Annual Report 2024

Department of Endoscopy, Respiratory Endoscopy Division

Takaaki Tsuchida, Yuji Matsumoto, Hideaki Furuse

Introduction

 More than 1,000 bronchoscopies were performed between April 2024 and March 2025 (Table 1). We are one of the facilities with the highest number of bronchoscopies performed in Japan. Most cases of peripheral pulmonary and endobronchial lesions are diagnosed on an outpatient basis, and sedation is used in combination with bronchoscopy to reduce patient discomfort.

Table 1. Type of procedure and number of patients

 The special feature of our hospital is the use of endobronchial ultrasound (convex-probe EBUS and radial EBUS) for almost all examinations, and for 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-glass nodules or to obtain large specimens especially for next generation sequencing.

 Stenting for airway stenosis and tumor ablation were also performed. We actively performed thoracoscopy under local anesthesia for cases with unexplained pleural effusion and pleural thickening.

The Team and What We Do

 EBUS is used not only to evaluate mediastinal or hilar lesions but also to evaluate whether the biopsy devices can be directed to the peripheral pulmonary lesions. A total of 381 cases of EBUS-TBNA (EBUS-guided transbronchial needle aspiration) were performed as a less invasive procedure to improve the diagnosis of patients with mediastinal or hilar lymph node swelling. Transbronchial biopsies with virtual navigation were performed in most of the peripheral pulmonary lesions.

 Patients with endobronchial stenosis were treated with airway stent placement, debulking with a cryoprobe and/or endobronchial electrocautery ablation. Medical thoracoscopy under local anesthesia was performed in the endoscopic examination room on patients with unknown pleural effusion and/or pleural thickening.

Research Activities

1) We conducted a trial of photodynamic therapy for peripheral small lung cancer.

2) We have conducted a randomized controlled trial to evaluate the efficacy of cryobiopsy in the diagnosis of peripheral pulmonary lesions.

Clinical Trials

 The world's first multicenter trial of photodynamic therapy for peripheral lung cancer was performed.

Education

 Since the flexible bronchoscope was developed at our hospital for the first time in the world, many residents and doctors from overseas have wished to receive training at our hospital, and we actively accept them. Furthermore, we have given many residents opportunities to write papers and present at conferences.

Future Prospects

1) We will conduct a randomized controlled trial to evaluate the efficacy of cryobiopsy in the diagnosis of peripheral pulmonary lesions.

2) We will develop diagnostic and therapeutic procedures using the minimally invasive technique of bronchoscopy.

3) We will develop a method to nondestructively understand tissue architecture by X-ray phase imaging.

4) We will develop a new method for diagnosing malignant tumors using a desktop electron microscope.

5) We will conduct a research on multidimensional information analysis of lung cancer pathology and examine the potential diagnostic ability of ultra-high-resolution CT images for lung cancer.

6) We will analyze the data of a prospective observational study using a multicenter database on respiratory endoscopy in Japan.

List of papers published in 2024

Journal

1. Parasa S, Berzin T, Leggett C, Gross S, Repici A, Ahmad OF, Chiang A, Coelho-Prabhu N, Cohen J, Dekker E, Keswani RN, Kahn CE, Hassan C, Petrick N, Mountney P, Ng J, Riegler M, Mori Y, Saito Y, Thakkar S, Waxman I, Wallace MB, Sharma P. Consensus statements on the current landscape of artificial intelligence applications in endoscopy, addressing roadblocks, and advancing artificial intelligence in gastroenterology. Gastrointestinal endoscopy, 101:2-9.e1, 2025

2. Sakamoto T, Oda I, Okamura T, Cho H, Toyoshima N, Nonaka S, Suzuki H, Nakamura T, Watanabe D, Matsuo K, Hanano K, Takeyama T, Yoshinaga S, Saito Y. Exploratory investigation of virtual lesions in gastrointestinal endoscopy using a novel phase-shift method for three-dimensional shape measurement. DEN open, 5:e381, 2025

3. Mizutani S, Tamaki A, Shiba S, Salim F, Yamada M, Takamaru H, Nakajima T, Yoshida N, Ikuta S, Yachida T, Shibata T, Soga T, Saito Y, Fukuda S, Ishikawa H, Yamada T, Yachida S. Dynamics of the gut microbiome in FAP patients undergoing intensive endoscopic reduction of polyp burden. Gut, 74:335-338, 2025

4. Goto O, Morita Y, Takayama H, Hirasawa K, Sato C, Oyama T, Takahashi A, Abe S, Saito Y, Ono H, Kawata N, Otsuka T, Iwakiri K. Endoscopic hand suturing has the potential to reduce bleeding after gastric endoscopic submucosal dissection in patients on antithrombotic agents: Multicenter phase II study. Digestive endoscopy, 37:266-274, 2025

5. Sekiguchi M, Kawamura T, Horiguchi G, Mizuguchi Y, Takamaru H, Toyoizumi H, Kato M, Kobayashi K, Sada M, Oda Y, Yokoyama A, Utsumi T, Tsuji Y, Ohki D, Takeuchi Y, Shichijo S, Ikematsu H, Matsuda K, Teramukai S, Kobayashi N, Matsuda T, Saito Y, Tanaka K. Colorectal Neuroendocrine Neoplasm Detection Rate During Colonoscopy: Results From Large-Scale Data of Colonoscopies in Japan. The American journal of gastroenterology, 120:473-477, 2025

6. Hirai Y, Toyoshima N, Saito Y. Endoscopic Resection for Colorectal Tumors. Digestion, 106:115-121, 2025

7. Pattarajierapan S, Saito Y, Takamaru H, Toyoshima N, Wisedopas N, Wanpiyarat N, Lerttanatum N, Khomvilai S. Learning curve of colorectal endoscopic submucosal dissection of an endoscopist experienced hands-on training in Japan. Journal of gastroenterology and hepatology, 40:226-234, 2025

8. Hotta K, Matsuda T, Sano Y, Fujii T, Saito Y. Surveillance after Endoscopic Resection for Colorectal Tumors: A Comprehensive Review. Digestion, 106:131-137, 2025

9. Romańczyk M, Desai M, Kamiński MF, Abe S, Alkandari AA, Beyna T, Bisschops R, Budzyń K, Bugdol M, Grover SC, Gyawali CP, Inoue H, Iyer PG, Messmann H, Ragunath K, Saito Y, Srinivasan S, Teshima C, Yadlapati R, Hassan C, Sharma P. International Validation of a Novel PEACE Scale to Improve the Quality of Upper Gastrointestinal Mucosal Inspection During Endoscopy. Clinical and translational gastroenterology, 16:e00786, 2025

10. Takamaru H, Tsay C, Shiba S, Yachida S, Saito Y. Microbiome and Colorectal Cancer in Humans: A Review of Recent Studies. Journal of the anus, rectum and colon, 9:20-24, 2025

11. Nanami H, Matsumoto Y, Furuse H, Tanaka M, Tsuchida T, Ohe Y. Efficacy of cryobiopsy during medical thoracoscopy for diagnosing malignant pleural mesothelioma. Lung cancer (Amsterdam, Netherlands), 199:108074, 2025

12. Yamashige D, Hijioka S, Nagashio Y, Maruki Y, Fukuda S, Yagi S, Okamoto K, Hara H, Hagiwara Y, Agarie D, Takasaki T, Ohba A, Kondo S, Morizane C, Ueno H, Sone M, Saito Y, Okusaka T. Potential of 6-mm-diameter fully covered self-expandable metal stents for unresectable malignant distal biliary obstruction: a propensity score-matched study. Clinical endoscopy, 58:121-133, 2025

13. Saito Y, Sakamoto T, Dekker E, Pioche M, Probst A, Ponchon T, Messmann H, Dinis-Ribeiro M, Matsuda T, Ikematsu H, Saito S, Wada Y, Oka S, Sano Y, Fujishiro M, Murakami Y, Ishikawa H, Inoue H, Tanaka S, Tajiri H. First report from the International Evaluation of Endoscopic classification Japan NBI Expert Team: International multicenter web trial. Digestive endoscopy, 36:591-599, 2024

14. Ito S, Hotta K, Sekiguchi M, Takeuchi Y, Oka S, Yamamoto H, Shinmura K, Harada K, Uraoka T, Hisabe T, Sano Y, Kondo H, Horimatsu T, Kikuchi H, Kawamura T, Nagata S, Yamamoto K, Tajika M, Tsuji S, Kusaka T, Okuyama Y, Yoshida N, Moriyama T, Hasebe A, So S, Saito Y, Nakahira H, Ishikawa H, Matsuda T. Short-term outcomes of endoscopic resection for colorectal neuroendocrine tumors: Japanese multicenter prospective C-NET STUDY. Digestive endoscopy, 36:942-951, 2024

15. Mandarino FV, Danese S, Uraoka T, Parra-Blanco A, Maeda Y, Saito Y, Kudo SE, Bourke MJ, Iacucci M. Precision endoscopy in colorectal polyps' characterization and planning of endoscopic therapy. Digestive endoscopy, 36:761-777, 2024

16. Tanaka H, Uraoka T, Kobayashi N, Ohata K, Takeuchi Y, Chino A, Yamada M, Tsuji Y, Hotta K, Harada K, Ikematsu H, Murakami T, Tsuji S, Katagiri A, Hori S, Michida T, Suzuki T, Fukuzawa M, Kiriyama S, Fukase K, Murakami Y, Ishikawa H, Nagahara A, Saito Y. Short-term and long-term outcomes of submucosal dissection for residual or recurrent colorectal tumors after endoscopic resection: Analysis of a multicenter prospective study. Digestive endoscopy, 36:1003-1011, 2024

17. Cho H, Abe S, Nonaka S, Suzuki H, Yoshinaga S, Okuma K, Yamamoto S, Daiko H, Kato K, Sekine S, Boku N, Saito Y. Long-term outcomes after non-curative endoscopic resection for esophageal squamous cell carcinoma followed by additional chemoradiotherapy. Diseases of the esophagus, 37:doae004, 2024

18. Sekiguchi M, Suzuki H, Takizawa K, Hirasawa T, Takeuchi Y, Ishido K, Hoteya S, Yano T, Tanaka S, Toya Y, Nakagawa M, Toyonaga T, Takemura K, Hirasawa K, Matsuda M, Yamamoto H, Tsuji Y, Hashimoto S, Maeda Y, Oyama T, Takenaka R, Yamamoto Y, Shimazu T, Ono H, Tanabe S, Kondo H, Iishi H, Ninomiya M, Oda I. Potential for expanding indications and curability criteria of endoscopic resection for early gastric cancer in elderly patients: results from a Japanese multicenter prospective cohort study. Gastrointestinal endoscopy, 100:438-448.e1, 2024

19. Fujita K, Saito Y. A novel hood with a small-caliber tip and two traction strings for endoscopic submucosal dissection. Endoscopy, 56:E111-E113, 2024

20. Oka S, Tanaka S, Kajiwara Y, Saito S, Fukunaga Y, Takamatsu M, Kawachi H, Hotta K, Ikematsu H, Kojima M, Saito Y, Yamada M, Kanemitsu Y, Sekine S, Nagata S, Yamada K, Kobayashi N, Ishihara S, Saitoh Y, Matsuda K, Togashi K, Komori K, Ishiguro M, Kuwai T, Okuyama T, Ohuchi A, Ohnuma S, Sakamoto K, Sugai T, Katsumata K, Matsushita HO, Yamano HO, Eda H, Uraoka T, Akimoto N, Kobayashi H, Sugihara K, Ueno H. Treatment Decision for Locally Resected T1 Colorectal Carcinoma-Verification of the Japanese Guideline Criteria for Additional Surgery Based on Long-Term Clinical Outcomes. The American journal of gastroenterology, 119:2019-2027, 2024

21. Sekiguchi M, Kishida Y, Ikematsu H, Konno M, Mizuguchi Y, Hotta K, Imai K, Ito S, Takada K, Shiomi A, Yasui H, Tsukamoto S, Hirano H, Kobayashi N, Saito Y, Inaba A, Shinmura K, Konishi J, Ozawa H, Fujita S, Murakami Y, Matsuda T. Proportions and characteristics of interval cancer in annual fecal immunochemical test screening and postcolonoscopy colorectal cancer: Results from a Japanese multicenter prospective study using questionnaires, the C-DETECT study. Digestive endoscopy, 36:1140-1151, 2024

22. Saito Y. Top tips for performing high-quality optical zoom chromocolonoscopy (with video). Gastrointestinal endoscopy, 100:122-127, 2024

23. Matsuda T, Sekiguchi M, Kobayashi N. [Current status and issues of colorectal cancer screening - toward the introduction of colonoscopy into the population-based screening program]. Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology, 121:177-185, 2024

24. Agarie D, Hijioka S, Nagashio Y, Maruki Y, Chatto M, Saito Y, Okusaka T. The case of infected intra-abdominal hematoma complicating endoscopic ultrasound-guided tissue acquisition. Endoscopy, 56:E309-E310, 2024

25. Tsuchida H, Matsumoto Y, Furuse H, Tsuchida T. Adenocarcinoma originating in the anterior mediastinum diagnosed by endobronchial ultrasound-guided transbronchial cryobiopsy: a case report. BMC pulmonary medicine, 24:181, 2024

26. Makiguchi ME, Saito Y. The running suture with clip and string technique after colonic endoscopic submucosal dissection. Endoscopy, 56:E350-E351, 2024

27. Nakamura K, Kakukgawa Y, Sekiguchi M, Tsuruki ES, Matsumoto M, Hisada I, Mizuguchi Y, Takamaru H, Sakamoto T, Saito Y, Kobayashi N, Matsuda T. Chronological Trend of Opportunistic Endoscopic Screening for Gastric Cancer and Atrophic Gastritis. Asian Pacific journal of cancer prevention : APJCP, 25:1247-1255, 2024

28. Fukuda S, Hijioka S, Nagashio Y, Maruki Y, Chatto M, Saito Y, Okusaka T. Forward-viewing echoendoscope aids tissue acquisition via the afferent limb after pancreaticoduodenectomy. Endoscopy, 56:E366-E368, 2024

29. Nishizawa T, Watanabe H, Yoshida S, Matsuno T, Fujimoto A, Matsuda R, Ebinuma H, Fujishiro M, Saito Y, Toyoshima O. Association between colonic adenoma size and proliferative zone in the crypt. Scandinavian journal of gastroenterology, 59:875-879, 2024

30. Saito Y, Toyoshima N, Mizuguchi Y, Sakamoto T, Uraoka T, Ikematsu H, Tamai N, Matsuda T, Misawa M, Hotta K, Shibata T. Protocol for a prospective multicenter randomized controlled trial to evaluate the efficacy of texture and color enhancement imaging (TXI) observation in the detection of colorectal lesions (deTXIon study). Japanese journal of clinical oncology, 54:1052-1056, 2024

31. Uozumi T, Abe S, Mizuguchi Y, Sekiguchi M, Toyoshima N, Takamaru H, Yamada M, Kobayashi N, Sadachi R, Ito S, Takada K, Kishida Y, Imai K, Hotta K, Ono H, Saito Y. Endoscopic hand suturing using a modified through-the-scope needle holder for mucosal closure after colorectal endoscopic submucosal dissection: Prospective multicenter study (with video). Digestive endoscopy, 36:1245-1252, 2024

32. Fukuda S, Hijioka S, Nagashio Y, Maruki Y, Ohba A, Agarie D, Hagiwara Y, Hara H, Okamoto K, Yamashige D, Yagi S, Kuwada M, Chatto M, Kondo S, Morizane C, Ueno H, Saito Y, Okusaka T. Feasibility and safety of a novel plastic stent designed specifically for endoscopic ultrasound-guided pancreatic duct drainage. Endoscopy international open, 12:E715-E722, 2024

33. Hagiwara Y, Hijioka S, Nagashio Y, Maruki Y, Ohba A, Kawasaki Y, Takeshita K, Takasaki T, Agarie D, Hara H, Yagi S, Fukuda S, Kuwada M, Yamashige D, Okamoto K, Chatto M, Kondo S, Morizane C, Ueno H, Endo M, Sugawara S, Sone M, Saito Y, Tsuchiya K, Okusaka T. Efficacy of endoscopic ultrasound-guided gastroenterostomy using self-expandable metallic stent for afferent loop syndrome: A single-center retrospective study. Journal of gastroenterology and hepatology, 39:2136-2142, 2024

34. Tamaru Y, Kuwai T, Kajiwara Y, Oka S, Saito S, Fukunaga Y, Kawachi H, Takamatsu M, Hotta K, Ikematsu H, Kojima M, Saito Y, Kanemitsu Y, Yamada M, Sekine S, Tanaka S, Nagata S, Nakamura T, Yamada K, Konno M, Ishihara S, Saitoh Y, Matsuda K, Togashi K, Komori K, Ishiguro M, Okuyama T, Ohuchi A, Ohnuma S, Sakamoto K, Sugai T, Katsumata K, Matsushita HO, Yamano HO, Nakai K, Uraoka T, Akimoto N, Kobayashi H, Ajioka Y, Sugihara K, Ueno H. Long-Term Outcomes of Additional Surgery After Endoscopic Resection Versus Primary Surgery for T1 Colorectal Cancer. The American journal of gastroenterology, 119:2418-2425, 2024

35. Toyoshima O, Nishizawa T, Hiramatsu T, Matsuno T, Yoshida S, Mizutani H, Ebinuma H, Matsuda T, Saito Y, Fujishiro M. Colorectal adenoma detection rate using texture and color enhancement imaging versus white light imaging with chromoendoscopy: a propensity score matching study. Journal of gastroenterology and hepatology, 39:2105-2111, 2024

36. Sakamoto Y, Sakamoto T, Ohba A, Sasaki M, Kondo S, Morizane C, Ueno H, Saito Y, Arai Y, Okusaka T. Efficacy of hemostasis by gastroduodenal covered metal stent placement for hemorrhagic duodenal stenosis due to pancreatobiliary cancer invasion: a retrospective study. Clinical endoscopy, 57:628-636, 2024

37. Djinbachian R, Rex DK, Chiu HM, Fukami N, Aihara H, Bastiaansen BAJ, Bechara R, Bhandari P, Bhatt A, Bourke MJ, Byeon JS, Cardoso D, Chino A, Chiu PWY, Dekker E, Draganov PV, Elkholy S, Emura F, Goldblum J, Haji A, Ho SH, Jung Y, Kawachi H, Khashab M, Khomvilai S, Kim ER, Maselli R, Messmann H, Moons L, Mori Y, Nakanishi Y, Ngamruengphong S, Parra-Blanco A, Pellisé M, Pinto RC, Pioche M, Pohl H, Rastogi A, Repici A, Sethi A, Singh R, Suzuki N, Tanaka S, Vieth M, Yamamoto H, Yang DH, Yokoi C, Saito Y, von Renteln D. International consensus on the management of large (≧20 mm) colorectal laterally spreading tumors: World Endoscopy Organization Delphi study. Digestive endoscopy, 36:1253-1268, 2024

38. Takeshita K, Hijioka S, Nagashio Y, Maruki Y, Ohba A, Kawasaki Y, Takasaki T, Yagi S, Agarie D, Hara H, Hagiwara Y, Yamashige D, Okamoto K, Fukuda S, Kuwada M, Chatto M, Kondo S, Morizane C, Ueno H, Saito Y, Okusaka T. Comparison of stent patency between EUS-guided hepaticogastrostomy with bridging and endoscopic transpapillary biliary drainage for hilar obstruction. Endoscopy international open, 12:E875-E886, 2024

39. Salim F, Mizutani S, Shiba S, Takamaru H, Yamada M, Nakajima T, Yachida T, Soga T, Saito Y, Fukuda S, Yachida S, Yamada T. Fusobacterium species are distinctly associated with patients with Lynch syndrome colorectal cancer. iScience, 27:110181, 2024

40. Yagi S, Hijioka S, Okamoto K, Nagashio Y, Chatto M, Saito Y, Okusaka T. Successful gastroduodenal stenting using the endoscopic ultrasound-guided rendezvous technique by Treitz ligament puncture. Endoscopy, 56:E653-E655, 2024

41. Matsumoto Y, Kho SS, Furuse H. Improving diagnostic strategies in bronchoscopy for peripheral pulmonary lesions. Expert review of respiratory medicine, 18:581-595, 2024

42. Tsuji S, Doyama H, Kobayashi N, Ohata K, Takeuchi Y, Chino A, Takamaru H, Tsuji Y, Hotta K, Harada K, Ikematsu H, Uraoka T, Murakami T, Katagiri A, Hori S, Michida T, Suzuki T, Fukuzawa M, Kiriyama S, Fukase K, Murakami Y, Ishikawa H, Saito Y. Outcomes of noncurative endoscopic submucosal dissection for T1 colorectal cancer: Prospective, multicenter, cohort study in Japan. Digestive endoscopy, 36:1369-1379, 2024

43. Kho SS, Tan SH, Soo CI, Ramarmuty HYD, Chai CS, Huan NC, Ng KL, Matsumoto Y, Poletti V, Tie ST. An explorative analysis on the optimal cryo-passes and freezing time of the ultrathin cryoprobe in endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy. Scientific reports, 14:18653, 2024

44. Esaki M, Igarashi A, Tsukamoto S, Sugawara S, Sekiguchi M, Fujinaga A. [Health Economic Evaluation of Surgical Treatment for Cancer]. Gan to kagaku ryoho. Cancer & chemotherapy, 51:795-800, 2024

45. Kang SJ, Tae CH, Bang CS, Shin CM, Jeong YH, Choi M, Hwang JH, Saito Y, Chiu PWY, Rerknimitr R, Khor C, Khien VV, Choi KD, Shim KN, Song GA, Lee OY. International Digestive Endoscopy Network Consensus on the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy. Gut and liver, 18:764-780, 2024

46. Furuse H, Matsumoto Y, Nakai T, Tanaka M, Nishimatsu K, Uchimura K, Imabayashi T, Tsuchida T. Diagnostic efficacy of cryobiopsy for peripheral pulmonary lesions with ground-glass opacity: a propensity score-matched analysis. Translational lung cancer research, 13:2175-2186, 2024

47. Ikuta S, Saito Y, Takata S, Nakatani Y, Nagatomo I, Shiba S, Takeda Y, Totoki Y, Mizutani S, Sunakawa H, Ikematsu H, Takamaru H, Kumanogoh A, Yachida S. Variability in non-tumor areas of colorectal cancer patients as revealed by endoscopic intestinal step biopsies. Molecular cancer, 23:249, 2024

48. Toyoshima O, Nishizawa T, Watanabe H, Matsuno T, Yoshida S, Takahashi Y, Mizutani H, Ebinuma H, Fujishiro M, Saito Y. Endoscopic characteristics to differentiate SSLs and microvesicular hyperplastic polyps from goblet cell-rich hyperplastic polyps. Endoscopy international open, 12:E1251-E1259, 2024

49. Uozumi T, Abe S, Sugimoto M, Kusuhara M, Mizuguchi Y, Nonaka S, Saito Y. Computed tomography-based virtual reality-guided preoperative simulation for endoscopic full-thickness resection of a gastric submucosal tumor. Endoscopy, 56:E1010-E1011, 2024

50. Kawamura R, Abe S, Mizuguchi Y, Nonaka S, Saito Y. Over-the-scope pre-looping method using an endoloop in endoscopic full-thickness resection of gastric gastrointestinal stromal tumor. Endoscopy, 56:E1034-E1035, 2024

51. Khor CJL, Ichimasa K, Tsao SKK, Biber U, Saito Y. Safety and performance of the HYBRIDknife flex in a porcine model of esophageal endoscopic submucosal dissection: A pilot study. JGH open, 8:e70036, 2024