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Annual Report 2020

Endoscopy Center/ Department of Endoscopy, Gastrointestinal Endoscopy Division

Yutaka Saito, Takahisa Matsuda, Ichiro Oda, Yasuo Kakugawa, Shigetaka Yoshinaga, Haruhisa Suzuki, Satoru Nonaka, Taku Sakamoto, Seiichiro Abe, and Masayoshi Yamada, Masau Sekiguchi, Hiroyuki Takamaru, and Keiko (Sogame) Nakamura (Staff), Takao Itoi, Minori Matsumoto, and Eriko (Tsuruki) So (Attending staff), Mai Ego, Horin Cho, Kengo Kasuga, Yasuhiko Mizuguchi, Takuma Okamura, Kei Nakazawa, Gozo Fukishi, Takayuki Yamazaki, Reona Kawamura, Naoko Okuda, Akiko Urabe, Renpei Yagi, and Yoshimitu Taguchi (Resident), Masako Yamada, Wakana Ikeda, Ayano Okamura, and Yumiko Sakamoto (Endoscopic Engineer), Takaaki Tsuchida, Yuji Matsumoto, Midori Tanaka, and Tatuya Imabayashi (Bronchoscopy)

Introduction

 The Department of Endoscopy moved to the New Endoscopy Center on January 20th, 2014, and we believe this is one of the largest endoscopy centers in Japan (15 endoscopy rooms [251.112 m2] and 136.788 m2 of recovery rooms on two floors of 1949.554 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 recent developments have changed the operational mechanism and design of endoscopes along with a variety of accessory devices and instruments; thus, 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 among our Japanese medical students, residents and staff physicians as well as approximately 130 overseas post-graduate physicians who attend our training courses annually.

 Our Endoscopy Center was authorized as one of the World Endoscopy Organization (WEO) Centers of Excellence by the WEO and received an award during Gastro 2017 in Hyderabad. This is an honorable award for us because there are only 17 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 also 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 diagnoses of gastrointestinal disease, we are utilizing the NBI and BLI systems, which enable us to narrow the spectral transmittance bandwidth of optical filters used in the light source of electronic endoscope systems. In addition, we have introduced an endocytoscopy system. This system can magnify lesions up to 500x magnification and visualize nuclear atypia.

Clinical trials

 We have organized several multicenter study groups to prospectively evaluate the efficacy and clinical impact of newly developed endoscopies and medical devices.

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 with 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 comparing 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 of 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 the 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 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.

 Our division has developed and is leading the single-arm phase III confirmatory trial on indications of endoscopic submucosal dissection for elderly patients with early gastric cancer (JCOG1902: Elderly G-ESD study). This study is ongoing from 2020.

Duodenum

 A non-randomized confirmatory trial of cold snare polypectomy for superficial non-ampullary duodenal epithelial tumor (D-COP trial) has been 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 small duodenal 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 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 in a multicenter single-arm study (JCOG1612) for the possibility of CRT for high-risk rectal submucosal cancer after endoscopic resection. Should this study result show a noninferiority of CRT compared with 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 were enrolled to this multicenter cohort study, and a 5-year surveillance of all enrolled patients has been 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 ongoing since May 2017. This study is collecting many T1 CRC cases from over 70 institutions all over Japan and will provide 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 part of a new era for very early cancer diagnosis and detection of metastasis. We have started a collaborative study with the Departments of Endoscopy, Colorectal Surgery, Gastric Surgery, Pathology and Clinical Laboratories, the NCC, Research Institute, the University of Tokyo, and the Jikei University School of Medicine.

 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 become the largest and most precise database for all endoscopic procedures. Japanese endoscopists are well known as most excellent endoscopists, therefore, we will be able to gather a lot of evidence using this huge endoscopy database.

 In terms of research and development of new endoscopy using artificial intelligence (AI), recent developments in AI using deep learning are expected to be applicable in precision medicine. We have been researching and developing new endoscopic systems using AI. First, in order to support endoscopist’s detection of CRC and precancerous lesions during colonoscopy by 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 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 analyzing study led by Prof. Kudo’s group to compare a new automatic diagnosis system using AI with endoscopist’s diagnosis of colorectal lesions using endocytoscopy. In addition, we have also started the research and development of an endoscopic diagnosis support system on tumor invasion of gastrointestinal cancer using AI.

 We are collaborating with the NCCH Research Institute and Osaka University to perform 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 published in Nature Medicine.

Future Prospects

Research and development of new endoscopy

 The Olympus Medical Systems Corporation has opened a laboratory at our new research center, and we are collaborating with them for developing innovative endoscopy systems and devices.

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List of papers published in 2020

Journal

1. Cho H, Yamada M, Sekine S, Tanabe N, Ushiama M, Hirata M, Ogawa G, Gotoh M, Yoshida T, Yoshikawa T, Saito Y, Kuchiba A, Oda I, Sugano K. Gastric cancer is highly prevalent in Lynch syndrome patients with atrophic gastritis. Gastric Cancer, 24:283-291, 2021

2. Abe S, Oda I. How can endoscopists adapt and collaborate with artificial intelligence for early gastric cancer detection? Dig Endosc, 33:98-99, 2021

3. Gotoda T, Akamatsu T, Abe S, Shimatani M, Nakai Y, Hatta W, Hosoe N, Miura Y, Miyahara R, Yamaguchi D, Yoshida N, Kawaguchi Y, Fukuda S, Isomoto H, Irisawa A, Iwao Y, Uraoka T, Yokota M, Nakayama T, Fujimoto K, Inoue H. Guidelines for sedation in gastroenterological endoscopy (second edition). Dig Endosc, 33:21-53, 2021

4. Miyamoto Y, Nonaka S, Oda I, Abe S, Suzuki H, Yoshinaga S, Mano H, Saito Y. Safety and usefulness of endoscopic submucosal dissection for early esophageal cancers in elderly patients aged 80 years or older. Esophagus, 18:81-89, 2021

5. Abe S, Bhatt A, Saito Y. The journey to develop the ideal submucosal injection solution for endoscopic submucosal dissection. Gastrointest Endosc, 93:514-516, 2021

6. Uraoka T, Tanaka S, Saito Y, Matsumoto T, Kuribayashi S, Hori K, Tajiri H. Computer-assisted detection of diminutive and small colon polyps by colonoscopy using an extra-wide-area-view colonoscope. Endoscopy, 53:E102-E103, 2021

7. Kanamori J, Abe S, Kurita D, Ishiyama K, Hirano Y, Oguma J, Oda I, Saito Y, Daiko H. Minimally invasive hybrid surgery: A salvage tumor enucleation for local recurrence of thoracic esophageal carcinoma after definitive chemoradiotherapy. Asian J Endosc Surg, 14:77-80, 2021

8. Hatta W, Tsuji Y, Yoshio T, Kakushima N, Hoteya S, Doyama H, Nagami Y, Hikichi T, Kobayashi M, Morita Y, Sumiyoshi T, Iguchi M, Tomida H, Inoue T, Koike T, Mikami T, Hasatani K, Nishikawa J, Matsumura T, Nebiki H, Nakamatsu D, Ohnita K, Suzuki H, Ueyama H, Hayashi Y, Sugimoto M, Yamaguchi S, Michida T, Yada T, Asahina Y, Narasaka T, Kuribasyashi S, Kiyotoki S, Mabe K, Nakamura T, Nakaya N, Fujishiro M, Masamune A. Prediction model of bleeding after endoscopic submucosal dissection for early gastric cancer: BEST-J score. Gut, 70:476-484, 2021

9. Kudo SE, Ichimasa K, Villard B, Mori Y, Misawa M, Saito S, Hotta K, Saito Y, Matsuda T, Yamada K, Mitani T, Ohtsuka K, Chino A, Ide D, Imai K, Kishida Y, Nakamura K, Saiki Y, Tanaka M, Hoteya S, Yamashita S, Kinugasa Y, Fukuda M, Kudo T, Miyachi H, Ishida F, Itoh H, Oda M, Mori K. Artificial Intelligence System to Determine Risk of T1 Colorectal Cancer Metastasis to Lymph Node. Gastroenterology, 160:1075-1084.e2, 2021

10. Nishida T, Matsumoto Y, Sasada S, Tanaka M, Nakai T, Fukai R, Ohe Y, Watanabe SI, Motoi N. Feasibility study of cryobiopsy for practical pathological diagnosis of primary lung cancer including immunohistochemical assessment. Jpn J Clin Oncol, 51:271-278, 2021

11. Takamaru H, Yoshinaga S, Takisawa H, Oda I, Katai H, Sekine S, Taniguchi K, Saito Y. Endoscopic Ultrasonography Miniature Probe Performance for Depth Diagnosis of Early Gastric Cancer with Suspected Submucosal Invasion. Gut Liver, 14:581-588, 2020

12. Kadota T, Ikematsu H, Sasaki T, Saito Y, Ito M, Mizutani T, Ogawa G, Shitara K, Ito Y, Kushima R, Kanemitsu Y, Muto M. Protocol for a single-arm confirmatory trial of adjuvant chemoradiation for patients with high-risk rectal submucosal invasive cancer after local resection: Japan Clinical Oncology Group Study JCOG1612 (RESCUE study). BMJ Open, 10:e034947, 2020

13. Ego M, Abe S, Wu SYS, Oda I, Saito Y. Salvage endoscopic submucosal tunneling dissection using an electrosurgical knife for an elderly patient with circumferential residual esophageal squamous cell carcinoma after radiotherapy. VideoGIE, 5:193-195, 2020

14. 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

15. Kato M, Tanaka K, Kida M, Ryozawa S, Matsuda K, Fujishiro M, Saito Y, Ohtsuka K, Oda I, Katada C, Kobayashi K, Hoteya S, Horimatsu T, Kodashima S, Matsuda T, Muto M, Yamamoto H, Iwakiri R, Kutsumi H, Miyata H, Kato M, Haruma K, Fujimoto K, Uemura N, Kaminishi M, Tajiri H. Multicenter database registry for endoscopic retrograde cholangiopancreatography: Japan Endoscopic Database Project. Dig Endosc, 32:494-502, 2020

16. Nishimura M, Saito Y, Nakanishi Y, Shia J, Lauwers GY, Wallace MB. Pathology definitions and resection strategies for early colorectal neoplasia: Eastern versus Western approaches in the post-Vienna era. Gastrointest Endosc, 91:983-988, 2020

17. Saito Y, Parra-Blanco A. Traction is most important for the widespread use of endoscopic submucosal dissection, especially in procedures presenting particular difficulty. Endoscopy, 52:328-329, 2020

18. Kudo SE, Misawa M, Mori Y, Hotta K, Ohtsuka K, Ikematsu H, Saito Y, Takeda K, Nakamura H, Ichimasa K, Ishigaki T, Toyoshima N, Kudo T, Hayashi T, Wakamura K, Baba T, Ishida F, Inoue H, Itoh H, Oda M, Mori K. Artificial Intelligence-assisted System Improves Endoscopic Identification of Colorectal Neoplasms. Clin Gastroenterol Hepatol, 18:1874-1881.e2, 2020

19. Yoshida N, Hisabe T, Ikematsu H, Ishihara H, Terasawa M, Inaba A, Sato D, Cho H, Ego M, Tanaka Y, Yasuda R, Inoue K, Murakami T, Inada Y, Itoh Y, Saito Y. Comparison Between Linked Color Imaging and Blue Laser Imaging for Improving the Visibility of Flat Colorectal Polyps: A Multicenter Pilot Study. Dig Dis Sci, 65:2054-2062, 2020

20. Erawijantari PP, Mizutani S, Shiroma H, Shiba S, Nakajima T, Sakamoto T, Saito Y, Fukuda S, Yachida S, Yamada T. Influence of gastrectomy for gastric cancer treatment on faecal microbiome and metabolome profiles. Gut, 69:1404-1415, 2020

21. Ego M, Yamada M, Saito Y. MLH1-positive sessile serrated lesion and an adenocarcinoma that is hiding the submucosal invasion. Jpn J Clin Oncol, 50:834-835, 2020

22. Takamaru H, Wu SYS, Saito Y. Endocytoscopy: technology and clinical application in the lower GI tract. Transl Gastroenterol Hepatol, 5:40, 2020

23. Sekine S, Yamashita S, Yamada M, Hashimoto T, Ogawa R, Yoshida H, Taniguchi H, Kojima M, Ushijima T, Saito Y. Clinicopathological and molecular correlations in traditional serrated adenoma. J Gastroenterol, 55:418-427, 2020

24. Abe S, Saito Y, Tanaka Y, Ego M, Yanagisawa F, Kawashima K, Takamaru H, Sekiguchi M, Yamada M, Sakamoto T, Matsuda T, Goto O, Yahagi N. A novel endoscopic hand-suturing technique for defect closure after colorectal endoscopic submucosal dissection: a pilot study. Endoscopy, 52:780-785, 2020

25. Mori Y, Kudo SE, East JE, Rastogi A, Bretthauer M, Misawa M, Sekiguchi M, Matsuda T, Saito Y, Ikematsu H, Hotta K, Ohtsuka K, Kudo T, Mori K. Cost savings in colonoscopy with artificial intelligence-aided polyp diagnosis: an add-on analysis of a clinical trial (with video). Gastrointest Endosc, 92:905-911.e1, 2020

26. Takamaru H, Yoshinaga S, Takisawa H, Oda I, Katai H, Sekine S, Taniguchi K, Saito Y. Endoscopic Ultrasonography Miniature Probe Performance for Depth Diagnosis of Early Gastric Cancer with Suspected Submucosal Invasion. Gut Liver, 14:581-588, 2020

27. Bhandari P, Subramaniam S, Bourke MJ, Alkandari A, Chiu PWY, Brown JF, Keswani RN, Bisschops R, Hassan C, Raju GS, Muthusamy VR, Sethi A, May GR, Alb?niz E, Bruno M, Kaminski MF, Alkhatry M, Almadi M, Ibrahim M, Emura F, Moura E, Navarrete C, Wulfson A, Khor C, Ponnudurai R, Inoue H, Saito Y, Yahagi N, Kashin S, Nikonov E, Yu H, Maydeo AP, Reddy DN, Wallace MB, Pochapin MB, R?sch T, Sharma P, Repici A. Recovery of endoscopy services in the era of COVID-19: recommendations from an international Delphi consensus. Gut, 69:1915-1924, 2020

28. Abe S, Wu SYS, Ego M, Takamaru H, Sekiguchi M, Yamada M, Nonaka S, Sakamoto T, Suzuki H, Yoshinaga S, Matsuda T, Oda I, Saito Y. Efficacy of Current Traction Techniques for Endoscopic Submucosal Dissection. Gut Liver, 14:673-684, 2020

29. Sakamoto T, Takamaru H, Sekiguchi M, Yamada M, Matsuda T, Saito Y. Reliability of Japan Narrow-Band Imaging Expert Team Classification for the Diagnosis of Colorectal Neoplasms: A Pilot Study. Digestion, 101:638-643, 2020

30. Itoh H, Nimura Y, Mori Y, Misawa M, Kudo SE, Hotta K, Ohtsuka K, Saito S, Saito Y, Ikematsu H, Hayashi Y, Oda M, Mori K. Robust endocytoscopic image classification based on higher-order symmetric tensor analysis and multi-scale topological statistics. Int J Comput Assist Radiol Surg, 15:2049-2059, 2020

31. Saito Y, Ono A. Endoscopic submucosal dissection is not for the interest of endoscopists but for the patients cure. Dig Endosc, 32:888-890, 2020

32. Kagemoto K, Saito Y, Mizuguchi Y, Sakamoto T, Taniguchi H, Sekine S, Takayama T. Optical biopsy in real time by endocytoscopy: a case of juvenile polyp. Endoscopy, 52:E142-E143, 2020

33. Kasuga K, Sakamoto T, Takamaru H, Sekiguchi M, Yamada M, Yamazaki N, Hashimoto T, Uraoka T, Saito Y. Endoscopic reduction of colocolonic intussusception due to metastatic malignant melanoma: A case report. World J Clin Cases, 8:5816-5820, 2020

34. Okamura T, Hashimoto T, Naka T, Yoshida T, Tanabe N, Ogawa R, Yamada M, Saito Y, Yatabe Y, Sekine S. Clinicopathologic and Molecular Characteristics of Familial Adenomatous Polyposis-associated Traditional Serrated Adenoma. Am J Surg Pathol, 44:1282-1289, 2020

35. Cho H, Budhathoki S, Kanehara R, Goto A, Yamaji T, Kakugawa Y, Saito Y, Matsuda T, Iwasaki M, Tsugane S. Association between dietary sugar intake and colorectal adenoma among cancer screening examinees in Japan. Cancer Sci, 111:3862-3872, 2020

36. Takamaru H, Goto R, Yamada M, Sakamoto T, Matsuda T, Saito Y. Predicting and managing complications following colonoscopy: risk factors and management of advanced interventional endoscopy with a focus on colorectal ESD. Expert Rev Med Devices, 17:929-936, 2020

37. Maehara K, Hijioka S, Nagashio Y, Ohba A, Maruki Y, Suzuki H, Sone M, Okusaka T, Saito Y. Endoscopic ultrasound-guided hepaticogastrostomy or hepaticojejunostomy without dilation using a stent with a thinner delivery system. Endosc Int Open, 8:E1034-E1038, 2020

38. Nagashio Y, Hijioka S, Kanai Y, Ohba A, Maruki Y, Okusaka T, Saito Y. Novel side-by-side metal stent placement for recurrent hepatic hilar obstruction after placement of multiple metal stents. Endoscopy, 52:E330-E332, 2020

39. Maruki Y, Hijioka S, Wu SYS, Ohba A, Nagashio Y, Kondo S, Morizane C, Ueno H, Okusaka T, Saito Y. Novel endoscopic technique for trisegment drainage in patients with unresectable hilar malignant biliary strictures (with video). Gastrointest Endosc, 92:763-769, 2020

40. Sekiguchi M, Kakugawa Y, Nakamura K, Matsumoto M, Tomizawa Y, Murakami Y, Saito Y, Matsuda T. Family history of colorectal cancer and prevalence of advanced colorectal neoplasia in asymptomatic screened populations in different age groups. Gastrointest Endosc, 91:1361-1370, 2020

41. Sekiguchi M, Kakugawa Y, Matsumoto M, Nakamura K, Mizuguchi Y, Takamaru H, Yamada M, Sakamoto T, Saito Y, Matsuda T. Prevalence of serrated lesions, risk factors, and their association with synchronous advanced colorectal neoplasia in asymptomatic screened individuals. J Gastroenterol Hepatol, 35:1938-1944, 2020

42. Sekiguchi M, Igarashi A, Sakamoto T, Saito Y, Esaki M, Matsuda T. Cost-effectiveness analysis of colorectal cancer screening using colonoscopy, fecal immunochemical test, and risk score. J Gastroenterol Hepatol, 35:1555-1561, 2020

43. Maehara K, Hijioka S, Nagashio Y, Ohba A, Kanai Y, Okusaka T, Saito Y. Simultaneous endoscopic ultrasound-guided hepaticogastrostomy and bridging stenting with partial stent-in-stent method. Endoscopy, 52:E381-E382, 2020

44. Ichijima R, Abe S, Kobayashi S, Minagawa T, Tagawa T, Nakajima T, Yamada M, Takamaru H, Sekiguchi M, Sakamoto T, Oda I, Matsuda T, Saito Y, Gotoda T. Efficacy of Full-Spectrum Endoscopy to Visualize the Major Duodenal Papilla in Patients with Familial Adenomatous Polyposis. Digestion, 101:563-570, 2020

45. Inoki K, Sakamoto T, Takamaru H, Sekiguchi M, Yamada M, Matsuda T, Saito Y. The Diagnostic Performance for Colorectal Neoplasms Using Magnified Endoscopy Differs between Experts and Novice Endoscopists: A Post Hoc Analysis. Digestion, 101:590-597, 2020

46. Oda I, Shimizu Y, Yoshio T, Katada C, Yokoyama T, Yano T, Suzuki H, Abiko S, Takemura K, Koike T, Takizawa K, Hirao M, Okada H, Yoshii T, Katagiri A, Yamanouchi T, Matsuo Y, Kawakubo H, Kobayashi N, Shimoda T, Ochiai A, Ishikawa H, Yokoyama A, Muto M. Long-term outcome of endoscopic resection for intramucosal esophageal squamous cell cancer: a secondary analysis of the Japan Esophageal Cohort study. Endoscopy, 52:967-975, 2020

47. Nonaka S, Hashimoto T, Oda I, Sekine S. Sporadic pyloric gland adenoma associated with a large fundic gland polyp: genetic evidence for stepwise progression. Gastric Cancer, 23:1102-1106, 2020

48. Tateishi A, Matsumoto Y, Tanaka M, Nakai T, Sasada S, Aoshima M, Tsuchida T. The utility of transbronchial rebiopsy for peripheral pulmonary lesions in patients with advanced non-squamous non-small cell lung cancer. BMC Pulm Med, 20:238, 2020

49. 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

Book

1. Namasivayam V,Saito Y. Colonic ESD. In: Wagh MS, Wani SB (ed), Gastrointestinal Interventional Endoscopy: Advanced Techniques, Switzerland, Springer, pp 107-125, 2020