Background/AimsThe rate of diagnosis of gastric adenoma has increased because esophagogastroduodenoscopy is being performed at an increasingly greater frequency. However, there are no treatment guidelines for low-grade dysplasia (LGD). To determine the appropriate treatment for LGD, we evaluated the risk factors associated with the categorical upgrade from LGD to high grade dysplasia (HGD)/early gastric cancer (EGC) and the risk factors for recurrence after endoscopic treatment.MethodsWe compared the complication rates, recurrence rates, and remnant lesions in 196 and 56 patients treated with endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR), respectively, by histologically confi rming low-grade gastric epithelial dysplasia.ResultsThe en bloc resection rate was significantly lower in the EMR group (31.1%) compared with the ESD group (75.0%) (p<0.001). However, no significant difference was observed in the prevalence of remnant lesions or recurrence rate (p=0.911) of gastric adenoma. The progression of LGD to HGD or EGC caused an increase in the incidence of tumor lesions >1 cm with surface redness and depressions.ConclusionsFor the treatment of LGD, EMR resulted in a higher incidence of uncertain resection margins and a lower en bloc resection rate than ESD. However, there was no signifi cant difference in recurrence rate.

The most common cause of esophagorespiratory fistulas (ERFs) is associated with malignancy. The use of self-expandable metal stents is effective for the treatment of malignant ERFs, but benign ERF is rare, which is why its optimal treatment is not defined yet. There have been few reports describing benign esophagopleural fistula and its treatments in South Korea. Here, we report a rare case of spontaneous esophagopleural fistula, which was successfully treated by endoscopic placement of a membrane covered metal stent.

We report a rare case of cervical cancer with duodenal obstruction accompanied by obstructive symptoms, which was treated using duodenal stenting. A 48-year-old woman was diagnosed with stage IV cervical cancer (according to the International Federation of Gynecology and Obstetrics staging system), which had invaded the vagina, the uterine body, and the external iliac and common iliac lymph nodes. Endoscopy showed an encircling mass with erythematous mucosa and luminal narrowing in the second and third portions of the duodenum, which prevented the endoscope from advancing. We placed an uncovered stent in the duodenum, which ameliorated abdominal discomfort, nausea, and vomiting, and simultaneously performed a biopsy. Endoscopic stent insertion appears to be the most effective treatment for duodenal obstruction in patients with advanced cancer.

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