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| 1 | Efficacy and safety of over-the-scope clip: Including complications after endoscopic submucosal dissection显示文摘AIM: To retrospectively review the results of over-thescope clip (OTSC) use in our hospital and to examine the feasibility of using the OTSC to treat perforations after endoscopic submucosal dissection (ESD). METHODS: We enrolled 23 patients who presented with gastrointestinal (GI) bleeding, fistulae and perforations and were treated with OTSCs (Ovesco Endoscopy GmbH, Tuebingen, Germany) between November 2011 and September 2012. Maximum lesion size was defined as lesion diameter. The number of OTSCs to be used per patient was not decided until the lesion was completely closed. We used a twin grasper (Ovesco Endoscopy GmbH, Tuebingen, Germany) as a grasping device for all the patients. A 9 mm OTSC was chosen for use in the esophagus and colon, and a 10 mm device was used for the stomach, duodenum and rectum. The overall success rate and complications were evaluated, with a particular emphasis on patients who had undergone ESD due to adenocarcinoma. In technical successful cases we included not only complete closing by using OTSCs, but also partial closing where complete closure with OTSCs is almost difficult. In overall clinical successful cases we included only complete closing by using only OTSCs perfectly. All the OTSCs were placed by 2 experienced endoscopists. The sites closed after ESD included not only the perforation site but also all defective ulcers sites.RESULTS: A total of 23 patients [mean age 77 years (range 64-98 years)] underwent OTSC placement during the study period. The indications for OTSC placement were GI bleeding (n = 9), perforation (n = 10), fistula (n = 4) and the prevention of post-ESD duodenal artificial ulcer perforation (n = 1). One patient had a perforation caused by a glycerin enema, after which a fistula formed. Lesion closure using the OTSC alone was successful in 19 out of 23 patients, and overall success rate was 82.6%. A large lesion size (greater than 20 mm) and a delayed diagnosis (more than 1 wk) were the major contributing factors for the overall unsuccessful clinical cases. The location of the unsuccessful lesion was in the stomach. The median operation time in the successful cases was 18 min, and the average observation time was 67 d. During the observation period, none of the patients experienced any complications associated with OTSC placement. In addition, we successfully used the OTSC to close the perforation site after ESD in 6 patients. This was a single-center, retrospective study with a small sample size. CONCLUSION: The OTSC is effective for treating GI bleeding, fistulae as well as perforations, and the OTSC technique proofed effective treatment for perforation after ESD. | Noriko Nishiyama Hirohito Mori Hideki Kobara Kazi Rafiq Shintarou Fujihara Mitsuyoshi Kobayashi Makoto Oryu Tsutomu Masaki | 2013 | World Journal of Gastroenterology2013，19，18： | 42 |
| 2 | Outcomes of gastrointestinal defect closure with an overthe-scope clip system in a multicenter experience: An analysis of a successful suction method显示文摘AIM To demonstrate the clinical outcomes of a multicenter experience and to suggest guidelines for choosing a suction method. METHODS This retrospective study at 5 medical centers involved 58 consecutive patients undergoing over-the-scope clips(OTSCs) placement. The overall rates of technical success (TSR), clinical success (CSR), complications, and procedure time were analyzed as major outcomes. Subsequently, 56 patients, excluding two cases that used the Anchor device, were divided into two groups: 14 cases of simple suction (SS-group) and 42 cases using the Twin Grasper (TG-group). Secondary evaluation was performed to clarify the predictors of OTSC success.RESULTS The TSR, CSR, complication rate, and median procedure time were 89.7%, 84.5%, 1.8%, and 8 (range 1-36) min, respectively, demonstrating good outcomes. However, significant differences were observed between the two groups in terms of the mean procedure time (5.9 min vs 14.1 min). The CSR of the SS- and TG-groups among cases with a maximum defect size ≤ 10 mm and immediate or acute refractory bleeding was 100%, which suggests that SS is a better method than TG in terms of time efficacy. The CSR in the SS-group (78.6%), despite the technical success of the SS method (TSR, 100%), tended to decrease due to delayed leakage compared to that in the TG-group (TSR, CSR; 88.1%), indicating that TG may be desirable for leaks and fistulae with defects of the entire layer. CONCLUSION OTSC system is a safe and effective therapeutic option for gastrointestinal defects. Individualized selection of the suction method based on particular clinical conditions may contribute to the improvement of OTSC success. | Hideki Kobara Hirohito Mori Shintaro Fujihara Noriko Nishiyama Taiga Chiyo Takayoshi Yamada Masao Fujiwara Keiichi Okano Yasuyuki Suzuki Masayuki Murota Yoshitaka Ikeda Makoto Oryu Mohamed Abo Ellail Tsutomu Masaki | 2017 | World Journal of Gastroenterology2017，23，9： | 3 |
| 3 | Feasibility of pure EFTR using an innovative new endoscopic suturing device: the Double-arm-bar Suturing System (with video)显示文摘 | Hirohito Mori Hideki Kobara Shintaro Fujihara Noriko Nishiyama Kazi Rafiq Makoto Oryu Masao Fujiwara Yasuyuki Suzuki Tsutomu Masaki | 2014 | Surgical Endoscopy2014，，2： | 2 |
| 4 | Aerodynamic characteristics of a 2-box girder section adaptable for a super-long span suspension bridge显示文摘 | Ogawa K Shimodoi H Oryu T | 2002 | Journal of Wind Engineering and Industrial Aerodynamics2002，90，12： | 1 |
| 5 | Indications of endoscopic submucosal dissection for symptomatic benigngastrointestinal subepithelial or carcinoid tumors originating in the submucosa显示文摘 | Hideki Kobara Hirohito Mori Kazi Rafiq Shintarou Fujihara Noriko Nishiyama Maki Ayaki Tatsuo Yachida Johji Tani Hisaaki Miyoshi Hideki Kamada Asahiro Morishita Makoto Oryu Kunihiko Tsutsui Reiji Haba Tsutomu Masaki | 2013 | Molecular and Clinical Oncology2013，，6： | 1 |
| 6 | New flexible endoscopic full-thickness suturing device: a triple-arm-bar suturing system显示文摘 | H. Mori H. Kobara K. Rafiq N. Nishiyama S. Fujihara M. Kobayashi M. Oryu M. Fujiwara Y. Suzuki T. Masaki | 2013 | Endoscopy2013，，08： | 1 |
| 7 | Novel method to prevent gastric antral strictures after endoscopic submucosal dissection: Using triamcinolone显示文摘Endoscopic submucosal dissection(ESD) of large gastric lesions often leads to severe gastric strictures, especially in cases of large ESD in the antrum of the stomach. It has recently been reported that balloon dilation, mucosal incision, and local steroid injections can successfully treat gastric strictures. However, there are some complications with existing methods and decreasing the quality of life. We have developed a novel method to prevent severe gastric strictures that does not involve balloon dilation, mucosal incision, or steroid injections after circumferential ESD. Our original method involves the submucosal injection of a mixed solution composed of triamcinolone acetonide and a general solution of glycerol, hyaluronic acid, and a small amount of indigo carmine and epinephrine dur-ing the ESD procedure; this mixture is called a mixed solution of triamcinolone(MST). According to standard ESD procedures, several milliliters of MST are injected into the submucosal layer for the purpose of elevating the submucosa during ESD resulting in prevention of severe strictures. Our method using MST take several advantages such as MST method suppress inflammation in ulcer from initial phase, prevention of stricture without obstructive symptoms, and does not require several ballooning. Therefore, MST method is safe and gentle, shorten the hospitalization duration. Here, we described two cases in which we prevented severe strictures of the gastric antrum after completing a circumferential ESD using MST without any complications. | Noriko Nishiyama Hirohito Mori Hideki Kobara Kazi Rafiq Shintaro Fujihara Tae Matsunaga Maki Ayaki Tatsuo Yachida Makoto Oryu Tsutomu Masaki | 2014 | World Journal of Gastroenterology2014，20，33： | 1 |
| 8 | Accurate hemostasis with a new endoscopic overtube for emergency endoscopy显示文摘Endoscopic hemostasis performed in the emergency room is difficult due to the presence of blood clots and food residue that makes obtaining a clear view of the bleeding vessel difficult. We experienced the efficacy of a newly developed inverted overtube to shorten the hemostatic time and obtain a clear endoscopic view with upper gastrointestinal bleeding patient who were transferred by ambulance car and required emergency endoscopy. The technique improved the endoscopic views and enabled us to perform the hemostatic procedures from the conventional standing position while freely and easily changing the patient's position. The presence of blood clots and food residue in the gastric fornix or upper gastric body makes identifying a bleeding exposed vessel impossible. This set-up significantly shortened the procedure time. The inverted overtube helped us obtain a clear view in patients who were laid in the right lateral position. Rapid identification of ex-posed vessels resulted in success of hemostasis. | Hirohito Mori Hideki Kobara Shintaro Fujihara Noriko Nishiyama Makoto Oryu Kazi Rafiq Tsutomu Masaki | 2013 | World Journal of Gastroenterology2013，19，17： | 1 |
| 9 | New flexible endoscopic full-thickness suturing device: a triple-arm-bar suturing system显示文摘 | H. Mori H. Kobara K. Rafiq N. Nishiyama S. Fujihara M. Kobayashi M. Oryu M. Fujiwara Y. Suzuki T. Masaki | 2013 | Endoscopy2013，，08： | 1 |
| 10 | Cytomegalovirus-associated gastric ulcer:A side effect of steroid injections for pyloric stenosis显示文摘The local injection of triamcinolone acetonide(TA) is effective in preventing pyloric stenosis and deformity following large endoscopic submucosal dissection(ESD).However,because of its long-acting nature,TA can induce long-term local immunosuppression and subsequent adverse events.We report a case of a cytomegalovirus(CMV) ulcer that formed only at the TA local injection site.A 68-year-old man underwent ESD to treat early gastric cancer that formed over the pylorus.The lesion extended to the duodenum,and an artificial ulcer covered more than two-thirds of the circumference of the pylorus.To prevent pyloric stenosis,TA was locally injected into the ulcer floor.On day 12,a deeper ulcer 10 mm in diameter was discovered in the center of the post-ESD ulcer.Biopsies revealed large cells with intranuclear inclusion bodies,which stained positive for the anti-CMV antibody.Local TA injections are useful,however,CMV ulcer might occur as adverse events. | Hirohito Mori Shintaro Fujihara Noriko Nishiyama Hideki Kobara Makoto Oryu Kiyohito Kato Kazi Rafiq Tsutomu Masaki | 2013 | World Journal of Gastroenterology2013，19，7： | 0 |
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