Publications by authors named "Teppei Akimoto"
Article Synopsis
- Live swine are not ideal for training to manage intraoperative bleeding during endoscopic submucosal dissection (ESD) due to their coagulation issues.
- The study aimed to determine an effective heparin dosage for a bleeding model and to see how it affects bleeding during ESD procedures.
- Results showed that high doses of heparin led to significantly more intraoperative bleeding and hematomas in the heparinized model compared to a control group.
Article Synopsis
- Endoscopic submucosal dissection including papilla (ESDIP) was developed to improve outcomes for patients with duodenal tumors, addressing issues like lesion size and local recurrence that are common with endoscopic papillectomy (EP).
- A study of 54 patients from 2010 to 2024 showed that ESDIP had a high success rate, with 96% of resections completed and a low overall recurrence rate of 15% after one year.
- While some complications occurred, such as intraprocedural perforation and delayed bleeding, the approach remains a promising low-invasive alternative to more extensive surgeries like pancreaticoduodenectomy.
Article Synopsis
- The study investigates the link between duodenal epithelial tumors (DETs) and colorectal tumors, addressing a controversial topic in familial colorectal adenomatous polyposis.
- Conducted over four years, the research compared 163 patients with DETs to 177 individuals undergoing routine colonoscopy, finding a significantly higher adenoma detection rate (ADR) in the DET group (63.2% vs 23.6%).
- The results indicated that DETs are associated with a five-fold increase in adenoma detection and a six-fold increase in advanced neoplasia detection, suggesting the need for screening colonoscopy in DET patients.
Article Synopsis
- - This study investigated the link between specific genetic variations (SNPs) related to chronic pancreatitis and clinical features of patients with intraductal papillary mucinous neoplasm (IPMN).
- - A total of 100 patients with IPMN and 116 control patients were analyzed, measuring various serum enzyme levels and performing endosonography to evaluate the severity of the condition.
- - Findings indicated that certain genotypes, particularly for carboxypeptidase A1 and gamma-glutamyltransferase 1, may help diagnose and predict concerning features of IPMN, such as cyst size.
The incidence of duodenal tumors (DTs) is increasing. However, the mechanisms underlying its development remain unclear. Environmental factors, including the microbiome and bile acids (BAs), are believed to influence tumor development.
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- The Water Pressure Method (WPM) in colorectal endoscopic submucosal dissection (ESD) has advantages but faces challenges like excess water injection and field contamination.
- A study evaluated a new continuous liquid-suction catheter attachment (CLCA) to improve ESD outcomes using WPM, analyzing 31 cases from August 2022 to September 2023.
- Results showed all lesions were successfully removed without perforation, with effective volume measurements for injection and suction, indicating that the novel system helps maintain a clear operative field during the procedure.
Article Synopsis
- Superficial pharyngeal cancers can be effectively treated with transoral surgery (TOS), which helps maintain organ function and quality of life.
- This study evaluated the outcomes of a specific technique called water pressure method-endoscopic submucosal dissection (WPM-ESD) for treating pharyngeal lesions at Keio University.
- Results showed that WPM-ESD had a 100% en bloc resection rate, short procedure time, no serious complications, and a median hospital stay of 6 days, indicating its potential as a viable treatment option for these types of cancers.
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.
Article Synopsis
- Underwater endoscopic mucosal resection (UEMR) and cold snare polypectomy (CSP) are two new techniques being evaluated for treating superficial duodenal tumors, with no clear consensus on their best use.
- A study conducted from January 2020 to June 2022 found that UEMR had a significantly higher rate of sufficient vertical resection compared to CSP (65.6% vs 41.5%), although the overall R0 resection rates were similar between the two.
- While UEMR is more effective for certain lesions, CSP is quicker and has fewer bleeding complications, making it preferable for most small tumors that are easier to manage.
Objectives: Fever and increased inflammatory responses sometimes occur following endoscopic resection (ER). However, the differences in causes according to the organ are scarcely understood, and several modified ER techniques have been proposed. Therefore, we conducted a comprehensive prospective study to investigate the cause of fever and increased inflammatory response across multiple organs after ER.
View Article and Find Full Text PDFBackground And Aim: Apolipoprotein A2 (apoA2) isoforms have been reported to undergo the aberrant processing in pancreatic cancer and pancreatic risk populations compared with that in healthy subjects. This study aimed to clarify whether apoA2 isoforms were as useful as N-benzoyl-p-aminobenzoic acid (BT-PABA) test for exocrine pancreatic dysfunction markers in patients with early chronic pancreatitis (ECP).
Methods: Fifty consecutive patients with functional dyspepsia with pancreatic enzyme abnormalities (FD-P) (n = 18), with ECP (n = 20), and asymptomatic patients with pancreatic enzyme abnormalities (AP-P) (n = 12) based on the Rome IV classification and the Japan Pancreatic Association were enrolled in this study.
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 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 PDFBackground: This study aimed to clarify whether any risk factors including clinical characteristics, endosonographic features, and exocrine pancreatic dysfunction may be useful for a predictive factor for patients with early chronic pancreatitis.
Methods: A total of 163 consecutive patients that presented with functional dyspepsia with pancreatic enzyme abnormalities (FD-P) (n = 46), early chronic pancreatitis (ECP) (n = 47), and asymptomatic patients with pancreatic enzyme abnormalities (AP-P) (n = 70) based on the Rome III classification and the Japan Pancreatic Association were included in this study. The enrolled patients were evaluated using endosonography (EUS) and EUS elastography.
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.
Background And Aims: Noninvasive, imaging diagnosis of gastrointestinal mesenchymal tumors (GIMTs) is still difficult. This study aimed to develop a novel diagnostic method of GIMTs via endoscopic ultrasonography (EUS) using circularity.
Methods: In a derivation series, we retrospectively collected 50 GIMTs 2-5 cm in diameter of two institutions.
Background: It is unclear whether prophylactic endoscopic closure after colorectal endoscopic submucosal dissection (ESD) reduces the risk of postoperative adverse events due to variability in lesion characteristics. Therefore, we conducted a retrospective study using propensity score matching to evaluate the efficacy of prophylactic clip closure in preventing postoperative adverse events after colorectal ESD.
Methods: This single-center retrospective cohort study included 219 colorectal neoplasms which were removed by ESD.
Background: Three-dimensional (3D) technology has been used in many fields, including flexible endoscopy. We evaluated the usefulness of 3D visualization for endoscopically diagnosing superficial gastric neoplasia.
Methods: Twelve participants (4 novices, 4 trainees and 4 experts) evaluated two-dimensional (2D) and 3D endoscopic still images of 28 gastric neoplasias, obtained before ESD with white-light imaging (WLI) and narrow-band imaging (NBI).