We report repeated perforations during colorectal endoscopic submucosal dissection (ESD) and successful endoscopic closure. A 72-year-old man with a laterally spreading tumor, 25mm in diameter, in the lower rectum was referred for ESD. ESD was started from the anal side using a DualKnifeJ (Olympus, Tokyo, Japan). The lesion had severe fibrosis in the submucosal layer. The submucosal layer was n...

A 37-year-old man presented to our hospital for early rectal cancer accompanied by mucosal prolapse syndrome. Biopsy confirmed an adenocarcinoma, and endoscopic ultrasonography indicated proximity to the dentate line but no submucosal invasion. The tumor was removed en bloc via endoscopic submucosal dissection without complications, and its margin was free of tumor cells. The total procedure du...

In our previous study, the healing effect of proton pump inhibitor plus rebamipide for endoscopic submucosal dissection-related artificial ulcer smaller than 40 mm showed statistical significance. However, such effect of the combination was not yet clear for ulcers with dissected diameter more than 40 mm. The aim of this present study was to resolve this problem under sufficient statistical pow...

submucosal dissection, and local surgical excision, including transanal excision and transanal endoscopic microsurgery (TEM). In a study by Kim et al. [6], the complete resection rate for TEM was over 97%. Although TEM is superior to other endoscopic procedures, TEM must be considered to be more invasive because of the risk associated with the use of anesthesia. Third, guidelines for follow-up ...

Endoscopic treatment can be a curative option for small carcinoid tumors with an extremely low risk of metastasis. Since most carcinoid tumors are characterized by a specific growth pattern in the submucosal (SM) layer, specialized endoscopic techniques for deeper resection to achieve clear vertical margins are needed. The endoscopic submucosal dissection (ESD) method in the SM space is superio...

Endoscopic submucosal dissection (ESD) is a minimally invasive technique developed by Japanese endoscopists that allows one-piece endoscopic removal of early malignant lesions in the gastrointestinal tract. There is now a large and ever-increasing number of reports worldwide, and in the West use of this technique is on the increase. New materials and techniques have been developed to improve th...

benign tumors [1]. Esophagectomy is the conventional surgical approach to treatment, but recently less invasive approaches by endoscopic therapy have become more widely used [2,3]. However, because conventional endoscopic therapy cannot obtain specimens for pathological examination and is associated with a risk of residual or recurrent hemangioma [4], en bloc removal is another possible treatme...

Surgical therapy is the traditional approach for early gastric cancer. Patients with comorbidities cannot benefit from this treatment because of high surgical morbidities and mortalities. Endoscopic submucosal dissection is a new technique for complete en bloc resection of early gastric cancer. We report the case of a patient with severe cardiomyopathy who developed early gastric cancer without...

A 45-year-old woman had refractory Epstein–Barr virus-associated gastroparesis. Despite lifestyle modification and medication therapy, the patient had recurrent hospitalizations for gastroparesis. Management also included four previous sessions of endoscopic botulinum toxin injection. Despite transient symptomatic improvement, the patient’s symptoms had recurred. She was not a candidate for sur...