{"title":"Novel method using a surgical glove for retrieving large specimens during colorectal endoscopic submucosal dissection.","authors":"Yoshitsugu Misumi, Kouichi Nonaka","doi":"10.1111/den.15024","DOIUrl":"10.1111/den.15024","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"898-899"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hisatomo Ikehara, Ryoji Ichijima, Yoji Takeuchi, Jun Kanazawa, Takuya Wada, Kosuke Okuwaki, Tomoya Ueda, Hirofumi Kogure, Chika Kusano, Hiroyuki Ono
{"title":"Efficacy and safety of remimazolam for sedation during endoscopic procedures in Japanese: A prospective phase III clinical trial.","authors":"Hisatomo Ikehara, Ryoji Ichijima, Yoji Takeuchi, Jun Kanazawa, Takuya Wada, Kosuke Okuwaki, Tomoya Ueda, Hirofumi Kogure, Chika Kusano, Hiroyuki Ono","doi":"10.1111/den.15030","DOIUrl":"10.1111/den.15030","url":null,"abstract":"<p><strong>Objectives: </strong>Remimazolam is a general anesthetic with a short elimination half-life and its pharmacokinetics are less affected by liver and kidney function. It may be useful for sedation during endoscopic procedures in patients. This single-arm clinical trial aimed to evaluate the efficacy and safety of remimazolam for sedation in patients undergoing endoscopic procedures.</p><p><strong>Methods: </strong>Patients undergoing endoscopic procedures were included in this study. Remimazolam was administered intravenously with opioid analgesics, and the endoscopic procedure was started after an efficient level of sedation (Modified Observer's Assessment of Alertness/Sedation score ≤3) was achieved. The primary end-point for efficacy was the sedation success rate during the endoscopic procedures. Data on adverse events were collected for safety evaluation.</p><p><strong>Results: </strong>Sixty-two patients were included in the analysis. The sedation success rate of 93.5% (84.3-98.2%) exceeded the threshold success rate of 80% (P = 0.004). In all, 98.4% of patients were appropriately sedated before endoscope insertion. The median time from the first dose of remimazolam to achieving sedation was 4.0 min, while the median time from the end of the endoscopic procedure to being deemed ready to leave the room was 2.0 min. Adverse events were observed in 22 cases (35.5%). The severity of adverse events was moderate in five cases (8.1%), mild in 17 cases (27.4%), and there was no severe case.</p><p><strong>Conclusion: </strong>Sedation with remimazolam plus opioid analgesics was effective and well tolerated, regardless of endoscopic procedure site. These findings suggest that remimazolam is a useful sedative during endoscopic procedures.</p>","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"878-887"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gel-immersion-assisted endoscopic injection sclerotherapy under observation with Texture and Color enhancement imaging for esophageal varices.","authors":"Tsunetaka Kato, Takuto Hikichi, Takumi Yanagita","doi":"10.1111/den.15029","DOIUrl":"10.1111/den.15029","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":" ","pages":"895-897"},"PeriodicalIF":4.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yuki Takashina, S. Kudo, Y. Kouyama, K. Ichimasa, H. Miyachi, Y. Mori, T. Kudo, Y. Maeda, Y. Ogawa, Takemasa Hayashi, K. Wakamura, Enami Yuta, N. Sawada, T. Baba, T. Nemoto, F. Ishida, M. Misawa
{"title":"Whole slide images-based prediction of lymph node metastasis in T1 colorectal cancer using unsupervised artificial intelligence.","authors":"Yuki Takashina, S. Kudo, Y. Kouyama, K. Ichimasa, H. Miyachi, Y. Mori, T. Kudo, Y. Maeda, Y. Ogawa, Takemasa Hayashi, K. Wakamura, Enami Yuta, N. Sawada, T. Baba, T. Nemoto, F. Ishida, M. Misawa","doi":"10.2139/ssrn.4185475","DOIUrl":"https://doi.org/10.2139/ssrn.4185475","url":null,"abstract":"BACKGROUND AND AIMS\u0000Lymph node metastasis (LNM) prediction for T1 colorectal cancer (CRC) is critical for determining the need for surgery after endoscopic resection because LNM occurs in 10%. We aimed to develop a novel artificial intelligence (AI) system using whole slide images (WSIs) to predict LNM.\u0000\u0000\u0000METHODS\u0000We conducted a retrospective single center study. To train and test the AI model, we included LNM status-confirmed T1 and T2 CRC between April 2001 and October 2021. These lesions were divided into two cohorts: training (T1 and T2) and testing (T1). WSIs were cropped into small patches and clustered by unsupervised K-means. The percentage of patches belonging to each cluster was calculated from each WSI. Each cluster's percentage, sex, and tumor location were extracted and learned using the random forest algorithm. We calculated the areas under the receiver operator characteristics curves (AUCs) to identify the LNM and the rate of over-surgery of the AI model and the guidelines.\u0000\u0000\u0000RESULTS\u0000The training cohort contained 217 T1 and 268 T2 CRCs, while 100 T1 cases (LNM-positivity 15%) were the test cohort. The AUC of the AI system for the test cohort was 0.74 (95% confidence interval [CI], 0.58-0.86), and 0.52 (95% CI, 0.50-0.55) using the guidelines criteria (p=0.0028). This AI model could reduce the 21% of over-surgery compared to the guidelines.\u0000\u0000\u0000CONCLUSION\u0000We developed a pathologist-independent predictive model for LNM in T1 CRC using WSI for determination of the need for surgery after endoscopic resection.","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90837064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Esophagitis Dissecans Superficialis in a 49- year-old woman.","authors":"Noam Harpaz, Suparna A Sarkar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"28 2","pages":"238-9"},"PeriodicalIF":0.0,"publicationDate":"2016-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34667013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Esophageal stromal tumor.","authors":"Joseph Sung","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"24 1","pages":"66"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39967855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Brainteaser. Eosinophilic esophagitis.","authors":"Bjorn Rembacken","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"24 1","pages":"66-7"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39967892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Proceedings of the Endoscopy Forum, Japan 2007-2008.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":72813,"journal":{"name":"Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society","volume":"21 Suppl 1 ","pages":"S1-120"},"PeriodicalIF":0.0,"publicationDate":"2009-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28625069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}