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- 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
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Abstract
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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.
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Citations
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- 296 Download
- 29 Web of Science
- 24 Crossref
Original Articles
- Clinical Factors Predicting the Detection of Abnormalities by Double Balloon Endoscopy in Patients with Obscure Overt Gastrointestinal Bleeding
- Jun-Won Chung, Jeong-Sik Byeon, Kee Don Choi, Kwi-Sook Choi, Benjamin Kim, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim
- Intest Res 2006;4(2):95-100. Published online December 30, 2006
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Abstract
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- Background/Aims
The most frequent indication of double balloon endoscopy (DBE) is obscure gastrointestinal bleeding (OGIB). The aim of the study was to evaluate the clinical factors predicting the detection of bleeding focus by DBE in patients with overt OGIB. Methods: Twenty eight patients (male：female=16：12, 13-82 years) with overt OGIB who underwent DBE were enrolled. Medical records were reviewed and analyzed. Results: Bleeding focus was found in 21 patients (75.0%). Age, gender, time interval between the last blood passage and DBE, transfusion amount, hemodynamic instability, and the number of past bleeding episodes were not different between patients whose bleeding focus was found by DBE and those whose bleeding focus was not found. Duration of bleeding was significantly longer in patients whose bleeding focus was found by DBE than those whose bleeding focus was not found (196.8⁑238.5 vs. 15.5⁑13.7 days, p=0.04). Conclusions: Duration of bleeding may be a useful clinical parameter which predicts the detection of bleeding focus by DBE in overt OGIB. (Intestinal Research 2006;4:95-100)
- 1,878 View
- 20 Download
- Clinical Characteristics and Long-term Course of Ulcerative Colitis in Korea
- Young Min Kim, Sang Hyoung Park, Suk-Kyun Yang, Jae-Won Choe, Sai-Hui Kim, Jeong-Sik Byeon, Seung-Jae Myung, Yun Kyung Cho, Chang-Sik Yu, Kwi-Sook Choi, Jun-Won Chung, Benjamin Kim, Kee Don Choi, Jin-Ho Kim
- Intest Res 2006;4(1):12-21. Published online June 30, 2006
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Abstract
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- Background/Aims
Clinical characteristics of ulcerative colitis (UC) in Asian populations are not well recognized. We therefore investigated the clinical features and natural history of UC in Korea. Methods: We retrospectively analyzed 304 Korean UC patients first diagnosed at Asan Medical Center between June 1989 and August 2005. Results: The male to female ratio was 0.94：1 and the median age at diagnosis was 40.0 years (range, 12-72 years). At diagnosis, proctitis was noted in 134 patients (44.1%), left-sided colitis in 69 (22.7%), and extensive colitis in 101 (33.2%). Disease activity at diagnosis was mild in 149 patients (49.0%), moderate in 125 (41.1%), and severe in 26 (8.6%). In addition, 4 (1.3%) asymptomatic patients were detected as a result of a screening colonoscopy. Clinical remission after the first attack was documented in 97.4% of patients. The cumulative relapse rates at 1, 5, 10 years were 30.2%, 72.0%, and 88.4%, respectively. The cumulative risk of proximal extension in patients with proctitis or left-sided colitis was 33.0% at 5 years and 44.5% at 10 years. The cumulative probability of colectomy was 2.0% at 1 year, 2.8% at 3 years, and 3.3% at 5-15 years. The cumulative survival rates at 1, 5, and 10 years were 100%, 99.4%, and 97.4%, respectively. Conclusions: Clinical features of Korean UC patients at diagnosis are similar to those of Westerners. However, UC in Koreans may have a milder course than in Westerners, since Koreans have a lower rate of colectomy. (Intestinal Research 2006;4:12-21)
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- 37 Download
- Clinical Manifestations and Course of Intestinal Behet's Disease: An Analysis in Relation to Disease Subtypes
- Dae-Kyoum Kim, Suk-Kyun Yang, Jeong-Sik Byeon, Seung-Jae Myung, Ji-Yun Jo, Kee Don Choi, Gin Hyug Lee, Hwoon-Yong Jung, Weon-Seon Hong, Jin-Ho Kim, Young Il Min, Chang Sik Yu
- Intest Res 2005;3(1):48-54. Published online June 30, 2005
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Abstract
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- Background/Aims
Intestinal Behet's disease (BD) is one of the main causes of morbidity and mortality of BD because it frequently results in serious complications such as perforation and bleeding. But clinical course of intestinal BD is not well-known. The aim of this study was to review clinical manifestations of intestinal BD, and to compare clinical findings of complete and incomplete types with those of suspected type. Methods: From June 1989 to January 2005, 87 patients who had colonoscopic evidence of intestinal BD and met the criteria proposed by BD Research Committee of Japan were enrolled in this study. Clinical manifestations were collected by retrospective review of medical records. Results: Mean age at diagnosis was 38.4 years (14-66) and sex ratio was 2：1. Abdominal pain was the most frequent gastrointestinal symptom. A single, round ulcer localized at the ileocecal area was the most common colonoscopic finding. Cumulative incidence of first and second operation in 10 years was 30.9% and 38.2%, respectively. Clinical manifestations of suspected type were not different from those of complete and incomplete types. Conclusions: Long-term follow up and close observation is needed for patients with intestinal BD. Although suspected type does not meet the criteria proposed by International Study Group for BD, it should be considered as BD. (Intest Res 2005; 3:48-54)
- 1,865 View
- 20 Download
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