Publications by authors named "Toshitatsu Takao"
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
- After esophagectomy, patients often experience anastomotic strictures that complicate food passage and increase the risk of aspiration pneumonia, potentially affecting quality of life and nutrition.
- A study of 188 patients who underwent minimally invasive esophagectomy identified that 23% developed strictures, with a significantly higher occurrence among those who had neoadjuvant chemotherapy.
- Early intervention—specifically within 69 days post-surgery—was found to be a crucial risk factor for requiring more than five balloon dilatations to treat strictures, indicating a need for careful treatment planning.
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
- EndoTrac is a new traction device designed to improve the control during endoscopic submucosal dissection (ESD) for gastric tumors, though its effectiveness is still under investigation.
- The G-Trac study is a multicenter trial in Japan that compares conventional ESD with EndoTrac ESD, enrolling patients with superficial gastric neoplasms and measuring outcomes like procedure time and safety.
- The study has received ethical approval and will share its findings through academic platforms, aiming to involve 142 participants for robust statistical analysis.
Background And Aims: Recent studies on endoscopic submucosal dissection have aimed to reduce the difficulty of the procedure by using multi-degrees-of-freedom articulating devices. In this study, we evaluated the usefulness of adding three-dimensional (3D) video imaging into simulated endoscopic submucosal dissection tasks using multi-degrees-of-freedom devices.
Methods: We designed an endoscopic platform with a 3D camera and two multi-degrees-of-freedom devices.
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.
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.
Article Synopsis
- Researchers investigated the characteristics and frequency of oxyntic gland neoplasms (OGNs) by analyzing data from patients diagnosed with OGN at an internal medicine clinic, finding an occurrence rate of 0.36% from a total of 7,488 patients.
- Out of 30 confirmed OGN lesions in 27 patients, a significant number occurred in non-atrophied stomach regions, with some patients not having any history of Helicobacter pylori infection.
- The study concluded that the prevalence of OGN is higher than previously believed and noted that specific small lesions in the stomach can be endoscopically treated, with no recurrences reported during follow-up.
Purpose: No study has focused on the safety and feasibility of our previously developed open-window suturing technique to close mucosal defects on the pancreatic side after endoscopic submucosal dissection from the opened duodenal wall. This study aimed to evaluate the safety and usefulness of laparoscopic endoscopic cooperative surgery for duodenal tumors for treating superficial non-ampullary duodenal epithelial tumors on the pancreatic side of the duodenum.
Methods: This retrospective study included 61 consecutive patients who underwent surgery during August 2014-November 2021.
Article Synopsis
- A new speech recognition (SR) system was developed to improve the efficiency of writing endoscopic reports, allowing endoscopists to input data more effectively during procedures.
- In a pilot study with 34 patients undergoing upper endoscopy, the SR system achieved a 100% correct recognition rate, with no revisions needed for the findings reported.
- The median time to register findings was just 2.57 seconds, showcasing a significant reduction in time compared to traditional reporting methods.
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.
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- The study investigates how different levels of artificial gastric acid affect the stability of fibrin glue combined with polyglycolic acid (PGA) sheets, which are used to prevent complications from endoscopic submucosal dissection.
- Fibrin glue dissolves at varying rates depending on the acidity, with complete dissolution occurring in as little as 2.5 hours at pH 1.2 and taking up to 48 hours at a pH of 5.5.
- To ensure the fibrin glue lasts longer in the stomach, it’s suggested to avoid acid conditions that activate pepsin, potentially by using strong antacids.
Background/aims: The anastomotic site after distal gastrectomy is the area most affected by duodenogastric reflux. Different reconstruction methods may affect the lesion characteristics and treatment outcomes of remnant gastric cancers at the anastomotic site. We retrospectively investigated the clinicopathologic and endoscopic submucosal dissection outcomes of remnant gastric cancers at the anastomotic site.
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- This study investigates risk factors and post-ESD management strategies for pyloric stenosis after endoscopic submucosal dissection (ESD).
- Researchers analyzed 159 pyloric ESD cases, identifying patients with circumferential mucosal defects ≥ 76% as high-risk for stenosis.
- They found that stenosis typically develops between weeks three to eight after the procedure, but most cases can be effectively treated with endoscopic balloon dilation without complications.
Background: Endoscopic submucosal dissection (ESD) for remnant gastric cancer (RGC) after distal gastrectomy (DG) is considered technically challenging due to the narrow working space, and severe fibrosis and staples from the previous surgery. Technical difficulties of ESD for RGC after DG have not been thoroughly investigated. This study aimed to develop and validate a risk-scoring system for assessing the technical difficulty of ESD for RGC after DG in a large multicenter cohort.
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- Adequate mucosal elevation is essential for safe and efficient endoscopic procedures, and this study investigates the use of fibrin glue (FG) as a long-lasting submucosal injection agent for endoscopic submucosal dissection (ESD).
- The study compared FG with hyaluronic acid and normal saline by injecting them into a porcine gastric specimen and measuring submucosal elevation over time.
- Results showed that FG produced the highest submucosal elevation, and successful ESD procedures were performed using FG, indicating its potential effectiveness in practical applications.
Background/aims: Application of polyglycolic acid (PGA) sheets using fibrin glue in post-endoscopic submucosal dissection (ESD) ulcers to prevent bleeding has been reported to be difficult with the conventional delivery method because of gravity. This study assessed the usefulness of the envelope-based delivery system with and against gravity in living pigs.
Methods: PGA sheets were applied on post-ESD ulcers with and against gravity six times each using the conventional and envelope methods, respectively.
Objective: Laparoscopic endoscopic cooperative surgery for duodenal tumors (D-LECS) has been developed to prevent duodenal leakage by reinforcing the endoscopic submucosal dissection site. However, there has been no prospective trial showing the feasibility of D-LECS. Herein, we conducted a single-arm confirmatory trial to evaluate the safety of D-LECS for non-ampullary superficial duodenal neoplasms.
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- Gastric adenocarcinoma with enteroblastic differentiation (GAED) is a rare subtype of alpha-fetoprotein-producing gastric cancer, characterized by cuboidal or columnar cells with clear cytoplasm that resemble primitive gut cells.
- GAED tends to be more aggressive than typical gastric cancer, showing significant signs of invasion, such as lymphovascular infiltration and metastasis to lymph nodes and the liver.
- This report presents a unique case of early-stage GAED that was successfully removed through endoscopic submucosal dissection, featuring a pure enteroblastic differentiation component without any conventional adenocarcinoma elements.