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Metachronous Gastric Cancer Following Curative Endoscopic Resection of Early Gastric Cancer
Seiichiro Abe,Ichiro Oda,Takeyoshi Minagawa,Masau Sekiguchi,Satoru Nonaka,Haruhisa Suzuki,Shigetaka Yoshinaga,Amit Bhatt,Yutaka Saito 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.3
This review article summarizes knowledge about metachronous gastric cancer (MGC) occurring after curative endoscopic resection (ER)of early gastric cancer (EGC), treatment outcomes of patients who developed MGC, and efficacy of Helicobacter pylori eradication toprevent MGC. The incidence of MGC following curative ER increases over time and is higher than in patients undergoing gastrectomy. Increasing age and multifocal EGC are independent risk factors for developing MGC. An MGC following curative ER is usually a small(<20 mm) and differentiated intramucosal cancer. Most MGC lesions are found at an early stage on semiannual or annual surveillanceendoscopy and are successfully treated by further ER, with excellent long-term outcomes. Eradication of H. pylori may reduce the riskof MGC following ER of EGC, but further prospective studies with long-term outcomes are required. Surveillance endoscopy followinggastric ER should be continued indefinitely, due to the risk of MGC even after successful H. pylori eradication. Risk stratification andtailored endoscopic surveillance schedules need to be developed.
Endocuff-Assisted versus Cap-Assisted Colonoscopy Performed by Trainees: A Retrospective Study
Yutaka Okagawa,Tetsuya Sumiyoshi,Yusuke Tomita,Shutaro Oiwa,Fumihiro Ogata,Takashi Jin,Masahiro Yoshida,Ryoji Fujii,Takeyoshi Minagawa,Kohtaro Morita,Hideyuki Ihara,Michiaki Hirayama,Hitoshi Kondo 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.3
Background/Aims: The adenoma detection rate (ADR) of screening colonoscopies performed by trainees is often lower than thatof colonoscopies performed by experts. The effcacy of cap-assisted colonoscopy (CAC) in adenoma detection is well documented,especially that of CACs performed by trainees. Endocuff, a new endoscopic cap, is reportedly useful for adenoma detection; however,no trials have compared the effcacy of Endocuff-assisted colonoscopy (EAC) and CAC conducted by trainees. Therefore, the presentstudy retrospectively compared the effcacy between EAC and CAC in trainees. Methods: This was a single-center, retrospective study involving 305 patients who underwent either EAC or CAC performed by threetrainees between January and December 2018. We evaluated the ADR, mean number of adenomas detected per patient (MAP), cecalintubation rate, cecal intubation time, and occurrence of complications between the EAC and CAC groups. Results: The ADR was significantly higher in the EAC group than in the CAC group (54.3% vs. 37.3%, p=0.019), as was the MAP (1.36vs. 0.74, p=0.003). No significant differences were found between the groups with respect to the cecal intubation rate or cecal intubationtime. No major complications occurred in either group. Conclusions: Our results suggest that EAC exhibits increased ADR and MAP compared to CAC when performed by trainees.