Annual Report 2019
Department of Endoscopy, Gastrointestinal Endoscopy Division (Endoscopy Center)
Yutaka Saito, Takahisa Matsuda, Ichiro Oda, Yasuo Kakugawa, Shigetaka Yoshinaga, Haruhisa Suzuki, Satoru Nonaka, Taku Sakamoto, Seiichiro Abe, Masayoshi Yamada, Masau Sekiguchi, Hiroyuki Takamaru, Keiko (Sogame) Nakamura, Takao Itoi, Hajime Takisawa, Minori Matsumoto, Eriko (Tsuruki) So, Mai Ego, Hourin Cho, Kengo Kasuga, Yasuhiko Mizuguchi, Takuma Okamura, Kei Nakazawa, Gozo Fukishi, Takayuki Yamazaki, Naoko Okuda, Yuki Hashimoto, Kazumasa Kawashima, Yohei Koyama, Masako Yamada, Wakana Ikeda, Ayano Okamura, Yuji Matsumoto, Midori Tanaka, Takaaki Tsuchida
Introduction
The Department of Endoscopy moved to the New Endoscopy Center on January 20, 2014 and we believe this is currently the biggest endoscopy center in Japan (15 Endoscopy Rooms [251.112 m2] and 136.788 m2 Recovery Rooms on two floors of 1,949.554 m2).
The total number of nursing staff increased to 18, and three endoscopy engineers are working with us. The Gastrointestinal Endoscopy Division has 13 staff physicians in the National Cancer Center Hospital (NCCH), and in the Division of Screening Technology of the Center for Public Health Sciences, two chief residents, 11 residents, and several rotating residents.
The Respiratory Endoscopy Division has three staff members, and the total number of bronchoscopies and therapeutic procedures has been dramatically increased.
The Team and What We Do
Dramatic developments have recently changed the operational mechanism and design of endoscopes along with a variety of accessory devices and instruments, so clinical applications using the latest equipment are evolving on a continuous basis.
In the Gastrointestinal Endoscopy Division, more advanced and technically difficult endoscopic treatments such as endoscopic submucosal dissection (ESD) are being used in place of conventional endoscopic mucosal resection (EMR) not only for early gastric cancer, but also for superficial esophageal and colorectal neoplasms. In addition, educational activities are an important part of our division’s activities with many Japanese medical students, residents and staff physicians as well as approximately 130 overseas post-graduate physicians attending our training courses annually.
Our Endoscopy Center was authorized as one of the WEO Centers of Excellence by the World Endoscopy Organization (WEO) and got an award during Gastro 2017 in Hyderabad. This is a prestigious award for us because there are only 17 famous international centers in the world and just two centers in Japan.
We are also focusing on the development of new medical devices. A joint laboratory with Olympus has been developed in the new research building, and new medical devices are being jointly developed with the three main topics of diagnosis, treatment, and education. We are planning to apply for a joint patent for two new medical devices.
Research activities
Our efforts have been focused on new diagnostic and therapeutic strategies. For more accurate endoscopic diagnosis of gastrointestinal disease, we are utilizing the NBI and BLI systems that enable us to narrow the spectral transmittance bandwidth of the optical filters used in the light source of electronic endoscope systems. In addition, we have introduced an endocytoscopy system. This system can magnify lesions to up to 500x magnification to visualize nuclear atypia.
Clinical trials
We have organized several multicenter study groups to evaluate the efficacy and clinical impact of newly developed endoscopies and medical devices prospectively.
Esophagus
We are currently enrolling our patients in several multicenter randomized controlled trials (RCTs).
A phase III study is ongoing to compare oral steroid administration to local steroid injection therapy for the prevention of esophageal stricture after endoscopic submucosal dissection (JCOG1217: Steroid EESD P3). Also, a randomized controlled phase II/III study has been conducted to compare endoscopic balloon dilation combined with steroid injection versus radial incision and cutting combined with steroid injection for refractory anastomotic stricture after esophagectomy (JCOG1207: RICS study).
In addition to the RCTs, preoperative endoscopic depth diagnosis of superficial esophageal squamous cell carcinoma is current a hot topic in GI endoscopy. A non-randomized study for the usefulness of endoscopic ultrasonography is ongoing to compare it with magnified endoscopy with narrow band imaging for diagnosing cancer invasion depth of clinical stage IA esophageal squamous cell carcinoma (JCOG1604: Odyssey trial). The optimal additional treatment strategy for endoscopic resection for patients with T1a-MM and T1b-SM1 esophageal cancer, particularly esophageal adenocarcinoma is still under discussion and further prospective studies are warranted. A multicenter prospective observational cohort study is ongoing to investigate long-term outcomes of those patients.
Stomach
A nationwide cancer registry system has been developed for early gastric cancer treated with EMR/ESD. A five-year multicenter prospective cohort study has been being conducted using this cancer registry system since 2010 (J-WEB/EGC) and the short-term outcomes were published in DEN. The long-term outcomes were being analyzed this year and will be published in 2020.
We had conducted a retrospective cohort study on the incidence risk and clinicopathological features of gastric neoplasms in Lynch syndrome (LS), an inherited cancer predisposition syndrome. This study demonstrated new important findings that revealed that LS patients, particularly those with atrophic gastritis, are at high risk of gastric neoplasm and often develop multiple tumors. The results were published in Gastric Cancer.
Duodenum
A non-randomized confirmatory trial of cold snare polypectomy for superficial non-ampullary duodenal epithelial tumor (D-COP trial) has been being conducted at more than 100 institutions in Japan since 2017. Recently, cold snare polypectomy is widely used in the colorectal region and it is expected that the same concept can be applied for duodenal small tumors (familial adenomatous polyposis [FAP] is excluded from this trial).
Colorectum
RCTs concerning colorectal neoplasms are ongoing as well.
The Japan Polyp Study (JPS), a multicenter RCT conducted at 11 participating centers was initiated in 2003. The aim of this study was to assess whether follow-up colonoscopy using a high-definition colonoscope at three years as well as at both one and three years would detect important lesions including non-polypoid colorectal neoplasia. The JPS will provide preexisting comorbidity data, including the prevalence of both flat and depressed colorectal lesions, the quality of colonoscopy, and the risk of colorectal cancer (CRC). Furthermore, the study will clarify the long-term impact of colonoscopic removal on mortality due to CRC. The evidence will enable us to elaborate the fundamental basis for the updated Japanese surveillance guidelines (Participants of JPS: 3,926, JPS Cohort: 1,291).
The first outcome of JPS has just been published in Gut.
We are playing a leading part to conduct a multicenter single-arm study (JCOG1612) for the possibility of CRT for high-risk rectal submucosal cancer after endoscopic resections. If this study result shows noninferiority of CRT compared to surgery, we could propose a new non-invasive treatment strategy for rectal T1 cancer patients.
A nationwide cancer registry system has also been developed for early CRC treated with ESD. A five-year multicenter prospective cohort study has been ongoing using this cancer registry system since 2013. A total of 2,066 patients was enrolled in this multicenter cohort study and 5-year surveillance of all enrolled patients was completed. This should be the largest cohort study in colorectal ESD in the world.
We have been conducting a multicenter prospective cohort study on colorectal neuroendocrine tumors (NETs) since January 2017. This study is expected to provide new important findings on colorectal NETs.
A multicenter prospective cohort study on T1 CRC has also been being performed since May 2017. This study is collecting many T1 CRC cases from over 70 institutions all over Japan and will bring important information on the management of T1 cancer.
J-CAPP Study II
To evaluate the influence of low-dose aspirin tablets (100 mg/day for four years) on colorectal tumor recurrence, we have been conducting a multicenter prospective study since 2015 (chief conductor: Hideki Ishikawa, M.D., Kyoto Prefectural University of Medicine).
Molecular and Fluorescence Imaging and Database Study
Molecular imaging endoscopy is one of the new era methods for very early cancer diagnosis and detection of metastasis. We have started a collaborative study with the Departments of Endoscopy, Colorectal Surgery, Gastric Surgery, and Pathology and Clinical Laboratories, the NCC, the Research Institute, the University of Tokyo, and the Jikei University School of Medicine.
Probe-based confocal laser endomicroscopy (pCLE) allows real-time, in vivo high-resolution imaging of the gastrointestinal epithelium at a cellular level. We started a multicenter prospective study using an advanced medical treatment system (type B) supported by the Japan Agency for Medical Research and Development (AMED) to evaluate the diagnostic yield of pCLE for gastric neoplasms in Dec. 2019.
We have been collaborating with the Japan Gastroenterological Endoscopy Society (JGES) in order to build a Japan endoscopy database (JED) of gastrointestinal endoscopies including not only therapeutic but also diagnostic procedures. This all-Japan project is named JED and has the potential to construct the largest and most precise database of all endoscopic procedures. Japanese endoscopists are well known as most excellent endoscopists, so we will be able to gather a lot of evidence using this huge endoscopy database.
Research and development of new endoscopy using artificial intelligence (AI) and collaboration with Research Center for fecal metagenomic and metabolomic studies
Recent developments in artificial intelligence (AI) using deep learning are expected to be applied in precision medicine. We have been researching and developing new endoscopic systems using AI. First, in order to support endoscopists’ detection of CRC and precancerous lesions during colonoscopy using AI, we have been researching and developing a software program using convolutional neural networks based on mathematical morphology and hardware, which works in real-time. We first published a press release of the results worldwide on October 2017, and the first report was published in Scientific Reports (https://www.ncc.go.jp/jp/information/pr_release/2017/0710/index.html). We finished a clinical performance study in accordance with the principles of the Good Clinical Practice guidelines and have been applying for approval of this program as a medical device (DEISGN AI-01 study). We will extend this system to genomic data and other gastrointestinal organs, such as the stomach and esophagus, in the future. Second, we joined a multicenter image analysis study leaded by Prof. Kudo’s group to compare a new automatic diagnosis system using AI with endoscopists’ diagnoses of colorectal lesions using endocytoscopy. We have also started the research and development of an endoscopic diagnosis support system for tumor invasion of gastrointestinal cancer using AI.
We are collaborating with the NCCH Research Institute and Osaka University and performed fecal metagenomic and metabolomic studies on samples from a large cohort of 616 participants who underwent colonoscopy to assess taxonomic and functional characteristics of gut microbiota and metabolites. Our large cohort multi-omics data indicate that shifts in the microbiome and metabolome occur from the very early stages of the development of colorectal cancer, which is of possible etiological and diagnostic importance and was published in Nature Medicine.
Future prospects
Research and development of new endoscopy
Olympus Medical Systems Corp. has opened a laboratory at our new research center and we are collaborating with them to develop innovative endoscopy systems and devices.
List of papers published in 2019
Journal
1. Hashiguchi Y, Muro K, Saito Y, Ito Y, Ajioka Y, Hamaguchi T, Hasegawa K, Hotta K, Ishida H, Ishiguro M, Ishihara S, Kanemitsu Y, Kinugasa Y, Murofushi K, Nakajima TE, Oka S, Tanaka T, Taniguchi H, Tsuji A, Uehara K, Ueno H, Yamanaka T, Yamazaki K, Yoshida M, Yoshino T, Itabashi M, Sakamaki K, Sano K, Shimada Y, Tanaka S, Uetake H, Yamaguchi S, Yamaguchi N, Kobayashi H, Matsuda K, Kotake K, Sugihara K. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. Int J Clin Oncol, 25:1-42, 2020
2. Yoshinaga S, Itoi T, Yamao K, Yasuda I, Irisawa A, Imaoka H, Tsuchiya T, Doi S, Yamabe A, Murakami Y, Ishikawa H, Saito Y. Safety and efficacy of endoscopic ultrasound-guided fine needle aspiration for pancreatic masses: A prospective multicenter study. Dig Endosc, 32:114-126, 2020
3. Kasuga K, Saito Y, Wu SYS, Takamaru H, Sakamoto T, Sekine S, Uraoka T. Impact of endoscopic submucosal dissection of an anal squamous intraepithelial lesion with indistinct border. Endoscopy, 52:E75-E77, 2020
4. Tanaka S, Kashida H, Saito Y, Yahagi N, Yamano H, Saito S, Hisabe T, Yao T, Watanabe M, Yoshida M, Saitoh Y, Tsuruta O, Sugihara KI, Igarashi M, Toyonaga T, Ajioka Y, Kusunoki M, Koike K, Fujimoto K, Tajiri H. Japan Gastroenterological Endoscopy Society guidelines for colorectal endoscopic submucosal dissection/endoscopic mucosal resection. Dig Endosc, 32:219-239, 2020
5. Inoki K, Kakugawa Y, Takamaru H, Sekiguchi M, Matsumoto M, Matsuda T, Ito A, Tanaka T, Inamoto Y, Fuji S, Kurosawa S, Kim SW, Fukuda T, Ohe Y, Saito Y. Capsule Endoscopy after Hematopoietic Stem Cell Transplantation Can Predict Transplant-Related Mortality. Digestion, 101:198-207, 2020
6. Kobayashi K, Tanaka S, Murakami Y, Ishikawa H, Sada M, Oka S, Saito Y, Iishi H, Kudo SE, Ikematsu H, Igarashi M, Saitoh Y, Inoue Y, Hisabe T, Tsuruta O, Sano Y, Yamano H, Shimizu S, Yahagi N, Matsuda K, Nakamura H, Fujii T, Sugihara K. Predictors of invasive cancer of large laterally spreading colorectal tumors: A multicenter study in Japan. JGH Open, 4:83-89, 2020
7. Kakinuma R, Muramatsu Y, Asamura H, Watanabe SI, Kusumoto M, Tsuchida T, Kaneko M, Tsuta K, Maeshima AM, Ishii G, Nagai K, Yamaji T, Matsuda T, Moriyama N. Low-dose CT lung cancer screening in never-smokers and smokers: results of an eight-year observational study. Transl Lung Cancer Res, 9:10-22, 2020
8. Nunobe S, Oda I, Ishikawa T, Akazawa K, Katai H, Isobe Y, Miyashiro I, Tsujitani S, Ono H, Tanabe S, Fukagawa T, Suzuki S, Kakeji Y. Surgical outcomes of elderly patients with Stage I gastric cancer from the nationwide registry of the Japanese Gastric Cancer Association. Gastric Cancer, 23:328-338, 2020
9. Usuda J, Inoue T, Tsuchida T, Ohtani K, Maehara S, Ikeda N, Ohsaki Y, Sasaki T, Oka K. Clinical trial of photodynamic therapy for peripheral-type lung cancers using a new laser device in a pilot study. Photodiagnosis Photodyn Ther, 30:101698, 2020
10. Lao AM, Matsumoto Y, Tanaka M, Matsunaga T, Sasada S, Tsuchida T. Pleural cryobiopsy during local anaesthetic thoracoscopy in dry pleural dissemination. Respirol Case Rep, 8:e00503, 2020
11. Yachida T, Oda I, Abe S, Sekiguchi M, Nonaka S, Suzuki H, Yoshinaga S, Taniguchi H, Sekine S, Masugata H, Masaki T, Daiko H, Saito Y. Risk of Lymph Node Metastasis in Patients with the Superficial Spreading Type of Esophageal Squamous Cell Carcinoma. Digestion, 101:239-244, 2020
12. Yoshida M, Takizawa K, Nonaka S, Shichijo S, Suzuki S, Sato C, Komori H, Minagawa T, Oda I, Uedo N, Hirasawa K, Matsumoto K, Sumiyoshi T, Mori K, Gotoda T, Ono H. Conventional versus traction-assisted endoscopic submucosal dissection for large esophageal cancers: a multicenter, randomized controlled trial (with video). Gastrointest Endosc, 91:55-65.e2.doi: 10.1016/j.gie.2019.08.014, 2020
13. Sekimizu M, Yoshida A, Mitani S, Asano N, Hirata M, Kubo T, Yamazaki F, Sakamoto H, Kato M, Makise N, Mori T, Yamazaki N, Sekine S, Oda I, Watanabe SI, Hiraga H, Yonemoto T, Kawamoto T, Naka N, Funauchi Y, Nishida Y, Honoki K, Kawano H, Tsuchiya H, Kunisada T, Matsuda K, Inagaki K, Kawai A, Ichikawa H. Frequent mutations of genes encoding vacuolar H+ -ATPase components in granular cell tumors. Genes Chromosomes Cancer, 58:373-380, 2019
14. Katada C, Horimatsu T, Muto M, Tanaka K, Matsuda K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Kato M, Kida M, Kobayashi K, Hoteya S, Kodashima S, Matsuda T, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. Current status of esophageal endoscopy including the evaluation of smoking and alcohol consumption in Japan: an analysis based on the Japan endoscopy database. Esophagus, 16:174-179, 2019
15. Hashimoto T, Ogawa R, Tang TY, Yoshida H, Taniguchi H, Katai H, Oda I, Sekine S. RHOA mutations and CLDN18-ARHGAP fusions in intestinal-type adenocarcinoma with anastomosing glands of the stomach. Mod Pathol, 32:568-575, 2019
16. Kuwabara H, Abe S, Nonaka S, Suzuki H, Yoshinaga S, Oda I, Saito Y. Clinical feasibility of endoscopic submucosal dissection with minimum lateral margin of superficial esophageal squamous cell carcinoma. Endosc Int Open, 7:E396-E402, 2019
17. Abe S. Post ESD bleeding prevention: Are polyglycolic acid sheets here to stay? Endoscopy, 51:613-614, 2019
18. Yachida S, Mizutani S, Shiroma H, Shiba S, Nakajima T, Sakamoto T, Watanabe H, Masuda K, Nishimoto Y, Kubo M, Hosoda F, Rokutan H, Matsumoto M, Takamaru H, Yamada M, Matsuda T, Iwasaki M, Yamaji T, Yachida T, Soga T, Kurokawa K, Toyoda A, Ogura Y, Hayashi T, Hatakeyama M, Nakagama H, Saito Y, Fukuda S, Shibata T, Yamada T. Metagenomic and metabolomic analyses reveal distinct stage-specific phenotypes of the gut microbiota in colorectal cancer. Nat Med, 25:968-976, 2019
19. Kobayashi S, Nonaka S, Oda I, Abe S, Suzuki H, Yoshinaga S, Taniguchi H, Sekine S, Igarashi Y, Saito Y. A case of mixed-type early gastric cancer with recurrence following curative endoscopic submucosal dissection for expanded indication. Endosc Int Open, 7:E841-E845, 2019
20. Sakamoto T, Inoki K, Takamaru H, Sekiguchi M, Yamada M, Nakajima T, Matsuda T, Saito Y. Efficacy of linked colour imaging in magnifying chromoendoscopy with crystal violet staining: a pilot study. Int J Colorectal Dis, 34:1341-1344, 2019
21. Chen HY, Yamada M, Saito Y. Successful removal of a serrated lesion involving the appendiceal orifice using a traction device. Dig Endosc, 31:333, 2019
22. Jimenez-Garcia VA, Yamada M, Ikematsu H, Takamaru H, Abe S, Sakamoto T, Nakajima T, Matsuda T, Saito Y. Endoscopic submucosal dissection in management of colorectal tumors near or involving a diverticulum: a retrospective case series. Endosc Int Open, 7:E664-E671, 2019
23. Saito Y, Sylvia Wu SY, Ego M, Abe S. Colorectal endoscopic submucosal dissection with use of a bipolar and insulated tip knife. VideoGIE, 4:314-318, 2019
24. Niikura R, Yamada A, Fujishiro M, Tanaka K, Matsuda K, Saito Y, Ohtsuka K, Oda I, Katada C, Kato M, Kida M, Kobayashi K, Hoteya S, Horimatsu T, Kodashima S, Matsuda T, Muto M, Yamamoto H, Ryozawa S, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Shinozaki T, Tajiri H, Koike K. The Effects of Direct Oral Anticoagulants, Warfarin, Aspirin and Thienopyridine on the Performance of Immunochemical, Faecal, Occult Blood Tests. Digestion, 100:117-126, 2019
25. Kobayashi S, Yamada M, Takamaru H, Sakamoto T, Matsuda T, Sekine S, Igarashi Y, Saito Y. Diagnostic yield of the Japan NBI Expert Team (JNET) classification for endoscopic diagnosis of superficial colorectal neoplasms in a large-scale clinical practice database. United European Gastroenterol J, 7:914-923, 2019
26. Inoki K, Yamada M, Kuwabara H, Takamaru H, Sekiguchi M, Sakamoto T, Matsuda T, Saito Y. Newly-developed colonoscope (PCF-PQ260L) is useful for patients with difficult colons. Turk J Gastroenterol, 30:630-635, 2019
27. Yamada M, Saito Y, Imaoka H, Saiko M, Yamada S, Kondo H, Takamaru H, Sakamoto T, Sese J, Kuchiba A, Shibata T, Hamamoto R. Development of a real-time endoscopic image diagnosis support system using deep learning technology in colonoscopy. Sci Rep, 9:14465, 2019
28. Sakamoto T, Tomizawa Y, Cho H, Takamaru H, Sekiguchi M, Yamada M, Matsuda T, Murakami Y, Saito Y. Additional value of linked color imaging in colonoscopy: a retrospective study. Endosc Int Open, 7:E1448-E1454, 2019
29. Abe S, Oda I, Suzuki H, Yoshinaga S, Saito Y. A challenging case of gastric endoscopic submucosal dissection: removal of a sizable cancer through altering patient's position and multiple clip-line traction. VideoGIE, 4:558-560, 2019
30. Atkinson NSS, Ket S, Bassett P, Aponte D, De Aguiar S, Gupta N, Horimatsu T, Ikematsu H, Inoue T, Kaltenbach T, Leung WK, Matsuda T, Paggi S, Radaelli F, Rastogi A, Rex DK, Sabbagh LC, Saito Y, Sano Y, Saracco GM, Saunders BP, Senore C, Soetikno R, Vemulapalli KC, Jairath V, East JE. Narrow-Band Imaging for Detection of Neoplasia at Colonoscopy: A Meta-analysis of Data From Individual Patients in Randomized Controlled Trials. Gastroenterology, 157:462-471, 2019
31. Abe S, Ishihara R, Takahashi H, Ono H, Fujisaki J, Matsui A, Takahashi A, Goda K, Kawada K, Koike T, Takeuchi M, Tsuji Y, Hirasawa D, Oyama T. Long-term outcomes of endoscopic resection and metachronous cancer after endoscopic resection for adenocarcinoma of the esophagogastric junction in Japan. Gastrointest Endosc, 89:1120-1128, 2019
32. Saito Y, Nonaka S. ESD as first-intent resection method: also for the duodenum? Endosc Int Open, 7:E1761-E1762, 2019
33. Mizuguchi Y, Sakamoto T, Hashimoto T, Tsukamoto S, Iwasa S, Saito Y, Sekine S. Identification of a novel PRR15L-RSPO2 fusion transcript in a sigmoid colon cancer derived from superficially serrated adenoma. Virchows Arch, 475:659-663, 2019
34. Iwabu J, Yamashita S, Takeshima H, Kishino T, Takahashi T, Oda I, Koyanagi K, Igaki H, Tachimori Y, Daiko H, Nakazato H, Nishiyama K, Lee YC, Hanazaki K, Ushijima T. FGF5 methylation is a sensitivity marker of esophageal squamous cell carcinoma to definitive chemoradiotherapy. Sci Rep, 9:13347, 2019
35. Nakajo K, Abe S, Oda I, Ishihara R, Tanaka M, Yoshio T, Katada C, Yano T. Impact of the Charlson Comorbidity Index on the treatment strategy and survival in elderly patients after non-curative endoscopic submucosal dissection for esophageal squamous cell carcinoma: a multicenter retrospective study. J Gastroenterol, 54:871-880, 2019
36. Minashi K, Nihei K, Mizusawa J, Takizawa K, Yano T, Ezoe Y, Tsuchida T, Ono H, Iizuka T, Hanaoka N, Oda I, Morita Y, Tajika M, Fujiwara J, Yamamoto Y, Katada C, Hori S, Doyama H, Oyama T, Nebiki H, Amagai K, Kubota Y, Nishimura K, Kobayashi N, Suzuki T, Hirasawa K, Takeuchi T, Fukuda H, Muto M. Efficacy of Endoscopic Resection and Selective Chemoradiotherapy for Stage I Esophageal Squamous Cell Carcinoma. Gastroenterology, 157:382-390.e3, 2019
37. Uemura N, Oda I, Saito Y, Ono H, Fujisaki J, Matsuhashi N, Ohata K, Yahagi N, Yada T, Satoh M, Tajiri H, Inomata M, Kitano S. Efficacy and safety of 0.6% sodium alginate solution in endoscopic submucosal dissection for esophageal and gastric neoplastic lesion: A randomized controlled study. Dig Endosc, 31:396-404, 2019
Book
1. Saito Y, Takamaru H, Ono A, Sakamoto T,Yamada M, Sekiguchi M, Abe S, Sekine S, Matsuda T. Chapter 10. Endoscopic Submucosal Dissection for T1 Colorectal Cancer. In: Endoscopic Management of Colorectal T1(SM) Carcinoma, Singapore, Springer Singapore, pp 77-86, 2019
2. Abe S, Catalano F, Saito Y. Endoscopic Resections: EMR and ESD. In: Galloro G (ed), Revisiting Barrett’s Esophagus, Switzerland, Springer Switzerland, pp 147-158, 2019