Publications by authors named "Saito Yutaka"
Objectives: This study aimed to investigate the diagnostic performance and safety of endoscopic ultrasound-guided tissue acquisition (EUS-TA) for perivascular soft-tissue cuffing (PSTC).
Methods: This single-center, retrospective study evaluated patients in whom EUS-TA was performed for PSTC in pancreatic or bile duct cancer lesions between October 2017 and March 2024. PSTC was defined as a perivascular soft-tissue area contiguous with nearby blood vessels from the suspected primary tumor.
Introduction: The performance of a high quality esophagogastroduodenoscopy (EGD) is dependent on the mucosal cleanliness. Recently, the Polprep: Effective Assessment of Cleanliness in EGD (PEACE) scale was created to assess the degree of mucosal cleanliness during EGD. The aim of this study was to validate this scoring system in a cohort of international endoscopists.
View Article and Find Full Text PDFBackground And Study Aims: Prophylactic clip closure after colorectal endoscopic submucosal dissection (ESD) among patients on anticoagulants is of uncertain effectiveness in reducing delayed bleeding (DB) risk. We aimed to assess the effect of prophylactic clip closure in preventing DB after colorectal ESD among patients on anticoagulants.
Patients And Methods: We used the ABCD-J study database, a large-scale multicenter study analyzing DB among 34,455 colorectal ESD cases from 47 Japanese institutions.
Background And Aim: Endoscopic submucosal dissection (ESD) is considered the best modality for achieving en bloc resection of larger neoplastic mucosal lesions in the upper and lower gastrointestinal (GI) tract. Multiple devices are available for ESD, and refinements continue to be made to develop devices that improve the safety and efficiency of performing ESD. Submucosal injection with viscous fluids like glycerol, which prolong submucosal expansion, could facilitate the procedure.
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- The study focuses on the need for an objective method to evaluate and compare different computer-aided detection (CADe) algorithms used in colorectal cancer screening, as their performance varies and no standard exists.
- A modified Delphi approach was employed, where 25 experts generated and prioritized scoring criteria over eight months, ultimately identifying six key metrics, including sensitivity and adenoma detection rate.
- The resulting criteria aim to guide the development and improvement of CADe software, with future research suggested to validate these metrics on benchmark video datasets.
Background: Pyloric gland adenoma (PGA) is a distinct subtype of duodenal adenoma. PGA has been increasingly recognized as a histologically and molecularly distinct entity; however, its endoscopic features have not been precisely described. This study aims to investigate the endoscopic characteristics of duodenal PGA, including the association of their putative precursors, Brunner's gland hyperplasia (BGH), and gastric epithelial heterotopia/metaplasia (GEM/H).
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- The effectiveness of post-endoscopic surveillance for colorectal tumors aims to decrease cancer rates and enhance patient quality of life, with guidelines established by European and American organizations.
- Recent studies have provided a basis for these guidelines, categorizing patients into different risk groups like low-risk and high-risk adenomas to tailor surveillance intervals.
- Ongoing research and the application of these guidelines in clinical settings are essential for their effectiveness and for updating practices as new evidence emerges.
Article Synopsis
- A new technique called underwater injection EMR (UI-EMR) was developed to improve the removal of submucosal tissue in T1 colorectal cancer (T1-CRC) while ensuring adequate margins.
- A study involving 135 patients showed that UI-EMR achieved a high success rate in resection, with en bloc success in 94.1% of cases and minimal adverse events.
- The method also resulted in sufficient vertical margins for all evaluated T1-CRCs, suggesting it could be a favorable option for treating small non-pedunculated colorectal polyps that are concerning for T1-CRC.
Article Synopsis
- The study compares metal stents (MS) and plastic stents (PS) for treating malignant biliary obstruction during endoscopic ultrasound-guided hepaticogastrostomy (EUS-HGS).
- The results showed that while MS led to a greater reduction in bilirubin levels within two weeks, PS had a better safety profile with fewer adverse events.
- Even though MS had longer stent patency after 100 days, PS was suggested to be an adequate option for palliative care in these cases.
Among colorectal serrated polyps (SPs), sessile serrated lesions (SSLs) and hyperplastic polyps (HPs) have a similar endoscopic appearance. However, the endoscopic distinctions between those two categories, microvesicular HPs (MVHPs) and goblet cell-rich HPs (GCHPs), are not well understood. Therefore, we compared the endoscopic features of SSLs, MVHPs, and GCHPs.
View Article and Find Full Text PDFBackground And Aim: Colorectal endoscopic submucosal dissection is a technically demanding procedure with a steep learning curve. In Japan, the National Cancer Center Hospital allows overseas doctors to participate in hands-on training. We aimed to assess the colorectal endoscopic submucosal dissection performance and learning curve of an endoscopist who participated in hands-on training.
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- A study compared gene expression in the normal intestines of healthy individuals and colorectal cancer patients using a step biopsy procedure involving 78 participants.
- Significant differences in gene expression were found not only between the healthy intestine regions but also in cancer patients' normal mucosa, indicating concealed alterations due to cancer.
- These findings suggest that seemingly normal tissues in colorectal cancer patients might harbor cancer-predisposing conditions, highlighting potential pathways for new immunotherapy and treatments.
Background: Endoscopic resection techniques for colorectal tumors are constantly evolving with improvements.
Summary: Over the past decade, there has been a paradigm shift toward cold polypectomy for the removal of small lesions (<10 mm), known as the "cold revolution". In recent years, underwater endoscopic mucosal resection (EMR) has emerged as an alternative to conventional EMR and has been gaining popularity for resection of intermediate and large-sized lesions (≥10 mm).
Background And Aim: The risk of colorectal cancer among fecal immunochemistry test-positive individuals who had undergone previous colonoscopies remains unclear. Therefore, this study aimed to determine the differences in the risk of colorectal cancer among fecal immunochemistry test-positive individuals according to the timing of their previous colonoscopies.
Methods: This multicenter, retrospective, observational study was conducted in Japan as a subgroup analysis of the J-SCOUT study (UMIN000040690), which integrated and analyzed a database comprising all colonoscopies performed at participating Japanese institutions between 2010 and 2020.
Article Synopsis
- Advanced gastric cancer (AGC) has a poor prognosis, with median survival under 14 months, and there are limited effective molecular targeted therapies available.
- The study developed a deep phosphoproteome analysis from quick endoscopic biopsies, identifying three subtypes of AGC based on phosphorylation signaling and indicating dynamic changes in cancer cell behavior during treatment.
- The research focuses on targeting AXL in relation to epithelial-mesenchymal transition (EMT) signaling and offers valuable insights for future therapeutic strategies and biomarkers for AGC.
Article Synopsis
- * A total of 82,005 colonoscopy cases were analyzed, revealing 71 identified colorectal NENs, which corresponds to a detection rate of 0.087%. Most cases were small lesions in the rectum.
- * Findings suggest that the detection rate of colorectal NENs during colonoscopy is higher than previously anticipated, indicating the importance of thorough screening.
Article Synopsis
- The study aimed to assess the safety and effectiveness of propofol sedation in complex endoscopic procedures like endoscopic cholangiopancreatography, focusing on risk factors for excessive sedation.
- A review of 870 patient cases highlighted sedation-related issues, revealing rates of excessive sedation (7.8%), hypoxemia (6.0%), and hypotension (1.8%), with obesity and sleep apnea significantly linked to higher sedation risks.
- The findings suggest that sedation strategies for these patients should be personalized, especially for those with identified risk factors such as obesity and prolonged procedure times.
Antithrombotic agents, including antiplatelet agents and anticoagulants, are widely used in Korea because of the increasing incidence of cardiocerebrovascular disease and the aging population. The management of patients using antithrombotic agents during endoscopic procedures is an important clinical challenge. The clinical practice guidelines for this issue, developed by the Korean Society of Gastrointestinal Endoscopy, were published in 2020.
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- 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.
Objectives: This study investigated the incidence of lymph node metastasis and long-term outcomes in patients with T1 colorectal cancer where endoscopic submucosal dissection (ESD) resulted in noncurative treatment. It is focused on those with deep submucosal invasion, a factor considered a weak predictor of lymph node metastasis in the absence of other risk factors.
Methods: This nationwide, multicenter, prospective study conducted a post-hoc analysis of 141 patients with T1 colorectal cancer ≥20 mm where ESD of the lesion resulted in noncurative outcomes, characterized by poor differentiation, deep submucosal invasion (≥1000 μm), lymphovascular invasion, high-grade tumor budding, or positive vertical margins.