Publications by authors named "Toru Okuzono"
Article Synopsis
- * A retrospective analysis was conducted on 56 patients with gastroenterological diseases who were referred from a regional hospital to a tertiary facility, primarily using a cloud-based image-sharing system over three years.
- * The study found that most patients (80.4%) had hepatobiliary pancreatic issues, with swift referral processes leading to timely treatments; however, many patients faced waiting lists, highlighting the benefits of remote imaging for efficiency in care.
Background And Aims: The efficacy of the suprapapillary placement of inside plastic stents (iPSs) for unresectable malignant hilar biliary obstructions (MHOs) is unknown compared with that of uncovered inside metal stents (iMSs). This randomized controlled trial was designed to evaluate the outcomes of endoscopic placement of these stents for unresectable MHOs.
Methods: This open-label, randomized study was conducted at 12 Japanese institutions.
Esophageal cancer after endoscopic treatment may recur depending on the risk. We present a case of a rare T1b esophageal cancer after endoscopic treatment plus chemoradiotherapy (CRT) that recurred with metastasis of the dorsal muscles. A 70-year-old man was referred for treatment of early-stage esophageal carcinoma.
View Article and Find Full Text PDFEsophagogastroduodenoscopy (EGD) is an effective and important diagnostic tool to detect gastric cancer (GC). Although previous studies show that examiner, patient, and instrumental factors influence the detection of GC, we analyzed whether assigning a different examiner to surveillance EGD would improve the detection of GC compared to assigning the same examiner as in the previous endoscopy. We retrospectively reviewed patients who underwent two or more consecutive surveillance EGDs at a single center between 2017 and 2019.
View Article and Find Full Text PDFIntroduction: In early 2020, the Japanese government declared a nationwide state of emergency for the COVID-19 pandemic. We investigated the impact of the emergency declaration on endoscopy adherence and conducted a follow-up study of patients with canceled examinations at a tertiary endoscopy facility in Japan in 2020.
Methods: We compared the number of endoscopies performed, and cancelations at the endoscopy unit between 2019 and 2020 and used the Bayesian structural time series (BSTS) model to estimate the decrease in the number of endoscopies in 2020.
Article Synopsis
- Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for diagnosing pancreatic tumors, and this study focused on needle tract seeding (NTS) occurrences post-EUS-TA in Japan.
- A survey of over 12,000 patients revealed an overall NTS incidence of 0.330%, notably higher in those with pancreatic ductal adenocarcinomas (PDACs) compared to other tumors.
- NTS was only found after transgastric procedures, with the majority located in the gastric wall, and patients who underwent resection of NTS lesions had significantly better survival rates.
Novel anchoring device for endoscopic ultrasound-guided gallbladder drainage: Secondary publication.
J Hepatobiliary Pancreat Sci
July 2022
Background: Recently, endoscopic ultrasound-guided gallbladder drainage has attracted much attention. However, the risk management of adverse events and techniques to avoid them are not yet mature. Difficulty dilating the fistula with a dilator or placing a stent for drainage often prolongs the procedure time, which increases the risk of peritonitis or the procedure failure rate.
View Article and Find Full Text PDFArticle Synopsis
- Endoscopic submucosal dissection (ESD) is a minimally invasive procedure for early gastric cancer, but patients on anticoagulants face a higher risk of delayed bleeding.
- A study analyzed 1855 patients, finding that 21% of those on anticoagulants experienced delayed bleeding after ESD, with specific risks noted for warfarin users post-heart valve replacement.
- The study underscores the need for careful monitoring of patients on anticoagulants following ESD procedures, particularly those taking warfarin.
Objectives: Guidelines for magnified endoscopic diagnosis of esophageal squamous cell carcinoma (SCC) have been proposed by the Japan Esophageal Society. Type B1, B2, and B3 reflect increasing tumor invasion depths (within mucosal epithelium or into lamina propria mucosa [T1a-EP/LPM], into muscularis mucosa or superficial invasion into submucosa [T1a-MM/T1b-SM1], and into submucosa [T1b-SM2], respectively). The diagnostic accuracy of type B1 and B3 is high, but accuracy of type B2 is low.
View Article and Find Full Text PDFBackground: Secondary aortoenteric fistula is a rare but fatal complication after reconstructive surgery for an aortic aneurysm characterized by abdominal pain, fever, hematochezia, and hematemesis, and the mortality rate is high. It has been suggested that it arises due to either continuous physical stimulation or prosthesis infection during primary surgery. We describe an aortoenteric fistula following reconstructive surgery for an abdominal aortic aneurysm together with postmortem pathological findings.
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- Recent studies highlight the potential benefits of preoperative endoscopic ultrasonography-guided fiducial tattooing (EUS-tattooing) for pancreas tumor marking, though procedural challenges remain unresolved.
- This study analyzed six patients who underwent EUS-tattooing using a new injector to deliver a very small amount (0.02 mL) of a marking solution, a mix of sodium hyaluronate and India ink.
- Results showed that the tattoo mark could be successfully detected in five out of six patients during surgery, with no significant adverse events reported, indicating that EUS-tattooing may be safe and effective, but further research is needed.