Intestinal Research

Statement

Cancer

Clinical practice guideline for endoscopic resection of early gastrointestinal cancer: Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong Yeul Lee, Jeong-Sik Byeon, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Hoon Jai Chun; Intest Res 2021;19(2):127-157. Published online October 13, 2020; DOI: https://doi.org/10.5217/ir.2020.00020

Abstract PDF Supplementary Material PubReader ePub

Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.

Citations

Citations to this article as recorded by

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Risk factors and predictive nomogram for non-curative resection in patients with early gastric cancer treated with endoscopic submucosal dissection: a retrospective cohort study
Lihua Guo, Yong Ding, Jinfeng Wen, Min Miao, Kefeng Hu, Guoliang Ye
World Journal of Surgical Oncology.2025;[Epub] CrossRef
High Frequency of RhoGAP Fusion and Muscularis Mucosae Invasion in pT1a Gastric Adenocarcinoma Harboring Lymph Node Metastasis
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Pathology International.2025; 75(8): 414. CrossRef
Tissue engineering-based strategies of prevention and treatment for esophageal stenosis after endoscopic submucosal dissection
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Yinxin Wu
American Journal of Cancer Research.2024; 14(12): 5784. CrossRef
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D. H. Kim, B. C. Jin, H. H. Oh, H. Y. Song, S. J. Kim, D. S. Myung, H. S. Kim, S. W. Kim, J. Lee, Y. E. Joo, G. S. Seo
Endoscopy.2024; 56(S 02): S210. CrossRef
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Original Articles

Clinical Predictors Associated with the Severity of Colonic Diverticulitis: Su Jin Lee, Jeong Eun Shin, Sun Young Cho, Hoon Choi, Do Hyun Lee, Woo Hee Cho, Ha Yan Kang, Bae Hwan Kim, Joon Hyuk Lee, Hyun Duk Shin, Il Han Song; Intest Res 2013;11(1):23-27. Published online January 31, 2013; DOI: https://doi.org/10.5217/ir.2013.11.1.23

Abstract PDF

Background/Aims
Colonic diverticular diseases are increasing in Korea due to aging of the population and westernization of people's lifestyle. The aim of this study was to investigate the clinical predictors associated with the severity of colonic diverticulitis in Korea. Methods: We retrospectively reviewed the medical records of 107 patients who were hospitalized with diverticulitis and underwent abdominopelvic computerized tomography at Dankook University Hospital between March 2002 and August 2011. The severity of colonic diverticulitis was evaluated by using Modified Hinchey classification, stage 0 to stage Ia were classified as mild group and stage Ib to stage IV were classified as severe group. Patients' records were assessed for age, sex, underlying diseases, history of diverticulitis, associated symptoms, location of diverticulitis, white blood cells, and C-reactive protein (CRP). Results: Male to female ratio was 1.6:1 with the mean age of 43.1 years. Eighty-three patients (77.6%) were in the mild group and 24 patients (22.4%) were in the severe group. In multivariated analysis, the clinical predictors associated with the severity of colonic diverticulitis were left location (odds ratio [OR], 7.268; P=0.030), duration of symptoms (≥3 days; OR, 4.174; P=0.022), and elevated CRP (≥5 mg/dL; OR, 4.576; P=0.018). Conclusions: Left location, duration of symptom, and elevated CRP were the meaningful predictors for severity of colonic diverticulitis. When confronting with patients with these risk factors, we should keep in mind about the possibility of severe diverticulitis. (Intest Res 2013;11:23-27)

Citations

Citations to this article as recorded by

Is Colonoscopy Necessary after Computed Tomography Diagnosis of Acute Diverticulitis?
Min Jung Kim, Young Sik Woo, Eun Ran Kim, Sung Noh Hong, Dong Kyung Chang, Poong-Lyul Rhee, Jae J. Kim, Soon Jin Lee, Young-Ho Kim
Intestinal Research.2014; 12(3): 221. CrossRef

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The Characteristics of Colonoscopic Findings in Differentiating Crohn's Disease from Intestinal Tuberculosis: In Soo Je, Sang Hyuk Lee, Eun Uk Jung, Myoung Joo Kang, Sang Won Park, Paul Choi, Ji Hyun Kim, Sung Jae Park, Sam Ryong Jee, Eun Taek Park, Youn Jae Lee, Sang Yong Seol; Intest Res 2007;5(2):158-164. Published online December 30, 2007

Abstract PDF: Background/Aims
The incidence of Crohn's disease (CD) is on the increase in Korea. The differentiation of Crohn's disease from intestinal tuberculosis (IT) is difficult. The aim of this study is to determine the characteristics of colonoscopic findings and factors that differentiate CD from IT. Methods: A total of 136 patients who were diagnosed with CD or IT at the Busan Paik Hospital from January 1995 to May 2005 were included in this study. We analyzed endoscopic findings, clinical characteristics and histological findings of 75 patients with CD and 61 patients with IT retrospectively. Results: For patients with IT, 18 (58.1%) of the patients had circular ulcers. For patients with CD, 27 (42.1%) of the patients had transverse ulcers, 18 (28.1%) of the patients had longitudinal ulcer, and 19 (29.6%) of the patients had both types of ulcers. The involvement of the ileocecal valve was noted in 18 (58.0%) of the patients with CD and in 37 (57.8%) of the patients with IT. The involvement of the rectum or anus was noted in 24 (51.5%) of the patients with CD and one (3.2%) patient with IT. Conclusions: According to previous studies, the presence of an ulcer was important to differentiate CD from IT. However, the presence of an ulcer was not a significant differentiating factor in our study. On colonoscopic findings, involved segments, an aphthous ulcer, cobblestone appearance, involvement of the rectum or anus and mucosal bridge should be observed carefully. (Intest Res 2007;5:158-164)

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