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8 protocols using eg l600zw7

1

Efficacy of LCI in Detecting SNADETs

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Esophagogastroduodenoscopy was conducted using the LASEREO system (FUJIFILM, Tokyo, Japan) with an EG-L600WR7 or EG-L600ZW7 endoscope. To investigate the efficacy of LCI in increasing the visibility of SNADETs, we prospectively collected one image acquired using white light imaging (WLI), LCI, and blue laser imaging-bright (BLI-bright) at the same site and angle. SNADETs were resected via endoscopy and were pathologically confirmed thereafter. Both endoscopic resection and pathological examination were performed in our institution.
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2

Magnifying Blue Laser Imaging Endoscopy

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All procedures were carried out with optical magnifying endoscopes (EG‐L600ZW7; Fujifilm Corporation, Tokyo, Japan) and the endoscope video system (LASEREO 7000 series; Fujifilm Corporation). In the blue laser imaging mode, the structure enhancement function was fixed at the B6 level, with the color mode fixed at level 1. To obtain well‐focused magnifying endoscopic images of the lesion easily, we attached a black soft hood (MAJ‐1989; Olympus Medical Systems, Tokyo, Japan) on the tip of the scope and used water immersion technique with maximal magnification during the M‐BLI procedure. In addition, we usually used the antiperistaltic agent to obtain well‐focused magnifying endoscopic images of the lesion. We selected spraying l‐menthol into the stomach or intravenous injection of scopolamine butylbromide or glucagon. The level of maximal magnification was set at high (three white blocks, about 115×) or maximum (four white blocks, 145×) magnifications on 26‐in. monitor, and a scale in 1‐mm increments was visualized at 115× or 145× magnifications prior to examination (Fig. S1). All endoscopic investigations involving M‐BLI were performed by H. U., a skilled endoscopist accredited by the Japan Gastroenterological Endoscopy Society.
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3

Comprehensive Gastroesophageal Assessment

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We used the electronic gastroscope system GIH-Q260H (Olympus Corporation, Tokyo, Japan), EG-L600ZW7 (Fujifilm Corporation, Tokyo, Japan), high-resolution esophageal manometric system ZAN-S61C01E (Sandhill Scientific, Inc., Colorado, USA), 24-h esophageal MII–pH monitoring system A089022B (Sandhill Scientific, Inc., Colorado, USA), and endoscopic radiofrequency equipment MER-200GA (Medi Corporation, Heilongjiang, China).
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4

Esophagogastroduodenoscopy Protocol for Barrett's Evaluation

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Esophagogastroduodenoscopy was conducted using the LASEREO VP-7000 system with an EG-L600WR7 or EG-L600ZW7 endoscope (FUJIFILM, Tokyo, Japan). The EVIS LUCERA ELITE CV-290 system with a GIF-H260Z or GIF-H290T endoscope (Olympus, Tokyo, Japan) was also used. Moreover, CLE is defined as the area from the squamous-columnar junction (SCJ) to the lower end of the palisade vessels (PVs) when the PVs are recognized or the area from the SCJ to the upper end of the gastric folds when the PVs are not recognized. This study defined CLE ≥ 1 cm as BE with or without intestinal metaplasia. CLE ≥ 3 cm in maximum length was classified as LSBE. CLE < 3 cm was classified as SSBE. The Plague and Paris classifications were used to indicate BE length19 (link) and classify EAC20 (link), respectively. Reflux esophagitis was evaluated and graded according to the Los Angeles classification (A–D)21 (link). The degree of atrophic gastritis was evaluated according to the Kimura–Takemoto classification (closed or open type)22 (link).
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5

Endoscopic Evaluation of Barrett's Esophagus

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Esophagogastroduodenoscopy was conducted using the LASEREO system with an EG-L600WR7 or EG-L600ZW7 endoscope (FUJIFILM, Tokyo, Japan). Endoscopic images were taken at the same site in three modes: white light imaging (WLI), LCI mode, and blue laser imaging bright (BLI-b) mode. LSBE and SSBE were defined as ≥3 cm and <3 cm in length of BE, respectively. EACs were resected via endoscopically (ESD or EMR) and were pathologically confirmed as Barrett's EAC.
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6

Comparative Endoscopic Surveillance Efficacy

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We used high-definition and non-high-definition endoscopes for surveillance EGD. The high-definition endoscopes were GIF-H290, GIF-H260Z, GIF-H290Z (Olympus, Tokyo, Japan), and EG-L600ZW7 (FUJIFILM, Tokyo, Japan). The non-high-definition endoscopes were GIF-XP260N, GIF-XP290N GIF-PQ260 (Olympus), and EG-L580NW7 (FUJIFILM). Evis Lucera Elite (Olympus) and Lasareo 7000 (FUJIFILM) were used as processors. Patients were sedated (using midazolam or propofol) during EGD based on patient request or the endoscopist’s decision for the patient’s safety and pain relief. Safety during sedation was ensured over time by biomonitoring. Endoscopists with <10 years or ≥ 10 years of endoscopic experience were defined as non-experts (n = 12) or experts (n = 17), respectively
12 (link)
. All expert endoscopists were certified by the Japan Gastroenterological Endoscopy Society, and non-expert endoscopists were not certified. The observation procedure was left to the endoscopist.
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7

Diagnostic Endoscopy for Pharyngeal ESD

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Pharyngeal ESD is recommended for lesions that are suspected to be pharyngeal cancer based on endoscopic observations and histological findings. Diagnostic endoscopy using was used to identify indications for ESD (GIF-H260Z, 290Z, or 1200EZ; Olympus Medical Systems Co., Tokyo, Japan, or EG-L600ZW7; FUJIFILM, Tokyo, Japan). If the lesion exhibited a well-demarcated brownish area and irregular microvascular patterns on NBI, it was diagnosed as endoscopically suspected “superficial cancer.” The details of these findings have been previously reported
22 (link)
23 (link)
. The horizontal extent of the lesions was assessed using the Valsalva method as required
24 (link)
. The feasibility of pharyngeal ESD was determined through discussion between the otolaryngologists and gastroenterologists.
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8

Diagnostic Capability of DCSS for Early Gastric Lesions

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We sought to assess the diagnostic capability of the DCSS using white light, non-magnified images by retrospectively analyzing of our database. This system uses only white light, non-magnified images. We enrolled 855 cases who underwent EGD and were diagnosed with early gastric carcinoma (EGC) or malignant lymphoma (ML) at Chiba University Hospital and Chiba Foundation for Health Promotion and Disease Prevention from September 2014 to January 2019. For GC, we included only cases in the early stage that were considered eligible for endoscopic treatment, and excluded cases in the advanced stage that were eligible for surgery or chemotherapy. Multiple endoscopists captured the endoscopic images using standard endoscopes [GIF-H260, GIF-XP260NS, GIF-H260Z, GIF-Q260J, GIF-H290, GIF-HQ290, GIF-H290Z, GIF-H290T, GIF-XP290N (Olympus Corporation, Tokyo, Japan], EG-580NW, EG-590WR, and EG-L600ZW7 (Fujifilm, Tokyo)] and standard video processors [EVIS LUCERA CV-260, CV-260SL, EVIS LUC-ERA ELITE CV-290 (Olympus), Advancia VP-4450, VP-4450HD, and LASEREO VP-7000 (Fujifilm)].
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