Annual Report 2019
Department of Endoscopy, Respiratory Endoscopy Division
Takaaki Tsuchida, Yuji Matsumoto, Midori Tanaka
Introduction
More than 1,300 bronchoscopies were performed between March 2019 and April 2020 (Table 1). We are one of the facilities with the highest number of bronchoscopies in Japan. Almost all cases of peripheral and central pulmonary lesions are diagnosed on an outpatient basis, and sedation is used in combination with bronchoscopy to reduce patient suffering.
The special feature of our hospital is the use of endobronchial ultrasound (EBUS-TBNA, radial EBUS) for almost all examinations, and for small peripheral lesions, virtual bronchoscopy and virtual fluoroscopy using workstations and other instruments are used to simulate the lesion before the examination. Efforts were made to shorten the length of the procedure.
Guided biopsies were combined with rapid onsite cytology. Cryobiopsies were used to diagnose ground grass nodules or to obtain large specimens especially for next generation sequencing.
The Team and What We Do
Endobronchial ultrasonography (EBUS) is used not only to evaluate mediastinal or hilar malignant lesions but also to evaluate whether the biopsy devices can be directed to the peripheral lung lesions. Three hundred seventy-six cases of EBUS-TBNA (EBUS-guided transbronchial needle aspiration) were performed as a less invasive procedure to improve diagnosis for patients with mediastinal or hilar lymph node swelling. Transbronchial biopsies with virtual navigation were performed in most of the peripheral pulmonary lesions.
Endobronchial stenosis patients were treated with airway stent placement, debulking with a cryoprobe and/or endobronchial electrocautery ablation. Medical thorachoscopy under local anesthesia in the endoscopic examination room were performed with unknown pleural effusion and/or pleural thickening.
Research activities
We reported the results of a multicenter study of photodynamic therapy for peripheral small lung cancer with no serious adverse events.
We demonstrated the usefulness of cryobiopsy in medical thoracoscopy under local anesthesia for the diagnosis of malignant pleural mesothelioma.
Table 1. Type of procedure and number of patients
Clinical trials
Preparations were made to initiate the world's first multicenter trial of photodynamic therapy for peripheral type lung cancer.
Education
A flexible bronchoscope was developed for the first time in the world in this institution. There are many resident and overseas doctors wishing to train at our division. We were given the opportunity of writing papers and conference presentations for many residents. Overseas training doctors came from many countries.
Future prospects
1) We will initiate a multicenter clinical trial of photodynamic therapy for small peripheral lung cancer.
2) We will develop a new method of diagnosing malignant tumors using a desktop electron microscope.
3) We will develop methods of diagnosis and treatment using the minimally invasive technique of bronchoscopy.
4) We will study the multidimensional analysis of lung cancer pathology using pathology information, ultra-high-definition CT images, and medical information to investigate the diagnostic potential of ultra-high-definition CT images for lung cancer.
5) We plan to conduct a prospective observational study using a multicenter collaborative database on respiratory endoscopy.
6) We will conduct an observational study on the usefulness of the new cryoprobe in transbronchial lung biopsy for peripheral lung lesions.
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