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Rino Hasegawa,Kenshi Yao,Shoutomi Ihara,Masaki Miyaoka,Takao Kanemitsu,Kenta Chuman,Go Ikezono,Akikazu Hirano,Toshiharu Ueki,Hiroshi Tanabe,Atsuko Ota,Seiji Haraoka,Akinori Iwashita 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.6
Background/Aims: While the occurrence of multiple whitish flat elevated lesions (MWFL) was first reported in 2007, no studieson MWFL have been published to date. The present retrospective observational study aimed to clarify the endoscopic findings andclinicopathological features of MWFL. Methods: Subjects were consecutive patients who underwent upper gastrointestinal endoscopy as part of routine screening betweenApril 2014 and March 2015. The conventional white-light, non-magnifying and magnifying narrow-band images were reviewed. Clinical features were compared between patients with and without MWFL. Results: The conventional endoscopic findings of MWFL include multiple whitish, flat, and slightly elevated lesions of various sizes,mainly located in the gastric body and fundus. Narrow-band imaging enhanced the contrast of MWFL and background mucosa,and magnifying narrow-band imaging depicted a uniformly long, narrow, and elliptical marginal crypt epithelium with an unclearmicrovascular pattern. Histopathological findings revealed hyperplastic changes of the foveolar epithelium, and parietal cell protrusionsand oxyntic gland dilatations were observed in the fundic glands, without any intestinal metaplasia. The rate of acid-reducing drug usewas significantly higher in patients with MWFL than in those without (100% [13/13] vs. 53.7% [88/164], p<0.001). Conclusions: The present study indicated a relationship between the presence and endoscopic features of MWFL and history of acidreducingdrug use.
Yoichiro Ono,Kenshi Yao,Yasuhiro Takaki,Satoshi Ishikawa,Kentaro Imamura,Akihiro Koga,Kensei Ohtsu,Takao Kanemitsu,Masaki Miyaoka,Takashi Hisabe,Toshiharu Ueki,Atsuko Ota,Hiroshi Tanabe,Seiji Haraoka 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.3
Background/Aims: Image-enhanced endoscopy can detect superficial oro-hypopharyngeal squamous cell carcinoma; however, reliable endoscopy of the pharyngeal region is challenging. Endoscopy under general anesthesia during transoral surgery occasionally reveals multiple synchronous lesions that remained undetected on preoperative endoscopy. Therefore, we aimed to determine the lesion detection capability of endoscopy under general anesthesia for superficial oro-hypopharyngeal squamous cell carcinoma. Methods: This retrospective study included 63 patients who underwent transoral surgery for superficial oropharyngeal squamous cell carcinoma between April 2005 and December 2020. The primary endpoint was to compare the lesion detection capabilities of preoperative endoscopy and endoscopy under general anesthesia. Other endpoints included the comparison of clinicopathological findings between lesions detected using preoperative endoscopy and those newly detected using endoscopy under general anesthesia. Results: Fifty-eight patients (85 lesions) were analyzed. The mean number of lesions per patient detected was 1.17 for preoperative endoscopy and 1.47 for endoscopy under general anesthesia. Endoscopy under general anesthesia helped detect more lesions than preoperative endoscopy did (p<0.001). The lesions that were newly detected on endoscopy under general anesthesia were small and characterized by few changes in color and surface ruggedness. Conclusions: Endoscopy under general anesthesia for superficial squamous cell carcinoma is helpful for detecting multiple synchronous lesions.