Publications by authors named "Osamu Goto"
In Japan, differentiated-type early gastric cancer with submucosal invasion <500 µm, tumor diameter <3 cm, no lymphovascular invasion, and negative resection margin are included in pathological curative criteria after endoscopic resection (ER). However, there are a few reports presenting local or metastatic recurrence after ER for the lesions described above. A 72-year-old man was diagnosed with early gastric cancer and underwent endoscopic submucosal dissection (ESD).
View Article and Find Full Text PDFPeroral flexible endoscopy is a minimally invasive technique that enables the local resection of gastric subepithelial tumors (SETs) with malignant potential. Resection techniques are mainly chosen on the basis of the lesion size. Minute SETs less than 1 cm should be managed through a watch and wait strategy, with the exception of histologically diagnosed superficial lesions, which require endoscopic mucosal resection or endoscopic submucosal dissection.
View Article and Find Full Text PDFBackground: An "esophageal rosette" (ER) sign is one of the endoscopic findings in primary esophageal achalasia. We investigated whether ER was associated with the therapeutic efficacy of peroral endoscopic myotomy (POEM).
Methods: The clinical characteristics and short-term outcomes of POEM were retrospectively evaluated in 69 patients who underwent the procedure for esophageal achalasia.
Article Synopsis
- Collaborative surgery involving both endoscopists and surgeons is shown to be an effective method for less invasive removal of gastrointestinal tumors, addressing the limitations of traditional treatments.
- In a study of 131 patients with various lesions, 96% achieved complete collaboration, and 95% had successful tumor resections.
- Overall, the results suggest that this collaborative approach is safe, with only 4% experiencing significant postoperative issues, making it a viable alternative to conventional surgical methods.
Article Synopsis
- This study reviewed the effectiveness and safety of mucosal incision-assisted biopsy (MIAB) for diagnosing gastric subepithelial tumors (SETs).
- The analysis included 11 studies with a total of 339 cases, showing a high diagnostic rate of 87.8% and a very low adverse event rate of 0.2%.
- The use of acid secretion inhibitors proved effective in reducing postoperative bleeding, while the benefits of local injection to prevent complications were not clearly established.
Article Synopsis
- The study aimed to assess the effectiveness of endoscopic hand suturing (EHS) in reducing postoperative bleeding after gastric endoscopic submucosal dissection (ESD) in patients on antithrombotic agents (ATAs).
- It involved a phase II multicenter study with 49 enrolled patients, 43 of whom were evaluated; the postoperative bleeding rate was found to be 7%, significantly lower than the expected 10% rate.
- The success rate of EHS was 100%, with minimal complications, suggesting that EHS is a promising method to mitigate bleeding risks in these high-risk patients.
Aims: During intraoperative bleeding in endoscopic submucosal dissection (ESD), switching to spray coagulation may be beneficial compared with the continuous use of swift coagulation and can reduce the need for hemostatic forceps. We retrospectively assessed the effectiveness of spray modes on intraoperative bleeding during gastric ESD.
Methods And Results: A total of 316 bleeding events (156 in the Swift group and 160 in the Spray group) were consecutively recorded.
The Japanese Esophageal Society classification for prediction of superficial esophageal squamous cell neoplasia invasion depth: Validation in a Western population.
United European Gastroenterol J
October 2024
Article Synopsis
- - The JES microvessel classification was proposed for evaluating early esophageal squamous cell neoplasia (ESCN) based on the assessment of intrapapillary capillary loops, aiming to determine eligibility for endoscopic resection in Western patients.
- - A study analyzed 113 Western ESCN lesions with assessments from nine endoscopists of different experience levels, revealing good interobserver agreement among experts but only moderate agreement among residents-in-training.
- - The overall accuracy of the classification was found to be low, especially among Western endoscopists and trainees, with highlighted limitations in effectively predicting invasion depth, though experienced endoscopists showed some success in identifying superficial layers without B3 vessels.
Article Synopsis
- The text indicates that there is a correction to the article referenced by DOI: 10.1055/a-2284-9492.
- This means that previously published information in that article may have errors that need to be addressed.
- Corrections like this are important for maintaining the accuracy and integrity of scholarly communication.
Article Synopsis
- Endoscopic hand suturing (EHS) was developed to close mucosal defects and is being explored for various medical applications.
- A pilot study involving 15 patients assessed the feasibility and safety of EHS in different clinical scenarios, including after removals and closures related to gastric, rectal, and esophageal procedures.
- Results showed that EHS was technically successful in most cases (87%) with no severe adverse events reported, although some procedures were difficult due to anatomical constraints.
Article Synopsis
- The study focuses on how tumor size evaluations for colorectal endoscopic submucosal dissection (ESD) are often inaccurate, affecting the procedure's difficulty and success rate.
- Researchers analyzed data from 377 lesions removed via ESD to identify discrepancies between endoscopic and pathological size assessments, categorizing them as correct or incorrect scaling.
- Results showed that larger lesions and less experienced clinicians contributed significantly to inaccurate size estimates, with an average discrepancy of 21% found in the evaluations.
Article Synopsis
- - This study investigates the bleeding risks associated with direct oral anticoagulants (DOACs) after gastric endoscopic submucosal dissection (ESD), as there are few reports on this issue.
- - A meta-analysis of seven clinical studies found that patients on DOACs had a significantly higher rate of postoperative bleeding (17.0%) compared to those not on anticoagulants (3.4%) and those on antiplatelet drugs (16.9%).
- - The bleeding risk for DOACs was similar to that of warfarin, indicating that careful management is required for patients taking any form of anticoagulants after gastric ESD.
Objective: Mucosal incision-assisted biopsy (MIAB) has been introduced as an alternative to endoscopic ultrasound-guided fine needle aspiration for tissue sampling of subepithelial lesions. However, there have been few reports on MIAB, and the evidence is lacking, particularly in small lesions. In this case series, we investigated the technical outcomes and postprocedural influences of MIAB for gastric subepithelial lesions 10 mm or greater in size.
View Article and Find Full Text PDFInflammatory myofibroblastic tumor (IMT) is an intermediate malignancy with myofibroblast proliferation and inflammatory cell infiltration with malignant potential. Primary IMTs are predominantly reported in the lungs, while gastric IMTs are very rare. Therefore, no guidelines exist for the diagnosis and treatment of gastric IMTs.
View Article and Find Full Text PDFBackground: Subclinical stricture after esophageal endoscopic submucosal dissection (ESD) makes the detection and re-ESD of metachronous lesions difficult. This study aimed to investigate the effectiveness of prophylactic steroid use after esophageal ESD for mucosal defects with a circumference less than 75% for the prevention of symptomatic and asymptomatic stricture.
Methods: In 80 retrospectively enrolled patients, we collected paired endoscopic images of a mucosal defects immediately after resection and a scar thereafter.
A 78-year-old man was admitted to our hospital with a tarry stool. Esophagogastroduodenoscopy identified tiny oozing on the greater curvature at the antrum. Despite repeated endoscopic hemostasis by coagulation and clipping, rebleeding occurred.
View Article and Find Full Text PDFIntroduction: Endoscopic suturing of a mucosal defect is expected to prevent postoperative bleeding after endoscopic submucosal dissection (ESD). Endoscopic suturing causes mucosal deformity, which may interfere with endoscopic surveillance thereafter. We retrospectively investigated long-term chronological changes in mucosal suturing by endoscopic suturing.
View Article and Find Full Text PDFArticle Synopsis
- Esophageal submucosal hematoma is a rare condition primarily caused by mechanical damage to the esophageal wall.
- A case was reported where this condition occurred after a transesophageal echocardiography (TEE) during heart surgery, influenced by TEE insertion and the use of multiple blood-thinning medications.
- This is the first document of esophageal submucosal hematoma connected to TEE, highlighting the need for cautious endoscopic ultrasonography in patients prone to bleeding and under anesthesia.
Background: Endocytoscopy (ECS) aids early gastric cancer (EGC) diagnosis by visualization of cells. However, it is difficult for non-experts to accurately diagnose EGC using ECS. In this study, we developed and evaluated a convolutional neural network (CNN)-based system for ECS-aided EGC diagnosis.
View Article and Find Full Text PDFBackground And Aims: Surgery is recommended in early gastric cancer (EGC) after noncurative endoscopic submucosal dissection (ESD), although observation can be an alternative. We aimed to develop a tailor-made treatment strategy for noncurative EGCs by comparing the lymph node metastasis risk (LNMR) and the surgical risk.
Methods: We retrospectively identified 485 patients with differentiated-type, noncurative EGCs removed by ESD and classified them into two groups: a surgery-preferable group and an observation-preferable group, according to the clinical courses.