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RISS 인기검색어
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- 저자 : Hideyuki Miyachi (검색결과 3 건)
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( Katsuro Ichimasa ),( Shin-ei Kudo ),( Hideyuki Miyachi ),( Yuta Kouyama ),( Masashi Misawa ),( Yuichi Mori ) 대한간학회 2021 Gut and Liver Vol.15 No.6
With the widely spreading population-based screening programs for colorectal cancer and recent improvements in endoscopic diagnosis, the number of endoscopic resections in subjects with T1 colorectal cancer has been increasing. Some reports suggest that endoscopic resection prior to surgical resection of T1 colorectal cancer has no adverse effect on prognosis and contributes to this tendency. The decision on the need for surgical resection as an additional treatment after endoscopic resection of T1 colorectal cancer should be made according to the metastasis risk to lymph nodes based on histopathological findings. Because lymph node metastasis occurs in approximately 10% of patients with T1 colorectal cancer according to current international guide lines, the remaining 90% of patients may be at an increased risk of surgical resection and associ ated postoperative mortality, with no clinical benefit derived from unnecessary surgical resection. Although a more accurate prediction system for lymph node metastasis is needed to solve this problem, risk stratification for lymph node metastasis remains controversial. In this review, we focus on the current status of risk stratification of T1 colorectal cancer metastasis to lymph nodes and outline future perspectives. (Gut Liver 2021;15:818-826)
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Analysis of Risk Factors for Colonic Diverticular Bleeding: A Matched Case-Control Study
( Yuusaku Sugihara ),( Shin Ei Kudo ),( Hideyuki Miyachi ),( Masashi Misawa ),( Shogo Okoshi ),( Hiroyuki Okada ),( Kazuhide Yamamoto ) 대한소화기학회 2016 Gut and Liver Vol.10 No.2
Background/Aims: Diverticular bleeding can occasionally cause massive bleeding that requires urgent colonoscopy (CS) and treatment. The aim of this study was to identify significant risk factors for colonic diverticular hemorrhage. Methods: Between January 2009 and December 2012, 26,602 patients underwent CS at our institution. One hundred twenty-three patients underwent an urgent CS due to acute lower gastrointestinal hemorrhage. Seventy-two patients were diagnosed with colonic diverticular hemorrhage. One hundred forty-nine age- and sex-matched controls were selected from the patients with nonbleeding diverticula who underwent CS during the same period. The relationship of risk factors to diverticular bleeding was compared between the cases and controls. Results: Uni- and multivariate conditional logistic regression analyses demonstrated that the use of nonsteroidal anti-inflammatory drugs (odds ratio [OR], 14.70; 95% confidence interval [CI], 3.89 to 55.80; p<0.0001), as well as the presence of cerebrovascular disease (OR, 8.66; 95% CI, 2.33 to 32.10; p=0.00126), and hyperuricemia (OR, 15.5; 95% CI, 1.74 to 138.00; p=0.014) remained statistically significant predictors of diverticular bleeding. Conclusions: Nonsteroidal anti-inflammatory drugs, cerebrovascular disease and hyperuricemia were significant risks for colonic diverticular hemorrhage. The knowledge obtained from this study may provide some insight into the diagnostic process for patients with lower gastrointestinal bleeding. (Gut Liver 2016;10:244-249)
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Clinical Efficacy of Endocytoscopy for Gastrointestinal Endoscopy
Masashi Misawa,Shin-ei Kudo,Yuki Takashina,Yoshika Akimoto,Yasuharu Maeda,Yuichi Mori,Toyoki Kudo,Kunihiko Wakamura,Hideyuki Miyachi,Fumio Ishida,Haruhiro Inoue 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.4
Endocytoscopy (EC) is a contact-type optical endoscope that allows in vivo cellular observation during gastrointestinal endoscopyand is now commercially available not only in Japan but also in Asian, European Union, and Middle Eastern countries. EC helpsconduct a highly accurate pathological prediction without biopsy. Initially, EC was reported to be effective for esophageal diseases. Subsequently, its efficacy for stomach and colorectal diseases has been reported. In this narrative review, we searched for clinicalstudies that investigated the efficacy of EC. EC seems to accurately diagnose gastrointestinal diseases without biopsy. Most of thestudies aimed to clarify the relationship between endocytoscopic findings of gastrointestinal neoplasia and pathological diagnosis. Some studies have investigated non-epithelial lesions or diseases, such as inflammatory bowel disease or infectious diseases. However, there are few high-level pieces of evidence, such as randomized trials; thus, further studies are needed.
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