Publications by authors named "T Kuwai"
Objectives: Studies have suggested that computer-aided polyp detection using artificial intelligence improves adenoma identification during colonoscopy. However, its real-world effectiveness remains unclear. Therefore, this study evaluated the usefulness of computer-aided detection during regular surveillance colonoscopy.
View Article and Find Full Text PDFBackground: Additional surgery with lymph node (LN) dissection is recommended for pT1 colorectal carcinoma (CRC) resected by endoscopy, based on pathological risk factors for LN metastasis (LNM), according to guidelines by the Japanese Society for Cancer of the Colon and Rectum (JSCCR), National Comprehensive Cancer Network (NCCN), and European Society for Medical Oncology (ESMO).
Methods: We retrospectively analyzed 560 consecutive patients with T1 CRC who underwent endoscopic resection alone (n=190) or initial or additional surgery with LN dissection (n=370) between 1992 and 2017 at Hiroshima University Hospital. Patients were classified into LNM low- and high-risk groups according to guidelines by the JSCCR, NCCN, and ESMO as follows.
Article Synopsis
- Serum markers like gastrin and pepsinogen help assess the risk of gastric cancer, but their effectiveness in predicting metachronous gastric cancer after endoscopic submucosal dissection (ESD) remains uncertain.
- A study analyzed 197 patients with gastric cancer lesions who underwent ESD, finding significant predictive factors such as severe mucosal atrophy and high gastrin levels that increase the likelihood of metachronous gastric cancer.
- The research indicates that elevated serum gastrin levels, especially in patients not using proton pump inhibitors, could serve as a valuable tool for monitoring gastric cancer risk after ESD.
Article Synopsis
- The study aimed to assess endoscopic resection methods for cT1b colorectal carcinomas (CRCs) measuring ≤20 mm, focusing on achieving sufficient vertical margins (VMs).
- Researchers evaluated 128 patients, categorizing tumor lifting conditions into types A (soft dome), B (hard trapezoid), and non-lifting, where they found that all non-lifting tumors required hybrid endoscopic submucosal dissection (ESD) to ensure VMs of at least 500 µm.
- The results indicated that hybrid ESD is more effective for type B tumors, producing significantly better VM outcomes compared to endoscopic mucosal resection.
An 80-year-old woman with a history of endoscopic balloon dilation for esophageal stricture caused by accidental ingestion of caustic soda during infancy presented with dysphagia. Upper gastrointestinal endoscopy revealed a 10-cm-long, highly white, elevated lesion with a feathered appearance. This lesion was determined to be the cause of dysphagia and was completely resected via endoscopic submucosal dissection.
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