Publications by authors named "Yoji Takeuchi"
Background And Study Aims: Prophylactic clip closure after colorectal endoscopic submucosal dissection (ESD) among patients on anticoagulants is of uncertain effectiveness in reducing delayed bleeding (DB) risk. We aimed to assess the effect of prophylactic clip closure in preventing DB after colorectal ESD among patients on anticoagulants.
Patients And Methods: We used the ABCD-J study database, a large-scale multicenter study analyzing DB among 34,455 colorectal ESD cases from 47 Japanese institutions.
Background And Aims: Local recurrence is a significant concern in endoscopic resection of superficial nonampullary duodenal tumors (SNADTs). Our objective was to elucidate the clinical outcomes of salvage endoscopic treatment.
Methods: This retrospective study included consecutive patients who underwent endoscopic resection of SNADTs between January 2013 and December 2021.
Background And Aim: The risk of colorectal cancer among fecal immunochemistry test-positive individuals who had undergone previous colonoscopies remains unclear. Therefore, this study aimed to determine the differences in the risk of colorectal cancer among fecal immunochemistry test-positive individuals according to the timing of their previous colonoscopies.
Methods: This multicenter, retrospective, observational study was conducted in Japan as a subgroup analysis of the J-SCOUT study (UMIN000040690), which integrated and analyzed a database comprising all colonoscopies performed at participating Japanese institutions between 2010 and 2020.
Article Synopsis
- This study evaluates the effectiveness of AI-assisted computer-aided diagnosis (CAD) systems in identifying colorectal lesions, which is crucial for preventing colorectal cancer.
- The research involved 380 lesions from 139 patients, comparing the diagnostic accuracy of AI using different imaging techniques, with results showing that AI performance was similar to expert endoscopists when using magnified imaging.
- Findings suggest that while AI is a reliable tool for lesion differentiation, its accuracy can depend on both the imaging method used and the experience level of the endoscopist.
Article Synopsis
- * A total of 82,005 colonoscopy cases were analyzed, revealing 71 identified colorectal NENs, which corresponds to a detection rate of 0.087%. Most cases were small lesions in the rectum.
- * Findings suggest that the detection rate of colorectal NENs during colonoscopy is higher than previously anticipated, indicating the importance of thorough screening.
Article Synopsis
- In familial adenomatous polyposis (FAP) patients, fundic gland polyps (FGPs) are thought to increase the risk of gastric neoplasms, and this study explored how the distribution of these polyps relates to cancer development.
- A review of 195 FAP patients showed that those with a wider distribution of FGPs (classified from P0 to P4) had a higher likelihood of developing gastric neoplasms, particularly in those who were Helicobacter pylori-negative.
- The study concluded that the pattern of FGP distribution is significantly linked to gastric neoplasm risk in FAP patients, with the most severe distribution (P4) indicating the highest risk.
Objectives: This study investigated the incidence of lymph node metastasis and long-term outcomes in patients with T1 colorectal cancer where endoscopic submucosal dissection (ESD) resulted in noncurative treatment. It is focused on those with deep submucosal invasion, a factor considered a weak predictor of lymph node metastasis in the absence of other risk factors.
Methods: This nationwide, multicenter, prospective study conducted a post-hoc analysis of 141 patients with T1 colorectal cancer ≥20 mm where ESD of the lesion resulted in noncurative outcomes, characterized by poor differentiation, deep submucosal invasion (≥1000 μm), lymphovascular invasion, high-grade tumor budding, or positive vertical margins.
Video 1Three cases of underwater EMR for small gastric neoplasms in the reconstructed gastric conduit after esophagectomy.
View Article and Find Full Text PDF: Gastric cancer (GC) epidemiology and outcomes vary by gender. : We reviewed 18,436 GC patients from 2008 to 2018 and looked for gender differences in clinical characteristics and survival. : The gender proportion was 71% male and 29% female.
View Article and Find Full Text PDF1: ESGE recommends cold snare polypectomy (CSP), to include a clear margin of normal tissue (1-2 mm) surrounding the polyp, for the removal of diminutive polyps (≤ 5 mm).Strong recommendation, high quality of evidence. 2: ESGE recommends against the use of cold biopsy forceps excision because of its high rate of incomplete resection.
View Article and Find Full Text PDFBackground And Aim: Perforation is one of the most important complications of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Several studies have examined risk factors for intraoperative and delayed perforations, but most were retrospective analyses with small numbers of patients.
Methods: This study represents a secondary analysis of a Japanese multicenter prospective cohort study.
Article Synopsis
- The study examined 354 patients with primary small bowel adenocarcinoma (PSBA) in Japan, revealing a median age of 67 years and a majority being male (61.6%).
- The majority of tumors were located in the jejunum (66.2%) and ileum (30.4%), with over 76% of patients presenting symptoms at diagnosis, often at an advanced stage.
- The research found that clinical stage was the main predictor of disease-specific survival, emphasizing the importance of early detection for better patient outcomes.
Article Synopsis
- A new imaging technique called red dichromatic imaging (RDI) may improve the assessment of eosinophilic esophagitis severity compared to the traditional white-light imaging (WLI).
- In a study of 21 patients, those with higher RDI grades showed significantly higher peak eosinophil counts and more frequent heartburn symptoms.
- The findings suggest that RDI offers a more accurate way to evaluate the severity of eosinophilic infiltration in the esophagus.
Article Synopsis
- Endoscopic resection is a common local treatment for small rectal neuroendocrine tumors, but there's no clear consensus on the best method, prompting a comparison of two techniques: ESD and ESMR-L.
- The study is a prospective, multicenter, randomized trial involving 266 patients, evaluating the effectiveness of ESMR-L versus ESD, with the main goal of determining if ESMR-L offers similar rates of complete tumor removal (R0 resection).
- This trial will also assess additional factors like procedure time, costs, and complications, contributing to understanding the best approach for treating these tumors.
Article Synopsis
- This study explored the characteristics and outcomes of stage IV small bowel adenocarcinoma (SBA) in Japan, analyzing data from 128 patients to determine the effectiveness of different treatment strategies.
- The treatments included chemotherapy alone, surgery alone, surgery combined with chemotherapy, and best supportive care, revealing a median overall survival of 16 months, with the best outcomes seen in those receiving surgery and chemotherapy.
- Results indicated that patients who underwent surgery or chemotherapy had better survival rates compared to those with best supportive care, and survival did not significantly vary among different chemotherapy regimens.
Article Synopsis
- A study was conducted to evaluate the effectiveness of endoscopic resection (ER) for elderly patients (≥75 years) with early gastric cancer (EGC), as previous evidence was limited.
- The analysis involved 3,371 patients with 3,821 EGCs, highlighting key outcomes such as high rates of successful resections and low rates of complications, particularly for lesions within the established treatment guidelines.
- The findings suggest that lesions of ≤3 cm and those classified as elderly-low have the potential to be new indicators for ER suitability, demonstrating favorable curative outcomes for elderly patients.
Article Synopsis
- Patients with familial adenomatous polyposis (FAP) are at a higher risk of gastric neoplasms, including adenomas and cancer, and this study investigates their incidence over time.
- A cohort of 443 FAP patients was analyzed, revealing that by age 50, 22.8% had gastric adenomas and 7.6% had gastric cancer, with the highest risk for adenomas occurring around age 65.
- The study suggests that regular monitoring of the upper gastrointestinal tract in older FAP patients could improve early detection of gastric cancer, indicating a need for more frequent check-ups as patients age.
Article Synopsis
- The study evaluates the effectiveness of endoscopic submucosal dissection (ESD) as a treatment for local residual or recurrent colorectal tumors, building on previous findings that showed favorable long-term outcomes for large colorectal neoplasms.
- A multicenter prospective study involved 54 patients with local residual or recurrent tumors, where ESD successfully completed in 98.1% of cases and achieved high rates of en bloc and R0 resections.
- The results indicated that ESD is a safe and effective option for managing these challenging tumors, with no significant short-term complications and no tumor recurrences during a median follow-up of 60 months.
Article Synopsis
- * In a study of 451 FAP patients, 59% had duodenal polyps and 18% had ampullary polyps; duodenal cancer incidence was 4.7% and ampullary cancer was 18% in those with respective polyps.
- * The study suggests that patients with duodenal polyps require regular endoscopic monitoring, especially those with intermediate- or profuse-type APC variants, due to the high rate of progression of these polyps.*
Background: Esophageal endoscopic submucosal dissection (ESD) is technically challenging, especially for trainees, and requires a safe training system. This study aimed to identify predictors of technical difficulty facing trainees performing esophageal ESD to establish such system.
Methods: This was a single-center retrospective study of patients with esophageal cancer who underwent ESD performed by trainees between January 2010 and August 2022.
Article Synopsis
- The study investigates the link between pharmacokinetic parameters of direct oral anticoagulants (DOACs) and the risk of post-endoscopic submucosal dissection (ESD) bleeding, noting that GI bleeding is a significant concern.
- It found a 12.8% incidence of post-ESD bleeding in patients on DOACs, with factors such as age and FXa activity correlating significantly with bleeding risk.
- The research suggests that measuring drug levels and anticoagulant effectiveness could help identify patients at higher risk for bleeding after ESD procedures.