Publications by authors named "Teppei Masunaga"
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
- The study investigates the safety and effectiveness of endoscopic submucosal dissection (ESD) for colorectal and gastric cancers, focusing on predicting resectability using endoscopic ultrasound (EUS).
- EUS classifications for tumors were established, determining how visible the submucosal layer was, and the findings showed a significant correlation with the pathological results following ESD.
- The results indicated that EUS could be crucial in predicting which tumors are likely to be successfully resected, with higher success rates observed in Type I tumors compared to Type II and III.
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.
View Article and Find Full Text PDFArticle Synopsis
- 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
- 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 PDFColorectal endoscopic submucosal dissection (ESD) remains challenging for novice endoscopists. Not only the underwater conditions but also active use of water pressure with the water pressure method (WPM) can help widen the submucosal layer. This study aimed to clarify the usefulness of WPM in colorectal ESD, especially for novice endoscopists.
View Article and Find Full Text PDFArticle Synopsis
- The study focuses on evaluating the effectiveness of intensive endoscopic resection as a treatment for multiple duodenal polyposis in patients with familial adenomatous polyposis (FAP), a condition linked to a high risk of duodenal cancer.
- Researchers analyzed data from 28 patients who underwent various endoscopic procedures from 2012 to 2022, successfully removing a total of 1,040 lesions and observing significant reductions in the severity of polyposis.
- The results indicated that the intensive treatment approach effectively reduced the Spigelman index, which measures duodenal polyp severity, with none of the participants requiring surgical intervention during the follow-up period.
Article Synopsis
- The study focused on developing a new quantitative assessment system for measuring endoscopic submucosal dissection (ESD) training effectiveness using an electrical surgical unit (ESU).
- In the first phase, researchers found a strong correlation between the time the ESU was activated and the resection speed, establishing efficiency indicators.
- The second phase revealed that experienced endoscopists had more stable electrical performance compared to novices, indicating potential precision indicators, while the learning curve showed improvement among novice endoscopists over repeated ESDs.
Article Synopsis
- A new traction device called ENDOTORNADO was developed for esophageal endoscopic submucosal dissection (ESD), allowing for adjustable traction from multiple directions.
- A study compared the new device's effectiveness (in 6 cases) with conventional methods (in 23 cases) and found that both groups achieved successful resection without complications.
- The results showed that the total procedure speed was significantly faster with ENDOTORNADO, and submucosal dissection time was reduced to about one-quarter compared to traditional techniques.
Colorectal endoscopic submucosal dissection (ESD) of diverticulum-associated lesions is challenging because these lesions require precise excision in narrow spaces. The water pressure method (WPM) uses active water pressure by the waterjet function under saline solution-filled conditions. This study aimed to determine the feasibility of WPM for resection of diverticulum-associated lesions.
View Article and Find Full Text PDFArticle Synopsis
- A novel endoscopic closure technique called the origami method (OGM) was developed to improve closure of large colorectal defects after endoscopic submucosal dissection (ESD) using through-the-scope clips (TTSCs).
- In a study at a tertiary care hospital from October 2021 to October 2022, the OGM was applied in 47 cases, successfully achieving complete closure in 94% of cases, particularly for defects in the lower rectum.
- The OGM was found to be a safe and reliable method for closing large post-ESD defects without causing any perforations or significant complications.
Duodenal endoscopic submucosal dissection (ESD) is a high-risk technique; however, prophylactic closure of mucosal defects reduces the risk. Unfortunately, we have encountered cases where closure is difficult, especially in large lesions. Therefore, we developed a novel closure technique, a string clip suturing method with an anchor (SCSM-A).
View Article and Find Full Text PDFBackground And Aims: Although lesions occupying a large circumference are associated with the risk of post-endoscopic submucosal dissection (ESD) strictures, the corresponding data for duodenal lesions are unknown. We aimed to analyze the incidence of post-ESD strictures after wide-field duodenal ESD.
Methods: In this retrospective study of duodenal lesions treated with ESD between July 2010 and August 2021, we included lesions that resulted in mucosal defects occupying more than half of the circumference and excluded lesions located in bulbs and involving Vater's papilla.