Innovative therapeutic endoscopy in the upper gastrointestinal tract: Review of Japan Gastroenterological Endoscopic Society Core Sessions

Abstract

Workshops on "Innovative Therapeutic Endoscopy" for upper gastrointestinal tract diseases were held four times as the Japan Gastroenterological Endoscopic Society (JGES) Core Sessions at the 93rd to 96th Biannual Meetings of the JGES. A total of 48 research presentations (including two invited lectures) were reported, and various discussions were held on these topics. When the research presentations were categorized according to the therapeutic procedure, endoscopic submucosal dissection (ESD) was the most frequent with 28 presentations (58.3%), followed by laparoscopy endoscopy cooperative surgery (LECS) with six presentations (12.5%). When the research presentations were classified by the target organ of the therapeutic procedures, the duodenum was the most frequent with 26 presentations (54.1%), followed by the stomach with 13 presentations (27.1%). The most important issue was the establishment of a safe and reliable endoscopic resection method for duodenal lesions. Issues related to gastric ESD were establishing an efficient traction method and a method to prevent post‐ESD bleeding in high‐risk patients. Other important issues were establishment of an efficient traction method and methods of preventing delayed bleeding in high‐risk patients who undergo gastric ESD, expansion of indications for minimally invasive treatment using LECS for gastric cancer, the development of endoscopic full‐thickness resection (EFTR) for gastric submucosal tumors (SMTs), and improvement of per‐oral endoscopic myotomy (POEM) for esophageal achalasia and per‐oral endoscopic tumor resection (POET) for esophageal SMTs. Through the JGES Core Sessions, it is expected that the minimally invasive treatments using endoscopes developed in Japan will be further advanced.

Comparison of Lidocaine Spray and Lidocaine Ice Popsicle in Patients Undergoing Unsedated Esophagogastroduodenoscopy: A Single Center Prospective Randomized Controlled Trial

“…The data are expressed as mean ± standard error of the mean. Statistical analysis was performed using the χ 2 for Social Sciences, SPSS, Inc., Chicago, IL, USA). A p-value <0.05 was considered to be statistically significant.…”

“…Esophagogastroduodenoscopy (EGD) is an essential and widely used diagnostic and therapeutic procedure in gastroenterology. [1][2][3][4] EGD can be performed in association with topical anesthesia of the pharynx, 5,6 intravenous anesthesia, [7][8][9] or with their combination. [10][11][12][13] EGD under topical pharyngeal anesthesia has the advantage of avoiding unwanted cardiopulmonary adverse events from intravenous sedationlike respiratory depression, cardiorespiratory arrest, especially in patients with cardiopulmonary disease, the elderly, and obese.…”

Endoscopic Delivery of Polymers Reduces Delayed Bleeding after Gastric Endoscopic Submucosal Dissection: A Systematic Review and Meta-Analysis

“…In recent years, the endoscopic application of biodegradable polymers has emerged as one of the most promising anti-bleeding techniques for post-ESD management. Polyglycolic acid (PGA), a synthetic, braided polymer commonly used in surgical procedures, has been combined with fibrin, a natural biopolymer, to create a much stronger sealant than any other biomaterial combination for GI ulcer coverage [15][16][17]. In addition, endoscopic delivery of hemostats has shown potential benefits for the prevention of delayed bleeding, despite its short retention period [18,19].…”

Is General Anesthesia Needed in Endoscopic Submucosal Dissection for Lesions Located in the Mid to Upper Stomach?

“…Therefore, much research is being conducted to develop instruments and techniques to improve the effectiveness of ESD, such as the use of endoscopes and traction. 5,6 However, there are limitations to their broad accessibility.…”

“…In terms of location, the middle to upper stomach is technically challenging because of the more vascular structure, the high incidence of early gastric cancer with submucosal invasion, and the retroflexion approach in endoscopic dissection. Therefore, much research is being conducted to develop instruments and techniques to improve the effectiveness of ESD, such as the use of endoscopes and traction [ 5 , 6 ]. However, there are limitations to their broad accessibility.…”