Intestinal Research

Original Article

Local recurrence and subsequent endoscopic treatment after endoscopic piecemeal mucosal resection with or without precutting in the colorectum: Myeongsook Seo, Eun Mi Song, Gwang Un Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon; Intest Res 2017;15(4):502-510. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.502

Background/Aims

Precutting before endoscopic piecemeal mucosal resection (EPMR) may increase colorectal polyp resection effectiveness. We aimed to identify risk factors for recurrence after conventional EPMR (CEPMR) and precut EPMR (PEPMR) and investigated endoscopic treatment outcomes for recurrent cases.

Methods

The medical records of patients with colorectal polyps treated by EPMR were analyzed. Patients without follow-up surveillance colonoscopies were excluded.

Results

Among 359 lesions, the local recurrence rate on the first surveillance colonoscopy was 5.8% (18/312) and 6.4% (3/47) after CEPMR and PEPMR, respectively. Among lesions without recurrence at the first surveillance colonoscopy, the rates of late recurrence on subsequent surveillance colonoscopy were 3.9% (6/152) and 0% after CEPMR and PEPMR, respectively. Larger tumor size was the only independent risk factor for recurrence (odds ratio, 7.93; 95% confidence interval, 1.95–32.30; P<0.001). Endoscopic treatment was performed for all 27 recurrences. A combination of ≥2 endoscopic treatment modalities was used in 19 of 27 recurrences (70.4%). Surveillance colonoscopies were performed in 20 of 27 recurrences after endoscopic treatment. One (5.0%) had a re-recurrence and was treated by surgical resection because recurrence occurred at the appendiceal orifice. Nineteen of 20 lesions (95.0%) could be cured endoscopically, although 3 of the 19 showed second or third recurrences and were treated by repeat endoscopic resection.

Conclusions

The local recurrence rates after CEPMR and PEPMR were similar. Larger tumor size was an independent risk factor for local recurrence after EPMR. Endoscopic treatment of recurrences resulted in high cure rates, although combination methods were necessary in many cases.

Citations

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The efficacy and safety of precutting-endoscopic mucosal resection for colorectal tumors: a systematic review and meta-analysis
Yi Chen, Zhengjie Wu
Minimally Invasive Therapy & Allied Technologies.2025; 34(3): 177. CrossRef
A systematic literature review of real-world evidence (RWE) on post-market assessment of medical devices
Stefania Manetti, Elisa Guidotti, Federico Vola, Milena Vainieri
Health Economics, Policy and Law.2025; : 1. CrossRef
Cold Versus Hot Endoscopic Mucosal Resection for Sessile Serrated Colorectal Polyps ≥10 mm
Talia F. Malik, Babu P. Mohan, Smit Deliwala, Lena L. Kassab, Saurabh Chandan, Neil R. Sharma, Douglas G. Adler
Journal of Clinical Gastroenterology.2024; 58(9): 889. CrossRef
Cold EMR vs. Hot EMR for the removal of sessile serrated polyps larger than 10 mm: a systematic review and meta-analysis
Cong Ding, Jian-feng Yang, Xia Wang, Yi-feng Zhou, Hayat Khizar, Zheng Jin, Xiao-feng Zhang
BMC Surgery.2024;[Epub] CrossRef
Hybrid Versus Conventional Endoscopic Submucosal Dissection for Laterally Spreading Tumors (LSTs): A Retrospective Multicenter Study
Hongxia Li, Yiping Hong, Linhua Yao, Xia Ji, Dan Chen, Maogen Tao, Huihui Yan, Jiamin Chen, Lingling Wang, Liyi Xu, Leilei Wang, Erfei Luo, Jianting Cai, Wei Wei
JGH Open.2024;[Epub] CrossRef
Does precutting prior to endoscopic piecemeal resection of large colorectal neoplasias reduce local recurrence? A KASID multicenter study
Hong Jin Yoon, Dae Kyung Sohn, Yunho Jung, Hyun Seok Lee, Hoon Sup Koo, Kyeong Ok Kim, Jeong Eun Shin, Hyun Gun Kim, Il Kwun Chung, Young Hwangbo
Surgical Endoscopy.2022; 36(5): 3433. CrossRef
Adenoma Recurrence after Endoscopic Piecemeal Mucosal Resection of Colorectal Flat Lesions: Applicability of the Sydney EMR Recurrence Tool in a Non-Tertiary Centre
Maria Azevedo Silva, Carina Leal, André Ruge, Alexandra Fernandes, Liliana Eliseu, Helena Vasconcelos
GE - Portuguese Journal of Gastroenterology.2022; 29(4): 247. CrossRef
Management of the malignant colorectal polyp
Matthew Symer, James Connolly, Heather Yeo
Current Problems in Surgery.2022; 59(5): 101124. CrossRef
Risk factors for local recurrence of large gastrointestinal lesions after endoscopic mucosal resection
Yasar Colak, Badar Hasan, Walid Hassaballa, Mamoon Ur Rashid, Victor Strassmann, Giovanna DaSilva, Steven D. Wexner, Tolga Erim
Techniques in Coloproctology.2022; 26(7): 545. CrossRef
Cost of Endoscopic Submucosal Dissection Versus Endoscopic Piecemeal Mucosal Resection in the Colorectum
Nam Seok Ham, Jeongseok Kim, Eun Hye Oh, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
Digestive Diseases and Sciences.2020; 65(4): 969. CrossRef
Clinical outcomes of submucosal colorectal cancer diagnosed after endoscopic resection: a focus on the need for surgery
Yun Sik Choi, Wan Soo Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
Intestinal Research.2020; 18(1): 96. CrossRef
Efficacy and Safety of Endoscopic Resection of Sessile Serrated Polyps 10 mm or Larger: A Systematic Review and Meta-Analysis
Viveksandeep Thoguluva Chandrasekar, Muhammad Aziz, Harsh K. Patel, Naaz Sidhu, Abhiram Duvvuri, ChandraShekhar Dasari, Kevin F. Kennedy, Ashwini Ashwath, Marco Spadaccini, Madhav Desai, Ramprasad Jegadeesan, Anjana Sathyamurthy, Prashanth Vennalaganti, D
Clinical Gastroenterology and Hepatology.2020; 18(11): 2448. CrossRef
Cold snare piecemeal EMR of large sessile colonic polyps ≥20 mm (with video)
Dileep Mangira, Karla Cameron, Koen Simons, Simon Zanati, Richard LaNauze, Spiro Raftopoulos, Gregor Brown, Alan Moss
Gastrointestinal Endoscopy.2020; 91(6): 1343. CrossRef

7,243 View
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13 Web of Science
13 Crossref

Case Report

Chronic intractable diarrhea caused by gastrointestinal mastocytosis: Hyungil Seo, Sang Hyoung Park, Jeong-Sik Byeon, Chang Gok Woo, Seung-Mo Hong, Kiju Chang, Hoonsub So, Minseob Kwak, Wan Soo Kim, Jeong-Mi Lee, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang; Intest Res 2016;14(3):280-284. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.280

Abstract PDF PubReader ePub

As mast cells have been highlighted in the pathogenesis of diarrhea-predominant irritable bowel syndrome, a new term "mastocytic enterocolitis" was suggested by Jakate and colleagues to describe an increase in mucosal mast cells in patients with chronic intractable diarrhea and favorable response to treatment with antihistamines. Although it is not an established disease entity, two cases have been reported in the English medical literature. Here, for the first time in Asia, we report another case of chronic intractable diarrhea caused by gastrointestinal mastocytosis. The patient was a 70-year-old male with chronic intractable diarrhea for 3 months; the cause of the diarrhea remained obscure even after exhaustive evaluation. However, biopsy specimens from the jejunum were found to have increased mast cell infiltration, and the patient was successfully treated with antihistamines.

Citations

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Mastocytic Enterocolitis: An Overlooked Diagnosis for Unexplained Chronic Diarrhea in a Patient With Colon Polyps and a Family History of Colon Cancer
Leeann Hu, Liliana Franco, Jignesh Parikh, Vania Zayat
Cureus.2023;[Epub] CrossRef
Systemic Mastocytosis: A Rare Cause of Diarrhea
Leonard Hamera, Andrew M Santos, Sean-Patrick A Prince, Sreekanth Chandrupatla, Jeffrey Jordan
Cureus.2020;[Epub] CrossRef
Gastrointestinal Manifestations of Hypereosinophilic Syndromes and Mast Cell Disorders: a Comprehensive Review
Vivian C. Nanagas, Anna Kovalszki
Clinical Reviews in Allergy & Immunology.2019; 57(2): 194. CrossRef
Mastocytosis
Jingtao Chen, Patrick Brady, Jay Mamel
The Nurse Practitioner.2019; 44(8): 17. CrossRef
The roles of mast cells in allergic inflammation and mast cell-related disorders
Hee-Kyoo Kim
Allergy, Asthma & Respiratory Disease.2017; 5(5): 248. CrossRef

9,518 View
93 Download
7 Web of Science
5 Crossref

Original Articles

Change in the diagnosis of inflammatory bowel disease: a hospital-based cohort study from Korea: Ho-Su Lee, Jaewon Choe, Hyo Jeong Lee, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Kim, Suk-Kyun Yang; Intest Res 2016;14(3):258-263. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.258

Abstract PDF PubReader ePub

Background/Aims

Accurately diagnosing inflammatory bowel disease (IBD) remains a challenge, but is crucial for providing proper management for affected patients. The aim of the present study was to evaluate the frequency of change in diagnosis in Korean patients who were referred to our institution with a diagnosis of IBD.

Methods

We enrolled 1,444 patients diagnosed with ulcerative colitis (UC) and 1,452 diagnosed with Crohn's disease (CD), who had been referred to the Asan Medical Center between January 2010 and December 2014. These patients were assessed and subsequently classified as having UC, CD, indeterminate colitis, possible IBD, or non-IBD.

Results

During a median follow-up of 15.9 months, 400 of the 2,896 patients (13.8%) analyzed in this study experienced a change in diagnosis. A change in diagnosis from UC to CD, or vice-versa, was made in 24 of 1,444 patients (1.7%) and 23 of 1,452 patients (1.6%), respectively. A change to a non-IBD diagnosis was the most common modification; 7.5% (108 of 1444) and 12.7% (184 of 1452) of the patients with a referral diagnosis of UC and CD, respectively, were reclassified as having non-IBD. Among the 292 patients who were ultimately determined not to have IBD, 135 (55 UC and 80 CD cases) had received IBD-related medication.

Conclusions

There are diagnostic uncertainties and difficulties in relation to IBD. Therefore, precise assessment and systematic follow-up are essential in the management of this condition.

Citations

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Diagnosis change in pediatric inflammatory bowel disease
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Muhammad Z Ali, Muhammad Usman Tariq, Muhammad Hasan Abid, Hamma Abdulaziz, Mohmmad AlAdwani, Arif Khurshid, Muhammad Rashid, Fawaz Al Thobaiti , Amjad Althagafi
Cureus.2023;[Epub] CrossRef
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Guglielmo Albertini Petroni, Laura Francesca Pisani, Edoardo Borsotti, Maria Doria, Maria Laura Annunziata
SAGE Open Medical Case Reports.2023;[Epub] CrossRef
Thirty-year Trend in Inflammatory Bowel Disease on Jeju Island, South Korea
Jin Woo Kim, Hyun Joo Song, Sun-Jin Boo, Heung Up Kim, Ki Soo Kang, Soo-Young Na
The Korean Journal of Gastroenterology.2023; 81(6): 243. CrossRef
PD-1-positive cells contribute to the diagnosis of inflammatory bowel disease and can aid in predicting response to vedolizumab
Min Kyu Kim, Su In Jo, Sang-Yeob Kim, Hyun Lim, Ho Suk Kang, Sung‑Hoon Moon, Byong Duk Ye, Jae Seung Soh, Sung Wook Hwang
Scientific Reports.2023;[Epub] CrossRef
IBD barriers across the continents – East Asia
Joyce Wing Yan Mak, Agnes Hiu Yan Ho, Siew Chien Ng
Therapeutic Advances in Gastroenterology.2023;[Epub] CrossRef
Inflammatory bowel disease in Korea: epidemiology and pathophysiology
Jung Won Lee, Chang Soo Eun
The Korean Journal of Internal Medicine.2022; 37(5): 885. CrossRef
Systematic evaluation of the diagnostic approach of inflammatory bowel disease guidelines
Bing‐He Xiao, Xu‐Dong Ma, Jia‐Jun Lv, Ting Yang, Xin‐Jie Liu, Li‐Ya An, Yu‐Xing Qi, Ming‐Liang Lu, Yong‐Qing Duan, Da‐Li Sun
International Journal of Clinical Practice.2021;[Epub] CrossRef
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Yong-Sung Choi, Jong-Kyu Kim, Wan-Jung Kim
World Journal of Gastrointestinal Endoscopy.2021; 13(9): 407. CrossRef
Current status of inflammatory bowel diseases in Korea
Suk-Kyun Yang
Journal of the Korean Medical Association.2021; 64(9): 572. CrossRef
EpidemIBD: rationale and design of a large-scale epidemiological study of inflammatory bowel disease in Spain
María Chaparro, Manuel Barreiro-de Acosta, José Manuel Benítez, José Luis Cabriada, María José Casanova, Daniel Ceballos, María Esteve, Hipólito Fernández, Daniel Ginard, Fernando Gomollón, Rufo Lorente, Pilar Nos, Sabino Riestra, Montserrat Rivero, Pilar
Therapeutic Advances in Gastroenterology.2019;[Epub] CrossRef
Illuminating an Invisible Epidemic: A Systemic Review of the Clinical and Economic Benefits of Early Diagnosis and Treatment in Inflammatory Disease and Related Syndromes
Lukasz S. Wylezinski, Jamieson D. Gray, Julia B. Polk, Andrew J. Harmata, Charles F. Spurlock
Journal of Clinical Medicine.2019; 8(4): 493. CrossRef
Impact of Cumulative Corticosteroid Dosage on Preventable Hospitalization among Taiwanese Patients with Ankylosing Spondylitis and Inflammatory Bowel Disease
Beth I. Wallace, Chelsea A. Harris, Lu Wang, Mochuan Liu, Jung-Sheng Chen, Chang-Fu Kuo, Kevin C. Chung
Journal of Clinical Medicine.2019; 8(5): 614. CrossRef
Perforated diverticulitis in the setting of ulcerative colitis: An unusual case report
M. Baimas-George, L. Cetrulo, A. Kao, K.R. Kasten
International Journal of Surgery Case Reports.2018; 49: 126. CrossRef
Assessment of factors associated with smoking cessation at diagnosis or during follow‐up of Crohn's disease
Eun Mi Song, Gwang‐Un Kim, Myeongsook Seo, Sung Wook Hwang, Sang Hyoung Park, Eunja Kwon, Ho‐Su Lee, Dong‐Hoon Yang, Kyung‐Jo Kim, Byong Duk Ye, Jeong‐Sik Byeon, Seung‐Jae Myung, Suk‐Kyun Yang
Journal of Gastroenterology and Hepatology.2018; 33(1): 180. CrossRef
Incidence and Clinical Outcomes of Inflammatory Bowel Disease in South Korea, 2011–2014: A Nationwide Population-Based Study
Yoon Suk Jung, Minkyung Han, Won Ho Kim, Sohee Park, Jae Hee Cheon
Digestive Diseases and Sciences.2017; 62(8): 2102. CrossRef
Human alpha defensin 5 is a candidate biomarker to delineate inflammatory bowel disease
Amanda D. Williams, Olga Y. Korolkova, Amos M. Sakwe, Timothy M. Geiger, Samuel D. James, Roberta L. Muldoon, Alan J. Herline, J. Shawn Goodwin, Michael G. Izban, Mary K. Washington, Duane T. Smoot, Billy R. Ballard, Maria Gazouli, Amosy E. M'Koma, Shree
PLOS ONE.2017; 12(8): e0179710. CrossRef
Clinical course of ulcerative colitis patients who develop acute pancreatitis
Jong Wook Kim, Sung Wook Hwang, Sang Hyoung Park, Tae Jun Song, Myung-Hwan Kim, Ho-Su Lee, Byong Duk Ye, Dong-Hoon Yang, Kyung-Jo Kim, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
World Journal of Gastroenterology.2017; 23(19): 3505. CrossRef
Overall and cause‐specific mortality in Korean patients with inflammatory bowel disease: A hospital‐based cohort study
Ho‐Su Lee, Jaewon Choe, Seon‐Ok Kim, Sun‐Ho Lee, Hyo Jeong Lee, Hyungil Seo, Gwang‐Un Kim, Myeongsook Seo, Eun Mi Song, Sung Wook Hwang, Sang Hyoung Park, Dong‐Hoon Yang, Kyung‐Jo Kim, Byong Duk Ye, Jeong‐Sik Byeon, Seung‐Jae Myung, Yong Sik Yoon, Chang S
Journal of Gastroenterology and Hepatology.2017; 32(4): 782. CrossRef
Endoscopic Diagnosis and Differentiation of Inflammatory Bowel Disease
Ji Min Lee, Kang-Moon Lee
Clinical Endoscopy.2016; 49(4): 370. CrossRef

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Clinical Features and Prognosis of Resectable Primary Colorectal Signet-Ring Cell Carcinoma: Ho-Su Lee, Jae Seung Soh, Seohyun Lee, Jung Ho Bae, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Sun A Kim, Young Soo Park, Seok-Byung Lim, Jin Cheon Kim, Chang Sik Yu, Dong-Hoon Yang; Intest Res 2015;13(4):332-338. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.332

Abstract PDF PubReader ePub

Background/Aims

We attempted to investigate the prognosis of signet-ring cell carcinoma (SRC) patients who underwent curative surgery by comparing them with age-, sex-, and stage-matched non-mucinous adenocarcinoma (NMAC) patients.

Methods

Between January 2003 and December 2011, 19 patients with primary SRC of the colorectum underwent curative surgery. Four SRC patients under the age of 40 were excluded, and the clinicopathological data of 15 patients (7 men; median age, 56 years) were reviewed and compared with the data of 75 NMAC patients matched by age, sex, and pathologic stage.

Results

The median follow-up duration was 30.1 months for the SRC group and 43.7 months for the NMAC group (P=0.141). Involvement of the left side of the colon (73.3% vs. 26.7%, P=0.003) and infiltrative lesions such as Borrmann types 3 and 4 (85.7% vs. 24.0%, P=0.001) were more common in the SRC group than in the NMAC group. The five-year overall survival rate was significantly lower for patients with SRC than for those with NMAC (46.0% vs. 88.7%, hazard ratio, 6.99; 95% confidence interval, 2.33-20.95, P=0.001).

Conclusions

Patients with even resectable primary colorectal SRC had a poorer prognosis than age-, sex-, and stage-matched colorectal NMAC patients.

Citations

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Prognostic implications of T stage in different pathological types of colorectal cancer: an observational study using SEER population-based data
Nan Yao, Wenqiang Li, Jiwei Wang, Hongyuan Chu, Ning Duan, Xinyu Niu, Guoyong Yu, Jun Qu
BMJ Open.2024; 14(2): e076579. CrossRef
Systematic review of risk factors, prognosis, and management of colorectal signet-ring cell carcinoma
Frederiek Nuytens, Vincent Drubay, Clarisse Eveno, Florence Renaud, Guillaume Piessen
World Journal of Gastrointestinal Oncology.2024; 16(5): 2141. CrossRef
Modeling the survival of colorectal cancer patients based on colonoscopic features in a feature ensemble vision transformer
Chung-Ming Lo, Yi-Wen Yang, Jen-Kou Lin, Tzu-Chen Lin, Wei-Shone Chen, Shung-Haur Yang, Shih-Ching Chang, Huann-Sheng Wang, Yuan-Tzu Lan, Hung-Hsin Lin, Sheng-Chieh Huang, Hou-Hsuan Cheng, Jeng-Kai Jiang, Chun-Chi Lin
Computerized Medical Imaging and Graphics.2023; 107: 102242. CrossRef
Metastatic colorectal carcinoma with signet-ring cells: Clinical, histological and molecular description from an Association des Gastro-Entérologues Oncologues (AGEO) French multicenter retrospective cohort
Marion Allart, Florence Leroy, Stephano Kim, David Sefrioui, Mihane Nayeri, Aziz Zaanan, Benoit Rousseau, Meher Ben Abdelghani, Christelle de la Fouchardière, Wulfran Cacheux, Romain Legros, Samy Louafi, David Tougeron, Olivier Bouché, Nadim Fares, Guilla
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Xueting Liu, Litao Huang, Menghan Liu, Zhu Wang
Medicina.2022; 58(7): 836. CrossRef
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Michael G. Fadel, George Malietzis, Vasilis Constantinides, Gianluca Pellino, Paris Tekkis, Christos Kontovounisios
Discover Oncology.2021;[Epub] CrossRef
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Lili Zhu, Chunrun Ling, Tao Xu, Jinglin Zhang, Yujie Zhang, Yingjie Liu, Chao Fang, Lie Yang, Wen Zhuang, Rui Wang, Jie Ping, Mojin Wang
Pathology and Oncology Research.2021;[Epub] CrossRef
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Jie Mao, Peng Du, Han-teng Yang, Huan Hu, Shi-Yao Wang, Xia Wu, Zhi-Bin Cheng
Medicine.2020; 99(14): e19420. CrossRef
Primary signet ring cell carcinoma with tubular adenoma of the rectum
Yong-Ping Yang, Ling-Yun Yu, Jian Shi, Jian-Nan Li, Xin-Yu Wang, Tong-Jun Liu
Medicine.2020; 99(26): e20985. CrossRef
Prognosis of Signet Ring Cell Carcinoma of the Colon and Rectum and their Distinction of Mucinous Adenocarcinoma with Signet Ring Cells. A Comparative Study
Luis I. Pozos-Ochoa, Leonardo S. Lino-Silva, Alberto M. León-Takahashi, Rosa A. Salcedo-Hernández
Pathology & Oncology Research.2018; 24(3): 609. CrossRef
Impact of histological subtype on the prognosis of patients undergoing surgery for colon cancer
Fabio Bagante, Gaya Spolverato, Eliza Beal, Katiuscha Merath, Qinyu Chen, Ozgür Akgül, Robert A. Anders, Timothy M. Pawlik
Journal of Surgical Oncology.2018; 117(7): 1355. CrossRef
Prognosis and value of preoperative radiotherapy in locally advanced rectal signet-ring cell carcinoma
Chun-Run Ling, Rui Wang, Mo-Jin Wang, Jie Ping, Wen Zhuang
Scientific Reports.2017;[Epub] CrossRef
The Characteristics and Prognostic Effect of E-Cadherin Expression in Colorectal Signet Ring Cell Carcinoma
Renjie Wang, Xiaoji Ma, Yaqi Li, Yiping He, Dan Huang, Sanjun Cai, Junjie Peng, Javier S Castresana
PLOS ONE.2016; 11(8): e0160527. CrossRef
Younger Age Is Associated with Poorer Survival in Patients with Signet-Ring Cell Carcinoma of the Colon without Distant Metastasis
Ben Huang, Mengdong Ni, Chen Chen, Yang Feng, Sanjun Cai
Gastroenterology Research and Practice.2016; 2016: 1. CrossRef

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14 Crossref

Colonic Chicken Skin Mucosa is an Independent Endoscopic Predictor of Advanced Colorectal Adenoma: Eun Ju Chung, Ji Young Lee, Jaewon Choe, Hye-Sook Chang, Jongcheol Kim, Dong Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Kyung-Jo Kim, Suk-Kyun Yang, Jin-Ho Kim, Seung-Jae Myung; Intest Res 2015;13(4):318-325. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.318

Abstract PDF PubReader ePub

Background/Aims

Chicken skin mucosa (CSM), surrounding colorectal adenoma, is an endoscopic finding with pale yellow-speckled mucosa; however, its clinical significance is unknown. This study aimed to evaluate the prevalence and clinical characteristics of CSM, and the association between colorectal carcinogenesis and CSM.

Methods

This cross-sectional study was performed in 733 consecutive patients who underwent endoscopic polypectomy for colorectal adenoma after the screening of colonoscopy at the Asan Health Promotion Center between June 2009 and December 2011. The colonoscopic and pathological findings of colorectal adenoma including number, size, location, dysplasia, morphology, and clinical parameters were reviewed.

Results

The prevalence of CSM was 30.7% (225 of 733 patients), and most CSM-related adenomas were located in the distal colon (93.3%). Histological analysis revealed lipid-laden macrophages in the lamina propria of the mucosa. Multivariate analyses showed that CSM was significantly associated with advanced pathology, including villous adenoma and high-grade dysplasia (odds ratio [OR], 2.078; 95% confidence interval [CI], 1.191-3.627; P=0.010), multiple adenomas (i.e., ≥2 adenomas; OR, 1.692; 95% CI, 1.143-2.507; P=0.009), and a protruding morphology (OR, 1.493; 95% CI, 1.027-2.170; P=0.036). There were no significant differences in polyp size or clinical parameters between patients with and without CSM.

Conclusions

CSM-related adenoma was mainly found in the distal colon, and was associated with advanced pathology and multiple adenomas. CSM could be a potential predictive marker of the carcinogenetic progression of distally located colorectal adenomas.

Citations

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Mucosa color and size may indicate malignant transformation of chicken skin mucosa-positive colorectal neoplastic polyps
Ying-Jie Zhang, Meng-Xia Yuan, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Ye Yang, Feng-Lin Chen
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Kai Korekawa, Yusuke Shimoyama, Fumiyoshi Fujishima, Hiroshi Nagai, Takeo Naito, Rintaro Moroi, Hisashi Shiga, Yoichi Kakuta, Yoshitaka Kinouchi, Atsushi Masamune
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Ying-Jie Zhang, Wu Wen, Fan Li, Yi Jian, Chuan-Ming Zhang, Meng-Xia Yuan, Ye Yang, Feng-Lin Chen
World Journal of Gastrointestinal Oncology.2023; 15(6): 1062. CrossRef
Characteristics and potential malignancy of colorectal juvenile polyps in adults: a single-center retrospective study in China
Jie Dong, Tian-Shi Ma, Yuan-Hong Xu, Peng Li, Wan-Yuan Chen, Jiang-Feng Tu, You-Wei Chen
BMC Gastroenterology.2022;[Epub] CrossRef
Colonic Chicken Skin Mucosa Surrounding Colon Polyps Is an Endoscopic Predictive Marker for Colonic Neoplastic Polyps
Yu Mi Lee, Kyung Ho Song, Hoon Sup Koo, Choong-Sik Lee, Inseok Ko, Sang Hyuk Lee, Kyu Chan Huh
Gut and Liver.2022; 16(5): 754. CrossRef
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You-Wei Chen, Jiang-Feng Tu, Wen-Juan Shen, Wan-Yuan Chen, Jie Dong
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Hepatitis B Virus Infection Is Independently Associated With Advanced Colorectal Adenoma
Su Hwan Kim, Ji Won Kim, Kook Lae Lee, Seohui Lee, Seong-Joon Koh, Ji Bong Jeong, Byeong Gwan Kim
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Adriana Ciocalteu, Dan Ionut Gheonea, Adrian Saftoiu, Liliana Streba, Nicoleta Alice Dragoescu, Tiberiu Stefanita Tenea-Cojan
World Journal of Gastrointestinal Oncology.2018; 10(12): 465. CrossRef

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83 Download
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9 Crossref

Case Report

Natural Course of an Untreated Metastatic Perirectal Lymph Node After the Endoscopic Resection of a Rectal Neuroendocrine Tumor: Sang Hyung Kim, Dong-Hoon Yang, Jung Su Lee, Soyoung Park, Ho-Su Lee, Hyojeong Lee, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Chan Wook Kim, Jihun Kim; Intest Res 2015;13(2):175-179. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.175

Abstract PDF PubReader

Lymph node metastasis is rare in small (i.e., <10 mm) rectal neuroendocrine tumors (NETs). In addition to tumor size, pathological features such as the mitotic or Ki-67 proliferation index are associated with lymph node metastasis in rectal NETs. We recently treated a patient who underwent endoscopic treatment of a small, grade 1 rectal NET that recurred in the form of perirectal lymph node metastasis 7 years later. A 7-mm-sized perirectal lymph node was noted at the time of the initial endoscopic treatment. The same lymph node was found to be slightly enlarged on follow-up and finally confirmed as a metastatic NET. Therefore, the perirectal lymph node metastasis might have been present at the time of the initial diagnosis. However, the growth rate of the lymph node was extremely low, and it took 7 years to increase in size from 7 to 10 mm. NETs with low Ki-67 proliferation index and without mitotic activity may grow extremely slowly even if they are metastatic.

Citations

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World Journal of Gastroenterology.2025;[Epub] CrossRef
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Soo-Young Na, Seong Jung Kim, Hyoun Woo Kang
International Journal of Gastrointestinal Intervention.2023; 12(3): 105. CrossRef
Tumor grade 2 as the independent predictor for lymph node metastasis in 10–20 mm sized rectal neuroendocrine tumor
Byung-Soo Park, Sung Hwan Cho, Gyung Mo Son, Hyun Sung Kim, Su Jin Kim, Su Bum Park, Cheol Woong Choi, Hyung Wook Kim, Dong Hoon Shin
Korean Journal of Clinical Oncology.2021; 17(1): 37. CrossRef
Lymphovascular invasion as a prognostic value in small rectal neuroendocrine tumor treated by local excision: A systematic review and meta-analysis
Ho Suk Kang, Mi Jung Kwon, Tae-Hwan Kim, Junhee Han, Young-Su Ju
Pathology - Research and Practice.2019; 215(11): 152642. CrossRef
Trans‐anal full‐thickness endoscopic resection of a rectal neuroendocrine neoplasm performed with a TEO® (Karl Storz microsurgery device) and laparoscopic indocyanine‐green‐guided lymphatic sampling – a video vignette
P. Leon, A. Balduzzi, M. Troian, N. de Manzini
Colorectal Disease.2017; 19(4): 399. CrossRef
Usefulness of endoscopic resection using the band ligation method for rectal neuroendocrine tumors
Ju Seung Kim, Yoon Jae Kim, Jun-Won Chung, Jung Ho Kim, Kyoung Oh Kim, Kwang An Kwon, Dong Kyun Park, Jung Suk An
Intestinal Research.2016; 14(2): 164. CrossRef
Lymphovascular invasion in more than one-quarter of small rectal neuroendocrine tumors
Mi Jung Kwon, Ho Suk Kang, Jae Seung Soh, Hyun Lim, Jong Hyeok Kim, Choong Kee Park, Hye-Rim Park, Eun Sook Nam
World Journal of Gastroenterology.2016; 22(42): 9400. CrossRef
Cap-assisted EMR for rectal neuroendocrine tumors: comparisons with conventional EMR and endoscopic submucosal dissection (with videos)
Dong-Hoon Yang, Yangsoon Park, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang
Gastrointestinal Endoscopy.2016; 83(5): 1015. CrossRef
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Original Articles

Patient Descriptions of Rectal Effluents May Help to Predict the Quality of Bowel Preparation With Photographic Examples: Hoonsub So, Sun-Jin Boo, Hyungil Seo, Ho-Su Lee, Hyojeong Lee, Sang Hyoung Park, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Seungbong Han, Dong-Hoon Yang; Intest Res 2015;13(2):153-159. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.153

Abstract PDF PubReader

Background/Aims

Previous studies have suggested a weak correlation between self-reported rectal effluent status and bowel preparation quality. We aim to evaluate whether photographic examples of rectal effluents could improve the correlation between patient descriptions of rectal effluents and bowel preparation quality.

Methods

Before colonoscopy, patients were asked to describe the nature of their last three rectal effluents. Photographic examples of rectal effluents were provided as a reference for scoring. Bowel preparation was subsequently assessed by a single endoscopist using a global preparation assessment scale. Preparation outcomes were grouped into two levels (excellent to good vs. fair to inadequate). Both univariate and multivariate logistic regression models were used to find any association between bowel preparation quality and patient characteristics.

Results

A total of 138 patients completed the questionnaires. The mean age was 56.5±10.4 years. The mean sum of the last three rectal effluent scores was 5.9±2.0. Higher rectal effluent scores (odds ratio [OR], 0.82; P=0.043) and the presence of diverticula (OR, 0.16; P<0.001) were risk factors for suboptimal preparation.

Conclusions

Photographic example-guided patient descriptions of rectal effluents showed a statistically significant association with bowel preparation quality. However, clinical significance seemed to be low. The presence of diverticula was an independent predictive factor for suboptimal bowel preparation quality.

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Individualized intervention based on a preparation-related prediction model improves adequacy of bowel preparation: A prospective, multi-center, randomized, controlled study
Long Chen, Xiaoyu Kang, Gui Ren, Hui Luo, Linhui Zhang, Limei Wang, Jianghai Zhao, Rongchun Zhang, Xiaoying Zhang, Lina Zhao, Yanglin Pan
Digestive and Liver Disease.2024; 56(3): 436. CrossRef
Comparison of Objectively Assessed Versus Patient-Reported Clarity of Last Rectal Effluent for the Prediction of Quality of Bowel Preparation for Colonoscopy: A Prospective, Case-Control Study
Ajay Patwa, Satish Kumar, Deepak Bhagchandani, Amit Kumar, Virendra Atam, Navneet Anil, Priya Mishra, Abhishek Singh, Archana Devi, Ajay K Pal
Cureus.2024;[Epub] CrossRef
Development and validation of a novel scoring system based on a nomogram for predicting inadequate bowel preparation
Xiaxia Zhao, Yanglin Pan, Jinyong Hao, Jie Feng, Zhongyuan Cui, Huimin Ma, Xiaojun Huang
Clinical and Translational Oncology.2024; 26(9): 2262. CrossRef
Patients' Description of Rectal Effluents Help Predict the Quality of Colonoscopy Preparation
Manuel Antonio Lescano Lescano, Rodrigo Strehl Machado, Maria Rachel Rohr, Sender Jankiel Miszputen
Journal of Coloproctology.2024; 44(02): e106. CrossRef
Superiority of a preparation‐related model for predicting inadequate bowel preparation in patients undergoing colonoscopy: A multicenter prospective study
Long Chen, Gui Ren, Hui Luo, Linhui Zhang, Limei Wang, Jianghai Zhao, Rongchun Zhang, Xiaoying Zhang, Xiaoyu Kang, Yanglin Pan
Journal of Gastroenterology and Hepatology.2022; 37(12): 2297. CrossRef
Comparison of bowel-cleansing efficacy of split-dose and same-day dose bowel preparation for afternoon colonoscopy in patients with gastrectomy: a prospective randomized study
Tae-Geun Gweon, Cheal Wung Huh, Jeong Seon Ji, Chang Hyun Kim, Jin-Jo Kim, Seung-Man Park
Surgical Endoscopy.2020; 34(10): 4413. CrossRef
Evaluating the practice of canceling colonoscopies for presumed inadequate bowel preparation
Reid L. Hopkins, David Parsons, Leonie Hoyo, Brian C. Jacobson
Gastrointestinal Endoscopy.2020; 92(2): 382. CrossRef
A Randomized Controlled Trial Comparing Colonoscopic Enema With Additional Oral Preparation as a Salvage for Inadequate Bowel Cleansing Before Colonoscopy
Hyo-Joon Yang, Dong Il Park, Soo-Kyung Park, Sunyong Kim, Taeheon Lee, Yunho Jung, Chang Soo Eun, Dong Soo Han
Journal of Clinical Gastroenterology.2019; 53(8): e308. CrossRef
Comparison of Bowel Cleansing Efficacy, Safety, Bowel Movement Kinetics, and Patient Tolerability of Same-Day and Split-Dose Bowel Preparation Using 4 L of Polyethylene Glycol: A Prospective Randomized Study
Myeongsook Seo, Tae-Geun Gweon, Cheal Wung Huh, Jeong Seon Ji, Hwang Choi
Diseases of the Colon & Rectum.2019; 62(12): 1518. CrossRef
Randomized trial comparing oral sulfate solution with 4‐L polyethylene glycol administered in a split dose as preparation for colonoscopy
Hyo‐Joon Yang, Soo‐Kyung Park, Jee Hyun Kim, Jong Pil Im, Dong Han Yeom, Geom Seog Seo, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(1): 12. CrossRef
Patient Description of Rectal Effluents With Photographic Examples as a Predictive Indicator for the Quality of Bowel Preparation
Hyoun Woo Kang
Intestinal Research.2015; 13(4): 362. CrossRef
Author's Reply
Hoonsub So, Seungbong Han, Dong-Hoon Yang
Intestinal Research.2015; 13(4): 364. CrossRef

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The Clinical Usefulness of Endoscopic Ultrasound-Guided Fine Needle Aspiration and Biopsy for Rectal and Perirectal Lesions: Jae Seung Soh, Ho-Su Lee, Seohyun Lee, Jungho Bae, Hyo Jeong Lee, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim, Jeong-Sik Byeon; Intest Res 2015;13(2):135-144. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.135

Abstract PDF PubReader

Background/Aims

Endoscopic ultrasound-guided fine needle aspiration and/or biopsy (EUS-FNA/B) have been used to diagnose subepithelial tumors (SETs) and extraluminal lesions in the gastrointestinal tract. Our group previously reported the usefulness of EUS-FNA/B for rectal and perirectal lesions. This study reports our expanded experience with EUS-FNA/B for rectal and perirectal lesions in terms of diagnostic accuracy and safety. We also included our new experience with EUS-FNB using the recently introduced ProCore needle.

Methods

From April 2009 to March 2014, EUS-FNA/B for rectal and perirectal lesions was performed in 30 consecutive patients. We evaluated EUS-FNA/B performance by comparing histological diagnoses with final results. We also investigated factors affecting diagnostic accuracy.

Results

Among 10 patients with SETs, EUS-FNA/B specimen results revealed a gastrointestinal stromal tumor in 4 patients and malignant lymphoma in 1 patient. The diagnostic accuracy of EUS-FNA/B was 50% for SETs (5/10). Among 20 patients with non-SET lesions, 8 patients were diagnosed with malignant disease and 7 were diagnosed with benign disease based on both EUS-FNA/B and the final results. The diagnostic accuracy of EUS-FNA/B for non-SET lesions was 75% (15/20). The size of lesions was the only factor related to diagnostic accuracy (P=0.027). Two complications of mild fever and asymptomatic pneumoperitoneum occurred after EUS-FNA/B.

Conclusions

The overall diagnostic accuracy of EUS-FNA/B for rectal and perirectal lesions was 67% (20/30). EUS-FNA/B is a clinically useful method for cytological and histological diagnoses of rectal and perirectal lesions.

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Girish Mishra, Anne Marie Lennon, Nonthalee Pausawasdi, Vanessa M. Shami, Reem Z. Sharaiha, B. Joseph Elmunzer
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Quality Indicators for EUS
Girish Mishra, Anne Marie Lennon, Nonthalee Pausawasdi, Vanessa M. Shami, Reem Z. Sharaiha, B. Joseph Elmunzer
American Journal of Gastroenterology.2025; 120(5): 973. CrossRef
Colonoscopic Ultrasound-Guided Fine-Needle Aspiration Using a Curvilinear Array Transducer: A Single-Center Retrospective Cohort Study
Spencer Cheng, Sergio E. Matuguma, Guilherme H. P. de Oliveira, Gustavo L.R. Silva, Henrique Cheng, Sergio A. Sánchez-Luna, Mauricio K Minata
Diseases of the Colon & Rectum.2022; 65(2): e80. CrossRef
Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs)
Francesco Maione, Alessia Chini, Marco Milone, Nicola Gennarelli, Michele Manigrasso, Rosa Maione, Gianluca Cassese, Gianluca Pagano, Francesca Paola Tropeano, Gaetano Luglio, Giovanni Domenico De Palma
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Long-term experience with percutaneous biopsies of pelvic lesions using CT guidance
Petr Hoffmann, Michal Balik, Martina Hoffmannova, Jiri Spacek, Jiri Vanasek, Adam Rezac, Petr Dvorak
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Prospective histological evaluation of a 20G core trap with a forward-cutting bevel needle for EUS-FNA of pancreatic lesions
Nobu Nishioka, Takeshi Ogura, Yoshitaka Kurisu, Miyuki Imanishi, Saori Onda, Wataru Takagi, Tatsushi Sano, Atsushi Okuda, Akira Miyano, Mio Amano, Kazuhide Higuchi
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Concise review on the comparative efficacy of endoscopic ultrasound-guided fine-needle aspiration vs core biopsy in pancreatic masses, upper and lower gastrointestinal submucosal tumors
Tawfik Khoury, Wisam Sbeit, Nicholas Ludvik, Divya Nadella, Alex Wiles, Caitlin Marshall, Manoj Kumar, Gilad Shapira, Alan Schumann, Meir Mizrahi
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Endoscopic ultrasound-guided fine needle aspiration of extra-rectal lesions
J. Lim, S. A. Norton, N. A. Wong, M. G. Thomas
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Eun Young Kim
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Benign Prostatic Hyperplasia Mimicking a Symptomatic Rectal Submucosal Tumor
Seung Wook Hong, Jaeyoung Chun, Kyu Joo Park, Cheol Kwak, Joo Sung Kim
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Case Reports

A Case of Cronkhite-Canada Syndrome Showing Spontaneous Remission: Dong-Uk Kang, Dong-Hoon Yang, Yunsik Choi, Ji-Beom Kim, Ho-Su Lee, Hyo Jeong Lee, Sang Hyoung Park, Kee Wook Jung, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2013;11(4):317-322. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.317

Abstract PDF

Cronkhite-Canada syndrome (CCS) is a rare, noninherited gastrointestinal polyposis syndrome associated with ectodermal changes such as alopecia, nail dystrophy, and cutaneous hyperpigmentation. The etiology and pathogenesis of CCS are not known, but diarrhea, malnutrition, gastrointestinal bleeding, and infection may occur in the affected patient; moreover, this condition could be fatal. However, previous reports have described several cases of spontaneous remission. We report a 60-year-old man who was incidentally found to have colonic polyposis, alopecia, and hypogeusia and was diagnosed to have CCS. However, this patient experienced spontaneous remission, including regrowth of body hair and alleviation of bowel inflammation, without any specific medications such as steroids, antibiotics, or proton pump inhibitors. (Intest Res 2013;11:317-322)

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Cronkhite-Canada Syndrome Showing Good Early Response to Steroid Treatment
Woohee Cho, Kwangwoo Nam, Ki Bae Bang, Hyun Deok Shin, Jeong Eun Shin
The Korean Journal of Gastroenterology.2018; 71(4): 239. CrossRef

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1 Crossref

A Case of Isolated Ileal Ganglioneuroma: Ju Hyung Song, Byong Duk Ye, Yong Sik Yoon, Mi-Jung Kim, Dong-Hoon Yang, Kee Wook Jung, Kyung-Jo Kim, Jung-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2011;9(1):46-50. Published online April 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.1.46

Abstract PDF

Ganglioneuromas of the gastrointestinal tract are rare, but have an established association with genetic disorders, such as the multiple endocrine neoplasia (MEN) syndrome (type 2b) and neurofibromatosis (type 1). However, solitary ganglioneuromas are not associated with an increased risk for MEN 2b, neurofibromatosis type 1, or any other systemic conditions. Ganglioneuromas of the gastrointestinal tract have been reported to predominantly involve the colon and rectum, and are thereby occasionally detected during colonoscopy or surgery. Although there are no characteristic symptoms of solitary ganglioneuromas, symptoms can be induced by solitary ganglioneuromas, such as abdominal pain, bleeding, or obstruction, depending on the location and size. Herein we report a case of a solitary ganglioneuroma of the ileum. A 34-year-old man sought evaluation at our hospital for anemia. The medical and family histories were benign and there was no history of genetic disorders. The evaluation for anemia revealed iron-deficiency anemia and CT enterography revealed a single mass in the ileum. Laparoscopic resection of the lesion was performed and the pathologic examination confirmed an ileal ganglioneuroma. (Intest Res 2011;9: 11-50)

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A Case of Duodenal Ganglioneuroma Manifesting as a Subepithelial Tumor
Dong Chan Joo, Gwang Ha Kim, Chul Byung Chae, So Jeong Lee, Do Youn Park
The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2018; 18(4): 271. CrossRef

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Editorial

The Role of F¹⁸-FDG PET/CT in Colorectal Neoplasm: Kyung-Jo Kim; Intest Res 2010;8(1):84-86. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.84

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Original Articles

Clinical Characteristics of Constipation with Hypothyroidism: Jaeil Kim, Seung-Jae Myung, Dong-Hoon Yang, In Ja Yoon, So Young Seo, Heun Sook Ku, Soon Man Yoon, Kyung-Jo Kim, Byong Duk Ye, Jung-Sik Byeon, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2010;8(1):48-57. Published online June 30, 2010; DOI: https://doi.org/10.5217/ir.2010.8.1.48

Abstract PDF

Background/Aims
Constipation is a well-recognized gastrointestinal symptom in patients with untreated hypothyroidism. Although thyroid function tests are recommended to exclude hypothyroidism in patients with constipation, there have been no reports to determine the causal relationship between thyroid function and constipation. The aim of this study was to determine the prevalence of hypothyroidism in constipated patients and the clinical features of constipation associated with hypothyroidism. Methods: A total of 1,481 constipated patients were included. These patients were divided into overt hypothyroidism, subclinical hypothyroidism, and normal thyroid function groups based on thyroid function tests. We reviewed the clinical presentation, anorectal function, colonic transit time, defecographic findings, and response to biofeedback therapy. Results: The prevalence of overt and subclinical hypothyroidism was 0.41% (men, 0.36%; women, 0.53%) and 1.76% (men, 1.28%; women 2.03%), respectively. There were no differences in total or segmental colonic transit times and subtypes of constipation among the normal thyroid function (n=54), overt hypothyroidism (n=4), and subclinical hypothyroidism groups (n=21). On anorectal manometry, the prevalence of dyssynergic defecation did not differ between the three groups. Rectal hyposensitivity was more frequent in the overt hypothyroidism group (overt hypothyroidism group, 50.0%; subclinical hypothyroidism group, 19.0%; normal thyroid function group, 20.4%) without statistical significance (P=0.372). Conclusions: The prevalence of overt and subclinical hypothyroidism in constipated patients was very low. The colonic transit time is not affected by thyroid function. (Intest Res 2010;8:48-57)

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Long-Term Risks of Parkinson’s Disease, Surgery, and Colorectal Cancer in Patients With Slow-Transit Constipation
Eun Mi Song, Hyo Jeong Lee, Kee Wook Jung, Mi Jung Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Jaewon Choe, Suk-Kyun Yang, Satish S.C. Rao, Seung-Jae Myung
Clinical Gastroenterology and Hepatology.2021; 19(12): 2577. CrossRef
Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management
Amir Mari, Mahmud Mahamid, Hana Amara, Fadi Abu Baker, Afif Yaccob
Korean Journal of Family Medicine.2020; 41(3): 139. CrossRef
Primary Care Management of Chronic Constipation in Asia: The ANMA Chronic Constipation Tool
Kok-Ann Gwee, Uday C Ghoshal, Sutep Gonlachanvit, Andrew Seng Boon Chua, Seung-Jae Myung, Shaman Rajindrajith, Tanisa Patcharatrakul, Myung-Gyu Choi, Justin C Y Wu, Min-Hu Chen, Xiao-Rong Gong, Ching-Liang Lu, Chien-Lin Chen, Nitesh Pratap, Philip Abraham
Journal of Neurogastroenterology and Motility.2013; 19(2): 149. CrossRef

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The Efficacy of Bedside Colonoscopy for Critically Ill Patients with Acute Lower Gastrointestinal Hemorrhage: Jongha Park, Byong Duk Ye, Jae Keun Lee, Dong-Hoon Yang, Soon Man Yoon, Kyung-Jo Kim, Jung-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2009;7(2):86-92. Published online December 30, 2009

Abstract PDF: Background/Aims
Most studies on acute gastrointestinal (GI) hemorrhage of intensive care unit (ICU) patients have focused on upper GI hemorrhage (UGIH), but reports on acute lower GI hemorrhage (LGIH) with the role of bedside colonoscopy are still lacking. Therefore, we determined the clinical characteristics of acute LGIH in ICU patients and the efficacy of bedside colonoscopy in ICU setting. Methods: We reviewed the medical records of 76 ICU patients who underwent bedside colonoscopy for acute LGIH between January 2005 and December 2007. The clinical characteristics of the patients, the outcomes of colonoscopy, and the clinical course after colonoscopy were investigated. Results: Of 76 patients, 43 patients (56.6%) were males and the median age was 67 years. End-stage renal diseases were the most common underlying diseases, followed by cardiovascular diseases. Cecal intubation was possible in 18 patients (23.7%) and bleeding foci were identified in 41 patients (53.9%). The two main causes of bleeding were rectal ulcers (48.8%) and ischemic colitis (22.0%). Endoscopic treatments were successful in 12 patients (15.8%), and there was only 1 case of rebleeding after 7 days. There were no severe complications associated with bedside colonoscopy; 3 patients (3.9%) died of uncontrolled LGIH during hospital period. Conclusions: Bedside colonoscopy is effective and safe for the diagnosis of acute LGIH in ICU patients. In addition, endoscopic treatment can be successfully performed in select patients. Therefore, in acute LGIH of ICU patients, bedside colonoscopy can be performed as a first-line procedure. (Intest Res 2009;7:86-92)

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The Safety and Efficacy of Azathioprine and 6-Mercaptopurine in the Treatment of Korean Patients with Crohn's Disease: Hyun Ju Lee, Suk-Kyun Yang, Kyung-Jo Kim, Jae-Won Choe, Soon Man Yoon, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Jin-Ho Kim; Intest Res 2009;7(1):22-31. Published online June 30, 2009

Abstract PDF: Background/Aims
This study aimed to evaluate the adverse events and efficacy of azathioprine (AZA) and 6-mercaptopurine (6-MP) in Korean patients with Crohn's disease (CD). Methods: We retrospectively analyzed 700 patients with CD (male：female=469：231; median age at diagnosis, 22 years; agerange, 9-74 years) who were treated at the Asan Medical Center between January 1997 and January 2006. Results: Of 700 patients, 372 (53.1%) were treated with AZA/6-MP. The cumulative rates of AZA/6-MP treatment at 1, 5, 10, and 20 years were 17.4%, 51.6%, 73.1%, and 94.5%, respectively. Of 372 patients treated with AZA/6-MP, 217 patients (58.3%) experienced 291 adverse events, requiring discontinuation of therapy in 41 patients (11%). Nausea occurred in 120 patients (32.3%) and led to discontinuation of therapy in 11 patients (3.0%). Leukopenia developed in 116 patients (31.2%), requiring dose adjustments in 100 patients (26.9%) and discontinuation of medications in 16 patients (4.3%). Other adverse events included infections (2.7%), abnormal liver function tests (2.7%), fever (0.8%), hair loss (0.8%), arthralgias (0.5%), pancreatitis (0.5%), headaches (0.5%), and skin rashes (0.3%). Complete corticosteroids withdrawal was achieved in 70.9% of the patients based on an intention-to-treat analysis. The remission rate of perianal fistulas was 32.6%. Conclusions: The risk of leukopenia by AZA/6-MP is higher in Korean patients with CD than in Western patients. Although the adverse events of AZA/6-MP are not uncommon in Korean patients with CD, the actual discontinuation rate of the treatment is low. Therefore, AZA/6-MP can be administered to most Korean patients with CD without serious adverse events. (Intest Res 2009;7:22-31)

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Diverticulitis: Focused on Clinical Course and Relapse: Kwi-Sook Choi, Jeong-Sik Byeon, Soon Man Yoon, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2008;6(1):37-44. Published online June 30, 2008

Abstract PDF: Background/Aims
There are a limited number of studies concerning the outcomes of diverticulitis in the Oriental population. We sought to evaluate the clinical features and the long-term outcomes of diverticulitis in Korean patients. Methods: We retrospectively reviewed the clinical courses of 104 patients (59 men, 45 women; median age 48.5 years [range: 24-83 years]) hospitalized for their first episode of diverticulitis between 1989 and 2005. Results: Right-sided diverticulitis was more common (71/104, 68%). However, the proportion of left-sided diverticulitis increased as age increased. Thirty-two patients underwent operations: 30 because of complications and 2 because of presumed appendicitis. Left-sided diverticulitis was an independent risk factor for complications (OR=7.6, p＜ 0.001), and it required surgical treatment more often than right-sided diverticulitis did (61% vs. 17%, p＜0.001). Eighty-five patients were followed for a median of 36 months. Four of the 62 medically treated patients developed recurrence of diverticulitis, with a 3-year cumulative recurrence rate of 4.8%. None of the 4 recurrences showed complications, and all were successfully managed using conservative treatment. No predictive factors for the recurrence of diverticulitis could be determined. Conclusions: The recurrence rate and risk of complications associated with recurrence are low in patients treated conservatively for the first episode of diverticulitis. Therefore, elective surgery to prevent recurrence and complications should be utilized sparingly in patients with diverticulitis. (Intest Res 2008;6:37-44)

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