRP (
33. Yosuke Minoda, Shuzaburo Nagatomo, Nao Fujimori, Kei Nishioka, Shotaro Kakehashi, Katsuhito Teramatsu, Yu Takamatsu, Haruei Ogino, Eikichi Ihara, Usefulness of a gel immersion-assisted EUS-guided fine-needle aspiration/biopsy for ampullary lesions (with videos)., Endoscopic ultrasound, 10.4103/EUS-D-21-00043, 2021.09.
34. Mitsuru Esaki, Yosuke Minoda, Eikichi Ihara, In Living Color: Linked Color Imaging for the Detection of Early Gastric Cancer., Digestive diseases and sciences, 10.1007/s10620-021-07235-4, 2021.08.
35. Kosuke Maehara, Mitsuru Esaki, Yosuke Minoda, Ultra-thin endoscope-assisted insertion of a suction tube for the removal of massive gastric blood clots., Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.13990, 33, 5, e106-e108, 2021.07.
36. Mitsuru Esaki, Eikichi Ihara, Norikazu Hashimoto, Shuichi Abe, Chihoko Aratono, Noriko Shiga, Yorinobu Sumida, Hiroyuki Fujii, Kazuhiro Haraguchi, Shunsuke Takahashi, Tsutomu Iwasa, Kayoko Nakano, Masafumi Wada, Shinichi Somada, Kei Nishioka, Yosuke Minoda, Haruei Ogino, Yoshihiro Ogawa, Efficacy of hybrid endoscopic submucosal dissection with SOUTEN in gastric lesions: An ex vivo porcine model basic study., World journal of gastrointestinal surgery, 10.4240/wjgs.v13.i6.563, 13, 6, 563-573, 2021.06, BACKGROUND: Hybrid endoscopic submucosal dissection (ESD) that comprises mucosal incision and partial submucosal dissection followed by snaring in a planned manner, has been developed for endoscopic resection of gastrointestinal neoplasms to overcome the technical barrier of ESD. Although the superiority of hybrid ESD with SOUTEN, a single multifunctional device, over conventional ESD has been indicated, the actual effect of snaring itself remains unclear since SOUTEN could be applied to hybrid ESD group, but not to the conventional ESD group, due to ethical issue in clinical practice. AIM: To determine whether and how hybrid ESD was superior to conventional ESD in the endoscopic treatment of gastric lesions in an ex vivo porcine model basic study. METHODS: Sixteen endoscopists participated in this basic study in August 2020 at Kyushu University, performing 32 procedures each for hybrid ESD and conventional ESD. Mock lesions (10-15 mm, diameter) were created in the porcine stomach. The primary outcome was total procedure time and secondary outcomes were en bloc or complete resection, perforation, procedure time/speed for both, mucosal incision, and submucosal dissection. Factors associated with difficulty in ESD including longer procedure time, incomplete resection, and perforation, were also investigated. Categorical and continuous data were analyzed using the chi-square test or Fisher's exact test and the Mann-Whitney U test, respectively. RESULTS: The median total procedure time of hybrid ESD was significantly shorter than that of conventional ESD (median: 8.3 min vs 16.2 min, P
37. Mitsuru Esaki, Ryosuke Maehara, Shuzaburo Nagatomo, Kei Nishioka, Yosuke Minoda, Haruei Ogino, Eikichi Ihara, Application of traction-method to hybrid endoscopic submucosal dissection for gastrointestinal tumors., Endoscopy, 10.1055/a-1422-2902, 2021.04.
38. Yosuke Minoda, Yuichi Hisamatsu, Eikichi Ihara, Usefulness of preoperative site marking with an indocyanine green fluorescent clip for gastrointestinal stromal tumor., Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.13978, 33, 5, e95-e96, 2021.04.
39. Shuzaburo Nagatomo, Yosuke Minoda, Eikichi Ihara, Double scope recovery technique to manage procedure-related trouble during wire trimming with a Loop cutter., Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.13954, 33, 4, e83-e84, 2021.03.
40. Mitsuru Esaki, Toshiki Horii, Ryoji Ichijima, Masafumi Wada, Seiichiro Sakisaka, Shuichi Abe, Naru Tomoeda, Yusuke Kitagawa, Kei Nishioka, Yosuke Minoda, Shinichi Tsuruta, Sho Suzuki, Hirotada Akiho, Eikichi Ihara, Yoshihiro Ogawa, Takuji Gotoda, Assistant skill in gastric endoscopic submucosal dissection using a clutch cutter., World journal of gastrointestinal surgery, 10.4240/wjgs.v13.i2.116, 13, 2, 116-126, 2021.02, BACKGROUND: A clutch cutter is a scissor-type knife used in endoscopic submucosal dissection (ESD) for gastrointestinal tract tumors. The assistant during the ESD using a clutch cutter (ESD-C) needs to rotate the device and grasp the target tissue appropriately; therefore, the assistant's skill may affect the technical outcomes of ESD-C. AIM: To determine how assistant skill level affected the technical outcomes of gastric ESD-C using an ex vivo porcine training model. METHODS: In this pilot study, mock lesions of 15-30 mm in diameter were created in the middle or lower third of the porcine stomach. A total of 32 ESD-C procedures were performed by 16 trainees. Each trainee operator performed two ESD-C procedures; one ESD-C was assisted by an expert (ESD-C-E), and the other was assisted by a non-expert (ESD-C-NE). The total procedure time of the ESD was set as the primary outcome, and en bloc resection rate, complete procedure rate, perforation rate, and each procedure time/speed for mucosal incision or submucosal dissection were set as the secondary outcomes. In addition, we investigated factors associated with the difficulty of ESD including incompletion of ESD procedure, a long procedure time (≥ 20 min) or intraoperative perforation. RESULTS: The median total procedure time of the ESD-C-E was significantly shorter than that of the ESD-C-NE (12.9 min vs 21.9 min, P = 0.001). The en bloc resection rate was 100% in both groups. Complete resection rates of the ESD-C-E and ESD-C-NE groups were 100% and 93.8%, respectively. No intraoperative perforation was observed in both groups. In the multivariate analysis, assistant skill was significantly associated with the difficulty of ESD, with the highest odds ratio of 16.5. CONCLUSION: Assistance by an expert is an important factor when trainees perform ESD-C procedures..
41. Mitsuru Esaki, Yosuke Minoda, Masafumi Wada, Seiichiro Sakisaka, Shinichi Tsuruta, Taizo Hosokawa, Takahiro Matsuguchi, Ryoji Ichijima, Sho Suzuki, Yu Tamura, Aya Iwao, Shun Yamakawa, Akira Irie, Eikichi Ihara, Yoshihiro Ogawa, Self-Completion Method of Endoscopic Submucosal Dissection Using Endosaber without Any Other Device or Assistance: An ex vivo Porcine Model Study., Digestion, 10.1159/000502771, 102, 2, 139-146, 2021.02, BACKGROUND: Endoscopic submucosal dissection (ESD) is a standard treatment for tumors of the gastrointestinal tract. We developed a self-completion method of ESD using Endosaber to eliminate the need for an additional device or human assistance during the procedure. The aim of this study was to evaluate the technical feasibility and outcomes of this method in an ex vivo porcine training model. METHODS: This was a pilot study, and the procedures were performed by 4 experts. Mock lesions measuring 15 mm in diameter were prepared at the posterior wall in the middle or lower esophagus obtained from domestic pigs. Each operator performed ESD on the mock lesions in 3 models. The primary outcome was ESD completion rate using the self-completion method. The secondary outcomes were procedure time, en bloc resection rate, perforation rate, and number of injections during the procedure. RESULTS: All 12 ESDs were completed using the self-completion method. The median procedure time (interquartile range) was 483.5 (399-619.3) s (median incision time: 240.4 [168.3-332.5] s; median dissection time: 222 [182.8-257] s). En bloc resection rate was 100%. No perforation was noted during any of the procedures. The median number of injections was 10.5 (9-14.3). The procedure time decreased significantly with increase in experience (p = 0.020). CONCLUSIONS: The self-completion ESD method using one Endosaber without any assistance achieved a 100% en bloc resection rate without any perforation. The need for an additional device or assistance was successfully eliminated. This method may prove to be a simple and cost-effective ESD procedure for lesions in humans..
42. Nao Fujimori, Takashi Osoegawa, Akira Aso, Soichi Itaba, Yosuke Minoda, Masatoshi Murakami, Kazuhide Matsumoto, Katsuhito Teramatsu, Yu Takamatsu, Takehiro Takaoka, Takamasa Oono, Eikichi Ihara, Tomoharu Yoshizumi, Takao Ohtsuka, Masafumi Nakamura, Yoshihiro Ogawa, Efficacy of Early Endoscopic Ultrasound-Guided Transluminal Drainage for Postoperative Pancreatic Fistula., Canadian journal of gastroenterology & hepatology, 10.1155/2021/6691705, 2021, 6691705-6691705, 2021.01, Background: Endoscopic ultrasound-guided transluminal drainage (EUS-TD) is generally performed 4 weeks after disease onset for evacuating pancreatic fluid collections. However, the optimal timing for conducting the procedure in those diagnosed with postoperative pancreatic fistula (POPF) has not been established. We aimed to elucidate the efficacy and safety of early EUS-TD procedures for treating POPF. Methods: We retrospectively reviewed patients diagnosed with POPF who underwent EUS-TD in the Kyushu University Hospital between 2008 and 2019. Clinical features were comparatively analyzed between the two patient groups who underwent either early (≤15 days postoperatively) or late (>15 days postoperatively) EUS-TD. Factors prolonging hospital stay were also analyzed using Cox proportional hazard models. Results: Thirty patients (median age, 64.5 years) were enrolled. The most common initial operation was distal pancreatectomy with splenectomy (60.0%). Median size of POPF was 69.5 (range, 38-145) mm, and median time interval between surgery and EUS-TD was 17.5 (range, 3-232) days. Totally, 47% patients underwent early EUS-TD. Rates of technical success, clinical success, and complications were 100%, 97%, and 6.9%, respectively. No recurrence of POPF occurred during a median follow-up period of 14 months. Clinical characteristics and outcomes were comparable between the early and late drainage patient groups, except for the rates of infection and nonencapsulation of POPF, which were significantly higher in the early drainage group. Performing simultaneous internal and external drainage (hazard ratio (HR): 0.31; 95% confidence interval (CI): 0.11-0.93, p=0.04) and conducting ≥2 treatment sessions (HR: 0.26; 95% CI: 0.08-0.84, p=0.02) were significantly associated with prolonged hospitalization after EUS-TD. Conclusions: EUS-TD is a safe and effective method for managing POPF, regardless of when it is performed in the postoperative period. Once infected POPF occurs, clinicians should not hesitate to perform EUS-TD even within 15 days of the initial operation..
43. Yosuke Minoda, Eikichi Ihara, Keishi Komori, Haruei Ogino, Yoshihiro Otsuka, Takatoshi Chinen, Yasuo Tsuda, Koji Ando, Hidetaka Yamamoto, Yoshihiro Ogawa, Efficacy of endoscopic ultrasound with artificial intelligence for the diagnosis of gastrointestinal stromal tumors., Journal of gastroenterology, 10.1007/s00535-020-01725-4, 55, 12, 1119-1126, 2020.12, BACKGROUND: Although endoscopic ultrasound (EUS) is reported to be suitable for determining the layer from which subepithelial lesions (SELs) originate, it is difficult to distinguish gastrointestinal stromal tumor (GIST) from non-GIST using only EUS images. If artificial intelligence (AI) can be used for the diagnosis of SELs, it should provide several benefits, including objectivity, simplicity, and quickness. In this pilot study, we propose an AI diagnostic system for SELs and evaluate its efficacy. METHODS: Thirty sets each of EUS images with SELs ≥ 20 mm or
44. Ryoji Ichijima, Mitsuru Esaki, Shun Yamakawa, Yosuke Minoda, Sho Suzuki, Chika Kusano, Hisatomo Ikehara, Takuji Gotoda, Ex vivo porcine model study on the treatment outcomes of scissor-type knife versus needle-type knife in endoscopic submucosal dissection performed by trainees., BMC surgery, 10.1186/s12893-020-00955-w, 20, 1, 287-287, 2020.11, BACKGROUND: Endoscopic submucosal dissection (ESD) for gastrointestinal neoplasms can be technically difficult for trainee endoscopists. Presently, there is no consensus for trainees to select the endo-knife type in ESD. Therefore, we conducted a comparison study of treatment outcomes between scissors-type and needle-type knives in ESD performed by trainees in an ex vivo porcine model. METHODS: This study was conducted on trainee endoscopists who participated in ESD hands-on seminars held in August 2018 and September 2019. A total of 22 trainees from 13 institutions were divided into two groups according to their endoscopic experience. Under expert supervision, each trainee performed two ESDs in porcine models, namely, scissor-type knife (ESD-S) and needle-type knife (ESD-N). The efficacy and safety, including the procedure time and rates of self-completion, en bloc resection, and complications, were compared between ESD-S and ESD-N. In subgroup analysis, we also investigated the predictors associated with the difficulty of ESD for trainees using multivariate logistic regression analysis. RESULTS: Eight trainees had an experience of over 1000 endoscopies (senior trainee: S-Trainee), whereas the others had an experience of less than 1000 endoscopies (junior trainee: J-Trainee). Among the S-Trainees, no significant differences were observed in any treatment outcome between ESD-S and ESD-N. Among the J-Trainees, the total procedure and mucosal incision times were significantly shorter in ESD-S than in ESD-N [total procedure time: 16.5 min (range 10.0-31.0) vs. 22.3 min (range 10.0-38.0), P = 0.018; circumferential incision time: 10.0 min (range 6-16) vs. 17.0 min (range 5.0-31.5); P = 0.019]. Regarding complications, muscular injury occurred in two patients during ESD-N performed by J-Trainees; however, no muscular injury occurred during ESD-S. In subgroup analysis, ESD-N was an independent predictive factor of difficult ESD (odds ratio 5.28, 95% confidence interval 1.25-22.30; P = 0.024). CONCLUSIONS: This study revealed that trainees, particularly those who have experienced less than 1000 endoscopies, should opt for the scissor-type knife to perform ESD..
45. Mitsuru Esaki, Kazuhiro Haraguchi, Kazuya Akahoshi, Naru Tomoeda, Akira Aso, Soichi Itaba, Haruei Ogino, Yusuke Kitagawa, Hiroyuki Fujii, Kazuhiko Nakamura, Masaru Kubokawa, Naohiko Harada, Yosuke Minoda, Sho Suzuki, Eikichi Ihara, Yoshihiro Ogawa, Endoscopic mucosal resection vs endoscopic submucosal dissection for superficial non-ampullary duodenal tumors., World journal of gastrointestinal oncology, 10.4251/wjgo.v12.i8.918, 12, 8, 918-930, 2020.08, BACKGROUND: The selection of endoscopic treatments for superficial non-ampullary duodenal epithelial tumors (SNADETs) is controversial. AIM: To compare the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for SNADETs. METHODS: We retrospectively analyzed the data of patients with SNADETs from a database of endoscopic treatment for SNADETs, which included eight hospitals in Fukuoka, Japan, between April 2001 and October 2017. A total of 142 patients with SNADETs treated with EMR or ESD were analyzed. Propensity score matching was performed to adjust for the differences in the patient characteristics between the two groups. We analyzed the treatment outcomes, including the rates of en bloc/complete resection, procedure time, adverse event rate, hospital stay, and local or metastatic recurrence. RESULTS: Twenty-eight pairs of patients were created. The characteristics of patients between the two groups were similar after matching. The EMR group had a significantly shorter procedure time and hospital stay than those of the ESD group [median procedure time (interquartile range): 6 (3-10.75) min vs 87.5 (68.5-136.5) min, P
46. Yosuke Minoda, Keishi Komori, Nao Fujimori, Endoscopy-guided suction method for residual food in the stomach caused by the obstruction of a duodenal stent., Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.13637, 32, 4, e69-e70, 2020.05.
47. Yosuke Minoda, Eikichi Ihara, Haruei Ogino, Keishi Komori, Yoshihiro Otsuka, Hiroko Ikeda, Mitsuru Esaki, Takatoshi Chinen, Takahiro Matsuguchi, Shunsuke Takahashi, Noriko Shiga, Rie Yoshimura, Yoshihiro Ogawa, The Efficacy and Safety of a Promising Single-Channel Endoscopic Closure Technique for Endoscopic Treatment-Related Artificial Ulcers: A Pilot Study., Gastrointestinal tumors, 10.1159/000503994, 7, 1-2, 21-29, 2020.04, Background/Aims: It is important to appropriately manage patients with procedure-related artificial mucosal ulcers or procedure-related complications. Many endoscopic closure techniques have been reported; however, they often require the use of special devices. We developed a single-channel endoscopic closure technique (SCCT) that can be performed with conventional devices. In the present study, we describe the technique and evaluate its efficacy. Methods: Twenty-five consecutive patients who underwent endoscopic treatment and whose artificial ulcer was closed using the SCCT were enrolled in this study. The technical success rate, number of clips for closure, procedure time, complication rate on the day of the procedure, clinical success rates on days 1 and 5, and incidence of severe stenosis of the gastrointestinal (GI) tract at 2 months after the procedure were evaluated. Results: The median ulcer diameter was 20 mm. The tumor locations were the stomach (n = 19), jejunum (n = 1), and colon (n = 5). The technical success rate was 100% (25/25), and the rate of incomplete closure was 0% (0/25). Eight clips were needed on average. The median procedure time was 18 min (range 5-49 min). The complication rate was 0% (25/25). The clinical success rates on days 1 and 5 were 100% (19/19) and 100% (9/9), respectively. No patients presented stenosis as a late complication at 2 months after the procedure (0/25). Conclusion: The SCCT could be applied in the treatment of artificial ulcers in several parts of the GI tract with a high clinical success rate and no complications. The SCCT appears to be a good option for closing artificial mucosal ulcers..
48. Mitsuru Esaki, Yasuyo Hayashi, Hisatomo Ikehara, Eikichi Ihara, Toshiki Horii, Yu Tamura, Ryoji Ichijima, Shun Yamakawa, Akira Irie, Hitoshi Shibuya, Sho Suzuki, Chika Kusano, Yosuke Minoda, Hirotada Akiho, Yoshihiro Ogawa, Takuji Gotoda, The effect of scissor-type versus non-scissor-type knives on the technical outcomes in endoscopic submucosal dissection for superficial esophageal cancer: a multi-center retrospective study., Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus, 10.1093/dote/doz077, 33, 4, 2020.04, The Clutch Cutter was invented as a scissor-type knife for endoscopic submucosal dissection (ESD) of gastrointestinal neoplasms. ESD with the scissor-type knife (ESD-S) may be considered a technically easier procedure than ESD with non-scissor-type knives (ESD-NS). Therefore, this study aimed to compare the technical outcomes of ESD-S with those of ESD-NS for superficial esophageal cancer. This was a multicenter retrospective study. Patients with superficial esophageal cancer treated with ESD between October 2015 and March 2018 at three hospitals were retrospectively reviewed. The ESD-S group had 48 patients and the ESD-NS group had 114 patients. A propensity score matching analysis was performed to compensate for the confounding bias between both groups. Multivariate analyses and propensity score matching were used to adjust for age, sex, the tumor size, tumor location, tumor depth, degree of tumor circumference, operator level, usage of the traction method, and the sedation method. The primary outcome was the procedure time of the ESD. Secondary outcomes were the rate of en-bloc/complete resection and the rate of complications including perforation, delayed bleeding, and stricture. Propensity score matching analysis provided 36 matched pairs. Median procedure time in the ESD-S group was significantly shorter than that in the ESD-NS group (44.0 min vs. 66.5 min, P = 0.020). In addition, the treatment outcomes were similar in both groups (en-bloc resection: 100% vs. 97.2%, P = 1; complete resection: 88.9% vs. 86.1%, P = 1; curative resection: 80.6% vs. 77.8%, P = 1; perforation: 0% vs. 5.6%, P = 0.49; delayed bleeding: 0% in both groups; stricture: 2.8% vs. 8.3%, P = 0.61). ESD-S was associated with a shorter procedure time than ESD-NS, without an increase in the incidence of complications. Therefore, the scissor-type knife should be considered as an endo-knife for ESD of superficial esophageal cancers..
49. Nao Fujimori, Yosuke Minoda, Masatoshi Murakami, Yuta Suehiro, Takamasa Oono, Eikichi Ihara, Yoshihiro Ogawa, Endoscopic removal of a lumen-apposing metal stent that migrated into the walled-off necrosis during the first drainage procedure., Endoscopy, 10.1055/a-0992-8900, 52, 2, E51-E52, 2020.02.
50. Mitsuru Esaki, Yosuke Minoda, Eikichi Ihara, Seiichiro Sakisaka, Shinichi Tsuruta, Taizo Hosokawa, Masafumi Wada, Yoshitaka Hata, Sho Suzuki, Aya Iwao, Shun Yamakawa, Akira Irie, Hirotada Akiho, Yoshihiro Ogawa, Efficacy of traction, using a clip-with-thread, for esophageal endoscopic submucosal dissection for esophageal lesions with fibrosis in an ex vivo pig training model., The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 10.5152/tjg.2020.19207, 31, 1, 58-64, 2020.01, BACKGROUND/AIMS: Endoscopic submucosal dissection (ESD) of recurrent esophageal carcinoma is technically difficult to perform due to submucosal fibrosis that develops after definitive chemoradiation therapy. Therefore, our aim was to evaluate the usefulness of clip-with-thread traction for ESD of esophageal lesions with submucosal fibrosis. MATERIALS AND METHODS: Four endoscopists excised 16 lesions by ESD in an ex vivo pig training model. Mock lesions (30 mm in diameter) were created, including a 10-mm area of submucosal fibrosis in the center of each lesion. Each endoscopist performed two ESDs with traction (ESD-T) and two without traction (ESD-N). The primary outcome was the time required for submucosal dissection. Secondary outcomes were the rate of en bloc (complete) resection and perforation during the procedure, and the total amount of solution injected. RESULTS: All esophageal ESDs were completed. The median dissection time was significantly shorter for the ESD-T group (median 12.5 min, interquartile range 10.2-14.5) when comparing to the ESD-N group (median 18.0 min, interquartile range 14.6-19.2) (P=0.040). The en bloc resection rate was 100% in both groups, with a rate of complete resection of 87.5% and a rate of perforation of 37.5% for both groups. The median amount of solution injected was not significantly different between the ESD-T (18.0 ml) and ESD-N (20.5 ml) groups (P=0.526). CONCLUSION: Clip-with-thread traction improved the performance of ESD for lesions with submucosal fibrosis. However, the method might not reduce the risk of perforation, which remains an important clinical issue to resolve..
51. Yosuke Minoda, Takatoshi Chinen, Takashi Osoegawa, Soichi Itaba, Kazuhiro Haraguchi, Hirotada Akiho, Akira Aso, Yorinobu Sumida, Keishi Komori, Haruei Ogino, Eikichi Ihara, Yoshihiro Ogawa, Superiority of mucosal incision-assisted biopsy over ultrasound-guided fine needle aspiration biopsy in diagnosing small gastric subepithelial lesions: a propensity score matching analysis., BMC gastroenterology, 10.1186/s12876-020-1170-2, 20, 1, 19-19, 2020.01, BACKGROUND: Gastric subepithelial lesions, including gastrointestinal stromal tumors, are often found during routine gastroscopy. While endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) has been the gold standard for diagnosing gastric subepithelial lesions, alternative open biopsy procedures, such as mucosal incision-assisted biopsy (MIAB) has been reported useful. The aim of this study is to evaluate the efficacy of MIAB for the diagnosis of gastric SELs compared with EUS-FNAB. METHODS: We retrospectively analyzed medical records of 177 consecutive patients with gastric SELs who underwent either MIAB or EUS-FNAB at five hospitals in Japan between January 2010 and January 2018. Diagnostic yield, procedural time, and adverse event rates for the two procedures were evaluated before and after propensity-score matching. RESULTS: No major procedure-related adverse events were observed in either group. Both procedures yielded highly-accurate diagnoses once large enough samples were obtained; however, such successful sampling was more often accomplished by MIAB than by EUS-FNAB, especially for small SELs. As a result, MIAB provided better diagnostic yields for SELs smaller than 20-mm diameter. The diagnostic yields of both procedures were comparable for SELs larger than 20-mm diameter; however, MIAB required significantly longer procedural time (approximately 13 min) compared with EUS-FNAB. CONCLUSIONS: Although MIAB required longer procedural time, it outperformed EUS-FNAB when diagnosing gastric SELs smaller than 20-mm diameter..
52. Yosuke Minoda, Nao Fujimori, Eikichi Ihara, Forward-viewing endoscopic ultrasound-guided fine-needle biopsy using the clip-with-thread method for small gastric subepithelial lesions., Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.13476, 31, 6, e103-e104, 2019.11.
53. Keishi Komori, Eikichi Ihara, Yosuke Minoda, Haruei Ogino, Taisuke Sasaki, Minako Fujiwara, Yoshinao Oda, Yoshihiro Ogawa, The Altered Mucosal Barrier Function in the Duodenum Plays a Role in the Pathogenesis of Functional Dyspepsia., Digestive diseases and sciences, 10.1007/s10620-019-5470-8, 64, 11, 3228-3239, 2019.11, BACKGROUND: An altered gastrointestinal barrier function is reportedly associated with the pathogenesis of functional dyspepsia (FD); however, the pathogenesis of FD has not yet been fully elucidated. AIMS: The objective of the present study was to determine whether the mucosal barrier function is impaired in patients with FD and to investigate the mechanisms underlying FD. METHODS: The present study included patients with FD (FD group, n = 24), non-FD patients with abdominal symptoms (symptomatic control group, n = 14), and patients with no abdominal symptoms (asymptomatic control group, n = 20). The groups were compared regarding the mucosal electrical impedance (MI) values of the stomach and duodenum, which were measured using a tissue conductance meter during esophagogastroduodenoscopy. RESULTS: There were no significant differences between the three groups in the MI of the stomach. In contrast, the duodenal MI of the FD group (17.8 ± 4.3 Ω) was significantly lower than those of the symptomatic control group (27.2 ± 6.4 Ω, p 
54. Yosuke Minoda, Haruei Ogino, Takatoshi Chinen, Eikichi Ihara, Kazuhiro Haraguchi, Hirotada Akiho, Nobuyoshi Takizawa, Akira Aso, Yosuke Tomita, Mitsuru Esaki, Keishi Komori, Yoshihiro Otsuka, Tsutomu Iwasa, Yoshihiro Ogawa, Objective validity of the Japan Narrow-Band Imaging Expert Team classification system for the differential diagnosis of colorectal polyps., Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.13393, 31, 5, 544-551, 2019.09, BACKGROUND AND AIM: The Japan Narrow-Band Imaging (NBI) Expert Team (JNET) classification is a recently proposed NBI magnifying endoscopy-based classification system for colorectal tumors. Although the usefulness of this system has been reported by JNET experts, its objective validity remains unclear. We tested its validity and usefulness for the diagnosis of colorectal polyps by including colonoscopy experts and non-experts as test participants. METHODS: Forty NBI images of polyps of various JNET types were shown to 22 doctors (11 experts and 11 non-gastrointestinal [GI] trainees) who had not examined the patients. The doctors diagnosed the polyps based solely on the surface and vessel patterns in the magnified images and the JNET classification system. Concordance rates of their diagnoses with the pathological findings of the polyps were determined, and the results for experts and non-GI trainees were compared. RESULTS: Both for colonoscopy experts and non-GI trainees, the JNET classification system was particularly useful for classifying polyps as benign or malignant. Although the accuracy rates for classifying polyps into each JNET type varied among colonoscopy experts, those who were familiar with the JNET classification system were able to diagnose polyps with approximately 90% accuracy. Common mistakes were attributable to misunderstandings of the wording in the JNET classification chart and lack of proper training. CONCLUSION: The JNET classification system is a practical approach for the diagnosis of colorectal polyps. Training is required even for experienced colonoscopists to adopt the system properly. Common pitfalls must be shared among colonoscopists to improve the accuracy of the diagnosis..
55. Takashi Osoegawa, Yosuke Minoda, Eikichi Ihara, Keishi Komori, Akira Aso, Ayako Goto, Soichi Itaba, Haruei Ogino, Kazuhiko Nakamura, Naohiko Harada, Kosuke Makihara, Shinichi Tsuruta, Hidetaka Yamamoto, Yoshihiro Ogawa, Mucosal incision-assisted biopsy versus endoscopic ultrasound-guided fine-needle aspiration with a rapid on-site evaluation for gastric subepithelial lesions: A randomized cross-over study., Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 10.1111/den.13367, 31, 4, 413-421, 2019.07, OBJECTIVES: This study aimed to compare the diagnostic yield of mucosal incision-assisted biopsy (MIAB) and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with a rapid on-site evaluation (ROSE) for gastric subepithelial lesions (SEL) suspected of being gastrointestinal stromal tumors (GIST) with an intraluminal growth pattern. METHODS: This was a prospective randomized, cross-over multicenter study. The primary outcome was the diagnostic yield of EUS-FNA and MIAB. The secondary outcomes were the technical success rate, complication rate, procedure time and biopsy frequency. RESULTS: A total of 47 patients were randomized to the MIAB group (n = 23) and EUS-FNA group (n = 24). There was no significant difference in the diagnostic yield of MIAB and EUS-FNA (91.3% vs 70.8%, P = 0.0746). The complication rates of MIAB and EUS-FNA did not differ to a statistically significant extent. The mean procedure time in the MIAB group was significantly longer than that in the EUS-FNA group (34 vs 26 min, P = 0.0011). CONCLUSIONS: The diagnostic yield of MIAB was satisfactorily as high as EUS-FNA with ROSE for gastric SEL with an intraluminal growth pattern..
56. Yasuyo Hayashi, Mitsuru Esaki, Sho Suzuki, Eikichi Ihara, Azusa Yokoyama, Seiichiro Sakisaka, Taizo Hosokawa, Yoshimasa Tanaka, Takahiro Mizutani, Shinichi Tsuruta, Aya Iwao, Shun Yamakawa, Akira Irie, Yosuke Minoda, Yoshitaka Hata, Haruei Ogino, Hirotada Akiho, Yoshihiro Ogawa, Clutch Cutter knife efficacy in endoscopic submucosal dissection for early gastric neoplasms., World journal of gastrointestinal oncology, 10.4251/wjgo.v10.i12.487, 10, 12, 487-495, 2018.12, AIM: To compare the outcomes of endoscopic submucosal dissection (ESD) for gastric neoplasms using Clutch Cutter (ESD-C) or other knives (ESD-O). METHODS: This was a single-center retrospective study. Gastric neoplasms treated by ESD between April 2016 and October 2017 at Kitakyushu Municipal Medical Center were reviewed. Multivariate analyses and propensity score matching were used to reduce biases. Covariates included factors that might affect outcomes of ESD, including age, sex, underlying disease, anti-thrombotic drugs use, tumor location, tumor position, tumor size, tumor depth, tumor morphology, tumor histology, ulcer (scar), and operator skill. The treatment outcomes were compared among two groups. The primary outcome was ESD procedure time. Secondary outcomes were en bloc, complete, and curative resection rates, and adverse events rates including perforation and delayed bleeding. RESULTS: A total of 155 patients were included in this study; 44 pairs were created by propensity score matching. Background characteristics were quite similar among two groups after matching. Procedure time was significantly shorter for ESD-C (median; 49 min) than for ESD-O (median; 88.5 min) (P
57. Yosuke Minoda, Keishi Komori, Ryoko Naruo, Tsutomu Iwasa, Haruei Ogino, Eikichi Ihara, Yoshihiro Ogawa, Recovery technique using a double scope to rescue failed primary endoscopic ligation., Endoscopy, 10.1055/a-0631-7760, 50, 9, E244-E245, 2018.09.
58. Kiyoshi Saeki, Yoshihiro Miyasaka, Yoshihiro Ohishi, Takeo Yamamoto, Ryota Matsuda, Naoki Mochidome, Yasuhisa Mori, Kohei Nakata, Takao Ohtsuka, Kousei Ishigami, Yosuke Minoda, Yutaka Koga, Yoshinao Oda, Masafumi Nakamura, Intrapancreatic recurrence of intraductal tubulopapillary neoplasm (ITPN) 16 years after the initial surgery for noninvasive ITPN: a case report., Surgical case reports, 10.1186/s40792-018-0497-1, 4, 1, 96-96, 2018.08, BACKGROUND: Intraductal tubulopapillary neoplasm (ITPN) is a rare pancreatic intraductal neoplasm. It is characterized by a tubulopapillary growth pattern, entirely high-grade atypical cells, minimal cytoplasmic mucin, and no obvious luminal mucin secretion. Most of its biological nature remains unclear. CASE PRESENTATION: We herein report a case of intrapancreatic recurrence of ITPN in the remnant pancreas of a patient who underwent pancreatoduodenectomy 16 years previously for a noninvasive intraductal pancreatic head tumor. We reexamined the primary tumor and compared it with the most recently resected specimen. Histologically, the primary tumor showed a tubulopapillary growth of high-grade atypical cells with scanty cytoplasmic mucin, which was similar to the recently resected specimen except for the invasive area. Immunohistochemically, the neoplastic cells in both specimens showed focal staining of MUC1 and positivity for MUC6 but negativity for MUC2, MUC5AC, CDX2, and trypsin. Molecular analysis revealed no KRAS/GNAS/BRAF/PIK3CA mutations in either of the specimens. CONCLUSIONS: These findings of the original tumor and recently resected tumor were compatible with the features of ITPN. Thus, recurrence is possible even for a primary noninvasive ITPN, and long-term surveillance is recommended..
59. Mitsuru Esaki, Sho Suzuki, Yasuyo Hayashi, Azusa Yokoyama, Shuichi Abe, Taizo Hosokawa, Shinichi Tsuruta, Yosuke Minoda, Yoshitaka Hata, Haruei Ogino, Hirotada Akiho, Eikichi Ihara, Yoshihiro Ogawa, Propensity score-matching analysis to compare clinical outcomes of endoscopic submucosal dissection for early gastric cancer in the postoperative and non-operative stomachs., BMC gastroenterology, 10.1186/s12876-018-0855-2, 18, 1, 125-125, 2018.08, BACKGROUND: Endoscopic submucosal dissection (ESD) of the postoperative stomach (ESD-P) for early gastric cancer (EGC) is considered a technically difficult procedure. However, it is difficult to compare the outcomes of ESD-P and ESD of the non-operative stomach (ESD-N) because their baseline characteristics are different. Therefore, we aimed to compare the technical outcomes of ESD-P with those of ESD-N using a propensity score-matching analysis to compensate for the differences. METHODS: The chart records of 1046 patients with EGC who were treated with ESD between January 2004 and July 2016 at Kitakyushu Municipal Medical Center in Japan were reviewed in this retrospective study. Multivariate analyses and propensity score-matching were performed for age, sex, lesion location, lesion size, tumor invasion, tumor size, ulcer (scar), and operator skill. The primary outcome was procedure time. Secondary outcomes were percentages of en bloc, complete, and curative resections, and percentages of adverse events, which were evaluated between the two groups. RESULTS: Forty-one patients were in the ESD-P group and 1005 patients were in the ESD-N group. Propensity score-matching created 41 matched pairs. According to the adjusted comparisons, ESD-P required a significantly longer procedure time (85 min vs 51 min, p 
60. Yosuke Minoda, Kazuya Akahoshi, Yoshihiro Otsuka, Masaru Kubokawa, Yasuaki Motomura, Masafumi Oya, Kazuhiko Nakamura, Endoscopic submucosal dissection of early duodenal tumor using the Clutch Cutter: a preliminary clinical study., Endoscopy, 10.1055/s-0034-1392209, 47 Suppl 1 UCTN, E267-8, 2015.12.
61. Soichi Itaba, Toyoma Kaku, Yosuke Minoda, Hiroyuki Murao, Kazuhiko Nakamura, Gastric intramural hematoma caused by endoscopic ultrasound-guided fine-needle biopsy., Endoscopy, 10.1055/s-0034-1390867, 46 Suppl 1 UCTN, E666, 2014.06.
62. Yosuke Minoda, Kazuya Akahoshi, Masafumi Oya, Masaru Kubokawa, Yasuaki Motomura, Kazuhiko Nakamura, Gastric glomus tumor diagnosed by endoscopic ultrasound-guided fine-needle aspiration biopsy: report of a case., Fukuoka igaku zasshi = Hukuoka acta medica, 105, 4, 105-9, 2014.04, A glomus tumor of the stomach is rare. It is difficult to diagnose the tumor before surgery by only endoscopic biopsy and radiography, and there is no established method of diagnosis before surgical treatment. Esophagogastroduodenoscopy (EGD) on a 50-year-old Japanese woman revealed a 10 mm submucosal tumor in the anterior wall of the gastric angle. Follow-up EGD revealed an increase in the size of the tumor to 15mm. Endoscopic ultrasonography (EUS) demonstrated a 15mm subepithelial hypoechoic solid tumor with continuity to the proper muscle layer. Histologic diagnosis by endoscopic ultrasonography guided fine needle aspiration (EUS-FNA) was glomus tumor. The tumor was treated by laparoscopic local resection. The histologic diagnosis of the resected tumor was similar to the preoperative EUS-FNA results. EUS-FNA would appear to be an effective histologic test for early diagnosis of gastric glomus tumor..
63. Kazuya Akahoshi, Yousuke Minoda, Keishi Komori, Yasuaki Motomura, Masaru Kubokawa, Yoshihiro Otsuka, Syouhei Hamada, Shinichirou Fukuda, Risa Iwao, Junya Gibo, Masafumi Oya, Kazuhiko Nakamura, Endoscopic submucosal dissection using the "Clutch Cutter" for early esophageal squamous cell carcinoma., Endoscopy, 10.1055/s-0033-1344863, 45, 12, 1035-8, 2013.12, BACKGROUND AND STUDY AIMS: To reduce the risk of complications related to the use of knives in endoscopic submucosal dissection (ESD), we developed the Clutch Cutter which can grasp and incise targeted tissue using electrosurgical current, similarly to a biopsy technique. The study aim was to evaluate the efficacy and safety of ESD using the Clutch Cutter for early esophageal squamous cell carcinoma. PATIENTS AND METHODS: ESD using the Clutch Cutter was performed on 32 consecutive patients with early esophageal squamous cell carcinoma. Therapeutic efficacy and safety were assessed. RESULTS: All lesions were treated easily and safely without unintended incision. En bloc resection was obtained in all patients. Histologically negative margins were obtained in 26/32 patients (81%). Endoscopic perforation due to the hood in one patient (3%), mediastinitis without endoscopic perforation in one patient (3%), and post-ESD stricture in 5 patients (16%) were observed. All were successfully managed conservatively. CONCLUSIONS: ESD using the Clutch Cutter appears to be a safe, easy, and technically efficient method for resecting early esophageal squamous cell carcinomas..