Publications by authors named "Shinwa Tanaka"
Background/aims: Visualization of palisade vessels (PVs) in Barrett's esophagus is crucial for proper assessment. This study aimed to determine whether red dichromatic imaging (RDI) improves PV visibility compared with white-light imaging (WLI) and narrow-band imaging (NBI).
Methods: Five expert and trainee endoscopists evaluated the PV visibility in Barrett's esophagus using WLI, NBI, and RDI on 66 images from 22 patients.
Article Synopsis
- - The study develops a risk-scoring system to identify patients who may need additional hospital-specific care (HIC) after undergoing a procedure called peroral endoscopic myotomy (POEM) for esophageal issues.
- - It analyzed data from 589 patients over eight years, finding that 8.5% experienced HIC, with four key factors included in the scoring: age, nutritional status, surgical site complications, and pneumonia.
- - The scoring system showed strong predictive ability and is useful for optimizing patient discharge decisions post-surgery.
Background: Repeat endoscopic submucosal dissection for metachronous recurrence of esophageal squamous cell carcinoma close to previous endoscopic submucosal dissection scars is challenging. Therefore, this study evaluated the efficacy and safety of repeat endoscopic submucosal dissection for recurrent esophageal squamous cell carcinoma.
Methods: The study included 1680 patients.
Article Synopsis
- A study evaluated the safety and effectiveness of same-day sodium picosulfate plus magnesium citrate (SP + MC) bowel preparation for colonoscopy in 145 Japanese patients, as Japan currently only approves day-before and split-dose methods.
- Out of 137 patients who had colonoscopies, 97.1% achieved adequate bowel cleansing, with a high mean Boston Bowel Preparation Score, and only five patients experienced minor adverse events.
- The majority of patients were satisfied with the same-day preparation method, with 99.2% expressing a preference for its use in future colonoscopies, indicating it’s a safe and effective option.
Article Synopsis
- The video discusses a procedure called peroral endoscopic myotomy, which is used to treat congenital esophageal stenosis in pediatric patients.
- It highlights the techniques and tools used during the procedure to safely and effectively widen the esophagus.
- The video also emphasizes the importance of proper diagnosis and patient care in managing esophageal conditions in children.
Background And Aims: Perforation during esophageal endoscopic submucosal dissection (ESD) typically results from electrical damage. However, there are cases in which perforation occurs because of segmental absence of intestinal musculature (SAIM) without iatrogenic muscular injury. We investigated the occurrence rate and clinical course of SAIM during esophageal ESD.
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- This study aimed to identify factors that predict the technical difficulty of endoscopic submucosal dissection (ESD) for superficial esophageal squamous cell carcinoma (ESCC), especially in patients with different lesion types.
- The research was conducted across 10 hospitals in Japan, analyzing data from 1,505 patients after excluding certain lesions and defining "difficult lesions" based on criteria like long procedure time and complications.
- Key predictive factors found for ESD difficulty included the presence of varices or diverticulum, antiplatelet medication, tumor size and circumference, as well as the experience level of the surgeon and the center's patient volume.
Introduction: Peroral endoscopic myotomy (POEM) is a minimally invasive endoscopic procedure for achalasia; its indication has expanded from adults to children. We aimed to evaluate the postoperative efficacy and antireflex status of POEM in young children with achalasia aged 12 years or younger.
Patients: AND METHODS: Pediatric patients with achalasia aged 18 years or younger who underwent POEM in our hospital between 2016 and 2021 were included and divided into two age groups: group A (≤ 12 years) and group B (13-18 years).
Article Synopsis
- The study investigates the long-term outcomes of endoscopic submucosal dissection (ESD) for early remnant gastric cancer (ERGC) using a large multicenter database, addressing a gap in previous research that focused on single centers.
- A total of 242 cases were analyzed, with a median follow-up of 48.4 months, revealing a 5-year overall survival rate of 81.3% and a gastric cancer-specific survival rate of 98.1%.
- The results indicate that while ESD is effective for ERGC regardless of hospital volume, patients categorized as endoscopic curability C-2 without further surgery had significantly shorter survival compared to those with higher curability ratings or those who underwent additional
Article Synopsis
- Heavy drinking is linked to esophageal cancer and varices, and this study explores the safety and effectiveness of endoscopic submucosal dissection (ESD) for treating esophageal cancer in patients with varices.
- Conducted across 10 centers in Japan from 2013 to 2019, the study analyzed data from 1,708 patients, finding that only 1.6% had esophageal varices, with 100% achieving en bloc resection and a R0 resection rate of 77.8%.
- Results indicated that while patients with varices experienced longer procedure times, there were no significant differences in adverse events or outcomes based on whether lesions were located on varices, suggesting that E
Article Synopsis
- Gastric stasis occurs after endoscopic submucosal dissection in the lower stomach, with two types identified: stenosis and deformation, the latter being less understood.
- A study of 41 patients revealed that 12% had gastric stasis due to deformation, which was closely linked to having a large mucosal defect (over 3/4 circumferential) and certain dissection types.
- The results indicated that deformation was rare in cases involving pyloric dissections but prevalent in those with angular dissections, suggesting specific risk factors are influential in the development of gastric stasis from deformation.
Objectives: Peroral endoscopic myotomy (POEM) is an effective treatment for esophageal motility disorders including achalasia and its variants. However, some surgeons have encountered challenging cases. This study aimed to develop a risk-scoring system to predict challenging cases of POEM.
View Article and Find Full Text PDFIntroduction: Sodium picosulfate plus magnesium citrate is a bowel preparation agent with high patient acceptability. However, it is unclear which patients are more likely to have inadequate bowel preparation when using this agent. This study aimed to identify the risk factors for inadequate bowel preparation when using sodium picosulfate plus magnesium citrate for colonoscopy and to develop a scoring model to predict which patients will have inadequate bowel preparation.
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- Peroral endoscopic myotomy (POEM) is a treatment for achalasia that may not work for some patients, leading researchers to create a risk scoring system to predict its effectiveness before surgery.
- The study included 2,740 patients who underwent POEM, identifying clinical failure based on a specific scoring system, resulting in a 4.1% failure rate after 6 months.
- The scoring system assigns points based on preoperative factors, categorizing patients into low and high-risk groups, which helps guide treatment decisions by estimating the likelihood of clinical failure.
Background/aims: Endoscopic submucosal dissection (ESD) for diverticulum-associated colorectal lesions is generally contraindicated because of the high risk of perforation. Several studies on patients with such lesions treated with ESD have been reported recently. However, the feasibility and safety of ESD for lesions in proximity to a colonic diverticulum (D-ESD) have not been fully clarified.
View Article and Find Full Text PDFObjective: Benign esophageal strictures (BES) cause dysphagia and decrease patients' quality of life. Although mechanical dilation is the standard of care for BES, in some patients, dysphagia is unrelieved despite repeated procedures. The biodegradable stent was developed to resolve refractory BES, with reported favorable outcomes, but it is unapproved in Japan.
View Article and Find Full Text PDFBackground: Esophageal motility disorders are sometimes misdiagnosed on endoscopic examination. We aimed to identify the proportion of patients with esophageal motility disorders missed during endoscopy and their clinical characteristics.
Methods: Patients diagnosed with either disorder with esophagogastric junction outflow obstruction or major disorders of peristalsis using high-resolution manometry in our hospital from April 2015 to March 2021 were included in this study.
Geriatric patients with existing studies on the safety and efficacy of peroral endoscopic myotomy (POEM) for achalasia involve small sample sizes and single institutions. However, multi-center, large-scale data analyses are lacking. The study aimed to clarify the characteristics of geriatric patients with esophageal motility disorders (EMDs) and determine the procedure-related outcomes and clinical course following POEM.
View Article and Find Full Text PDFContext: There is an increasing demand for appropriate preclinical mice models for evaluating the efficacy of cancer immunotherapies.
Aims: Therefore, we established a humanized patient-derived xenograft (PDX) model using microsatellite instability-high (MSI-H) colorectal cancer (CRC) tissues and patient-derived peripheral blood mononuclear cells (PBMCs).
Subjects And Methods: The CRC tissues of patients scheduled for surgery were tested for MSI status, and CRC tumors were transplanted into NOD/LtSz-scid/IL-2Rg-/-(NSG) mice to establish MSI-H PDX models.
Article Synopsis
- The study investigates the perioperative management of per-oral endoscopic myotomy in patients undergoing antithrombotic therapy, as the safety and efficacy in this context were previously unknown.
- Researchers analyzed 2752 patients treated between 2010 and 2019, identifying 120 patients on antithrombotic therapy, and compared their outcomes with those not on such therapy.
- Results showed that while patients on antithrombotic therapy generally had poorer health statuses, the clinical success and adverse event rates did not differ significantly, indicating that this procedure can be performed safely and effectively in these patients.
Background: With the development of high-resolution manometry (HRM) and peroral endoscopy, more patients with esophageal motility disorders (EMDs) including achalasia are diagnosed and treated. The characteristics of Japanese patients with EMDs are unknown and should be elucidated.
Methods: A large-scale database analysis was performed at seven high-volume centers in Japan.