Adenocarcinoma of the duodenum arising from Brunner's gland resected by partial duodenectomy: a case report.

Background: Duodenal carcinoma originating in Brunner's gland is rare. Herein, we report a case of duodenal carcinoma arising from Brunner's gland in a 63-year-old man.

Case Presentation: On diagnostic imaging, the lesion presented as a non-invasive carcinoma; the patient also had uncontrolled diabetes and liver cirrhosis.

Real-world learning curve analysis of colorectal endoscopic submucosal dissection: a large multicenter study.

Background: The current status of colorectal endoscopic submucosal dissection (ESD) performed by endoscopists without colorectal ESD experience is unknown. This study evaluated the quality of colorectal ESD performed by endoscopists without colorectal ESD experience.

Methods: We retrospectively examined the outcomes of 420 consecutive patients with 427 superficial colorectal tumors (male/female, 251/169; mean age, 69 years) who underwent ESD.

Preceding endoscopic submucosal dissection for T1 colorectal carcinoma does not affect the prognosis of patients who underwent additional surgery: a large multicenter propensity score-matched analysis.

Background: We analyzed the influence of preceding endoscopic submucosal dissection (ESD) on the prognosis of patients with T1 colorectal carcinoma (CRC) after additional surgery using propensity-score matching.

Methods: 1638 consecutive patients with T1 CRC were retrospectively identified between January 1998 and December 2016 at the Hiroshima GI Endoscopy Research Group. We assessed 602 patients with 602 T1 CRC who underwent additional surgery after ESD (n = 216) or surgery alone (n = 386).

Long-term prognosis after treatment for T1 carcinoma of laterally spreading tumors: a multicenter retrospective study.

Purpose: Long-term prognosis of T1 laterally spreading tumors (LSTs) after treatment have not been clarified. This study compared clinicopathological characteristics and long-term prognosis of T1 LSTs.

Methods: We retrospectively assessed 169 patients with 169 T1 LSTs between January 1992 and December 2008 by ten hospitals.

Clinical outcomes of endoscopic submucosal dissection for colorectal tumors: a large multicenter retrospective study from the Hiroshima GI Endoscopy Research Group.

Background And Aims: Although advanced high-volume centers have reported good outcomes of colorectal endoscopic submucosal dissection (ESD), a limited number of highly skilled experts in specialized institutions performed these procedures. We undertook a retrospective multicenter survey, which included nonspecialized hospitals, to investigate the clinical outcomes of colorectal ESD.

Methods: We recruited 1233 consecutive patients with 1259 colorectal tumors resected by ESD at 12 institutions.

Long-term outcomes after treatment for T1 colorectal carcinoma: a multicenter retrospective cohort study of Hiroshima GI Endoscopy Research Group.

Background: We aimed to clarify the long-term outcomes of patients with T1 colorectal carcinoma (CRC) after endoscopic resection (ER) and surgical resection.

Methods: We examined T1 CRC patients treated during 1992-2008 and who had ≥5 years of follow-up. Patients who did not meet the curative criteria after ER according to the Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines were defined as "non-endoscopically curable" and classified into three groups: ER alone (Group A: 121 patients), additional surgery after ER (Group B: 238 patients), and surgical resection alone (Group C: 342 patients).

A trial of the use of patency capsules in combination with overnight capsule endoscopy.

Background: The PillCam® patency capsule (PPC) was developed to minimize the risk of capsule retention during capsule endoscopy (CE). Typically, the use of patency capsules prior to CE requires patients to be monitored over a period of time. To reduce the need for frequent outpatient visits during PPC examination and CE, we developed the overnight CE (ON-CE) procedure.

Risk factors for delayed bleeding after endoscopic submucosal dissection for colorectal neoplasms.

Purpose: Although delayed bleeding is a major complication of endoscopic submucosal dissection (ESD) for colorectal neoplasms, few reports have assessed the risk factors for delayed bleeding after colorectal ESD.

Methods: This study included 363 consecutive patients in whom 377 colorectal neoplasms were resected using ESD between April 2006 and August 2012. We classified patients and lesions into two groups on the basis of presence or absence of delayed bleeding and retrospectively compared the clinicopathological characteristics and clinical outcomes of ESD between the two groups.

Endoscopic features and management of diminutive colorectal submucosal invasive carcinoma.

Background And Aim: The vast majority of diminutive (∼5 mm) colorectal tumors consist of a very low prevalence of advanced neoplasia, and a predict-resect-and-discard policy has been proposed recently in Western countries. The histology of some diminutive colorectal tumors reveals carcinoma, not adenoma, although the frequency is relatively low. Clarifying the endoscopic features of diminutive submucosal invasive colorectal carcinoma (CRC) during colonoscopy is important for managing diminutive lesions.

Site-specific tumor grading system in colorectal cancer: multicenter pathologic review of the value of quantifying poorly differentiated clusters.

The study aimed to determine the value of a novel site-specific grading system based on quantifying poorly differentiated clusters (PDC; Grade(PDC)) in colorectal cancer (CRC). A multicenter pathologic review involving 12 institutions was performed on 3243 CRC cases (stage I, 583; II, 1331; III, 1329). Cancer clusters of ≥5 cancer cells and lacking a gland-like structure (PDCs) were counted under a ×20 objective lens in a field containing the maximum clusters.

Condition of muscularis mucosae is a risk factor for lymph node metastasis in T1 colorectal carcinoma.

Background: The Japanese Society for Cancer of the Colon and Rectum Guidelines for the Treatment of Colorectal Cancer 2010 state that curable T1 colorectal carcinoma (CRC) after endoscopic resection shows favorable histologic grade, absence of vessel involvement, submucosal invasion depth of <1,000 μm, and low-grade tumor budding.

Methods: We evaluated 322 consecutive T1 CRCs with LN dissection between January 1993 and March 2012. According to the muscularis mucosae condition, CRCs were classified into three groups: type A, clearly identified; type B, incompletely disrupted with deformity; or type C, completely disrupted.

Predictors of incomplete resection and perforation associated with endoscopic submucosal dissection for colorectal tumors.

Background And Objective: Colorectal endoscopic submucosal dissection (ESD) is technically challenging. Our aim was to identify predictors of incomplete resection and perforation in colorectal ESD.

Design: Retrospective study.

Risk analysis of submucosal invasive rectal carcinomas for lymph node metastasis to expand indication criteria for endoscopic resection.

In the 2010 guidelines for the treatment of colorectal cancer from the Japanese Society for Cancer of the Colon and Rectum (JSCCR), the criteria for identifying curable submucosal invasive colorectal carcinoma after endoscopic resection is as follows: differentiated adenocarcinoma, no vascular invasion, submucosal invasion depth <1000 μm and budding grade 1 (low grade). A total of 118 rectal submucosal carcinomas, treated by primary surgical resection or additional surgical resection with lymph node (LN) dissection, were analyzed. Relationships between clinicopathological findings and LN metastasis were evaluated.

Risk factors for vertical incomplete resection in endoscopic submucosal dissection as total excisional biopsy for submucosal invasive colorectal carcinoma.

Purpose: Endoscopic submucosal dissection (ESD) for colorectal tumor is a minimally invasive treatment. Histologic information obtained from the entire ESD specimen is important for therapy selection in submucosal invasive colorectal carcinoma (SMca). This study aimed to identify risk factors for vertical incomplete resection (vertical margin-positive [VM+]) when ESD was performed as total excisional biopsy for SMca.

Characteristic magnifying narrow-band imaging features of colorectal tumors in each growth type.

Purpose: We investigated the surface characteristics and vascular patterns of colorectal tumors according to growth type by means of magnifying narrow-band imaging (NBI).

Methods: Four hundred ninety-seven colorectal tumors larger than 10 mm (204 tubular adenomas [TAs], 199 frankly invasive intramucosal carcinomas to shallow invasive submucosal [M/SM-s] carcinomas, and 94 deeply invasive submucosal [SM-d] carcinomas) were analyzed. These colorectal tumors were classified according to growth type as follows: polypoid type, n = 224; laterally spreading tumor-granular (LST-G) type, n = 133; and LST-non-granular (LST-NG) type, n = 140.

Management of T1 colorectal carcinoma with special reference to criteria for curative endoscopic resection.

Background And Aim: In guidelines 2010 for the treatment of colorectal cancer from the Japanese Society for Cancer of the Colon and Rectum (JSCCR), the criteria for identifying curable T1 colorectal carcinoma after endoscopic resection were well/moderately differentiated or papillary histologic grade, no vascular invasion, submucosal invasion depth less than 1000 µm and budding grade 1 (low grade). We aimed to expand these criteria.

Methods: A total of 499 T1 colorectal carcinomas, resected endoscopically or surgically, were analyzed.

Clinical outcomes of endoscopic submucosal dissection and endoscopic mucosal resection for laterally spreading tumors larger than 20 mm.

Background And Aims: Colorectal laterally spreading tumors (LST) > 20 mm are usually treated by endoscopic submucosal dissection (ESD) or endoscopic mucosal resection (EMR). Endoscopic piecemeal mucosal resection (EPMR) is sometimes required. The aim of our study was to compare the outcomes of ESD and EMR, including EPMR, for such LST.

A case of multiple hepatic peribiliary cysts which contributed to the obstructive jaundice and led to liver failure at the young man with von Recklinghausen's disease.

We treated a young man with obstructive jaundice, in whom multiple hepatic peribiliary cysts were detected at autopsy. He had been diagnosed with von Recklinghausen's disease in early childhood and had undergone surgery for a ventricular septal defect with massive blood transfusion at the age of 4 years. Examination at the age of 21 revealed prominent splenomegaly and a low platelet count.