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This study reviews the progress and recent advances in vaginal natural orifice transluminal endoscopic surgery (vNOTES) as a minimally invasive gynecologic procedure. The proposed advantages of vaginal natural orifice transluminal surgery include enhanced cosmesis due to a scarless procedure, better exposure compared with the pure vaginal approach, tolerable pain scores, fewer perioperative complications, and a shorter hospital stay. Recent advances in surgical instrumentation and technology have improved the feasibility of vNOTES as an innovative treatment option for gynecological conditions. However, technical challenges and training issues must be overcome before its widespread use. As a promising surgical innovation, further randomized comparative studies are required to clarify the safety and effectiveness of vNOTES in gynecology.

Background: Colorectal cancer is a common malignancy and a major health concern in Korea. The increased use of screening colonoscopies has led to improved survival of patients with colorectal cancer despite its high prevalence; this highlights the importance of early detection and removal of neoplastic polyps such as adenoma and sessile serrated lesions. Therefore, optical diagnosis of colorectal polyps is crucial in deciding whether the lesion requires removal and if endoscopic procedures can be used for its removal. current concepts: Several image-enhanced endoscopy (IEE) techniques and classifications can be used to improve the optical diagnosis of different polyps that match the histopathologic findings. Kudo's pit pattern classification is based on features of pit patterns observed from different types of polyps via chromoendoscopy. The Narrow-Band Imaging (NBI) International Colorectal Endoscopic (NICE) classification is an international classification based on patterns observed from NBI findings. The Japan NBI Expert Team (JNET) classification identifies different patterns observed from magnified images with NBI. The Workgroup serrAted polypS and Polyposis (WASP) classification helps to differentiate hyperplastic polyps from sessile serrated lesions. Endoscopy manufacturers have also developed IEE techniques such as I-scan, flexible spectral imaging color enhancement, and blue laser imaging/linked color imaging to highlight, delineate, and differentiate various polyps. discussion and conclusion: Optical diagnosis of colorectal polyps using IEE such as NBI with different classifications such as NICE, JNET, and WASP is important for differentiating neoplastic polyps and removing them with an appropriate method. [ABSTRACT FROM AUTHOR]

Background: Dysphagia refers to an abnormality in the process of transporting food from the mouth to the stomach. Patients with dysphagia have a high risk of airway aspiration, which can often lead to fatal complications such as pneumonia and asphyxia. Recently, interest in the clinical importance of dysphagia has increased in the medical community and society at large. Current Concepts: Dysphagia can be caused by neurological diseases such as stroke and brain injury, or by non-neurological diseases such as head and neck cancer or diverticulum. Diagnosis is mainly performed using videofluoroscopic swallowing study or endoscopic evaluation of swallowing based on a detailed history and physical examination, scintigraphy or esophageal manometry may also be helpful. Recently developed imaging technology using 3-dimensional computed tomography and dynamic magnetic resonance imaging has been implemented. Treatment of dysphagia can be divided into compensatory and facilitative rehabilitation techniques. The most important principle for successful treatment of dysphagia is that it should be performed with a multidisciplinary team approach. Discussion and Conclusion: Dysphagia is an important problem that can seriously impair the patients' quality of life. Although the general public and medical professionals are interested in dysphagia, many unknown aspects exist regarding the mechanism of dysphagia, and few treatments have been sufficiently proven in terms of safety and effectiveness. Therefore, much attention and effort is still required. [ABSTRACT FROM AUTHOR]

Guillain-Barré syndrome (GBS) is an autoimmune disease that is generally preceded by an infection. Its typical symptoms are progressive symmetric paresis and an absence of deep tendon reflexes. GBS could be a life-threatening condition due to the paralysis of respiratory muscles, and admission to the intensive care unit should be considered for close monitoring. Intravenous immunoglobulin can improve the course of the disease. Postoperative GBS is most likely to occur after gastrointestinal, cardiac, thoracic, neurological, or orthopedic surgery, as well as surgery in the female reproductive tract. The duration of surgery, age, infectious diseases, preexisting autoimmune diseases, and malignant diseases are associated with postoperative GBS. Patients with these factors have a higher risk of postoperative GBS and therefore require precautions to be taken after surgery. We report a case of 53-year-old woman who had experienced GBS after Nasal surgery preceded by gastrointestinal infection and treated by intravenous immunoglobulin.

Background: Sodium hypochlorite is commonly used as a household bleaching agent (for example, the Clorox brand). Sodium hypochlorite poisoning with ingestion of a bleaching agent is often observed in clinical practice. Current Concepts: Ingestion (intentional or accidental) is the most common route of exposure to household bleaching agents. Accidental ingestion of household bleaching agents is rarely clinically important. However, ingestion of a large amount of a dilute formulation or a high-concentration preparation of bleaching agents can result in severe and rarely fatal corrosive injury. Therefore, prompt supportive care is essential because a specific antidote is currently unavailable. Severe poisoning requires hospital admission. Emergency endoscopy and thoracic and abdominal computed tomography are warranted to aid with diagnosis and management of hypochlorite-induced corrosive injury in patients with severe poisoning, who develop clinical features suggestive of corrosive injury. Discussion and Conclusion: Intentional poisoning, which accounts for most cases of household bleaching agent poisonings in Korea, is likely to cause severe corrosive injuries. Therefore, it is necessary to gain deeper and accurate understanding of the clinical aspects and treatment of poisoning by household bleaching agents. [ABSTRACT FROM AUTHOR]

Background: Treatment for early colon cancer has progressed rapidly with endoscopic resection and minimally invasive surgery. Selection of patients without risk of lymph node metastasis is necessary before deciding on endoscopic resection for early colon cancer treatment. We aimed to review the optimal multidisciplinary treatment strategies for early colon cancer, including endoscopy and surgery. Current Concepts: Pathological risk factors include histologic grade of cancer cell differentiation, lymphovascular invasion, perineural invasion, tumor budding, and deep submucosal invasion. These risk factors for predicting lymph node metastasis are crucial for determining the treatment strategy of endoscopic excision and radical resection for early colon cancer. Prediction of the depth of invasion in early colon cancer using endoscopic optical assessments is vital to determine the appropriate treatment method for endoscopic or surgical resection. Furthermore, optical assessment of pit and vascular patterns is useful for estimating the depth of submucosal invasion using magnifying chromoendoscopy and narrow-band imaging endoscopy. Performing an endoscopic and pathologic evaluation of the risk factors for lymph node metastasis is imperative when selecting endoscopic or surgical resection. Endoscopic treatments include cold snare polypectomy, endoscopic mucosal resection, and endoscopic submucosal dissection. In addition, appropriate surgical treatment should be recommended for patients with early colon cancer with a high risk of lymph node metastasis. Discussion and Conclusion: A multidisciplinary approach should be recommended to establish an optimized treatment strategy, minimize the risk of complications, and obtain excellent oncologic outcomes via patienttailored treatment in patients with early colon cancer. [ABSTRACT FROM AUTHOR]

Background: Rhinosinusitis, one of the most common conditions encountered by clinicians, affects quality of life and reduces work productivity. Despite its high prevalence and economic burden, there are considerable differences in practice regarding the management of rhinosinusitis. Based on many studies, including the updated guidelines, classifications have been subdivided, and new treatments have been added. Current Concepts: Rhinosinusitis can be classified as acute rhinosinusitis (ARS) or chronic rhinosinusitis (CRS) with a cut-off duration of 12 weeks. It is diagnosed based on subjective symptoms and objective findings on computed tomography or endoscopy. Viral infections account for the majority of the causes of ARS, with watchful waiting without antibiotics as its important initial management. Meanwhile, CRS is divided into primary and secondary CRS, which is further subdivided by anatomic distribution and endotype. Particularly, the Type 2 endotype is characterized by a high recurrence rate and high resistance to current therapies. Biologics using monoclonal antibodies could therefore be used as new therapeutic options for the treatment of primary type 2 CRS. Furthermore, given the chronicity of CRS, it is important to recognize that endoscopic sinus surgery and continuous postoperative medical treatment are important for its management. Discussion and Conclusion: Accurate diagnoses based on diagnostic criteria and subdivided classifications are necessary to determine the treatment plan and prognosis. In particular, it is important to differentiate the endotype of CRS and provide appropriate treatments to improve the patient's symptoms and quality of life. [ABSTRACT FROM AUTHOR]

Background: In 2019, gastric cancer was one of the most common cancers in Korea. As a secondary prevention strategy for gastric cancer, the cancer screening has been provided since 1999 by the National Cancer Screening Program every 2 years for adults aged >40 years. Current Concepts: The participation rates for gastric cancer screening program have increased from 7.4% in 2002 to 62.9% in 2019. Until 2017, either upper gastrointestinal series or endoscopy were recommended for screening method. Since 2018, endoscopy has become the preferred screening method and 89.1% of the participants underwent endoscopy in 2019. After the introduction of the screening program, the 5-year relative survival rates have markedly improved (43.9% between 1993 and 1995 vs. 77.5% between 2015 and 2019), and the proportion of early gastric cancer detection has increased (28.6% in 1995 vs. 63.6% in 2019). The risk of death from gastric cancer decreased by 47% in participants who had undergone endoscopy screening. Additionally, the gastric cancer screening program is cost-effective, and endoscopy-associated adverse events rarely occur. Discussion and Conclusion: With the implementation of the screening program, mortality due to gastric cancer has decreased owing to early detection. After the completion of ongoing clinical trials in the general population, the primary prevention strategy of Helicobacter pylori eradication should be considered to effectively reduce the incidence of gastric cancer. Further studies are also required to provide optimal screening interval according to the presence of risk factors including H. pylori infection and presence of gastric mucosal atrophy. [ABSTRACT FROM AUTHOR]