Intestinal Research

Review

Cancer

Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 revised edition: Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):20-42. Published online January 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00096

Abstract PDF Supplementary Material PubReader ePub

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for managing advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of the limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: adenoma ≥10 mm in size; 3 to 5 (or more) adenomas; tubulovillous or villous adenoma; adenoma containing high-grade dysplasia; traditional serrated adenoma; sessile serrated lesion containing any grade of dysplasia; serrated polyp of at least 10 mm in size; and 3 to 5 (or more) sessile serrated lesions. More studies are needed to fully comprehend the patients who are most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

Citations

Citations to this article as recorded by

Clinical Efficacy of Real-Time Artificial Intelligence-Assisted Colonoscopy in Colorectal Polyp Detection: A Prospective Multicenter Randomized Controlled Trial
Han Jo Jeon, Bora Keum, Eui Sun Jeong, Seong-Eun Kim, Chang Mo Moon, Bomee Lee, Sanghyun Kim, Hyuk Soon Choi, Jae Min Lee, Eun Sun Kim, Yoon Tae Jeen
Gut and Liver.2026; 20(1): 97. CrossRef
Comparison between endoscopic resection and transanal surgery for treatment of rectal tumors: a systematic review and meta‑analysis
Chan Hyuk Park, Byung Wook Jung, Yoon Suk Jung
Intestinal Research.2026; 24(1): 38. CrossRef
Survey of the Actual Practices Used for Endoscopic Removal of Colon Polyps in Korea: A Comparison with the Current Guidelines
Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong-Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, Eun R
Gut and Liver.2025; 19(1): 77. CrossRef
The impact of COVID-19 on clinical practices of colorectal cancer in South Korea
Kwang Woo Kim, Hyoun Woo Kang
Intestinal Research.2025; 23(1): 6. CrossRef
Colorectal Cancer after Colonoscopy: Causes and Prevention Strategies
Seongwoo Choi, Yunho Jung
The Korean Journal of Medicine.2025; 100(1): 19. CrossRef
The histologic features, molecular features, detection and management of serrated polyps: a review
Jin-Dong Wang, Guo-Shuai Xu, Xin-Long Hu, Wen-Qiang Li, Nan Yao, Fu-Zhou Han, Yin Zhang, Jun Qu
Frontiers in Oncology.2024;[Epub] CrossRef
Screening and surveillance for hereditary colorectal cancer
Hee Man Kim, Tae Il Kim
Intestinal Research.2024; 22(2): 119. CrossRef
Prediction of Lymph Node Metastasis in T1 Colorectal Cancer Using Artificial Intelligence with Hematoxylin and Eosin-Stained Whole-Slide-Images of Endoscopic and Surgical Resection Specimens
Joo Hye Song, Eun Ran Kim, Yiyu Hong, Insuk Sohn, Soomin Ahn, Seok-Hyung Kim, Kee-Taek Jang
Cancers.2024; 16(10): 1900. CrossRef
Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef
Efficacy of Oral Sulfate Tablet and 2 L-Polyethylene Glycol With Ascorbic Acid for Bowel Preparation: A Prospective Randomized KASID Multicenter Trial
Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
Post-colonoscopy Colorectal Cancer: Causes and Prevention
Jong Yoon Lee
Journal of Digestive Cancer Research.2024; 12(3): 160. CrossRef
Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revision
Su Young Kim
The Korean Journal of Medicine.2023; 98(3): 102. CrossRef
Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis
Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
Intestinal Research.2023; 21(4): 510. CrossRef
Summary and comparison of recently updated post-polypectomy surveillance guidelines
Yoon Suk Jung
Intestinal Research.2023; 21(4): 443. CrossRef
Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
Journal of the Korean Medical Association.2023; 66(11): 652. CrossRef

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Original Articles

Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease: Yonghyun Kim, Seong Ran Jeon, Sang Myung Choi, Hyun Gun Kim, Tae Hee Lee, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joon Sung Lee, Moon Sung Lee; Intest Res 2017;15(4):467-474. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.467

Abstract PDF PubReader ePub

Background/Aims

Although the role of capsule endoscopy (CE) in Crohn's disease (CD) has expanded, CE is not used routinely for diagnosing and evaluating CD in Korea. We aimed to investigate current patterns of practice and evaluate the clinical significance of the use of CE in CD in Korean patients.

Methods

Among 651 CE procedures performed for various indications, we retrospectively analyzed the medical records of patients who underwent CE in 57 cases of suspected CD (sCD) and 14 cases of established CD (eCD).

Results

In the sCD group, CE was most commonly used for the initial diagnosis of CD (54.4%). Capsule retention was found in only 1 patient in the eCD group (1/71, 1.4%). In the sCD group, 28.1% of patients were diagnosed with CD on the basis of CE findings; other diseases diagnosed included tuberculous enteritis (7.0%), non-steroidal anti-inflammatory drug-induced enteropathy (5.3%), and other enteritis (17.5%). Only 11.5% of patients with eCD (14/122) underwent CE. The indication for CE in the 14 patients with eCD was to assess disease extent and activity. The overall diagnostic yield of CE was 59.7%. Therapeutic strategies were changed in 70.2% of patients in the sCD group and 50% of those in the eCD group based on CE findings.

Conclusions

In clinical practice, CE was most commonly indicated for the initial diagnosis of CD and was not generally performed in patients with eCD. CE appears to be an effective diagnostic modality for evaluating sCD and is useful for determining therapeutic strategies for patients with sCD and those with eCD.

Citations

Citations to this article as recorded by

The role of capsule endoscopy in Crohn's disease
Nicoletta NANDI, Aymeric BECQ, Marco MICHELON, Reena SIDHU
Minerva Gastroenterology.2026;[Epub] CrossRef
Video capsule endoscopy in inflammatory bowel disease
Kenji J.L. Limpias Kamiya, Naoki Hosoe, Yukie Hayashi, Takaaki Kawaguchi, Kaoru Takabayashi, Haruhiko Ogata, Takanori Kanai
DEN Open.2022;[Epub] CrossRef
Enteroscopy in Crohn’s Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study
Seong Ran Jeon, Jin-Oh Kim, Jeong-Sik Byeon, Dong-Hoon Yang, Bong Min Ko, Hyeon Jeong Goong, Hyun Joo Jang, Soo Jung Park, Eun Ran Kim, Sung Noh Hong, Jong Pil Im, Seong-Eun Kim, Ja Seol Koo, Chang Soo Eun, Dong Kyung Chang
Gut and Liver.2021; 15(3): 375. CrossRef
Capsule Endoscopy in Crohn’s Disease—From a Relative Contraindication to Habitual Monitoring Tool
Adi Lahat, Ido Veisman
Diagnostics.2021; 11(10): 1737. CrossRef
Use of small bowel capsule endoscopy in clinical practice: how has it performed?
Seong Ran Jeon
The Korean Journal of Internal Medicine.2020; 35(4): 854. CrossRef
Pursuing therapeutic success in Crohn’s disease: A matter of definition, tools and longterm outcomes
Loredana Goran, Monica State, Ana Maria Negreanu, Lucian Negreanu
European Journal of Inflammation.2020; 18: 205873922096289. CrossRef
Capsule endoscopy: Current status and role in Crohn’s disease
Loredana Goran, Ana Maria Negreanu, Ana Stemate, Lucian Negreanu
World Journal of Gastrointestinal Endoscopy.2018; 10(9): 184. CrossRef
Role of capsule endoscopy in suspected or established Crohn's disease in real practice
Hyun Joo Jang
Intestinal Research.2017; 15(4): 431. CrossRef

8,545 View
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8 Crossref

Double-Balloon Enteroscopy in Elderly Patients: Is It Safe and Useful?: Dae Han Choi, Seong Ran Jeon, Jin-Oh Kim, Hyun Gun Kim, Tae Hee Lee, Woong Cheul Lee, Byung Soo Kang, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Joo Young Cho, Joon Seong Lee, Moon Sung Lee; Intest Res 2014;12(4):313-319. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.313

Abstract PDF PubReader ePub

Background/Aims

Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.

Methods

We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age ≥65 years; mean 71.4±5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5±13.5; n=124; 177 DBEs).

Results

In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).

Conclusions

DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.

Citations

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Was Motorized Spiral Enteroscopy Too Risky? A Systematic Review and Meta‐Analysis Including German Registry Data
Ingo Steinbrück, Armin Kuellmer, Siegbert Faiss, Hendrik Buchholz, Björn Lewerenz, Daniel Fitting, Felix Wiedbrauck, Stephan Hollerbach, Arthur Schmidt, Johannes Wilhelm Rey, Martha M. Kirstein, Franz‐Ludwig Dumoulin, Fabian Maximilian Wittich, Andreas Wa
United European Gastroenterology Journal.2026;[Epub] CrossRef
Clinical outcomes in frail elderly patients undergoing small-bowel capsule endoscopy
Rebecca K Grant, Alexander R Robertson, Kirsty A Lennon, Eksha Gupta, Ursula E Walton, Ross J Porter, Niall T Burke, Solomon Ong, Atul Anand, Sarah Douglas, Alice Corbett, William M Brindle, Rahul Kalla, John N Plevris
Frontline Gastroenterology.2025; 16(1): 30. CrossRef
Outcomes of Double Balloon-Enteroscopy in Elderly vs. Adult Patients: A Retrospective 16-Year Single-Centre Study
Margherita Trebbi, Cesare Casadei, Silvia Dari, Andrea Buzzi, Mario Brancaccio, Valentina Feletti, Alessandro Mussetto
Diagnostics.2023; 13(6): 1112. CrossRef
Enteroscopy in the Elderly: Review of Procedural Aspects, Indications, Yield, and Safety
Ana Catarina Ribeiro Gomes, Rolando Pinho, Adélia Rodrigues, Ana Ponte, João Carvalho
GE - Portuguese Journal of Gastroenterology.2020; 27(1): 18. CrossRef
Device assisted enteroscopy in the elderly — A systematic review and meta-analysis
Stefania Chetcuti Zammit, David S. Sanders, Reena Sidhu
Digestive and Liver Disease.2019; 51(9): 1249. CrossRef
Double-balloon enteroscopy: Indications, approaches, diagnostic and therapeutic yield, and safety. Early experience at a single center
J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México (English Edition).2018; 83(1): 31. CrossRef
Enteroscopia de doble balón: indicaciones, abordajes, eficacia diagnóstica y terapéutica y seguridad. Experiencia temprana de un solo centro
J.J.E. García-Correa, J.J. Ramírez-García, L.F. García-Contreras, C. Fuentes-Orozco, L. Irusteta-Jiménez, L.R. Michel-Espinoza, A.S. Carballo Uribe, J.A. Torres Chávez, A. González-Ojeda
Revista de Gastroenterología de México.2018; 83(1): 31. CrossRef
Device-assisted enteroscopy in the UK: description of a large tertiary case series under conscious sedation
Vijay Pattni, David J Tate, Ana Terlevich, Peter Marden, Steve Hughes
Frontline Gastroenterology.2018; 9(2): 122. CrossRef
Paradigm shift: should the elderly undergo propofol sedation for DBE? A prospective cohort study
Hey-Long Ching, Federica Branchi, David S Sanders, David Turnbull, Reena Sidhu
Frontline Gastroenterology.2018; 9(3): 192. CrossRef
Efficacy and Safety of Single-Balloon Enteroscopy in Elderly Patients
Chen-Wang Chang, Ching-Wei Chang, Wei-Chen Lin, Chia-Hsien Wu, Horng-Yuan Wang, Tsang-En Wang, Cheng-Hsin Chu, Ming-Jen Chen
International Journal of Gerontology.2017; 11(3): 176. CrossRef
Diagnostic yield and safety of double balloon-assisted enteroscopy in the elderly: A systematic review and meta-analysis
Y. Chen, G. Liu, T. Zhang, K. Yang, H. Yu, Y. Tie, J. Liang, J. Zhou, H. Gan
European Geriatric Medicine.2017; 8(4): 354. CrossRef
Clinical outcome after enteroscopy for small bowel angioectasia bleeding: A Korean Associateion for the Study of Intestinal Disease (KASID) multiceter study
Seong Ran Jeon, Jeong‐Sik Byeon, Hyun Joo Jang, Soo Jung Park, Jong Pil Im, Eun Ran Kim, Ja Seol Koo, Bong Min Ko, Dong Kyung Chang, Jin‐Oh Kim, Su Yeon Park
Journal of Gastroenterology and Hepatology.2017; 32(2): 388. CrossRef
Systematic review: Safety of balloon assisted enteroscopy in Crohn’s disease
Ahilan Arulanandan, Parambir S Dulai, Siddharth Singh, William J Sandborn, Denise Kalmaz
World Journal of Gastroenterology.2016; 22(40): 8999. CrossRef
Current status and future perspectives of capsule endoscopy
Hyun Joo Song, Ki-Nam Shim
Intestinal Research.2016; 14(1): 21. CrossRef
Author's Reply
Seong Ran Jeon
Intestinal Research.2015; 13(1): 99. CrossRef
Clinical Characteristics and Treatment Outcomes of Cryptogenic Multifocal Ulcerous Stenosing Enteritis in Korea
Sook Hee Chung, Sang Un Park, Jae Hee Cheon, Eun Ran Kim, Jeong-Sik Byeon, Byong Duk Ye, Bora Keum, Ki-Nam Shim, Sung-Ae Jung, Jin-Oh Kim, Seong Ran Jeon, Hyun Joo Song, Jeong Seop Moon, Dong Kyung Chang
Digestive Diseases and Sciences.2015; 60(9): 2740. CrossRef
Questions About Sedation Protocols for Double-Balloon Enteroscopy
Dong-Hoon Yang
Intestinal Research.2015; 13(1): 97. CrossRef

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17 Crossref

Case Report

A Case of Localized Amyloid Light-Chain Amyloidosis in the Small Intestine: Jong Hyo Choi, Bong Min Ko, Cheol Kim, Hee Kyung Kim, Jae Pil Han, Su Jin Hong, Jong Ho Moon, Moon Sung Lee; Intest Res 2014;12(3):245-250. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.245

Abstract PDF PubReader ePub

Amyloidosis is characterized by the abnormal deposition of extracellular amyloid fibrils. Cases involving amyloid light-chain amyloidosis in the small intestine have been reported infrequently in Korea. Here, we report a case of localized light chain protein amyloidosis in the small intestine. Esophagogastroduodenoscopy, push enteroscopy, and capsule endoscopy revealed submucosal tumor-like lesions, multiple shallow ulcers, and several erosions in the distal duodenum and jejunum. An endoscopic biopsy established the diagnosis of amyloidosis. In through an immunohistochemical analysis, the presence of lambda light chain protein was detected. The patient had no evidence of an underlying clonal plasma cell disorder or additional organ involvement. Therefore, we concluded that the patient had localized amyloidosis of the small intestine.

Citations

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A systematic review of the literature on localized gastrointestinal tract amyloidosis: Presentation, management and outcomes
Mariuxi Alexandra Viteri Malone, David Alfonso Alejos Castillo, Heitor Tavares Santos, Anahat Kaur, Tarek Elrafei, Lewis Steinberg, Abhishek Kumar
European Journal of Haematology.2024; 113(4): 400. CrossRef
Iatrogenic Sigma Perforation in a Patient with Localized Rectal and Sigma AL Amyloidosis: A Forensic Case and a Literature Review
Giuseppe Davide Albano, Stefania Zerbo, Simone Di Franco, Elisabetta Orlando, Eleonora Formisano, Antonina Argo, Beatrice Belmonte
Forensic Sciences.2024; 4(3): 453. CrossRef
Systemic Immunoglobulin Light Chain Amyloidosis Involving the Large Intestine
Renugadevi Swaminathan, Samuel Igbinedion, Sudha Pandit
ACG Case Reports Journal.2021; 8(5): e00578. CrossRef
Unusual case of amyloidosis presenting as a jejunal mass
Sachin Mohan, Elliot Graziano, James Campbell, Irshad H Jafri
BMJ Case Reports.2021; 14(5): e240226. CrossRef
Gastrointestinal AA amyloidosis secondary to chronic pyelonephritis presenting with refractory diarrhea and severe hypoalbuminemia
Tomoko Tanaka, Tatsushi Naito, Yohei Midori, Takuto Nosaka, Kazuto Takahashi, Kazuya Ofuji, Hidetaka Matsuda, Masahiro Ohtani, Katsushi Hiramatsu, Yoshiaki Imamura, Osamu Yokoyama, Hironobu Naiki, Yasunari Nakamoto
Clinical Journal of Gastroenterology.2021; 14(6): 1642. CrossRef
Morphological and Immunohistochemical Characteristics of Experimental Mandibular Fractures Healing Process
A. A. Matchin, A. A. Stadnikov, E. V. Nosov, S. Kh. Kiriakidi
Journal of Anatomy and Histopathology.2019; 8(1): 44. CrossRef
Specific Clinical and Morphological Characteristics of Amyloidosis of the Stomach and Duodenum
Z. V. Gioeva, L. M. Mikhaleva
Journal of Anatomy and Histopathology.2019; 8(1): 39. CrossRef
Localized Gastrointestinal ALλ Amyloidosis
Tomoya Iida, Kentaro Yamashita, Hiroshi Nakase
Clinical Gastroenterology and Hepatology.2018; 16(9): e93. CrossRef
Small Bowel Amyloidosis
Raghav Bansal, Umer Syed, Jacob Walfish, Joshua Aron, Aaron Walfish
Current Gastroenterology Reports.2018;[Epub] CrossRef
Systemic amyloidosis with gastrointestinal involvement: Diagnosis from endoscopic and histological views
Tomoya Iida, Hiroo Yamano, Hiroshi Nakase
Journal of Gastroenterology and Hepatology.2018; 33(3): 583. CrossRef

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Original Articles

Does Metformin Affect The Incidence of Colonic Polyps and Adenomas in Patients with Type 2 Diabetes Mellitus?: Youn Hee Cho, Bong Min Ko, Shin Hee Kim, Yu Sik Myung, Jong Hyo Choi, Jae Pil Han, Su Jin Hong, Seong Ran Jeon, Hyun Gun Kim, Jin Oh Kim, Moon Sung Lee; Intest Res 2014;12(2):139-145. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.139

Abstract PDF PubReader

Background/Aims

Colorectal cancer (CRC) develops from colonic adenomas. Type 2 diabetes mellitus (DM) is associated with a higher risk of CRC and metformin decreases CRC risk. However, it is not certain if metformin affects the development of colorectal polyps and adenomas. This study aimed to elucidate if metforminaffects the incidence of colonic polyps and adenomas in patients with type 2 DM.

Methods

Of 12,186 patients with type 2 DM, 3,775 underwent colonoscopy between May 2001 and March 2013. This study enrolled 3,105 of these patients, and divided them in two groups: 912 patients with metformin use and 2,193 patients without metformin use. Patient clinical characteristics, polyp and adenoma detection rate in the two groups were analyzed retrospectively.

Results

The Colorectal polyp detection rate was lower in the metformin group than in the non-meformin group (39.4% vs. 62.4%, P<0.01). Colorectal adenoma detection rate was significantly lower in the metformin group than in the non-metformin group (15.2% vs. 20.5%, P<0.01). Fewer advanced adenomas were detected in the metformin group than in the non-metformin group (12.2% vs. 22%, P<0.01). Multivariate analysis identified age, sex, Body mass index and metformin use as factors associated with polyp incidence, whereas only metforminwas independently associated with decreased adenoma incidence (Odd ratio=0.738, 95% CI=0.554-0.983, P=0.03).

Conclusions

In patients with type 2 DM, metformin reduced the incidence of adenomas that may transform into CRC. Therefore, metformin may be useful for the prevention of CRC in patients with type 2 DM.

Citations

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Metformin for primary prevention of colorectal neoplasms in adenoma-free populations: a systematic review and dose-response meta-analysis
Mengdan Shen, Shan Lu, Zihao Xu, Feifei Zhou, Li-Ting Sheng, Qiang Yu
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Is Metformin Associated with a Lower Prevalence of Polyps, Adenomas, and Colorectal Carcinoma in Patients with Diabetes Mellitus?
Maria Inês Canha, Gonçalo Ramos, Rita Prata, Pedro Lages Martins, Marta Viúla Ramos, João Coimbra
Journal of Gastrointestinal Cancer.2024; 55(1): 435. CrossRef
Metformin administration in prevention of colorectal polyps in type 2 diabetes mellitus patients
Xiao-Qing Wu, Li-Hua Deng, Qian Xue, Xia Li, Meng-Han Li, Jing-Tong Wang
World Journal of Clinical Cases.2024; 12(20): 4206. CrossRef
Anti-cancer Efficacy of Metformin: Recent Updates on Breast and Other Cancers
Md. Imtiazul Kabir, Robin Kumar, Lakshmi Sai Pratyusha Bugata, Komal Raina
Current Pharmacology Reports.2023; 9(5): 284. CrossRef
Metformin Use Is Inversely Associated with Prevalent, but Not Incident Colorectal Adenomas
Anna Krigel, Snow Trinh T. Nguyen, Nawar Talukder, Ching-Ho Huang, Carlos Buitrago, Gabriel Karkenny, Benjamin Lebwohl, Julian A. Abrams, James L. Araujo
Digestive Diseases and Sciences.2022; 67(10): 4886. CrossRef
Effect of metformin on thyroid cancer risk in patients with acromegaly: A preliminary observational study
Cem Sulu, Ayyuce Begum Bektas, Suleyman Sami Guzel, Kubilay Tay, Serdar Sahin, Emre Durcan, Hande Mefkure Ozkaya, Pinar Kadioglu
Growth Hormone & IGF Research.2022; 66: 101484. CrossRef
Metformin Modifies the Gut Microbiota of Mice Infected with Helicobacter pylori
Marine Jauvain, Sarah Courtois, Philippe Lehours, Emilie Bessède
Pharmaceuticals.2021; 14(4): 329. CrossRef
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Suppressive effects of metformin on colorectal adenoma incidence and malignant progression
Min Deng, Siqin Lei, Dongdong Huang, Hui Wang, Shuli Xia, Enping Xu, Yihua Wu, Honghe Zhang
Pathology - Research and Practice.2020; 216(2): 152775. CrossRef
Use of metformin and risk of breast and colorectal cancer
Gad Rennert, Hedy S. Rennert, Naomi Gronich, Mila Pinchev, Stephen B. Gruber
Diabetes Research and Clinical Practice.2020; 165: 108232. CrossRef
Diabetes Mellitus: a Clinical Condition Associated with Metabolic Syndrome and Colorectal Cancer Risk
Vesna Brzacki, Aleksandar Nagorni, Manolis Kallistratos, Athanasios Manolis, Dragan Lovic
Current Pharmacology Reports.2019; 5(4): 205. CrossRef
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Junichi Kato, Yohei Shirakami, Masahito Shimizu
Gastrointestinal Disorders.2019; 1(2): 273. CrossRef
Metformin in colorectal cancer: molecular mechanism, preclinical and clinical aspects
Muhamad Noor Alfarizal Kamarudin, Md. Moklesur Rahman Sarker, Jin-Rong Zhou, Ishwar Parhar
Journal of Experimental & Clinical Cancer Research.2019;[Epub] CrossRef
Postoperative adjuvant chemotherapy is associated with a lower incidence of colorectal adenomas in patients with previous colorectal cancer
Hee Seung Lee, Sung Bae Kim, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Jae Hee Cheon, Won Ho Kim, Tae Il Kim
Gastrointestinal Endoscopy.2018; 87(3): 688. CrossRef
Parameters of Glucose and Lipid Metabolism Affect the Occurrence of Colorectal Adenomas Detected by Surveillance Colonoscopies
Nam Hee Kim, Jung Yul Suh, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Chong Il Sohn, Kyuyong Choi, Yoon Suk Jung
Yonsei Medical Journal.2017; 58(2): 347. CrossRef
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Mirabella Zhao, Donghua Liao, Jingbo Zhao
World Journal of Diabetes.2017; 8(6): 249. CrossRef
Metformin use and the risk of colorectal adenoma: A systematic review and meta‐analysis
Yoon Suk Jung, Chan Hyuk Park, Chang Soo Eun, Dong Il Park, Dong Soo Han
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Juhong Yang, Reiko Nishihara, Xuehong Zhang, Shuji Ogino, Zhi Rong Qian
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Yi-Chao Hou, Qiang Hu, Jiao Huang, Jing-Yuan Fang, Hua Xiong
Oncotarget.2017; 8(5): 8843. CrossRef
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Feifei Liu, Lijing Yan, Zhan Wang, Yuanan Lu, Yuanyuan Chu, Xiangyu Li, Yisi Liu, Dongsheng Rui, Shaofa Nie, Hao Xiang
Oncotarget.2017; 8(9): 16017. CrossRef
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Azza Ali Abdelsatir, Nazik Elmalaika Husain, Abdallah Tarig Hassan, Wadie M Elmadhoun, Ahmed O Almobarak, Mohamed H Ahmed
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Yoon Suk Jung, Jung Ho Park, Dong Il Park, Chong Il Sohn, Kyuyong Choi
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Clinical Comparison for Colon Polyps between Right and Left Colon in Koreans: Wook Hyun Um, Hyun Gun Kim, Seong Ran Jeon, Tae Hee Lee, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joo Young Cho, Joon Seong Lee, Moon Sung Lee; Intest Res 2012;10(4):372-378. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.372

Abstract PDF

Background/Aims
Comparative studies of colon polyps between right and left colon in Korean population are limited. We investigated the clinical characteristics of the patients according to polyp location and compared the results of the morphological and histological analysis of right and left colon polyps. Methods: The study was performed prospectively for the patients who underwent colon polypectomy for health check-ups in a single tertiary center. The patients were classified into three groups by the location of the polyps: right group (from the cecum to the splenic flexure), left group (from the descending colon to the anus), and total group. The size, the morphology, the location and the pathology of the polyps were evaluated. Results: From June 2010 to June 2011, Overall 2596 polyps from 950 patients (male=646) were analyzed. Colon polyps were right side-shift with increased patients age (P<0.001). The incidence of polyps was most common in sigmoid colon (26.5%). Polyps less than 5 mm size were more common in left colon (P<0.001) and flat polyps larger than 1 cm in right colon (P=0.006), respectively. In histopathological findings, the distribution of advanced adenoma was not different according to the location, however tubular adenomas and serrated adenomas (P<0.001) were more common in right colon. Female was more distributed in right group, respectively (P<0.001). Conclusions: In a single center study, colon polyps were more distributed in right colon with age and in females. Also flat polyps larger than 1cm, tubular adenoma and serrated adenoma were found in larger proportion in right colon. (Intest Res 2012;10:372-378)

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Clinicopathological features of colorectal polyps in 2002 and 2012
Yoon Jeong Nam, Kyeong Ok Kim, Chan Seo Park, Si Hyung Lee, Byung Ik Jang
The Korean Journal of Internal Medicine.2019; 34(1): 65. CrossRef

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Clinical Significance of Screening Colonoscopy in Elderly: A KASID Multi-center Study: Sung Geun Park, Dong Il Park, Young-Ho Kim, Hyun Soo Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk-Kyun Yang, Jeong-Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Sung-Ae Jung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Dong Soo Han, Jae Suk Song; Intest Res 2008;6(1):25-30. Published online June 30, 2008

Abstract PDF: Background/Aims
Currently, screening colonscopy is widely performed in the medical field. The initial time of screening is recommended at an age of 50 years, but the age to cease screening is unknown. Accordingly, we have investigated the diagnostic yield of colonoscopy according to indications in the elderly, and we evaluated if screening colonoscopy is useful in the elderly. Methods: We recruited asymptomatic individuals undergoing screening colonoscopy according to age (2830 subjects aged 50-74 years and 111 subjects ≥75 years-old), The colonoscopy findings of the study subjects were compared. In addition, colonoscopy findings of asymptomatic subjects more than 75 years-old were compared with the findings of symptomatic subjects with the same age. Results: The yield for overall neoplasia and advanced adenoma was higher in the group of subjects ≥75 years-old than in the 50-74 years age group (overall adenoma: 49.54% versus 24.98%, p＜0.001; advanced adenoma: 16.2% versus 8.23%, p=0.003). The overall frequency of neoplasms was higher in asymptomatic subjects ≥75 years-old than in symptomatic subjects ≥75 years-old (49.54% versus 28.19%, p＜0.001). Conclusions: The prevalence of advanced adenoma increased with age. Screening colonoscopy was still significantly effective in elderly subjects ≥75 years-old. The lack of a decline in the frequency of adenoma, including advanced adenoma, justifies continuing screening colonoscopy in the elderly. (Intest Res 2008;6:25-30)

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Review

Balloon Enteroscopy: Bong Min Ko, Moon Sung Lee; Intest Res 2007;5(1):06-12. Published online June 30, 2007

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Case Report

A Case of Gastrointestinal Stromal Tumor of the Jejunum with Hemorrhage Which was Preoperatively Diagnosed by Double Balloon Enteroscopy: Sang Hoon Han, Chang Bum Ryu, Hyun Sik Na, Sang Gyune Kim, Bong Min Ko, Kye Won Kwon, Su Jin Hong, Young Suk Kim, Jin Oh Kim, Joon Seong Lee, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim; Intest Res 2006;4(2):110-113. Published online December 30, 2006

Abstract PDF: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tracts that usually arise in the stomach and small intestine. Recent studies, suggest that they originate from gastrointestinal pacemaker cells (interstitial cell of Cajal). In most cases symptoms are nonspecific and diagnosis is achieved incidentally after radiologic evaluation. Some patients initially present with obscure GI bleeding and are diagnosed after sugical intervention. We report a patient who presented with hematochezia who was diagnosed preoperatively with gastrointestinal stromal tumor of the jejunum by double-balloon enteroscopy and multi-directional computed tomogram. (Intestinal Research 2006;4:110-114)

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Original Articles

Clinical Value of Distal Colon Polyps for Prediction of Advanced Proximal Neoplasia: The KASID Prospective Multicenter Study: Bora Keum, Yoon Tae Jeen, Jai Hyun Choi, Sung-Ae Jung, Hyun Soo Kim, Young-Ho Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk Kyun Yang, Seung Jae Myung, Jeong Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Hwang Choi, Dong Soo Han, Jae Suk Song; Intest Res 2005;3(2):121-126. Published online December 30, 2005

Abstract PDF: Backgroud/Aims: Proximal lesion without distal finding is weak point in colon cancer screening. Clinical significance of distal finding for advanced proximal neoplasia (APN) is uncertain. Aims of this study were to assess distal finding for prediction of APN. Methods: Asymptomatic 826 adults (age≥50) were collected in KASID prospective study, who underwent colonoscopy and polypectomy. Polyps located distal to splenic flexure were defined as distal polyps. Age, gender, size, appearance, histology of distal polyps were analyzed as risk factor of APN (adenoma≥10 mm or villous histology or high grade dysplasia or invasive cancer). Sensitivity and positive predictive value of distal polyp on APN were assessed. Results: APN were found in 98 patients and 45 (45.9%) patients of them were not associated with any distal findings. Risk factors of APN were male, size of distal polyp and advanced distal polyp. Sensitivity of distal polyp size≥10 mm on APN was 38.8% and advanced distal polyp also 38.8%. Positive predictive value of distal polyp size≥10 mm and advanced distal polyp were 13.3%, 14.4% respectively. Conclusions: Although distal colon findings were helpful to predict APN in asymptomatic 50 years of age or order patients screening, more careful examination is required considering APN without distal polyps. (Intestinal Research 2005;3:121-126)

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Clinicopathological Characteristics and Malignant Potential of Colonic Flat Adenomas Compared to That of Polypoid Adenomas: Myeong Gwan Jee, Hyun Soo Kim, Won Ho Kim, Tae Il Kim, Dong Il Park, Young-Ho Kim, Hyo Jong Kim, Jeong-Sik Byeon, Suk-Kyun Yang, Moon Sung Lee, Il Kwon Jung, Sung-Ae Jung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Kyu Yong Choi, Dong Soo Han; Intest Res 2005;3(2):127-132. Published online December 30, 2005

Abstract PDF: Background/Aims
Colorectal flat adenomas have been a topic of debate in the view of malignant potential. The aims of this study are to investigate the clinicopathological features of flat adenomas compared to that of polypoid adenomas and to identify the determinants for malignant transformation in colorectal flat and polypoid adenomas. Methods: This was a prospective, cross sectional study of 3,360 patients who diagnosed as adenomas via total colonoscopy and polypectomy at 13 tertiary medical centers between July 2003 and July 2004. Potential risk factors for malignant transformation were analyzed. Results: Out of 3,360 adenomas, 207 (6.2%) were flat adenomas and 3,153 (93.8%) were polypoid adenomas. The patients with flat adenoma were older (59.6 vs. 57.1, p＜0.01) and more frequently located in the right colon than polypoid adenomas (49.3% vs. 32.0%, p<0.01). The incidence of high grade dysplasia or cancer in flat adenomas was similar to that of polypoid adenomas (5.4% vs. 4.6%, p=0.36). Multivariate analysis revealed that the size ≥11 mm (OR 6.8; 95% CI 4.8-9.7) and location of adenoma in the left colon (OR 1.6; 95% CI 1.07-2.38) were significant determinants for malignant potential of colonic adenoma. Conclusions: Clinicopathological determinants for malignant potential in colorectal adenomas were not gross morphology but size and location of adenoma. (Intestinal Research 2005;3:127-132)

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Usefulness of Double Balloon Enteroscopy in Small Bowel Disease: Jun Hwan Wi, Jin Oh Kim, In Seop Jung, Bong Min Ko, Joo Young Cho, Joon Seong Lee, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim; Intest Res 2005;3(2):140-144. Published online December 30, 2005

Abstract PDF: Background/Aims
Conventional studies for small bowel such as small bowel series, enteroscopy with Push, Sonde and Ropeway method had some limitations such as high missing rate, incomplete study, long procedure time and patient inconvenience. Double balloon enteroscopy is a promising method to overcome these limitations. Our aim was to evaluate the usefulness of double balloon enteroscopy. Methods: Between Nov. 2004 and Feb. 2005, 24 patients with suspected small bowel disease underwent double balloon enteroscopy. Results: Indications for double balloon enteroscopy were obscure gastrointestinal bleeding, chronic abdominal pain and Crohn's disease etc. Thirty eight cases of double balloon enteroscopy in 24 patients were performed. We could identify positive diagnostic findings in 20 of the 24 patients. In 16 obscure gastrointestinal bleeding patients, the causes of bleeding were 7 small bowel ulcers, 4 angiodysplasias, 3 Crohn's diseases etc. Procedure-related complications were not observed in any patients. Conclusions: Double balloon enteroscopy is a useful and safe diagnostic tools in small bowel disease with high diagnostic accuracy (83%). (Intestinal Research 2005;3:140-144)

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The Characteristics of Colorectal Adenoma with Colonoscopic Polypectomy in Population under 50 Years Old: The KASID Prospective Multicenter Study: Hyun Joo Song, Sung-Ae Jung, Hyun Soo Kim, Young-Ho Kim, Won Ho Kim, Tae Il Kim, Hyo Jong Kim, Suk Kyun Yang, Seung Jae Myung, Jeong Sik Byeon, Moon Sung Lee, Il Kwon Jung, Moon Kwan Chung, Yoon Tae Jeen, Jai Hyun Choi, Hwang Choi, Dong Soo Han, Jae Suk Song; Intest Res 2005;3(1):18-26. Published online June 30, 2005

Abstract PDF: Background/Aims
The current practice of colonoscopic polypectomy reduce the risk of colorectal cancer. However, clinicopathologic charateristics of colorectal adenoma in population under 50 years old are uncertain. This study was performed to investigate clinicopathologic characteristics of colorectal adenoma and to determine colonoscopic indication of advanced adenoma in this population. Methods: A large scale, multicenter, prospective study was conducted from July 2003 through June 2004. Of the total 19,288 patients performed colonoscopy at 11 tertiary medical centers, we analysed 3,366 patients who undergone polypectomy and divided two groups by age of 50. Results: Among colonoscopic polypectomy, 10.7 percent (831/7,789) was younger patients and 22.0 percent (2.535/11,499) was older patients (p＜0.001), and the detection rate of advanced adenoma was significantly lower in younger patients than older patients (17.7% vs. 21.1%, p＜0.0050). In younger patients, the indications of colonoscopy were asymptomatic screening (32.7%), bowel habit change (24.0%), abdominal pain (16.8%), hematochezia (9.2%) and so on. The risk factors for advanced adenoma as colonoscopic indications in younger patients were hematochezia (OR 1.9, 95% CI 1.1-3.3) and referred patients from primary clinic (OR 2.0, 95% CI 1.3-3.0). Conclusions: This study documents lower prevalence of adenoma requiring polypectomy in younger patients compared with older patients and the low detection rate of advanced adenoma. Also, in this younger population, the colonoscopic polypectomy should be the first consideration in polyps with hamatochezia patients or referred patients from primary clinic. (Intest Res 2005;3:18-26)

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Endoscopic Mucosal Resection of Early Colon Cancer: Additional Therapy and Clinical Outcomes: Sang Gyune Kim, Chang Beom Ryu, Moon Sung Lee, Bong Min Ko, Sung Won Jung, Su Jin Hong, Young Seok Kim, Jin Oh Kim, Kye Won Kwon, Chan Sup Shim, Boo Sung Kim; Intest Res 2004;2(2):65-70. Published online December 22, 2004

Abstract PDF: Background/Aims
The prevalence of early colon cancer is increasing and endoscopic removal of it has been widely accepted. After endoscopic resection, a number of remnant or recurrent tumors were managed successfully through salvage endoscopic mucosal resection (EMR) or argon plasma coagulation (APC). This study evaluated the outcomes of EMR for early colon cancer and efficacy of additional therapy in preventing recurrence. Methods: During the period from March 2001 to April 2004, a total of 50 early colon cancers were resected and analyzed retrospectively. EMR was performed either piecemeal by snare and cap aspiration or en bloc by conventional EMR and submucosal dissection. The patients were followed up at 3, 6, 12, 24 months and median follow up period was 21.8 months. By using the magnifying endoscopy, If the endoscopists judged the tumors incompletely excised or recurred. APC and EMR as additional therapy were done. Results: 50 early colon cancers comprised 44 mucosal cancers and 6 submucosal cancers in which en bloc resection was 34 (68%) and piecemeal resection was 16 (32%). Apart from the 13 cases which is unable to decide its lateral margin free because of piecemeal resection, Complete resection rate was 26/37(70.3%). The 20 cases receiving additional therapy consisted of en bloc resection 8 cases and piecemeal resection 12 cases. Recurrence rate of previous additional therapy was 1/20(5%) and had no significant difference with no additional therapy. Conclusions: For endoscopic treatment of early colon cancer En bloc resection is much better than piecemeal resection. Because of its high complete resection rate. But, in case of suggestive incomplete resection, recurrence rate will be decreased through the additional therapy. The long term results of additional therapy after EMR for Early colon cancer seem to be required for more study. (Intestinal Research 2004;2:65-70)

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Clinical Study for Gastrointestinal Carcinoid Tumor; Aspect of Endoscopic, Endosonographic Findings and Endoscopic Treatment: Bong Min Ko, Chang Beom Ryu, Moon Sung Lee, Kye Won Kwon, Sang Gyune Kim, Sung Won Jung, Su Jin Hong, Jin Oh Kim, Chan Sup Shim, Boo Sung Kim; Intest Res 2004;2(2):89-95. Published online December 22, 2004

Abstract PDF: Background/Aims
Because screening for colonic cancer includes colonoscopy, more of carcinoid tumors may be diagnosed at an earlier stage. Metastatic disease is rare in lesions smaller than 1cm and common in lesions larger than 2cm. Small lesions are managed with local excision or endoscopic resection. Endoscopic resection, a major advance in endoscopy, provides an endoscopic option for management of carcinoid tumor of the GI tract. We study to evaluate the efficacy and safety of high-frequency probe EUS-assisted endoscopic resection in the management of carcinoid tumor of the GI tract, to evaluate of clinical usefulness of cap aspiration method in comparison with snare polypectomy. Methods: For 31 patients, snare polypectomy and cap aspiration lumpectomy were performed between February 2001 and September 2004 after evaluating by endosonography. Results: EUS examination confirmed that all of the rectal carcinoid tumor were hypoechic mass confined to the second or third layer of the rectum. The rate of complete removal of carcinoid tumors with aspiration lumpectomy was significantly higher than with snare polypectomy (p<0.05). Conclusions: EUS can provide precise information about size, layer of origin, and echogenicity of the carcinoid tumor. It is useful in the diagnosis of carcinoid of the rectum and can have an important role in the choice of therapy. Endoscopic resection with cap is a useful and safe method for resection of small carcinoid tumor of the rectum according to endoscopic shape and EUS findings. (Intestinal Research 2004;2:89-94)

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High Dose Midazolam versus Propofol plus Midazolam in Conscious Sedation during Colonoscopy: Sung Won Jung, Sang Kyune Kim, Moon Sung Lee, Bong Min Ko, Su Jin Hong, Chang Beom Ryu, Young Seok Kim, Jin Oh Kim, Chan Sup Shim, Boo Sung Kim; Intest Res 2004;2(2):107-112. Published online December 22, 2004

Abstract PDF: Background/Aims
Colonoscopy under sedation has grown in popularity recently. Midazolam and propofol are generally used for conscious sedation during colonoscopy. In comparison of midazolma, propofol is shorter-acting hypnotic agent and has shorter plasma half-life and it was reported that combined use of propofol with benzodiazepines, barbiturates or opioids enhanced sedative effect by drug interaction. We investigated the effect of high dose midazolam and combined use of midazolam and propofol in conscious sedation during colonoscopy. Methods: We injected midazolam intravenously in 61 patients for sedation before colonoscopy. We divided patients into two groups; one group was injected with additional midazolam (31 patients, high dose midazolam group) and the other was injected with additional propofol (30 patients, combined group). We compared followings in both groups; 1) decrease of systolic and diastolic blood pressure, heart rate, respiration rate per minute, and oxygen saturation rate 2) recovery time 3) degree of amnesia 4) content of patient 5) adverse effects. Results: There is no significant difference between two groups in sex and mean age. In both groups, significant difference was not observed in decrease of systolic and diastolic blood pressure, heart rate, respiration rate, and peripheral blood oxygen saturation rate (p>0.05). Recovery time was shorter in combined group than in high dose midazolam group (p<0.05). Content of patients was higher in combined group (p<0.05), Fatal adverse effect was not found in both groups. Conclusions: Combine use of midazolam and propofol is more effective sedative method than use of high dose midazolam because of shorter recovery time and increased content of patients without increasing adverse effect. (Intestinal Research 2004;2:107-112)

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Brief Report

A case of Small Bowel Obstruction due to Jejunal Adenocarcinoma Diagnosed by Double-balloon Enteroscopy: Su Jin Hong, Jun Yong Bae, Moon Sung Lee, Sung Won Jung, Sang Gyune Kim, Bong Min Ko, Chang Beom Ryu, Young Seok Kim, Jin Oh Kim, Chan Sup Shim, Boo Sung Kim; Intest Res 2004;2(2):124-128. Published online December 22, 2004

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Original Articles

Clinical Review about Colon Perforation Complicated Diagnostic or Therapeutic Colonoscopy: Song Won Jung, Chang Beom Ryu, Yon Soo Kim, Min Soo Song, Bong Min Ko, Sang Woo Cha, Kwon Ho You, Soo Jin Hong, Young Seok Kim, Jong Ho Moon, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim; Intest Res 2004;2(1):21-25. Published online April 16, 2004

Abstract PDF: Colonoscopy is used increasingly because the indication for therapeutic colonoscopy has been increased and the technique has been developed continuously as well as colonosopy is useful for diagnosis of colonic disease. Therefore, It is important understanding precisely about the complication of colonoscopy and managing the complication immediately and properly. In particular, colon perforation is the most fatal, emergency case and have needed surgical treatment, generally. Recently, the case treated with endoscopic clipping and conservative management has been reported. but until now, when perforated, wheather the endoscopic clipping or the surgical management at each other case is beneficial is not confirmed. (Intestinal Research 2004;2:21-25)

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Usefulness of Follow-up Colonoscopy in Laterally Spreading Tumor Resected by Endoscopic Piecemeal Mucosal Resection: Hwan Yeol Kim, Bong Min Ko, Sang Woo Cha, Kye Won Kwon, Soo Jin Hong, Chang Beom Ryu, Young Seok Kim, Jong Ho Moon, Jin Oh Kim, Joo Young Cho, Joon Sung Lee, Moon Sung Lee, Chan Sup Shim, Boo Sung Sung Kim; Intest Res 2003;1(2):186-191. Published online November 27, 2003

Abstract PDF: Background/Aims
Laterally spreading tumors (LST) of the colon are defined as tumors over 10 mm in diameter that are low in height and grow superficially. These tumors are highly malignant and usually mucosal lesions, therefore endoscopic mucosal resection is desirable. We analysed retrospectively the result of endoscopic piecemeal mucosal resection (EPMR) in LSTs larger than 20 mm in diameter. Methods: 21 patients with LSTs larger than 20 mm in diameter were treated using EPMR. The resection sites were examined for residual or recurrent lesions by follow-up colonoscopy. Results: Of the 21 patients who underwent EPMR, 2 patients performed surgical resection and 4 patients were lost during follow-up period. Residual or recurrent lesions were detected in 5 of these 15 patients after EPMR. After additional endoscopic therapy, no more residual or recurrent lesions were detected. Conclusions: After EPMR for large LSTs, it is necessary to strictly follow-up at least within 1 year. (Intestinal Research 2003;2:186-191)

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Case Report

A Case of Recurrent Cancer after Endoscopic Resection for Colorectal Mucosal Cancer: Hwan Yeol Kim, Bong Min Ko, Kye Won Kwon, Soo Jin Hong, Chang Beom Ryu, Young Seok Kim, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim; Intest Res 2003;1(2):201-210. Published online November 27, 2003

Abstract PDF: Early colon cancers were resected endoscopically in many cases. But problems with recurrences and remnants of tumors have occured. We reported a case of recurrent cancer on 9 months after endoscopic resection for mucosal cancer of colon, with review of relevant literature. (Intestinal Research 2003;2:201-204)

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Original Articles

Usefulness of a Self-expandable Metal Stent Through the Scope for Malignant Colorectal Obstruction: Chang Beom Ryu, Hwan Yeol Kim, Kang An Kwon, In Sup Jung, Su Jin Hong, Jin Oh Kim, Joo Young Cho, Joon Sung Lee, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim; Intest Res 2003;1(1):45-50. Published online May 27, 2003

Abstract PDF: Background/Aims
The optimal palliative treatment of unresectable colorectal malignant obstruction is still debated. Recently, successful short-term palliation of malignant colorectal obstruction using self-expandable metal stents has been reported by several groups of investigators. Aims: The aim of this study was to evaluate the clinical usefulness of these self-expandable metal stents (SEMS) through the scope for the treatment of malignant colorectal cancer. Methods: Between May 1999 and December 2002, 35 patients (M:F=19:16) with malignant colorectal obstruction were treated for relief from the obstruction with endoscopically guided intubation of a SEMS through the working channel of an endoscope. Uncovered stents were intserted in 29 patients and covered stents in 6 patients. The technical and clinical success rates and complication were evaluated. Results: The sites of obstructions were on the rectum (n=3), sigmoid colon (n=9), descending colon (n=9), transverse colon (n=8) and ascending colon (n=6). SEMS insertion was successful in 34 of 35 patients (97%). In 31 of 34 patients with successful placement of the stent, symptoms of obstruction resolved within 72 hours. Two patients underwent the formal bowel preparation and elective single-stage surgery without complication 10 and 60 days after stent placement. Perforation occurred in 1 patients during stent placement and died. The mean follow up was 144 days (5-610 days). Stent migration occurred in 7 patients during follow-up who were 2 (33.3%) of 6 patients with covered stent and 5 (17.8%) of 28 patients with uncovered stent. After migration of stents, another stent was reinserted in 3 of 7 patients. Obstruction of the stent because of tumor ingrowth and overgrowth was observed in 4 patients with uncovered stent. Conclusions: SEMS placement through the working channel of an endoscope provide not only palliative decompression in cases with inoperable malignant colorectal obstruction but preoperative decompression to undergo the one-step surgery in patients with malignant colorectal obstruction. (Intestinal Research 2003;1:45-50)

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Analysis of Early Colon Cancers Diagnosed by Endoscopic Resection: Bong Roung Kim, Jin O Kim, Seong Hwan Kim, Sang Ho Lee, In Seop Jung, Su Jin Hong, Chang Byum Ryu, Joo Yung Cho, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim, So Young Jin; Intest Res 2003;1(1):51-54. Published online May 27, 2003

Abstract PDF: Backgrounds/Aims: The aim of this study was to analyze clinicopathologic feature of early colon cancer diagnosed by endoscopic resection. Methods: 41 early colon cancers from 22 patients endoscopically removed during the period from 2001.1~2002.6 were analysed. Results: 22 patients who were diagnoised as early colon cancer patient had totally 210 colonic polyps and 41 early colonic cancers. Most common age of distributuion was 6th decade. Of the 41 early colon cancers, malignant polyps less than 5 mm in size were in 43%, 6~10 mm in 10%, 11~20 mm in 21%, >21 mm in 26%. Malignant polyps were more common in left side colon than right side colon (7:3). Endoscopic shapes of early colon cancers were mostly sessile type (sessile type were in 90.2%). Conclusions: Significant fraction of early colon cancers were less than 1 cm in size. To detect and treat early colon cancers more earlier, It is advisable to remove all of the colon polyps even though small polyps. (Intestinal Research 2003;1:51-54)

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Case Report

A Case of Colonic Ameboma: Hwan Yeo Kim, Bong Min Ko, Kye Won Kwon, Soo Jin Hong, Chang Beom Ryu, Jin Oh Kim, Joo Young Cho, Joon Sung Lee, Moon Sung Lee, Chan Sup Shim, Boo Sung. Kim; Intest Res 2003;1(1):68-71. Published online May 27, 2003

Abstract PDF: Amebiasis is observed worldwide. Usual symptoms of amebiasis include bloody stool, diarrhea, abdominal pain, fever and weight loss. Severe form of amebiasis is associated with perforation, pseudopolyp, peritonitis, toxic megacolon and ameboma. An ameboma represents a localized amebic infection with organized granulation tissue and is almost found in cecum and rectum. We report a case of ameboma of rectum detected incidentally without specific symptom, with review of relevant literature. (Intestinal Research 2003;1:68-71)

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