DEN open最新文献

{"title":"Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patients","authors":"Takeshi Uozumi,&nbsp;Satoru Nonaka,&nbsp;Yasuhiko Mizuguchi,&nbsp;Haruhisa Suzuki,&nbsp;Seiichiro Abe,&nbsp;Shigetaka Yoshinaga,&nbsp;Shigeki Sekine,&nbsp;Yutaka Saito","doi":"10.1002/deo2.70038","DOIUrl":"https://doi.org/10.1002/deo2.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pyloric gland adenoma (PGA) is a distinct subtype of duodenal adenoma. PGA has been increasingly recognized as a histologically and molecularly distinct entity; however, its endoscopic features have not been precisely described. This study aims to investigate the endoscopic characteristics of duodenal PGA, including the association of their putative precursors, Brunner's gland hyperplasia (BGH), and gastric epithelial heterotopia/metaplasia (GEM/H).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was a single-center, retrospective case series. Fourteen consecutive patients with duodenal PGA were retrieved from the pathological database. PGA was diagnosed according to the World Health Organization classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median tumor size was 22.5 mm (range: 12–40 mm), and 79% of cases were located in the first part of the duodenum. Six PGAs demonstrated high-grade dysplasia. PGA could be classified into two subtypes based on their appearance: villous lobulated type and smoothly protruding type. BGH and GEM/H were identified in the background mucosa in 28% and 7% of the cases, respectively. BGH was more abundant in the background mucosa of the PGA group than in the control group <i>(p</i> &lt; 0.05). Six PGAs (43%) exhibited high-grade dysplasia, and no significant difference was observed in the endoscopic findings between low- and high-grade dysplasia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The 14 patients with PGA demonstrated characteristic endoscopic findings. BGH and GEM/H might be precursors of PGA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to “The outcomes of endoscopic ultrasound-guided tissue acquisition for small focal liver lesions measuring ≤2 cm”","authors":"","doi":"10.1002/deo2.70039","DOIUrl":"https://doi.org/10.1002/deo2.70039","url":null,"abstract":"<p>Takano Y, Tamai N, Yamawaki M <i>et al.</i> The outcomes of endoscopic ultrasound-guided tissue acquisition for small focal liver lesions measuring ≤2 cm. <i>DEN Open</i> 2025; <b>5</b>: e70031.</p><p>1. In the abstract section, the next “The sensitivity, specificity, and accuracy rates were 96.8%, 100%, and 96.8%, respectively, in the ≤2 cm group and 97.4%, 100%, and 97.4%, respectively, in the &gt;2 cm group, with no significant differences between the groups. There was no difference in adverse events between the groups (0% in the ≤2 cm group and 2.3% in the &gt;2 cm group).” was incorrect.</p><p>This should have read: “The sensitivity, specificity, and accuracy rates were <span>96.5%</span>, 100%, and 96.8%, respectively, in the ≤2 cm group and <span>97.2%</span>, 100%, and 97.4%, respectively, in the &gt;2 cm group, with no significant differences between the groups. There was no difference in adverse events between the groups (0% in the ≤2 cm group and <span>2.5%</span> in the &gt;2 cm group). ” (Please correct the underlined numbers.)</p><p>2. In the result outcomes of the EUS-TA section, the next “The sensitivity, specificity, and accuracy rates of EUS-TA were 96.8%, 100%, and 96.8%, respectively, in the ≤2 cm group and 97.4%, 100%, and 97.4%, respectively, in the &gt;2cm group, with no significant differences between the two size groups. Moreover, there was no difference in adverse events between the two groups. There were two cases (2.3%) of mild abdominal pain in the &gt;2 cm group, but the pain resolved spontaneously.” was incorrect</p><p>This should have read: “The sensitivity, specificity, and accuracy rates of EUS-TA were <span>96.5%</span>, 100%, and 96.8%, respectively, in the ≤2 cm group and <span>97.2%</span>, 100%, and 97.4%, respectively, in the &gt;2 cm group, with no significant differences between the two size groups. Moreover, there was no difference in adverse events between the two groups. There were two cases (<span>2.5%</span>) of mild abdominal pain in the &gt;2 cm group, but the pain resolved spontaneously.” (Please correct the underlined numbers.)</p><p>3. The numbers in Table 3 are incorrect.\u0000\u0000 </p><p>The correct table is listed below: Please correct the underlined numbers.\u0000\u0000 </p><p>We apologize for this error.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PuraStat as secondary therapy for hemostasis in Mallory−Weiss syndrome with oral antithrombotic medication","authors":"Makoto Higashino,&nbsp;Hidehiro Murakami,&nbsp;Tetsu Hirata,&nbsp;Hiroaki Miyaoka","doi":"10.1002/deo2.70033","DOIUrl":"https://doi.org/10.1002/deo2.70033","url":null,"abstract":"<p>Mallory−Weiss syndrome (MWS) is a common cause of gastroesophageal bleeding. Vomiting increases intra-abdominal and intra-esophageal pressures, causing hyperextension of the esophagogastric junction and laceration. Most affected patients respond well to conservative treatment; however, those with active bleeding require endoscopic intervention. Upon contacting blood, PuraStat gels and coats the bleeding point to achieve hemostasis. PuraStat is reportedly effective for non-variceal bleeding and bleeding associated with endoscopic procedures. However, there have been no reports on the use of PuraStat in MWS. Here we report a case in which PuraStat was useful for achieving hemostasis in a patient with MWS and difficult-to-achieve hemostasis. The patient was a 67-year-old man who had undergone coronary artery bypass grafting 1 month earlier and was taking an antithrombotic drug. He visited our hospital with bloody vomiting and melena in the evening and was diagnosed with upper gastrointestinal bleeding for which he underwent endoscopy. MWS with active bleeding was observed in the lower esophagus extending to the esophagogastric junction. We treated the patient with clipping; however, the oozing did not stop because of the large laceration. We applied PuraStat to the bleeding site and confirmed that the oozing had resolved; therefore, the procedure was terminated. The endoscope was reinserted the next day and confirmed the hemostasis. The patient was discharged without further deterioration. In patients with MWS with active bleeding, endoscopic hemostasis is commonly achieved using clips or endoscopic band ligation. However, PuraStat can achieve complete hemostasis when these techniques fail.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of time from diagnosis to endoscopic submucosal dissection on curability in superficial esophageal squamous cell carcinoma","authors":"Daiki Sato,&nbsp;Maasa Sasabe,&nbsp;Tomohiro Mitsui,&nbsp;Yasuaki Furue,&nbsp;Takako Yoshii,&nbsp;Hiroki Hara,&nbsp;DaiJi Oka,&nbsp;Takashi Fukuda,&nbsp;Yusuke Yoda","doi":"10.1002/deo2.70035","DOIUrl":"10.1002/deo2.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the time delay effect from initial diagnosis to endoscopic submucosal dissection on superficial esophageal squamous cell carcinoma curability, considering the preoperative invasion depth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included superficial esophageal squamous cell carcinoma diagnosed as T1a-epithelial/lamina propria mucosa cancer (cEP/LPM; cancer invading up to the lamina propria mucosa) or cT1a-muscularis mucosa (MM)/T1b-submucosal cancer (cMM/SM1; cancer invading up to 200 µm into the submucosa) and treated using endoscopic submucosal dissection from January 2017 to December 2021. We compared curability in lesions treated within three months (early treatment group) versus those treated ≥7 months post-diagnosis (delayed treatment group). Curative resection criteria included lesions confined within the muscularis mucosae, with negative vertical margins, and with absence of lymphovascular invasion. Non-curative resection included all other cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 231 and 75 lesions in the early and delayed treatment groups, respectively, no significant difference was observed in non-curative resections for all lesions and cEP/LPM lesions (early: 194, delayed: 70). Conversely, the proportions were significantly higher in the delayed treatment group than in the early treatment group for cMM/SM1 lesions (early: 37, delayed: 5; <i>p</i> = 0.018).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study suggests that delayed endoscopic submucosal dissection does not significantly affect cEP/LPM lesions curability but is associated with reduced cMM/SM1 lesions curability. Prompt treatment is important for cMM/SM1, whereas delayed treatment may be acceptable for cEP/LPM.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The competency of the novel through-the-scope suture device for gastric mucosal defects: In vivo study in a porcine model (with video)","authors":"Mamoru Ito,&nbsp;Akira Dobashi,&nbsp;Takanori Tominaga,&nbsp;Toshiki Futakuchi,&nbsp;Naoto Tamai,&nbsp;Machi Suka,&nbsp;Kazuki Sumiyama","doi":"10.1002/deo2.70037","DOIUrl":"10.1002/deo2.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic closures of mucosal defects following endoscopic resection can be challenging and time-consuming. The novel through-the-scope suture device has demonstrated acceptable closure times, but its learning curve is still unknown. This study aims to evaluate the number of cases required to achieve competency in this device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two endoscopists participated; a novice with less than 400 experiences in upper gastrointestinal endoscopy and an expert with over 500 experiences in endoscopic submucosal dissection. Neither endoscopist had previous exposure to the device. In four porcine models, 24 gastric mucosal defects, each 2–4 cm in diameter, were created by endoscopic mucosal resection with ligation. Each endoscopist performed endoscopic closure for 12 mucosal defects with a single through-the-scope suture device per lesion. The primary endpoint was the number of cases needed to reach competency, defined as achieving a procedure time below the average closure time reported in the literature. Secondary endpoints included procedure time, complete closure success rates, and incidence of adverse events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean defect size was 2.9 (±0.2) cm. Competency was achieved after six cases in the expert and seven cases in the novice. The median closure time was 9.0 (interquartile range [IQR]: 6.0–11.0) min for the expert and 8.0 (IQR: 6.2–9.7) min for the novice (<i>p</i> = 0.862). Complete closure success rates were 75.0% (<i>n</i> = 9) for the expert and 83.3% (<i>n</i> = 10) for the novice. No adverse events were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A small number of cases were required for both expert and novice endoscopists to reach competency in the novel through-the-scope suture device.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of artificial intelligence endoscopic diagnosis and Kimura-Takemoto classification determined by endoscopic experts may effectively evaluate the stratification of gastric atrophy in post-eradication status","authors":"Kumiko Kirita,&nbsp;Seiji Futagami,&nbsp;Ken Nakamura,&nbsp;Shuhei Agawa,&nbsp;Nobue Ueki,&nbsp;Kazutoshi Higuchi,&nbsp;Mayu Habiro,&nbsp;Rie Kawawa,&nbsp;Yusuke Kato,&nbsp;Tomohiro Tada,&nbsp;Katsuhiko Iwakiri","doi":"10.1002/deo2.70029","DOIUrl":"10.1002/deo2.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Since it is difficult for expert endoscopists to diagnose early gastric cancer in post-eradication status, it may be critical to evaluate the stratification of high-risk groups using the advance of gastric atrophy or intestinal metaplasia. We tried to determine whether the combination of endoscopic artificial intelligence (AI) diagnosis for the evaluation of gastric atrophy could be a useful tool in both pre- and post-eradication status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>270 <i>Helicobacter pylori</i>-positive outpatients (Study I) were enrolled and Study II was planned to compare patients (<i>n</i> = 72) with pre-eradication therapy with post-eradication therapy. Assessment of endoscopic appearance was evaluated by the Kyoto classification and Kimura-Takemoto classification. The trained neural network generated a continuous number between 0 and 1 for gastric atrophy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were significant associations between the severity of gastric atrophy determined by AI endoscopic diagnosis and not having a regular arrangement of collecting venules in angle, visibility of vascular pattern, and mucus using Kyoto classification in <i>H. pylori</i>-positive gastritis. There were significant differences (<i>p</i> = 0.037 and <i>p</i> = 0.014) in the severity of gastric atrophy between the high-risk group and low-risk group based on the combination of Kimura-Takemoto classification and endoscopic AI diagnosis in pre- and post-eradication status. The area under the curve values of the severity of gastric atrophy (0.674) determined by the combination of Kimura-Takemoto classification and gastric atrophy determined by AI diagnosis was higher than that determined by Kimura-Takemoto classification alone in post-eradication status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A combination of gastric atrophy determined by AI endoscopic diagnosis and Kimura-Takemoto classification may be a useful tool for the prediction of high-risk groups in post-eradication status.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment outcomes of non-curative endoscopic submucosal dissection for superficial gastric neoplasia: A retrospective study at a tertiary care center in the United States","authors":"Sayaka Nagao,&nbsp;Makoto Nishimura,&nbsp;Mako Koseki,&nbsp;Jacques Beauvais,&nbsp;Monika Laszkowska,&nbsp;Laura Tang,&nbsp;Vivian E. Strong,&nbsp;Mark A. Schattner","doi":"10.1002/deo2.70034","DOIUrl":"10.1002/deo2.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Endoscopic submucosal dissection (ESD) is a minimally invasive treatment for early gastric cancer; additional treatment may be recommended for patients in whom resection is not curative per the American Society for Gastrointestinal Endoscopy guidelines. The aim of this study was to assess treatment outcomes of ESD for gastric neoplasia, with a focus on cases of non-curative resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective study of all individuals undergoing ESD for the treatment of gastric adenocarcinoma or dysplasia in a high-volume tertiary care center in the United States. Data on patient demographic characteristics, clinical history, lesion characteristics, and procedural and clinical outcomes were collected from the electronic medical record.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 82 cases undergoing ESD for the management of gastric neoplasia, 32 cases resulted in non-curative resection. 20 of these non-curative cases did not get additional treatment, among which recurrence occurred in two cases with positive horizontal margins only. These patients did not show lymph node metastasis and underwent further endoscopic or surgical resection. There was no recurrence in 11 cases with undifferentiated carcinomas of ≤2 cm in size.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although this study was limited by its retrospective design, small sample size, and follow-up duration, our findings suggest that a risk-adapted strategy could be employed for certain patients undergoing non-curative ESD per American Society for Gastrointestinal Endoscopy guidelines, with close follow-up instead of routine surgery in select cases with favorable features. Further studies are needed to refine the criteria for additional treatment after non-curative ESD in Western populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11547226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct observation of an exposed blood vessel in a colonic diverticulum using ultrathin endoscopy","authors":"Kensuke Suzuki,&nbsp;Daisuke Kikuchi,&nbsp;Satoshi Yamashita","doi":"10.1002/deo2.70032","DOIUrl":"10.1002/deo2.70032","url":null,"abstract":"<p>In recent years, cases of diverticular bleeding have become more common. Although identifying the bleeding diverticulum is difficult, it is even more difficult to identify the exposed blood vessels in the bleeding diverticulum. We experienced a case in which we succeeded in directly observing the exposed blood vessels of a sigmoid colon diverticulum using the ultrathin endoscope. The patient was a 71-year-old man who experienced rebleeding after hemostasis in the sigmoid colon by endoscopic band ligation. In the case of diverticular bleeding in the sigmoid colon, we showed that identifying exposed blood vessels by observing the diverticulum under direct vision using the ultrathin endoscope may be useful for hemostasis.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of primary duodenal Brunner's gland hamartoma that gradually underwent morphological changes over a period of 10 years","authors":"Yusuke Sunada,&nbsp;Hiromichi Yamane,&nbsp;Nobuaki Ochi,&nbsp;Hirohito Kirishi,&nbsp;Takako Saitou,&nbsp;Masafumi Miura,&nbsp;Hidekazu Nakanishi,&nbsp;Hideyo Fujiwara,&nbsp;Nagio Takigawa","doi":"10.1002/deo2.70028","DOIUrl":"10.1002/deo2.70028","url":null,"abstract":"<p>Brunner's gland hamartoma (BGH) is a benign tumor occurring in the duodenal bulb. BGH is typically asymptomatic, but it has been shown to occasionally cause anemia.</p><p>The patient was a 76-year-old male. In October 2011, he was diagnosed with prostate cancer with multiple bone metastases and was referred to us for the treatment and examination of anemia. Hormonal therapy with androgen receptor antagonists and bisphosphonate administration following orchiectomy improved his symptoms. In August 2012, esophagogastroduodenoscopy (EGD) was performed due to stomach discomfort, revealing a 5 mm semi-pedunculated polyp in the duodenal bulb, Yamada-Fukutomi classification type II. Over the next 5 years, the prostate cancer treatment proceeded smoothly, and no endoscopic follow-up was conducted. In January 2017, during a health checkup, EGD revealed that the polyp in the duodenum bulb had changed morphologically with a distinct stalk measuring 10 mm. As there were no symptoms and only minimal tumor growth, a watchful waiting approach was adopted. In April 2022, due to the rapid progression of anemia, EGD was performed again, showing that the pedunculated polyp had enlarged to 20 mm in maximum diameter with an eroded surface and a stalk extending to 40 mm. Given the tumor enlargement and further examination of anemia, an endoscopic polypectomy was performed in May 2022. Histopathological examination confirmed the diagnosis of BGH. We observed a case of primary duodenal BGH during treatment for advanced prostate cancer, with endoscopic monitoring over 10 years. The morphological changes of BGH were clearly documented via EGD.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical usefulness of hybrid endoscopic submucosal dissection for T1b colorectal carcinomas ≤20 mm to ensure adequate vertical margins","authors":"Yudai Takehara,&nbsp;Ken Yamashita,&nbsp;Shin Morimoto,&nbsp;Fumiaki Tanino,&nbsp;Noriko Yamamoto,&nbsp;Yuki Kamigaichi,&nbsp;Hidenori Tanaka,&nbsp;Hidehiko Takigawa,&nbsp;Yuji Urabe,&nbsp;Toshio Kuwai,&nbsp;Koji Arihiro,&nbsp;Shiro Oka","doi":"10.1002/deo2.70030","DOIUrl":"10.1002/deo2.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate endoscopic resection strategies for cT1b colorectal carcinomas (CRCs) ≤20 mm to determine strategies that enable adequate vertical margins (VMs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 128 consecutive patients with cT1b colorectal carcinomas ≤20 mm resected by endoscopic mucosal resection or hybrid endoscopic submucosal dissection (ESD). Tumor lifting conditions after submucosal injection were classified into type A (lifting, soft dome-like), type B (lifting, hard trapezoid-like), and non-lifting (positive non-lifting sign). Predictors of positive VMs (VM 1) and adequate VMs were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All non-lifting tumors were resected by hybrid ESD and VMs were ≥500 µm. Vertical margin 1 tumors were only found in the endoscopic mucosal resection group, in which, the proportion of type B tumors with VM 1 was significantly higher than that of tumors with negative VMs (<i>p</i> &lt; 0.01). Type A tumors showed no significant between-group differences. Among type B tumors, the proportion of VMs ≥500 µm was significantly higher (<i>p</i> &lt; 0.01) and the VM distance was significantly longer (<i>p</i> &lt; 0.01) in the hybrid ESD group than in the endoscopic mucosal resection group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Hybrid ESD can be selected for type B tumors to ensure adequate VMs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}