Taiji Akamatsu

Shinshu University, Shonai, Nagano, Japan

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Publications (158)595.2 Total impact

  • Taiji Akamatsu · Takuma Okamura · Yugo Iwaya · Tomoaki Suga
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    ABSTRACT: The purpose of this study was to elucidate the prevalence and effect of Helicobacter pylori infection in Japanese teenagers. The study subjects were students ages 16 to 17 from one high school studied between 2007 and 2013. Students who tested positive on this screening examination underwent esophagogastroduodenoscopy and biopsy samples to determine their H pylori status using culture and histology. Cure of H pylori infections was determined by urea breath test. The low rate of prevalence of H pylori infection in present Japanese teenagers makes it possible and cost effective to perform examinations and carry out treatment of this infection in nationwide health screenings of high school students. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Jun 2015 · Gastroenterology clinics of North America
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    ABSTRACT: The prevalence of celiac disease (CD) among Japanese population has been unknown, whereas it has been increasingly recognized in the US and in the European countries. The aim of the present study is to identify possible cases with CD among Japanese population and clarify the relevance of screening for the disease. We conducted a serologic screening for the disease among 710 Japanese patients and 239 healthy volunteers at a local tertiary teaching hospital, using an anti-tissue transglutaminase IgA (TTG-IgA) test, and histological examination of the small intestines from the TTG-IgA positive subjects. There were no TTG-IgA positive sera among the healthy volunteers. Twenty of the patients (2.8%), including eight with malignant lymphoma, were tested positive for TTG-IgA. The histological examination of the eleven patients among those with positive TTG-IgA, seven showed villous atrophy and partial lymphocytes infiltration in the mucosa, which could be compatible to mucosal changes observed in CD. Five of them had non-Hodgkin lymphoma in the gastrointestinal tracts. Serologic tests using TTG-IgA might be relevant to screen for those with undiagnosed CD among Japanese population.
    Full-text · Article · Jun 2014 · International journal of medical sciences
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    ABSTRACT: A spiral bacterium (SH9), morphologically different from Helicobacter pylori (H. pylori), was found in a 62-year-old woman's gastric mucosa. Gastroscopic examination revealed multiple gastric ulcers near the pyloric ring; mapping gastric biopsy showed mild mononuclear infiltration with large lymphoid follicles in the antrum, without corpus atrophy. Urea breath test and H. pylori culture were negative, but Giemsa staining of biopsies revealed tightly coiled bacteria that immunostained with anti-H. pylori antibody. Sequencing of SH9 16S rRNA and the partial urease A and B subunit genes showed that the former sequence had highest similarity (99%; 1302/1315 bp) to Helicobacter heilmannii (H. heilmannii) sensu stricto (H. heilmannii s.s.) BC1 obtained from a bobcat, while the latter sequence confirmed highest similarity (98.3%; 1467/1493 bp) to H. heilmannii s.s. HU2 obtained from a human. The patient was diagnosed with multiple gastric ulcers associated with H. heilmannii s.s. infection. After triple therapy (amoxicillin, clarithromycin, and lansoprazole) with regimen for eradicating H. pylori, gastroscopy showed ulcer improvement and no H. heilmannii s.s. upon biopsy.
    Full-text · Article · Mar 2014 · World Journal of Gastroenterology
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    ABSTRACT: Although Helicobacter pylori eradication is a first-line treatment of gastric MALT lymphoma, roughly 25% of patients do not respond to treatment. CD4+ FOXP3+ regulatory T (Treg) cells regulate immune responses in physiological conditions and various inflammatory conditions, including H. pylori-associated diseases. Our goal was to determine how Treg cells affect responsiveness to H. pylori eradication therapy. We performed dual immunohistochemistry for CD4 and FOXP3 to evaluate the prevalence of FOXP3+ Treg cells in the stomach of 63 patients with MALT lymphoma and 55 patients with chronic active gastritis. Receiver operating characteristic analysis was carried out to determine the best cut-off point in differentiating H. pylori eradication responders from nonresponders. Both the FOXP3+/CD4+ cell ratio and the absolute number of FOXP3+ cells per high-power field in MALT lymphoma were significantly greater in H. pylori eradication responders compared with nonresponders, suggesting that Treg cells function in regression mechanisms of MALT lymphomas. Cut-off points with good sensitivities and specificities were obtained to predict eradication outcome. A high number of Treg cells or a high ratio of Treg cells to the total number of CD4+ T cells in gastric MALT lymphoma could predict responsiveness to eradication therapy.
    No preview · Article · Apr 2013 · Helicobacter
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    ABSTRACT: Background Recently, a significant relationship between gastric cancer and Helicobacter pylori infection has been proven. The purpose of this study was to elucidate the actual conditions of H. pylori infection in Japanese teenagers. Methods The study subjects were students at a certain high school between 2007 and 2009. They were first examined with a urine-based enzyme-linked immunosorbent assay (ELISA) for detection of the antibody to H. pylori (RAPIRAN®). Students who tested positive on this screening examination visited Shinshu University Hospital and received esophagogastroduodenoscopy, and biopsy samples were taken to examine their H. pylori status. The resolution of H. pylori infection was assessed by urea breath test. Results For 3 years, 1,224 of 1,232 students (99.4%) received a screening examination for H. pylori infection. Sixty-four of these 1,224 students (5.2%) were found to be positive for H. pylori. Thirty of these 64 H. pylori-positive students visited our hospital, and 24 of them (80%) were confirmed to be infected by H. pylori. The most common endoscopic findings for students with H. pylori infection were nodular gastritis (58.3%) and closed-type atrophic gastritis (45.8%). Histological findings showed no evidence of intestinal metaplasia, except in one of the students. All 24 students were successfully cured of H. pylori infection. If this procedure were to be introduced into the nationwide health screening at Japanese high schools, we calculated that the cost of the prevention of a gastric cancer would be 454,073 yen for each person. Conclusions The low rate of prevalence of H. pylori infection in Japanese teenagers would make it possible to perform examinations and carry out treatment for this infection in high school health screenings from the standpoint of medical economy.
    Full-text · Article · Sep 2012 · Journal of Gastroenterology
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    ABSTRACT: We here describe the clinical course of a 70-year-old male patient with Waldenström macroglobulinemia (WM) putatively transformed from refractory mucosa-associated lymphoid tissue lymphoma (MALTL). Immunological staining was performed on formalin-fixed, paraffin-embedded tissue sections, and M-protein and cryoglobulin were identified by immunofixation electrophoresis and the cold precipitation method. Chromosome translocation was analyzed by the G-banded karyotype, and API2/MALT1 fusion gene underwent fluorescent in situ hybridization. Multiplex polymerase chain reaction was performed to analyze the VH-JH or DH-JH rearrangements of the IGH gene. At diagnosis, the WM patient had monoclonal IgM with cryoglobulinemia and hyperviscosity syndrome. Eight years before developing WM, the patient experienced the onset of typical gastric MALT-L with H. pylori infection, but in spite of negative for chromosome translocation, t (11;18) and the successful eradication of H. pylori, the MALT-L relapsed repeatedly, and finally led to systemic metastasis. The lymphoma cells also infiltrated the large intestine and spleen. Immunoglobulin gene analyses of cellular clonality revealed that the same clone had been present in the stomach, bone marrow (BM) at the onset of MALT L, and in the BM at the diagnosis of WM. In this case, lymphoma developed as H. pylori-associated gastric MALT-L with negative for t (11;18), and might be transformed into MW during the systemic metastasis.
    No preview · Article · Jun 2012 · Rinsho byori. The Japanese journal of clinical pathology
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    ABSTRACT: Recently, a significant relationship between gastric cancer and Helicobacter pylori infection has been proven. The purpose of this study was to elucidate the actual conditions of H. pylori infection in Japanese teenagers. The study subjects were students at a certain high school between 2007 and 2009. They were first examined with a urine-based enzyme-linked immunosorbent assay (ELISA) for detection of the antibody to H. pylori (RAPIRAN). Students who tested positive on this screening examination visited Shinshu University Hospital and received esophagogastroduodenoscopy, and biopsy samples were taken to examine their H. pylori status. The resolution of H. pylori infection was assessed by urea breath test. For 3 years, 1,224 of 1,232 students (99.4%) received a screening examination for H. pylori infection. Sixty-four of these 1,224 students (5.2%) were found to be positive for H. pylori. Thirty of these 64 H. pylori-positive students visited our hospital, and 24 of them (80%) were confirmed to be infected by H. pylori. The most common endoscopic findings for students with H. pylori infection were nodular gastritis (58.3%) and closed-type atrophic gastritis (45.8%). Histological findings showed no evidence of intestinal metaplasia, except in one of the students. All 24 students were successfully cured of H. pylori infection. If this procedure were to be introduced into the nationwide health screening at Japanese high schools, we calculated that the cost of the prevention of a gastric cancer would be 454,073 yen for each person. The low rate of prevalence of H. pylori infection in Japanese teenagers would make it possible to perform examinations and carry out treatment for this infection in high school health screenings from the standpoint of medical economy.
    No preview · Article · Aug 2011 · Journal of Gastroenterology
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    ABSTRACT: We conducted a multicenter, retrospective study to determine the anatomical distribution and prognostic factors of gastrointestinal (GI) follicular lymphoma (FL). This study included 125 patients with stage I and II(1) GI-FL. Of the 125 patients, the small intestine was examined in 70 patients, with double-balloon endoscopy and/or capsule endoscopy. The most frequently involved GI-FL site was the duodenal second portion (DSP) (81%), followed by the jejunum (40%); 85% of patients with involvement of the DSP also had jejunal or ileal lesions. The absence of abdominal symptoms and macroscopic appearance of multiple nodules were significantly present in the DSP-positive group. During a median follow up of 40 months, six patients showed disease progression. Patients with involvement of the DSP had better progression-free survival (PFS) than those without such involvement (P = 0.001). A multivariate analysis revealed that male sex, the presence of abdominal symptoms, and negative involvement of the DSP were independently associated with poor PFS. In conclusion, most patients with GI-FL have duodenal lesions associated with multiple jejunal or ileal lesions. Gastrointestinal follicular lymphomas involving the DSP might be a distinct entity showing a favorable clinical course.
    No preview · Article · May 2011 · Cancer Science
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    ABSTRACT: The trefoil factor family (TFF) 2 protein is produced by gastric gland mucous cells (GMCs), and the secreted TFF2 shares a mucosal barrier function with GMC-type mucin. Recently, we presented an enzyme-linked immunosorbent assay (ELISA) method for measurement of GMC-type mucin in the gastric juice. We aimed to develop an ELISA for TFF2 and to assess pathophysiological changes in the gastric surface mucous gel layer (SMGL) of patients with Helicobacter pylori infection. The distribution of TFF2 and GMC-type mucin in the SMGL was immunohistochemically determined. The ELISA for TFF2 was based on a polyclonal goat antibody. Recombinant TFF2 was employed to prepare the calibrators. TFF2 and GMC-type mucin in the gastric juice in healthy individuals (n = 33) and patients with gastritis (n = 37), gastric ulcer (n = 16), and duodenal ulcer (n = 10) were assayed using ELISA. TFF2 and GMC-type mucin were immunohistochemically co-localized in the gastric SMGL and GMCs. The TFF2 levels in the patients were significantly higher than those in the healthy individuals. Further, the TFF2 levels in the H. pylori-positive patients were significantly higher than those in the H. pylori-negative patients, and decreased after the eradication of the infection. GMC-type mucin levels showed a tendency similar to that of TFF2 levels. The upregulation of TFF2 and GMC-type mucin secretion may reflect the response of the gastric mucosa to H. pylori-induced injuries. TFF2 and GMC-type mucin secreted into the SMGL may protect the gastric mucosa against H. pylori.
    No preview · Article · May 2011 · Digestive Diseases and Sciences
  • N. Koide · D. Komatsu · A. Suzuki · T. Akamatsu · S. Miyagawa
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    ABSTRACT: We reported a case of emergency operation for esophageal perforation in endoscopic treatment for esophageal cancer. A 73-year-old man underwent endoscopic treatment for superficial cancer in the lower thoracic esophagus. After a mucosal incision around the tumor, the endoscope with its covered cap was accidentally inserted into the mediastinum via the mucosal incision. The diameter of the esophageal perforation was about 15 mm. Computed tomography showed right pneumothorax, peumomediastinum and subcutaneous emphysema of the neck and chest. The patient complained of dyspnea with hyopoxia, and a chest drain was inserted into the right thorax for improvement of right pneumothorax. Emergency operation, thoracic esophagectomy via right thoracotomy, was performed for esophageal peraforation. The patient was successfully recovered after surgery. Second operation was performed due to digestive construction using a gastric tube. This case is educational for gastrointestinal surgeons as well as endoscopists treating esophageal cancer, and it is important to closely collaborate between surgeons and endoscopists in emergency situation.
    No preview · Article · May 2011 · Endoscopic Forum for Digestive Disease
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    ABSTRACT: A 38-year-old man presented to our hospital with abdominal pain and melena. Gastrointestinal endoscopy revealed a large gastric ulcer, and the pathological diagnosis of diffuse large B-cell lymphoma (DLBCL) was made based on immunohistochemical findings. Left diplopia developed soon after commencement of chemotherapy. Despite normal findings from head MRI, orbital involvement in DLBCL was detected with 18F-fluorodeoxyglucose positron emission tomography (FDG-PET). The patient was treated with salvage chemotherapy with success. Treatment analysis using FDG-PET for patients with DLBCL, especially for those with clinical symptoms and negative findings on conventional modalities, may be useful for assessing disease status and adjusting treatments.
    No preview · Article · Jan 2011 · Internal Medicine
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    ABSTRACT: A 83-year-old man was diagnosed as having a duodenal SMT-like tumor with an opening pit via an esophagogastroduodenoscopy (EGD), and the size of the tumor increased over two months. He was referred to our hospital for further examination. The tumor was located on the superior duodenal angle (SDA) of the duodenal bulb, and had a depression on its anal side. Biopsy specimens showed well differentiated adenocarcinoma. The tumor was diagnosed as advanced carcinoma with duodenography and endoscopic ultrasonography therefore we selected a partial distal gastrectomy and partial duodenectomy as the surgical approach. Histological findings of the resected specimen revealed well differentiated tubular adenocarcinoma, which had invaded the subserosa and lymphatic vessels. Immunohistochemical staining indicated that gastric mucin such as MUC5AC and MUC6 were both positive, and that intestinal mucin such as MUC2 and CD10 were both negative, so this duodenal tumor was the completely gastric type of carcinoma.
    No preview · Article · Jan 2011 · Gastroenterological Endoscopy
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    ABSTRACT: Along with the growing elderly population, patients with gastric ulcers caused by low-dose aspirin have increased. Gastric cancer is also common among the elderly population, but is sometimes difficult to distinguish from gastric ulcers, especially those stemming from aspirin use. To differentiate the diagnostic symptoms of gastric ulcers and gastric cancers in elderly patients, we compared the endoscopic findings of 198 subjects (92 benign ulcers and 106 cancers) aged 65 years and older. Despite their benign nature, aspirin-induced ulcers tended to have more irregularity of the ulcer edge and heterogeneous formation of regenerating epithelium than ulcer unrelated to aspirin. Asking about the use of low-dose aspirin is therefore important when confronted with such lesions in elderly patients.
    No preview · Article · Nov 2010 · Nippon rinsho. Japanese journal of clinical medicine
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    ABSTRACT: Non-steroidal anti-inflammatory drug (NSAID)-related small intestinal complications exist, since developed new diagnostic modalities, such as balloon and capsule endoscopies. Some experiments have shown rebamipide to protect from NSAID-induced small intestinal complications. The purpose of this study is to investigate whether the effective concentrations of rebamipide (COR) are present in the small intestine after taking an ordinary clinical dose and double dose of this drug. Twelve healthy male subjects were enrolled. After taking 100 or 200 mg of rebamipide, balloon enteroscopy was performed at 1 and 3 h, and biopsy samples were obtained from the jejunum and the stomach. Venous blood samples were taken simultaneously. Samples were analyzed by high-performance liquid chromatography. The mean COR in the jejunum was higher than 100 µM at 1 h and higher than 10 µM at 3 h in both the 100 and 200 mg groups. Mean COR in the stomach was less than 100 µM at 1 h in the 100 mg group; however it was higher than 100 µM in the 200 mg group. In conclusion, the COR level in the jejunum was sufficient to protect for NSAID-induced gastrointestinal complications.
    Full-text · Article · Nov 2010 · Journal of Clinical Biochemistry and Nutrition
  • S. Yokosawa · T. Akamatsu · K. Kitahara · H. Shirakawa · E. Tanaka · H. Ota
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    ABSTRACT: A 74-year-old woman was referred to our hospital with dysphagia and abnormal barium meal study in August 2003. EGD performed at our department disclosed a 20 mm-sized pedunculated protrusion in the upper gastric body; the lesion appeared to be a submucosal tumor. Endoscopic ultrasonography depicted it as a rather hyperechoic mass originating from the 3rd layer and containing multiple anechoic areas. Since the pedicle was narrow at the base, endoscopic polypectomy was performed. Resected specimen showed proliferation of foveolar glands of various sizes without atypia partly showing cystic dilatation in the submucosa; these pathological findings were considered compatible with hamartomatous inverted polyp. It is a rare condition, but this case seems to show typical findings. Being a pedunculated or semi-pedunculated submucosal tumor in the upper stomach, it seems probable to make its endoscopic diagnosis in the future.
    No preview · Article · Oct 2010
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    ABSTRACT: Autoimmune pancreatitis (AIP) is a recently recognized disease entity. In some patients, this disease is associated with other inflammatory diseases. In this study, we aimed to elucidate the pathologic characteristics of AIP-associated gastritis (AIP-G). We evaluated and compared the pathologic findings and immunohistochemical expressions of immunoglobulin G (IgG)4 and IgG in gastric biopsy specimens from 13 AIP-G patients with those from patients of 2 control groups. We divided the AIP-G patients who did not receive steroid therapy [AIP-G-ST(-)] into the following 2 groups: without Helicobacter pylori (HP) infection [AIP-G-HP(-)] and with HP infection [AIP-G-HP(+)]. The control groups comprised 19 patients who were diagnosed with chronic active gastritis associated with HP infection and 7 patients with nonsteroidal anti-inflammatory drug-induced gastritis. We classified the findings for the gastric mucosa into those for the upper and the lower lamina propria. The characteristic finding of AIP-G groups was diffusely lymphoplasmacytic infiltration in the lamina propria. The IgG4-positive plasma cell/IgG-positive plasma cell ratios (IgG4/IgG ratios) in both the upper and lower lamina propria in the AIP-G-ST(-) groups were predominantly higher than the corresponding values in the other groups. In the AIP-G-ST(-) groups, the IgG4/IgG ratio in the lower lamina propria was predominantly higher than that in the upper lamina propria, irrespective of the HP status. In conclusion, diffuse lymphoplasmacytic infiltration in the lamina propria and increased IgG4/IgG ratio in the gastric mucosa (notably in the lower lamina propria) may be the characteristic findings of AIP-G.
    No preview · Article · Sep 2010 · The American journal of surgical pathology
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    ABSTRACT: A 23-year old man was referred to our department in May 2008 with high fever and vomiting. He had been treated in the Neurosurgery Department of our hospital for a brain tumor from 4 months previously. Because he had been suffering from unconsciousness due to the brain tumor, he was under intubation feeding. A proton pump inhibitor and a steroid hormone were administered every day to prevent peptic ulcer formation and secondary adrenal insufficiency. Enhanced CT examination showed remarkable thickness of the gastric wall and existence of gas in the portal vein. Esophagogastroendoscopy showed swelling of the gastric fold, multiple erosions, mucosal redness, and edema in the upper and the middle portion of the stomach. Endoscopic ultrasonography revealed the disappearance of normal laminated structure and some small hypoechoic lesions in the thick gastric wall. Enterobacter aerogenes and Enterococcus faecalis were cultured in the gastric juice and biopsy specimens taken from the stomach, but no pathogenic bacteria was cultured from his blood sample. Based on those findings, the patient was diagnosed as having acute phlegmonous gastritis with hepatic portal venous gas (HPVG). His clinical symptoms improved and the abnormal endoscopic and CT examination findings were normalized following the administration of antibiotics. Fifty cases of phlegmonous gastritis with and without HPVG have been reported in Japan since 1996 and their clinical features are reviewed.
    No preview · Article · Jul 2010
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    ABSTRACT: A male in his late 50's visited our hospital with dysphagia which had started 3 months previously. The physical examination showed no abnormal findings except for limited extension of the neck. Upper gastrointestinal endoscopy revealed an extramural compression at the posterior wall of the laryngopharynx. X-ray examination of the cervical spine showed osteophytes at the anterior of the vertebral bodies, and the patient was diagnosed as having ossification of the anterior longitudinal ligament (OALL). MRI and barium meal examination revealed compression of the laryngopharyngeal wall by the osteophytes. The osteophytes (ossified ligament) from C4 to C6 were resected surgically whereafter the symptoms disappeared immediately. Endoscopic and radiographic findings confirmed a marked improvement. The present case clearly showed that OALL can be a cause of dysphagia. Thus, we should not overlook findings of extramural compression at the posterior wall of the laryngopharynx during endoscopic examination of patients who complain of dysphagia.
    No preview · Article · Jul 2010 · Gastroenterological Endoscopy
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    ABSTRACT: Outcomes of endoscopic submucosal dissection (ESD) for early gastric neoplasms at low-volume centers have been unknown, because all previous reports have studied in advanced single centers. The aim of this study was to compare ESD outcomes between high- and low-volume centers. A retrospective questionnaire survey was conducted and 30 centers (96.8%) responded. The complete en-bloc resection rate (CERR) and the incidence of complications were analyzed. Early gastric cancer (EGC) was divided into three categories on the basis of pathological diagnosis-standard indication (SI), expanded indication (EI) and out-of-indication (OI). A total of 703 early gastric neoplasms (586 EGCs, 117 gastric adenomas) were treated with ESD from January to December 2005. The institutions that treated more than 30 cases a year were classified as high-volume centers, and those with less than 30 cases, low-volume centers. In SI, the CERRs at high- and low-volume centers were 92.1% and 91.1%, in EI, CERRs were 86.2% and 82.6% and in OI, CERRs were 80.3% and 88.0%. The perforation rates at high- and low-volume centers were 3.6% and 4.7%. The intra-operative bleeding rates at high- and low-volume centers were 0.26% and 0%, while the delayed bleeding rates were 0% and 0.63%. There were no significant difference in the outcomes of ESD for early gastric neoplasms between high- and low volume centers.
    Full-text · Article · Jan 2010 · Internal Medicine
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    ABSTRACT: Objective Outcomes of endoscopic submucosal dissection (ESD) for early gastric neoplasms at low-volume centers have been unknown, because all previous reports have studied in advanced single centers. The aim of this study was to compare ESD outcomes between high- and low-volume centers. Methods A retrospective questionnaire survey was conducted and 30 centers (96.8%) responded. The complete en-bloc resection rate (CERR) and the incidence of complications were analyzed. Early gastric cancer (EGC) was divided into three categories on the basis of pathological diagnosis-standard indication (SI), expanded indication (EI) and out-of-indication (OI). Results A total of 703 early gastric neoplasms (586 EGCs, 117 gastric adenomas) were treated with ESD from January to December 2005. The institutions that treated more than 30 cases a year were classified as high- volume centers, and those with less than 30 cases, low-volume centers. In SI, the CERRs at high- and low-volume centers were 92.1% and 91.1%, in EI, CERRs were 86.2% and 82.6% and in OI, CERRs were 80.3% and 88.0%. The perforation rates at high- and low-volume centers were 3.6% and 4.7%. The intra-operative bleeding rates at high- and low-volume centers were 0.26% and 0%, while the delayed bleeding rates were 0% and 0.63%. Conclusion There were no significant difference in the outcomes of ESD for early gastric neoplasms between high- and low volume centers.
    Full-text · Article · Jan 2010 · Internal Medicine

Publication Stats

4k Citations
595.20 Total Impact Points

Institutions

  • 1985-2014
    • Shinshu University
      • • Shinshu University Hospital
      • • Division of Neurology and Rheumatology
      • • Department of Laboratory Medicine
      • • Department of Medicine
      • • Department of Clinical Laboratory Sciences
      • • Department of Legal Medicine
      • • Department of Pathology
      Shonai, Nagano, Japan
  • 2010
    • Saku Central Hospital
      Сакура, Chiba, Japan
  • 2002
    • Nagano University
      長野, Nagano, Japan
  • 2000
    • Tokyo Medical University
      Edo, Tōkyō, Japan
    • University of Hamburg
      Hamburg, Hamburg, Germany
  • 1999
    • Aichi Cancer Center
      Nagoya, Aichi, Japan