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수록범위 : 1권1호(2007)~15권3호(2021) |수록논문 수 : 1,353
Gut and Liver
15권3호(2021년 05월) 수록논문
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KCI등재 SCI

1Is Paradigm for the Role of Balloon-Assisted Enteroscopy Changing in Crohn's Disease?

저자 : Yoo Jin Lee

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 15권 3호 발행 연도 : 2021 페이지 : pp. 325-326 (2 pages)

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KCI등재 SCI

3Image-Enhanced Endoscopy and Its Corresponding Histopathology in the Stomach

저자 : Hisashi Doyama , Hiroyoshi Nakanishi , Kenshi Yao

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 15권 3호 발행 연도 : 2021 페이지 : pp. 329-337 (9 pages)

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In recent years, the technological innovation and progress of endoscopic equipment have been remarkable, and various endoscopic observation techniques have been developed. Among them, representative techniques are magnified observation and narrow-band imaging. Magnifying endoscopy with narrow-band imaging (M-NBI) can visualize superficial microanatomies in the stomach. The normal morphology of the microanatomy visualized using M-NBI differs according to the part of the stomach. The vessel plus surface (VS) classification system has been developed as a diagnostic criterion for early gastric cancer using M-NBI, and its usefulness has been proven. Based on the VS classification system, a magnifying endoscopy simple diagnostic algorithm for early gastric cancer (MESDA-G), a simplified algorithm used for early gastric cancer diagnosis, was created. We aimed to describe the anatomic structure of the stomach that can be viewed using M-NBI and outline the principles and clinical application of the VS classification system and MESDA-G. (Gut Liver 2021;15:329-337)

KCI등재 SCI

4Characteristics and Early Diagnosis of Gastric Cancer Discovered after Helicobacter pylori Eradication

저자 : Masanori Ito , Shinji Tanaka , Kazuaki Chayama

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 15권 3호 발행 연도 : 2021 페이지 : pp. 338-345 (8 pages)

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The prevalence of gastric cancer after eradication (GCAE) is increasing dramatically in Japan. GCAE has characteristic features, and we must understand these features in endoscopic examinations. Differentiated cancer types were frequently found after eradication and included characteristic endoscopic features such as reddish depression (RD). However, benign RD can be difficult to distinguish from gastric cancer because of histological alterations in the surface structures (nonneoplastic epithelium or epithelium with low-grade atypia [ELA]) as well as multiple appearances of RD. Recently, we clarified similar alterations in genetic mutations between ELA and gastric cancer, suggesting that ELA is derived from gastric cancer. Clinically, submucosal invasive cancer was frequently found in patients after eradication therapy even if they received annual endoscopic surveillance. We can improve the diagnostic ability using image-enhanced endoscopy with magnified observation. (Gut Liver 2021;15:338-345)

KCI등재 SCI

5Application of Artificial Intelligence in the Detection and Characterization of Colorectal Neoplasm

저자 : Kyeong Ok Kim , Eun Young Kim

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 15권 3호 발행 연도 : 2021 페이지 : pp. 346-353 (8 pages)

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Endoscpists always have tried to pursue a perfect colonoscopy, and application of artificial intelligence (AI) using deep-learning algorithms is one of the promising supportive options for detection and characterization of colorectal polyps during colonoscopy. Many retrospective studies conducted with real-time application of AI using convolutional neural networks have shown improved colorectal polyp detection. Moreover, a recent randomized clinical trial reported additional polyp detection with shorter analysis time. Studies conducted regarding polyp characterization provided additional promising results. Application of AI with narrow band imaging in real-time prediction of the pathology of diminutive polyps resulted in high diagnostic accuracy. In addition, application of AI with endocytoscopy or confocal laser endomicroscopy was investigated for realtime cellular diagnosis, and the diagnostic accuracy of some studies was comparable to that of pathologists. With AI technology, we can expect a higher polyp detection rate with reduced time and cost by avoiding unnecessary procedures, resulting in enhanced colonoscopy efficiency. However, for AI application in actual daily clinical practice, more prospective studies with minimized selection bias, consensus on standardized utilization, and regulatory approval are needed. (Gut Liver 2021;15:346-353)

KCI등재 SCI

6Clinical and Technical Guideline for Endoscopic Ultrasound (EUS)-Guided Tissue Acquisition of Pancreatic Solid Tumor: Korean Society of Gastrointestinal Endoscopy (KSGE)

저자 : Moon Jae Chung , Se Woo Park , Seong-hun Kim , Chang Min Cho , Jun-ho Choi , Eun Kwang Choi , Tae Hoon Lee , Eunae Cho , Jun Kyu Lee , Tae Jun Song , Jae Min Lee , Jun Hyuk Son , Jin Suk Park , Chi Hyuk

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 15권 3호 발행 연도 : 2021 페이지 : pp. 354-374 (21 pages)

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Endoscopic ultrasound (EUS)-guided tissue acquisition of pancreatic solid tumor requires a strict recommendation for its proper use in clinical practice because of its technical difficulty and invasiveness. The Korean Society of Gastrointestinal Endoscopy (KSGE) appointed a task force to draft clinical practice guidelines for EUS-guided tissue acquisition of pancreatic solid tumor. The strength of recommendation and the level of evidence for each statement were graded according to the Minds Handbook for Clinical Practice Guideline Development 2014. The committee, comprising a development panel of 16 endosonographers and an expert on guideline development methodology, developed 12 evidence-based recommendations in eight categories intended to help physicians make evidence-based clinical judgments with regard to the diagnosis of pancreatic solid tumor. This clinical practice guideline discusses EUS-guided sampling in pancreatic solid tumor and makes recommendations on circumstances that warrant its use, technical issues related to maximizing the diagnostic yield (e.g., needle type, needle diameter, adequate number of needle passes, sample obtaining techniques, and methods of specimen processing), adverse events of EUS-guided tissue acquisition, and learning-related issues. This guideline was reviewed by external experts and suggests best practices recommended based on the evidence available at the time of preparation. This guideline may not be applicable for all clinical situations and should be interpreted in light of specific situations and the availability of resources. It will be revised as necessary to cover progress and changes in technology and evidence from clinical practice. (Gut Liver 2021;15:354-374)

KCI등재 SCI

7Enteroscopy in Crohn's Disease: Are There Any Changes in Role or Outcomes Over Time? A KASID Multicenter Study

저자 : 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 ,

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 15권 3호 발행 연도 : 2021 페이지 : pp. 375-382 (8 pages)

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Background/Aims: Although balloon-assisted enteroscopy (BAE) enables endoscopic visualization of small bowel (SB) involvement in Crohn's disease (CD), there is no data on the changes in outcomes over time. We therefore investigated the changes in BAE use on CD patients over different time periods in terms of its role and clinical outcomes.
Methods: We used a multicenter enteroscopy database to identify CD patients with SB involvement who underwent BAE (131 procedures, 116 patients). We compared BAE-related factors and outcomes between the first period (70 procedures, 60 patients) and the second period (61 procedures, 56 patients). The specific cutoff point for dividing the two periods was 2007, when BAE guidelines were introduced.
Results: Initial diagnosis of SB involvement in CD was the most common indication for BAE during each period (50.0% vs 31.1%, p=0.034). The largest change was in the number of BAE uses for stricture evaluation and/or treatment, which increased significantly in the latter period (2.9% vs 21.3%, p=0.002). The diagnostic yield in patients with suspected CD was 90.7% in the first period and 95.0% in the second (p=0.695). More endoscopic interventions were performed in the second period than in the first (5.1% vs 17.6%, p=0.041). Enteroscopic success rates were high throughout (100% in the first period vs 80.0% in the second period, p>0.999). In the first and second periods, therapeutic plans were adjusted in 62.7% and 61.4% of patients, respectively.
Conclusions: The overall clinical indications, outcomes, and effectiveness of BAE were constant over time in CD patients with SB involvement, with the exception that the frequency of enteroscopic intervention increased remarkably. (Gut Liver 2021;15:375-382)

KCI등재 SCI

8Metabolically Healthy Obesity Is Associated with an Increased Risk of Colorectal Adenoma Occurrence Diagnosed by Surveillance Colonoscopy

저자 : Hyunbeom Chae , Hyo-joon Yang , Soo-kyung Park , Yoon Suk Jung , Jung Ho Park , Dong Il Park , Chong Il Sohn

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 15권 3호 발행 연도 : 2021 페이지 : pp. 383-390 (8 pages)

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Background/Aims: The risk of recurrence of colorectal adenoma among obese individuals without metabolic abnormalities or in those with metabolically healthy obesity is largely unexplored. Therefore, we longitudinally investigated the risk of adenoma occurrence in individuals undergoing surveillance colonoscopy according to metabolic status and obesity.
Methods: This retrospective cohort study included 16,872 Korean adults who underwent their first screening colonoscopy between 2003 and 2012 and who then underwent follow-up colonoscopy until 2017. Participants were categorized into a metabolically healthy nonobese group (reference group), a metabolically healthy obese group, a metabolically abnormal nonobese group, and a metabolically abnormal obese group. Hazard ratios (HRs) for adenoma recurrence compared to the reference group were calculated in each group.
Results: During a median follow-up duration of 47.3 months (interquartile range, 35.6 to 58.9 months), 3,673 (21.8%) and 292 (1.73%) participants developed adenoma and advanced adenoma, respectively. When age, sex, smoking, alcohol consumption, family history of colorectal cancer, and baseline adenoma risk were adjusted, the risk of adenoma recurrence was increased in metabolically healthy obese individuals (HR, 1.33; 95% confidence interval [CI], 1.12 to 1.57) and metabolically abnormal obese individuals (HR, 1.18; 95% CI, 1.08 to 1.30) but not in metabolically abnormal nonobese individuals (HR, 1.03; 95% CI, 0.94 to 1.13).
Conclusions: In this study, metabolically healthy obese individuals and metabolically abnormal obese individuals exhibited increased risks of occurrence of colorectal adenoma diagnosed by surveillance colonoscopy. This finding implies that obesity itself, even without metabolic abnormalities, is associated with an increased risk of adenoma recurrence. (Gut Liver 2021;15:383- 390)

KCI등재 SCI

9Colonoscopic Polypectomy Preferences of Asian Endoscopists: Results of a Survey-Based Study

저자 : Dong-hoon Yang , Bayasgalan Luvsandagva , Quang Trung Tran , Achmad Fauzi , Panida Piyachaturawat , Thida Soe , Zhiqin Wong , Jeong-sik Byeon

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 15권 3호 발행 연도 : 2021 페이지 : pp. 391-400 (10 pages)

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Background/Aims: The clinical practice pattern of polypectomy is not well-investigated in Asian countries. We aimed to survey Asian endoscopists about their preferred polypectomy techniques for given conditions and images of polyps.
Methods: A survey was performed using questionnaires composed of two parts: a scenariobased questionnaire using scenarios of polyps, which were adopted from the European Society of Gastrointestinal Endoscopy guidelines, and an image-based questionnaire using provided endoscopic images of polyps.
Results: A total of 154 endoscopists participated in this survey. The most preferred resection techniques for diminutive (≤5 mm), small (6-9 mm), and benign-looking intermediate (10-19 mm) nonpedunculated polyps were cold forceps polypectomy, hot snare polypectomy, and endoscopic mucosal resection (EMR), respectively, in both the scenario- and image-based questionnaires. For benign-looking large (≥20 mm) nonpedunculated polyps, EMR and endoscopic submucosal dissection (ESD) were preferred in the scenario- and image-based surveys, respectively. In case of malignant nonpedunculated polyps, EMR and ESD were preferred for intermediate-sized and large lesions, respectively, according to the scenario-based survey. However, ESD was preferred in both intermediate-sized and large malignant nonpedunculated polyps according to the imagebased survey. Trainee endoscopists, endoscopists working in referral centers, and endoscopists in the colorectal cancer-prevalent countries were independently associated with preference of cold snare polypectomy for removing small polyps.
Conclusions: The polypectomy practice patterns of Asian endoscopists vary, and cold snare polypectomy was not the most preferred resection method for polyps <10 mm in size, in contrast to recent guidelines. (Gut Liver 2021;15:391-400)

KCI등재 SCI

10Clinical Significance of Residual Nonrectal Inflammation in Ulcerative Colitis Patients in Clinical Remission

저자 : Jongbeom Shin , Sung Min Kong , Tae Jun Kim , Eun Ran Kim , Sung Noh Hong , Dong Kyung Chang , Young-ho Kim

발행기관 : 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 간행물 : Gut and Liver 15권 3호 발행 연도 : 2021 페이지 : pp. 401-409 (9 pages)

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Background/Aims: The treatment goal of ulcerative colitis (UC) has been changed to achieve endoscopic remission (ER). However, there is insufficient clinical evidence to determine whether a step-up treatment should be performed to achieve ER in clinical remission (CR) without ER, and there are inadequate data on the need to consider the distribution and severity of residual inflammation. This retrospective study aimed to evaluate the prognostic significance of the distribution and severity of residual inflammation in UC patients in CR.
Methods: A total of 131 UC patients in CR who underwent endoscopic evaluation for more than three times between January 2000 and December 2018 were reviewed. The patients were allocated by the endoscopic healing state and the distribution of inflammation to ER (n=31, 23.7%), residual nonrectal inflammation with patchy distribution (NRI) (n=17, 13.0%) or residual rectal involvement with continuous or patchy distribution (RI) (n=83, 63.3%) groups. We reviewed clinical characteristics, endoscopic findings, and factors associated with poor outcome-free survival (PFS).
Results: In UC patients in CR, PFS was significantly higher in the ER and NRI groups than in the RI group (p=0.003). Patients in the ER and NRI groups had similar PFS (p=0.647). Cox proportional hazard model showed only RI (hazard ratio, 5.76; p=0.027) was associated with a higher risk of poor outcome.
Conclusions: We suggest that escalation of treatment modalities may be selectively performed in consideration of the residual mucosal inflammation pattern, even if ER has not been achieved, in UC patients with CR. (Gut Liver 2021;15:401-409)

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