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IMSUT Hospital

Department of Gastroenterology
消化器内科

Professor
Hiroaki Ikematsu, M.D., Ph.D.
Associate Professor
Yoshihiro Hirata, M.D., D.M.Sc.
Senior Assistant Professor Yasuo Matsubara, M.D., D.M.Sc.

教 授
准教授
講 師

博士（医学）
博士（医学）
博士（医学）

池平
松

松
田原弘
喜康朗
裕朗

The department of Gastroenterology, which focuses on endoscopy and treatment,
started in October 2023. We are committed to quality endoscopy, and our mission
is to provide careful observation, accurate diagnosis using magnifying endoscopes,
and advanced treatments such as endoscopic submucosal dissection (ESD). Inaddition, collaborating with various departments for comprehensive, minimallyburdensome patient care.

1.  Introduction
We primarily focus on endoscopic examinations
for the early detection and treatment of esophageal,
gastric, and colorectal cancers. Our mission is to provide painless endoscopic procedures, thorough andminimally overlook observations, precise diagnoses
using magnification endoscopy, and advanced endoscopic treatments, particularly Endoscopic Submucosal Dissection (ESD). In addition, we aim to tailor
our approach to each specific lesion, choosing themost suitable treatment options and collaborate with
Oncology, Surgery, Radiology, and other departments to provide treatment that that impose minimalburden on the patient’s overall well-being. The outpatient clinic treats all gastrointestinal diseases and alsooffers Helicobacter pylori outpatient clinic.
2.  Endoscopic examination
Endoscopic examinations are conducted forscreening, investigating symptomatic cases, and precisely diagnosing and treating lesions. Additionally,procedures such as gastric fistula construction, ileus
tube insertion, and stent placement are also performed.
When a lesion is detected, a magnifying endoscope is used to closely examine the surface microvasculature and pit patterns. Endoscopic treatment op-tions encompass cold polypectomy, hot snare
polypectomy using bipolar snare, EMR (Endoscopic
Mucosal Resection), and ESD (Endoscopic Submucosal Dissection), selected based on the size, morphology, and depth diagnosis of the detected lesion.
The number of endoscopies and treatments during the year were as follows; upper endoscopy: 753
cases, colonoscopy: 521 cases, gastric ESD: 6 cases,
other gastric treatments: 3 cases, colorectal ESD: 9 cases, and other colorectal treatments: 239 cases. We plan
to significantly increase both the number of endoscopic examinations and treatments in the next year
and beyond. We also plan to participate in single-center and multi-center clinical studies.
3.  Treatment of drug-resistant Helicobacter pylori infection
Some patients fail to respond first- and second-line
Helicobacter pylori (H. pylori) eradication therapy,
but third-line eradication is not always done. Meanwhile, penicillin allergy patients do not take routine
eradication medicines because insurance coverageregimens in Japan include amoxicillin. In H. pylori
out-patient clinic, we make correct diagnosis of infection by multiple modalities, give eradication therapy
for these refractory patients, and achieve high rates ofsuccessful eradication.
The number of patients who visited the Helicobac-

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ter pylori outpatient clinic in the past year was 94 cases, (including 18 cases with allergies, 19 cases withdifficulty in achieving third-stage sterilization, and 15
cases with fourth-stage sterilization and beyond.)Publications
1.		Kajiwara Y, Oka S, Tanaka S, Nakamura T, 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, Ajioka Y, Sugihara K,Ueno H. Nomogram as a novel predictive tool forlymph node metastasis in T1 colorectal cancer
treated with endoscopic resection: a nationwide,multicenter study. Gastrointest Endosc. 97(6):11191128, 2023.
2.		Matsumura T, Ebigbo A, Römmele C, Ikematsu H,Ishigami H, Suzuki T, Harada H, Yada T, Takatori
Y, Takeuchi M, Okimoto K, Akizue N, Maruoka D,Kitagawa Y, Minamide T, Iwaki T, Amano Y, Matsusaka K, Nagashima K, Maehata T, Yahagi N,Messmann H, Kato N. Diagnostic Value of Adding
Magnifying Chromoendoscopy to Magnifying
Narrow-Band Imaging Endoscopy for Colorectal
Polyps. Clin Gastroenterol Hepatol. 21(10): 25512559, 2023.
3.		Ouchi A, Komori K, Masahiro T, Toriyama K, Kajiwara Y, Oka S, Fukunaga Y, Hotta K, Ikematsu H,Tsukamoto S, Nagata S, Yamada K, Konno M, Ishihara S, Saitoh Y, Matsuda K, Togashi K, Ishiguro
M, Kuwai T, Okuyama T, Ohuchi A, Ohnuma S,
Sakamoto K, Sugai T, Katsumata K, Matsushita
HO, Nakai K, Uraoka T, Akimoto N, Kobayashi H,Ajioka Y, Sugihara K, Ueno H; Study Group for
the JSCCR-T study. How Does Omitting Additional Surgery after Local Excision Affect the Prognostic Outcome of Patients with High-risk T1 Colorectal Cancer? Ann Surg. 2023. In press.
4.		Kano Y, Yamamoto Y, Ikematsu H, Sasabe M, Minakata N, Watanabe T, Yamashita H, Mitsui T, Inaba A, Sunakawa H, Nakajo K, Murano T, KadotaT, Shinmura K, Yano T. Investigation of verticalmargin involvement in endoscopic resection forT1 colorectal cancer. Dig Endosc. 2023 in press.
5.		Sano Y, Hotta K, Matsuda T, Murakami Y, Fujii T,Kudo SE, Oda Y, Ishikawa H, Saito Y, Kobayashi
N, Sekiguchi M, Ikematsu H, Katagiri A, Konishi
K, Takeuchi Y, Iishi H, Igarashi M, Kobayashi K,Sada M, Osera S, Shinohara T, Yamaguchi Y, Hasuda K, Morishima T, Miyashiro I, Shimoda T, Taniguchi H, Fujimori T, Ajioka Y, Yoshida S; Japan
Polyp Study Workgroup.Endoscopic Removal ofPremalignant Lesions Reduces Long-Term
Colorectal Cancer Risk: Results From the Japan

Polyp Study. Clin Gastroenterol Hepatol. S15423565(23)00588-8, 2023.
6.		Murano T, Ikematsu H, Shinmura K, Okumura K,Kuwata T, Ushiama M, Yoshida T, Takashima K,Nakajo K, Kadota T, Yoda Y, Oono Y, Yano T. Endoscopic management of familial adenomatous
polyposis targeting colorectal lesions greater than
5 mm in size: a single-center retrospective study.
Fam Cancer. 22(1):83-89, 2023.
7.		Minakata N, Murano T, Wakabayashi M, SasabeM, Watanabe T, Mitsui T, Yamashita H, Inaba A,Sunakawa H, Nakajo K, Kadota T, Shinmura K,Ikematsu H, Yano T. Hot snare polypectomy vsendoscopic mucosal resection using bipolar snare
for intermediate size colorectal lesions: Propensity
score matching.World J Gastroenterol. 29(23):36683677, 2023.
8.		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; IEE-JNET Group. First
report from the International Evaluation of Endoscopic classification Japan NBI Expert Team: International multicenter web trial. Dig Endosc. 2023.
in press.
9.		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 orrecurrent colorectal tumors after endoscopic resection: Analysis of a multicenter prospectivestudy. Dig Endosc. 2023. in press.
10.	Kawamura T, Sekiguchi M, Takamaru H, Mizuguchi Y, Horiguchi G, 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. Endoscopist-related factors affecting adenoma detection duringcolonoscopy: Data from the J-SCOUT study. DigEndosc. 2023. in press.
11.	Minamide T, Ikematsu H, Kajiwara Y, Oka S, Ajioka Y, Ueno H; Japanese Society for Cancer of theColon and Rectum. Impact of Lesion Location onRecurrence After Resection of T1 Colorectal Cancer: Post Hoc Analysis of a Nationwide Multicenter Cohort Study. Gastroenterology. 166(1):198201, 2024