Intestinal Research

Original Articles

Colorectal neoplasia

A survey of current practices in post-polypectomy surveillance in Korea: Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran 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, on behalf of the Intestinal Tumor Research Group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2024;22(2):186-207. Published online April 25, 2024; DOI: https://doi.org/10.5217/ir.2023.00109

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
We investigated the clinical practice patterns of post-polypectomy colonoscopic surveillance among Korean endoscopists.
Methods
In a web-based survey conducted between September and November 2021, participants were asked about their preferred surveillance intervals and the patient age at which surveillance was discontinued. Adherence to the recent guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) was also analyzed.
Results
In total, 196 endoscopists completed the survey. The most preferred first surveillance intervals were: a 5-year interval after the removal of 1–2 tubular adenomas < 10 mm; a 3-year interval after the removal of 3–10 tubular adenomas < 10 mm, adenomas ≥ 10 mm, tubulovillous or villous adenomas, ≤ 20 hyperplastic polyps < 10 mm, 1–4 sessile serrated lesions (SSLs) < 10 mm, hyperplastic polyps or SSLs ≥ 10 mm, and traditional serrated adenomas; and a 1-year interval after the removal of adenomas with highgrade dysplasia, >10 adenomas, 5–10 SSLs, and SSLs with dysplasia. In piecemeal resections of large polyps ( > 20 mm), surveillance colonoscopy was mostly preferred after 1 year for adenomas and 6 months for SSLs. The mean USMSTF guideline adherence rate was 30.7%. The largest proportion of respondents (40.8%–55.1%) discontinued the surveillance at the patient age of 80–84 years.
Conclusions
A significant discrepancy was observed between the preferred post-polypectomy surveillance intervals and recent international guidelines. Individualized measures are required to increase adherence to the guidelines.

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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; Intest Res 2016;14(2):164-171. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.164

Abstract PDF PubReader ePub

Background/Aims

Rectal neuroendocrine tumors (NETs) are among the most common of gastrointestinal NETs. Due to recent advances in endoscopy, various methods of complete endoscopic resection have been introduced for small (≤10 mm) rectal NETs. However, there is a debate about the optimal treatment for rectal NETs. In our study, we aimed to evaluate the efficacy and feasibility of endoscopic resection using pneumoband and elastic band (ER-BL) for rectal NETs smaller than 10 mm in diameter.

Methods

A total of 55 patients who were diagnosed with rectal NET from January 2004 to December 2011 at Gil Medical Center were analyzed retrospectively. Sixteen patients underwent ER-BL. For comparison, 39 patients underwent conventional endoscopic mucosal resection (EMR).

Results

There was a markedly lower deep margin positive rate for ER-BL than for conventional EMR (6% [1/16] vs. 46% [18/39], P=0.029). Four patients who underwent conventional EMR experienced perforation or bleeding. However, they recovered within a few days. On the other hand, patients whounderwent endoscopic resection using a pneumoband did not experience any complications. In multivariate analysis, ER-BL (P=0.021) was independently associated with complete resection.

Conclusions

ER-BL is an effective endoscopic treatment with regards to deep margin resection for rectal NET smaller than 10 mm.

Citations

Citations to this article as recorded by

Endoscopic treatments for rectal neuroendocrine tumors: a systematic review and network meta-analysis
Jie Chen, Jianfang Ye, Xiong Zheng, Jianyong Chen
Journal of Gastrointestinal Surgery.2024; 28(3): 301. CrossRef
Outcome of Endoscopic Resection of Rectal Neuroendocrine Tumors ≤ 10 mm
Roberta Elisa Rossi, Maria Terrin, Silvia Carrara, Roberta Maselli, Alexia Francesca Bertuzzi, Silvia Uccella, Andrea Gerardo Antonio Lania, Alessandro Zerbi, Cesare Hassan, Alessandro Repici
Diagnostics.2024; 14(14): 1484. CrossRef
Endoscopic mucosal resection using anchored snare Tip-in versus precut technique for small rectal neuroendocrine tumors
Seung Wook Hong, Dong-Hoon Yang, Yoo Jin Lee, Dong Hoon Baek, Jaeyoung Chun, Hyun Gun Kim, Sung Joo Kim, Seung-Mo Hong, Dae-Seong Myung
The Korean Journal of Internal Medicine.2023;[Epub] CrossRef
Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD
Yuki Kamigaichi, Ken Yamashita, Shiro Oka, Hirosato Tamari, Yasutsugu Shimohara, Tomoyuki Nishimura, Katsuaki Inagaki, Yuki Okamoto, Hidenori Tanaka, Ryo Yuge, Yuji Urabe, Koji Arihiro, Shinji Tanaka
DEN Open.2022;[Epub] CrossRef
Endoscopic Mucosal Resection in Children
David S. Vitale, Kelly Wang, Laith H. Jamil, Kenneth H. Park, Quin Y. Liu
Journal of Pediatric Gastroenterology and Nutrition.2022; 74(1): 20. CrossRef
Rectal neuroendocrine tumors: Current advances in management, treatment, and surveillance
Camilla Gallo, Roberta Elisa Rossi, Federica Cavalcoli, Federico Barbaro, Ivo Boškoski, Pietro Invernizzi, Sara Massironi
World Journal of Gastroenterology.2022; 28(11): 1123. CrossRef
Comparison of underwater endoscopic mucosal resection and endoscopic submucosal dissection of rectal neuroendocrine tumors (with videos)
Sung Sil Park, Kyung Su Han, Bun Kim, Byung Chang Kim, Chang Won Hong, Dae Kyung Sohn, Hee Jin Chang
Gastrointestinal Endoscopy.2020; 91(5): 1164. CrossRef
Treatment Results of Endoscopic Mucosal Resection with a Ligation Device for Duodenal Neuroendocrine Tumors
Ai Fujimoto, Motoki Sasaki, Osamu Goto, Tadateru Maehata, Yasutoshi Ochiai, Motohiko Kato, Atsushi Nakayama, Teppei Akimoto, Jyunko Kuramoto, Yuichiro Hayashi, Kaori Kameyama, Naohisa Yahagi
Internal Medicine.2019; 58(6): 773. CrossRef
Endoscopic submucosal resection with an endoscopic variceal ligation device for the treatment of rectal neuroendocrine tumors
Masahide Ebi, Shoko Nakagawa, Yoshiharu Yamaguchi, Yasuhiro Tamura, Shinya Izawa, Yasutaka Hijikata, Takaya Shimura, Yasushi Funaki, Naotaka Ogasawara, Makoto Sasaki, Takashi Joh, Kunio Kasugai
International Journal of Colorectal Disease.2018; 33(12): 1703. CrossRef
Neuroendocrine neoplasms of rectum: A management update
Emilio Bertani, Davide Ravizza, Massimo Milione, Sara Massironi, Chiara Maria Grana, Dario Zerini, Alessandra Nella Piccioli, Giuseppe Spinoglio, Nicola Fazio
Cancer Treatment Reviews.2018; 66: 45. CrossRef

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Case Reports

Removal of Rectal Foreign Bodies Using Tenaculum Forceps Under Endoscopic Assistance: Keun Joon Lim, Joon Sung Kim, Boo Gyoung Kim, Sung Min Park, Jeong-Seon Ji, Byung-Wook Kim, Hwang Choi; Intest Res 2015;13(4):355-359. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.355

Abstract PDF PubReader ePub

The incidence of rectal foreign bodies is increasing by the day, though not as common as that of upper gastrointestinal foreign bodies. Various methods for removal of foreign bodies have been reported. Removal during endoscopy using endoscopic devices is simple and safe, but if the foreign body is too large to be removed by this method, other methods are required. We report two cases of rectal foreign body removal by a relatively simple and inexpensive technique. A 42-year-old man with a vibrator in the rectum was admitted due to inability to remove it by himself and various endoscopic methods failed. Finally, the vibrator was removed successfully by using tenaculum forceps under endoscopic assistance. Similarly, a 59-year-old man with a carrot in the rectum was admitted. The carrot was removed easily by using the same method as that in the previous case. The use of tenaculum forceps under endoscopic guidance may be a useful method for removal of rectal foreign bodies.

Citations

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Characteristics and Outcomes Associated With Emergent Rectal Foreign Body Management: A Retrospective Cohort Analysis
Eric Frendt, Momin Masroor, Arman Saied, Arianna Neeki, Santana Youssoffi, Aldin Malkoc, Fanglong Dong, Louis Tran, Rodney Borger, David T Wong, Michael Neeki
Cureus.2023;[Epub] CrossRef
Management of unusual rectal foreign body – Case report and literature review
Ana Elisa de Landa Moraes Teixeira Grossi, Juan Eduardo Rios Rodriguez, Alexia Aina de Freitas Sousa, Danielle Alcântara Barbosa Machado, Victor Vinícius Monteiro Lins de Albuquerque, Frank Pinheiro Pessoa Coelho de Macedo
International Journal of Surgery Case Reports.2022; 94: 107051. CrossRef
Novel Bedside Utilization of Foley Catheter in the Emergent Removal of Colorectal Foreign Body: A Case Report and Literature Review
Terry Lefcourt, Andrew Ku, Leo Issagholian, Arianna S Neeki, Milton Retamozo, Fanglong Dong, Michael M Neeki
Cureus.2021;[Epub] CrossRef
Endoscopy-assisted Removal of a Large Rectal Foreign Body by the Valsalva Maneuver
Min Young Son, Seun Ja Park, Won Moon, Gyu Man Oh, Moo In Park, Sung Eun Kim, Jae Hyun Kim, Kyoungwon Jung
The Korean Journal of Gastroenterology.2020; 76(1): 42. CrossRef
Rectal Foreign Body Removal in the Emergency Department: A Case Report
Samuel Nesemann, Kimberly Hubbard, Mehdi Siddiqui, William Fernandez
Clinical Practice and Cases in Emergency Medicine.2020; 4(3): 450. CrossRef
Pfählungsverletzungen und rektale Fremdkörper
M. Roblick, S. Farke
coloproctology.2019; 41(1): 49. CrossRef
Pfählungsverletzungen und rektale Fremdkörper
M. Roblick, S. Farke
Notfall + Rettungsmedizin.2019; 22(5): 449. CrossRef
New endoscopic technique for retrieval of large colonic foreign bodies and an endoscopy-oriented review of the literature
Alberto Tringali, Giulia Bonato, Lorenzo Dioscoridi, Massimiliano Mutignani
BMJ Case Reports.2018; : bcr-2018-226348. CrossRef
Rectal Foreign Body of Eggplant Treated Successfully by Endoscopic Transanal Removal
Hiroo Sei, Toshihiko Tomita, Keisuke Nakai, Kumiko Nakamura, Akio Tamura, Yoshio Ohda, Tadayuki Oshima, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
Case Reports in Gastroenterology.2018; 12(1): 189. CrossRef
Surgical management of rectal foreign bodies: a 10-year single-center experience
Pia Kokemohr, Lars Haeder, Fabian Joachim Frömling, Peter Landwehr, Joachim Jähne
Innovative Surgical Sciences.2017; 2(2): 89. CrossRef
Successful Transanal Removal of a Rectal Foreign Body by Abdominal Compression under Endoscopic and X-Ray Fluoroscopic Observation: A Case Report
Hironobu Mikami, Norihisa Ishimura, Akihiko Oka, Ichiro Moriyama, Takafumi Yuki, Kousaku Kawashima, Shuichi Sato, Shunji Ishihara, Yoshikazu Kinoshita
Case Reports in Gastroenterology.2016; 10(3): 646. CrossRef

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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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Clinical application of endoscopic ultrasonography in the management of rectal neuroendocrine tumors
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
Are Small Rectal Neuroendocrine Tumors Safe?
Jae Ho Choi, Jae Myung Cha
Intestinal Research.2015; 13(2): 103. CrossRef

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Original Article

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.

Citations

Citations to this article as recorded by

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
Science Progress.2021;[Epub] CrossRef
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
Surgical Endoscopy.2018; 32(10): 4125. CrossRef
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
World Journal of Gastrointestinal Endoscopy.2018; 10(10): 267. CrossRef
Endoscopic ultrasound-guided fine needle aspiration of extra-rectal lesions
J. Lim, S. A. Norton, N. A. Wong, M. G. Thomas
Techniques in Coloproctology.2017; 21(5): 393. CrossRef
Application of Endoscopic Ultrasonography in the Diagnosis and Treatment of Lower Gastrointestinal Disease
Eun Young Kim
Intestinal Research.2015; 13(2): 101. CrossRef
Benign Prostatic Hyperplasia Mimicking a Symptomatic Rectal Submucosal Tumor
Seung Wook Hong, Jaeyoung Chun, Kyu Joo Park, Cheol Kwak, Joo Sung Kim
Soonchunhyang Medical Science.2015; 21(2): 164. CrossRef

6,498 View
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