Publications by authors named "Yusuke Saitoh"

Objectives: To date, there have been no reports on the long-term effects of a method that combines external hemorrhoidectomy with aluminum potassium sulfate and tannic acid (ALTA) sclerotherapy. This study aimed to investigate the efficacy and safety of external hemorrhoidectomy combined with ALTA sclerotherapy (EA) in reducing postoperative complications associated with conventional hemorrhoidectomy.

Methods: EA was performed under sacral epidural anesthesia, and ALTA sclerotherapy was applied to the remaining internal hemorrhoids after resection of the external hemorrhoids.

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  • The study aimed to evaluate the long-term outcomes, specifically overall survival (OS), of patients with T1 colorectal cancer (CRC) who underwent endoscopic resection (ER) followed by additional surgery (AS) compared to those who had primary surgery (PS) alone.
  • It involved analyzing data from 6,105 patients treated at various high-volume Japanese institutions and utilized propensity score matching to ensure comparability between the two groups.
  • The findings suggested that patients who underwent AS after ER had a 5-year OS rate of 97.1%, comparable to 96.0% for the PS group, indicating that ER before AS does not adversely affect long-term outcomes.
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  • 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.
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  • The study aimed to assess the effectiveness of pathological criteria from the JSCCR guidelines for determining the need for additional treatment in patients with pT1 colorectal carcinoma who had undergone local resection.
  • Researchers analyzed data from 4,667 patients and found that those with risk factors for lymph node metastasis had a significantly higher incidence of metastasis and recurrence, while those without risk factors had excellent survival rates.
  • Overall, the findings support the JSCCR criteria, highlighting their importance in identifying low-risk patients who can expect favorable outcomes post-resection.
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  • 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.
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Objectives: Double incontinence (DI), which is the co-occurrence of fecal incontinence (FI) and urinary incontinence (UI), increases with age and has a greater negative impact on the quality of life (QOL) than either incontinence alone. We aimed to assess lower urinary tract symptoms (LUTS) in patients with FI to elucidate the prevalence and characteristics of DI.

Methods: This study enrolled consecutive patients who visited our hospital with FI symptoms.

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Objectives: Conventional anal dilatation for anal fissures has long been abandoned because of the high incidence of anal incontinence. However, less invasive and more precise dilation techniques have been developed that have shown high healing and low incontinence rates. This study aimed to evaluate the efficacy and safety of controlled anal dilatation (CAD) using a standardized maximum anal diameter.

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  • The study investigates the impact of skipping additional surgery after local excision in patients with high-risk T1 colorectal cancer, questioning the need for invasive procedures when outcomes are similar.
  • Analyzing data from 1975 patients, the research matches 401 pairs to compare those who underwent extra surgery with those who didn’t.
  • Findings show that while the need for additional surgery resulted in slightly better overall survival rates, the LE-alone group experienced few complications and strong cancer-specific survival, highlighting the importance of tailored treatment plans.
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  • A novel nomogram was developed to assess the risk of lymph node metastasis (LNM) in patients with T1 colorectal cancer (CRC), incorporating various risk factors such as tumor budding and submucosal invasion depth.
  • The study analyzed data from 4,673 T1 CRC patients across 27 institutions, identifying six key risk factors and demonstrating strong predictive ability with a concordance index around .790.
  • This nomogram is the first of its kind to utilize real-world data and aims to enhance treatment strategies for patients diagnosed with T1 CRC based on comprehensive risk assessment.
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The Japan Gastroenterological Endoscopy Society published the second edition of the "Guidelines for Colorectal Endoscopic Submucosal Dissection/Endoscopic Mucosal Resection" in 2019 to clarify the indications for colorectal endoscopic mucosal resection (EMR) and endoscopic submucosal dissection and to ensure appropriate preoperative diagnoses as well as effective and safe endoscopic treatment in front-line clinical settings. Endoscopic resection with electrocautery, including polypectomy and EMR, is indicated for colorectal polyps. Recently, the number of facilities introducing and implementing cold polypectomy without electrocautery has increased.

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A series of workshops entitled "Advanced endoscopy in the management of inflammatory digestive disease" was held at the 97 to 100 biannual meeting of the Japan Gastroenterological Endoscopy Society. During these core sessions, research findings concerning various endoscopic practices in the field of inflammatory bowel disease (IBD) were presented, and meaningful discussions were shared on the evolving role and future challenges of endoscopy in IBD. This article reviews these core sessions and discusses current topics on the role of endoscopy, focusing on the diagnosis, disease monitoring, mucosal healing assessments, cancer surveillance, and therapeutic interventions in IBD.

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Background: Granulocyte and monocyte adsorptive apheresis (GMA) is widely used as a remission induction therapy for active ulcerative colitis (UC) patients. However, there are no available biomarkers for predicting the clinical outcome of GMA. We investigated the utility of Fecal calprotectin (FC) as a biomarker for predicting the clinical outcome during GMA therapy in active UC patients.

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Background: The Japanese Society of Gastroenterology (JSGE) published ''Daicho Polyp Shinryo Guideline 2014'' in Japanese and a part of this guideline was published in English as "Evidence-based clinical practice guidelines for management of colorectal polyps" in the Journal of Gastroenterology in 2015. A revised version of the Japanese-language guideline was published in 2020, and here we introduce a part of the contents of revised version.

Methods: The guideline committee discussed and drew up a series of clinical questions (CQs).

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Suitable lesions for endoscopic treatment include not only early colorectal carcinomas but also several types of precarcinomatous adenomas. It is important to establish practical guidelines wherein preoperative diagnosis of colorectal neoplasia and selection of endoscopic treatment procedures are appropriately outlined and to ensure that actual endoscopic treatment is useful and safe in general hospitals when carried out in accordance with guidelines. In cooperation with the Japanese Society for Cancer of the Colon and Rectum, the Japanese Society of Coloproctology, and the Japanese Society of Gastroenterology, the Japan Gastroenterological Endoscopy Society compiled colorectal endoscopic submucosal dissection/endoscopic mucosal resection guidelines by using evidence-based methods in 2014.

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Background: Autofluorescence imaging (AFI) is useful for diagnosing colon neoplasms, but what affects the AFI intensity remains unclear. This study investigated the association between AFI and the histological characteristics, aberrant methylation status, and aberrant expression in colon neoplasms.

Methods: Fifty-three patients with colorectal neoplasms who underwent AFI were enrolled.

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At each of the 89th to the 92nd congresses of the Japan Gastroenterological Endoscopy Society, a series of featured discussion sessions concerning advanced diagnostic endoscopy in the lower gastrointestinal tract were presented. In total, 45 lectures were presented in this subject area. It was shown that, in recent years, several convenient and less invasive colonoscopic modalities have been developed.

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The clinical importance of Crohn's disease (CD)-specific lesions in the upper gastrointestinal tract (upper GIT) has not been sufficiently established. The aim of this case-control study is to investigate the characteristic findings of CD in the upper GIT. In 2740 patients who underwent gastroduodenoscopy at Asahikawa Medical University between April 2011 and December 2012, 81 CD patients, 81 gender- and age-matched non-IBD patients, and 66 ulcerative colitis (UC) patients were investigated in the present study.

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Background And Aims: No endoscopic examination has been able to evaluate severity of ulcerative colitis (UC) by quantification. This prospective study investigated the efficacy of quantifying autofluorescence imaging (AFI) to assess the severity of UC, which captures the fluorescence emitted from intestinal tissue and then quantifies the intensity using an image-analytical software program.

Materials And Methods: Eleven endoscopists separately evaluated 135 images of conventional endoscopy (CE) and AFI from a same lesion.

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As a result of recent advances in endoscopic therapeutic technology, the number of endoscopic resections carried out in the treatment of early colorectal carcinomas with little risk of lymph node metastasis has increased. There are no reports of lymph node metastasis in intramucosal (Tis) carcinomas, whereas lymph node metastasis occurs in 6.8-17.

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Objectives: Conventional endoscopic resection (CER) is a widely accepted treatment for early colorectal neoplasia; however, large colorectal neoplasias remain problematic, as they necessitate piecemeal resection, increasing the risk of local recurrence. Endoscopic submucosal dissection (ESD) can improve the en bloc resection rate. This study aimed to evaluate local recurrence and its associated risk factors after endoscopic resection (ER) for colorectal neoplasias ≥20 mm.

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Colorectal endoscopic submucosal dissection (ESD) has become common in recent years. Suitable lesions for endoscopic treatment include not only early colorectal carcinomas but also many types of precarcinomatous adenomas. It is important to establish practical guidelines in which the preoperative diagnosis of colorectal neoplasia and the selection of endoscopic treatment procedures are properly outlined, and to ensure that the actual endoscopic treatment is useful and safe in general hospitals when carried out in accordance with the guidelines.

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Background: Recently in Japan, the morbidity of colorectal polyp has been increasing. As a result, a large number of cases of colorectal polyps that are diagnosed and treated using colonoscopy has now increased, and clinical guidelines are needed for endoscopic management and surveillance after treatment.

Methods: Three committees [the professional committee for making clinical questions (CQs) and statements by Japanese specialists, the expert panelist committee for rating statements by the modified Delphi method, and the evaluating committee by moderators] were organized.

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